Why does a biological underpinning to gender identity matter?

science

Biological essentialism vs social constructivism

Biological essentialism (or biological determinism), is the idea that behaviours, interests or abilities are biologically pre-determined, rather than shaped by society. In an essentialist interpretation, innate differences between men and women result in  ‘natural’ gender divisions  – with men inherently (innately) better at decision making and women better at nurturing.

Feminists, Freudians, and queer theorists have all challenged biological essentialism. Second wave feminists argued that gender-based inequalities and differences were not natural, and were instead socially constructed. Girls are not inherently worse than boys at physics (due to having pink and fluffy brains) but rather, are often denied the opportunities offered to boys. Social constructivists demonstrated the many ways in which observed gender differences between men and women are socially engineered. Some went a step further, arguing that gender is purely a learned behaviour or a performance.

Brains are complex, and social constructivists, like the popular science writer Cordelia Fine, have rightly debunked the simplified and shoddy science that underpins essentialist claims that men are from Mars with their manly brains, and women are from Venus, with feminine brains.

Gender identity and the neurology of ‘trans brains’

Where then does gender identity fit in?

Some scientists have conducted neurological imaging studies on trans people, exploring whether there are specific, sexually dimorphic areas of the brain in which trans people differ from their assigned sex (the sex they were presumed to have at birth).

Published research findings, often with low sample sizes, have been interpreted as indicating that trans women have a brain more similar to a cis (not trans) woman’s brain than to a cis man’s brain. Such findings have been publicised in newspaper headlines as proof of the existence of trans people.

Such scientific studies, and their shallow interpretation and presentation in the media, have received strong criticism from a wide number of transgender commentators. There are a range of extremely valid reasons for criticism:

  • The suggestion that one specific variable can define ‘transness’ is reductive and overlooks the ways in which society, culture and experience impact on every individual including on the structure of the brain.
  • The reliance on any study as legitimacy for human rights is extremely dangerous – if the study results are later rejected, what happens to these rights?
  • The idea that any brain can be easily classified as male or female is simplistic and overly binary.
  • The suggestion (made by inaccurate media representation of the studies) that one specific variable can be used as a diagnostic test for transness also fills people with fear that any such test could be used by gatekeepers to judge who is accepted as trans and who can be denied support and denied rights. Any such diagnostic test would be entirely at odds with autonomy, with respecting people’s lived experience, with self-identification and dignity.

These reasons for fearing how science will be politically used, or for criticising simplified interpretations of scientific data, make total sense and have historical antecedents – I understand the fear and upset.

Rejection of biology

However, such comments very often seem to take one step further, rejecting not only biological essentialism and the unhelpful simplified, ‘soundbite’ biology loved by the media, but also moving into a sweeping rejection of any mention of a link between biology and gender identity. A culture in which the very mention of biology is discouraged.

This is where as a cisgender (not trans) parent of a transgender child I feel uneasy. I’ll attempt here to explore this from my cis parent’s perspective.

Pathologisation of diversity

For many decades, psychologists and psychiatrists have been aware of trans children expressing distinct gender identities at an early age – 2 or 3 years old.

Across the twentieth century mainstream medical convention, with some exceptions, rejected out of hand any possibility of a biological underpinning to gender identity. The consensus then was that a trans gender identity was a delusion, a mental illness that could, and should, be ‘cured’.

For young trans children, misogynist male psychologists and psychiatrists, frequently working in the field of sexology, focused their attention on the mother.

Therapy and treatment for young trans children focused on presumed maternal abuse or maternal failings.

Does it even matter why trans adults are trans?

When I hear people say ‘does it even matter why people are trans’ – when I hear people dismiss as offensive and unnecessary any consideration of any biological influence on gender identity, I have an emotional response. I also see this reaction in some other parents of trans children (though certainly not in all).

The denial of any possibility of a ‘biological underpinning to gender identity’ is historically tied up with the denial of the existence of younger trans children. The erasure of the existence of younger trans children has caused untold suffering.

As a parent of a trans child who is loving life, it makes me think of the trans children from decades past (and present in too many places in the world) who were traumatised and institutionally abused by medical systems designed to prevent or convert their gender identity. Neither the genitals = sex = gender approach of simplified biology, nor the feminist ‘gender is a social construct’ mantra, left any space for younger children to be trans. Trans children did not fit with either theory so therefore could not exist.

Impact of denial on families

Denial of the possibility of some young children being trans makes me think of the consequences of this denial. It makes me think of the mums who were coerced into distancing themselves from their trans daughters, based on some unsubstantiated theory that an overly close mother-‘son’ bond might lead to a child ‘misidentifying’ as female. How unbelievably cruel to do that to a family.

Shon Faye, whose work I greatly admire, recently wrote that she disagrees with anyone who suggests gender identity is innate and that it should not matter why people are trans. CN Lester, another writer whose work, and excellent book, I’ve learnt a lot from, critiqued the reporting of the research study under discussion  and recommended reading work by Cordelia Fine, author of ‘Delusions of Gender’.

This particular recommendation makes me want to cry.

Delusions of gender as a book has real merits in its debunking of simplified biology,  in its understanding that gender-based inequalities are not natural, and that men are not inherently better at parking. So far so commendable.

However, Cordelia Fine replaces the simplified biology of biological essentialism not with nuanced and complex biology, but a nod to social constructivism. Her work is routinely used by those who argue that gender is merely a ‘performance’ and that trans identities do not exist, except perhaps as a non-conforming person’s misguided response to gender norms.

The view that gender is purely a construct and therefore not ‘real’ is pervasive and extremely dangerous. Adherents of this view may well tolerate trans adults – with a patronising assumption that trans adults made a ‘choice’ to ‘change gender’ as a response to their non-conformity. But whilst adherents of social constructivism may begrudgingly  tolerate the existence of trans adults to some degree, they allow no such tolerance for younger trans children.

The gender as purely a social construct contingent see social influence and gender stereotyping as the only reason for trans identities. They see no valid reason for the existence of young trans children.

Some of the more fringe, actively transphobic, elements of this group, throw their hate and bile at parents of trans children, accusing us of child abuse, demanding that the state take our children away, demanding that children be protected from ‘transing’.

The recommendation to read Cordelia Fine hit a particular nerve as ‘Delusions of Gender’ had a direct impact on my family. We had a family friend who was unable ‘ideologically’ to accept the possibility of the existence of a trans child. They rejected our child and through that rejection, our family entirely. In a parting gesture, they pleaded for us to read ‘Delusions of Gender’. This very book had been the germ of our now former friend’s belief that any trans identity is a delusion, and that pandering to childhood delusion is parental abuse.

Through my shock and upset, I was struck at the time by the unbelievable arrogance. The recommendation that instead of loving my daughter, I should ‘read up on Fine’ and learn that gender isn’t real. This was not to be the first such recommendation.

Fine’s work is populist and best selling, and over the years I’ve had countless similar comments from ‘well meaning’ individuals. It is not that I am ignorant or closed minded, far from it, I’d hazard I know more of Fine’s exploration of gender than those dabblers. I have read, considered, understood the theoretical position being proffered. The same cannot however be said of the Fine pushers. Their position is based on an assumption (from those who have no first hand experience of trans children) that trans children do not, indeed cannot, exist.

The recommendation to read Cordelia Fine is also, depressingly, front and centre in the advice that the UK Children’s Gender Service’s website provides for parents of trans kids. No space here for a clear and much needed message that ‘some kids are trans – get over it, try to be kind’. Instead they present a false dichotomy between simplified biological essentialism reduced to mention of “a boy’s brain in a girl’s body” and “academic psychologist Dr Cordelia Fine” and “gender as a social construct”, with differences based on experiences rather than biology. Parents wondering whether to accept and love their trans child are instead advised to read about the delusion of gender.

When parents and their children reach the children’s gender service in the UK, if they are allocated one of several apparently deeply transphobic clinicians (clinicians who hold so much power over trans children and families), they may then endure literally years of probing and questioning on parental views on gender, as the clinicians probe for the ‘root cause’ of gender diversity.

The social constructivist view also makes me think of the school teachers and class parents and wider community who argue that a child is too young to make a ‘choice’ to be trans and should wait until adolescence or adulthood. Who don’t see the harm of denying a child a happy childhood.

It makes me think of the people who look at us with suspicion, hostility, scrutiny, when I mention I have a trans child. Of the parents who steer their child away from ours, in case being trans is socially contagious.

It makes me think of the people who are no longer in our family’s life, who are unable to see a trans child as anything other than ‘social conditioning gone wrong’.

It makes me think of the people online and in person who target parents of trans children and accuse them of child abuse for loving their child. It makes me think of the haters who want trans children erased from our schools and communities. Who want trans children to be marginalised, made invisible, kept apart from other children.

The existence of trans children poses a challenge both to the simplified biology of biological essentialism and to social constructivism (the idea that gender is merely a performance).

Who cares whether or not biology has any role?

Many people argue that it should not matter whether being trans is partly influenced by biology or fully shaped by culture, society and upbringing. They argue that acceptance will not come through identifying a ‘cause’ for transness, but through people getting to know trans people.

I imagine and hope that acceptance will gradually emerge for trans adults. I think things are slowly moving forward.

What about trans children though? How do we ensure that gains in acceptance and visibility and legislative rights do not leave out trans children, the most vulnerable, those without a voice.

Too many advocates for the rights of trans adults are silent on the topic of young trans children. Many have no understanding or awareness that trans children exist. Others, consider trans children too controversial, too divisive to stick up for.

Trans children are nearly completely invisible. And whilst there remains a default assumption that gender identity is shaped not at all by biology but purely by culture and upbringing, then there will remain a reluctance to support younger transgender children.

Those who believe that gender is purely a performance, who believe that trans identities are socially constructed, do not believe in the existence of young trans children.

The erasure of trans children allows haters to paint themselves as crusaders saving children from being socially influenced or indoctrinated into being trans.

With no openness to the possibility of a trans child being part of natural diversity, they look for a reason. With young children it is blame the parents. With older children it is social contagion. In the first scenario they advocate removing children from abusive parents. With the second scenario they ask that trans identities never be mentioned, embraced or supported at school. For parents who are afraid and unsure how to react to a trans child, they advise conversion therapy.

Another way

Yet, as soon as people open their minds to the idea that there might be a (complex, messy, unattributable) biological underpinning to trans identities, that trans children exist, and have in fact, always existed, the whole deck of cards upon which the transphobes build their hate comes crashing down.

This opening of minds is possible. This opening of minds and shifting of world view happened to me.

Growing up as a gender non-conforming feminist, tired of sexist societal restrictions and expectations, I was instinctively drawn to a social constructivist view point. I had never met a trans person, but had subconscious, lazy, uneducated assumptions about trans people being enthralled to gender stereotypes. I have former friends who are still tied to this world view.

My world view was shaken when I had the good fortune to have a child who opened my eyes. An assigned male child who was insistent, consistent and persistent that she was a girl from the youngest age.

Learning to reset my assumptions

At first, I really struggled to accept my child as a girl. I told her she was wrong. Mistaken.

I did not believe it was possible for a young child to be trans.

I was certain that this child was too young to understand or reject gender norms or sexism or heteronormativity. I knew they were not making a choice, and certainly weren’t being influenced to be trans (she had never come across any representation of a trans person and I was unconsciously transphobic). She wasn’t even gender non-conforming in her interests. A suggestion I sometimes hear (from people who have barely met a trans person) that she was repressing internalised homophobia in infancy is absurd.

She had a persistent, consistent, insistent knowledge that she was a girl that withstood all forms of persuasion.

Like hundreds of parents all around the world who have experienced the same, I had to learn to reset my assumptions about gender identity. I learnt to love and accept my child for who she is. I have never looked back. She is happy and thriving.

I see how people who emphasise ‘gender as a social construct’ utilise that simplistic maxim to make my daughter’s life impossible. How they use it to argue against her rights. How they use it to accuse parents of abuse.

I see how people who claim genitals = sex = gender similarly use simplified biological essentialism to argue that my child is defined and invalidated by parts of her anatomy.

Neither the simplified biology of essentialism, nor simplistic social constructivism, leaves space for my daughter to exist.

Is there an alternative paradigm?

Holistic views of gender

I recently had a short email exchange with Julia Serano and she kindly shared a chapter she wrote on this topic back in 2013 (Excluded: Making Feminist and Queer Movements More Inclusive – chapter 13: Homogenizing Versus Holistic Views of Gender and Sexuality). What follows is what I took away from her chapter, adapted into my own words – I recommend reading her chapter first hand.

In this chapter, Julia critiques the failings of both simplified biology, (gender determinism) and social constructivism, which she terms gender artifactualism.

She outlines how biological essentialists and biological determinists, (often genital obsessed religious conservatist non-scientists), misrepresent and misunderstand biology and science. They present a simplistic last century school child’s version of human biology, assuming that a simple gene or hormone or chromosome works unilaterally triggering a domino rally of binary outcomes.

She also outlines the failings in social constructivism. For decades children’s gender services were dominated by social constructivists who believed that children could not really be trans and that such children could be engineered into accepting their assigned gender. Yet these efforts failed. Medical consensus is now absolutely clear that conversion therapy is unethical and ineffective – conversion therapy did not change a person’s gender identity, merely produced shame, self-hate and depression. Julia notes that gender identities are often ‘profound, deeply felt and resistant to change’. She notes that some people have a fluid gender identity, and that some people do experience a shift in their identity over time, but that such shifts do not result from external pressure and are ‘almost always inexplicable, unexpected’.

She advocates rejection of both simplified biology (biological determinism) and social constructivism (gender artifactualism). In its place she presents a holistic model of gender.

This holistic model of gender acknowledges that biology is complicated. Human biology is not the simplistic yes/no on/off approach that non-scientists and biological essentialists like to pretend. Real biology is complex, multi-faceted, interactive. Just because some people misuse (simplified) biology, does not mean biology itself is essentialist, deterministic, reductionist or sexist.

Julia notes that ‘the human genome has 20,000-25,000 genes. Any given gene or hormone is affected by countless different interacting factors. Because genes and other biological factors act within intricate networks, any given factor will push a system in a particular direction, but will not single-handedly determine a particular outcome’.

Julia argues that ‘while our brains are shaped by learning and socialisation, they are not infinitely plastic ie they are not blank slates. Some traits have a strong intrinsic component’. She notes that though ‘socialisation has a significant impact on brains and behaviours’ it ‘cannot fully override certain intrinsic inclinations’.

She makes a comparison with left-handedness, which is observed in utero before any socialisation. Even with societal pressure to conform to right-handedness some individuals maintain a preference for using their left-hand.

A holistic model of gender allows space for a biological underpinning to gender identity. A holistic model of gender considers the complex interactions between biology, society, experience.

Biological underpinning to gender identity

A wide number of scientific studies have concluded that there is a durable biological underpinning to gender identity.

This supports what other parents with experience like mine have been saying for decades from their lived experience. This backs up what some trans adults remember from their earliest childhood memories.

There is increasing evidence of trans children who have clear gender identities at a very young age. This evidence of young trans children is present in diverse countries and cultures across the world.

