Transing children

[Pratchet]

Brace doctor breaks cover and warns of the dangers

I don't Terfmore I learn to live with ambiguity.

Trans women are women because 'woman' (or female) is not only a legal designation but having a gender identity of 'woman' is a legitimate female gender identity with some basis in biology and physiology. No-one said this is an exact science. It's pragmatic.

No but it has been quoted here before. And yes I get it's run by lots of men and not always 100% factually correct. But it contains some useful summaries and it's accuracy is not actually that bad (see Nature study).

And everyone here, gender critical or not, can join Wiki and put in their own information and facts. Mate!

Supermatch Game
First point -
you quote a length from legislation that is obsolete. The current guidance is that someone is recognised as the biological sex of their choosing without need for the two years process.
Business/ agencies that do not recognise that change can be (but not necessarily) in breach of the EqA.

In public law proceedings a child is separately represented whatever their age.

Trans women are women because 'woman' (or female) is not only a legal designation but having a gender identity of 'woman' is a legitimate female gender identity with some basis in biology and physiology

Do you mean sex or gender here?

Because if you mean sex males who identify as women have the biology and physiology of males not females, of men, not women.

Saying that a man is a woman, is not pragmatic in any way.

the second point - best to give up on your analogy as (without being rude) I don't think you understand it.

@supermatchgame I want to thank you for your contributions here which are helping us to have a proper reasoned debate. I see that your understanding of gender identity as produced by a range of factors with specific emphasis on biology informs a lot of your other thinking, just as my understanding of gender identity as largely a social construct (including the individual response and performity) infforms mine. I just wondered if I could get your thoughts on the idea that the crossover of ASD and GID and homosexuality and GID is EVIDENCE of the social nature of gender? If I was a referrer and I concluded that GID in children was actually a response to mass societal homophobia and gender based oppression and never referred children to a GID clinic but instead went down a CBT route with family and school interventions to address the stories and narratives around gender and sexuality that were harming the child, do you think I would get away with that?

Albadross They do use identical twins - if they don't both have GID they know it's not innate, and that's what they found.

Not true. The few studies that have been done:

2011 Gender Identity Disorder in Twins: A Review of the Case Report Literature (includes Ken Zucker in this one)
Conclusion: These findings suggest a role for genetic factors in the development of GID.

Transsexuality Among Twins: Identity Concordance, Transition, Rearing, and Orientation. 2013 M. Diamond
The responses of our twins relative to their rearing, along with our findings regarding some of their experiences during childhood and adolescence show their identity was much more influenced by their genetics than their rearing. [bit overstates the case this one I think]

The heritability of gender identity disorder in a child and adolescent twin sample.
Coolidge FL1, Thede LL, Young SE.
Overall, the results support the hypothesis that there is a strong heritable component to GID. The findings may also imply that gender identity may be much less a matter of choice and much more a matter of biology.

Gender identity disorder and anorexia nervosa in male monozygotic twins.
Hepp U1, Milos G, Braun-Scharm H.
DISCUSSION:
GID in childhood could be at least partly hereditary, whereas the development of the later phenotype of the gender identification is more determined by environmental factors. GID might be a risk factor for the development of AN.

You wouldn't expect 100% concordance - there isn't for sexual orientation either. But there is increased concordance for both, and both reach statistical significance.

(That's it from me tonight, going to bed.)

SarahCarer sorry meant to answer you but getting side tracked. Will try again tomorrow or in the week.

SarahCarer -
"If I was a referrer and I concluded that GID in children was actually a response to mass societal homophobia and gender based oppression and never referred children to a GID clinic but instead went down a CBT route with family and school interventions to address the stories and narratives around gender and sexuality that were harming the child, do you think I would get away with that?"

not sure you'd get away with telling parents that they may need to change their way of doing things. Much easier to "fix" those pesky kids.

@supermatchgame thank you! I'd just like to add for the record that I obviously agree there are significant genetic factors since I think it likely that (diagnosed or undiagnosed) autism is a major factor and this is genetic. I'm not denying other external factors, including experience of sexual abuse. You see all of these things make sense to me. And then I read statements about something more innate about gender identity itself, something hard to define, hard to pin down. Not fully understood but somehow observable. Experts holding up their hands and saying "well it's complicated" "none of us can fully understand it" "a lot more research is needed" and then they go ahead and treat with chemicals and surgery, giving the patient the benefit of the doubt that this indefinable thing that we don't really understand is best accepted and reinforced even if there is a completely separate underlying cause.

Indeed Terfmore

I have been reading this thread with interest, thank you to posters who (with a much deeper understanding than me) are digesting studies and know enough to compare them with other bodies of research. I don’t agree that “treating” an under 18 who is experiencing some level of discomfort with their gender is acceptable. As a PP has posted, you don’t treat anorexics with an affirmative model that agrees they are fat.

