[Commentary] [USA] When Talking About Children's Gender, Words Matter
Stephanie Stevens
Diane Ehrensaft, Ph.D.
Developmental and clinical psychologist; mental health director, Child
and Adolescent Gender Center
When Talking About Children's Gender, Words Matter
Posted: 03/ 1/2012 5:04 pm
Over the last year, there is no question that transgender and
gender-nonconforming children have become more visible in our media
and culture than ever before. Most recently, a Colorado Girl Scout
troop ignited a national controversy by stepping up to include a
transgender child as a member of their troop. And a very
unconventional young boy, Roscoe Kaan, who wears girls' clothing and
wants to play Sandy in his school's production of Grease, is a
featured character on the popular Showtime series House of Lies.
Transgender and gender-nonconforming children and their families, like
the ones I work with every say, constitute one of the least visible or
understood parts of the LGBT community. They are just beginning to
come into focus. As we see the media's and the public's growing
interest in these families, I can't underscore enough the
responsibility of journalists who cover them and the issues related to
these children and young people to get the terminology right, as they
are often the general public's main portal on these issues. All of us
need to get educated; it is far too easy in the binary-gendered world
in which we live to confuse and misinform people who are only just
becoming aware of the children who live outside these gender boxes.
Take a recent, well-intentioned example of how terminology can lead
readers astray. The Associated Press' Lindsey Tanner and her article
"Sex-Changing Treatment for Kids: It's on the Rise
<http://abcnews.go.com/Health/wireStory/sex-changing-treatment-kids-rise-15749414#.T00svnJWpM4>
," published last week, confused sex-change with delaying puberty,
right from the headline and lead sentence: "A small but growing number
of teens and even younger children who think they were born the wrong
sex are getting support from parents and from doctors who give them
sex-changing treatments, according to reports in the medical journal
Pediatrics."
First of all, "teens and even younger children" are conflated into one
group, even though the treatments used for transgender and
gender-nonconforming children are completely different depending on
age and maturity. Secondly, she lumps all medical treatment for these
children into the category of "sex-changing treatments," a wording
often associated with surgery or irreversible hormonal treatments to
change genitals and other gender characteristics. This is completely
inaccurate; no "sex-changing treatment" is or should be prescribed to
young children. As Tanner herself notes, an increasingly common
treatment for younger children (and by that we are referring to
pre-teens entering puberty) is the use of pubertal suppression
treatment, which merely delays the onset of puberty. Far from changing
a child's sex, this is a completely reversible treatment that simply
buys time for a child struggling with gender identity to decide his or
her own true gender. It can only happen when a youth has reached
Tanner Stage 2 of puberty. Finally, Tanner credulously includes a
claim by one doctor, Margaret Moon, that "some [children] may be gay
and are coerced into treatment by parents more comfortable with a sex
change than having a homosexual child." But a Pediatrics study
<http://pediatrics.aappublications.org/content/early/2012/02/15/peds.2011-0907.abstract>
conducted by the Gender Management Service clinic in Boston, just
released in February 2012, found no such coercion. Overwhelmingly, it
is the children, not the parents, who want to get the treatment that
will allow them to live in their true gender, which may not be the
gender listed on their birth certificate. And no irreversible
treatment is provided to children "too early"; such treatment is
provided only to older youth, and only after a long and extensive
period of complex preparation and review, which may include using
pubertal suppression to allow time to make the decision to move on to
cross-sex hormones.
As I said above, Tanner's good intentions are evident in her piece.
Regretfully, the same cannot be said about a piece produced by Fox
News last October
<http://www.foxnews.com/us/2011/10/17/controversial-therapy-for-young-transgender-patients-raises-questions/>
about a transgender girl, 11-year-old Tammy. While their report
included two gender-affirming quotations from two professionals (Joel
Baum and I), the bulk of the professionals quoted cast aspersions on
Tammy's family and made evidence-free, scientifically erroneous
arguments that her pubertal suppression treatment could harm her, such
as increasing her risks of cancer, creating the impression that this
child had fallen victim to a dangerous and unsafe treatment regime.
Said one: "This is child abuse. It's like performing liposuction on an
anorexic child." Another professional, who was given the last word,
suggested that Tammy's parents, a lesbian couple, might have coerced
her into becoming a girl -- regardless of the fact that extensive,
thorough psychological and medical review was conducted before Tammy
began pubertal suppression, and that Tammy has a brother who is not
transgender and who is much-loved by both parents, as a boy. Not one
of these experts stopped to consider that it might be Tammy's
decision, based on her own authentic psychological needs -- and one
that was far from rashly made, which I can only conclude meant that
they had never themselves talked to a transgender or
gender-nonconforming child, or, if they had, they had failed to listen
to the child and instead imposed their own ideology.
Fortunately, not all media coverage of transgender children has these
weaknesses. In November I appeared alongside Tammy and her family on
an episode <http://www.youtube.com/watch?v=Y5rod9VQydw> of Anderson
Cooper's talk show, Anderson. This broadcast sensitively, accurately
portrayed the mothers' decision to put Tammy on puberty-delaying
treatment (and similar decisions by two other sets of parents) as one
made with respect and responsibility, and one that was necessary for
her health. Careful distinctions were made between pubertal
suppression and actual "sex-changing treatment" -- that is, hormone
treatment and surgical interventions, which we might more correctly
call "sex-affirming," not "sex-changing," treatment. What came through
was the message that this treatment was the right one for these
children, that the harm would come from not giving the children the
hormone blockers, and that we now have the means to allow children to
live happy and healthy lives in the gender they know themselves to be.
This April, In the Life Media, which produces the nationally
syndicated program In the Life, will air an in-depth piece about
transgender children, one I expect will provide a comprehensive and
nuanced look at the lives of these children. This is just the
beginning of visibility for these children and their families -- their
"Stonewall," if you will, and it is vital that the larger community
support and embrace these courageous families who are stepping into
the public eye to tell their stories. And it is equally important that
the media get it right from the beginning, helping all of us
understand gender, gender identity, and gender expression.
My best teachers are the brave and creative children I have met who
transgress and transcend the social gender constraints we have all
been ingrained with and can show us the path to true acceptance,
beyond a binary world of pink and blue and boys and girls. If we truly
want to educate ourselves and get the words right, just listen to the
children. We will discover that they are our best teachers, not just
about themselves but about our own selves, as well.
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