The growing scientific consensus of a biological underpinning to gender identity led to the global endocrine society publishing a position statement last year:

“The medical consensus in the late 20th century was that transgender and gender incongruent individuals suffered a mental health disorder termed “gender identity disorder.” Gender identity was considered malleable and subject to external influences. Today, however, this attitude is no longer considered valid. Considerable scientific evidence has emerged demonstrating a durable biological element underlying gender identity. Individuals may make choices due to other factors in their lives, but there do not seem to be external forces that genuinely cause individuals to change gender identity.”

(for the full position statement and more on the studies see here)

I welcome this consensus. I view it with hope that it will help open eyes and minds and hearts to the existence of trans children like my daughter.

I would happily share this scientific consensus on a biological underpinning to gender identity with a wider audience – I see in it hope of greater acceptance and support for trans children.

However I note that since the publication of this evidence based position statement from the medical establishment, I cannot recall having seen this printed in the media or even referenced in the few articles commissioned by trans authors. Indeed quite the opposite – more often there is a strong resistance to any mention of biology.

Do we have to reject biology?

I understand the scepticism around how biology can be misused, but surely that does not mean this should be rejected outright?

Whilst supporters of trans rights shy away from biology and science, it allows transphobic groups to present themselves as champions of science and rationality. Claims that couldn’t be farther from the truth.

Transphobes focus on gender as performance, as fake, as a delusion. Whilst a huge part of what we call gender is socially constructed, my child’s gender identity is not a choice, is not a delusion, is not a product of societal or parental persuasion.

Transphobic groups like to focus on what they simplistically call biological sex. They describe biological sex as a simple binary reality, with gender identity operating on some parallel dimension outside of biology. My daughter is 100% biological. She does not have a magic gender identity spirit disconnected to her biological body. Her biology is no less real or valid than the biology of cis girls. It is not essentialist to claim that her identity is an integral aspect of her biological reality. The true essentialists are those trying to present a simplified and fraudulent version of biological science, utilising distorted, cherry picked and biased pseudo-science to support a transphobic position.

Acknowledging biology without essentialism

The argument that we should avoid science in case it is essentialist or in case it is used against trans rights is a false logic.

  • It is possible to acknowledge the biological underpinnings of gender identity whilst acknowledging that a person’s felt and expressed gender identity is a complex interplay of biology, culture, socialisation and experience.
  • It is possible to acknowledge the biological underpinnings of gender identity whilst simultaneously recognising that identity is neither fixed, nor binary.
  • It is possible to acknowledge the biological underpinnings of gender identity whilst arguing very strongly against diagnostic testing for ‘transness’ or biological gate-keeping and identity policing.
  • It is possible to acknowledge the biological underpinnings of gender identity whilst maintaining that the only way to know someone’s gender identity is to ask them, and that a right to self-identification is a basic part of dignity

My daughter is real and valid and deserving of rights, equality, respect and dignity regardless of our current understanding of science.

But science already has plenty of evidence that trans children exist and that there is a biological underpinning to gender identity and I see no reason not to talk about this. Having a trans child (or being a trans child) does not mean rejecting science.

We should embrace science

My daughter is growing up with a love of science. A thirst for knowledge. I’ll teach her all the science I know, on microbiology, on chemical reactions, on photosynthesis, on plate tectonics. On neurology, on genes, on hormones and gender identity. On sample sizes, on causality, on peer review, on rigour, on interpretation and data manipulation.

Biology is rich and complex and we have so much still to learn. If she carries on with a love of science she will learn things far beyond my knowledge. Science (high quality science) is full of wonder and excitement and discovery.

We should not be afraid of saying loud and proud that we support science. We should be clear that those attempting to attack or dismiss transgender children and adults not only lack empathy and kindness, they also lack sophisticated understanding of science, of biology, of complexity.

Trans children exist.

They know it.

Parents know it.

Science knows (a bit about) it.

Stand up for trans children

 

 

I am (and always will be) learning. Friendly feedback is welcomed.

 

 

Girl Guides: How to radicalise hate against trans children in 10 easy steps

supporting trans members

Tomorrow, following a short but successful propaganda campaign, a UK Newspaper will publish an open letter asking Girl Guiding UK to suspend their policy of inclusion for All Girls, including those who are transgender.  Guides has always, quietly, been inclusive of trans children. While there was a small amount of sensationalist and transphobic media reporting in 2015 when the current policy was formally adopted, until six weeks ago, there has been no organised attack on the organisation which my daughter is a part of. Why now? What has changed to make Girl Guides, Brownies and Rainbows a target of action from transphobic groups? This is not a random act, but follows concerted attempts by trans exclusionary groups to influence thinking within the UK Labour party on whether trans women should be included on All Women Shortlists.

It is part of the wider context of a small but vocal and increasingly organised loose coalition of groups made up of Evangelical lobbyists such as Christian Concern, radical feminist academics, misogynistic Men’s Rights Activists, reactionary conservative voices, and a growing grass roots anti transgender rights movement which has formed around the parenting forum ‘Mumsnet’. There, with few restrictions on content, under a banner of free speech, these groups have found one another, have radicalised and organised without challenge or moderation, united behind a single purpose – preventing advances to the rights of transgender people in the UK.

The campaign against inclusion of transgender women on Labour Party All Women Shortlists was the first active campaign to find an audience outside niche anti transgender corners of social media. This anti-trans equality campaign included a crowdfunding initiative calling for legal challenge to Labour Party policy, petitions to the Government, multiple linked websites promoting (mis)information, national public speaking tours by trans exclusionary activists. It provided easy media pieces for an already transphobic UK media, satisfying the UK Public’s seemingly unquenchable interest in stories written about (but not by) transgender people.

Girl Guiding are the next and latest focus of this anti trans rights coalition. Strategically, Girl Guides are seen as a soft target. Transgender children have little support, are regularly maligned by the mainstream press and importantly have no voice or right of reply.

The campaign built against Girl Guiding has been so rapid, so honed, that without knowledge of the context and the anti-trans equality groups involved, it could be misinterpreted as representing the concerns of the guiding movement. Instead of what it actually represents, the latest target of existing transphobic political lobbying by a small but active group of dedicated anti trans equality activists.

Here I present a 10 step guide to ‘how this campaign against trans girls and Girl Guides has played out’. And in response, rather than engage with their hate, I’ve simply listed 10 more productive activities that our daughter, a trans member of girl guiding, and the target of this campaign, has been engaged in during the same period.

Ten Steps to Raising Hate against Trans Children

Step 1: Take a committed transphobe with multiple anti-transgender websites.

Step 2: Get invited onto The BBC Victoria Derbyshire show (05/03/18) to discuss reform of the 2004 Gender Recognition Act (Spoiler, this act and therefore this discussion has no relevance to trans children –  trans inclusivity is already covered by the 2010 Equality Act).

Step 3. Veer off topic with a hypothetical story about a predatory 14 year old boy pretending to be a girl to assault 11 year old girls at guide camp. Use this to publicly criticise Girl Guides for having a long standing approach welcoming All Girls, including those, who happen to be transgender.

Step 4: Create a thread on Mumsnet (home of transphobic discussion) to stir up hate and radicalise a wider population against a vulnerable minority (trans girls).

Step 5: Set into action existing anti-trans children websites and social media platforms, spreading fear and hate.

Step 6: Launch new anti-trans-children Facebook groups specifically to campaign against trans girls being accepted in Girl Guiding.

Step 7: Reinforce inflammatory talking points to enable radicalisation of people against trans children: focus specific attention on ‘child on child sex abuse’

Step 8: Send Mumsnet thread to friendly transphobic Times journalist for yet another attack piece in a long running campaign against transgender children. Have anti-trans-children story picked up by multiple other national newspapers.

Step 9: Inundate Girl Guides HQ with letters and emails, in an attempt to pressure Guiding to change their trans inclusive approach, adding veiled threats of legal action.

Step 10: Get your friendly anti-trans newspaper to publish a letter demanding that Girl Guides review their Transgender Policy (This Sunday, according to Mumsnet, the oracle on all things transphobic).

How to respond?

How can a mum like me fight back against such organised hate? How can I keep my daughter safe?

I write an anonymous blog. I have no power, no influence. I can count upon a tiny handful of allies willing to stand up for trans girls like my daughter.

There is no ‘powerful transgender lobby’ to defend us. I wish there was. There are no trans newspaper editors, no trans judges, no trans MPs.

It is hard to deal with so much hate. It is hard not to feel afraid. To feel like my country is not a safe place for my child. But life carries on.

Girl Guiding has been strong in their refusal to bend before a building anti transgender media, and have reinforced their commitment to All Girls in public statements. I am confident they will not waver in their commitment despite the latest media onslaught.

While incessant transphobes devote days upon days to making my (transgender) daughter unsafe and unwelcome, she’s been getting on with her life. Whilst they spread lies, misinformation, and hate, let’s see what my trans daughter has been up to:

10 better ways to spend your time

1: Learning British Sign Language to be able to better communicate with a deaf friend: https://www.youtube.com/watch?v=VRYQayi9czM

2: Going to school, learning stuff, (same as every other child)

3: Enjoying a Guides celebration of Mardi Gras (dancing, eating, painting)

4: Practicing tent building skills (indoors as it was snowing!)

5: Going to the cinema, eating popcorn

6: Attending a talk by local police officer on women in policing

7: Building a fire in the garden – attempting to make smores – giant mess

8: Reading Harry Potter (again!)

9: Eating too many Easter eggs (trading white chocolate eggs with younger sibling)

10: Laughing, smiling, talking, sleeping, loving, dancing, dreaming, living.

 

It is easy to paint trans girls as a scary menace.

My child is not a risk. She is not a threat. She is not scary.

She loves camping with her friends, staying up late, eating marshmallows (& smores) and telling ghost stories.

Anyone who knows a trans child like my daughter, can see how ridiculous anti-trans girl fear-mongering is. She is just like any other girl.

Those inciting anti trans fear, prejudice and hate know that the public don’t know any trans people, much less trans girl guides, brownies, rainbows. They rely on this ignorance.

Inciting hate against trans girls is not balanced ‘debate’. This is hate against a defenceless and vulnerable group of children.

No wonder trans children are at breaking point and the UK has become a dangerous place to be transgender.

No wonder, according to Stonewall’s School Report, 84% of trans children in school have self-harmed.

Anyone reading this who is a parent or carer – how would you feel if a child you love was the target of a cruel hate campaign? If they were being targeted just for being different.

My child is not a risk. She is not a threat.

She loves painting, hiking in the country, climbing trees, camping with her friends. She loves dancing like no-one’s watching.

My daughter is wonderful, kind, sweet (brave, clever, strong, and funny) and she loves Guiding.

Girl Guiding’s motto is ‘For All Girls’. Girl Guides is inclusive of deaf girls, girls with disabilities, girls from different ethnic or religious groups, and yes, trans girls too. Diversity. Inclusion. Kindness.

That includes my daughter.

Update 15/04/2018:

This morning the letter was published in The Sunday Times. Of the 100,000 volunteers in Guiding a paltry 220 people signed the letter who claimed to have some involvement in Guiding of whom a meagre 12 are current leaders. This demonstrates just how fringe these anti trans rights views are within Guiding, the wider British public and the UK Media led by the Times.

This last month and the last year or so has been a truly frightening time to be parents of a child who happens to be trans living in the UK. A week ago we were near to coming to the difficult decision to withdraw our child from Guiding as we were concerned her presence might not continue to be welcome. This would have been giving in to the bullies something we have raised our daughter, supported by Guiding to stand against.

We want to thank all those who have sent messages of support by email, Facebook, twitter from all corners of the world. Girl Guiding truly is a global movement and we’ve been overwhelmed by the positivity and solidarity in the face of these bullies.  Thank you to Girl Guiding UK, Chief Guide Amanda Medler, and the UK media communications team. Thank you to the incredible leaders, both locally and throughout the UK who have helped us stand strong, either because they have a trans child, sibling or family member, have a trans child in their section, or who simply because they wanted to help spread the message that Guiding is for all girls.

Thank you,

thank you,

thank you.

 

#ForAllGirls

GPs and trans children – BBC drama ‘Doctors’ and the UK Gender Identity Development Service

dr

BBC show Doctors included a trans teenager, and their mum meeting with a new GP. The show certainly had made an effort to provide an accurate and appropriate portrayal of a trans adolescent, so does score some points. It did also include some misleading stereotyping of trans children, and ignorance/misinformation on NHS protocols and timelines. I hope upcoming ITV drama Butterfly will do even better.

The first segment was the worst for misrepresenting the experience of parenting a trans child, and for perpetuating lazy stereotypes.

The child is described by the mum as ‘born a boy’ who ‘liked girly things’. The emphasis in the first segment is on the child’s interests, toy preferences, clothing preferences, not on the child’s gender identity. A later segment makes clear the child had identified as a girl her whole life, but this is not mentioned in the first segment.

The focus on non-conformity is misplaced – many trans girls I know are not especially feminine or especially in to girly toys – trans girls are not the cliché of femininity the media leads you to believe.

The first segment suggests that the child one day stated ‘I want to be a girl’ and the parent switched pronoun. It mentions that two years later the child is on puberty blockers. It makes it sound so straight-forward. This unlikely scenario is a misrepresentation of the current NHS pathway for gender variant or trans children and does not match the experience of many families who I know.

Let’s look at a more realistic scenario.

A child, assigned male at birth, states ‘I am a girl’. Frequently. Consistently. Insistently. Persistently. (sure some children are less insistent, some are more fluid, some less clear – in my experience only the ones who are extremely insistent are likely to be supported to socially transition at a young age – it is a huge step in this gendered and transphobic world).

The parent spends months or often years telling their child that they can be a non-stereotypical boy, as non-stereotypical as they like, so long as not trans. Perhaps they say things they will later regret, like it is not possible to be trans, or that your genitals define who you are.

The parent spends months or years reading and learning, working through their own ignorance, fear and transphobia (I have met very few cis parents who did not have to first work through a lifetime of unconscious transphobia).

During this time while the parent finds the knowledge and understanding (and courage) to listen to their child, the child gets increasingly distressed and withdrawn – being rejected by your family is hard on a child.

The parent finally takes what feels like a monumental step of booking an appointment with their GP. The media may have led them to believe that things happen quickly from that point, so the parent may have delayed visiting their GP until the child is in puberty and increasingly distressed.

In, as a rough estimate, half of cases the GP refuses to refer the child to the children’s gender service, sending the parent on an unnecessary 12+ month delay via children’s mental health services. Or the GP tells the parent to come back in a couple of years. Or to come back at age 16. Or the GP flat out tells the parents that kids can’t be trans and they shouldn’t pander to a delusion. This happens a lot.

Parents with transphobic or ignorant GPs go away without any help, only returning to the GP when their child is extremely distressed, depressed, self harming or suicidal.

If they are lucky enough to get a referral from a GP to the sole Children’s Gender Service (In England and Wales), and the referral is accepted, the parents then wait in limbo for a further 14 months for a first appointment. 14 months. For an increasingly distressed child.

Once they get to the gender service the approach is extraordinarily slow and conservative, frequently breaking international guidelines that recommend puberty blockers at tanner stage two. It is often 1-3 years before approval for blockers (even for children who reach the service when puberty is well underway).

Clinicians have all the power and are quite keen to emphasise that the teenager and their parents have no rights whatsoever on whether the service will ever prescribe puberty blockers. Trans children feel this powerlessness, adding greatly to their stress and anxiety at what is already a very difficult time of progressing puberty.

