Sunday, December 18, 2016

National Geographic's Gender Revolution

Recently, National Geographic made headlines by putting a transgender child on the cover.  The response has been mixed to put it mildly, ranging from praise for furthering human rights to criticism for promoting child abuse. In light of that discussion, I thought it worth noting several things about the transgender question that ought to be part of the discussion.

TRANSGENDERISM HAS COMPLICATED ORIGINS

Glenn Stanton offers a list of potential causes for gender dysphoria: the “girl trapped in a boy’s body” conviction; family and parental dynamics (“family noise”); psychosexual disorders; not being directed or encouraged in typical gender behavior; and a mix of many of factors. His conclusion?

"The truth is that no one really knows what’s behind it, even the most cutting-edge researchers and clinicians. A 2014 book for clinicians, Treating Transgender Children and Adolescents, explains, in academic terms, 'No unequivocal etiological [causal root] factor determining atypical gender development has been found to date.' Translation: We’re just not sure what causes it."
Walt Heyer, who was formerly transgender, writes:
Has any biological basis been found that indicates who will develop into a transgender? Is there a genetic marker in transgenders? The answer is no. Researchers have looked for evidence to prove that transgenders are different biologically but they haven’t found any. One study published in 2014 looked at certain suspected areas of the brain for an association with male-to-female (MtF) transsexualism and found none. Another study, published in 2009, looked for “evidence that genetic variants of sex hormone-related genes confer individual susceptibility to MtF or FtM transsexualism” and didn’t find any. Yet another study, published in 2013, found that “gender disorder does not seem to be associated with any molecular mutations of some of the main genes involved in sexual differentiation." Not a smidgeon of abnormality can be found in the genetic makeup of transgenders so, no, transgenders are not born that way. They are normal males and females.
In response to a flyer that read, "“Gender dysphoria is increasingly understood…as having biological origins,” Kenneth Zucker, one of the top researchers in the world, responded, "In terms of empirical data, this is not true. It’s just dogma, and l’ve never liked dogma. Biology is not destiny.”

The current science has found no compelling evidence that gender dysphoria is a case of being “born that way.”  Genetic or epigenetic arguments offer only speculation based on circumstantial reasons, and an imbalance of hormones seems unlikely. Male to female transgender brains are not feminized. The y-antigen connection has been disproven. People may feel they were 'born that way' because they have had the feelings for as long as they can remember, but that is very different from saying there is a verifiable physical cause.

What is abundantly clear, however, is the role that nurture plays. Nurture is a broad term that includes a lot of complexities about how peers and communities affect one’s view of self and genderMany boys report feeling ostracized because of ineptness at sports. In clinical settings, abuse rates as high as 80% have been recorded. Some feel like they don't fit in with their peers' expectations of gender-related appearances or activities; some are same-sex attracted and don't want to be perceived as gay, and they see switching genders as the solution. The rising number of young girls who are being diagnosed claim they want to be male because of the objectification and pornification they feel even at an early age.

Considering the role that nurture plays, it would seem prudent to explore what has been present in the environment of children that has encouraged them toward gender dysphoria rather than celebrate something that current research suggests is a response a troubled past.

TRANSGENDERISM IS USUALLY TRANSIENT IN CHILDREN

A child’s desire to be transgender is usually transient. For three-quarters of them (and perhaps as high as 88%), the desire will fade if there is early intervention. Study after study confirms this.
  • “Multiple longitudinal studies provide evidence that gender-atypical behavior in childhood often leads to a homosexual orientation in adulthood, but only in 2.5% to 20% of cases to a persistent gender identity disorder (3, 6, 22). Even among children who manifest a major degree of discomfort with their own sex, including an aversion to their own genitalia (GID in the strict sense), only a minority go on to an irreversible development of transsexualism…All of the 21 patients who received a new diagnosis of GID in our clinic up to mid-2008 (aged 5 to 17; 12 boys, 9 girls) had psychopathological abnormalities that, in many cases, led to the diagnosis of additional psychiatric disorders. As a rule, there were also major psychopathological abnormalities in their parents.”   
  • “This study provided information on the natural histories of 25 girls with gender identity disorder (GID). Standardized assessment data in childhood (mean age, 8.88 years; range, 3-12 years) and at follow-up (mean age, 23.24 years; range, 15-36 years) were used to evaluate gender identity and sexual orientation. At the assessment in childhood, 60% of the girls met the Diagnostic and Statistical Manual of Mental Disorders criteria for GID, and 40% were subthreshold for the diagnosis. At follow-up, 3 participants (12%) were judged to have GID or gender dysphoria.” 
Dr. Kenneth Zucker, a psychologist and head of the gender-identity service at the Center for Addiction and Mental Health in Toronto, has noted:
“The fantasy solution [a full transgender transformation] provides relief but at a cost. They are unhappy children who are using their cross gender behaviors to deal with their distress. Treatment goal is to develop same sex skills and friendships. In general, we concur with those who believe that the earlier treatment begins, the better... It has been our experience that a sizable number of children and their families can achieve a great deal of change. In these cases, the gender identity disorder resolves fully, and nothing in the children's behavior or fantasy suggest that gender identity issues remain problematic."
Based simply on the clinical research, the best course of action for the vast majority of gender confused children is to offer treatment, not applause.

