Tuesday, October 21, 2008

Transgendered Children

Completely unrelated to my recent post "Questions on the T" and the subsequent discussion, a facebook acquaintence of mine recently posted an article to a group of people from The Atlantic entitled A Boy's Life. The article tells the story of transgendered children by following one little boy who, ever since he could speak, said that he was supposed to be a girl. Perhaps the most phenomenal part of this story is that the boy (pictured) has the support of his working-class family.

This article is actually really incredible and does a great job of portraying all of the issues that a parent has to deal with when raising a child who believes he was born in the wrong body.

One of the more interesting parts of this article is scientific research that it relays. First, there's the story of an infant boy who had his penis burned off in a circumcision accident. He was used in a horrible experiment where, through surgeries, hormones and socialization, he was raised as a girl. Guess what? The experiment failed. With tragic results. This story was the topic of the 2000 book As Nature Made Him which looks like an excellent read. This makes me think that gender is fixed in the brain before birth and is immutable.

Another interesting research result in the article describes a 1987 study wherein 44 "sissy boys" were followed for 15 years to chart their psycho-sexual development. The researcher had originally assumed that all of the boys, who played with dolls as well as played hide-the-penis "look ma I'm a girl", would turn out transgendered. In fact, only one of them did. But 3/4 of the 44 turned out to be gay. This study does more to link effeminate behaviors with sexual orientation than it does with gender, in my mind. However, those behaviors aren't necessarily directly correlated to orientation.

The most compelling thing reported on in the above article was this: doctors now can administer hormone blockers to transgendered children, basically delaying puberty until the child grows up and has a better ability to decide whether their self-gender-identity matches their chromosomal gender. Wow.

I'll freely admit that I was pretty sissy when I was a kid. I was horrible at sports and preferred playing in the woods with the girls while our brothers played little league baseball. While my brothers monopolized the television all year 'round with baseball, football and basketball, I spent time in the other room listening to the radio and tying bedsheets around my body into intricate saris that I'd show off to my mother. I always preferred helping my mother in the kitchen, inventing recipes for "apple cake" and "fritters" or trying to master my grandfather's chewy fudge recipe, all while my brothers were out back tossing the pig-skin. After I'd given up on sports, my mother enrolled me in a jazz dance class in 4th grade. Though I didn't like it enough to re-enroll for another year, I did decide to teach the routine to two girl friends in my neighborhood and we eventually put on a show in front of our parents and neighbors that included home-baked refreshments and a "gymnastics" routine. I even once tucked my pre-pubescent package between my legs and showed my mother, proudly proclaiming, "Look, mom, I'm a girl!"

But for all this girlie, sissy behavior, did I ever actually want to be a girl? I don't think so. And, especially once puberty hit, I quickly grew into a (gay) man who was comfortable in his body.

Perhaps I'm the lucky one. Perhaps ending up gay is a better fate than actually wanting to be the other gender, or feeling that you were born in the wrong body. Or perhaps the transfolk are luckier? Between hormones and surgery, many can easily integrate themselves into the majority straight culture, leaving behind the world of sexual deviance and focusing instead on a "medical condition" for which science and medicine can provide at least a semblance of a cure.

So, perhaps here is another question for the trans members of our community. How early did you know? And if you knew early enough and hormone blockers were available to you at the time, would you have taken them?

And to everyone who commented on my previous post, please read the article I'm describing here and share any new perspectives you may have in the comments.

26 comments:

Anderov said...

I actually read that article the other day (it was linked in Jezebel. You might be a fag when...). An interesting piece.

First, small nit-pick/reminder. "Trans" does not equal "transsexual"; most trans people aren't transsexual and don't need/want medical treatment. Language precision! (Actually, that whole "lucky" paragraph uncomfortably heterocentrist, but that's me personally.)

I think if I had known that being trans was actually an option, I would have known very, very young. As it was, I was (and am) very realistic, and I don't think it would have ever occurred to me that being a boy could be anything other than a fantasy. I am exceedingly envious of children for whom hormone blockers are available - I would've been on that like dead on Elvis. However, as amazing as they might have been for me, I've got very mixed feelings about hormone blockers in any larger context.

