A fault line should be developing between those who advocate defining pre-pubescent children with gender dysphoric behavior as transgender and starting them down the road to transitioning (including hormones to block puberty), and those who believe it’s way too early to make that call—and that if left alone, many of these kids will grow up to be healthy gay or lesbian adults.
In a Wall Street Journal op-ed (firewalled; try googling The Transgender Battle Line: Childhood), Debra W. Soh writes:
How best to deal with [children who identify with the opposite sex] has become so politicized that sexologists, who presumably would be able to determinine the helathiest approach, are extremely reluctant to get involved. They have seen what happens when they deviate from orthodoxy.
She gives as an example the experience of Kenneth Zucker, a psychologist in Toronto who was charged with practicing conversion therapy, which aims to change a patients’ sexual orientation. Writes Soh:
But he had not been trying to dissuade anyone from being transgender. Instead his therapy facilitated exploration of gender identity. For example, in addition to thinking about transitioning, gender-atypical males could consider being boys who simply liked female-typical things. One doesn’t necessarily need to be a girl to enjoy nail polish or bedtime stories about fairy princesses.
Pointing that out to a gender-dysphoric child isn’t the same as practicing conversion therapy…. Of the boys and girls seen in clinics like Dr. Zucker’s, a high percentage—up to 80% in a study of 44 gender-dysphoric boys—grow up to be not transgender, but bisexual, gay or lesbian adults. Thus, helping prepubescent children feel comfortable in their birth sex makes more sense than starting a lifetime of hormonal treatments and surgeries that will in all likelihood turn out to be unnecessary and unwanted.
Soh concludes:
The silencing of those who oppose this sends the message to parents that early transitioning is the only valid and ethical approach for a gender-dysphoric child. This message—pushing children to transition at increasingly younger ages so that they will fit neatly into one of two gender categories—is false and unscientific. It is more progressive to offer them the time and the space they need to figure out who they are and what is ultimately best for them.
Similar points are made in a recent New York Magazine article by Jesse Singal, Why Some of the Worst Attacks on Social Science Have Come From Liberals.
Allowing effeminate boys and masculine girls to develop and decide (after puberty kicks in) whether they are, in fact, transgender or gay/lesbian is the least we owe these children.
More. Tweet by Alice Dreger (@AliceDreger): “I’m getting a lot of mail from gay and lesbian adults who say they believe they would have been pressured to transition gender if then=now.”
Furthermore. In a critical letter to the editor, the Human Rights Campaign Foundation, an affiliate of the nation’s largest LGBT lobby, predictably dismisses Dr. Zucker’s efforts and Ms. Soh’s commentary:
By relying on “data” produced by Dr. Kenneth Zucker, a psychologist whose gender-identity clinic closed last year after an external review found it “out of step with current operational practices,” Ms. Soh thoroughly undermines her own nonscientific musings.
Note the scare quotes around “data,” and the fact that being “out of step with current operational practices” means that attempts to explore whether or not children with gender dysphoria are actually transgender is now out of bounds (and, in some places, illegal).
HRC continues:
What’s really happening here is that doctors and parents are finally supporting our [transgender] lives, even the youngest among us. To do otherwise dangerously denies transgender children their very humanity—and their safety and well-being.
The real threat to “safety and well-being” seems to be directed at gay kids at risk for being put on a premature and unnecessary path to sexual reassignment. As another letter puts it, a child’s gender identity is “a difficult and complex issue that needs serious attention and should not be decided on the merits of gender-identity politics.”
And finally. From the New York Times Magazine, How the Fight Over Transgender Kids Got a Leading Sex Researcher Fired.
Dr. Zucker encouraged effeminate boys and butch girls to be content with their gender. For that, he was fired. The progressive line is now is that you can’t be an effeminate male or butch woman (and if so, you must gender transition). Once again, the progressives show just how reactionary and authoritarian they truly are.
