“I didn’t know what to do. My own dad was so tough on us — always saying things like “Be a Man!”
My father’s voice cracks with grief as he continues. “I thought I had to — like he used to say — whup the sissy out of you.”
His eyes are watery, and I feel hot tears rolling down my face too. I’m surprised by how sad I feel, for both of us. I never thought, before that moment, that I’d be able to forgive him for all the yelling, the anger, the bullying. Especially for the few times he paddled me hard–much harder than he ever whacked my sister. I didn’t even understand why until that day; I didn’t even know that there was a why behind the way he acted towards me when I was growing up. It never occurred to me that he felt an overwhelming, internalized pressure to make sure I conformed; to make sure I stopped screwing up my gender so badly.
That moment when we sat looking at each other in my living room was almost five years ago now. It was the first time he came to visit me, the first time we saw each other, since I started going through life as a woman. I remember the complex play of emotions on his face throughout that weekend: as we went out to dinner, while he was buying me a dress, when I gave him a goodnight hug. A startled mix of confusion and relief, struggling with the feeling he was tying to describe to me in that conversation, the feeling like he had failed as a parent not once but twice. First, at his traditional duty of raising me to be a man — obviously, that didn’t work out so well.
My father was a little too unorthodox to simply accept that socially-mandated responsibility that rode along in his unconscious baggage. By the time I came out, he was no longer a young and scared first-time parent and now feels like he failed me more by not noticing and understanding that I was different. My parents both feel guilty about this, and I still don’t know how to set their minds at ease about it. “I should have known,” my mother said. “If I had paid attention I would have seen all the patterns. I could have made it easier for you to talk to me.” I can’t blame them for this; who expects to have a transgender child? Who wants to? I grew up in the 80s and the 90s, long before Barbara Walters started her own misty-eyed coverage of the subject.
All this came flooding back to me when someone sent me a link to this NPR story about two families struggling with their kids’ gender non-conformity. I realized that there was something different about me, that I didn’t fit right into what I was supposed to be, before I ever went to preschool… I guess I must have been three or four. But I realized just as quickly that I was in big trouble if anyone found out. I quickly became terrified and secretive. These two kids, Bradley and Jona, are not like I was. For whatever reason, they wear their gender differences on their sleeves. It’s hard for me to see that as a bad thing, especially since I don’t think I’ll ever fully heal all of my own scars — the ones a child gets when they internalize the notion that they, as individuals, are monstrously and fundamentally flawed.
It was very hard for me to read Bradley’s story — about a kid who’s basically being straightjacketed into a designated gender, and growing increasingly distressed, sad, and burdened. But I’m glad NPR told these stories side by side, because their Q&A with each child’s psychologist illuminates a vast divide in how gender non-conforming children are treated. Ken Zucker of Toronto’s Clarke Institute represents the widespread, traditional approach, where the goal is to eliminate cross-gender behavior and the desire to be a different gender. He basically describes his success rate as the number of kids he’s managed to steer away from becoming an adult trans person; as he’s said elsewhere, he wants to “help these kids be more content in their biological gender.”
Which sounds all right on paper, but how far do you go in denying a child’s perfectly innocent inclinations? Diane Ehrensaft, on the other side of the continent in Oakland, sees Zucker’s methods as “trying to bend a twig”:
I would say that I think that there is a subgroup of children who, if we listen to them carefully, will tell us, “I know who I am. And if you let me be who I am, I will be a healthy person. And if you try to bend my twig” — which is what I think Zucker does — “then I will be a repressed, suppressed, depressed person who will learn to do what other people expect of me and I’ll hide who I really am.”
No shit, Diane.
Here is the upshot: the American Psychiatric Association has just put Ken Zucker in charge of delineating the official diagnosis applied to trans people in the DSM-V. (Hat tip to Lisa.) That makes this NPR special a very timely political piece indeed.
When you have a child whose behavior and expression goes against the grain of what’s expected of them — certainly at school and on play-dates if not at home — I don’t think there are any easy answers. I don’t blame my parents, who worked at having no clue, or the parents of these kids, who looked to professionals for help and guidance. I definitely do blame the prominent psychologists and institutions that pathologize and try to “fix” kids who are happy expressing their own gender until they encounter the disapproval and hostility of others. You read stories about these kids and the external pressures on them are what really stand out to me:
The year before, Jamie went to school, forgetting about some red polish on her toes.
“Some boys noticed and I was really scared, so I said it was bleeding,” she said. “I got some tissue and acted like it was bleeding.”
