I am very alarmed by the story that is all over the internet today about an Australian 14-year boy who has reportedly reversed his decision to change gender. What angers me most is the way that the media, both here and in Australia, is using the story to undermine the treatment of all trans children and stir up public dissent.
First, the story is very scant – probably because the Australian TV show, 60 minutes, is planning a sensationalist programme on Sunday and has limited how much of the story can be revealed. In essence, Patrick had shown clear signs of gender dysphoria, an extreme sense of discomfort with his male body, from an early age. At the age of 12 he begged his mother to make him into a girl and she agreed to him taking female hormones. Now 2 years later, after his school began referring to him as a girl he has decided that he doesn’t want to be a girl after all, but has already developed breasts, so will need surgery to remove the breast tissue.
Not surprisingly the anti trans lobby is having a field day and declaring that this is evidence that no child should receive treatment – they should all wait until they are adults – 18 years old. Sadly this story is also being covered by at least three UK newspapers and already I am hearing comments from friends who had assumed this was a UK story.
So what’s wrong with this story?
Well, first I want to know how Patrick was allowed to start cross-gender hormone treatment so young. I know that children have a clear sense of gender by the age of 3 years 0ld – but allowing them to make irreversible body changes at that age is another matter. In the UK a child, at the onset of puberty, can be put on hormone blockers. This treatment can only happen after proper clinical diagnosis and it temporarily delays puberty. If the treatment is stopped, puberty proceeds as normal – there are no irreversible effects. This is what should have happened to Patrick.
What usually happens at the same time or even earlier is that the child begins living in their new gender. Living in the new gender means that they are treated in every way as if they are the boy or girl they feel they should have been born but there is no medical treatment to make it permanent, it’s a social adjustment. It seems that this did not happen for Patrick and it was the reaction to the social change that has made him think again.
In the UK trans children continue to have regular clinical assessments to ensure that they are coping with life in their new gender. This way, if the child decides that they are not comfortable with the gender change they can stop treatment and revert to their birth gender with no problems. If they are comfortable with this social gender change then at about 14 they can proceed to cross-hormone treatment and then at 16 undergo genital reconstruction surgery if desired. Most trans people never have any surgery
So why not just leave it until the child is an adult when they are legally allowed to make the decision. The answer to that is Puberty. For a child with gender dysphoria, the onset of puberty and the resulting natural changes to the body is a devastating experience. For someone who feels they are a boy, the commencement of menstruation and breast growth is torture, as is the voice dropping and development of masculine facial and body features for someone who feels they are a girl. This experience is so bad that 50% of trans-people under the age of 25 attempt suicide.
But that is not the worst of it. Children and young people with gender dysphoria, who do not receive support for their condition, are 4 times more likely to attempt suicide, self-harm, take drugs and engage in sex work. Most also leave home at a very early age. What this means is that for Trans children who do not receive support from family, there is an 80% chance of them attempting suicide. Hardly surprising that parents want to do everything to support their trans children and prevent them having to experience the horrors of puberty.
But this has to be managed properly. Putting a child on cross-gender hormones before they are psychologically ready is just as bad. Listening to the trailer for the sensationalistic 60 minutes programme is seems that Patrick’s mother may have given him her hormone pills. I hope not – but if so it’s a lesson for all parents.
So why might a child showing such clear signs of gender dysphoria, change their minds? I can’t obliviously comment on this particular instance, but I can talk about some of the experience I have had in supporting young trans people.
I noticed, while running a trans support service, that we were getting far fewer young trans girls accessing the service than trans boys, which is the reverse of the situation with older service users. Part of this seems to be because it is a lot easier for girls to express masculinity when young than for boys to express femininity. So boys with milder gender dysphoria often hide it – That was certainly what I did, and it’s what a lot of my trans friends did.
If a boy does start to live as a girl by the time they reach teenage years there is a real challenge with relationships. If you have watched any of the Jazz Jennings documentary programmes, you will recall that it was the issue of engaging with boys as she became a teenager that caused the biggest fears for her parents. What trans girls have told me is that there are very few straight boys prepared to be seen to go out with someone known to be a trans girl, and most gay boys want a relationship with them as a boy, not a girl.
I was aware of a number of trans girls who, at 13 to 16, decide that life would be a lot easier if they opted to identify as gay boys. That way they can just be a camp gay boy, even still dress in girls clothes or do drag and female impersonation though, for most of them, an androgynous look worked best where they were seen as neither boys or girls.
I am not sure if we will get to see the whole of the 60 Minutes TV programme or the Woman’s Day magazine article that started the story, here in the UK. It concerns me that Partick’s mother has sold this story to the media with little concern for the damage this may do to other trans boys and girls when frankly it seems to be her irresponsible behaviour that has caused the problem. What I do hope is that this article is read by some of the dissenters so that they do get a better understanding of the real difficulties for any parent with a trans child and will take and more supportive approach if they are unlucky enough to find that their child is trans.