40 Comments for “Trans Kids or Gay Kids?”
posted by Tom Scharbach on
Old fashioned as it may be, my view is that this should be a decision of the child’s parents and therapists/doctors. The government and others should butt out, except in cases of child abuse/neglect, in which case child welfare agencies have a role to play. Politicizing this issue is wrongheaded, in my view, and that goes for everyone on all sides of the issue.
posted by Jorge on
Thus, helping prepubescent children feel comfortable in their birth sex makes more sense than starting a lifetime of hormonal treatments and surgeries that will in all likelihood turn out to be unnecessary and unwanted.
Hmm–urgh–mmm–grr–rrgh–urgh!
1) Yes, that’s one of the reasons I oppose laws banning reparative therapy.
2) I believe that is a conversation that must occur between the therapist and the parent. Below a certain age, a child has a very limited capacity to make these kinds of decisions.
3) If the therapist in their professional opinion believes that an exploration of gender-congruent identity (and I’ll include any rejection of gender-binariness, too) is warranted before coming to a diagnostic impression and a treatment plan, the patient and their guardian must be given the options of getting a seeking a second opinion and ending treatment.
4) An important consideration in many health treatments is informed disclosure of the potential risks and benefits of the treatment. The patient should be aware of the risks of engaging in hormone therapy that the author has just described.
5) This whole discussion should be unnecessary. There should already be plenty of professional and ethical constraints against “moving too quickly” or diagnosing too quickly. You methodically go down the list of procedures and practices–get the records from the therapist before you if you have to.
5a) The flip side of this is that the same professional and ethical constraints must be used to prevent dismissing gender-changing therapy (or the clinical impression that would support it) too quickly. A therapist who is unable or unwilling to exercise their due diligence in a way that is objective and focused on the health of the patient is not qualified to practice in this area and should not do so.
6) Get malpractice insurance.
Of the boys and girls seen in clinics like Dr. Zucker’s, a high percentage—up to 80% in a study of 44 gender-dysphoric boys—grow up to be not transgender, but bisexual, gay or lesbian adults.
Oh, this is too easy. Do an audit on him. If his rate is above 80%, sack him.
Allowing effeminate boys and masculine girls to develop and decide (after puberty kicks in) whether they are, in fact, transgender or gay/lesbian is the least we owe these children.
That is a value judgment, and value judgments about how children shall be raised belong firmly to the parent. A parent is legally permitted to tell a gay child that homosexuality is a sin. A parent is permitted to punish a gay child for having sex with a man. A parent is also permitted to tell a transgender child that gender dysphoric clothes shall not be worn at the dinner table. A parent is even legally permitted not to believe there is such a thing as gender identity or sexual orientation (this is where I’ll probably get in trouble). A parent may not control what an outsider’s professional assessment is. A parent’s duty to protect their child’s emotional health and well-being outweighs value considerations. And most importantly, after age 18, a child is legally permitted to make their own decisions as to their values and conduct in the community.
That was a little long-winded. My point is that “what is right for the child” is not an outsider’s decision to make, whether that decision favors exploring congruence or deviation from social norms.
I’ll read the rest later.
posted by tom jefferson 3rd on
Jorge
Um, If a minor is having sex with an adult, it is very much the business of the government. It is not something that families can coverup.
posted by Doug on
“1) Yes, that’s one of the reasons I oppose laws banning reparative therapy.”
So you support quack medicine. I assume you support snake oil salesmen too. That says a lot about you. No one, including parents, should force or encourage their children to undergo reparative therapy.
posted by Jorge on
I support good medicine and good government, you wolf-crier. I do not support Oba-mamacare Nanny State medicine.
posted by Doug on
Reparative Therapy is not considered ‘good medicine’ by any legitimate medical professional. And that has absolutely nothing to do with ObamaCare.
posted by Jorge on
You’re playing a word game here, and I’m not interested in letting you get away with it. Laws banning reparative therapy are highly likely to become open to interpretation and overreach beyond their intent. You will either acknowledge or deny this, or you will silence yourself and relieve yourself from commenting on my comments. You will not pick and choose from my comments in such a way as to present a deceptive picture of what I am stating.