What needs fixing in this picture? Do gender-different kids need to change, or do they need protection from ignorance and bullies? Is it really healing, increasing the well-being of a patient, if you force them to become different so they won’t get harassed? Will it save children who are in elementary and middle school from the tragic fate of Lawrence King if we restrict their behavior to what’s considered proper?
Obviously I’m biased here, but please bear with my belief that my own life, despite shit I had to go through, is not really a “bad outcome.” The lives of other trans people, despite discrimination and violence, are not a plague-pit that we have to rescue kids from with a straightjacket. Despite scars, I and a lot of other trans folks are pretty happy and healthy. What’s more, I have a lot of hope that the next generation of kids will have an easier road, no matter which turns and forks they end up taking.
These kinds of discussions tend to drift into a few fairly predictable digressions, so I figure I might as well mention some now. Conservatives freak out about other children being exposed to something “bizarre” that ruins their innocence. More reasonable people wonder if kids are being tracked prematurely into an adult notion of transgender identity, and worry about kids taking hormones or making other irreversible life decisions. The theoretically-minded quickly get into discussions of etiology and nature vs. nurture: what causes this kind of situation, is it something in a child’s biological makeup? Is it something environmental that we could change? (Would we want to?)
All of those are important questions, but they’re also a little besides the point here. Letting a child play and dress and call themselves what they want is not the same thing as deciding that they should take hormones, nor does it automatically set them on that track, despite what Zucker claims. Kids are fluid, and not all kids who are gender non-conforming stay that way, not all go on to be trans adults. Ehrensaft also cautions against parents who read too much into a child’s behavior too quickly, and also against overconfidence that gender identities are certain or fixed.
You may have noticed that I’m not even referring to these kids as transgender like she does; to a lot of people that implies a certain course in life, which just doesn’t make sense at an early age. I would rather acknowledge that not everyone who transitions is always going to stay in a particular gender, especially if they’re still young and figuring their life out, but “trans” carries a connotation of permanence in the current discourse because the idea of fluidity is a little too scary for many people.
As for permanent medical decisions, the professionals who provide trans health care have a pretty good understanding of what’s permanent and what’s not; there’s a reason why some kinds of decisions are off-limits until someone’s both mature and mentally healthy enough to make them. People tend to panic and assume the worst about “permanent decisions” in kids’ lives without realizing that denying a child certain kinds of medical care and keeping them on the default path can be an equally permanent decision — it just doesn’t seem that way to most people because it’s “normal.” For more on that, the second part of NPR’s series has more on hormone blockers and kids who are facing a potentially dysphoric puberty.
When it comes to the origins of differences in gender identity and expression, does it really matter one way or the other? Once you have a child who feels strongly enough about their gender that you have to make them very unhappy to “bend their twig” into changing? Parents have to figure out what to do as their child’s life moves forward, regardless of origins, and nobody has been able to provide a clear answer yet on what exactly might cause this kind of human variance. Proponents of social-psychological theories haven’t been able to point to any particular event or family structure or pattern of parental behavior that can consistently be found across trans people’s histories. Biological theories have offered up some clues but nothing very conclusive. It might surprise you that I actually tend to agree more with Zucker on this:
But I think the hidden assumption is that they believe the child’s cross-gender identity is entirely caused by biological factors. That’s why I call them essentialists. Liberals have always been critical of biological reductionism, but here they embrace it. I think that conceptual approach is astonishingly naive and simplistic, and I think it’s wrong.
Obviously he’s tarring and feathering “liberals” in a gross way that displays his leanings — but he’s right that biological reductionism crops up in all sorts of unlikely places. There’s simply no way that anything as complex as gendered behavior is entirely biological; it’s a complex interplay of factors, some of which may be biological, others of which are surely social. Nobody is biologically hardwired to prefer pink; poor Bradley feels the way he does about pink because he imprinted somehow (maybe partly biologically) on female role models in his life or surroundings who in turn have an association, as a class, with the color pink. In another culture it could be black, or orange, or polka-dots.
But even in the hypothetical case that Bradley is emulating and identifying with his mother and female relatives, friends, and media role models, is this really such a horrible outcome in and of itself, setting aside the risks of societal prejudice? Honestly, I’d be more worried about the number of male-assigned children who don’t identify with women at all. Zucker needs to believe that gender identity isn’t biological because his program of changing kids’ behavior is founded on it being less innate. But the problem isn’t innateness or lack thereof; it’s who is forced to change and what societal prejudices don’t have to.
