Jesse Singal Gets It Entirely Wrong…Again!
Why is it so hard to understand the accepted and effective treatments for gender dysphoric kids? There may be a reason, innocent or not.
NB: As you can see above, the title of this piece in the print magazine is “Your Child Says She’s Trans. She Wants Hormones and Surgery. She’s 13.” The title for the online version is simply “When Children Say They’re Trans.” Did the folks at The Atlantic think about how ridiculous and exploitative the print title was and so changed the online title? One wishes they thought harder before they printed this claptrap.
There is so much wrong with Jesse Singal’s latest piece in the Atlantic, I can barely bring myself to address it — the muddy writing, the sloppy journalism, the obvious bias, the half-truths and occasional lies, not to mention the potential damage this sort of writing can do. I admit to being overwhelmed by Singal’s 12,000 words of nearly perfect wrongness. It is irresponsible for a trusted journal like The Atlantic to publish such a piece, especially with what appears to be little to no editorial oversight.
So I can’t — or at least I decline — to take on the whole piece, even though it is a hanging curve ball right over the plate. But one small item, almost an aside in Singal’s piece, got me thinking about something else, beyond Singal’s professional failings as a journalist, which are legion.
Singal tells many, many stories about children who thought they were trans and later changed their minds and older kids who had some sort of medical treatment — blockers, cross-sex hormone treatment, surgery — and later came to regret those choices. In a failed attempt to appear balanced, Singal eventually (9,000 words in) drops in a very few stories of happy and healthy trans and GNC kids and adults.
It was one of these references to a success story that caught my eye. From Singal’s piece (emphasis mine):
More recently, a wave of success stories has appeared. In many of these accounts, kids are lost, confused, and frustrated right up until the moment they are allowed to grow their hair out and adopt a new name, at which point they finally become their true self. Take, for example, a Parents.com article in which a mother, writing pseudonymously, explains that she struggled with her child’s gender-identity issues for years, until finally turning to a therapist, who, after a 20-minute evaluation, pronounced the child trans. Suddenly, everything clicked into place. The mother writes: “I looked at the child sitting between my husband and me, the child who was smiling, who appeared so happy, who looked as if someone finally saw him or her the way she or he saw him or herself.”
Setting aside Singal’s sneering tone about affirmation, his description seemed highly unlikely. A competent therapist would never pronounce a child, somewhere around 5 or 6-years-old, as transgender after twenty minutes and on the very first visit. Singal is promoting what I like to call the “trans and done” fallacy.
Singal provides a link to the article where we find out the truth. By the way, please read this piece. It is honest and beautifully written.
Quoting now from the mother (emphasis in the original):
It wasn’t easy to find a psychologist with experience in the kinds of problems our family had. We ended up finding someone more than an hour away.
Before our rear ends had even warmed the couch, I blurted, “I need to know if this is just a phase. If she’s transgender, I need to know for sure.” I wanted a test, a diagnostic tool like the Beck Depression Inventory, something definitive that would pronounce my child transgender or not. I learned that no such test exists.
Still, my husband and I left the room so the therapist could conduct an initial evaluation.
Twenty minutes later, we settled down on the same couch, my husband on one side of Isabel, me on the other.
”Your son said something interesting,” the psychologist said.
I heard the word “son” louder than the “your” and the “something interesting.” It was as if the therapist shouted that one word through a bullhorn and bolded and underlined it just before it traveled the distance from her mouth and to my ears.
“He said he didn’t think his parents were ready yet.”
I looked at the child sitting between my husband and me, the child who was smiling, who appeared so happy, who looked as if someone finally saw him or her the way she or he saw him or herself.
Note carefully what the therapist is doing here. Just one simple thing: using the pronouns the child (nee Isabel, now Shane) preferred. The therapist never uses the word “transgender.” The therapist is simply affirming what this child is saying.
Also note that Shane is not confused at all. He knows who and what he is. The only problem, as he sees it (and he is certainly right), is that his parents aren’t ready. They don’t understand.
Singal misrepresented what the mother wrote; an unacceptable journalistic oversight at least. Did he not read the very piece that he linked too?
But the “reveal” is how Singal and many people think about and understand the therapeutic approach usually called “social transition” or “affirmation therapy.”
First, it is important to understand that affirmation therapy is the only accepted treatment for children who display signs of gender dysphoria before puberty. Let’s be very clear on this: there are no drugs involving hormones (blockers or cross-sex hormones) used when treating prepubescent children because hormones are not yet an issue for these kids.
Affirmation therapy is actually quite simple to describe although perhaps less simple to actually put into action. Affirmation means you use the child’s preferred pronouns. If they wish to have a new name that matches their gender, use that name. Let them use the bathroom and other gender-segregated facilities and activities at school and elsewhere that match their identity. Let them dress as they wish and wear their hair (long or short) as they choose. In general, listen to the child and follow his or her lead.