You will cease from alleging the falsehood that because I oppose an overreaching and overbroad legal trend, must mean I am a supporter of the practice it intends to ban, in either intent of effect. In doing so you are engaging in a reckless disregard for the truth, and I resent the fact that you are polluting my attention with it. Now that I have corrected you, you will stop it.
posted by Doug on
ROFLMAO
posted by Doug on
ROFLMAO
posted by Houndentenor on
Any medical or therapeutic claim that cannot be proven is quackery. We have whole industries (homeopathy, acupuncture, etc.) built around things that cannot be proven to work. Reparative therapy should be banned like all other fraudulent products and services. it’s a con perpetrated on desperate people who should know better but who don’t.
posted by Jorge on
Since then, research has established best-treatment practices for adolescents and adults with gender dysphoria: full transitioning, which includes treatment with hormones to suppress puberty and help the individual develop breasts or facial hair, as well as gender-reassignment surgery.
This is an exaggeration. Is the World Professional Association of Transgender Health going to overtake the Vatican as my most cited source on this site?
(Yes, but that’s an international organization.)
…In keeping with that outlook, Dr. Zucker had been following the most up-to-date standards of care published by the World Professional Association for Transgender Health—a document he had co-written.
Lovely. His John Hancock is littering the citations, too.
Well, I’ll leave it at this citation, then. “Social Transition in Early Childhood… This is a controversial issue, and divergent views are held by health professionals. The current evidence base is insufficient to predict the long-term outcomes of completing a gender role transition during early childhood.”
This means, according to the very WPATH Standards of care, “that Zucker co-wrote”, Dr. Zucker is wrong. Where two doctors disagree, and one doctor is employed by the government, the government doctor is right.
Trying to turn a gay person straight is unethical, because sexual orientation is immutable. Gender identity, however, is different, in that it is flexible and can change over the course of life.
Er, what?
That statement is so glaringly false I barely know what to do with it. First, sexual orientation is not immutable. A prior post on this website has discussed that bisexuality and fluidity in sexual orientation are more common in women than in men. And if you’re gonna talk about the difference between children and adolescence, uh, hello? Most children are asexual. More importantly, according to the WPATH standards of care (“that Zucker co-wrote,”) “Treatment aimed at trying to change a person’s gender identity and expression to become more congruent with the sex assigned at birth has been attempted in the past without success. Such treatment is no longer considered ethical.”
To try to guide a potentially gender dysphoric child toward doing one thing and not another is only appropriate for one purpose: diagnosis and treatment of current psychosocial distress.
Such research explains why Dr. Zucker worked with children to explore gender. Then if a child’s dysphoria persisted into adolescence—gender identity becomes more fixed with age, and the start of puberty often determines whether it will desist—Dr. Zucker would recommend transitioning, including puberty-blocking hormonal therapy.
…..That is an interesting and highly defensible mode of practice. I’ll repeat #s 1-6 above, they all still apply here.
Well, well. This does not lead to easy answers. We’ll need to look into why the Canadian government shut him down.
posted by Jorge on
So here we go:
http://www.camh.ca/en/hospital/about_camh/newsroom/news_releases_media_advisories_and_backgrounders/current_year/Documents/GIC-Review-26Nov2015.pdf
……
I agree with 95% of the review’s conclusions and recommendations.
To put things in the light most favorable to the clinic, a big key is #4 in the reviewer’s clinical concerns: “There appears to be a mismatch between literature research findings (including those from GIC itself) and clinical practice and approach. The wealth of factual knowledge often gets lost in translation to practice. The approach to clinical practice appears to be filtered by a bias that assumes most children presenting with gender variant behaviors require clinical intervention. This does not reflect the findings of the clinic’s own research. While intensity of gender variant behaviors may correlate with persistence, this does not indicate a need to redirect this behavior.”