Most trans people aren't transsexual, and most gender variant children probably don't even grow up to identify as trans. Given the uncomfortableness of most straight people with queer identities (sexual and gender orientations), I'm not sure letting parents choose the option of conformity for their children is such a hot idea. Even though it is reversible, that pressure is there. Also (and I don't know what other people's relationships are with their child-selves), kids are insane. And stupid. Just sayin', I'm not sure I would necessarily trust me-14-years-ago to be making decisions for me-now.

I'm thrilled for the kids for whom this has worked out, and maybe 13yos might, generally, be mature enough to make that sort of decision. But I'm very leery of the missing statistic of what happens to non-trans gender variant kids and their parents given these sorts of options.

Andrew Pendleton said...

NPR had a great pair of pieces on All Things Considered, back in May, about non-gender-conforming kids. The first part can be found at http://www.npr.org/templates/story/story.php?storyId=90247842, and it's excellent, if a bit heartrending in parts.

Sam said...

As Nature Made Him is an incredible and heartbreaking read. The "experiment" was actually performed by a doctor at our local Johns Hopkins campus, and the fellow in the book is not the only person that has been subjected to this sort of treatment.

Anonymous said...

I agree with Anderov that the hormone blockers are really problematic - most gender variant children are not trans or even gay.

I would even take it one step further, though, and say that most gender variant *people* are not trans or gay. These are heterocentric, conformist stereotypes that need to be worked against and not supported by medical and social communities.

Anonymous said...

I am not understanding the "trans" references in the comments. If someone could explain.

The thing that worries me is letting the child decide so early. I think of myself and that a gay child could end up a transexual. The Dutch study, the implied homophobia is interesting. I caught the NPR report in May and was fascinated by it. It is just a terrible thing to have to go through. As a parent you are always trying to do the best for your child and never knowing if you are doing the right thing.

I was Billy and I HAD many dolls. My dad said something to my sister like, "I remember the last toy I had to buy was Patty O'Green."(from Rainbow Bright)

Her response was: "That wasn't for me." My dad just shrugged.

Anderov said...

re clearlyhere:
"I am not understanding the "trans" references in the comments. If someone could explain."
Could you clarify what you are looking at?

and re: Anon
Having re-read my post, I realise that I didn't make myself terribly clear. Given the options covered by article (cross-living at a very young age, intensive therapy in the "right" gender, and hormone blockers), hormone blockers are the ones I have the least problem with. I've got much more issues with the other two because the children involved are so very young (if nothing else), and more issues with hormone blockers if preceded by early cross-living.

I've obviously got no numbers to back this up, but I would guess that the number of 12 year old gay boys who would ask for hormone blockers to keep from being gay would be significantly smaller than the number of 6 year old boys who want to "be girls" to escape being bullied for playing with dolls (and vice versa for girls, it was just impossible to word such as to include both in one go).

Also, "...most gender variant *people* are not trans..." That's a bit of a stretch, and would depend very heavily on your definition of "gender variant". If "gender variant" means "not the perfect 1940s stereotype of (wo)man", maybe. But that makes the idea of gender variance meaningless, since no one is a living stereotype.

Anonymous said...

Anderov, I'm not sure what you mean by saying that no one is a "living stereotype," but many people do exhibit accordance with stereotypical or prescribed "norms" of gender.

Those who do not meet the "norms" of those gender definition are then "gender variant," but that does not necessarily make them trans or gay (even though both of those things are also "gender variant").

Either way, semantics aside, my statement was(is) that it is problematic, inappropriate and dangerous for people to suggest/implement medical "solutions" for gender variant behavior - regardless of a person's age.

meichler said...

I guess my post and the subsequent comments show that I (and perhaps we all) have a way to go in fully understanding trans issues. Honestly, I don't even feel comfortable using the term "trans issues" anymore, since it seems that "trans" isn't just one thing that can be easily pinned down and defined.

My understanding of the concept of "trans" whether transgender or transsexual is that it denotes a desire to identify as the gender other than ones biological gender.