TRANSGENDERISM IS SOMETIMES DIFFICULT TO DIAGNOSE

There are a number of things that mimic gender dysphoria, such as autogynephillia, Body Dysmorphic Disorder, Dissociative Disorders, transvestitism, and internalized sexism. The children are in a tough situation, and they need help to find their way toward healing and hope. To quote Walt Heyer once again:

What researchers have found is that a majority of transgenders have at least one psychiatric co-existing (co-morbid) disorder, the most prevalent being major depressive disorder, specific phobia and adjustment disorder…What researchers have found is that 30 percent of gender dysphoria patients have a lifetime diagnosis of dissociative disorder (formerly called multiple personality disorder). Dissociative disorder and gender dysphoria appear very similar, and clinicians often cannot distinguish between the two in the transgender patient.

I think psychologists quickly default to the diagnosis of gender dysphoria and don’t consider the possibility of other disorders. I know: this is what happened with me. The most highly regarded gender specialist in the nation diagnosed me with gender dysphoria. He told me that I was a transgender and recommended that I undergo surgery to transition from male to female. All my discomfort would go away after surgery, he said. He was wrong.”

There have even been cases where other co-existing conditions like OCD were treated and the gender dysphoria went away. 

To summarize so far: if a young child, such as the one on National Geographic's cover, exhibits gender dysphoria, there should be a long, rigorous intervention that carefully explores and then addresses the reasons why, with the primary goal being the realignment of identity with biology, not the cover of a magazine. That's not religious nutcrackery; that's a solidly pragmatic response based on the research. 

OPENING PANDORA'S TRANSGENDER BOX

It's one thing to be a society where we allow people to view themselves as they wish and adjust their lives accordingly. I suspect that if that was all that was happening, people would agree or disagree with little fanfare. Generally speaking, most people like to 'live and let live' within the ordinary constraints of the law. The issue isn't the freedom to self-identify; the issue is whether or not everyone else should be asked - or even forced - to affirm or celebrate that self-identity.

Let's follow the idea on a logical progression. Why should our acceptance and affirmation stop with the self-identifying of gender? Why not include age or race? People like Stefoknee are identifying as a different age than they actually are (Age Dysphoria, or Age Identity Dysphoria). Others are creating a lot of tension by identifying as having an ethnic background different than their actual one.

We don't have to merely speculate on where this could take us; we can look at some people who are currently pushing the identity envelope. Some people have Body Identity Disorder; they are amputating perfectly healthy limbs because they identify as transabled. Some think they are animals (species dysphoria). Others claim to be otherkin or furries, and they are ready to be taken seriously. A Norwegian woman thinks she is a cat; another is convinced she’s a dragon (you can watch a documentary on this phenomenon here). Vinny Ohh is changing his body to match his self-perception of being a genderless alien. Some think they are vampires, and not everyone is convinced they should be told differently.  A few even think they are dead (Cotard's Syndrome).

I don’t highlight their cases to shame them. I am simply noting that they have a serious self-identification very much at odds with reality, and they are increasingly asking others to accommodate them. While the manifestation is different than someone who is transgender - someone who thinks they are dead is in a very different place indeed than someone who questions their gender identity -  the principle is the same: people believe they are something different than what their biology dictates, and they are committed to living as if their perception is true.

Let's grant that people have the right to self-identify as they wish. Let's also grant that no one should hate, mock, or belittle them. But will there ever be a time when we as individuals or a society ought to step in and say, "I'm sorry, but you are not what you think you are. And because we care, we cannot enable you." I think the obvious answer is yes (just look at the list above again). We agree that we should at some point; we disagree about whether or not that point begins with gender identity or somewhere else. 

I don't think it's bigotry or discrimination when we draw that line. It's a support of truth - a hard, inconvenient and uncomfortable truth, to be sure, but one that someone must speak in an increasingly post-truth world.
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RECOMMENDED LINKS

Gender Dysphoria in Children: American College of Pediatricians 
Transgender Trend: Parents Questioning The Trans Narrative 
4th Wave Now
Regret Isn’t Rare: The Dangerous Lie of Sex Change Surgery’s Success

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