Daniella's Ramblings

Sadly, I came across this article on a relative’s Facebook page the other day. I really wanted to respond to my relative but felt unable to do so as responding would almost certainly result in me ‘outing’ myself to my entire extended family. Something I am not prepared to do. So I have decided to vent my spleen upon you all, my dear readers. I think it is actually not  bad idea as we need to be aware of what is out there, even if sometimes we would rather not know.

The gist of the article is that
‘a cross-discipline study has challenged the belief that human sexuality and gender identity are determined by biology and remain fixed, saying that there is no scientific proof of this. The study cautioned against drastic medical treatment for transgender children.’ The study does not claim that being gay is a choice but rather asserts that the opposite assertion (the dominant paradigm) may not be true as there is a lack of scientific evidence. The study then rightly points out that there is great deal of confusion in the literature (both scientific and non-scientific) with terms such as sexuality and sexual orientation being used loosely or simply incorrectly and that often misleading conclusions can be drawn due to a lack of common nomenclature and agreed definitions.

They then went on to look at the evidence and found that whilst there are biological explanations for human sexual orientation, they were unable to determine whether these were innate or caused by environmental or psychological factors. They could also not ascertain to what extent these factors influenced sexual orientation. So far this is all sounding quite reasoned, rational and balanced, but I think this could be summed up as
‘we know we do not know some things, and we do not really know what we do not know, but we know we can write an article about it and possibly cause a great deal of harm to others because we are cisgender, heterosexual men. Ergo we are respected by our colleagues and we do not have to suffer the consequences of publishing an article that could result in already marginalised people experiencing even more discrimination.’
This is all looking rather bleak for the gay subjects (perhaps ‘targets’ is a better descriptor) of their study, but for transgender people things are about to get worse.

The study points out that
‘the notion that gender identity is fixed and determined by biological factors is also not backed up by data. “In reviewing the scientific literature, we find that almost nothing is well understood when we seek biological explanations for what causes some individuals to state that their gender does not match their biological sex.”’
The authors therefore strongly advised against ‘drastic medical treatment such as sex-reassignment surgery for people identified or identifying as transgender. This is especially true in children, whose sexuality is mutable.’
They warned that these treatments could do more harm than good. They included treatments that delay the onset of puberty in these ‘more harm than good’ therapies.
They then suggested that ‘although some children may have improved psychological well-being if they are encouraged and supported in their cross-gender identification, there is no evidence that all children who express gender-atypical thoughts or behavior should be encouraged to become transgender.”’
Now firstly these eminent and highly respected scientists seem to have committed the very same failing that they accuse others of: they are conflating and indeed confusing gender identity and sexuality. What has a person’s gender identity got to do with their sexuality? Why should a mutable sexuality mitigate against treatments helping transgender children? That is a nonsensical and illogical argument. They also hold gender therapies up to an incredibly high standard. I do not believe any therapy  is 100 percent effective. Yet they say ‘there is no evidence that all children who express gender-atypical thoughts or behavior should be encouraged to become transgender’. Imagine if they were treating some other, better understood conditions. Would the scientific community accept statements such as ‘there is no evidence that all patients who test positive for HIV should  should be encouraged to take ARVs because they do not always work’ as valid? I strongly doubt it. They would look at a cost benefit analysis, they would look at what results were achieved but they wouldn’t accept the lack of full efficacy as a reason to abandon the therapy. Such articles would almost certainly not be repeated in mainstream media, especially not ones that purport to broaden scientific knowledge.

Now to be clear, I am on record saying that I believe that the medical profession does not properly understand the transgender experience and that they have unnecessarily made being transgender an illness that requires treatment. Perhaps we as a community have aided and abetted them in this regarded but this is only because in our desire to be accepted, be taken seriously and receive the support that we need. We have therefore played their game and told them what we thought they wanted to hear. This has muddied the waters and we are complicit but that does not in and of itself invalidate the treatments we know we need.

I have also said that I do not believe that all transgender people need to be treated with hormones and/or surgery, but that does not mean that I think that people should have to jump through more hoops to get these treatments, if that is what they need. On the contrary, if you are experiencing significant levels of dysphoria you should get treatment sooner not later. If you need some more minor gender re-orientating interventions (eg electrolysis) this should be seen as a necessary medical intervention and it should absolutely be treated as such by the relevant authorities. We need more not less understanding and we need more not less acceptance of our very real situation.

