Monday, July 04, 2016

WPATH Conference

There are article coming out about the WPATH conference that was held in the Netherlands last month, two articles appeared in the Huffington Post. The first article  is about the DSM, SOC, and children while other article is about our favorite punching bag, Dr. Zucker.
The War Against Trans Children is Over - Part 1 on the WPATH Conference
By Dana Beyer
June 23, 2016

The war is over. There will be, as is usually the case, post-truce skirmishes, guerrilla warfare, even major battles as occurred at New Orleans in 1815 because word of the Treaty of Ghent hadn’t yet made it to the combatants. The losers may shift residence and find new employment, even continue to publish papers in a journal they founded and still completely control (so much for peer review), but the consensus on the treatment of gender-variant children has shifted to the gender-affirming crowd.

I will provide my personal take on this issue later, and I’ve covered the debate in the past few years. Nothing much has changed, except that more children are being supported and allowed to transition when appropriate. There is still no high quality clinical evidence to guide the treatment of these children on hand, though projects such as TransNet, co-led by medical doctors Joshua Safer and Jamie Feldman, and the Transyouth Project led by psychologist Dr. Kristina Olson of Seattle, the first large-scale, national, longitudinal study of devel­op­ment in gender nonconforming, transgender, and gen­der vari­ant youth, are developing. What does exist, in the absence of medical studies, however, is the experience of treating children supportively, vs. the decades-long experience of rejecting them.

This conclusion was evident to me over the course of the recently completed 2016 World Professional Association for Transgender Health (WPATH) conference in Amsterdam. It was not only evident in the wealth of presentations by those who practice such care, such as Drs. Jo Olson, Maddie Deutsch and Carys Masarella, who run major trans health clinics, and psychiatrists such as Dr. George Brown, who keeps churning out research data, but in two presentations which highlighted the denouement of the conflict. The first was during the initial plenary session, opened by the Queen of the Netherlands (it’s nice having a queen around who is available for such duty), when there was a “debate” over the inclusion of the diagnosis “Gender Incongruence of Childhood (GIC)” in the upcoming World Health Organization’s ICD-11 manual of diseases due in 2018. The second was evident in what may very well be the last pitched battle of the war, a presentation on “Gender Laws” by the proponents of the traditional form of care, which many consider a form of reparative therapy. The audience in that much smaller room did not sit on their hands or remain quiet.
The article goes on to discuss some of the workshops that were presented during the conference and her second article covers Dr. Zucker.
Amen to That - The War Against Trans Children is Over, Part 2

Finally, the event for which we had all been waiting, the presentation by Dr. Zucker. Having lost his job and clinic in December, and having filed three lawsuits since, he came in with his boots on, opening with:
This feels like a Bernie Sanders rally.
He went on to say that he doesn’t like politics, having stayed away from it since 1968 when he held a Vietcong flag at a rally, and preferring to focus on the lack of the “evidence base” I’ve discussed above. He couldn’t understand, even with the help of a $500/hour attorney, the operational meaning of “identity exploration” in the Ontario conversion therapy law and how it differed from his therapeutic treatments, but concluded by saying that these conversion therapy laws (and the repudiation of his therapeutic approach which they represent) were:
a political hegemonic maneuver [by activists] leading to complete control over what constitutes best practice clinical care [of trans and gender non-conforming children].
He came closest to the fundamental issue when he mentioned that people had “divergent ideas of optimal outcomes.” Dr. Zucker’s suggestion that the law was vague was challenged by Nicole Nussbaum, Past-President of the Canadian Professional Association for Transgender Health (CPATH), who had presented in favor of the Bill to the legislative committee. Nicole read more of the law to the crowd which showed there really isn’t the ambiguity he fears. The Ontario law, sponsored by LGBTQ opposition critic, Cheri DiNovo, is seen by many as the primary factor leading to the closure of his practice by the Province of Ontario.

He came closest to the fundamental issue when he mentioned that people had “divergent ideas of optimal outcomes.” Dr. Zucker’s suggestion that the law was vague was challenged by Nicole Nussbaum, Past-President of the Canadian Professional Association for Transgender Health (CPATH), who had presented in favor of the Bill to the legislative committee. Nicole read more of the law to the crowd which showed there really isn’t the ambiguity he fears. The Ontario law, sponsored by LGBTQ opposition critic, Cheri DiNovo, is seen by many as the primary factor leading to the closure of his practice by the Province of Ontario.
I find that Dr. Beyer summed it up nicely when she wrote…
Going one step deeper, however, we discover over years of experience that the problem is the definition of harm. The Zucker side believes gay is good and trans is bad. One could go so far as to say Dr. Zucker believes that “not one more trans person” is the preferable outcome, and he has practiced what can be considered reparative therapy to prevent that. The Ontario commission that closed down his practice stated, in a very convoluted manner, that it could not be determined that he did not practice conversion therapy. This aversion to the trans experience is evident in his deep resistance to possibly transitioning gay boys, believing that such a transition would do irreparable harm to those boys, while feeling nothing of the same about trans girls who we know are deeply harmed when refused transition. I have a very dear friend who believes the same, and I have tried to understand her fear, but I can’t. I believe it’s grounded in a profound misogyny, and ignores the fact that a gay boy who is very feminine in his behavior is very unlikely to suffer from “going all the way” for a few years before he reverts to living as a gay boy. Will he be teased by his peers? Maybe. These boys often call one another “girls” anyway, so how bad could it be? But closeted and denigrated trans girls become depressed and suicidal. We know this, and we have statistics to prove it, but some people simply don’t care, or care enough.
One of these days I have to attend one of the conferences just to see what it is like; I am an associate member of WPATH.

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