Transgender
NOprophet_NØprofit
Shipmate
in Epiphanies
I've no expertise in the area. It is affecting my extended family, of which I don't have much, so we all get quite involved. You might not have guessed it from my persona on SOF, but I'm the calm, sensible, and supportive one, who keeps opinions to himself - you guys get more of my turmoil and your discussion is appreciated. Probably transgender affects many? I'm thinking that there are at least 4 things:
We seem to be dealing with the fully affirming 1st approach, and the mental health 4th approach in my list. I've developed the understanding that the fully affirming approach is too much, that there is merit to the mental health approach, and that the 2nd approach is probably best.
I'm also not finding myself agreeing that gender and biological sex are fully different. Obviously for the vast majority, they are coincident. So the the norm is they are the same. That's not necessarily to judge abnormal when they are different, but to say that they usually (normatively) coincide.
I found this article thoughtfully written:
When Children Say They’re Trans. Hormones? Surgery? The choices are fraught—and there are no easy answers (The Atlantic).
- fully affirming approach - someone says they are trans and it is accepted and supported without any or much question, and doctors who are in to this start on hormones and easily and quickly refer to surgery.
- a watchful waiting approach - someone says they are trans and people are supportive, say go slowly, and there is a bit of inquiry and scepticism
- sceptical approach - see trans as part of a development process is an open society which has made it possible to question gender identity
- mental health approach - sees gender questioning and trans as part of a mental illness issue where depression and other mood problems use trans and gender as solutions, much like people use substance abuse or self harm to deal with feelings
We seem to be dealing with the fully affirming 1st approach, and the mental health 4th approach in my list. I've developed the understanding that the fully affirming approach is too much, that there is merit to the mental health approach, and that the 2nd approach is probably best.
I'm also not finding myself agreeing that gender and biological sex are fully different. Obviously for the vast majority, they are coincident. So the the norm is they are the same. That's not necessarily to judge abnormal when they are different, but to say that they usually (normatively) coincide.
I found this article thoughtfully written:
When Children Say They’re Trans. Hormones? Surgery? The choices are fraught—and there are no easy answers (The Atlantic).
Comments
It was back then (maybe still is) classified in the DSM as a mental disorder. Something we discussed was the idea that it was more like a physical disorder - if a person’s body doesn’t match their inner gender, that is something wrong with the body rather than the mind, and can be addressed by altering the body.
The "sound mind" bit seems to be that if you aren't then it may be that the lack of acceptance by others and yourself caused the mental health issues. Which is from my view probably an association with causation a whole other thing - correlation. The affirming way seems to march along the path that if you aren't affirming you may be "evil". And then we have announcements of changes to pronouns and names....
I cannot find any decent data at all for this contention. It seems to be in the realm of opinion and ideology. Like the research which is said to support drinking
What I would be interested to know is, how much is profound response and how much, in a sense, fashion of the moment? No one could doubt Jan Morris living at a time when the topic was at the wilder margins of NoW sensationalism. But now, is it in danger of being flavour of the month, the answer to all and every discontent with societal expectations?
I was a big, boisterous, ungirly girl, reading boys’ comics and modelling myself on my older brother. I am not unhappy with my biological identity, while noting how differently my personality would have been perceived if it had been packaged in a male body. Is the problem with the individual or with what society decides is ‘male’ or ‘female’ attributes?
We were taught that there was a lot of research evidencing it, but as I didn’t specialise in this subject, I didn’t read it, so I did just pretty much take their word for it. I can see though, thinking about it, that it must be something quite difficult to get thorough research evidence on, as it wouldn’t be experimental, so no control groups, and maybe nothing longterm yet either, and accounts of mental health are to a large extent subjective.
AIUI, the process here is much slower, especially with those under 18. It used be the case that an order from the Family Court was needed at least for those under 15, but my recollection is that that is being changed - and I'm not sure if abolition a useful step or not. Even for adults, the hormone-taking stage is not reached until the person has had an extended period of living as a person of the chosen gender. In other words, the whole procedure is very much of your 2nd approach.