Because this indicates that there is a physical mismatch between gender and sex, I had assumed that anyone who was trans would consider puberty suppression and subsequent hormone therapy a boon. Those wishing to pass as their non-biological gender would greatly benefit from the secondary sex characteristics of that gender which would appear with the hormone therapy.

It's my understanding that the difference between transgender and transsexual is that the transsexuals are willing to take medical steps to transition into the other gender, whereas transgendered folks may adopt the opposite gender identity but not modify their physiology to match it. It was my thought that fear or mistrust of surgical and hormonal techniques were the barriers that separated transgendered from transsexuals, but that all trans folk wanted to be comfortable in their bodies.

Is this assumption blatantly wrong? Are there plenty of trans folk who haven't the slightest inkling of modifying their bodies to more conform to the gender with which they identify? If a trans-man gets top surgery, is he transsexual?

It was this assumption that lead me to believe that the hormone suppression would be such a boon: to delay the secondary sex characteristics of either gender until the child is old enough to decide. This way, there's no need to undo the effects of puberty that can be changed, and trying to deemphasize those that can't (like broad shoulders or child-bearing hips).

I'm also wondering if anyone in the trans community feels as strongly against sex reassignment surgery as many in the GL community feel about the ex-gay movement. Is there a sense that "we were made this way for a reason" and no amount of treatment is worth the loss of self? Is there an analogy to be made here anywhere?

I appreciate everyone's participation in this dialog.

Anderov said...

You are making a lot of incorrect assumptions... (and I'll apologise before-hand for the piecemeal nature of the response; I couldn't think of a good way to make it less so.)

- The phrase "the other gender": The definite article here ("the") is a problem, because you're presupposing the validity of the dichotomy - there are options other than "man" and "woman". Wiki-search "genderqueer" for an example.

- Just because one's gender and sex don't correspond in one of the more usual ways doesn't necessarily mean that one experiences body disphoria. This guy may not be the best example, but he talks about how he stopped testosterone because he didn't want to stop visibly being a queer female. Stone Butch Blues by Leslie Feinberg also gives some good examples (and is well worth the read on it's own merit).

- Non-transsexual transgender people may live full-time presenting as the sex other than what they were assigned at birth... or they may present as androgynous, or vary their gender presentation. Or they may present as their biological sex, but in decidedly gender-non-standard way (e.g. butch lesbians). Everybody wants to be comfortable in their bodies, but being trans doesn't necessarily preclude being comfortable in the one you were born with.

- "If a trans-man gets top surgery, is he transsexual?" Probably. If I couldn't ask him and for some odd reason had to make a call, I would say "yes", but he is completely free to say that he is not.

Don't get me wrong - the hormone blockers have the potential to be great. It's just the people involved in the decision-making process - parents (who are probably heterocentrist and tend to be irrational about their kids), doctors/psychologists (who have a decidedly mixed track record on these things, so pardon my reservations) and a 13 year old kid. Makes me wary.

"I'm also wondering if anyone in the trans community feels as strongly against sex reassignment surgery as many in the GL community feel about the ex-gay movement" Not that I know of... though there are people who strongly don't want surgery for themselves, and people who have issues with the medical system and how surgery gets handled. Actually, I think the converse is easier to find - transsexual people who look down on other trans people for not "going all the way". There is no "loss of self" associated with surgery, it's usually percieved as a realisation of self, and most people do not say they are no longer trans after surgery, there's no loss of history.

Anonymous said...

Michael,

I think trans terminology varies some from one community to another, so absolute definition for many (all?) of these terms don't exist. However, some definitions are more commonplace than others, and it's not unusual to see both "trans" and transgender applied to a broader group of people than just those who cross-identify. For a local example, see the DC Area Transmasculine Society's description of who they include: http://www.dcatsinfo.org/about_us.html

It's easier to figure out how the terms are being used in specific contexts (say, talking about hormone therapy safety or non-discrimination law) than in a more general conversation like this one.

