Monday, January 23, 2017

Dr. Zucker

Every trans person eyebrows just rose in wondering “What about Dr. Zucker?” he has that effect on us. Whether you are just coming out, or you are a seasoned veteran we all have our opinion about Dr. Zucker and almost all of them are bad opinions, which I think with just cause. Dr. Zucker is from the old school which included Dr. Money… which is that gender is a social construct (read “As Nature Made Him: The Boy Who Was Raised as a Girl”).

The website TransAdvocate has started a series on the history of the Centre for Addiction and Mental Health (CAMH) gender identity program which was recently closed down.
Part I – The Rise and Fall of #DiscoSexology: Dr. Zucker, CAMH, & Conversion Therapy

With the recent enthusiastic promotion of disco-era ideas about trans people and gender identity in general, the TransAdvocate felt that it would be important to release a comprehensive review of these ideas. In this series that will feature the tag #DiscoSexology, the TransAdvocate will review the fomentation of these gender postulations into an axiomatic body of circular logic, how this circular logic was and continues to be vigorously promoted and defended, regardless of the cost to it research subjects: children and even infants.  Moreover, this series will trace the rise and fall of the Centre for Addiction and Mental Health (CAMH) gender program as envisioned by Disco Sexologists, featuring full length interviews with the clinical director of CAMH and a long term survivor of Dr. Zucker’s specialized treatment. Other interviews include:
  • An interview with a Radical Feminist pioneer in affirmative care for trans people.
  • An interview with the co-author of the SAMHSA’s repudiation of reparative therapy and co-founder of Gender Infinity.
  • An interview with the author of the groundbreaking book, The Last Time I Wore A Dress: A Memoir.  
  • An interview with a sexologist who dared question the gender postulations of Dr. Money and paid the price.
Along the way, this article will provide first-hand accounts of a presentation in which Drs. Zucker and Green presented back-to-back arguments against laws banning conversion therapy, as well as a comprehensive review of the uncritical media exposure disco-era gender ontology currently enjoys.
Depending on who you believe, when Toronto’s Centre for Addiction and Mental Health (CAMH) parted ways with the controversial sexologist Dr. Kenneth J. Zucker and committed itself to a process of restructuring, CAMH either took a significant step towards providing ethical community-based trans care or, as Zucker’s advocates would have us believe, fell into the hands of politically correct trans activists who intend to use the bodies of vulnerable children to further their “transgender ideology” and/or “transgender agenda.” This article reviews and contextualizes the fact claims made by both sides of this story and contrasts these claims against the experience of a long-term recipient of Zucker’s therapy and the realities behind CAMH’s restructuring, as described by its medical director.

In the process of doing research for this article I noticed there seems to be a particular set of ideas, propagated around the time of the disco era, that stand in stark contrast to contemporary ethical therapeutic models for working with transgender individuals. I came to think of these particular views as “Disco Sexology.” At its heart this is a story about a cathartic moment in the way mental health professionals regard trans people and the trans experience itself.  Sexolological ideas about trans people from around the time of the disco era have held sway over the care and treatment of trans kids and adults until very recently. Sexologists who postulated that sexual fetishes and/or gender roles drove trans people to implicitly experience their bodies in the way they do in no small way comprised the ontological foundation of trans care for decades.
When I first heard about CAMH I thought it was great to have such of prestigious institution like CAMH on our side, but it didn’t take long for doubt to start forming in my mind about them.

The first doubt that formed was… I am not sexually attracted to men so they are saying that I’m not trans? Then there was that “sexual fetishes and/or gender roles drove trans people” but I knew that I should have been a girl long before I was sexually aware and don’t girls have sexual fantasies? And don’t lesbians have dreams about making love to other lesbians, why are mine now labeled “sexual fetishes” for the exact same thing?

Then the biggie came out… “autogynephilia” Whoa! What was that? Wait a minute what research was done, by whom, what was the control group? Were their findings repeatable? And for that matter how was their research conducted and the more I looked into it the more I found out it was junk research.

The TransAdvocate article goes on to said that this is the first part of a series of article on the history of CAMH.

In part II the history of CAMH is discussed,
Part II, The History – The Rise and Fall of #DiscoSexology: Dr. Zucker, CAMH, & Conversion Therapy

Founded in 1968, CAMH established a gender program for youth led by psychiatrist, Dr. Susan Bradley in 1975. Until recently, the type of sexology CAMH both practiced and promoted was the product of 1970s-era gender theory. Dr. Zucker was introduced to Bradley while at graduate school and went on to collaborate with Bradley’s gender identity program. Zucker became the program’s clinical lead in 2001.

While Dr. Bradley was working to establish the CAMH gender identity program, Dr. Richard Green, founding editor of the Archives of Sexual Behavior, began working on a study that would inform the CAMH approach to working with gender diversity in children: The Sissy Boy Syndrome study. This study found that since almost all of a group of effeminate boys grew up to be cisgender, the authors presumed that most trans kids will therefore also grow up to be cisgender. Around this time, Dr. John Money was working on his own study concerning gender identity in youth. While Green’s study continues to be cited in mainstream news, both studies were later implicated in the deaths of their study subjects.

What follows is an overview of how Green’s research informed the clinical practice of CAMH’s gender identity program for youth:

Comprehensive reviews of the literature by Zucker and Bradley (Zucker & Bradley, 1995, 1999; Bradley & Zucker, 1997) report that there are no definitive evaluations of interventions with children and adolescents diagnosed with GID. One study, often cited in discussions of the long-term implications of gender variance among youth is Green’s (1987) report on “sissy boys.” Very few discussions highlight the problematic findings of this study. Green conducted a follow-up on 66 feminine boys referred to his clinic and a control group of 56 masculine boys. He was able to contact only 44 of the feminine boys and 35 of the masculine boys for follow-up, representing a loss of approximately a third of both groups, growing concerns about biases among his remaining participants. Interestingly, of the feminine boys, only one was considering sex reassignment surgery at follow-up, but most reported same-sex or bisexual desires. Green concludes that most feminine boys eventually forgo the desire to change sex without therapy, suggesting that his sample largely consisted of “pre-homosexual” and not “pre-transsexual” boys. Green’s study is a central cornerstone of early approaches to gender variant youth, yet the study has been overvalued given its biases. A better sense of what happened to Green’s sissy boys was revealed in a recent report by one of the participants in Green’s study. Bryant (2004), one of Green’s “sissies,” in a paper presented to the American Psychiatric Association, describes Green’s treatments as a trauma. He reflected on Green’s rejection of his femininity and said this:
I experienced this as a strong negative judgment about something I felt very deeply about myself, at my core. As a result, I think that the main thing that I took away from my years at [Green’s gender clinic at] UCLA was a kind of self-hatred and a loss of a sense of who I really was. I learned to hide myself, to make myself invisible, even to myself. I learned that who I was, was wrong.
Bryant suggests that treatment protocols for these children and adolescents, especially those based on converting the child back to a stereotypically-gendered youth, may make matters worse, causing them to internalize their distress. In other words, treatment for GID in children and adolescents may have negative consequences.
The thing that I see wrong with CAMH is that they are living in the past and when science moved past them they clung onto their old ways, even when it was shown that their ways caused harm. I think because of that it was the right thing for CAMH to do in shutting down the gender clinic.

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