Puberty blockers, let’s not forget, are a safe, reversible and proven effective treatment that has been in use for cis kids (in precocious puberty) since the 1970s, that in countries with a less transphobic health system are prescribed to trans kids (or gender diverse kids distressed about puberty) promptly at the start of puberty. A treatment that is recommended by the international experts on these issues – WPATH (The World Professional Association on Transgender Health) and the International Endocrine Society. A treatment that has been shown to be effective for trans children since the early 1990s.

If approval for puberty blockers is eventually granted by the (monopoly) children’s gender service there is a referral (and further wait) for the endocrine service, with several further appointments (each requiring further trips to London and further days of missed education (and lost earnings for parents) for yet more 1 hour appointments) before prescription of blockers.

Then the parents and child are left to manage a drawn out discussion between the NHS endocrine service and their GP about who will administer the puberty blockers (a simple injection) and who will take on responsibility for the ongoing prescription.

The NHS endocrine service says the NHS GP should do this. The GP usually refuses, claiming that this simple injection, that has been deemed necessary by NHS specialists, that they already administer to cis children, is ‘specialist’ knowledge that they are allowed to refuse to administer (just because the child is trans). Parents are left to sort out this incompetency between different wings of the NHS.

In our realistic example, the parents are now trying to keep safe a desperate teenager  who has been waiting for years for the medically necessary treatment that they need and have a right to. Reports of self harm are common. These parents sometimes have to teach themselves how to administer an NHS prescribed injection as they can’t find any NHS workers locally willing to do this for trans adolescents. A simple injection that has been prescribed by NHS specialists which the local GP and nurses refuse to administer. Stressed adolescents are injected by a parent who has never before given an injection as their GP surgery has neglected their patient.

This is for a treatment that is already given as standard to 6 year old cis kids in precocious puberty. Because we can’t have a 6 year old cis girl with periods and breasts but that is fine for a 14 year old self-harming trans boy. Because we can’t have a 6 year old cis boy with a beard but that is fine for a 15 year old trans girl.

It is basic anti-trans children discrimination in health care.

The BBC show ‘Doctors’ includes a further brief reference to sex hormones. The mum states that the only way of getting hormones pre-age 16 is to go to the US. The GP shows a face heavy with scepticism and talks about safe-guarding. It would have been appropriate here to mention to Gillick competency, a concept familiar to all doctors. Across all areas of medicine adolescents are able to consent to complex irreversible medical interventions if they are deemed Gillick competent. The same benchmark should be applied to transgender adolescents.

The segment on sex hormones omitted to mention that provision of hormones before the age of 16 is deemed medical best practice in many clinics in the USA and elsewhere in certain circumstances – based on the benefits of peer concordant puberty (going through puberty at the same time as peers), due to recognition that children with a long track record of fixed trans identities are not going to suddenly change gender identities at age 15.

A well-informed GP would have also mentioned the global Endocrine Society’s 2017 guidance stating: “We recognize that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years”.

The mum in the BBC drama also makes a reference to “the operations” – a statement which is not clarified. There is so much ignorance about trans children in the UK that the fact that surgery is not considered for trans girls until adulthood does need stating.

One thing the show did portray convincingly is the parent pretty much begging a not-transphobic and slightly clued up GP to care for and advocate for her child. The programme ends with the GP in an ethical dilemma about whether to agree to be this child’s GP, and whether to be willing to state medical facts about accepted best practices for trans children’s care in a family court. Why is this an ethical dilemma? If the family were following any other medical specialist recommended health care, the GP would not consider it an ethical dilemma to defend this in family court.

The real ‘debate’ and ethical dilemma when it comes to GPs and trans children is why is there still such varied and poor practice? Why are desperate families encountering ignorance and transphobia from GPs? Why are GPs allowed to opt out of administering medically needed treatment that has been prescribed by an NHS specialist? Why are GPs treating trans children so much worse than cis children and why does no one care?

And if you want to a good indication of the wider institutional transphobia across the NHS that allows this poor healthcare for trans children to go unchallenged, look no further than the nonsense hokum that is “Rapid Onset Gender Dysphoria”. NHS children’s specialists have referenced ‘Rapid Onset’ in a presentation in a way that did not make it clear to service users and the general public that it is junk science.

In Canada, meanwhile, specialists working with trans children have endorsed a condemnation of Rapid Onset Gender Dysphoria as junk science, bunkum and quackery.

Where is the similar condemnation from the UK Gender Identity Development Service? I won’t hold my breath.

Given the poor state of the UK specialist service, whose protocols are outdated and not fit for purpose (with a 14+ month wait for current first appointments), we need GPs to step up and do more. GPs cannot continue to refuse basic care for trans children and adolescents. GPs cannot continue to claim that simple health care for trans adolescents is ‘too specialist’. It is discrimination clear and plain.

 

Update:

In episode 2 the GP goes to see a psychotherapist who tells him that the majority of socially transitioned 14 year olds change their minds. This is an outright falsehood.

Even the discredited Zucker/Steensma studies showed 14 year olds were extremely likely to maintain a trans identity.

The latest studies (Olson 2015 and Fast 2017) show that trans children have a clear identity at a very young age, that their identity is as valid and consistent as any other child’s.

The latest stats from Australia showed “From 2003 to 2017 96 percent of all patients assessed and diagnosed with Gender Dysphoria continued to identify as transgender or gender diverse into late adolescence”.

The ‘expert’ knows scarcely a thing of the latest evidence-based scientific consensus on care for transgender children.

My Daughter is that ‘Scary Trans Kid’ the BBC warned you about.

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I am crying and sad and afraid – watching yet more hate and fear-mongering thrown at trans children, specifically at girls like my daughter.

The BBC Victoria Derbyshire show (05/03/18) want a discussion on the Gender Recognition Act. An act that at present only applies to adults and only relates to birth certificates. Not, as they are discussing, access to changing rooms or toilets.

An act that bears zero relevance to the Girl Guides having a progressive policy of welcoming trans  girls.

Yet the BBC gives air time to the worst type of bigotry – raising fear about the threat my young daughter poses if she goes on a camping trip with her friends. .

No wonder trans children are struggling in the UK RIGHT NOW

Take any other minority. Take Muslim children, or black children or Jewish children, or neuro diverse children.

Would the BBC give air time to a person saying that Jewish girls are a threat to other girls? Would they say that parents need to be made aware of any Muslim girls going on a camping trip?

Would they allow such hate to go unchallenged?

Why is it fine to throw my child under the bus time and time again?

And to have this dangerous, scary, legally and morally wrong rhetoric of trans children being a threat utterly unchallenged?

With two trans panellists who were clearly out of their comfort zone on the topic of trans girls like my daughter.

One trans panellist even seemed to agree, focusing on the importance of careful ‘trans’ risk assessments before camping trips for children.

My child is not a risk. She is not a threat. She does not need a risk assessment. She is not to be feared.

She would love to go camping with her friends. She is a child.

She’d love to stay up late and eat marshmallows and tell ghost stories and play and laugh

How dare the BBC present trans girls in girl guides as a safety concern?

How am I meant to keep my child safe when even the lovely Victoria Derbyshire gives space to this outrageous hate and fear-mongering?

How dare the panel nod and agree that this scare-mongering against vulnerable children is balanced?

I don’t blame Rebecca Root or Clara Barker both incredible women.

They did a better job than I could of at staying calm in the face of such prejudice.

They were brought on to talk about the Gender Recognition Act not to talk about trans children.

But wake up people! We know that those opposed to trans rights are targeting trans children.

We know they quickly turn discussions to focus on children.

This is their standard approach. One of the panellists was even the public face of a website which explicitly states trans children are a ‘trend’ simultaneously denying their existence.

They do this because focusing on children is an easy win for those opposed to trans equality. They are defenceless.

They know that, like today, trans adults are often hesitant about speaking up for trans kids, possibly as the experience of socially transitioned trans kids today is outside of their direct experience.

They know that the UK public are totally ignorant about wonderful trans children like my daughter.

It is hard to stir up fear about trans women when sat opposite kind intelligent articulate trans women.

But without any young trans children on the show it is easy to spread fear about an unknown.

It’s easy to paint trans girls as a scary shadow.

The people who know trans children like my daughter see how preposterous this fear-mongering is.

She is just like any other girl.

But those raising anti-trans fear know that the public don’t know any trans girl guides.

They rely on this ignorance. They don’t care about the impact of this fear-mongering on my child.

Can you imagine being a 10 year old girl, happy to be moving up from Brownies to Girl Guides, excited to be going camping.

And watching the BBC describe you as a threat to your friends.

No wonder trans children are at breaking point in the UK.

The UK is not a safe place for my child and with every ‘debate’ which allows lies and misinformation to go unchallenged it becomes more dangerous.

How am I meant to tell my wonderful kind sweet (brave, clever, strong, funny) girl that everything is going to be alright when I just don’t have hope?

This country is a scary place to be a trans girl.

I am scared and I have had more than I can bear.

This is not balanced debate.

This is hate.

This is intent to incite fear and prejudice against a defenceless and vulnerable group of children and the BBC has once again provided the platform.

This is not ok.

This is never ok.

World. Be Better.

 

P.S. The photo is not my daughter. But is a wonderful trans girl (Rebekah) who deserves all the care and kindness and happiness the world can send. That girl’s mum (Jamie) blogs here

The Erasure of Trans Children

transgender children erasure

The current Scottish trans Gender Recognition Act consultation refers to ‘evidence that socially transitioned 16 year olds’ exist – but fails to include any acknowledgement of the existence of trans children under 16.

This got me thinking of the erasure of trans children.

All too often trans children are completely erased from discussions.

Without visibility this most vulnerable group of children continue to have their basic rights denied. All too often, trans allies and advocates avoid any reference at all to trans children – it’s too political, too controversial, or too outside of their personal knowledge. Trans children can just wait until they are 18 for fair treatment right? Maybe we can wait until the following generation, after trans adults achieve equality, and then consider trans children. Maybe your trans great grandchildren will be treated well.

Whilst trans advocates and allies pretend trans children don’t exist, the people who are left talking incessantly about children are those opposed to trans equality. Transphobes and trans-antagonists, railing ‘just think of the (cisgender) children’, ‘save them from the trans menace’!

Aside from a couple of notable exceptions (including Paris Lees) who exactly is speaking up for my child? Who cares about trans children?

I decided to do a small piece of simple research into the visibility or erasure of transgender children. I looked at the 208 submissions to the 2015 Women’s and Equalities Committee’s Transgender Equality Inquiry.

For each submission I searched for the use of the term ‘child’ (a search which will also find any references to children, childhood etc).

My results were pretty interesting. More detail is at the bottom of the post, but I’ll summarise the key findings here:

Over half of the submissions (58%) gave zero references to children (trans or cis). This included the vast majority of submissions from transgender adults, the submissions from nearly all government departments, from MPs, from Police forces, from the Royal College of GPs, from Action for Trans Health, from the Albert Kennedy Trust.

A further 16% only used the term children in reference to the (presumed cis) children of trans adults, to intersex children, or in a phrase like ‘looked after children’. This included the British Association of Gender Identity Specialists and the General Medical Council.

Three quarters (74%) of submissions contained zero references to the existence of transgender children

15% had only one or two very brief references to transgender children, some of which avoid acknowledging the existence of trans children. Both NHS England and Stonewall only mention children in reference to the existence of a “Children’s Gender service“. The Equality and Human Rights Commission manages only two references to “gender variant children” or “children whose gender identity is less well-developed or understood than that of an adult”.

89% of submissions to the 2015 Women and Equalities Commissions Transgender Equality Inquiry either didn’t mention children at all, or barely mentioned them.

The remaining 11% of submissions is where I now turn my attention:

 Submissions that referred to children more than twice:

Only 23 submissions (11%) referred to children more than twice.

These can be roughly divided into three categories:

a) 7 submissions (3%) were from anonymous parents of transgender children/transgender children – This included 6 parents of transgender children, and one trans young adult who had been treated in children’s services. These submissions contained credible and relevant real life information on transgender children (but there were only 7 submissions from the families affected). These submissions were all anonymous – a great indication of how voiceless these children are.

b) 7 submissions (3%) were from people or organisations whose submission is supportive or neutral towards trans people, these included:

  • FOCUS: The Identity Trust provides 3 references to transgender children and 2 to gender-variant children
  • GIRES provides 4 references to transgender children, but doesn’t use the term ‘transgender’, simply calling them children (though in the context the references are to trans or gender variant children)
  • Lancashire LGBT provides 16 references to trans children,
  • Mermaids provides 21 references to trans children, children referred to gender services or children with gender dysphoria
  • Peter Dunne provides 5 references to transgender children
  • Polly Carmichael from the Children’s Gender Identity Service provides 21 references to trans or gender variant children, yet fails to use the term transgender children even once, instead referring to a variety of terms including ‘children experiencing difficulties in their gender development’ ‘unconventional children’ ‘children with GID’ ‘Children with gender dysphoria’ ‘children with gender incongruence’
  • The British Psychological Society is rather a mixed bag with one reference to “rare cases it has been thought that the person is seeking better access to females and young children through presenting in an apparently female way”, with 1 reference to transgender children and 1 reference to children with gender dysphoria.

 c) 9 submissions (4%) were from people or organisations whose submission is negative or antagonistic to trans people:

  • A specific person, SJ, refers to children in terms of the threat posed by adults “luring children into women’s toilets in order to assault them”
  • A specific person, AF, provides 16 references about protecting children from psychologically disturbed individuals and gender ideology
  • Evangelical Alliance provides 7 references to the need to protect children
  • Lesbian Rights Group provides 14 references to children including outlining the ‘pressures on young people and small children to transgender’ and highlighting the ‘transgendering of children – a matter of concern’.
  • A specific person, MY, includes 7 references to protecting children including ‘from possible parental or other abuse’ and recommends ‘treating the parents’.
  • The group ‘Parents Campaigning for Sex Equality for Children and Young People’ contains 65 references to children focusing predominantly on gender expression / toy stereotypes as well as on the need to protect against ‘transgendering children’
  • ‘Scottish Women against Pornography’ has 17 references that confuse gender identity with gender stereotypes
  • A specific person, SDA, provides 11 references to children focusing on gender expression/toy stereotypes and arguing the need to stop the ‘powerful trans activist lobby from pathologising normal childhood’ and arguing against ‘trans theory’
  • ‘Women and Girls Equality Network (WAGEN)’, by Dr Julia Long, contains 13 references to children focusing on stereotypical gender expression/roles and arguing against ‘transgendering of children’.

These 9 trans-antagonistic submissions listed above contain 151 references to children. This is nearly more references to children than the other 199 submissions combined.

One qualification to the above research summary: I only searched for use of the word ‘child’ (or ‘children’). It is possible that some submissions focused on children without using the word children. Some submissions may, for example, have used the term transgender youth or adolescent – a more in depth analysis could consider more search terms – but arguably a decision to utilise the word ‘youth’ and avoid the word ‘child’ in a submission is itself a value judgement on the existence or not of trans children and is itself part of a culture of erasure of trans children.

 

Conclusion

Transgender children are almost completely invisible in society. Trans children need allies speaking up for them.

Yet over three quarters of submissions to the Women and Equalities Commission 2015 Transgender Equality Inquiry contained no acknowledgement of the existence of trans children.