I have no problem manning the “fault line” Mr. Miller mentions. But it often occurs that these kinds of divisions occur not at the fault line, but along one of the many irregularly shaped cracks that open up from it: problems and overreaches done by one side or another. This is one such situation. When you try to prevent someone from crossing such a breach onto “your side”, you’ve really already crossed too far.
Ideally you let them repair the breach down to the real boundary. Very often what occurs instead is the repair takes them to another breach that ends up a little over in your territory, so that in fixing the problem the other side overreaches as well. I am concerned with the cure here. But in this case the problem is worse than the resolution.
Wow. This made for such a fascinating day.
posted by Jorge on
(This probably should have gone after my below Wikipedia citation instead.)
posted by JohnInCA on
“Allowing effeminate boys and masculine girls to develop and decide (after puberty kicks in) whether they are, in fact, transgender or gay/lesbian is the least we owe these children.”
Why the hate for puberty blockers? Seriously. I get the “they should wait till they’re older before making irreversible decisions.” But by the same token, why should you force them through irreversible changes before they’re old enough to make a decision?
posted by Jorge on
https://en.wikipedia.org/wiki/Kenneth_Zucker#Therapeutic_intervention_for_gender_variance
Therapeutic intervention for gender variance.
Since the mid-1970s, Zucker has treated about 500 preadolescent gender-variant children to make them accept the gender identity they are assigned at birth until they are at an age he believes they may determine their own gender identity.
*Bangs head against wall.
For children assigned as males at birth, Zucker asks parents to take away toys associated with females and instruct the child not to play with or draw pictures of girls.[10] Psychologist Darryl Hill wrote that Zucker and Bradley believed that reparative treatments can reduce rejection by enabling gender non-conforming children to mix with children of the same sex, reducing the possibility of adult gender dysphoria.
…
Zucker says parents set the goals at his clinic. “We recommend that one goal be to help the child feel more secure about his or her actual gender, another to deal with the child’s emotional difficulties, and a third to help with problems in the family. It’s helpful to have parents set limits on things like cross-dressing, which many parents have not done before coming to us.”…. Zucker has stated that “the therapist must rely on the ‘clinical wisdom’ that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions.”
…
For adolescent clients expressing gender identity disorder, Zucker’s treatment protocol resembles that for adult GID…
Umm…
Controversy over reparative therapy for transgender children
…CAMH [Centre for Addiction and Mental Health] director Kwame McKenzie said that Zucker’s treatments were against the centre’s guidelines, but that there exist two groups of thinking on such therapy for children under 11 among professionals. The review was expected to take six months.
…
As a result of that review, CAMH shuttered it’s Child Youth and Family Gender Identity Clinic in December 2015. The reviewers, Dr. Suzanne Zinck of Dalhousie University and Dr. Antonio Pignatiello of Toronto’s Hospital for Sick Children found that the clinic operated as an insular entity and failed to reflect current best practices in treatment of transgender and gender-questioning youth. Zinck and Pignatiello also reported that many patients found Zucker’s treatment methods to be intimidatory, and highlighted a case in which a vulnerable 9-year-old patient was asked by a CAMH clinician about “what made him sexually excited”.
Mmmph. You can’t have clinics acting as “insular entities” and failing to reflect current best practices. Wikipedia has a link to the actual review.
By the way, CAMH is a private organization. But one of the concerns that led to the review was compliance with pending human rights legislation.
posted by Dale of the Desert on
Are there any transexuals contributing to or commenting on this topic?
posted by Lori Heine on
Not that I know of.
posted by Tom Scharbach on
More to the point, since this post is about medical treatment of gender-dysphoric children, are there any parents of such children commenting on this topic?
posted by Houndentenor on
I do not know enough about trans issues to form an opinion about this. I am open to hearing from researchers and trans people, however. We’ve only started having any kind of public discussion about this topic. We need to listen more and stay open minded rather than jumping to any sorts of policy decisions.
posted by Tom Jefferson 3rd on
Wait, so gay conservatives now care about transgender people? The same folks who were eager to toss the transgender community under the bus?!
posted by Jorge on
There are Hispanic conservatives who care about illegal immigrants.
