Simply the Best

Rarely, you see a article that exemplifies good journalism. An article that delves beneath the superficial, that doesn't tell just one side of the story. An article that is neither overly speculative, nor blindly adheres to long discredited notions. One that is up-to-date.

Such an article is A Boy's Life by Hanna Rosin, in the Atlantic Monthly. It is an article, in fact I'd say it is the definitive article, about Transgendered Children.

Some Highlights:

Dr. Peggy Cohen-Kettenis, who runs the main clinic in the Netherlands, has seen the average age of her patients plummet since 2002. “We used to get calls mostly from parents who were concerned about their children being gay,” says Catherine Tuerk, who since 1998 has run a support network for parents of children with gender-variant behavior, out of Children’s National Medical Center in Washington, D.C. “Now about 90 percent of our calls are from parents with some concern that their child may be transgender.”
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It took the gay-rights movement 30 years to shift from the Stonewall riots to gay marriage; now its transgender wing, long considered the most subversive, is striving for suburban normalcy too. The change is fuel‑ed mostly by a community of parents who, like many parents of this generation, are open to letting even preschool children define their own needs. Faced with skeptical neighbors and school officials, parents at the conference discussed how to use the kind of quasi-therapeutic language that, these days, inspires deference: tell the school the child has a “medical condition” or a “hormonal imbalance” that can be treated later, suggested a conference speaker, Kim Pearson; using terms like gender-­identity disorder or birth defect would be going too far, she advised. The point was to take the situation out of the realm of deep pathology or mental illness, while at the same time separating it from voluntary behavior, and to put it into the idiom of garden-variety “challenge.” As one father told me, “Between all the kids with language problems and learning disabilities and peanut allergies, the school doesn’t know who to worry about first.”
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At the conference, blockers were the hot topic. One mother who’d found out about them too late cried, “The guilt I feel is overwhelming.” The preteens sized each other up for signs of the magic drug, the way other teens might look for hip, expensive jeans: a 16-year-old (natal) girl, shirtless, with no sign of breasts; a 17-year-old (natal) boy with a face as smooth as Brandon’s. “Is there anybody out there,” asked Dr. Nick Gorton, a physician and trans-man from California, addressing a room full of older transsexuals, “who would not have taken the shot if it had been offered?” No one raised a hand.
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Today, the notion that gender is purely a social construction seems nearly as outmoded as bra-burning or free love. Feminist theory is pivoting with the rest of the culture, and is locating the key to identity in genetics and the workings of the brain. In the new conventional wisdom, we are all pre-wired for many things previously thought to be in the realm of upbringing, choice, or subjective experience: happiness, religious awakening, cheating, a love of chocolate. Behaviors are fundamental unless we are chemically altered. Louann Brizendine, in her 2006 best-selling book, The Female Brain, claims that everything from empathy to chattiness to poor spatial reasoning is “hardwired into the brains of women.” Dr. Milton Diamond, an expert on human sexuality at the University of Hawaii and long the intellectual nemesis of Money, encapsulated this view in an interview on the BBC in 1980, when it was becoming clear that Money’s experiment was failing: “Maybe we really have to think … that we don’t come to this world neutral; that we come to this world with some degree of maleness and femaleness which will transcend whatever the society wants to put into [us].”

Diamond now spends his time collecting case studies of transsexuals who have a twin, to see how often both twins have transitioned to the opposite sex. To him, these cases are a “confirmation” that “the biggest sex organ is not between the legs but between the ears.” For many gender biologists like Diamond, transgender children now serve the same allegorical purpose that David Reimer once did, but they support the opposite conclusion: they are seen as living proof that “gender identity is influenced by some innate or immutable factors,” writes Melissa Hines, the author of Brain Gender.

This is the strange place in which transsexuals have found themselves. For years, they’ve been at the extreme edges of transgressive sexual politics. But now children like Brandon are being used to paint a more conventional picture: before they have much time to be shaped by experience, before they know their sexual orientation, even in defiance of their bodies, children can know their gender, from the firings of neurons deep within their brains. What better rebuke to the Our Bodies, Ourselves era of feminism than the notion that even the body is dispensable, that the hard nugget of difference lies even deeper?
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According to Dr. Peggy Cohen-Kettenis, the psychologist who heads the Dutch clinic, no case of a child stopping the blockers and changing course has yet been reported.