I don’t unfortunately have anything particularly sensible to add, but I did want to thank @supermatchgame for sticking around and actually debating an opposing point of view. It’s very refreshing to see.

I too have benefitted a lot from reading this thread - SarahCarer especially. I can see how children who, for whatever reason - biological or not - have grown up with an unshakeable identity at odds with their birth sex, so that at some point their lives will be more tolerable if they can "pass" as the opposite sex.
I am deeply concerned, however, that older teenagers and young adults with no prior signs of gender dysphoria are being offered hormones and surgery pretty much a first line of treatment, especially when they have neurological differences (autism) or suffer from co-morbid mental health issues. The blanket ban on conversion therapy strikes me as entirely at odds with the premise that all patients deserve individualised care.
And I keep stepping back and saying "Really? Are we living in a society were surgically altering healthy bodies and administering cross sex hormones to people who (for whatever reason) do not conform to stereotypes is a better idea than helping them come to terms with the body they were born in (and challenging the stereotypes and bullying too)?"

The blanket ban on conversion therapy strikes me as entirely at odds with the premise that all patients deserve individualised care. And I keep stepping back and saying "Really? Are we living in a society were surgically altering healthy bodies and administering cross sex hormones to people who (for whatever reason) do not conform to stereotypes is a better idea than helping them come to terms with the body they were born in (and challenging the stereotypes and bullying too)?"

This is exactly how I feel. Also how did helping people to come to terms with a healthy body which they perceive as defective come to be viewed as 'conversion therapy'?

And I keep stepping back and saying "Really? Are we living in a society were surgically altering healthy bodies and administering cross sex hormones to people who (for whatever reason) do not conform to stereotypes is a better idea than helping them come to terms with the body they were born in (and challenging the stereotypes and bullying too)?"

Amen.

If I do not fit into the narrow little ‘girl’ stereotype box, the answer is not to surgically and chemically alter me into fitting the ‘boy’ box. It’s that our stereotypes are far, far too narrow. And damaging to people of both sexes. I don’t fit in that girl box, I never did. But I’m a woman, biologically. Stuff the stereotypes- they do untold damage.

This is major surgery, powerful drugs with multiple irreversible effects, with life altering consequences. A woman who is in her thirties and done having kids can’t even get sterilised but we are doing this to children? It’s against medical ethics.

@SupermatchGame in response to your twins studies comment:

There being genetic factors that lead to GID is NOT the same as gender ID being innate. It just means that there is some kind of disconnect between the sense of self and the body, which is also common in anorexia and ASD. It proves absolutely nothing about gender ID itself, just like anorexia is not actually that much about weight, it's about a mismatch of perception and reality in the mind.

Our sense of self by its very nature can only exist within the context of what's around us, it's not something we're born with that never changes.

My particular concern is for very young adults. I am not sure NHS clinicians dealing with children at least here in the UK are at all gung ho about hormones (no surgery under 18), except perhaps as a least worst option for a severely dysfunctional child.
Once you reach that magic age of 18, then you are an adult and have patient autonomy.
There is an enormous pressure from social media; from activists to "be your authentic self" and if anyone dares question you, that is transphobic; suicide promoted as a consequence of families not accepting wholeheartedly a change in gender..... Every public service seems hell-bent on enabling and encouraging social transition. Where is the route out of this for someone who in fact comes to a different conclusion about their gender identity? Where is the sane common sense voice which says, you've come this far, let's wait until you are a bit older?

And yes - doctors do seem to be able to gatekeep women wanting sterilisation, why not in the case of young adults seeking gender reassignment (that's an Orwellian phrase if ever there was one).

Also the sample sizes in those studies are tiny and the environment in which twins are raised will clearly have an effect on the sense of self.

Twins will also influence each other, just as much as the parents do, and will probably have a strong bond that may mean they will want to share traits or behaviours in a more pronounced way than with siblings who aren't twins. Their identities are going to be intertwined.

Its not conversion therapy though is it? It's not taking a person as they are and telling them that's wrong.

It's therapy to come to terms with your healthy physical body. It's self-esteem therapy. It's overcoming self-hatred therapy.

But this is want the ban says:

For the purposes of this document ’conversion therapy’ is an umbrella term for a therapeutic approach, or any model or individual viewpoint that demonstrates an assumption that any sexual orientation or gender identity is inherently preferable to any other, and which attempts to bring about a change of sexual orientation or gender identity, or seeks to supress an individual’s expression of sexual orientation or gender identity on that basis.

www.psychotherapy.org.uk/wp-content/uploads/2017/10/UKCP-Memorandum-of-Understanding-on-Conversion-Therapy-in-the-UK.pdf

Ah, another example of losing control of the language and you lose control of everything....

This:
’conversion therapy’ is an umbrella term for a therapeutic approach, or any model or individual viewpoint that demonstrates an assumption that any sexual orientation or gender identity is inherently preferable to any other, and which attempts to bring about a change of sexual orientation or gender identity, or seeks to supress an individual’s expression of sexual orientation or gender identity on that basis.

