Stuck on the belief that truth will save you

Alice Dreger has, with effort, learned to accept that historians are always too late with advice; people don’t listen until after it’s all over.

A group of transgender activists has achieved a major victory—the shutting down of the Child Youth and Family Gender Identity Clinic at Toronto’s Centre for Addiction and Mental Health (CAMH). Even better from their point of view, they got the head of it, psychologist Ken Zucker, fired.

The activists didn’t like Zucker because he never did subscribe to the “true transgender” model of identity, wherein you simply accept what any child (no matter how young) says about his or her gender. The transgender activists who called for his ouster insisted that Zucker was doing “reparative therapy,” trying to talk children out of being transgender when they “really” were.

I don’t doubt that these particular transgender adults look back and see that, from very early on, they had been assigned a gender that didn’t make sense for them. The mistake they make is then to assume that every child who expresses doubt about his or her birth gender assignment should simply be “affirmed” by parents and clinicians in their “new” gender.

It’s the other minds problem, as always. You can’t ever know that other people are thinking exactly what you thought in what you take to be the same situation. You just can’t. It’s all guesswork and extrapolation, and it’s inherently fallible.

This is an unbelievably simplistic understanding of what’s going on with these children. Yes, some of them will grow up to be transgender; Zucker and others have documented that, over and over again. But if history is a guide, the majority will not. Trying to make sure they all get the best care they need is the goal of clinics like Zucker’s, as well as the clinics run by other good folks at the children’s hospitals of UCLA, Northwestern, Seattle, and on and on.

Why not just go ahead and transition everyone who expresses doubt about his or her birth gender assignment? Because physical transition is a big deal. On the other hand starting early with kids who won’t later regret it is much better than waiting. There are reasons both ways. That’s why it’s important to get it right.

For many years, there was pretty heavy medical gatekeeping around sex reassignment. This had some to do with homophobia, heterosexism, and so on, and some to do with defensive medicine (fear of being sued if a patient later regretted transitioning). Today, the pendulum has swung really hard in the other direction. It is now much, much easier for children, adolescents, and adults who signal that they are transgender to gain access to social gender changes, hormone therapies, and sex changing surgeries. This has a lot to do with political rejection of homophobia, heterosexism, transphobia and so on, and some to do with defensive medicine (fear of being attacked as anti-transgender).

In other words, it’s still pretty damned political. Whereas before, some people who would have benefitted from transition were denied it, today some people who might benefit from alternative clinical help (alternative to transition) are effectively denied that help and are instead being “treated” with transition.

Dreger links to people who have later changed their minds about transitioning.

There are more and more of these, and they are typically not written by people who are anti-transgender by any means. They are written by people who realize transition isn’t what they needed after all. They are written by people who urge caution.

Many people today are afraid to urge caution, because when you do, you get labeled anti-trans, and sometimes coopted by genuinely anti-trans people. But some people are willing to talk in private or to speak pseudonymously. So, earlier this year for WIRED magazine, I interviewed a thirty-something woman I called Jess. She had been a gender nonconforming female child and was skeptical about sending children too quickly down the road of transition.

Today, in the clinics presumably the transgender activists want, a gender nonconforming, gender-questioning child like Jess would simply be transitioned over and sent out into the world. But Jess told me that, today, “I’m very happy having the body I have, with just some changes in how I express it.” She identifies as a genderqueer gay person with a female body (the body type she was born with), and works on LGBT rights issues professionally. She’s not anti-trans.

Not a bad outcome, is it?

The transgender activists who demanded and ultimately achieved the shut-down of Zucker’s CAMH clinic said that Zucker’s approach was full of stigma. That’s because he didn’t simply “gender affirm” every child that came by. He worked with them to figure out what they needed psychologically. For some, that was transition. For others, it was coming to see that you could be gender nonconforming without changing your sex, or dealing with depression or bi-polar disorder, or dealing with the mental health needs of parents who were not well enough to really care for their children as their children deserved. It was a pretty idiosyncratic approach, designed to help each individual child be the most healthy in the long run, no matter which label she or he came to inhabit. Again, for some children, that meant transition (becoming “T”), and for those children, Zucker arranged puberty-blocking hormones and then hormonal and surgical transition.

The trouble is, Zucker didn’t do the community education and outreach that was needed.

I so wish Zucker had done the “community education” that this review called for. Now it is too late. For years, I and others advised Zucker to be far more proactive in terms of the politics in which he was caught—to reach out to the public to directly engage them in conversation about the methods and reasoning of his clinic’s approach, the same approach used in many top clinics around the world. As late as this summer, I gave him a lot of the advice I also recently gave to the International Society for Intelligence Research about how to work to protect yourself in politically difficult fields (see video).

But Ken seemed to believe that he didn’t need to deal with the activists coming after him. He disregarded my repeated advice. As a consequence, what has happened to him reminds me very much of what happened to Napoleon Chagnon, as recounted in chapters five and six of Galileo’s Middle Finger. It’s the Galilean personality, stuck on the belief that truth will save you. Wrong. The Church of True Gender doesn’t give a crap what science shows.

But people don’t listen to historians until it’s too late.

61 Responses to “Stuck on the belief that truth will save you”