This suggests one of two things: either the screening is excellent, or once a child begins, he or she is set firmly on the path to medical intervention. “Adolescents may consider this step a guarantee of sex reassignment,” wrote Cohen-Kettenis, “and it could make them therefore less rather than more inclined to engage in introspection.” In the Netherlands, clinicians try to guard against this with an extensive diagnostic protocol, including testing and many sessions “to confirm that the desire for treatment is very persistent,” before starting the blockers.

As I said, both sides of the story.

And some issues which will come as no surprise to readers of this blog.

“Are we expecting to find some biological component [to gender identity]?” asks Vilain. “Certainly I am. But my hunch is, it’s going to be mild. My hunch is that sexual orientation is probably much more hardwired than gender identity. I’m not saying [gender identity is] entirely determined by the social environment. I’m just saying that it’s much more malleable.”

I doubt that he's read my article that came to exactly the same conclusion, but yes, I agree. That's what the data indicates.

Vilain has spent his career working with intersex patients, who are born with the anatomy of both sexes. He says his hardest job is to persuade the parents to leave the genitals ambiguous and wait until the child has grown up, and can choose his or her own course. This experience has influenced his views on parents with young transgender kids. “I’m torn here. I’m very ambivalent. I know [the parents] are saying the children are born this way. But I’m still on the fence. I consider the child my patient, not the parents, and I don’t want to alleviate the anxiety of the parents by surgically fixing the child. We don’t know the long-term effects of making these decisions for the child. We’re playing God here, a little bit.”

I've blogged about that too.

Green expected most of the boys in the study to end up as transsexuals, but nothing like that happened. Three-fourths of the 44 boys turned out to be gay or bisexual (Green says a few more have since contacted him and told him they too were gay). Only one became a transsexual. “We can’t tell a pre-gay from a pre-transsexual at 8,” says Green, who recently retired from running the adult gender-identity clinic in England. “Are you helping or hurting a kid by allowing them to live as the other gender? If everyone is caught up in facilitating the thing, then there may be a hell of a lot of pressure to remain that way, regardless of how strongly the kid still feels gender-dysphoric. Who knows? That’s a study that hasn’t found its investigator yet.”

Compare with my own conclusions:

Cross-Gendered (CG) Sexual Orientation is an unsubtle effect, and often associated with cross-gendered behaviour patterns in young children. It appears to be set by pre-natal hormone influences.

CG Gender Identity is also set by pre-natal influences. The effects appear later, and the tell-tale neurology appears after Gender Identity is formed. But the pattern that dictates the later neurological development is just as pre-ordained. It is a more subtle effect that sexual orientation, and many people are essentially Bi-Gendered, and would be able to function in either a male or female role, as circumstances dictate. Relatively few are strongly gendered, but for those that are, it's unchangeable. Just as CG sexual orientation is strongly correlated with CG behaviour in children, CG gender identity is universally(?) associated with CG patterns of thought in children.

About 2/3 of children exhibiting cross-gendered behaviour end up being Gay instead of TS. That's regardless of therapeutic measures, or lack thereof.

And then there's this...

Zucker put me in touch with two of his success stories, a boy and a girl, now both living in the suburbs of Toronto.
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When I visited the family, John was lazing around with his older brother, idly watching TV and playing video games, dressed in a polo shirt and Abercrombie & Fitch shorts. He said he was glad he’d been through the therapy, “because it made me feel happy,” but that’s about all he would say; for the most part, his mother spoke for him. Recently, John was in the basement watching the Grammys. When Caroline walked downstairs to say good night, she found him draped in a blanket, vamping. He looked up at her, mortified. She held his face and said, “You never have to be embarrassed of the things you say or do around me.” Her position now is that the treatment is “not a cure; this will always be with him”—but also that he has nothing to be ashamed of. About a year ago, John carefully broke the news to his parents that he is gay.