Like NEQ, we're baffled by the upswing. It certainly seems flavour of the month with the press here (and that's not a comment on No Prophet's relation).
For a while, people were thinking it was all societal - that gender identity was simply learnt from cultural norms rather than inbuilt sense of gender. Then there was that case in Winnipeg of the boy whose penis was removed when he was a baby because of a circumcision surgery gone wrong, so his parents decided to raise him as a girl, not telling him that he was born a boy. He always felt uncomfortable and wrong, not inderstanding why - and when they finally told him, it made sense to him and he decided to switch back to being a male. Sadly, he later decided to end his life. This case made people rethink the whole idea of gender as purely a social construct. https://en.m.wikipedia.org/wiki/David_Reimer
To me, it is fascinating because I seem to have no sense of gender identity at all. So I can understand people not identifying with a particular gender - but I can’t imagine what it must be like to identify with a particular gender, whether it is the one that matches your body or the one that doesn’t match it. I tend to think my lack of gender identity must be to some extent a societal thing - the same reason I don’t have the body shame that so many women have, because I’m quite a solitary person who doesn’t easily pick up on subtle societal messages. But I imagine it is inbuilt too.
‘If you want to have genital reconstructive surgery, you'll usually first need to live in your preferred gender identity full time for at least a year. This is known as "social gender role transition" (previously known as "real life experience" or "RLE") and it will help in confirming whether permanent surgery is the right option.’
It does also say: ‘One review of a number of studies that were carried out over a 20-year period found that 96% of people who had genital reconstructive surgery were satisfied.’
https://www.nhs.uk/conditions/gender-dysphoria/treatment/
I don't know about the medical stuff. I just hope that if someone close to me transitioned I would react with love. I'm sure most of the people visiting this page would do the same.
I didn't see the TV programme, but it was serialised on Radio 4, and I listened to it then. It bothered me, partially because it seemed to me that Amy wasn't living like most of the 10/11 year old girls I knew, going to Guides, taking part in sports, having sleepovers etc, but was into make -up and, by the end of the series, going on her first "date" at not quite 12.
I would not have been happy if my 11 year old daughter was obsessing about clothes, make-up and fancying boys whilst still in primary school.
Incidentally his partner did consider transitioning too, but in the end didn't. The partner is now a well-known drag artist. I am not sure if they are still together or not.
I knew them both as the safe adult who would take them to Camden Market at the weekend - with my daughter.
Nor would I, but this is within the normal range of possibilities for cisgendered girls. Some of my daughter's classmates in primary school were like this (she herself was more interested in ponies).
All I have to offer in this discussion (bearing in mind that the plural of anecdote is not data) is my trans friend T, who is far happier living as a woman than she ever was in her assigned birth gender.
ISTM that best practice is npnp's option 2. You would definitely want to wait until the person was old enough to understand all the implications of gender reassignment treatment.
We are in a sexualised world like it or not. I have seen some of my Reception class pupils in the last 10 years dancing very provocatively and using sexualised langauge - and knowing what it means!. The world is very different from when we were growing up.
Gender issues aren't new. They were hidden and not talked about - or people ended up mentally ill or worse because of the strain. At least now people can explore non-binary sexual identities as the grow into teenage years - or even younger now. Young people are not stupid. They know what they feel. If they need help and support to work through these issues wherever they might lead, we need to listen to them and support them and help them find help they need. Sadly waiting lists are long and the only gender counselling for under 18's in England is still in London at the Tavistock, with a long waiting list..
As a leader, in my last youth group I had a young friend whom I supported. She could not tell anyone else in the church, except my husband and I what she was going through - not even her dad, to begin with. She knew she would be condemned and shunned and whispered about. So she dyed her hair different colours, then went goth, then dyed her hair again and then went black haired and psudo-Asian wearing non-sexual clothes. It worked, in the end people just accepted her as an oddball Christian young teen and she didn't have to explain that she was trying to work out who she was in gender terms
Having gone through the horrors self-unacceptance, self-harming and even attempted suicide several times, it was certainly not a "passing phase" nor a "fashion statement". Fortunately her school were supportive, and her father eventually realised what she was going through was not just a mental health issue and she got good gender couselling. But had to wait for some time, so we took the strain to support her. She came through not as trans, which she thought she might be, but as a gloriously beautiful young gay woman.