There are plenty of trans people with no desire to modify their bodies. I like to think of trans as a plot with three axes: gender identity (women, man, other), physical sex identity (female, male , other), and gender expression (feminine, masculine, other). These can be combined in just about any way. There are female assigned trans people who use hormones and have surgery but do not identify as men and trans women who unambiguously identify as women but don't transition medically, any lots of other combinations.

Despite the diversity of the community, it would be unusual for someone to express strong opposition to sex reassignment surgery. Though there have at times been (sometimes heated) squabbles between different groups within the community, in my experience there is by-and-large a libertarian ethos when it comes to peoples' personal choices. Different people have different needs, and everyone should be able to pursue whatever path is best for them.

There is no comparison with the ex-gay movement. In becoming ex-gay, ex gays suppress who they really are. In transitioning, trans people strive to be visible as who they really are. In a similar vein, it's not appropriate to call post-transition trans people who keep their trans status private "closeted"; these people *are* showing the world who they "really" are. It's the pre-transition gender that was inaccurate. All that's being "hidden" is a personal medical history, which is something that many people, whether they're trans or not, choose to keep certain aspects of private (and they have every right to do so!)

Anonymous said...

I'm surprised to not see more support for hormone blockers for trans children in the comments.

I think it's pretty obvious that hormone blockers shouldn't be given to any little boy who likes dolls or any little girl who plays with trucks, or any kid who has expressed once or twice desire to be a boy/girl. I don't think many parents of gender variant young children *want* their kids to be transsexual, and I have a hard time imagining parents pushing their children down the path of hormone blockers. Since when is parental presser *to* transition a realistic concern?

But a child who has consistently and insisted from an early age that he *is* a boy/girl? A kid who attempts to cross-live to the extent possible, quite possibly *despite* parental objection? Pretty clear cases where hormone blockers can do real good in someone's life. Take appropriate precautions such as getting a good therapist involved and trying out less drastic interventions first, but if blockers still seem like an appropriate option after that, I'm all for it.

Anonymous said...

Why not just let the kids play the way they like and be who they are without hormone blockers and adult intervention?

It's the very thought that this is something odd and the very act of trying to control it that is the problem. That is why these kids grow up wanting surgery b/c everyone makes them feel like they don't fit.

Maybe if society just let them be who they already are in the bodies they already have and not force them to feel they must change something about themselves to be "normal" they would not grow up feeling so strange.

Ironically these kids aren't what needs to change. It's society's views about who has the "right" to inhabit which body that have to change. A woman has every right to grow up in a man's body without feeling pressured to get surgery in order to fit in.

Anonymous said...

re: anonymous

here! here! i completely and totally agree.

meichler said...

re: the two most recent anonymous comments

The reason that I find hormone blockers so interesting is that they provide these children with the opportunity to grow up into the body they want. What if they don't want to be who they are in the bodies that their chromosomes and hormones will turn them into after puberty? Why not postpone puberty with hormone blockers to allow a child (with lots of counseling and time) to choose whether their post-pubescent body exhibits male or female secondary sexual characteristics?

Anonymous said...

Anons above, I feel like you're totally denying the agency of trans people. I didn't pursue hormones or surgery to fit in with anyone's expectations except my own. I chose these things, because they were what *I* wanted for *my* body, thank you very much. Social pressure was a strong deterrent to medical transition, not an impetus to it, and I transitioned despite significant social obstacles.

Changing society so that people can be who they want in the body they were born in won't work because some people never wanted the body they were born in to begin with. If the body's the issue, you can change society all you want, but you won't solve the problem. Hormone blockers, however, do address the body-related dysphoria, as does hormone therapy for adults.

Anonymous said...

re: Samba

We aren't talking about trans adults, we're talking about children who don't necessarily know who they are or what they want.

"I didn't pursue hormones or surgery to fit in with anyone's expectations except my own.

Do you know that for a fact? If you grew up on another planet or in another culture do you know you would feel the same?

I respect your individual experience but are you speaking for all trans people right now or just yourself? As a gay man I know I am different in serious ways from other gay men, I feel that deeply. As such I am only able to generalize about all gay men.

Aidan said...

Anon,

What use is it to speculate about growing up on another planet? Trans individuals pursuing medical intervention are never pressured by their doctors; if anything it is quite the opposite.