The submissions with the most references to children (cis or trans) are those written by individuals and groups opposed to trans rights. Inputs on transgender children are overwhelmingly written by those ideologically opposed to supporting transgender people. Transphobic individuals and groups are being allowed to set the conversation on children, meaning the actual issues of enormous importance to trans children aren’t even on the agenda. The debate is instead being framed as between (trans-antagonistic or trans sceptical) people who care about protecting children versus trans adults. To re-frame this debate, we need trans advocates to talk about trans children.

Stop the erasure of trans children!

There were over 40 submissions from individual trans adults (or adults with a trans history/adults of trans experience). Almost none of these submissions from trans adults mentioned trans children. Parents of trans children are unable to speak openly (all submissions from parents were anonymous). Cisgender parents of trans children are also sometimes unsure about our credibility speaking out on trans issues. Trans children cannot speak for themselves. Someone needs to speak up.

Hardly any trans-supportive organisations mentioned trans children in their submissions. If your organisation only listens to the voices of trans adults, you are excluding the most vulnerable trans group. Organisations like Stonewall (whose 2015 submission ignored trans children) have a trans advisory panel consisting of only trans adults. Yet it is very clear from this review that transgender adults can’t be assumed to speak up for the needs of current transgender children.

Organisations aiming to support trans equality need to either work with parents of trans children (most of whom are cis, some of whom are trans), or, at the very least, make sure that at least one trans adult is designated to represent trans youth (reaching out to older trans adolescents directly) and we need at least one trans adult designated to represent trans children (reaching out to parents supporting trans children, as the stakeholders who best understand the very many challenges facing trans children).

Without proactive effort to engage with parents and families of trans children, trans children will remain voiceless.

The erasure of trans children in the 2015 submissions to the Trans Equality consultation is shocking.

We must do better for trans children.

Let’s start with the current Scottish GRA consultation (open to submissions from anywhere in the world – and we know those opposed to rights and respect for trans children are submitted from all over the world).

Please complete the short questionnaire on a reformed Scottish Gender Recognition Act. At a minimum please include in your submission acknowledgement of the existence of trans children. Better still, refer to the issues and challenges that affect trans children. If you don’t know any trans children – then get in touch with families of trans children, or organisations like Mermaids.

Trans children exist and they desperately need support.

Don’t leave them voiceless and invisible.

#SomeChildrenAreTrans #GetOverIt

Follow us on twitter @FierceMum and @DadTrans

 

Further info on the findings

Methodology

I looked at all 208 submissions to the Women’s and Equalities Committee’s Transgender Equality Inquiry.

For each submission I searched for the term ‘Child’ (a search which also found any reference to children, childhood etc).

Limitations of the research findings:

1) This research was carried out quickly to give an overview of the data. I looked at all 208 submissions, but quickly and without moderation of findings – some level of errors and oversights are likely.

2) The keyword used was ‘child’  (to include children). It is possible that some submissions focused on children without using the word children. Some may for example have used the term youth. Arguably the decision to utilise the word youth and not child is itself a value judgement on the existence or not of trans children and is part of a culture of erasure of trans children. The Gendered Intelligence submission uses the phrase ‘young trans people’ which refers to “people aged 25 and under”

Over half of the submissions (117 = 56%) gave zero references to children (trans or cis).

This included the vast majority of submissions from transgender adults, the submissions from nearly all government departments, from MPs, from Police forces, from the Royal College of GPs, from Action for Trans Health, from the Albert Kennedy Trust.

Another 16% (34), only used the word children when quoting the title of an NHS Department (eg Child and Adolescent Mental Health Services (CAHMS); in reference to the children of transgender adults, in a generic reference to childhood, in reference to intersex children, and in brief references to children in the phrase ‘looked after children’ or ‘children’s homes’. This group included the British Association of Gender Identity Specialists, the General Medical Council and Gendered Intelligence.

Organisations that refer once or twice to the existence of trans children

26 organisations (13%) had only one or two very brief references to transgender children, copied in table below:

Some of these avoided the term transgender children, only referring to ‘children in the gender service’ for example the single reference to trans children by Stonewall states “The Tavistock and Portman is the only specialist clinic, providing early intervention treatment for children and young people.” NHS England similarly only describes the ‘Children’s clinic’.

Table: Organisations that refer once or twice to transgender children

Organisation Reference to transgender children
The Albert Kennedy Trust “The right of the parent to support a child through their assignment is important.”
Genderagenda “Typically, 1 child per class will come out to me and another will say I know someone trans/non-binary and ask for help supporting them.
The Government Equalities Office has one reference to trans children, quoting Ofsted “Ofsted’s Common Inspection Framework, which takes effect in September 2015 and covers standard inspections of early years, schools and further education and skills providers, requires inspectors to pay particular attention to the outcomes of a number of specific groups, including transgender children and learners.”
A young trans adult makes one reference “I feel that children are discovering what trans means through the internet rather than in a classroom environment, and I fear that as a result, either children would grow up with a slight bias, or children who are trans would not realise this until many years later, when it is more difficult to transition. “
LGBT consortium “Medical interventions for children and adolescents have been inadequate and do not meet international best practice standards”
LGBT Youth Scotland “Further, transgender young people are aware of their gender identity and begin living in their acquired gender far earlier than the age of 16. We recommend implementing provision which would enable parents and carers to give consent for a child or young person to receive a GRC under the age of 16”
National LGB&T Partnership

 

Medical interventions for children and adolescents have been inadequate and do not meet international best practice standards
Outreach Cumbria ‘Fourthly there is no local support for children and adolescents with gender identity difficulties with the nearest (and only) gender clinic being the Tavistock and Portman Clinic in London
A volunteer with the Albert Kennedy Trust “Early access to transitioning and being accepted from a young age is vital to the emotional and mental well being of a trans person and therefore families, social services and the NHS should work with all trans children and trans youths to be able them to decide their future and how they wish to live.”
Support U “Most of the above issues all apply to young trans people, although more education of peer groups of trans children would help”
Terry Reed “Numbers presenting for treatment have grown at ~23% p.a. over the last couple of years. In the children and young people group, the growth is even faster.

inclusion of transgender people: adults, adolescents and children, in sport.”

Trans Media Watch “Louis Theroux’s recent documentary on trans children for the BBC also received much acclaim
UK Trans Info Provide a method for children and teenagers who are below the usual age requirement to obtain gender recognition with the consent of their parents or guardians, or without their consent through the courts where it is in their best interests.
Anonymous “Ensure that those working in proximity with minors are aware how potentially transgender children can and should be helped.
Equalities Officer, on behalf of UNISON Bournemouth Higher & Further Education Branch Ensure the implementation of compulsory, trans-inclusive PHSE curriculum in order that children are made aware of the issues facing trans persons, help trans children access support, and tackle transphobic behaviour before it begins.

Without access to educational information and resources on gender identity, trans children may be placed under undue stress, confusion, and harm. Through the provision of compulsory gender identity education within the PHSE curriculum, work can be done to make trans children aware that they’re not alone, that discriminatory behaviour they may face is not acceptable, and of the support available to them.

University of Leeds Particularly vulnerable groups include intersex bodied people and trans children under 18
Scottish Transgender Alliance With growing social acceptance, the annual number of children and adolescents coming out as transgender has increased five-fold over four years
Anon There is a need for a more robust communication / awareness programme to help parents who believe their children may be gender dysphoric , and how they can help and cope
Anon A close family friend has a trans child who, age 8, told his teachers that he wanted to be a boy and have ‘boy parts’. The school reported his parents to the social services, assuming that the child had been abused, based on no other evidence
Individual Studies indicate that the majority of trans people know they are trans by the age of 7, and many experience distress throughout their childhood. A growing number of children are transitioning, and the lack of any legal recognition until a child is 18 is starting to cause problems, for example with names in school systems and examination certificates.
Individual Inclusion of trans history as a compulsory element of the UK schools national curriculum, linking it to organisational support for trans children, adolescents, their families, and their friends
Individual We need to be intervening sooner, so that trans-children grow up with a chance of fitting in to society and being truly inclusive, and non-trans children will grow up with understanding and tolerance, rather than behaving in a segregatory manner and ostracising trans-people

 

 

On Gender Stereotypes

Someone recently wrote in to this blog, saying, in essence, that they ‘would like to support trans children’s rights, but can’t get over a nagging fear that children who are simply non-conforming are being pushed into identifying as trans’. The writer remembers being a ‘tomboy’ who hated dresses, and fears that such traits in today’s society would lead to her ‘being pushed into being a trans boy’. She asks whether a ‘butch woman who identifies as a woman can still be a woman’.

This is the way that very many people who are ‘on the fence’ about supporting trans rights feel. It is not dissimilar to the way I myself once thought about trans people, back when I had never knowingly met a trans person, back before I knew my daughter, back when a lifetime of ignorant media portrayals had depicted trans people, almost always trans women, as clichés of femininity.

Anyone who finds themselves thinking this way, please take a minute to consider a few things.

First consider where are you getting your information from? Have you met trans people who you consider to be making their lives harder and facing enormous discrimination simply from ignorance that girls can climb trees and boys can like dolls? Or do you perhaps know very few or zero actual trans people, and you are basing your judgement on media portrayals? If the latter, consider whether such media tropes are written by, directed by and feature trans people, or whether they simply project non trans (cis) people’s interpretation.

Second, can you really scrutinise the first statement – that you would like to support a marginalised group’s rights, but only once you have been persuaded by them that they deserve your support. Only once you have been persuaded that they are not naively/stupidly enthralled to stereotypes.

Can you not hear how that sounds?

It is not dissimilar to someone saying ‘yes I’ll support Muslim rights, as soon as they persuade me they’re not all terrorists’, or ‘yes I’ll support the rights of people on benefits, as soon as they persuade me they’re not lazy’ or ‘yes I’ll support asylum seekers rights, as soon as they persuade me they’re not criminals’.

I’m all too aware that certain people on the far right in our society hold all of these prejudiced views.

There is a mainstream portion of our society who would never dream of stating or even thinking those statements. Who understand that these sentiments and generalisations are grounded in media misrepresentation, ignorance and hate. Who would not buy into media vitriol about other minorities, yet fall into the trap of believing that trans rights, and trans children’s rights, need to be earned, can be withheld, are in some way conditional upon those children (and their parents) proving that their specific trans child is not a stereotype, and is not in fact a non-conforming child ‘forced into a trans identity’.

The insinuation that trans children are just non-conforming children being led astray is pervasive, a scare story proactively spread by those who want to marginalise trans people.

This accusation is thrown at parents like myself daily:

Why couldn’t you just let your boy play with dolls? (…she doesn’t like dolls)

Why couldn’t you just let him do ballet and wear a princess dress (…she likes football and prefers witches)

Those accusing us of stereotypes are the ones seemingly obsessed with outdated notions of gender specific toys and interests.

They worry that parental narrow mindedness or ignorance leads us to presume a ‘tom boy’ must be a trans boy, that a feminine boy must be a trans girl.

Because of course us blinkered parents of trans kids are tied to stereotypes and couldn’t love a non-conforming child.

Because of course, in their mind, all trans girls love pink and dolls and sparkly tiaras, and all trans boys must be ‘tom girls’ who hate dolls and dresses.

Having met many score of trans children, this couldn’t be farther from the truth. Trans children, and trans people in general are those who are tearing down the gender boundaries.

Of course we told my daughter that she could be whatever type of boy she wanted to be. This was totally misunderstanding the point and made our child deeply sad.

It is true that media depictions of trans children often focus on gender stereotypes, with pink = girl.

Every time I see any depiction of trans kids on TV I count the seconds until the trans girl pulls out a doll or the trans boy kicks a football. But guess what. I know scores of trans girls who had zero interest in dolls or dresses. I know trans boys who collect dolls.

Trans children are no more stereotypical than any other children.

The same for trans adults of course. Some trans women are extremely glamorous and feminine (just like I know some cis women who are always in dresses and makeup). Some trans women wear jeans and t-shirts and rarely if ever use makeup – just like me and tons of cis women. Gender expression is not the same as gender identity.

If you are ‘on the fence’ about whether to stand up for trans children, please question where you are getting your assumptions about transgender children from. If it is coming from a transphobic and ignorant media, or if it is coming from anti-trans children political groups, consider if the information you receive is biased, loaded or spun. Would you accept rhetoric about Muslims from Britain First?

On Media Tropes of trans children

I’ve identified three key factors why the vast majority of media does not present a true picture of trans children:

  1. Media stereotyping
  2. Societal expectations
  3. Personal narratives (of children and families)

1. Gender stereotypes are pervasive in media coverage of trans children. There are many reasons for this:

Media stereotyping: TV shows regularly confuse gender identity with behaviour, toys or interests. Some media pieces seem to do this maliciously, to undermine the validity of trans children, to suggest to unaware viewers that non-conforming children are being made trans. In other media pieces the stereotyping may be unconscious. This is particularly the case when transgender people (directors, producers, narrators) are not involved. Many (but not all) trans adults and parents of trans children are acutely aware of the distinction between trans and gender non-conforming – and of the difference between gender expression and gender identity

Simple soundbites: Documentary producers often seek to tell a simple story, and select and edit soundbites to fit their narrative. This usually reinforces a ‘traditional’ and expected depiction wherein gender expression (eg clothing) and toy preferences (boys = trucks, girls = dolls) are highlighted as synonymous with gender identity. The public as a whole is still poorly informed – many people don’t know what the term gender identity means, many have never heard the term cisgender, or assigned gender, and some are unsure whether a trans girl is someone who was assigned male or female at birth. Documentaries need to ‘hold the hands’ of an ill-informed general public, taking small bite size steps into the world of gender identity. In this context, it is hard for a brief media piece to quickly convey complex and nuanced information on identity. It is much easier to revert to old clichés to help tell the story, looking for soundbites like ‘I adored dolls when I was little’ or ‘I was born in the wrong body’. I’m not denying that some trans people do say these things, and for some trans people this is their truth. But this is not the heart of the story for very many trans people, yet these same clichéd and simplified stories are the ones we see in the media time and again. Reporting on adult trans people seems to be moving towards more complex and nuanced stories about identity – not yet so for trans kids.

Simplified Visuals: Documentary makers like to use imagery to tell their story. A gender identity is not something that can be photographed or visually depicted. Trans kids, like all kids, will have items of clothing of a variety of colours. But it is the photo of a trans girl wearing pink that will make the documentary, that will be selected for the front cover. Trans girls, like most cis girls, will sometimes wear pink. Indeed it is hard to avoid pink in the girls section of most stores. Media images of trans girls almost always show them in pink – this does not mean trans girls wear pink any more often than cis girls. My trans daughter actively dislikes pink.

Participant selection: Some trans girls like football and trousers and climbing trees. Some trans girls like dolls and princesses and pink. Documentaries will give greater emphasis to the latter over the former (I hardly ever see the former shown, despite knowing plenty of trans girls who would rather climb a tree or play a computer game than dress as a princess). Many trans girls will like a wide range of toys, both dolls and cars and will gladly play with both. Which footage will make it into the documentary though? Of course, it will be the clichéd footage of the trans girl with the doll. This is very similar to the clichéd media portrayal of trans women always being introduced showing them putting on make-up. This is part of the truth for some people, but it is manipulative – emphasising stereotypical and clichéd aspects of lives that are rich, nuanced and complex.

