The Globe and Mail 15 February 2014
What happens when your son tells you he’s really a girl? Twenty years ago, you probably would have crossed your fingers and tried to wait it out. Today, you might buy him a whole new wardrobe, find someone to prescribe hormone blockers, and help him live as a girl. Maybe he’ll even become a celebrity. A recent Maclean’s magazine cover, posing that very question, featured a lovely 11-year-old with long, flowing locks and enormous eyes. His name used to be Oliver. Suddenly transgender kids are everywhere – in the news, on Dr. Phil and in your neighbourhood. School boards have developed detailed transgender policies. Clinics to treat transgender kids have sprung up. A condition that used to be vanishingly rare, perhaps one in 10,000 children or less, now seems common. In a random sampling of 6th- to 8th-graders in San Francisco, kids were asked if they identified as male, female or transgendered – 1.3 per cent checked off the transgendered box.
What’s going on? To find out, I sat down with Dr. Ken Zucker, one of the world’s foremost authorities on gender identity issues in children and adolescents. As head of the Gender Identity Service at the Centre for Addiction and Mental Health in Toronto, he has worked with hundreds of kids like Olie. “The No. 1 factor is the Internet,” he said. “If you’re struggling to find out where you fit, the Internet is filled with things about gender dysphoria.” But for kids, especially younger ones, the issue is much more problematic. Gender confusion is often temporary. About three-quarters of little kids who have issues with their gender – boys who want to be princesses, girls who throw their dresses in the garbage – will be comfortable with it by adolescence, according to Dr. Zucker. (Many of them will grow up to be gay or bi.) Gender confusion can also be a handy label for whatever ails a child (or her family). That’s why Dr. Zucker takes a watch-and-wait approach. He even advises parents of princessy six-year-olds to say, “You’re not a girl. You’re a boy.”
…Alice Dreger is a bioethicist and professor at Northwestern University’s Feinberg School of Medicine in Chicago. She calls herself an (im)patient advocate who prefers evidence to ideology. She is a strong supporter of transgender rights. But she thinks the pendulum has swung too far. One reason is that social norms have dramatically changed. It is now fashionable to embrace your diverse child. Parents who encourage their kids to change gender “are socially rewarded as wonderful and accepting,” while parents who try to take it slow “are seen as unaccepting, lacking in affection and conservative,” she says. These days, parents who don’t like the slow-and-careful answer can shop for another one. Ms. Dreger is highly critical of what she calls the “hasty clinics,” which are happy to help a kid transition right away. “Parents don’t like uncertainty,” she says. “They’d rather be told, ‘Here’s the diagnosis, and it’s all gonna turn out fine.’” Teenagers can find fast help, too. Plenty of doctors are happy to help them out with hormone treatments just for the asking. For some people, including some adolescents, transgender treatment is lifesaving. But these treatments are neither simple nor benign. They may, among other things, retard maturation, suppress your growth or render you sterile. And in the end, medical science cannot create a body that makes you forget you were born the other sex. “Some kids need it, but for the kids who don’t, it’s dangerous,” she says. “All else being equal, it’s better to avoid long-term hormone therapy and major surgery that removes a lot of tissue.”