As for your proposed solution that society is the real problem - granting that for the sake of argument, it's a lot easier to operate on one body than it is upon the attitudes of an entire society.

Anonymous said...

And plenty of children do know who they are and what they want, Anon -- at least as much as any adult does. As I mentioned in my comment further up, I don't think hormone blockers are right for every trans child, and I think a therapist should be involved and other options should also be explored, but at the end of the day, there are some cases in which blockers are a positive and safe option.

Would you still have been gay if you'd grown up on Mars? This sort of question seems pointless to me. But in my own life here on planet Earth, I don't feel that my culture has encouraged me to transition in order to fit in. Actually, quite the opposite. I'm kinda curious - what sort of situation are you thinking of where society encourages people to transition? Iran, okay. But otherwise?

I can't speak for all trans people, only myself, but based on conversations over the years with many different trans people, I do think my experience of transition as a self-driven undertaking is a common one.

Anonymous said...

your decision to "transition" is as self-driven as your decision to get a tattoo or go to college, of course. This is not the question. To assert that your "transition" changes your gender is the problem. You can behave in any way that you want, modify your body to you heart's content, it still doesn't change your gender. It just changes your behavior and appearance. That's all. Gender is not based in behavior and appearance, gender expression is. Gender stereotypes are. Not gender.

Anonymous said...

"it's a lot easier to operate on one body than it is upon the attitudes of an entire society."

so just because it's a longer or difficult process, we should abandon it? It seems to me that the "easier" road of individual body modification is a whole lot more damaging overall and never improves any situation for anyone except for *maybe* that one individual (who still has to live in a world that does not understand/accept them).

Anderov said...

"You can behave in any way that you want, modify your body to you heart's content, it still doesn't change your gender."

Damn right it doesn't. I was a guy before I transitioned. Transitioning didn't change my gender, it just made me happier.

Anonymous said...

Anderov, can you define gender for us please? Because as far as I can tell you think gender is between a person and themselves... and that's all well and good for your arguments, and it's well and good for gender identity and gender expression, but it's not actually how gender itself is defined.

Anderov said...

"How gender is defined" by whom? In every day usage, where the overwhelming majority of people are not LGBT, "gender" can be used to mean the same as "sex" without there being any huge issue.

Everyday language falls short when it comes to describing the unusual - English was not developed with trans people in mind. As such, trans people (and feminists, though I am significantly less well versed on that) have made a distinction between the two, to incorporate sense of self and the interactions of self with culture.

Anonymous said...

Feminists most certainly do not believe that gender expression alters gender.

A woman can do anything that a man can do without being (or becoming) a man (and vice versa). To assert that a woman is in any way a man by virtue of her behaviors or feelings is completely antithetical to feminist tenets.

Anderov said...

That's not what I said at all...

The distinction between sex and gender has been made by feminists, and a lot of discussion about performance of gender (Judith Butler, feminist philosopher) and various other gender issues has been instigated by feminists and feminist thought.

Feminists believe a wide range of things, and plenty of them disagree with each other. I was not making a statement of "What Feminists Believe", just citing the history of the discussion.

Sam said...

I dealt with issues of how "gender" and "sex" are used in working on registries for health data. At the end of the day, it came down to the following:

* Sex: the patient's biological sex at birth, determined by dominant genetic and physiological traits, as documented in the medical record.

* Gender: the socially expressed characteristics of the patient categorized by biological sex (e.g. male, female, or other expression), as self-reported by the patient.

We had known issues at hospitals in which patients would report that their sex was male, for example, when in fact their biological sex at birth was female. Unfortunately, a lot of health care workers (specifically those handling intake and registration) are not trained to differentiate between sex and gender. This leads to doctors needing to change their approach when a patient hits the table, and can also lead practitioners to render inappropriate or ineffective care for transgendered or transsexual patients.

From a public health reporting standpoint (for cardiology, as was my area), we instructed hospitals to throw gender out the window and only provide us with biological sex at birth. For our purposes, it didn't matter how anyone self-identified once they were catheterized or cracked.