Because we didn't condemn she hasn't lost her Christian faith but she has not found a church in her area, with the kind of worship she likes that will accept her.
But we have been able to accept him just as he is and I believe it is possible he would not be alive at this point if we had not.
The problem I see is that for those in the confirmed group to be models for the not certain group may well be a problem, and the supporters of the well meaning confirming group may extend their support too soon and too assertively to the not certain.
In the situation to which I refer, a young person announced just after adulthood age that gender was changed. All of a sudden. Bang, with new name and insistence on it being used with threats if not. No signs of anything at all. With psychiatric history of hospitalization, and may have been influenced within a first love relationship. And less than 3 months later, hormones. Even getting attention to previous unstable history which contains nothing about gender orientation is very difficulty because now legally adult. So our situation is entirely difference I think.
to patients. And it feeds the arguments of those that would claim that any affirming treatment for transgender persons is wrong. The number of doctors willing to provide this care and properly trained to do so is a lot smaller than the need. At least were I live. Hopefully this will
improve as more people successfully transition. More and better data is needed.
Yes, they usually coincide. But it is also usual for people not to question their gender identity. If you ask the question "how many people who question their gender identity eventually decide that they are trans" then perhaps it's not so unlikely. I don't have the close experience that Ikkyu has, but I do have two young friends who are trans girls, and who I have known since before their transitions.
You draw a distinction between your 1 "fully affirming" and 2 "watchful waiting" approaches that seems to give the idea that in 1 everyone is rushing under the surgeon's knife at the slightest whim. That really doesn't happen, especially in kids.
I wouldn't want to be anything less than fully affirming, by which I mean accepting that when someone (child or adult) tells me that they feel a certain way, that they're honestly describing their feelings. Taking on a new name and new pronouns is a big step - it's not something that people do on a whim. Going to school, seeing all your friends, when you used to be Richard and now you're Rachel? Worrying how they're going to react? This is a big deal. Nobody decides they want to go through that lightly. So if your young relative decides that that's what they want, then what they need is support.
And sure, sometimes people change their minds. That's OK. Names and pronouns can be changed. Puberty blockers, if those are on the cards, aren't permanent. "I thought I might be a woman but now I realize I'm not" isn't a shameful thing, and your job is to not imply that it is.
I just remembered something I read about people that come out. It may seem surprising and new to you but it often takes months or years before people are able to get to the point of sharing it with you. I had not seen any sign before my son came out, but after the initial surprise I started remembering things that did not make sense previously that now do.
For example he had been depressed so we were happy to go with him and a friend to a wave pool. Something he previously enjoyed, we figured that this would only help. To our surprise his mood dropped so far as to self-harm afterwards. Something that did not make sense to me
at the time but now makes more sense if you take gender dysphoria into account.
Or just no signs to you?
One of my trans friends spent six months discussing how she felt with her parents before she felt ready to come out as trans in public. And then she did, and so she had a new name and new pronouns, and of course we all immediately started using her new name. She, you will note, has supportive parents.
You seem to be under the impression that calling someone by the name they prefer is somehow optional. Yes, of course it's a sudden change. Yesterday you called this person Richard, and now she wants to be called Rachel. What else do you expect - for her to be called Rachel for a couple of hours a day for a while? But it is not your choice. If your relative says that her name is Rachel, then you bloody well call her Rachel. She'll understand if you accidentally call her Richard and correct yourself, as long as you're making an effort to get it right, but you just don't get to say that it's too difficult for you, or that you're in the habit of calling her Richard and don't want to change, or even (and I hope this isn't the position you find yourself in) that you don't think she's serious, and so you're going to go on using male names and pronouns because you think you know better.