Why not gay conservatives who care about transgender people?
posted by Tom Jefferson III on
Jorge;
Your argument; “There are Hispanic conservatives who care about illegal immigrants. Why not gay conservatives who care about transgender people?”
Well, if this was indeed designed to reply to my comment, it is not a well very thought out reply.
For starters, being Hispanic (citizen or immigrant) does not automatically mean that you are illegal. Likewise, being a gay conservative does not mean that you cannot be transgender.
However, when gay conservatives attack civil rights legislation for transgender people (on one hand) and then claim to be deeply concerned about the rights and dignity of transgender people (as the argument is being made with this main article), the “smell test” ain’t going get passed.
Notice that I did not suggest that ALL gay conservatives were guilty of this cruel hypocrisy.
posted by Dale of the Desert on
What is the Tweet by Alice Dreger supposed to mean? Alice Dreger claims that “a lot” (quantification of “a lot” unspecified) of adults have speculated on what sort of social pressure they might have experienced if their childhood milieu had been the same then as it might have been today, which it wasn’t and isn’t, and they don’t know anyway. Huh?
Time to come up with a new topic, Stephen. How about how you personally contributed to the advancement and attainment of the right of LGBT people to marry?
Here’s how I contributed. Starting in the late 70s I picketed, I joined speakers bureaus, I co-founded the first openly LGBT group of my profession, I came out to my family and on the job, I marched in my first Gay Pride Parade (one year with a professional group, one year with a gay fathers group), I wrote checks when I had no money to spare. And I lived a responsible but unapologetic and non-appeasing life. Nowadays, I mainly write checks, but I live the same sort of life. I am grateful to be the beneficiary of the advocacy work of others whose efforts have been productive. I claim no personal credit for their successes, but I’m grateful that I have taken the opportunities to be a part of it all.
How about you, Stephen? How about you?
posted by Tom Scharbach on
What is the Tweet by Alice Dreger supposed to mean? Alice Dreger claims that “a lot” (quantification of “a lot” unspecified) of adults have speculated on what sort of social pressure they might have experienced if their childhood milieu had been the same then as it might have been today, which it wasn’t and isn’t, and they don’t know anyway. Huh?
Alice Dreger is an odd duck, to be sure, if prolific academically. Who knows what her Tweet is supposed to mean, or how it pertains to anything or than her longstanding argument with and disdain for “transgender activists”.
If Dreger is suggesting that kids dealing with gender dysphoria face significant cultural pressure to transition, I think that she’s dead wrong. Gays and lesbians like me who grew up in the 1950’s and 1960’s know a lot about social pressure, having come up in a time when our entire culture demanded that we conform to societal norms of straightness, constantly and unrelentingly. I doubt, somehow, that kids who experience gender dysphoria face that kind of unrelenting cultural pressure to transition or ever will. If anything, in most areas of the country, the cultural pressure will flow in the opposite direction.
I would like to repeat — again and as clearly as possible — that gender dysphoria is a medical condition, that medical decisions about children are best left to parents and doctors/therapists, and that playing politics with the issue (no matter from which side) is wrongheaded.
posted by Tom Scharbach on
I don’t think the American Psychological Association would agree with you, since they no longer classify it as a “disorder”. Either that or you’re taking a broad view of what a “condition” is.
I do not consider gender disphoria a “disorder”. It is simply a fact of life for a small number of people. I am using the term “medical condition” in a broad sense, in the sense that gender disphoria typically involves counseling before any decision about gender transitioning is made, and, if gender transitioning is the course elected upon, both counseling and medical procedures, such as hormone therapy and surgical procedures.
The law should allow for a minority of professionals who, because of their own independent research and professional knowledge, have chosen to doubt the collectivist combination of research, guesswork, and politics.
Of course.