2. Gender stereotyped expression may also be more prevalent in trans children, at some stages of their life due to external pressures

Medical gatekeeping: Adult gender identity services, for a very long time, insisted that trans women adhere to restrictive (and often outdated) gender stereotypes as a condition of acceptance for treatment. Trans women who might out of preference dress in a less stereotypically feminine manner were forced to conform to outdated stereotypes in terms of dress and hair style, or be denied support. This type of regressive gatekeeping is still experienced in children’s services, with reports of trans teenagers being told they need to ‘dress in a more stereotypically feminine manner’ or ‘need to sit in a more masculine posture’, or wear certain clothes, or style their hair in certain ways.

Securing support from other children: Trans kids want to gain the support of their peers. Adhering to a very stereotypical gender presentation is a way of signalling their gender identity to other children. When my child was trying to persuade her peers to address her as a girl she took to wearing sparkly hair clips as a visual queue of her identity. One day in the car en route to a party she lost her hair clips. She descended into uncontrollable sobs. When questioned she explained:

‘If I don’t have hair clips in, they will call me a boy’.

Since being accepted as a girl by all her peers, she soon stopped wearing hair clips. It was never about the hair-clip – it was about wanting to be seen by others and respected as a girl.

Asserting identity to parents: Trans kids desperately want to show their parents their identity. Clothing is an obvious route to asserting identity. When we were calling her a boy, my child refused to wear trousers (from a very young age). A very rigid and strident insistence on wearing dresses is for many trans girls a way to communicate their identity to their parents. Gender non-conforming boys like to wear dresses because they like the dress, maybe it sparkles, maybe it has a fun pony on it, maybe it is brighter than the dull colours in the boys section. But for transgender children, clothing is a means to an end, a useful way of trying to communicate and assert their identity. How do you know if it is a gender non-conforming boy or a trans girl? Listen to what the child is saying. Are they focused on liking dresses? Gender non-conforming child. Are they consistently, persistently and insistently saying ‘I am a girl’ and getting deeply upset and depressed when called a boy? That was our daughter. Once our daughter was accepted by us as a girl, her clothing choices gradually shifted to what is now a fairly neutral presentation for a girl – sometimes wearing dresses but most of the time preferring leggings or jeans.

3. Narratives of the child and their parents

Some parents of trans children like stereotypes and some parents like simple narratives that help explain their situation to a sceptical world: Parents of trans kids come from all walks of life. This is not an ideology that only parents with a certain world view sign up to. Trans kids appear in all kinds of families. These families are as varied as wider society, and the families of trans kids will mirror the views and prejudices of wider society.

Some parents of trans kids have very stereotyped and gendered expectations for their children. These parents, when recalling the childhoods of their transgender children, will remember and highlight examples of non-gender conforming behaviour. Such families may well say ‘It made sense that she was a trans girl, as she always liked dolls’. This does not mean that playing with dolls made the parent conclude their child was transgender, rather it meant that once she accepted her child as a girl, she recalled and emphasised examples of non-conforming behaviour that help her understand and accept her child.

Other parents do not have gendered or stereotyped views of children. These parents do not see any clear and simple correlation or causation between the clothes or toys that our children preferred, and their gender identity. Such parents present a more complex and less ‘packageable’ narrative. Such parents do not produce the short media friendly soundbites that documentaries rely on. This more complex parental narrative almost never appears in media depictions of trans children – instead media prefers the parents who say “my child loved dolls so I knew she was a girl”.

Some children need a simple answer: Our daughter has always known she is a girl. Like many children asked to explain her gender identity she cannot do so easily and simply. She quickly got tired of being asked “but why do you think you are a girl?” Gender identity is hard to explain, and adults would struggle to find an answer beyond ‘I just do’. When children assert an identity different to what was expected there is undoubtedly societal pressure to justify how they feel in some way. It would not be surprising to me for children to gravitate to emphasising examples of their own non-conforming behaviour or interests as extra justification for who they are. Especially when this is the depiction of trans children they see in the media. Especially when even the diagnostic criteria used by children’s gender identity services (in the UK and elsewhere) requires stereotypical ‘cross gender interests, behaviour, play preferences’ as credentials for being considered transgender (Gender Identity alone is not sufficient, children are expected to conform to stereotypes of behaviour, clothing or play preferences in order to be deemed gender dysphoric).

There is a popular children’s book written by a transgender girl called “I am Jazz” that seems to equate her liking ‘girls activities’ with being a trans girl. When I first read it with my trans daughter she noticed this and said “that’s silly, of course boys or girls can both like dancing/pink/ballet”. My trans daughter has a more nuanced understanding of the difference between identity and interests. And she shares my dislike of gender stereotyping.

It is possible to criticise some books and programmes about trans children as reinforcing stereotypes without jumping to a rejection of transgender children.

It is possible to dislike gender stereotypes and still want trans children to have happy and safe lives.

It is possible to want the best for gender non-conforming children and still want trans children to be treated with respect, dignity and acceptance.

Those of you on the fence about trans rights can carry on weighing up whether my daughter has proved her ‘not a stereotype’ credentials enough to be shown kindness, respect and acceptance.

I meanwhile will carry on raising a kind, confident, happy child.

I will carry on helping all my children to see beyond the stereotypes, limitations and restrictions society places on girls and boys (and non-binary people).

And I will teach them the importance of tolerance, kindness, and respect, especially for those who we don’t understand, especially for those who are different.

Research update: 12/04/2018

Research evidence is emerging which appears to confirm our experience of parenting a socially transitioned child:

Olson & Enright (2017) in the first ever study of socially transitioned children and stereotyping found that “transgender children and the siblings of transgender children endorse gender stereotypes less than the control group. Further, transgender children see violations of gender stereotypes as more acceptable, and they are more willing to indicate a desire to befriend and attend school with someone who violates gender stereotypes than the control participants. These results held after statistically controlling for demographic differences between families with and without transgender children.”

 

Too young to know their Gender? Constancy research in trans children

 

TransGender_Symbol_Color

The perception that trans children are ‘too young’ to know their gender identity is used as a basis for denying them a suite of rights, and has long been a corner stone of arguments against social transition or timely provision of puberty blockers.

Cisgender (not trans) children are generally considered to know if they are a boy or a girl by a young age. But, not so for transgender or gender questioning children, according to the latest paper written by experts from the UK Children’s Gender Service, including the head of service Carmichael.

Costa, R. Carmichael, P.; Colizzi, M. (2016) To treat or not to treat: puberty suppression in childhood-onset gender dysphoria Nature Reviews Urology 13, 456–462 (2016)

UK Children’s Gender Service experts’ view of Gender Constancy

The Costa (2016) paper has a section on gender identity development. It states that “research has shown that around the age of 3 years, children show a basic sense of self as male or female, owing to their inner experience of belonging to one gender”.

It goes on to note:

“Some research suggests that a developmental lag exists in gender constancy acquisition in children with gender variant behaviour” (reference number 16).

According to the paper “achieving gender constancy represents a cognitive-developmental milestone in gender identity development and is due to the understanding that being male or female is a biological characteristic that cannot be changed by altering superficial attributes, such as hairstyle or clothing”

The belief in trans children having a ‘developmental lag’ in gender constancy leads to this statement “treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender variance compared with gender-dysphoric adolescents and adults

The belief in trans children having ‘a developmental lag” in gender constancy feeds directly into the Tavistock’s treatment protocols, such as proposing puberty suppression only be prescribed to those aged at least 12 “safely above the gender constancy achievement”.

Only one reference is provided for the claim that transgender children achieve ‘gender constancy’ later than cisgender children, reference 16, which is the source of this key statement:

“Some research suggests that a developmental lag exists in gender constancy acquisition in children with gender variant behaviour (reference 16)

If this single reference underpins the Tavistock’s belief that trans children do not understand their gender at the same age as cisgender children, and if this claim has direct implications on the Tavistock’s approach to treating trans children, then it is vital we review this paper.

The paper in question is:

Zucker, K. J. et al.(1999) Gender constancy judgments in children with gender identity disorder: evidence for a developmental lag. Arch. Sex. Behav. 28, 475–502 (1999).

 

Zucker (1999) 

Gender constancy in the Zucker paper is defined as “the understanding that ‘superficial’ or surface transformations in gender behaviour such as activity preferences or clothing style” do not change a person’s gender. The paper concludes that children referred to a Gender Clinic for ‘problems in identity development‘ have a ‘developmental lag in gender constancy‘. This conclusion merits further scrutiny.

Zucker et al.’s study focuses on a group of children who were referred to the Toronto Gender Clinic between 1978 and 1995.

The majority of the Gender Clinic children in this study were assigned males (207/236 = 88%). There were a small number of assigned females in the sample (12%). In order to simplify this blog post I have decided to focus the examples throughout on assigned males (noting that this editorial simplification perpetuates historical erasure of trans boys / assigned females).

The children registered at the Gender Clinic I will hereafter refer to as the ‘clinical sample’, to contrast with the study’s ‘control sample’ (a sample of children of the same age who were not registered at the gender clinic and were not known to have any gender issues).

It is known (and acknowledged in Zucker’s paper) that some of the clinical sample of assigned males were non-conforming boys rather than trans girls. How many were gender non-conforming (GNC) rather than trans is unknown as historical diagnoses focused on behaviour and interests more than on identity and Zucker did not believe in distinguishing between young gender non-conforming boys and trans girls.

The children in the clinical sample, together with a control group (aged 4-8 – average age 6 and a half) were put through three different types of test, which they either ‘passed’ or ‘failed’.

Zucker 1999, the tests

We will now look at the three tests, and see whether they do provide convincing evidence that transgender children (or children treated in the gender service) have a ‘developmental lag’, and understand their gender identity later than cisgender children.

Zucker 1999: Test 1: Slabey & Frey test

Test 1 Part A focused on Gender Discrimination 

The children were shown dolls and photographs depicting a boy, girl, man, woman and asked to identify them. The children ‘passed’ if they got at least 12 out of 16 ‘correct’. 93% of the clinical sample ‘passed’ this test, compared to 98% of the control group.

Test 1 Part B:  Gender Identity

The children were asked their own gender. The assigned-male-at-birth (amab) children ‘passed’ the test if they answered ‘boy’.

93% of the clinical sample ‘passed’ this test compared to 98% of the control group.

(The very high ‘pass’ rate for the clinical sample at first glance seems high as transgender children like my daughter would certainly ‘fail’ this test.

Perhaps the high ‘pass’ rate may add weight to suggestions that a large proportion of children referred to the Toronto gender clinic in the 1970s, 1980s and early 1990s were there for gender non-conformity (proto-gay cure….) rather than children with a gender identity different to their assigned sex.

The fact that a trans girl was considered to have ‘failed’ in her understanding of gender identity if she said she was a girl is an indication of the bias of the researchers.

Test 1 Part C: Gender Stability

The children were asked if their gender can change over time, for example if they were a different gender when they were born to their current gender. The children ‘passed’ if they said gender can never change over time.

80% of the clinical group ‘passed’ compared to 92% of the control group

Test 1 Part D: Gender Consistency

The amab children were asked questions like ‘if you wear a dress, are you a girl?’ ‘If you played with a doll would you be a girl?’. (the exact script, and the exact phrasing, is not provided so we cannot be sure exactly how the questions were worded)

66% of the clinical sample ‘failed’ this test, by stating that playing with dolls makes you a girl.

46% of the control group also ‘failed’, also thinking that playing with a doll made you a girl.

The fact that nearly half the control also think playing with a doll makes you a girl seems more an indication of the segregated and gendered restrictions on toys of Canadian children in the 70s, 80s and early 90s than any conclusion about gender identity. Given very few of the clinical group identified as trans in this study, it also brought to mind the limited freedom for boys to be feminine or play with perceived girls toys, and made me wonder how many assigned males had been told to ‘stop being a girl’ when playing with dolls or putting on a dress.

Zucker 1999 Test 1 – Conclusion

The data from test 1 parts A-D, and the fact that the clinical sample had a slightly lower ‘pass’ rate than the control sample, was interpreted by Zucker et al. as evidence that children at the gender clinic were more ‘confused’ about gender.

The researchers then take a further leap of faith, into a conclusion that the lower pass rate of the clinical group compared to the control group implied a ‘developmental lag’ in understanding of gender. However, the clinical sample and the control sample were the same age (ages 4-8, average age 6.5), and the clinical sample were not re-tested at a later point in time. How therefore can they claim a developmental lag? It is simply not possible to claim a ‘developmental lag’ based on this data. The assertion of a ‘developmental lag’ (with the implication that the clinical sample reach a similar level of understanding but at a later age than children not referred to a gender clinic) is pure speculation/fabrication.

Test 1 provides zero evidence that transgender children (those with a consistent, insistent, persistent identity different to their assigned sex) have a delayed understanding of gender.

Zucker 1999: Test 2 Boy-Girl Identity Test

The assigned male children were then shown a drawing of a boy. They were asked to give the child in the drawing a name. If they chose a girl’s name for the drawing they were corrected and given a boy’s name, eg ‘this is Tom’.

Zucker 1999 Test 2 Part 1:

The children were asked ‘If Tom really wants to be a girl, can he be a girl?’.

The children ‘fail’ this test if they say yes Tom can be a girl.

32% of the clinical sample ‘fail’ this task by stating Tom can be a girl vs 21% of the control group

(Interestingly there is not a huge difference between the clinical group and the control group, with 21% of the control group, children with no gender issues, thinking that yes, Tom can be a girl – Canadian 5 year olds from the 1970s, 1980s and early 1990s showing more sophisticated understanding of gender than their specialists…)

The children are asked to give a reason for their answer, and are defined as having reached ‘operational constancy’ if they justify their answer ‘No Tom can’t be a girl’ answer with the justification ‘because he was born a boy’.

This unethical line of questioning Zucker et al put trans children through is a form of coercive persuasion, tantamount to brainwashing, where the ‘wrong answer’ is corrected with the ‘right answer’ – ‘BECAUSE TOM WAS BORN A BOY’ until the child submits and agrees.

Zucker 1999 Test 2 Part 2:

A dress and or long hair is added to the picture of ‘Tom’ and the children are asked ‘If Tom puts on a dress, is he a girl?’ The expected ‘correct’ answer is ‘No’ and the expected justification is ‘because he was born a boy’.

71% of the clinical group ‘fail’ this test, as do 64% of the control group.

Again the control group is pretty similar to the clinical group in their openness to the possibility of Tom being a girl.

Zucker 1999 Test 2 Conclusion

Zucker 1999 Test 2 provides no evidence of a ‘developmental lag’ in understanding gender for trans children.

Zucker 1999 – Test 3 looks at ‘sex-typed behaviour’

Zucker 1999 Test 3 Part 1 asks children to draw a person, and then asks them if the person they have drawn is a boy or a girl.

The assigned male at birth children ‘pass’ if they opt to draw a boy and ‘fail’ if they opt to draw a girl.

66% of the clinical sample ‘fail’ by drawing a girl (in case of the assigned males). 54% of the control sample also ‘fail’ this test by drawing a girl (in case of the presumed cis boys).

Again the results of the control are fairly similar to the clinical group.

Again there is no evidence of trans children having a developmental lag in understanding gender.

