Over the past year or so, there’s been a curious and sudden surge of awareness in the general public consciousness about the issue of transgender children. While their existence is something that has been going on for… well… forever, and the trans community has certainly been aware of the likely fact that gender identity is typically developed very early in life (even if not always precisely articulated and negotiated until later) and have been aware of the issues related to it, it seems that it wasn’t until 2011 that it was all that discussed or considered in the general imagination.
Yet now we’re beginning to find it in the news. The actual, mainstream news. There was Storm, the child in Ontario who was not openly assigned a gender by hir parents, the story of the identical twins Nicole and Jonas in Boston, one a trans girl and the other a cis boy, and the issue of Bobby Montoya, a young trans girl, being included in a Colorado Girl Scout troop. Last week a 10-year-old trans girl from England who has faced significant exploitation, dehumanization and misgendering by the media (I wonder which paper, possibly beginning with the word “Daily” and ending in the word “Mail”, may have been involved?), appeared with trans media activist Paris Lees on BBC Breakfast. I found out about this through the shower of horribly transphobic tweets that followed. And recently there’s been a controversy surrounding a father in Berlin’s efforts to have his 11 year old transgender daughter involuntarily admitted to a psychiatric hospital so as to ensure that she cannot follow through on her wish to prevent a masculinizing puberty (and ideally, in his view, “cure” her and have her somehow become a typical cisgender boy).
There’s a very key thing to remember: prevention.
I have no idea what’s triggered this cultural shift, and why this issue (and trans issues in general) are suddenly beginning to be paid attention to rather than ignored, ridiculed or sensationalized as they have been for the past half-century. Maybe some kind of zeitgeist thing with our movement? I may talk about that some time soon. As a whole I regard this as a good thing, a step in the right direction. This is how we move forward. We still have a very long way to go, and a long, hard, vicious fight ahead of us, and we’re a good fifteen years behind the gay/lesbian rights movement (at least), but we’re making progress. At least now people seem to know we exist. We’ve achieved visibility.
Trans children, though, raise a number of difficult ethical considerations, and while these stories allow on the one hand for a very humanizing portrayal of trans lives (it’s much, much harder to call a child a freak, an abomination, a sinner or someone who deserves to be stomped into a mudhole), it is also able to be almost effortlessly spun into a spooky tale of the horrors and moral failures of modern society by those with the means and motive to do so. With each story of trans lives and trans rights that are now entering the mainstream media (I know, mainstream media. I still feel a little bit shocked every time I type it) there also comes a reactionary transphobic response from the right wing viewing this as a collapse of some fundamental family value thing.
These responses to the stories of trans children inevitably swathe themselves in the panicky, transphobic, fear-mongering and painfully dishonest rhetoric of “doctors now giving sex changes to kids!” (where were you self-righteous fuckers when they were performing non-consensual genital surgery on intersex infants?!). There’s an undeniable parallel between this rhetorical tactic and the language of “Obama forcing religious organizations to pay for employees’ abortion-causing drugs!” …it’s also every bit as much about controlling other people’s bodies and sexuality. What terrifies me is the degree of success that this kind of strategy has had in controlling the debate surrounding contraception and abortion, and how effectively they’ve been able to use these simple but incredibly disingenuous terms and redefinitions to frame the discourse to their own preference. I’m terrified that they’ll be able to similarly control the discussion surrounding transgender minors.
The thing is, the ethical ambiguities of transition for minors are apparent to anyone. If someone takes the statement “doctors are giving sex changes to kids!” at face value, of course they’re going to be appalled. Even the most trans-friendly cis readers will look at that and find it ethically dodgy and unscrupulous at best. A minor can’t possibly provide informed consent for a medical treatment with such intense, long-term and irreversible implications and consequences. It would be horrible to allow an 11-year old to just say “I want to be a girl!” and then go ahead and perform a vaginoplasty right then and there.