So in essence I agree that more and better scientific study needs to be done but this should be done to better understand us with a desire to help us, not to further deny those who need treatment that treatment and to deepen the mistrust that society has for us. Sadly as long as you say ‘there is no evidence that this is innate’, the more certain sectors of society will choose to hear ‘these people are just a bunch of perverts looking for special treatment to which they are not entitled’. Sadly this will result in more stigmatization, more discrimination and less support and help.

So far I have dealt with the text of the article. However there is also a video clip embedded in the article in which the eminent scientists are interviewed. I find this video clip as, if not more, concerning.

The video starts by saying that there is a large gap between what the received wisdom (certainly held beliefs among much of the population) is in respect of the LGBT reality and what the scientists have observed in the course of their research. Now let me say that I completely understand that the ‘born this way’ narrative was primarily a sociological and political phenomenon and it almost certainly has little or no basis in empirical study or experimental testing. But it was and is a necessary narrative. It has been massively successful in gaining acceptance from legislators, the public at large and even ourselves. The danger of rejecting this narrative before society at large is ready to do so is that the hard won freedoms can be quickly and easily overturned. Also those of us living in less accepting parts of the world run the very real risk of never realising the freedoms that our brothers and sisters have as part of their lived reality. I am also not convinced how the ‘truth’ about what causes us to be LGBT matters. The fact remains LGBT people exist, we have a right to exist and we deserve to be treated fairly. The causes of being LGBT are in these senses irrelevant other than that some sectors of society will use the ‘fact’ that being LGBT is in fact not innate and mutable as an excuse to do further harm.  This is therefore a very dangerous position to adopt. It may be scientifically justified, but is it morally or ethically justified? Scientists are not absolved from the ethical and moral implications of their work. A position that has been endorsed by the UN, numerous faculties and ethics councils the world over.

One of the writers of the report, Paul McHugh, correctly points out that scientific study can never be ‘complete’ and that we should be careful not to close off debate by thinking that we have ‘all the answers’ when in fact we do not and cannot ever have ‘all’ the answers. I completely understand and agree with that point of view but again I assert that scientists have a moral and ethical duty to ensure that their work clarifies rather than obscures and that their published findings do not unjustifiably harm people. Scientists regularly complain that the mainstream media do not cover science well and that journalists do not in fact understand what they are reporting on. That may be a justified criticism, but I would argue that as soon as the scientists starts using their research to influence policy and in doing so seek to obfuscate, then they are acting in bad faith and that their error is worse than the journalists error/s and that the scientists cannot claim that the journalist ‘got it wrong’.

Another author Lawrence Mayer points out that we have very limited and outdated data on gender and sexuality. A point that I would agree with. But of course as always, social science is not as simple as the other sciences. Finding control groups and repeatable experiments (especially over the long term) are highly difficult if not impossible to achieve. How exactly do you replicate an experiment on a group of people without changing at least some of the conditions? I do not think that this is possible.

He then goes on to say that he is primarily concerned with the well being of children and that he has concerns regarding the diagnosis of  children, as young as two, as being transgender. He clearly has concerns regarding these diagnoses. These concerns may or may not be justified, but the real issue is that he is using a rhetorical trick. He is playing to our emotions and pretending to use scientific ‘facts’ to manipulate us when in fact his argument is emotional rather than rational. Who is not concerned with a child’s well being? To try and argue against this invites condemnation from all and sundry. It is very similar to the pro-life argument that abortion is nothing more than ‘baby killing’ and who can justify killing babies let alone identifying as a a baby killer. It is a powerful emotional argument and its sole rhetorical purpose is to negate the facts. Furthermore, conservatives are very good at caring deeply about unborn babies and children but seem to give a lot less consideration to adults. They seem to forget that babies become children, children become adults and that the circle of our misery grows in proportion to our maturity. We also (generally) spend many more years as adults than we do as children and for many of us much of our adulthood is spent dealing with the issues brought about by the conditions we experienced in our childhood.