Zucker 1999 Task 3 Part 2 has the children watched through a 1-way mirror in a room with ‘gender specific’ toys and or clothes and the researchers assess the amount of time the children spend with ‘appropriately gendered toys or clothes’. They are deemed to have ‘failed’ if they play too much with the ‘wrong’ gender toys or clothes.

This task has no place in today’s society in which children are not constrained by outdated gender stereotypes.

Zucker 1999 Task 3 Part 3 assesses what it calls ‘affected confusion’, assessing a child’s ‘desire’ to be a boy or a girl (rather than their identity). It asks assigned males (who have been referred to a gender clinic for non-conforming behaviour) questions like ‘is it better to be a boy or a girl’ and ‘do you ever wish you were a girl’. Assigned males are deemed ‘deviant’ if they state any wish to be a girl (perhaps because they are a trans girl or perhaps because they are a non-conforming boy who wants to be able to play with his dolls in peace without being taken to Dr Zucker every month/week…). Assigned males are also deemed ‘deviant’ if they acknowledge anything positive about girls or think that there are any ways in which it is better to be a girl than a boy.

64% of the clinical group are labelled ‘deviant’ due to their answers in this part, as are 50% of the control group (reminder the control group are ‘random’ children not being seen by the gender clinic and who are not known to have any gender issues and yet half are deemed by this test to be ‘deviant’).

Zucker 1999 Test 3 Conclusion

What on earth is going on, and how the heck is this research still being quoted in a 2016 journal article by the leading experts at the UK’s Children’s Gender Service!

The high ‘failure’ and ‘deviancy’ rate’ not only in the clinical group but also in the control group is perhaps indication that Canadian 5 years olds in the 70s, 80s and early 90s were did not have such ingrained stereotypes of gender, nor sexism, nor misogyny, as the ‘gender specialists’ who subjected them to such awful tests.

The Zucker 1999 article ends with a ‘blame the parents’ conclusion, proposing that parents of gender non-conforming boys or trans girls must have ‘actively’ encouraged ‘cross-dressing’ or appeared to ‘tolerate’ cross-gender behaviour. It highlights a view that “parental reinforcement of same-sex play was positively related to gender constancy in pre-schoolers”. It is pure ‘drop-the-barbie’ Zucker, more focused on installing out-dated gender conformity in non-conforming boys than any concern for how to help children who may be transgender.

Zucker 1999 in summary

To summarise, the Zucker 1999 research is deeply outdated, transphobic, stereotyped, homophobic, normative and unethical.

The clinical sample is known to contain at least some children who are non-conforming rather than trans and no effort is made to focus specifically on trans children.

The difference in answers between the clinical group and the control group are very small (the paper conducts regression analysis on a wide number of variables until it finds some that are considered statistically significant – this is an unsound approach to valid statistical analysis).

The study looks at a range of things that do not relate to gender identity (including toy preferences).

And most critical of all – the paper looks at the children at one moment in time – comparing the clinical group to a control group of children the same age (age range 4-8). There is no follow up at a later age and no comparison of children of different ages. Any claim to transgender children having a developmental lag (which I interpret to mean achieving a similar understanding of gender at a later age) is pure fabrication.

Given the obvious weaknesses of the the Zucker paper – why is it a core reference in the 2016 Costa paper from leading experts of the UK Children’s Gender Service

UK Children’s Gender Service

There are three major problems with the Tavistock’s view of gender constancy as shown in the Costa 2016 paper.

Problem 1 – Quoting fabricated conclusions as though evidence

The Costa 2016 paper states “Some research suggests that a developmental lag exists in gender constancy acquisition in children with gender variant behaviour”, referencing the Zucker 1999 paper.

As we’ve seen above, the Zucker 1999 research does not provide any evidence for this claim.

Problem 2 – Broadening the relevance of those unsound conclusions and applying them to clinical practice

The Zucker paper mentions a ‘developmental lag’, but does not mention any age at which transgender children reach ‘gender constancy’.

The Costa 2016 paper moves beyond even the conclusions claimed in Zucker 1999, taking a series of assumptions to extrapolate wider conclusions (for which no specific reference is provided). They move from the idea of ‘a developmental lag in gender constancy’ to the claim that “children with gender dysphoria are more likely to express an unstable pattern of gender variance”. They move from that unsupported statement to the claim that “treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender variance compared with gender-dysphoric adolescents and adults”. And they shift further to arrive at the final statement that puberty suppression is unwise until at least age 12 “safely beyond the age of gender constancy”. It is important to recall that Zucker 1999 provides no information on the age at which trans children ‘achieve gender constancy’ and focuses on children aged 4-8 (where the Costa paper get the age 12 figure from for gender constancy is anyone’s guess).

The Zucker 1999 research bears no relevance to the question of whether trans children understand their gender. Yet Costa et al 2016 use this study as their basis to suggest that transgender children do not know their gender. They use it to support an argument that transgender children have ‘unstable gender variance’ up until puberty, and they extend this to argue against pubertal suppression for those starting puberty under the age of 12.

Problem 3 – Omitting reference to critical recent research

The third, and perhaps the biggest error, is one of omission. The Costa 2016 paper, in its section on gender identity development / gender constancy in transgender children, only mentions the Zucker research, omitting mentioning any other research on transgender children’s gender identity.

The Zucker 1999 research paper is now 19 years old. Surely in the last two decades there has been some other research on the gender identity of transgender children, ideally research that makes an effort to focus on transgender (rather than gender non-conforming) children, and research that focuses on the children’s gender identity rather than toy preference? The answer is a clear yes. There are important studies on this topic that the Costa 2016 paper fails to even mention.

So let’s take a brief review of recent research on this topic which are noticeable by their absence:

New research on transgender children’s gender identity

Olson 2015

Olson, K.; Key, A.; Eaton, N. (2015) Gender Cognition in Transgender Children Psychological Science OnlineFirst, published on March 5, 2015

The introduction to the Olson el al 2015 paper describes historical (and current) scepticism to the idea of transgender children knowing their gender:

“This scepticism takes many forms: concerns that these children are “confused” and that they therefore need therapy, that these children are “delay[ed]” in their understanding of gender in part because of the behaviour of their parents (Zucker et al., 1999: Gender constancy judgments in children with gender identity disorder: evidence for a developmental lag), or that these children are merely saying they are the “opposite” gender, much as they might say on any given day that they are a dinosaur or princess.”

Olson et al.’s research aimed:

“to investigate whether 5- to 12-year-old prepubescent transgender children (N = 32), who were presenting themselves according to their gender identity in everyday life, showed patterns of gender cognition more consistent with their expressed gender or their natal sex, or instead appeared to be confused about their gender identity.”

Results:

“When the transgender children’s responses were considered in light of their natal sex, their responses differed significantly from those of the two control groups on all measures. In contrast, when transgender children’s responses were evaluated in terms of their expressed gender, their response patterns did not differ significantly from those of the two control groups on any measure.”

Conclusion:

“Using implicit and explicit measures, we found that transgender children showed a clear pattern: They viewed themselves in terms of their expressed gender and showed preferences for their expressed gender, with response patterns mirroring those of two cisgender (nontransgender) control groups. These results provide evidence that, early in development, transgender youth are statistically indistinguishable from cisgender children of the same gender identity.

Our findings refute the assumption that transgender children are simply confused by the questions at hand, delayed, pretending, or being oppositional. They instead show responses entirely typical and expected for children with their gender identity.

The data reported here should serve as evidence that transgender children do indeed exist and that their identity is a deeply held one.”

 See here for background and further details

Fast 2017

Fast, A & Olson, K. (2017) Gender Development in Transgender Preschool Children, Child Development

Abstract:

“An increasing number of transgender children—those who express a gender identity that is “opposite” their natal sex—are socially transitioning, or presenting as their gender identity in everyday life. This study asks whether these children differ from gender-typical peers on basic gender development tasks. Three- to 5-year-old socially transitioned transgender children (= 36) did not differ from controls matched on age and expressed gender (= 36), or siblings of transgender and gender nonconforming children (= 24) on gender preference, behavior, and belief measures. However, transgender children were less likely than both control groups to believe that their gender at birth matches their current gender, whereas both transgender children and siblings were less likely than controls to believe that other people’s gender is stable.”

 

Summary

So what do we know about gender constancy/ gender identity in transgender children?

We know that some claims are balderdash (junk science):

  •  The Zucker 1999 study holds no value in informing us about the gender identity development or constancy of transgender children.
  • The statement “a developmental lag exists in gender constancy acquisition in children with gender variant behaviour” is unsubstantiated and shouldn’t be quoted in future articles
  • Conclusions in the Costa (2016) report onchildren with gender dysphoria are more likely to express an unstable pattern of gender variance” and “treating prepubertal individuals with gender dysphoria is particularly controversial owing to their unstable pattern of gender variance compared with gender-dysphoric adolescents and adults” are unsubstantiated and should be disregarded
  • Policy recommendations in the Costa (2016) report on withholding pubertal suppression until “at least the age of 12, safely beyond the age of gender constancy” are unsubstantiated and should be disregarded

 

We know that recent research (Olson 2015 and Fast 2017) shows that:

  • “Transgender children do indeed exist and their identity is a deeply held one.”
  • “Three- to 5-year-old socially transitioned transgender children did not differ from controls or siblings on gender preference, behaviour, and belief measures.”
  • “Transgender children aged 5-12 viewed themselves in terms of their expressed gender and showed preferences for their expressed gender, with response patterns mirroring those of two cisgender control groups.”
  • “These results provide evidence that, early in development, transgender youth are statistically indistinguishable from cisgender children of the same gender identity.”
  • Research “findings refute the assumption that transgender children are simply confused by the questions at hand, delayed, pretending, or being oppositional. They instead show responses entirely typical and expected for children with their gender identity.”

Gender Recognition for Under 16s – Consultation on the Scottish Gender Recognition Act

scot flag

Scotland is currently holding a consultation on reforming their Gender Recognition Act. This proposes options to simplify the process for transgender people in Scotland to obtain full legal gender recognition (acquiring a Gender Recognition Certificate and amending their birth certificate).

This consultation seeks views on reforming the 2004 Act. The Scottish Government proposes to streamline the process for obtaining legal recognition and also to allow people aged 16 and over to apply. We are also seeking views about the options for people under 16 and for recognition of non-binary people.

We are inviting responses to this consultation by 5pm on 1 March 2018. 1.07. Please respond to this consultation using the Scottish Government’s consultation platform, Citizen Space. You can view and respond to this consultation online at: https://consult.scotland.gov.uk/family-law/reviewof-the-gender-recognition-act-2004.

Key information:

The consultation provides key information on the Gender Recognition Act. It is critical to note however that even without a Gender Recognition Certificate, transgender people are legally protected under the 2010 Equality Act and have rights to change identity markers in systems including schools, the NHS and their passports, and have the right to use facilities matching gender identity. The Gender Recognition Act is however the only route to updating a birth certificate.

“GRC” – a gender recognition certificate. Under the 2004 Act, a full GRC provides legal recognition of an applicant’s acquired gender. When a GRC is issued under the 2004 Act, the applicant’s legal sex also changes to male or female. ”

“The 2004 Act allows transgender people aged 18 and over to apply for legal recognition of their acquired gender and to change their legal sex accordingly”

The consultation considers two main models for gender recognition, the current system of an assessment model (where a doctor, psychologist and or court ‘evidences’ a person’s gender identity) or a self-declaration model (as already applied in Norway, Denmark, Malta, Colombia, Argentina, and the Republic of Ireland).

For an example of how this is working in practice, this article provides a useful overview of how a self-declaration based process is already in action in the Republic of Ireland.

I won’t focus here on the proposed options for how the gender recognition system will operate, but will instead give attention to eligibility based on age – namely whether trans youth and trans children are permitted to get a Gender Recognition Certificate and change their birth certificate.

Under 18s.

At present in Scotland, as elsewhere in the UK, trans youth and trans children under 18 are not eligible for a Gender Recognition Certificate, meaning under 18s cannot update their birth certificate. Trans children and youth are however given legal protections under the 2010 Equality Act, and already have the right to change their gender marker in almost all other documentation, without the need for a Gender Recognition Certificate (including a right to change their gender marker in their passport, and in systems including schools and the NHS) (*as with adults options for identity recognition for trans youth/children with non-binary identities are extremely limited).

The consultation questions:

 The survey starts with 4 questions for how GRC should work for adults including:

Question 1 The Scottish Government proposes to bring forward legislation to introduce a self-declaratory system for legal gender recognition instead. Do you agree or disagree with this proposal?

16-17 year olds.

The consultation proceeds to focus on 16-17 year olds:

“The Scottish Government considers that people aged 16 or older should be able to apply for legal recognition of their acquired gender using the proposed self-declaration process.

4.05. There is clear evidence that people aged 16 do live full time in their acquired gender and want this to be legally recognised. For example, the Women and Equalities Select Committee heard evidence from LGBT Youth Scotland to this effect. In the Republic of Ireland, 8 people aged 16 and 17 have received a GRC31 after obtaining a court order permitting them to apply under their self-declaration system. The court in the Republic of Ireland is required to consider evidence about the young person’s transition to their acquired gender. ”

Question 5 The Scottish Government proposes that people aged 16 and 17 should be able to apply for and obtain legal recognition of their acquired gender. Do you agree or disagree?

It is curious that the report notes the “clear evidence that people aged 16 do live full time in their acquired gender and want this to be legally recognised” and yet in subsequent sections does not similarly note the existence of transgender children under the age of 16. Parents of transgender children, and other groups supporting transgender young people were perhaps overlooked in the preparatory consultations? This oversight makes it especially important that parents and supporters of transgender children and young people provide feedback during this consultation that transgender children do indeed exist, and those under the age of 16 both want and need full legal recognition. Inputs from any under transgender young people themselves might also be an important addition to this consultation.

Under 16s

The consultation moves on to consider under 16s:

“4.08. The Scottish Government’s view is that there is a careful balance to be struck in relation to people under 16. On the one hand, we should treat children with dignity and respect, giving weight to their views and wishes in line with their individual capacity. On the other hand, we should ensure that children have the right protection and care. 4.09. People who are under 16 years of age can act on their own behalf in relation to a range of matters. Annex E contains further information about this. The CRWIA at Annex M refers to research evidence about children who identify as transgender. 4.10. The Scottish Government considers that there are five broad options in relation to people under 16 being able to apply for legal gender recognition.”

The consultation proceeds to outline 5 potential options for transgender children under the age of 16. I’ve quoted these here in full, following which I’ve outlined my thoughts on each option:

Under 16s – option 1 – nothing for those under 16 

4.11. Under this option, applicants would have to be at least 16 to apply for legal recognition of their acquired gender. This would be straightforward, but would stop those under 16 with a clear view of their gender identity from obtaining legal gender recognition.

Under 16s – option 2 – court process 

4.12. Option 2 would be for Scotland to adopt a court based process.

4.14. Any court based process, whether instigated by a child’s parents or by the child themself, would focus on the assessment of the child’s welfare. We would also consider specifying the matters the court would have to have regard to in determining what was in the child’s best interests. 4.15. Under this option, a court action could be raised by the child if they had sufficient capacity to do so, or if they did not, by a person or persons who had PRRs (parental responsibilities and rights) for them acting on their behalf.

