Monday, July 01, 2013

Trans-Kids

The New York Times had a letter-to-the-editor on the their Opinion Page about trans-children by a therapist who was on the APA DSM V workgroup for Sexual and Gender Identity Disorders and you wonder why we are still in the DSM?
Invitation to a Dialogue: Gender Identity
By Jack Drescher PhD.
Published: June 25, 2013

The state’s civil rights division has now ruled against the school, rejecting its argument that “as Coy grows older and his male genitals develop along with the rest of his body, at least some parents and students are likely to become uncomfortable” (the author's italics).

Actually, no one knows whether Coy will continue to feel that she is a girl when her body develops further, since most children like her grow up to be gay, not transgender.
Wow, where to begin?

Remember he was on the APA workgroup that kept us in the DSM!

He goes on the list three possible treatments, encourage early social transition, discourage any cross-gender behavior and the third is a more limited wait and see approach. He says that the first two are “without much empirical proof.”

As you can imagine this has created a firestorm of criticism. The author in his defense cited to studies; “Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study” and “Report of the American Psychiatric Association Task Force on Treatment of Gender Identity Disorder.” He also says there is no data to support early transition. While his critics point out that the studies had a limited number of children who transitioned early and that the criteria in the DSM IV & IV TR is overly broad. That the old criteria is based on behavior and not dysphoria so children in the early studies might have had only cross-gender behavior and never felt distressed in their birth gender.


In the link to the author’s paper on “Controversies in Gender Diagnoses” in the LGBT Health journal, he discusses in depth his thoughts on the state of diagnosing trans-patients. In it he says,
The treatment of extremely gender variant prepubescent children remains a controversial subject since some underlying assumptions of the treating clinicians are a matter of opinion rather than of empirical data.
The problem as I see it is that we are human and we can’t wait years and years for empirical data to be gathered. Yes, I would like to wait ten years to find out if transitioning at an early age helps but we are dealing with kids now, we do not have the luxury of waiting for the research data. I know a number of trans-kids who have transitioned and to me they seem very well adjusted. However, I will tell you where the stress in their lives come from, it comes from adults. It came from parents and school officials who had moral objections to the students. The trans-student in Maine was fine until a guardian of another student created a stir and went public that was when the trans-student’s problems began. In Colorado the other students had no problem with the trans-student until the school administration stepped in.

Next week’s New York Times should be very interesting with all the rebuttals.

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