gender studies 101

Actually… probably more like 501.  Best put on your thinking caps before proceeding, folks.

Thanks to a link my friend Green Weaver posted to facebook, I’ve spent some time over the past week or so reading articles on gender non-conforming kids.  It doesn’t go far enough by half just to call this an interesting topic; it’s fascinating, hopeful, challenging, and deliciously complex.

Warning:  I really pared down my writing on this post so as not to repeat territory already covered by the links on Accepting Dad’s blog (link above).  So unless you’re super-familiar with the topic already, it’d probably be best to read those articles first.  Some of the following is not going to make much sense otherwise.

What is gender non-conformance?  Although most of us feel that our gender identity matches our phenotype, some do not.  This is challenging enough in adults who have to grapple with issues of identity and change and acceptance; it is even more complicated in children.  Is gender non-conformance genetic or is it learned behaviour?  Is it a phase or something enduring?  Either way, what’s best for the children, immediately and long term?  Very tough questions.

As I understand it, there are two basic approaches:  either force affected kids to deny their feelings and adhere to societal expectations about their gender phenotypes (let’s call this the Toronto approach), or allow them to explore life as they wish (the Boston approach).  Unsurprisingly, I whole heartedly support the Boston approach.

We can look at this in terms of minimising risk.  Worst case scenario with the accepting (Boston) approach:  you get some weird looks from the neighbours because your little boy now dresses like a little girl (or vice versa), possibly you lose some evangelical Christian friends who tell you that you and your kids will go to hell (this of course could be viewed as a benefit), and maybe your kid reconsiders in a few years and transitions back to her or his original gender (some evidence indicates that gender non-conforming kids overwhelmingly do not grow up to be transgendered adults – though this evidence is reported by the Toronto clinic and has not (as far as I’m aware) been peer reviewed, so it may be suspect).  In short, I fail to see how any real damage could possibly result from allowing kids to try on other gender roles.

On the other hand, let’s look at the worst case scenario with the forced-to-maintain-birth-gender (Toronto) approach:  first off, your kid is miserable and feels that his/her feelings and needs are not deserving of consideration.  Possibly/probably, she or he ends up engaging in self-destructive behaviours.  Suicide is not unlikely.

The best case scenarios put forth by advocates of both the Boston and the Toronto approaches are essentially identical:  kids who grow up to be happy, healthy adults.  Because they are identical, we can discard them for purposes of comparing the approaches.  What would really help would be to know whether each approach works; however, this is very new territory, so we don’t have a whole lot of long term efficacy data (as far as I’m aware).  This leaves us only minimising risk as a decision making tool, and in these terms, the Boston approach is clearly superior.  QED.

And that, believe it or not, is the easy part.  What follows below is what really makes me wonder.  So, if you don’t want to be kept up nights trying to answer questions which may be unanswerable, it may be best to stop reading here.

All of what I wrote above applies to pre-puberty.  A newish development of the Boston approach is staving off puberty using hormone blockers, then prescribing hormones to induce the puberty of the kid’s self-identified gender.  This is where it gets somewhat more ambiguous for me.  For kids who are genuinely transgendered, this is clearly the right course of action.  But what about those (if any) who aren’t, and how do we tell who’s who?  What if the Toronto data is correct, and gender non-conforming kids usually don’t grow up to be transgendered adults?  Or – what if the Toronto data is biased by the fact that puberty had already occurred for all of their subjects, thus poisoning their bodies with the wrong hormonal mixture and totally changing their brain chemistry?  Would these people have been happier as adults if they’d transitioned as kids, even though they don’t currently identify as transgendered?  This is what I suspect (at least in some cases), but I don’t think there’s any way of testing my theory.  It would be unethical to run a case/control study comparing the Boston and Toronto approaches; with the hypothesis that one approach works and the other does not, too much would be at stake for the subjects.  And I don’t know if the two clinics are maintaining follow-up data that would be useful for purposes of comparison.

Another difficult question, and more (I think) to the point that Accepting Dad was making on his blog – why dichotomise?  Do we really have to shovel kids into one pigeon hole or another?  What about kids (or adults for that matter) who don’t want to change gender, but aren’t satisfied with the expectations placed on them because of gender?  (Here, too, though, I think the Boston approach is clearly superior.)

So… my idea is this.  Let gender non-conforming kids (and all kids for that matter) be who they wish, and try on whatever roles they want to try on.  Most of what we think of as gender is pretty outmoded anyway; it’d be better for everyone if we all started transitioning away from our biases.  And when puberty approaches, it’s inevitable that things will get messy (as they always do with puberty).  A certain amount of suffering may be unavoidable; I think the crucial thing before committing to any dramatic and largely irreversible course of action is to determine how damaging the alternative would be.  If a kid is going to be absolutely miserable without transitioning, then she or he should begin the biochemical process of transition.  A certain amount of suffering, as I said, is probably unavoidable; but that’s part and parcel of the human condition anyway (Buddhists proclamations to the contrary notwithstanding).  No one should have to be miserable, though.  And of course, hormonal interventions which are begun prior to puberty are going to be far, far, far more effective than those begun after puberty; so by all means, for kids who need to transition in order to be happy and healthy, sooner is better than later.

Caveat to all of the above:  I’m not a medical or psychology professional, or really in any way qualified to weigh in on this topic.  I do have a bachelor’s degree in psychology, with a concentration in psychobiology, and I have been working in (unrelated) medical research for over ten years.  My main qualification, though, is that I’m very interested in people, generally, and all of our glorious, unclassifiable, messy intricacies.  And I am interested in people being able to live the lives they want to live.


One Response

  1. Well, there is the problem of middle America. And rightwing America. And…

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