4.19. Malta has a court based process of legal gender recognition for those under 18. Those with parental authority for a child may file an application in the court. The court must consider the best interests of the child and give due weight to the views of the child depending on their age and maturity

4.20. In the Republic of Ireland, applications cannot be made by those aged under 16. However, applications by 16 and 17 year olds require to be accompanied by a court order permitting the application to be made. The court may only grant the order if the child’s parents, surviving parent or guardian consents. Two medical certificates must also be produced to the court. The medical certificates must confirm that: · the child has a sufficient degree of maturity to decide to apply for gender recognition; · the child is aware of, has considered and fully understands, the consequences of that decision; · the child’s decision is freely and independently made; and · the child has transitioned, or is transitioning to, their preferred gender.

4.21. Under option 2, a child who may not have reached puberty might apply to the court or a person with PRRs for such a child might apply.

Under 16s – option 3 – parental application

4.22. Option 3 would be to permit an application to be made on behalf of a person under 16 by someone with PRRs (parental responsibilities and rights) for them. Typically, this would be the child’s parents. Further information about PRRs, when parents get them and who else may have PRRs is in Annex F. 4.23. Usually, where more than one person has parental rights in relation to a child, each can exercise their rights without the consent of the other or any of the others.36 4.24. Where a person with PRRs is reaching a major decision regarding the fulfilling or exercise of PRRs, the person is under a duty to have regard to any views the child expresses, taking account of the child’s age and maturity. The person making the decision must also have regard to any views expressed by any other person with PRRs for the child concerned.37 The Scottish Government considers that seeking legal recognition in an acquired gender is an example of a major decision. 4.25. One possibility under this option would be to require the application to be made by all parents with PRRs for a child. This would mean that a person who had PRRs for the child but was not their parent would not require to be involved. However, we would still expect the person(s) applying on the child’s behalf to have regard to the views of such a person. 4.26. Another possibility under this option would be to require all people with PRRs to apply, not just a parent or parents with PRRs. This may mean that a local authority that had PRRs for a child would need to be involved in the application process. 4.27. If all the people who required to be involved in the application did not agree38, then a court order could be sought under existing arrangements. Section 11(1) of the Children (Scotland) Act 1995 allows the Sheriff Court or the Court of Session to make an order in relation to PRRs. The court could then make a decision based on the child’s welfare. 4.28. There are some children for whom no one has PRRs. One option might be for a person who has an interest to obtain PRRs from the court and then apply for legal gender recognition on behalf of the child.

4.30. In summary, therefore, under this option all parents with PRRs (or, perhaps, everybody with PRRs) would have to apply, having had regard to the child’s views. If there is a dispute amongst those with PRRs, an application could be made to the court to resolve the matter. There may be restrictions on the role of a person with limited PRRs. 4.31. Under this option, applications could be made on behalf of very young children, including both those who lack legal capacity and who have not reached puberty.

Under 16s – option 4 – minimum age of 12

4.32. Option 4 would permit children aged 12 and above to apply in the same way as those aged 16 or above

4.34. However, this option would take no account of a child’s capacity to take decisions nor their physical maturity.

4.36. The Scottish Government does not favour this option as it would allow a child to apply irrespective of their capacity to understand the nature and consequences of their decision.

Under 16s – option 5 – application by capable child

4.37. Option 5 would permit a person under 16 to apply in the same manner as an adult, provided they had capacity to understand the consequences of recognition in their acquired gender.

4.38. Under this option, someone would have to test the child’s capacity. This could potentially be done, for example, by a registered medical practitioner, or by a practising solicitor.

4.40. A person under 16 has legal capacity to instruct a solicitor, in connection with any civil matter, where the person has a general understanding of what it means to do so. Someone aged 12 or more is presumed to be old and mature enough to have such understanding.

The section ends with question number 6, which asks consultation respondents to state which of the 5 potential options for transgender children under 16 they most favour.

Question 6 

Which of the identified options for children under 16 do you most favour? Please select only one answer.

 

option 1 – nothing for those under 16

option 2 – court process

option 3 – parental application

option 4 – minimum age of 12

option 5 – application by capable child

My response to the consultation

My initial thoughts to the above is as follows:

Option 1 –  nothing for under 16s, is unacceptable. Many of our trans children are living as their identified gender from primary school, including changing their gender marker in other systems including on their passport. Why then should they have to wait until 16 to have who they are fully recognised in law? When they have been living for years with a passport and other markers in their gender identity, why should their birth certificate be out of sync? Inability to update birth certificate adds to stress for trans children that their identity will be unwillingly disclosed and presents to them the reality that the state does not fully respect them until adulthood. Trans children exist, and waiting until 16 or 18 for proper legal recognition is denial of basic rights for these young citizens.

Denying rights to under 16s is at odds with the recent WPATH (World Professional Association for Transgender Health) statement on identity:

“WPATH advocates that appropriate gender recognition should be available to transgender youth, including those who are under the age of majority,”

Option 2 – court process seems like an expensive, bureaucratic, stressful and unneccessary requirement. I would like to learn more from Ireland, who has a similar requirement for 16-17 year olds which is currently under review.  Australia, which has just got rid of a requirement for trans youth to go to court for hormone treatment, provides a useful case study of this process.

CASE STUDY: Australian experience of a court based process

Australia until very recently required under 16s to go to court to gain approval for gender related medical care. Families and transgender children in Australia found the process of going to court stressful and upsetting. When one family were told that the requirement to go to court was being removed, one family reportedlywere unable to contain their tears of relief” with their child commenting “No longer will young transgender young people have to keep justifying who they were“.

World leading specialist in supporting transgender children, Dr Telfer, Director of the Gender Service at the Royal Children’s Hospital in Melbourne described the amount of time gender specialists were having to devote to guiding families through the court proceedings:

“Gender Clinic staff have had to spend considerable time on counselling families on what the court process would be like, Dr Telfer said.

“No-one wants to be in a courtroom. Usually it’s a place where you go when something is wrong.

The requirement for transgender youth to go to court was described as “costly, traumatic and unnecessary”.

The director of legal advocacy at the Human Rights Law Centre, Anna Brown, described the decision to stop forcing transgender children in Australia to go to court as a “stunning victory” for young transgender people.

“This will make a profound difference to the lives of many young trans people who will now be relieved of the burden of a costly and unnecessary court process”

“This bizarre legal anomaly was born of outdated attitudes to trans young people”

“Importantly, also, for the young people themselves, going to court can be hugely taxing,”

“This decision is a huge victory for so many young people and their families. The latest research shows that there are probably around 45,000 trans and gender-diverse young people in Australia, and this will save them enormous amounts of money, time and heartache.”

Australia has made the decision to move away from requiring transgender children to go to court. Why then would Scotland wish to impose this on Scottish trans children? Based upon the Australian experience, the Option 2 court process, is not the right decision for our children.

Option 3 – parental application seems instinctively a sensible option. With parental approval children like my daughter could get their identities fully legally recognised. This would however limit options for youth who do not have parental support, and such youth would either need to wait until 16 or would need to have recourse to an alternative option eg to the court option. I wonder whether there are many youth without any parental support for whom gaining a GRC pre 16 would be a major priority? I’d welcome feedback from trans youth or organisations working with trans youth.

Option 4 – minimum age of 12 is largely ruled out by the Scottish consultation, and I would agree that basing declaration on age, rather than capacity for decision-making, would be unworkable.

Option 5 – application by capable child is attractive in theory but I question how it would work in practice. It would require an administration layer including professional gate keepers, requiring our children to submit to an assessment, and I wonder who would be willing to test a child’s capacity for this purpose. This might result in a very small number of medicalised gate-keepers and subject to waiting lists, delays and arbitrary protocols. There’s also a very serious question about how to ensure such professional are able to assess a child’s capacity in a sensitive and appropriate manner – those of us with trans children are well aware of the level of transphobia and ignorance about trans children so common across the UK.

Seeking another opinion

I decided to reach out to the Scottish Trans Alliance who provided their view on the options for under 16s

Scottish Trans Alliance:

“We’re currently in favour of Option 3 – the ‘parental application‘ option – where under 16s would be allowed to change gender on birth certificate on submission of a simple statutory declaration with signed parental consent. This would mirror how name changes on official documents are already done for under 16s.

We think that if a young trans person under 16 has unsupportive parents then the most urgent problems they will be facing are likely to be whether they are safe from transphobic emotional abuse at home and whether they are able to wear clothes they want and use the verbal pronouns they want. We think that it is rare that a child under 16 with unsupportive parents will be in a confident and safe enough position to risk trying to change their birth certificate against the wishes of their parents.

We think that nearly all under 16s who have been able to successfully start living fully in their gender identity (and therefore are at the point where it would make sense to change their birth certificate to improve their privacy) will have at least one supportive parent. However, it is important that there is a way of ensuring that an unsupportive parent is not able to block the wishes of the young person and their supportive parent. If a court process is needed to resolve a family dispute about whether a young person should be granted a GRC, then we think the court ought to be obliged to uphold the wishes of the young person provided they have capacity to understand the consequences of legal gender recognition.

While Option 5 – the ‘application by capable child’ option – sounds on the surface like a more empowering option than parental application, we have concerns that it may lead to problematic gatekeeping by doctors/solicitors who could be scared to approve the capacity of individual trans young people. It could result in say a 13 year old with supportive parents having to try to prove their capacity to a trans-ignorant doctor only to be told they are too young to understand the consequences and that they have to wait as their parent can’t give consent on their behalf. That could be a very stressful and disempowering experience.

Not allowing under 16s to change the gender on their birth certificate leaves them at risk of schools not taking their gender identity and right to privacy of their gender history seriously. Under 16s usually don’t have bank accounts or many letters sent to them so proving their identity without showing a birth certificate is harder for under 16s than for trans adults. This means trans people under 16 are at greater risk than adults of privacy violation, and transphobic harassment as a result, due to their birth certificate outing them as trans. The intensity of media hostility and resulting negative social attitudes towards trans youth and their families makes privacy rights particularly essential.

Changing birth certificate would have no impact on ability to access hormone blockers but could make a life enhancing difference to moving to a new school without being outed.

It’s worth noting that parents of trans young people under 16 can already change their child’s gender on their passport and medical records so it makes sense to bring birth certificates into alignment with these other official documents.”

Preferred option

Having reviewed the proposed options, and consulted with other stakeholders, the best option for under 16s seems to be Option 3 – parental application.

 

Flawed research evidence underpinning the consultation

Before concluding, I would also like to share my views on the annexes to the consultation which contain some worryingly flawed ‘evidence’ that if accepted as presented could seriously undermine trans children’s rights.

The Scottish consultation document presents ‘research evidence’ on transgender children in annex M part 4.

ANNEX M: PARTIAL CHILD RIGHTS AND WELLBEING IMPACT ASSESSMENT

  1. What research evidence is available?

4.1 There is evidence that children can experience incongruence between their assigned gender and their gender identity early in life. One study indicates the average age was 8.

4.2 There is a limited evidence base about whether children will continue to experience these feelings in the longer term. Follow-up studies indicate overall that for 85.2% of the children, their distress discontinued either before or early in puberty. 8 However, the rates in the individual studies varied widely. For instance, a 2008 study indicated that in 39% of children the feelings did continue beyond the onset of puberty9 whereas older studies from before 2000 had very much lower rates for children continuing to experience distress after the onset of puberty. It is thought that pre-2000 studies have included children who would not now be considered to be experiencing gender dysphoria. The studies may also be affected by the small clinical population of children with gender dysphoria – studies looking at whether gender dysphoric feelings persisted had a total population of 317 people.

Part 4.2 in particular misrepresents the current body of evidence and is danger of undermining the Scottish consultation through establishing a prejudicial approach to children gaining legal recognition.

It refers to two deeply flawed studies:

  1. Ristori, J and Steensma T.D “Gender dysphoria in childhood” in International Review of Psychiatry, Gender dysphoria and gender incongruence, Vol 28, 2016 Issue 1.
  2.  Wallien and Cohen-Kettenis “Psychosexual outcome of gender-dysphoric children” Journal of the American Academy of Child and Adolescent Psychiatry, 47, 1413–1423

We have previously addressed and demonstrated the lack of credibility of these exact studies here.

Conversely, new evidence, that has not been presented in the consultation Annex, suggests a very significantly higher rate of transgender children continuing to identify as transgender as adults and has been reviewed by us here.

4.3 There is also evidence that the more extreme a child’s gender dysphoria was before puberty, the less likely it was that their feelings will recede with the onset of puberty. For those who have reached puberty and continue to experience distress, evidence indicates that their distress then tends to intensify and that depression or self-harming behaviours are also more common in ages 12 and over. It is understood that physical changes caused by puberty may intensify the levels of distress experienced.

4.4 Available evidence suggests that factors arising around the ages of 10 to 13 may help explain changes in how a child feels about their gender: · the changes in social roles between boys and girls as their gender role become more distinct; · the anticipation or experience of physical changes as a result of puberty; and · their first experience of experiencing falling in love and discovering their sexual identity.

4.5. Evidence indicates that there is a difference of experience between boys and girls. 13 Although more boys are referred to gender identity clinics, some studies suggest that gender dysphoria is more prominent in girls.

Part 4.4 relies on one specific flawed study that absolutely does not evidence the claim presented here.

Steensma T.D et al (2011) “Desisting and persisting gender dysphoria after childhood; A qualitative follow up study” Clinical Child Psychology and Psychiatry Vol16 issue 4”

There is no evidence in this single referenced study that a transgender child changes identity between the ages of 10 and 13 as misrepresented here. This is grossly misleading and risks undermining support for trans children in Scotland gaining legal recognition. We have previously discussed the flaws of this specific paper in some detail here.

4.6 There is evidence that transgender young people are more than twice as likely as non-trans people to be diagnosed with depression (50.6% compared to 20.6%14) and with anxiety (26.7% compared to 10%). There is evidence that this most likely arises due to their experience of discrimination, lack of acceptance, and the abuse they may face and is not an inherent feature of their being transgender. 15 There is also evidence that transition to living in their preferred gender and being supported with gender confirming medical interventions may help improve mental health, in many cases reaching levels experienced in the general population.

It is clear that discrimination and lack of acceptance is damaging to trans youth. The government has a responsibility to tackle this, including through enabling trans children like my daughter to gain full legal recognition. Not allowing full legal recognition to children also sends out a damaging signal to those children and to wider society that transgender children are not worthy of respect or rights.

4.7 Scottish Government officials met members of LGBT Youth Scotland groups aged 13 and over. Their view was that legal gender recognition must be made available to people younger than 16. A person should be able to transition and live in their acquired gender before they have to take their qualifications or go to university. They felt that this would better support their rights not to be discriminated against, for example, at school. A high proportion expressed the desire for their parents (or other people with responsibility for them) to be involved and supporting them through the recognition process.

4.8 LGBT Youth Scotland gave evidence to the Women and Equality Select Committee inquiry into Transgender Equality which setting out the views of transgender people aged under 1817 about the benefits of legal gender recognition in terms of reducing discrimination and improving their mental health.

There is a concerted effort in the UK, as elsewhere, to deny transgender people basic human rights. This campaign is particularly targeting transgender children, the most vulnerable of transgender people, and those with the least power and voice. It is critical that this consultation focuses on listening to transgender children and to those families who support them. Trans children are a small and very marginalised group, and their voices must not get lost in the wider consultation. It is not acceptable to tell transgender children that they have to wait until they are adults before they can be recognised in law.