Zucker and the establishment vision of trans kids clearly see gender non-conforming behavior as a problem that has to be nipped in the bud, lest it take hold, spread and ruin a child’s life. A boy who prefers to play with girls, a girl who refuses dresses and long hair, or a kid who insists that they’re a different gender than their family is “at risk.” That’s how you treat a disease.
What’s even more ludicrous is that this method isn’t really anything new, under the hood — it’s just a new version of the time-honored “whup the sissy out of you” approach that has a long history in my own family. Of course, Zucker isn’t hitting or yelling at anyone. It’s a kinder, gentler approach that tries to more subtly push kids onto a more orthodox path. But when I read about what these kids go through, I can’t help but remember that the worst, longest-lasting bruises aren’t the ones from getting beaten up on the playground — they’re the psychological ones.
The rationale given by mainstream psychology for treating gender non-conformity this way is exemplified in the comments of top APA officials at an annual meeting a few years ago, when the controversial subject of the Gender Identity Disorder diagnosis came up:
Spitzer [who chaired the working group that developed the first DSM to include Gender Identity Disorder] maintained that certain behaviors “are part of being human—part of normal development.” In all cultures, adults expect certain “essential” things to happen as children mature, and these always include fulfilling gender-based roles and engaging in gender-congruent behaviors. It is thus legitimate for psychiatrists to identify a disorder in which persons of one gender reject these roles and behaviors and assume those of the opposite sex. He rejected the view he ascribed to Hill that “everything is socially determined” and that straying far from those expectations is an acceptable variance of human behavior.
The failure to identify with the gender with which one was born “is a dysfunction,” he said.
It’s a failure and a dysfunction to not follow the prescribed rules of society, in other words: the rules that your genitals determine how you act, how you dress, who you associate with, what you call yourself. Of course, a lot of psychological dysfunction does deal with coming into conflict with societal rules — don’t hit people, don’t scream for no reason or masturbate in public, etc. But when it comes to those rules about gender, we are slowly starting to have a choice to actually accept and protect trans kids. The story I linked to above is a good example; Jamie’s school in Colorado is supporting her, and there are more and more institutions that are choosing to support and protect difference instead of trying to stamp out nonconformity. The APA seriously needs to catch up to the times.
With that, I’ll leave you with a few links and ideas on what to do. You can read the thoughts of a clinical psychologist who also happens to be trans; she points out that Zucker’s approach is basically “reparative therapy” — it’s no wonder he gets cited by ex-gay movement proponents. Although I don’t know if I quite understand this given that the DSM is a diagnostic tool rather than a prescriptive tool, and given that previous DSMs were written from similarly retrogressive approaches, she also feels there’s “an additional danger that gay and lesbian communities need to be cognizant of [...] if Zucker and company entrench conversion therapy in the DSM-V, then it is a clear, dangerous step toward also legitimizing ex-gay therapy and re-stigmatizing homosexuality.”
If you want to read up more on Zucker or the Clarke Institute you can check out Andrea James’ repository of information. The subjects of scrutiny often complain that these pages are defamatory, and I certainly don’t think the research compiled there was making any attempts to shed a favorable light on them — but whatever you think of that, a lot of the quotes and referenced links speak for themselves.
You can also sign an online petition or find contact information for the APA on Mercedes Allen’s post at Bilerico. Finally, I want to point out that a lot of larger gay rights & trans rights organizations may be very hesitant to engage this issue, which makes it even more important that a variety of people, not just trans people, make their opinions heard about the APA and their decisions.
Why are large orgs nervous? Because some people are suggesting that “Gender Identity Disorder” be removed from the DSM entirely, just like homosexuality was. Although on the surface this might sound like a good idea, the existence of an official diagnosis is the only way that many trans people are currently able to get trans-specific health care. This is because our society’s idea of health almost always requires that you be pathologized as “sick” in order to get any kind of treatment — a problem that affects many different kinds of people. But it’s a double bind. Trans people, especially trans youth, need both access to health care when we need it AND freedom from pathologizing stigma that’s only really deserved by the forces that discriminate against us.
Fortunately, there are other models that could be pursued. Kelley Winters of GID Reform has been advocating tirelessly for changing the definitions and depathologizing them without deleting them entirely; if you want to write about this issue or write a letter in support of change or against Zucker-style “traditional” gender-restrictions, I urge you to check out her site, especially her page on gender non-conforming youth which points out that the diagnostic criteria have gotten overly broad, are unequally applied to boys and girls, may be used for homophobic purposes, etc.
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