Returning to Laidlaw and the “omissions” he found in I Am Jazz, it is important to consider a few things.
First, I Am Jazz is a book for very young children. As such, it is necessarily incomplete as to all the details of gender dysphoria and being transgender. It was not written to inform adults making policy decisions about how to deal with trans people. It simply and elegantly presents the basic concept that there is such a thing as a transgender girl or boy.
Also, Laidlaw begins to mix in references and events not in the book but from the reality television show, which takes place much later in Jazz’s life. This is unfair to the book, which is certainly appropriate for 4-year-olds, while I doubt anyone would claim that the TV show is.
Omission #1: The authors fail to mention that Jazz suffers from depression.
At least 70 percent of people with gender dysphoria suffer from mental illness currently or in their lifetime. The most common comorbid mental illnesses include depression, anxiety, bipolar disorder, and dissociative disorder. Jazz has depression, as he (sic) has discussed on the TLC program I Am Jazz.
The only question here is simply put, although neither I nor Laidlaw know the answer: Is Jazz’s teenage depression — discussed in the TV show but not the book — caused by her dysphoria or is it the cause of her dysphoria?
It might be good to know this since the difference might alter her treatment. But in any case, both the depression and the dysphoria clearly exist and both must be treated. Treating one and ignoring the other would be malpractice. More on mental illness below.
Omission #2: The suicide rate of transgender individuals is alarmingly high.
This is also true. But what is the cause? Does being transgender and being treated for gender dysphoria cause people to commit suicide? Or does the way society (and people like Laidlaw) treat trans people lead them to be suicidal? As a cisgender person, I can only try to imagine what it would be like to constantly be told that I am not who I know I really am. Is it such a surprise that this leads some people to seek an end to this suffering, especially if their dysphoria is untreated or treated incorrectly?
And how does not treating gender dysphoria, as Laidlaw advocates, solve the problem of suicide?
Omission #3: Jazz is currently being given hormone blockers to stop him (sic) from going through normal pubertal development.…Jazz is now a teenager who has not been allowed to go through puberty.
This is simply not true. Jazz is on hormone blockers and cross-sex hormones. She is going through puberty as a girl. The cross-sex hormones cannot replace male organs with female organs but in every other way, Jazz has gone through normal puberty.
Also why would this be an unacceptable omission from a book for young children? Laidlaw seems to have wandered into a bit of a conundrum. On one hand, he seems to find the book inappropriate for young children because it discusses things he thinks they are too young to understand, but on the other hand, he faults the book for not thoroughly discussing hormones and puberty? Which is it?
Omission #4: Jazz will need to have his (sic) child-sized penis surgically destroyed to create a false vagina.
Jazz might say the penis is the part that is false, but I digress.
It is fairly common for trans pseudo-skeptics to go into great detail about gender affirmation surgery. This is intended, one supposes, to shock the reader. Yes, turning penises into vaginas is an option for trans women. A phallus is an option for trans men. You can find videos on YouTube of the actual operations. I found them fascinating.
In his description, Laidlaw refers to such surgery as “dangerous.” In fact, it is not particularly dangerous, as surgeries go, and has become quite commonplace. It seems, for perhaps obvious reasons, that constructing a penis is more difficult than constructing a vagina. But a pioneer in the medical treatment of gender dysphoria recently said that vaginoplasty can now create a vagina which would “fool a gynecologist,” so one may hope and expect that plastic surgeons will continue to make advances on this front.
Omission #5: Jazz currently suffers from sexual dysfunction and will likely have permanent damage.
Here Laidlaw is diagnosing Jazz having never met her (and working far outside his area of expertise) and confidently predicting an unknowable future. No responsible doctor would do this.
Omission #6: Jazz will very likely be rendered permanently infertile.
This is true. I can only say that I have been capable of fathering a child for over 40 years and never chosen to do so. Perhaps Jazz, like me, has other priorities or perhaps this is an unfortunate trade-off that she chooses to make. In any case, it is none of my business nor Laidlaw’s.
Another trans pseudo-skeptical point arises here. Laidlaw says: “Is this a decision that any adolescent child has the maturity and insight to make? I do not believe so.” By Laidlaw’s logic, kids are always too young; at 5 years, too young to understand gender or even hear about the existence of their trans peers; as teens, too young to make informed decisions about their future fertility.
Kids are always too young until it is too late, a convenient metric for people like Laidlaw to deny children any advocacy of their own. Jazz is not making this decision in a vacuum or alone. I would suggest that Jazz, her parents, her doctors, and her therapist might have a better understanding of the consequences of her therapy than anyone else, including Laidlaw.
Omission #7: There is a high level of substance abuse among people who identify as transgender.
Laidlaw is again confusing correlation with causation. Does being trans lead to substance abuse? If this is true, might we want to discover why?
Laidlaw presents an easy answer that reveals much: transgender equals mental illness equals drug abuse. It is absolutely critical to the pseudo-skeptics that trans people be considered mentally ill. See Laidlaw’s claims about suicide above.
This is understandable. If being trans is an illness, then a trans person’s understanding of themselves can be summarily dismissed (they are crazy, after all), and all the standard treatments — affirmation, blockers to delay puberty, perhaps hormones and surgery — are treating the symptoms of the illness while not addressing the underlying cause. Worse, by participating in the standard treatments, we — therapists, doctors, parents, teachers, siblings, peers, allies, society at large — are all encouraging a mentally ill person to remain ill.
If, however, being trans is an admittedly rare but entirely normal human condition, the trans pseudo-skeptics’ arguments — their entire worldview — collapses.
Omission #8: There are a number of serious health risks associated with taking cross-sex hormones.
Here we can return to the guideline published by the Endocrine Society:
Gender-dysphoric/gender-incongruent persons should receive a safe and effective hormone regimen that will suppress the body’s sex hormone secretion, determined at birth and manifested at puberty, and maintain levels of sex steroids within the normal range for the person’s affirmed gender.
Laidlaw is entirely at odds with the preeminent organization in his specialty.
Omission #9: The mortality rate of those who identify as transgender is three times higher than that of the general population.
See my response to omissions #1, #2, and #7 above. It’s “trans equals mental illness” all the way down.