In other words, let the child be who they tell you they are.
What is affirmation meant to do? It relieves, at least to some degree, the dysphoria these kids are experiencing, a feeling that can be crippling and literally take over their lives. Affirmation unlocks a door so these kids can explore who and what they are and want to become. It allows therapists to begin to address other issues the child might have, perhaps anxiety or depression, whether caused by their dysphoria or other factors. It helps these kids and their parents begin to come to terms with what may have been tearing the family apart. It relieves pain and anguish.
This sounds wonderful and it truly is. The problem is this: many people, often unconsciously I think, assume that affirmation does something more. That it puts children on an inevitable path (or perhaps merely encourages them) to being transgender, to eventually take drugs to alter their bodies and even have surgery.
Singal expresses this misunderstanding perfectly, all the while trying (and failing) to sound balanced:
The affirming approach is far more humane than older ones, but it conflicts, at least a little, with what we know about gender-identity fluidity in young people. What does it mean to be affirming while acknowledging that kids and teenagers can have an understanding of gender that changes over a short span? What does it mean to be affirming while acknowledging that feelings of gender dysphoria can be exacerbated by mental-health difficulties, trauma, or a combination of the two?
Far from conflicting with “gender-identity fluidity”, affirmation actually embraces the idea. No one is deciding who the child is now (other than the child) or is going to become in the future. If the child says she is a girl at 5-years-old and then says he is a boy at 10-years-old, we affirm both choices.
As far as “mental-health difficulties, trauma, or a combination of the two”, Singal is inventing a conflict where there is none. There is ample anecdotal evidence that some kids’ feelings about gender and their dysphoria are related to other issues such as depression or trauma that they have experienced. Singal spends an inordinate amount of time relating these anecdotes.
There is not, however, a shred of scientific evidence, such as clinical studies, to prove this. Here Singal, as he often does, takes an idea, an hypothesis and pretends it is a known truth.
But what of it? Why and how does affirming a child’s true gender preclude treating them for mental health issues? In fact, affirmation, by removing or reducing an overwhelming problem, can help a child approach other issues they may have. It may well be necessary to address their dysphoria before any other issues can even be explored.
But now we are getting closer to the real reason Singal and others spend so much time and effort on this issue. If the real reasons kids are dysphoric are medical or emotional issues that have nothing to do with gender, then it follows that the child is not really transgender at all. Well, that’s a relief. Maybe being transgender is never a real thing? Maybe it is always something else, something that is more acceptable, less scary, more…normal?
Also it’s the words we use, especially “social transition.” The phrase implies that there is a certain destination involved. Transition means changing from one state to another. Even describing children experiencing these issues as being “on a journey,” as many gender therapists do, doesn’t seem quite right. Journeys have destinations, do they not? “Affirmation” is better, but in many people’s minds even this word implies a specific outcome which is being affirmed rather than simply affirming what the child feels right now, in this moment.
And if the idea of a destination, a final outcome, is implied, then I suggest the problem may really be a concern over what exactly the destination may be.
For anti-trans people, the idea of living as anything other than the gender assigned at birth, being gender non-conforming in any way at all, is a tragedy or a sin or otherwise an entirely bad outcome.
But for the majority of people, as expressed honestly by many parents having a tough time dealing with their own feelings about their trans or GNC child, the issue is much more subtle. They want their child to grow up to be happy and healthy. Of course they do. But there is still a sense that one outcome is better than another, that getting over being trans is better than not getting over it. That is where the hesitation and gatekeeping over affirming a little kid’s identity comes from. Affirmation does not make a child transgender but even opening up the possibility of that outcome, many years down the road, is perceived as a problem.
This feeling, this concern, I feel, is not bigotry at all. Cisgender folks have never had to make this journey, have never needed to conduct this exploration of ourselves. We were born male or female and we were happy to grow up in the gender we were assigned at birth. Of course it is difficult for cisgender parents to fully understand what their child is going through. How could it not be?
It’s difficult and Singal is making it more so.
That is what is most wrong, most damaging about Singal’s piece. He relies on his reader’s perhaps unconscious or at least not fully formed belief that being transgender is a bad or at least a less good outcome. He misrepresents what affirmation therapy is and what it is meant to accomplish. In doing this, he makes it more difficult to understand, not easier. Whether his bias comes from his own misunderstanding or a deeper, darker place I do not know. But it is past time that Singal and the publications that print his work consider what they are trying to accomplish.
Are they trying to clarify or obfuscate?
Are they trying to do good or cause harm?
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