Op-ed: Finally, Some Reliable Research on Trans Kids Like Mine
When the suicide of transgender teen Leelah Alcorn made headlines last month, my friends with nontransgender children made a point of congratulating me on my parenting: "That won't happen to your child because you're doing it differently," they said. Perhaps that's true, but I don't yet know for sure. The fact is that no one really does.
My child, at age 3, told me she was a girl. She looked me in the eyes and said, “Mama, something went wrong in your tummy that made me come out as a boy instead of a girl.” She wanted to go back inside me so she could come out again as a girl.
Since age 2, she’d been begging me to dress her in the pretty clothes she saw little girls wearing and had been obsessed with the things little girls often love, like princesses and fairies and the color pink. At first I assumed the whole thing was a phase. I said she could like pink and play with dolls, but that she had a boy body, so she was a boy. When she kept asserting her girlhood, I did what parents do — I went looking for advice from the experts. I took my child to our pediatrician and more than one therapist, including a psychologist who specialized in working with kids like mine — boys who feel like girls, girls who feel like boys.
I was desperate for answers to my long list of questions: Should I actually let my child switch genders at age 4, or should I mandate life as a boy? What were the chances that my child would change their mind? And would there be long-term damage if we switched from boy to girl and then back to boy? On the other hand, what were the risks of forcing the kid to continue to live as a boy when such a thing caused my child so much misery?
In every case, the experts I consulted had the same response to my questions. They didn’t know. They shrugged their shoulders apologetically, made some vague recommendations, and admitted that there wasn’t really any reliable research on kids like mine.
So I had to wing it. My initial impulse was not totally unlike that of the Alcorn parents. I figured my child was probably a less typical kind of boy, instead — perhaps a gay boy who needed my guidance. That’s the premise behind the now-infamous “conversion therapy” that Leelah Alcorn underwent to attempt to cure her of her transgender identity. And while it sounds alarm bells among those who consider it to be as unethical and inhumane as the therapy touted by the “ex-gay” movement, the reality is that this type of treatment is still practiced and promoted by some of the most influential medical professionals currently working with transgender children.
When families with young children like mine seek answers at the Child and Adolescent Gender Identity Clinic at Toronto’s Centre for Addiction and Mental Health, the staff doesn’t waste time discussing the pros and cons of cross-gender experimentation. According to the clinic’s director, Dr. Kenneth Zucker, transgender adulthood constitutes a negative outcome, the unfortunate result of a pathological family system centered on (who else?) the mother. Zucker argues that children like mine shouldn’t be allowed to play with “girl toys” nor have access to feminine clothes or colors. Instead, these young clients are encouraged to engage in stereotypically masculine activities and should spend more time with their fathers. Mothers like me are advised to undergo therapy to root out the true source of the problem, which is likely to be a deep-seated discomfort with masculinity or perhaps an intense but unacknowledged desire for a child of the opposite gender. Confusingly, Zucker has written that the smoking gun may lie in “maternal unavailability” or, alternatively, maternal “overcloseness.” (Lest you make the mistake of writing Zucker off as an outlier on the far Freudian fringe, keep in mind that in 2012 he was a member of the American Psychiatric Association’s work group on sexual and gender identity disorders, the panel of experts that literally wrote the book on how mental health professionals should assess and treat transgender clients).
Early on, I attempted a mild form of Zucker’s system with my own child. I tried to encourage more “masculine” activities, suggesting karate classes when she wanted to sign up for ballet (we compromised on co-ed gymnastics). She wanted an all-pink wardrobe; I pushed for red, purple, pastel blue. I encouraged more play dates with boys and more time with her dad.
But ultimately, I couldn’t stomach the idea of denying my child the things she loved nor bear to see her so unhappy. Her last Christmas as a boy was a disaster. After the packages had all been opened, she sat glumly amid the piles of shredded wrapping paper and surveyed the collection of shiny new trucks, sports equipment, building blocks, and dinosaur figurines. “Didn’t Santa get my letter?” she said.
I watched her valiantly attempt to muster some enthusiasm for a truck with purple wheels and I swore that Santa wouldn’t break my kid’s heart ever again.
