Friday, January 15, 2016

Insistence, Persistent, And Consistent

You might have heard that eighty percent of children who turn out not to be trans, but there are a number of inconsistencies in the way they reached that number.
Are Parents Rushing to Turn Their Boys Into Girls? 
Slate
By Kristina Olson and Lily Durwood
January 14, 2016

Should a boy who grows out his hair, likes to wear pink, and prefers to jump rope at recess rather than play football be raised as a girl instead of a boy? Several recent pieces in prominent media outlets would have us believe that this is a major issue in North America. In the latest such piece, “The Transgender Battle Line: Childhood,” an op-ed that appeared in the Wall Street Journal on Jan. 4, doctoral student of sexual neuroscience Deborah Soh raises alarm that many feminine boys and masculine girls are being encouraged by their parents and therapists to undergo social transitions, changing their names and pronouns to live full-time in the other gender. Soh characterizes these transitions as premature and in contradiction with established research, citing studies showing that most children who are gender nonconforming do not grow up to be transgender adults.

The central problem with this often-made argument is that it treats all children who violate cultural gender norms as a single category, when in fact there is a wide range of such children in the world. On one end of the spectrum are children who enjoy toys and clothing that are stereotypically associated with the opposite sex (imagine a girl who loves G.I. Joes and rough-and-tumble play or a boy who love Barbies and ballet). In the middle are children who express a lot of unhappiness about being a member of their gender group. For example, a boy who says he wishes he were a girl because then no one would tease him about his preference for nail polish or the fact that he only plays with girls. At the other end of the spectrum are children who consistently, persistently, and insistently assert that they are members of the opposite sex and who are beside themselves when they are not allowed to live as such. Such children sometimes resort to self-harm or become anxious and depressed that others will not recognize their gender identity. Importantly, while some children in the last group undergo social transitions, we see no evidence that anyone believes that children elsewhere on the spectrum should do so. We believe these recent articles, whose authors, to our knowledge, do not work with transgender children, overlook key differences within the spectrum of children who do not conform to gender norms, misinterpret past research, and misconstrue interventions to help transgender children.
But the problem with the 80% number is that they were comparing apples to oranges, not all of the children in the study met the diagnostic criteria for gender dysphoria and that those who dropped out of the study were labeled that they detransitioned.
These findings are used to argue that social transitions should not be encouraged, because according to the logic, around 80 percent of these children who are identified as gender dysphoric will not ultimately be transgender if left alone or given proper therapy. Here, again, the distinction between transgender children and the rest of the spectrum of gender nonconforming children is critical to acknowledge. The studies that found this 80 percent number (or similar numbers) included a broad range of gender nonconforming children. The authors of this particular study, Zucker and Bradley, wrote that it is actually quite rare for children who are brought to gender clinics to believe themselves to be the other gender. Much more common were children who showed cross-gender behaviors, who may have wished they were the other gender at times but still saw themselves as members of their original gender group. Thus, most of the children who are argued to have grown out of their gender dysphoria never claimed a transgender identity to begin with.
What we need is more longitudinal studies because there is no hard data on how children did over decades.
This is not to say that a transgender identity in childhood never desists in adulthood. The truth is that we do not know precisely how many transgender children will grow up to be transgender adults, because no long-term studies have recruited a large number of children who believe that they are members of the opposite sex nor separated the few they have included in past studies from the broader group of gender nonconforming children. Until the start of our project in 2013, we knew of no studies tracking large numbers of children who specifically identified as transgender in early childhood. Thus, while most popular articles on this topic imply that 80 percent of children with transgender identities will not grow up to be transgender adults, we believe it is more accurate to say that we have no good estimate. What little data do exist suggest that many transgender-identified young children do in fact become transgender-identified teens and adults.
I probably know a half a dozen children who transitioned at a very young age and all of them are doing very good. We need follow-up studies not only for children but for adults, for many of us once we transition we disappear. I know of one person who detransitioned but she did it because she had to move back in with her in-laws out in the mid-west.
We do not yet know what the outcomes of social transitions in childhood will be, but this is where people like Soh, the future generation of researchers and clinicians, as well as those who publicly write about these issues, such as Dreger, and those of us studying transgender children can hopefully all agree. By systematically studying the impact of social transitions in transgender children, and by studying outcomes in transgender children whose families make a wide array of decisions, we can best discover what is in the best interest of the transgender child.

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