Appendix A TRANSGENDER CHILDREN – EVIDENCE OF NUMBERS EXPERIENCING GENDER DYSPHORIA OR DISCOMFORT WITH THEIR ASSIGNED GENDER

Appendix A presents a confused view of the difference between transgender children, and children who are gender non-conforming. It alarmingly includes reference to studies from the discredited Zucker, and makes multiple references to “opposite sex behaviour”. It is worrying that a public consultation on gender recognition should have included such a muddled understanding.

Conclusion

Transgender children are one of the most marginalised, voiceless and powerless groups in society. I encourage all who care for transgender children to complete this consultation, and for question 6 I recommend selecting Option C – parental application.

Additionally, in the accompanying comments box for the consultation it would be useful to mention some basic facts:

a) transgender children exist

b) transgender children have legal rights and need legal recognition

c) transgender children face enough challenges, discrimination and hostility already – legal recognition should not be an additional burden for them

The consultation documents mention the “clear evidence that people aged 16 do live full time in their acquired gender and want this to be legally recognised” and yet are silent on  on the existence of transgender children or their desire and need for full legal recognition under the age of 16 year.

This right, if enabled, would not be pursued by every transgender child. Parents would not take this option on a whim. This option would be most appropriate for transgender children who have already been living in their identified gender for many years, who likely already have all other identity documents including their passport updated to their identified gender. To deny these children full legal recognition until 16 is a gross betrayal of their rights.

Yet transgender children are one of the least powerful and most marginalised groups in our society. We know that transphobic groups are actively campaigning against the provision of rights to transgender children. The needs and the voices of transgender children may not be heard in this consultation.

It is vital that families of transgender children feed in to this consultation, including those outside of Scotland, making it clear that transgender children do indeed exist and do deserve full legal recognition. Inputs from transgender adults and allies who care for transgender children will also be critical, as supportive families of transgender children are already overwhelmed with the barriers we have to overcome to enable our children to get the rights and the protections that other children take for granted.

Input from any transgender children and young people who are willing to share their thoughts and words would be especially valuable, perhaps explaining what an updated birth certificate would mean to them, or how they feel about being denied the right to full legal recognition.

The consultation can be completed here. It closes on March 1st 2018

The Reality behind the Myths about Trans Children: An Interview with us, Growinguptransgender

Vincent-the-Vixen-2Trans Children Myth Busting

Following recent negative news coverage, we thought it would be good to return to this interview with the LGBT children’s story publisher, Truth and Tails, in which we share our experience of raising a child who happens to be trans. We address many of the myths about Trans children, including advice for other parents, and the reasons for starting this blog.

For the first time we’ve published it here:

Background

We were interviewed by the lovely Truth & Tails, in March 2017, after they had read our blog and sent us a copy of their book ‘Vincent the Vixen’ which explores trans issues from the perspective of a gender questioning fox.

You can read the original interview in full here: Truth & Tails Interview

Interview Th

Truth & Tails: We first discovered the Growing Up Transgender blog back in October, when we read their post 10 reasons why the #dontjudgegender verdict makes families of transgender children concerned in response to a high court judge ruling on gender identity, which resulted in a seven-year-old being removed from their mother. The blog is written anonymously, to protect the family’s identity, by parents of a young transgender child living in the UK.

We spoke to the authors, about their reasons for starting the blog, what support is out there for parents of transgender children, and what the most common misconceptions are that they face day-to-day.

Tell us about the catalyst for starting the ‘Growing Up Transgender’ blog.

A few different things prompted us to start a blog. Firstly, we remembered how alone and confused we felt when we first realised our daughter might be transgender. We appreciated so much the few parents (mostly in America) who had shared their experiences online.

Secondly, we were frustrated by the huge amount of misinformation and distorted claims that are presented as fact on the internet. It took us a long time to be able to distinguish fact from fiction, and to distinguish helpful evidence based information from transphobic bigotry. Having thoroughly researched and understood the different issues, we wanted to share our understanding with others.

And thirdly, we noted a dramatic upsurge in anti-transgender children hysteria in the UK media. Fear-mongering media rhetoric has a direct impact on how adults, and in turn, their children treat our child. We felt compelled to speak out, yet also wanted to maintain our child’s privacy. A blog seemed like the best way to ensure our voices, and our experience of a wonderful trans daughter, could be shared. We hope our blog will in some way help other families dealing with this issue.

When did you realise your daughter was transgender, and how did you know? Is there a specific conversation that you remember?

Our daughter said she was a girl from a very young age. Daily. There was no one specific conversation that opened our eyes, it was more a very persistent stream of assertion over a long period of time. At first we didn’t take it seriously. We tried to dissuade. We tried to tell her she could be whatever type of boy she wanted to be. This was totally missing the point, and made her even sadder. Eventually it got to a point where we realised that we had a very depressed child, who felt rejected by her parents. We realised that we were letting her down.

What would you say to a parent who is beginning to have these sorts of conversations with their child?

Some parents worry about their boy playing with dolls, or preferring being friends with girls, or their girl rejecting dresses and wanting short hair. These behaviours that are related to how a child plays or dresses or expresses themselves are not focused on identity and there is no reason to think such children are likely to be transgender. My view would be not to narrow your child’s horizons, to allow toys to be toys and children to play however they like.

A much smaller number of parents will have the experience we have had, and other parents describe extremely similar experiences. A child who insists that they are a different gender to what you are expecting. A child who doesn’t perhaps care what toys or clothes they have as long as they are acknowledged as the gender they identify with. A child who repeats their identity consistently, persistently, insistently and gets increasingly sad and withdrawn, perhaps accompanied with concern about their body. For parents of those children, I would advise the following:

First, consider how scary and isolating it must be for a child to be repeatedly told that something they feel so deeply is unacceptable to those who love them mostly dearly. Listen to your child. Let them know that you love and accept them whatever. Let them know that you stand by them. Let them know that there are other children in the world who feel the way that they do. Let them know that some children feel like this when young, then grow up and don’t feel like this so strongly. Let them know that other children feel like this when young, then grow up and continue to feel like this and live like the gender they identify with. Let them know that both groups can grow up to have happy and well-adjusted lives. Let them know that either is ok with you. Let them know that they are not alone.

Secondly, find out more about the subject. Read as much as you can. But bear in mind that there is a vast quantity of material on the internet that is immensely transphobic; that is misleading, and even outright lies, and that may make you feel desperately scared for the future. I’d suggest reading some blogs by parents who are supporting their child in their gender identity, to understand that the worst-case scenario that you are fearing for your child really isn’t as bleak as you may be fearing. Our child has gone from a deeply sad to one of the happiest children you could meet since we told her we accepted her as a girl.

Thirdly, get some support for yourself as a parent.

What support is out there in the UK for parents of transgender children, and where have you personally found most support?

For us, the best source of support by a mile is other parents of transgender children. Find a way to reach out to other parents, for us it was through the charity Mermaids. Channels such as Mermaids provide a secure forum for parents to speak directly to each other, to provide a non-judgemental ear, to share experience, to be a shoulder to cry on. Many parents describe coming to terms with a child being transgender as a form of grief. Parents are often completely ignorant of the issue, and often have bleak views on the prospects for their child having a positive future.

In time, in person or virtually, parents come across remarkable trans young people and adults, and learn that with acceptance and support the outcome for trans children today is bright and hopeful. But that doesn’t immediately negate the very strong emotions that parents go through, particularly when they are doubting how to proceed, and particularly when they are facing judgement, criticism and hate from a wider society – including their own friends and family – who may not be willing to understand. Finding a support network, particularly if your own friends and family are not supporting you, is extremely important.

For transgender children approaching puberty, being registered in the UK Gender Identity Service for children at the Tavistock can be critical in case medical intervention (hormone blockers) is required. Waiting lists are extremely long: nine months from GP referral to first appointment and procedures once in the system are prolonged. Don’t wait until things are at a point of desperation to get a referral into the medical system. Better to get a referral a couple of years before puberty and pull out if you don’t later need it than delay referral and enter the waiting list at puberty when a two-year wait might become a major problem. Some GPs are supportive, many GPs are ignorant and unhelpful. Request a referral to Tavistock if you feel your child is transgender, and don’t let an ignorant GP tell you no.

What is the most common misconception about transgender children that you encounter, and what is your response?

There are so many misconceptions about transgender children that we wrote a whole blog on this topic! You can read it here.

The most common ones are:

Myth: Transgender children do not exist.
Reality: Yes, they do.

Myth: This is a modern, Western fad.
Reality: Transgender people have existed in societies throughout the centuries across the world, and there are millions of transgender people across Asia.

Myth: Parents are choosing this for their children to be trendy.
Reality: As a parent who has cried and cried buckets coming to terms with having a transgender child, I can assure you I would never have chosen this – although now I’m finally less ignorant I don’t in any way see it as the terrible path I once feared.

Myth: Kids who are just non-conforming (e.g. a boy who like dolls) are being pushed into being transgender
Reality: My child didn’t care what toys she played with as long as she was acknowledged as a girl. No one is pushing our children. This is just who they are.

Myth: Children are too young to make a life changing decision.
Reality: My child has not made a decision. They have not decided to change gender. They have always known they were a girl, it just took the rest of us a long time to catch up.

Myth: Transgender children can be turned into non-transgender children if you do X, Y, Z
Reality: There is no evidence for that, and a great deal of evidence that reparative therapy causes a great deal of damage.

Myth: Transgender children are likely to grow out of it.
Reality: Perhaps, but there is no clear evidence for this, and statistics quoted on this subject are extremely dodgy – read with care.

Myth: Transgender children/people will have sad and suicidal lives.
Reality: Emotional challenges experienced by transgender people are due to the hate and prejudice they face, not an inherent part of being transgender. Transgender children who are supported and accepted by their families are shown to have the same levels of mental health and well-being as other children.

What advice would you give to parents – not just parents with transgender children, but parents everywhere – around educating their children about gender and acceptance?

The world is a complex and diverse place. The more parents that share this diversity with their children, the more that let children know that it is ok to be different, the better for us all. Teaching love and acceptance will directly benefit your child too – at some point in everyone’s life they feel that they are different or an outsider – and having taught your child that difference is ok will stand your child in good stead whenever they find themselves on the outside.

Which children’s’ books about gender would recommend?

There is definitely a lack of books for younger children about gender. We’ve found many more interesting reads that have the central message that diversity is not only ok, but should be celebrated. We’re still finding our way a bit on books specifically about transgender children and haven’t found many our child identifies with, at least not in their entirety – however well-intentioned, books about boys who like dresses can sometimes perpetuate stereotypes of gender divide.

For young children, we like:
Red, A Crayon’s Story – Michael Hall
Red Rockets and Rainbow Jelly – Nick Sharratt
Vincent the Vixen – Truth and Tails (our daughter has loved this book)

For older children:
Lily and Dunkin – Donna Gephart

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About Truth & Tails:

Truth & Tails are a publisher who aim to write stories for young children in a straightforward, sensitive, and easy way. They seek to explain difficult concepts like feminism, racism, gender, and sexuality to children, and believe in the strength of stories to help children  grow up with a sense of understanding, empathy, and acceptance of those who are different to them.

 

 

 

NHS Failing Transgender Children

Another day waking up to a national broadsheet newspaper accusing me of child abuse. Painting my child as mentally ill and a threat to others when she is neither.

“Under the banner of transgender equality children are being subjected to a form of child abuse by an adult world that is failing to treat or even wilfully exacerbate an often transient confusion” Melanie Philips, The Times, 3rd October 2017

The fact that we live in a country where these lies, this hate, this prejudice is regularly printed in a national daily broadsheet defies belief. I cannot imagine any other area where parents following evidence based best practice to support their children are so accused. Surely there would be an outcry if columnists accused parents of child abuse for vaccinating their children? These lies damage transgender children. These lies are themselves a form of child abuse.

Worse still than the fact that ill-informed bigots can write lies in the national press, is the knowledge that these lies will go unchallenged. Bigots in the media know that transgender children cannot speak up. They know that parents of transgender children dare not speak up. We just bow our shoulders, avoid looking people in the eye, wonder which of the judgemental faces on the playground have read the latest attack piece and believe we are abusing our child.

Where are our allies standing up for transgender children?

Where are the NSPCC, articulating the evidence based consensus that supporting transgender children is in their best interests, and that to reject and stigmatise transgender children is a form of child abuse? Where are the journalists who were so vocal when Trump was calling out for Trans service people to be kicked out of the US military? Where is the Stonewall poster saying:

“Some Children Are Trans: Get Over it”.

somechildrenaretrans

Where is the challenge from the experts in the NHS?

The NHS Gender Identity Service (GIDS) understands that public ignorance and prejudice is the number one barrier to the happiness and wellbeing of transgender children. The NHS Gender Identity Service is, as per its own guidelines, supposed to advocate for transgender children. In other countries, such as America and Australia, Gender Experts devote a portion of their time to public advocacy, defending and educating about transgender children – publically challenging lies and misinformation. They do this because they are all too aware of the impact of societal stigma, created, developed and perpetuated by a media of misinformation and fake news.

In the media appearances of UK NHS Gender Specialists, more care is given to defending their Gender Service to sceptics and transphobes, emphasising how some children are not really trans, emphasising how much caution they have, how slow and conservative their support is. They fail in their moral and legal duty of educating the public and advocating for transgender children. When media lies, misinformation and prejudice appears, instead of ignoring or fuelling this, they need to be challenging it clearly, fiercely and publically.

In response to today’s Times piece they should:

  1. Put a statement on their website in an clear area where parents and journalists can see it
  2. Put out a press release
  3. Write to the Times expressing their concern
  4. Write to the Independent Press Standards Organisation outlining that lies about evidence based NHS support for transgender children is damaging and harmful

I’ll even write it for them:

 

Press release:

“Transgender people exist. Transgender people always have existed, in countries all around the world. Being transgender is widely recognised as a normal part of human diversity. Transgender people are not a threat, or mentally ill, or confused. There is a durable biological underpinning to gender identity – this is not a choice and transgender people cannot be converted. Attempting to convert transgender people into a different identity is considered unethical and ineffective and has been outlawed by all competent evidence based professionals.

Transgender children exist. Medical consensus is that transgender children thrive if acknowledged and supported to live in their identified gender. Transgender children suffer high levels of depression, self-harm and suicidality if forced to live a lie. This is not a choice. Parents who support transgender children are following evidence-based guidance and are doing what is best for their child. Spreading lies, ignorance and prejudice about transgender children is a serious threat to their well being. Media bigotry, exemplified by today’s piece in The Times, is a form of child abuse that causes significant harm and suffering to vulnerable transgender children.”

Here’s a Tweet to go with it:

tavistep up

All the evidence shows That transgender children pre-puberty who are supported at home and at school have normal levels of mental health and well-being and do not require regular appointments with medical professionals. The single biggest support that the NHS Gender Identity Service can offer to these children is clear, confident advocacy on behalf of transgender children to an ignorant and ill-informed (and often hostile) media.

Every single media communication from the UK Gender Identity Service should be designed to serve the best interests of transgender children. This is currently not happening.

Parents are fast losing patience with an NHS service that is failing our children. The NHS must do better. Clear, confident communications supporting, normalising and de-pathologising transgender children is where they need to start.