Implications of Current Transgender Theory on Children and Young People

Terms

The World Health Organisation definition states that ‘sex is biological’ whilst gender is the ‘socially constructed characteristics of women and men[1].’ In practice, this means sex (male/ female) is immutable but gender (masculinity/ femininity) changes with societal norms.

Conversely, the American Psychiatric Association (APA) who produce the guidance upon which NHS practice is based, describe gender identity as:

‘a category of social identity (that) refers to an individuals’ classification as male, female or occasionally some category other than male or female. It’s one’s deeply held sense of being male or female, some of both or neither, and does not always correspond to biological sex[2]’

As such according the APA & NHS gender identity is unverifiable andyet considered to exist independent of both gendered socialisation and biological sex.

Diagnosis

Many people consider themselves to be transgender without a Gender Recognition Certificate and without undergoinglegal, social or medical transition.[3]

The medical diagnosis of being transgenderin adults and children is dependent upon not adhering to stereotypicalgendered norms and/or a feeling of discomfort in one’s body. [4]

Iatrogenesis/ Social Contagion

Pressures that lead girls to bothfear becoming women andfeeluncomfortable about their bodieshave been traced to an increasingly image-obsessed society, rigid gender norms andonline pornography.Almost 40% of girls aged seven to 21 do not feel happy with how they look in 2016, compared with 27% in 2011. [5]

An NHS Inquiry into the state of mental healthin England found that 12.6% of women aged 16-24 screen positive for PTSD[6]. A common symptom of PTSD, particularly following sexual abuse, is feeling disassociated from one’s body.[7]

Social media sites such as Tumblr and Instagram are riddled with those who suggest to the suggestible that this anxiety and body dysmorphia is fact gender dysphoria. [8]

As words such as ‘transgender’ and ‘gender identity’ have become more common people have begun conceptualizing and interpreting their experience in these terms. [9]

Similar social contagions that occur include cutting, apotemnophilia (amputee identity disorder) eating disorders and isolated outbreaks of suicide[10]. Unlike the above examples, believing oneself to be born in the wrong body is currently enabled by health professionals, social services and teachers (arguably as recovered memory syndrome once was.)

  • The Tavistock clinic for children and adolescents has seen referral increases of about 50% a year since 2010-11. In the past year it has had an unexpected and unprecedented increase of 100%
  • 1,398 children and adolescents have been referred to the Tavistock Clinic this year (compared to 697 last year) and of that number almost 1,000 are girls. The disparity between boys and girls is increasing year on year
  • It is estimated that 95% to 100% of girls who transition during adolescence would otherwise grow up to be lesbian[11]..
  • A disproportionate number of children on the autistic spectrum identify as transgender[12].

As with those who attend eating disorder clinics, referrals to gender identity clinics are not representative of the numbers of children and young people who consider themselves transgender. Figures are difficult to obtain but there is evidence to suggest large numbers of adolescents (and adults) self-medicate with synthetic hormones bought online[13].

Side-effects of current treatment (on Female to Male)

  • In a recent study over97% reported at least one of 28 negative outcomes attributed to binding.[14]These include compressed or broken ribs, punctured or collapsed lungs, back pain, compression of the spine, damaged breast tissue, damaged blood vessels, blood clots, inflamed ribs and heart attacks[15].
  • Puberty blockers are often presented as a harmless way to delay the decision to move onto cross-sex hormones. The long-term effects are unknown though immediate side-effects include Depression, Hypertension, Weight changes, Hepato-biliary disorders, Convulsions, Interstitial lung disease[16].
  • Testosterone treatment on girls effectively produces an early menopause. The result of taking puberty blockers followed by testosterone treatment is permanent infertility and a significant increased risk of Diabetes, Stroke, Polycystic Ovarian Syndrome, Ovarian Cancer, Endometrial Cancer[17]
  • For those who undergo sex reassignment surgery the risks of mortality, suicidal behaviour, and psychiatric morbidity are significantly higher than the general population. A recent long-term study suggests a suicide rate of twenty times the average for the non-trans population[18].