Making this issue scarier is how enormously uninformed (or misinformed) the cis public are about transgenderism, transsexuality and related treatments, like lack of awareness of how ridiculously and needlessly difficult it is for even an adult to be approved for SRS. Most people simply aren’t going to understand the medical processes involved well enough to spot the lies, spin and manipulative rhetoric when they see it. Most people don’t know the differences between and definitions of anti-androgens, feminizing and masculinizing sex hormones, lower surgery, top surgery, facial feminization surgery, binding, tucking, tracheal shave, LHR, electrolysis, hysterectomy, etc. Most people just have a vague conception of “sex change operations”. Thanks to our good friend Shoddy Media Portrayals Of Transsexuality, the popular conception is that it’s an all-in-one surgical procedure: in walks a boy, out walks a girl (the popular conception doesn’t even include the vice versa, of course).
So if the reactionary, right-wing, transphobic contingent of society are able to control the terms of the discourse, and frame this as “doctors giving children sex changes!” (rather than, say, “transgender children being permitted access to medical options to preserve their choices and prevent traumatic and irreversible physical changes”), that will have terrible consequences in terms of how the public reacts to the issue of trans kids as it gains increasing visibility. There’s just not going to be enough cis people who understand this stuff well enough to fight that. We could easily end up in a situation where legislation is passed barring doctors from offering blockers to transgender children, and forcing them to endure an unwanted, hellish, traumatic living nightmare of an adolescence as their body develops in exactly the wrong way. And the general public aren’t going to give two damns about the number of suicides this will lead to, if they even hear about it. All they’ll hear is echoes of “doctors giving sex changes to kids!”
This is why it’s extremely important to address this now. To raise awareness and understanding, define the terms of the discourse and make sure the actual reality of what’s being discussed is clear. For instance, no one is talking about giving SRS to minors. It’s important to do all this before the misconceptions, lies and spin become entrenched and people look at it as something other than what it is.
The most important thing is that people be aware of the actual treatment that is offered to trans kids. It is not SRS, and it’s not even masculinizing / feminizing hormones like testosterone or estradiol (except in very rare, special circumstances). Treatment for minors typically involves Lupron.
Lupron, or Leuprorolin, is an agonist against certain pituitary receptors. It down regulates secretion of luteinizing hormone and follicle-stimulating hormone, and leads to very significant reduction in testosterone and estradiol levels in both sexes.
Basically, what Lupron does is delay the onset of puberty and the irreversible physical changes that go along with it. Lupron does not, in and of itself, cause any significant irreversible changes. What it does is preserves the child’s choice. It maintains a physiologically “blank slate” state in regards to secondary sex characteristics until they’re old enough to make an informed decision about transition, and provide consent for more serious, long-term treatments like hormone replacement therapy or SRS (such as around age 17 or so). Naturally, the child can choose to present or identify in whatever manner they choose during this time, and should be able to socialize relatively easily as their identified sex.
This has enormous benefits for a transgender child. In the case of a trans girl, for instance, you’ll prevent skeletal masculinization (irreversible), deepening of the voice (irreversible), the development of body hair and facial hair (the latter of which can only be eliminated through lengthy and extremely painful and expensive laser or electrolysis treatments), and allow the physiological process of transitioning to female to be far, far easier than it otherwise would have been, and also provides the additional psycho-social benefit of her being much more easily able to blend in and be accepted as her identified sex. Perhaps most importantly, you prevent an extremely traumatic, miserable, painful adolescence. You allow her to be able to enjoy the remainder of her youth instead. Puberty is already a pretty traumatic and horrible thing to endure, but when you’re trans and your gender identity doesn’t match what you’re body is turning into it is, like I’ve said, a waking nightmare. Needlessly subjecting a child to that is beyond reprehensible. It’s a form of torture. I wouldn’t wish any young girl to go through what I went through.
Conversely, in the unlikely case that the child doesn’t end up choosing to transition, and instead ends up choosing to live as their assigned sex instead, there’s been little to no long-term consequences from the Lupron being used as a preventative medication. Once it is discontinued, adolescent development can continue normally. If for whatever reason it doesn’t, it can be easily assisted through administration of testosterone or estradiol and progesterone.