This is not your decision. This is not a family decision. This is your relative's decision.
You don't know how long your relative spent talking to friends about this issue. You are, perhaps, in a position to know how much they talked to their parents about it, and the impression I get from your comments is that the parents are opposed to the whole idea in general, and particularly in the case of their child. If that is the environment that the child has grown up in, then I'm not surprised that this transition came "all of a sudden" to you - if the child's parents are not prepared to be supportive, it's unlikely that they would seek support from more distant relatives.
I'm not the primary relative, and the primary relatives have been dealing with this young person's instability, manipulation and behaviour problems since school age. With an early developmental history in addition. We're talking violence to parents and then teachers as a young child, suspensions, eating problems, various forms of self harm in the context of "look at what I'm doing", apparent enjoyment of causing emotional upset in others etc. The mental health records (psychiatry, psychology and counselling) from before 3 months haven't anything within of trans. So I support the immediate family's skepticism and I don't think it is okay to apply some general principle of accepting everything to a specific case.
I haven't been "trying to give advice" - unless you count things like me saying that you should call people by their chosen name as specific advice. It's not. That's completely general advice.
I'm also addressing your absence of logic. You are complaining that you heard all-of-a-sudden about the relative being trans, as if this suddenness were unexpected. I claim that this is exactly expected. In general, no extended family of a trans person will hear about anything until the person is ready to go public, and at that point, there will exactly be a sudden new name and new pronouns. You're right - I don't know anything about the details of your relative's life, but you really can't infer anything from the fact that you weren't told.
Now in your new post, you bring up your relative's extensive mental health history, with your suspicion that this claim to be trans might be another manipulative game they are playing. You claim that your relative's case is sufficiently unusual that general principles aren't useful.
As you point out, we are not here to give specific advice, and we are certainly not here to attempt to analyse your relative third-hand. But if your relative is sufficiently unusual that you don't think general principles are helpful, then making them the focus of this (necessarily general) thread wasn't terribly helpful.
I'm not going to attempt to engage with your relative's mental health history. That's not what we're here for. But again in general terms, if a young person has a poor relationship with their parents, and their parents are not likely to be supportive, then that young person isn't going to go to their parents for advice if they think they might be trans.
What I would expect from a young person in such a position would be to seek advice and counsel from friends, from a school LGBT organization, perhaps from a supportive teacher, and not come out to their parents until they had a fully-formed plan. And I would expect such a coming-out to be angry and aggressive.
My concerns certainly include the ease with which such a thing is confirmed. And what may be inadequate allowing of unconfirmed exploration by the very affirming and facilitating ideas such as you wrote Leorning Cniht. It seems to be precisely the sort of attitude that we've experienced as quickly promoted by the gender clinic people and a group of physicians. What they do may well be too much too soon for some while probably exactly what some others need. I detect a lack of discernment about it, non-scientific and political advocacy, and too little assessment about the specifics of the individuals who express it. I am willing to localize this, and see that it is perhaps a flaw in the system where we are. But it is at the level of complaint to ask if it is reasonable to consider all people as the same re an expression of being transgender, and to assert that it is unwise to do so, without taking into account the specifics of the individual. Not everyone is the same are they? My concern is systemic, and concern that a meme has caught the imagination and then if we question we are told to not do so, and we fear the term "transphobic".
I know that transgender has not been in the public mind for that long, but the clinical experience behind the SOC goes back for decades, and is based on certain amount of clinical trial and error. As I've said here before, the clinical consensus on these issues is not the product of what some oddball gender theorist came up with last year, despite what some people in the media would like you to believe. There are a lot of people on all sides of the political spectrum with ideological axes to grind against transgender people and unfortunately even media that I would consider "quality" media are often all too happy to give them a soapbox.
As already said, I've never heard of such speeded up treatment. In the UK, it's very doubtful if anyone could go to a doctor or clinic, and receive immediate treatment.
I'm also very conscious of tabloid distortions about trans people, well, downright hostility. I'm also wary of anecdotes.