But, Jorge, you miss my point, given the literal focus you have been taking. The thread is about treatment of gender disphoria in children, and I have been making a simple point about that subject: “Gender dysphoria is a medical condition, that medical decisions about children are best left to parents and doctors/therapists, and that playing politics with the issue (no matter from which side) is wrongheaded.”
Think on it.
posted by Jorge on
I would like to repeat — again and as clearly as possible — that gender dysphoria is a medical condition
I don’t think the American Psychological Association would agree with you, since they no longer classify it as a “disorder”. Either that or you’re taking a broad view of what a “condition” is.
I would like to add that to speak of “politicization” is more than just talking about government officials. We are talking about professional bodies and large health organizations. They, too, get lobbied by activists, and they, too do not always make decisions rationally. As a key example: although I have heard few complaints about the APA reclassifying and renaming gender identity disorder as a non-disorder (a decision it took a lot of reasoning for me to accept as logical), there have been plenty of complaints about other changes in their manual, complaints which exposed a lack of transparency and rigor in their process. I have absolutely no shame about standing on this strawman an running with it where I will.
So long as those changes present as mostly reasonable and clearly flawed, then there I would agree with you that the government should butt out. No “Regnerus is an academic whore” files should be possible. We have a “Zucker’s Place is insular and fails to reflect current best practices” file, which is a much more nuanced read (Dr. Z argues something to the effect that sometimes you have to go outside established professional knowledge in clinical work–not an unheard of view among clinicians. That link you have on Dreger puts her more in the Regnerus category). So Dr. Z doesn’t get the biggest perks or work for the biggest companies anymore, and that is where the matter should lie. The law should allow for a minority of professionals who, because of their own independent research and professional knowledge, have chosen to doubt the collectivist combination of research, guesswork, and politics.
posted by Dale of the Desert on
Inasmuch as transgender dysphoria is not a psychological disorder, then the transgender state requires no psychotherapy Can not be expected to benefit from it. But inasmuch as a state of dysphoria describes dissatisfaction or anxiety, then the only potential avenues of available help are available to bring about a euphoric state. But those who are not transgendered must look to those who are to set the goals and the means.
posted by Tom Scharbach on
Inasmuch as transgender dysphoria is not a psychological disorder, then the transgender state requires no psychotherapy.
I think that (a) the purpose of the counseling received by candidates for gender transitioning is to help candidates decide whether, when and how to transition, and to help resolve any issues that might have arisen for the candidate because of cultural/societal/family/religious response to gender dysphoria, and (b) the counseling received by transitioning persons during the transitioning process itself is intended help those in the process to deal with issues that arise during the transitioning period.
I say “I think …” because my understanding is based solely on what Ive learned from three friends who have transitioned, and from very limited reading on the topic. I’ve learned that the process is not easy or something to be taken lightly. And I’ve learned that my friends are happy that they made the transition. But that’s about it.
But those who are not transgendered must look to those who are to set the goals and the means.
Well, of course. But, just as was the case with gays and lesbians over the last fifty-odd years, we can expect a variety of opinions from the transgendered. Looking for a single, one-size-fits-all answer from the transgender community is likely to be futile.
And, at the expense of sounding like a broken record, when children are involved, so are the parents of the children. Don’t forget them.
posted by Dale of the Desert on
Sorry that last bit got garbled. It should read “avenues of available help,to bring about a euphoric state are medical.
posted by Houndentenor on
As to the addendum, there are some cultures (including a few countries in the middle east) that are more comfortable with accepting sex changes than homosexuality. No one should be pressured into coming out, staying in or transitioning. Ever. These are highly personal issues and we’ll all be better off when they are no longer so politicized and used for fear-mongering purposes (see: Houston/HERO).
posted by Tom Scharbach on
As another letter puts it, a child’s gender identity is “a difficult and complex issue that needs serious attention and should not be decided on the merits of gender-identity politics.”