It is also important to note that absolutely no medical intervention, not even Lupron, is either necessary or prescribed until adolescence. This is a case of teenagers being given a harmless means of preserving their own choices that we’re talking about, not 9-year-olds being put under the knife. We need to make sure that remains EXCEPTIONALLY clear, and not allow anyone to distort this into seeming like the latter. A 9-year-old who was assigned male may identify as female, and her parents may permit her to present as female and refer to her by a female name and pronouns, but so what? That’s not an issue of bio-ethics, it’s simply a set of parents making a choice to be loving and accepting, making the choice that they feel (almost certainly correctly) is best for their daughter. It’s nobody’s fucking business.
Another issue worth considering is the ways in which we’ll often try to advise that now’s not the best time for trans people. And trans people will themselves use this rationalization in their own thought processes. It’s important to understand that this statement, this means of denying the legitimacy of a trans identity, is used at every point in a trans person’s life. Within this mentality, “now” will never be the “best time”. There was a fantastic write-up of this at Cisnormativity a little while ago that provided the inspiration for this post. Basically, we say that now isn’t the best time in the case of children because they’re not old enough to know their own gender yet (bullshit; gender is one of the very first things we understand about ourselves). We say that now isn’t the best time in the case of teenagers because it’s too complicated a time in their lives and they’re still trying to figure out their sexuality and they’re all hormonal and it’s “probably just a phase” and so on. We say that now isn’t the best time for young adults in their 20s because they need to find work, and they can’t afford it, and their friends and family will shun them, and they have too much to lose, and besides it’s “too late” now anyway and they’ll never “pass” or find love or be happy (this is the one that kills me… within these rationalizations we go immediately from thinking we’re “too young” to thinking we’re “too old”). We say that now isn’t the best time for adults in their 30s or older because it’s definitely “too late”, they have too many responsibilities, they may have a spouse and/or children that they don’t want to hurt, they have a career they can’t risk, they’re “just going through a mid-life crisis” etc. At every point in a trans person’s life, there’s a justification that can be found to claim that they ought not transition at this point. The arguments we use against allowing minors to define their gender for themselves are no more reasonable, rational or justified than the ones we use against adults.
Now that this issue has ceased to be a private matter of individuals and families, and instead emerged into cultural visibility, I do worry about where things will go. I periodically participate and volunteer with Vancouver’s Trans Youth Drop-In. It’s a fantastic organization, really. What they do is provide a nice, friendly, safe space for trans youth to just come and hang out. Food and beverages are provided, as well as things like movies, video games, art stuff, activities, etc. It’s really an awesome, wonderful thing, and provides exactly what a lot of young trans people need the most… a space where they can feel safe, accepted, understood and “normal”.
That group has been a bit of an inspiration for me. It’s amazing to see all these kids who had the strength, courage, self-awareness, clarity, love and support to be able to transition before putting themselves through all the pointless pain and self-hatred. It’s the kind of thing that I’d expect myself to be bitter, jealous and a bit resentful about, but for some reason I’m just… not. Instead I’m just happy for them. I admire them and wish them the lives they deserve, that we all deserve.
It’s probably been my most distinct motive with all of this, with taking on this sort of role and getting involved in trans activism and everything. There are a lot of risks involved, it’s draining and exhausting, it’s often rather thankless, it usually seems utterly bleak, it sometimes seems hopeless, I have to constantly read and write about incredibly depressing things, I expose myself to all kinds of hostility, I’ve chucked my ability to reliably go stealth out the window, and it certainly hasn’t made my own life any easier or provided any material reward. But what it keeps coming back to for me, over and over again, is that I want young trans people, and the generations to come, to have a better world than the one I got. I want them to be able to just be who they are and not have it tied up in all the shame and hatred and ridicule and everything. I don’t want them to have to worry about any of the stuff I’ve built a blog out of worrying about. Do you know what I mean?
So when I see this issue being discussed in the media, I’m excited and proud. But I am also scared out of my mind.
Please, can this one turn out alright?