But my real turning point came about a year after she first told me she was a girl. I attended a support group for the parents of transgender and gender-nonconforming kids and heard a story that kept me up at night for weeks afterward. A young mother sat across the table from me, sobbing her heart out as she told us what had happened to her 5-year-old when a local psychologist advised a regimen reminiscent of Zucker’s.
“I took away all his dolls, all his most favorite things. I told him he was a boy and that’s that, because that’s what the doctor said to do,” she said. Within a couple of months, her kindergartener had stopped speaking and was diagnosed with severe depression. “I almost lost him,” she said.
The story haunted me because my child had recently begun a similar disappearing act. After months of fighting me (“I’m a girl!”), the kid was giving up. She stopped correcting me when I used her hated “boy name,” shrugged when I suggested karate lessons yet again, and gazed silently and sadly at the haze of forbidden pink in the “girl aisle” at the toy store. Another mom in the support group witnessed the same phenomenon in her child and described it perfectly: “My 4-year-old looked like a tired old man.”
I decided that enough was enough. I sat my child down, looked her in the eyes, and asked the question one last time: “Do you really want to be a girl?”
“I don’t want to be a girl, Mama,” she said. “I am a girl.”
We're pretty sure we're on the right track. We hope against hope that we are. Our kids, once miserable in one gender, are now thriving in the other. The "veteran" parents — those with tweens and teens whose kids transitioned five or more years ago — tell me how well their children are doing and I’m struck by how blessedly run-of-the-mill their lives seem to be, as they struggle with all the garden-variety teenage challenges: grades, peer pressure, dating, college applications.
But despite this rosy picture, the truth is that most days we’re flying blind — and it’s pretty terrifying. Even with all these validating anecdotes and success stories to point to, without any solid research to back us up, we parents are still far too easily branded (by Zucker and others) as overindulgent liberals or as pathological whack-jobs who have somehow manipulated and corrupted our children into their current state.
I recently heard a talk given by Aidan Key, a prominent transgender activist who focuses his work on kids like mine. "The world is watching your children," Key said to a roomful of parents of transgender kids. "They're the first generation of kids to be allowed to live in another gender. Your children are making history."
His words gave me goose bumps. I felt proud but also scared: Given the choice, how many parents would opt for their children to be guinea pigs in a riveting social experiment? Given the choice, of course, we’d much rather have some clue about what the future might hold, some hard evidence that my friends are right when they tell me my daughter “won’t end up like poor Leelah.”
A ray of hope appeared last fall when I heard about a study underway at the University of Washington in Seattle. Led by psychologist Dr. Kristina Olson, the TransYouth Project is a long-term longitudinal study of kids from around the U.S. who transitioned to another gender at a very young age. I signed my daughter up right away.
Olson plans to track my daughter throughout her childhood and beyond, as she goes through puberty, makes her way through high school, and heads off for college. Olson’s team is going to check in with my child each year, chronicling her development as she navigates the shark tank of middle school, gets her heart broken by a boy (or a girl?) in high school, and turns 18 and gets to decide if she wants to have gender confirmation surgery.
Olson admits that the study has its limitations. “As a scientist, if I lived in an imaginary world, the study I would run would be to randomly assign these kids to be raised in two different ways: One group would be allowed to live in a different gender from the one assigned them at birth, and the other wouldn’t. But ethically, we could never run that study, so we do the next best thing.” Perhaps one day a researcher will study these two groups as adults, compare them side by side, and we’ll have a pretty good idea who bet on the right horse. (It will probably surprise no one that I believe Zucker’s methods will be shown up as misguided and ineffective, if not downright harmful.)
In the meantime, Olson’s study has already shed some new light on children living transgender lives. Her first set of results, forthcoming in the journal Psychological Science, validates my own experience as a parent of one of these kids. “On all the measures that we have,” she said, “You can’t distinguish controls or siblings from transgender participants of the same gender. What these data tell us it that these kids aren’t merely going through a phase. Rather, their gender identity seems to be a deeply held view.”
My prediction is that Olson’s study will be an historic game-changer in the debate about how to best support children like mine. “In 10 years,” she said, “We will be able to start answering the questions everyone is asking: What is the life of a kid who, as a young child, identifies as transgender, going to look like? And how will a parent’s decisions influence what that outcome will be?”
As Leelah Alcorn’s story has shown us, gaining a better understanding of transgender kids is not just an interesting academic exercise; it is literally a matter of life and death.