Sure this is a "success", and not denial. Sure it is. And it looks as if I was right about some of Zucker's other "successes", even though I was hoping against hope that I was wrong.

Yet Zucker’s approach has its own disturbing elements. It’s easy to imagine that his methods—steering parents toward removing pink crayons from the box, extolling a patriarchy no one believes in—could instill in some children a sense of shame and a double life. A 2008 study of 25 girls who had been seen in Zucker’s clinic showed positive results; 22 were no longer gender-dysphoric, meaning they were comfortable living as girls. But that doesn’t mean they were happy. I spoke to the mother of one Zucker patient in her late 20s, who said her daughter was repulsed by the thought of a sex change but was still suffering—she’d become an alcoholic, and was cutting herself. “I’d be surprised if she outlived me,” her mother said.

Sometimes I hate having good intuition. Yes, Cassandra was cursed. For this is what I wrote months ago.

Perhaps, and I would like to think this is true, Dr Zucker is correct. That despite all the counter-examples, despite the "gender dysphoria", this boy's brain was adequately malleable to make him into a successful woman. He's trumpeted as a success anyway, not at all gender dysphoric, no desire to change. And just as importantly (to them), Straight too, and not at all lesbian.

Failing that, I would like to think of him as cheerfully insane, much as I was. OK, that would mean being unable to access memories of childhood. For him, that would mean being unable to wear a man's shirt, or anything but the frilliest, most girly clothes he could get, just in case anyone suspected. Frigid, though yearning for love like anyone else, and capable of pleasing his male partner, who he loves dearly. The bit that says that this is all horribly, terribly wrong and perverse, safely locked away in a box in a safe in a room in a sunken ship under the ocean on a planet in a distant galaxy, so he almost never can hear the screaming in his head. No Gender Dysphoria, no siree, not for this guy, er, gal, the idea is absurd! Happy, for you can be in this situation. I know. I've been there. It's not that bad, really (so why are you crying, Zoe?). It doesn't feel bad at the time, anyway, that at least is unquestionably true. You can be highly functional, and no-one suspect, least of all you.

What I fear is that he might be on huge doses of anti-depressants, or alcoholic, or attempting to drown the misery in activities of one sort or another. Promiscuous sex perhaps, to validate his female identity. Suicidally Ideating perhaps. But again, no Gender Dysphoria, for if he showed that, the voices in his head tell him that no-one would love him. Her. Conforming, Bidable, and not standing out.

I don't know which of these is the case. It might be something else entirely. I don't know because it wasn't in the report. A study using basic tests for mental health would have told us about the last condition anyway, though the first two situations would have been indistinguishable.

But you see, compared to whether GD was still present or not, "happiness", "quality of life" or even basic mental health, wasn't considered important. Not worth measuring. And this is my main critique, why I'm inclined to take a very jaundiced view, not important even compared to sexual preference. It appears to be all about conformity.

Now remember just how much interpolation I'm doing. How much guesswork, lacking facts. Humans are good at seeing patterns that don't exist. I'm not objective either.

But it fits all too well. I hope I'm wrong, I hope my wild surmises and conjectures are nowhere near the actuality. I fear I'm right though. People like me are good at intuition. It also is consistent with every single one of the narratives I've heard from literally dozens of Intersexed people who went through the same kind of thing, and similar to the testimony of literally hundreds of TS people I've corresponded with.

I hope someone at Jurassic Clarke can show me that I'm utterly wrong, and it's vastly improbable that I have all the details right anyway. But I think, in the main, it's likely to be all too accurate.

Ah Spit.

I'm not about to join the Zucker Fan Club any time soon. I know he means well, I have immense respect for him as a Scientist, but when you look at his "successes", let alone his failures, his experimentation on children is unethical, and because of the flawed metrics, even Bad Science.

I really wish I'd been wrong, you know? I really wish I wasn't in tears over what he's doing to these kids. I mean, those who are going to "grow out of it" and just become gay adults will do so no matter what. No need to torture them, just to instil dysfunctional conformity in a few.

Anyway, please go and read the whole article. It's simply the best on the subject ever written.