Normalisation of Damaging Treatments

The Transgender Equality Inquiry Report released by the Women and Equalities Commission earlier this year recommends ‘training for all teachers and the inclusion of gender issues as part of the Personal, Social and Health Education curriculum[19].’ Advice about how to support children who consider themselves trans is offered to schools by organisations such as GIRES, Gendered Intelligence and Mermaids.

Professionals and parents are told that the only method of support is to affirm a child or adolescents’ current gender identity[20]. Further, they suggest that not doing so could lead to suicide or self-harm[21]. Information supplied is often questionable and sometimes irresponsible. Testimony from those who regret their transition cites a lack of counselling as a reason for too hasty transition[22].

Gendered Intelligence offer the following advice to young people (16-24) ‘Surgery will affect sex in many ways but the most noticeable effect is a boost in body confidence. You may enjoy sex more as you begin to feel better about expressing yourself.’ The same guide defines gender as one’s emotions and personality[23].

Several local authorities have recently issued advice to schools on how best to support pupils who bind their breasts to prevent ‘breathing difficulties and fainting.’ Gendered Intelligence promote breast-binding for adolescent girls/trans boys on their website.

The uncritical approach of professionals who work with children has serious consequences. For example, Mr Justice Hayden recently ruled that a seven-year old boy was caused “significant emotional harm” by a mentally ill mother who insisted he was a girl[24]. Both Mermaids, the local education authority and social services blindly supported the mother with the social transition of her child. The ruling has been widely derided as transphobic by transgender advocacy groups including Mermaids and petitions have been circulated demanding that the ruling be ‘revoked or overruled by a higher authority’. [25]

[1] Gender, Equity and Health,.(2016) World Health Organisation,

[2] . American Psychiatric Association, (2013) Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5)

[3] Jenner Meierhans, (2013) Is a Gender Recognition Certificate Crucial or Cruel? BBC Online,

[4]American Psychiatric Association, (2013) Fifth Edition (DSM-5)Diagnostic and Statistical Manual of Mental Disorders,

[5] American Psychological Association (2007) Report of the APA Task Force on the Sexualisation of Girls

[6]Denis Campbell and Haroon Siddique (2016) Mental Illness Soars Among Young Women in England The Guardian,

[7]John Briere, Diana M Elliott (2003) Prevalence and Psychological Sequelae of Self-reported Childhood Physical and Sexual Abuse in a General Population Sample of Men and Women, Child Abuse & NeglectVol 27 (10)

[8]Questioning Teens and Social Contagion(2016), Transgender Reality,

[9]Carl Elliott, (2000) A New Way to Be Mad, The Atlantic,

[10] Carl Elliott, (2000) A New Way to Be Mad, The Atlantic

[11] A.D. Fisher et al, (2011) Desisting and persisting gender dysphoria after childhood: A qualitative follow-up study,

[12] D. E. Schumer et al, (2016) Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic LGBT Health.

[13]The words Asktransgender commenters don’t want teens to see (2016), Transgender Reality

[14] S Peitzmeier et al (2015) Culture, Health and Sexuality Health impact of chest binding among transgender adults: a community-engaged, cross-sectional study

[15] McClean Clinic (2016)

[16]Lynne Millican (2016)

[17] V.Victor et al (2014) Mitochondrial Impairment and Oxidative Stress in Leukocytes after Testosterone Administration to Female‐To‐Male TranssexualsThe Journal of Sexual Medicine, 11, Issue 2

[18]Cecilia Dhejne (2011) Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden, PLOS

[19]Women and Equalities Select Committee, (2016) Transgender Equality Inquiry

[20]Supporting Children (2016) Mermaids

[21]Mermaids (2013)Trans* Inclusion Schools Toolkit Supporting transgender and gender questioning children and young people in Brighton & Hove schools and colleges

[22]

[23] Gendered Intelligence (2016) Trans Youth Sexual Health Booklet

[24]England and Wales High Court (Family Division) Decisions (2016)

[25] Change.org Petition (2016)