Is the most perfect example of a direct conflict I've ever seen.

Gay male -> straight woman = assumption that straight is better than gay = homosexual conversion therapy.

Lesbian Female -> straight man = same

If you affirm the gender change you are 'converting' the sexuality.
If you affirm the existing homosexuality you are 'converting' the desired gender identity.

Pure conflict because one characteristic relies upon sex and the other is gender. You cannot affirm gender without subjugating sex. And you cannot uphold sexuality without claims you are denying gender.

"You wouldn't expect 100% concordance - there isn't for sexual orientation either.
"

Except that the concordance rate for homosexuality is very much higher (66% vs 39%). So such biological basis for being transgender as there is, is clearly weak, and that's before we drill down into sexuality - in some cultures there are vast numbers of transgender biological males who have sex with males, and we know, for instance, that in cultures that are more traditional/homophobic such as Hispanic & black in the US, that the rates of transgender are higher.

I know a gay man in a culture with a high rate of transgender MSMs, who formally expressed as transfemale, but after moving to a different area, chose to express as male.

Dysphoria is one thing, but biological males expressing as female is certainly not solely the outcome of dysphoria, and in some cultures dysphoria may not even be a significant factor.

If two identical male homosexual twins both express as female, is that a reflection of a 'trans' biology or instead a 'gay' biology being expressed in an effeminate way.

Try as they might, no-one has yet found biological markers that show a basis for trans identity. One ridiculous, recent study purported to show statistically significant differences of brains of transgender people, however when you read through, all the subjects were Brazillian trans-expressing males who had sex with men, aka homosexual men. And the comparison was not made with homosexual men, but with so-called 'cisgender' men, without adjusting for sexuality.

SarahCarer - some more thoughts below. Apologies if this is too long and I might have wandered into some confusion at one point.

your understanding of gender identity as produced by a range of factors with specific emphasis on biology

I don't think I'd say my emphasis is on biology, just that genetics and biology are evidenced components. As others have said identity development is multifactorial. Whatever its antecedents, gender identity appears to be immutable - in most children and adults (not all).

the idea that the crossover of ASD and GID and homosexuality and GID is EVIDENCE of the social nature of gender?

Ok but I'm not understanding your thinking. ASD is neurodevelopmental. Homosexuality likely has a significant biological and or genetic cause. So if there is an intersection with GID does that not indicate an even stronger likelyhood of a biological element in GID as well? Otherwise why would they coincide? Yes there could be a social cause but 2 of the 3 already have an established biological element. So yes it could point to a social cause, but at the very least (and possibly more so) it could also point to a biological cause?

The rigidity of thinking is some ASD people could contribute to the confusion in establishing gender identity in some individuals where there is already gnc behaviour. Or it could be that there is some sort of underlying developmental/ biological cause underpinning both, in some cases. There could be as many different combinations of factors as there are people.

For me a more social one would be say: a child who suddenly their school work declined, they avoided social situations, had suicidal ideation. 3 things. The common underlying cause could be 'bullying' as social cause. Reading that back I don't know if that helps really I'm just exploring the ideas. (I wasn't sue whether to delete this paragraph!)

If I was a referrer and I concluded that GID in children was actually a response to mass societal homophobia and gender based oppression and never referred children to a GID clinic but instead went down a CBT route with family and school interventions to address the stories and narratives around gender and sexuality that were harming the child, do you think I would get away with that?

Why would you conclude that it was a response to mass societal homophobia and oppression? When there is some evidence of biological element to both sexual orientation and gender identity? Also hasn't conversion/ reparative therapy failed for both homosexuality and GID?

Why would it be ok to try CBT for GID but not sexual orientation? A valid answer could be because GID requires medication and surgery and it would be best to avoid that. I agree. It would be best if anyone could avoid medication and surgery. Ken Zucker has tried that with children though. I actually supported his work. I don't think he was transphobic or homophobic. But I find it odd that in the whole world only one single person was openly trying it. That actually astonishes me... that in recent times there is only a record of one person openly trying to discourage a transgender outcome in children - in the entire world? That must tell us something surely?

The current thinking appears to have moved on to say that transgender identity is not a disorder - but a normal variant of human gender/ sex/ identity (whatever). I'm not sure I agree with that because I think if you need medication and surgery to function properly then surely that is a medical condition? What else is it? I guess they have dealt with that by changing the term to gender dysphoria.

"none of us can fully understand it" "a lot more research is needed" and then they go ahead and treat with chemicals and surgery, giving the patient the benefit of the doubt that this indefinable thing that we don't really understand is best accepted and reinforced even if there is a completely separate underlying cause.

So it comes down to what do we do with someone that is in extreme distress and we don't have an evidence base to 'cure' it? But there is a small amount of evidence that the chemicals and surgery route does have a positive outcome for some. So what do we do?