I don’t think that anyone on IGF would disagree with that statement. So why are you politicizing the issue by focusing on liberals rather than conservatives? For once in your life, stop trying to drive a political wedge.
posted by Tom Jefferson III on
When you make comments such as this, “A fault line should be developing between those who advocate…” you undermine any effort to be taken seriously when you subsequently argue that your position is removed from, “gender-identity politics.”.
Yes, the fact that a boy likes to cook (for example), does not automatically mean that he is straight or gay or transgender. Likewise, the fact that a girl dislikes cooking does not automatically mean that she is straight or gay or transgender.
If that is actually the sort of “evidence” that doctors are using to make such important decisions, then their years of training and experience were clearly a waste of time and money (and last I checked, medical school tends to be a very long and expensive process).
However, I suspect that the medical process to determine whether or not someone is transgender is probably a wee bit more complicated then see how well patient does in home economics (or sewing school).
Part of the problem, is that anti-bullying legislation in public schools (to say nothing of private schools) often does not cover sexual orientation/gender identity (SOGI) or it does cover SOGI, but generally gets ignored.
Part of the problem is that if a high school history textbook makes a few brief mentions of gay history (say, the fact that gay people were targeted by the Nazis during the Holocaust), it is considered wildly progressive, if not “anti-family”.
posted by Lori Heine on
I was somewhere recently when the women started bragging about what wonderful cooks they were. They looked at me, and I saw that it was my turn. I said, “I’m really good at blowing up bowls of chili in the microwave.”
It got very quiet, and someone changed the subject. I don’t know why.
posted by Jorge on
…To do otherwise dangerously denies transgender children their very humanity—and their safety and well-being.
I would dismiss the appeal to “humanity” as religious sectarianism unworthy of serious consideration in an argument advocating dismissing another perspective.
I would dismiss “safety and well-being” as not supported by the latest WPATH Standards of Care (“which Dr. Zucker co-wrote”) and rebutted by the review on his clinic.
WPATH states that social transition of children is controversial and long-term evidence is inconclusive.
The review by CAMH cites the exact same statistic Ms. Zoh gave (80% of children with gender dysphoria have it go away in adolescence) and provides evidence that both transitioning and not transitioning early can be harmful. So it’s not about the “data”. It’s about the clinical practice that is based on the data.
But, Jorge, you miss my point. . . and that playing politics with the issue (no matter from which side) is wrongheaded.”
I didn’t miss your point. I think you’re interpreting two separate thoughts in my last post as part of a single thought.
As another letter puts it, a child’s gender identity is “a difficult and complex issue that needs serious attention and should not be decided on the merits of gender-identity politics.”
–I don’t think that anyone on IGF would disagree with that statement.
This reminds me of a conversation I had with my unit once on a recent policy change that prohibited any attempt to change a person’s identified sexual orientation. I loved how it was worded. Obvioulsy that kind of policy comes from a perspective informed by the gay community. But as written, it demands neutrality, do not interfere. I made the trainer (who was from a LGBT organization) flustered when I asked in sum, what about children who are destined not to accept their own homosexuality as adults? Those who because of their beliefs, will seek (yes, I do mean children) reparative therapy? She made a statement in effect that she believes reparative therapy is child neglect or criminal and we’d be involved in that anyway.
If that is actually the sort of “evidence” that doctors are using to make such important decisions, then their years of training and experience were clearly a waste of time and money (and last I checked, medical school tends to be a very long and expensive process).
(Well, it is the kind of “evidence” doctors use to diagnose ADHD…)
posted by Lori Heine on
What if they’re “destined” not to accept the color of their skin? Or of their eyes? Should they get therapy to change these traits, or would they be better off getting therapy to accept them?
I think the Twelve-Step Prayer, originally penned by Reinhold Niebuhr, would be helpful to them: “God, grant me the serenity to accept the things I cannot change, the courage to change the things I can, and the wisdom to know the difference.”