Isn't there a profound difference? Medication and medical procedures being a particularly significant one. Not thinking this is an apt analogy. There's certainly information about people living as non-biological gender over history and in various cultures, with the significant change today being the access to things that will medically change what's going on physiologically in the body, and surgical structural changes. I'm also not pleased that inquiry seems to be categorized as hostile "transphobia" by some.
Which I think is as should be expected. Just because two people are both (say) gay, doesn't mean they're going to agree on everything having to do with being gay, let alone the whole alphabet soup. One would however think that someone who has been on the ugly end of discrimination and hate would have compassion and understanding for another person at the ugly end of a different (but closely related) hate.
Humans can reason, but we are not reasonable.
I could be wrong, but I don't think governments generally legislate standards for treating specific health issues. It's a question of professional medical judgment. The WPATH standards linked to in the page I linked to are established by the international professional organization for health professionals who serve trans clients. They should give you some sense of whether what's happening locally in your case is consistent with international practice.
Just to flag this one - age inappropriate sexualised behaviour or knowledge are red flags for recognising sexual abuse in young children.
Information from the NSPCC
But who says it is quick, and why is it your place to undertake an inquiry?
The trans folks I know spent at least several months figuring out what was going on with them, and didn't go public with any of this until they had it figured out. Until they came out, nobody knew anything except for their trusted confidantes and advisors. For the rest of us, it was very sudden. Suddenly Richard doesn't exist but Rachel does. I'm confused as to why you would expect anything different.
Ah, the passive voice. Such a convenient tool.
But let's settle a few other things. A person asking to be called by a different name and to have different pronouns used for them is not the end of a process of exploration - it is a part of it. Most people, by the time they reach that stage, don't go back. Some do - and that's OK. A name and pronoun change is completely reversible. Hormones have not completely reversible effects, depending on how long you take them and which ones. Surgery is obviously permanent. Although at this point I should also mention that not taking hormones (and so continuing to age under the influence of the hormones that accompany your biological sex) also has long-term effects, particularly in adolescents and young adults whose bodies are still altering. You don't get a time-out.
No, of course everyone isn't the same. Most people aren't trans at all, some people identify as agender or nonbinary, and some people indentify as transgender. Given that we don't know what causes transgenderism, it's hard to say whether these are all part of the same thing, and trans is a spectrum, or whether these are similar but distinct things.
I'm not asking you to "consider all people as the same re an expression of being transgender". I am asking you to call people by the name that they ask to be called by. If someone asks to be called Rachel, is it really so much to ask for you to try and not call them Richard?
I am also suggesting that you are not the judge of someone else's identity. The person best placed to know how they feel is the person with the feelings. This is true for everything - it's not specific to transgenderism. In some cases, their feelings might be clear to them. In other cases, they might not, and they might need extensive counselling in order to understand them. Both of these are OK. A person's feelings are their own - they do not require external validation from some kind of feelings police.
And yes, I quite firmly believe that the first step in interacting with another human is to believe them when they tell you about how they are feeling.
I was going to ask after your previous post if you'd feel comfortable specifying what is distressing about this discussion, and this answers my question. The thing is, your answer, the very existence of the discussion itself, hadn't come to my mind. Perhaps it should have. Men discussing, nay, deciding what healthcare women in my country get to have, white people discussing whether people of color are truly experiencing discrimination, straight people questioning why gay people need to have their own parades and complaining about gay people being so "in your face" when they're holding hands in public -- I get why those things are crazy and infuriating. So now I get to expand my understanding to include cis people discussing trans rights and medical treatment, i.e., what trans people can do with their own bodies. Duh. I'm a fool.
Without discussions, though, I'll remain a fool. You may need to look away while some of us cis people make asses of ourselves, flailing around trying to figure this out. I accidently misgendered an old friend at his wedding reception. He blew right past it like it hadn't happened and I was grateful, but one way or another I need to wrap my head around this if I'm going to be a decent friend to him and a decent ally to trans people.