If you have not watched Louis Theroux’ Transgender Kids documentary broadcast on BBC2 on Sunday 5th April – I recommend you grab the chance to watch it now on BBC iPlayer. I realise that may not be an option for anyone outside of the UK, but hopefully, as the programme explores Transgender Kids in California, it will become available elsewhere – perhaps even on YouTube.
There are now a growing number of documentaries on this topic and on my Transgender Awareness Workshops I still use extracts from the Barbara Walters ABC documentary from 2007 – My Secret Self. That thankfully is still freely available on YouTube. Unfortunately in the past UK produced documentaries have not been well produced and are often insensitive to issues like appropriate pronouns. Transgender Kids however is excellent.
Louis Theroux approaches the topic very sensitively and in particular gives the transgender kids themselves plenty of space to express themselves without too much direction. OK, for me, the programme had too much emphasis on surgery and that is a huge issues that has to be addressed. In the UK there are an estimated 300,000 to 500,000 people who are gender non conforming yet less than 5000 have actually applied for a gender recognition certificate to change their legal gender – and only about 15,000 have sought clinical support. So the vast majority of trans people remain in secret or have found a way to deal with their gender issues without medical or surgical treatment.
Sadly its clear that many of trans people remain in secret through fear. The Charity PACE reported on a four year study last year that almost 50% of transgender kids had attempted suicide compared to about 6% of all 16-24 years olds. Research in the USA in 2007 shows that children who are not supported by their parents are 4 times more likely to attempt suicide than those who are supported. I hope that parents of transgender kids who see this documentary will see clearly the value of supporting their children.
One of the key issues addressed in the programme was that of age. Is a child of five, old enough to make decisions that will impact the rest of their lives? Reading a number of comments on a Guardian Article about the programme it’s clear that this is still a huge issue for people, though what is also clear is that most people simply do not understand how young people are treated and and worse, most of the commentators were referring to the journalist’s much less detailed article and had not actually watched the programme itself.
The first important point to understand is that transgender kids do not undergo hormonal or surgical treatment until they reach puberty. As we saw in the programme, there are different degrees of “Gender Dysphoria” which is the underlying condition where a person experiences persistent discomfort or distress due to feeling that there is a mismatch between their biological sex and gender identity. We still don’t know exactly what causes this – but there is growing evidence that it is the result of hormonal imbalances during fetal development.
Although the UK is not as advanced in its treatment of transgender kids as the USA, there is a specialist Gender Identity Service for all gender non conforming children at the Tavistock and Portman Clinic in London and Leeds which will start treatment at onset of puberty. This treatment is to administer hormone blockers that suspend puberty. That means that the children will not experience the immediate irreversible effects of puberty which are known to be the primary trigger for suicidal actions. Hormone blockers do not cause any permanent changes. If the child stops treatment they will continue with normal pubertal development
But it does then allow time for full psychiatric assessment to take place and for the child to continue to live in their acquired gender until they are ready to start the permanent treatment of cross gender hormones at about 14 and surgery from about 16, if that is the right course of treatment. As we saw in the documentary not all transgender kids want full gender reassignment.
I particularly liked Louis’ final comment. “The choice to transition involves the possibility of social rejection and a lifetime of commitment to medication, but it is also the chance to exercise the most fundamental right we have – The right to be ourselves. In the end the hardest part of the challenge may be knowing who it is we really are.”
Right now it seems that the only choice we have is a rigid binary of “man or woman” despite increasing evidence that in reality there are many different possibilities. What we need is a more fluid approach to gender and language that allows us greater choice. To me the most interesting child in the programme was Cole/Crystal who is living as both male and female depending on how he/she feels today.