A.A. and her sister fellowships have worked so well, for eighty years, now, largely because they refuse to drag politics into the mix. I think they’re onto something.
posted by JohnInCA on
AA doesn’t really give out good data (largely because it’s so decentralized), but what data has been collected indicates AA isn’t any better then no intervention at all.
That is to say… the twelve steps work for people determined to change, sure. But those people determined to change don’t really need AA. But their black and white outlook, that moderation is impossible and one drink is as bad as ten, also sets people up to fail. Worse yet, the popularity of AA has suppressed research into alcoholism treatment programs that *do* beat the baseline in their efficacy.
All that said, I do like the Serenity Prayer. Don’t like the rest of AA. But the prayer is nice.
posted by Lori Heine on
It wasn’t my intention to sell anybody here on A.A. I was pointing out that the Serenity Prayer provides an answer to Jorge’s implication that one may merely choose whether one wants to accept their sexual orientation or gender identity.
If more solutions can be found, for addiction issues, than A.A., that’s fine with me. The reason for the continued popularity of the Twelve-Step program has more to do with the fact that it doesn’t milk every last damn dime out of people than anything else. Every other program I have heard of is out to make a buck. Once the quackery, snake oil and profiteering are driven out of these other programs, perhaps some of them will work better. I can’t afford them, so for now I’ll stay with A.A.
posted by Jorge on
That is to say… the twelve steps work for people determined to change, sure. But those people determined to change don’t really need AA.
Oh, that still leaves a lot of wiggle room.
In my career I’ve only heard one reference to either AA or NA by a client. The main problem with relying on AA or NA in terms of figuring out if someone is working on recovery is that verification is impossible by design. But I think that’s okay if you just think a different way about it. You think of it as a religious organization.
And as someone who goes to church less than once a year, I think religion is pretty hit or miss as a partner for better living. First you have to drag yourself to church. Then you have to open your mind to what they say. Then you have to do those horribly inhuman things your church tells you to do. Then you have to drag yourself back to church. And then you have to tell your priest you fell off the wagon when you fall off.
Almost all of those things are better done through some form of contract. What religion does do well–and this is critical–is make you feel better about yourself and your fellows. Oh, and it tells you what to do.
posted by Jorge on
What if they’re “destined” not to accept the color of their skin? Or of their eyes? Should they get therapy to change these traits, or would they be better off getting therapy to accept them?
Hey wait a minute.
There’s no law banning talking about such things in therapy, nor is there any ethical norm to that effect.
One is legally permitted, and even in some circles encouraged, to tell one’s own child, solely because of the color of their skin, “this is what to do when you encounter the police.”
On what to do or say after the child responds one way or another to such racialized instruction, there is… silence.
I strongly, strongly believe this is no different from parental instruction on “this is what to do when you feel like dressing up as a girl”. In both cases, it is not the business of the government or mental health professionals to overrule the parent, regardless of the wisdom of such instruction. You do not interfere. At the very least, you make it very clear that the parent is allowed to overrule you.
I was pointing out that the Serenity Prayer provides an answer to Jorge’s implication that one may merely choose whether one wants to accept their sexual orientation or gender identity.
If that is the implication I gave, then let me clarify. I do not express any opinion on whether a homosexual ends up as a self-affirming, self-denying, or in denial homosexual depends on free will. I do, however, mean to say that not all gay adults are self-affirming, and I do mean to imply that such people are likely to have enough of a mix of healthy and unhealthy traits that public policy should not seek to eradicate those who are not.
posted by Tom Jefferson 3rd on
Remeber that a great many kids or teens live in a community where any sort of gender non-conformity can get them bullied, harassed or even attacked or worse.
Whether or not a young person is gay or straight or bisexual or transgender may not matter as much as how they are preceived.
How they are preceived will certainly impact how they are treated school and within peer groups.
Our preceptions about sex, gender and sexual orientation are not necessarily accurate, enlightened or fair minded.
I cannot but help think that sexism, homophobia and transphobia makes it difficult for lots of kids and young people to sort out their gender-sexual identity and be true.