Meyer seems to think that medical interventions such as hormone blockers to delay puberty or the prescription of hormones in teenagers and the use of sexual reassignment surgery in children of any age is somehow wrong. He seems to think that the child has a diminished  ability to consent to these treatments. However he seems to miss the point that inaction is as deliberate as action. That is to say not doing something (when you are aware of other options) requires as much deliberation as doing something. Thus consent needs to be given to both courses of action. If the child is unable to consent to the one course then surely they are equally unable to consent to the other. We as a society are generally critical of parents who do not treat their children, who are suffering from treatable diseases such as measles, mumps, cancer etc, due to the parents religious beliefs, yet Meyer would seem to suggest that parents are somehow wrong to provide their gender non-conforming children with even relatively conservative treatments. His argument thus falls down: it is self contradictory, possibly tautologous and frankly illogical.

He then asserts that the majority of children who have identified as a member of the opposite sex ‘grow out of it’ at some time and that gender identity in children is ‘very very fluid’. This is perhaps (at least for me) the most problematic part of this whole piece. Meyer has made the cardinal error of thinking that what he is observing on the surface is representative of a ‘truth’. It is true, certainly in the past 50 years that many children have expressed some sort of gender non-conformity and that the majority of these children, having been denied gender affirming treatments, have gone on to live ‘normal lives’ as the gender matching the sex they were assigned at birth. But this view misses the fact that all that happened was that these children conformed. They conformed to an idea of  what they thought their parents, their siblings, their teachers, their doctors and indeed their peers wanted them to be. We all need to belong to the social group we find ourselves in. As a species we cannot survive as an individual we need  the help of others if we are to survive and we are very aware of this. Fitting in is thus a very important feature of our psyche. Failing to fit in results in expulsion from the social group and that has dire consequences for us. Conformity is a vital survival tool.

Added to this is the fact that in the pre-internet* world the transgender person was almost totally isolated. It was almost impossible to find other gender non-conforming people. Maybe the odd news report came out about a person undergoing sexual reassignment surgery or the odd transgender person was outed by the media, but this tended to reinforce our sense of isolation and show the need to conform rather than liberate us. Who wanted to have your genitals splashed across the newspaper? The conversations we heard from our societal groups in reference to these events showed that anyone expressing gender non-conformity would be treated as an outcast. We all had too much to lose and we were all made very aware that we would indeed lose. Sadly we therefore (almost) all conformed, or at least tried to. We hid our bras and panties. We purged, we begged our gods to ‘fix’ us (one way or the other) and we tried to make ourselves what we were not. Those of us assigned male at birth played rugby and pursued ‘manly’ careers (mechanics, builders etc). I am sure those assigned female at birth followed similar strategies. We hid, by conforming. We buried our shame, married and had children. In short we did what was expected of us and we made our parents and peers happy whilst making ourselves more miserable. But we feigned happiness because, well that was also expected of us. Sadly many of us took to alcohol and drugs, or committed suicide. All of which pretty much amounts to the same thing. Let me be clear I am not blaming society for being transphobic, or for somehow making us unhappy. Our happiness is no one’s responsibility but our own. But I am saying that ignorance from the cisgender world has caused behaviours in us that not many (including ourselves) entirely recognise, let alone understand.

It is quite common for the transgender person who has conformed in this way, who  then reaches a stage in their lives where they are so unhappy that something has to give and when they are sufficiently financially secure to need the support of others less to decide to ‘come clean’ and start being their true selves. They may or may not tell those close to them and they do achieve some sort of contentment but of course we are all products of our previous decisions and now we have spouses, in-laws, children and all sorts of other people who are now affected by us. We disrupt their worlds and this can cause all sorts of  additional unhappiness. Unhappiness that we are responsible for and a this creates a whole new burden for us to carry.

It is this hidden part of the iceberg that Meyer completely misses in his desire to protect children. He does not see the 40 year old who has lost their spouse, their children and their job because they could no longer hide their true self. Meyer does not see the teenager with a profound sense of unease because they just know that there is something profoundly different about them and who can only interpret this difference as something ‘wrong’. Something wrong with them. Something that needs to be hidden from the world lest the world turns on them. Meyer does not see the child who is beaten by their parents and their peers on a daily basis for being different and who then decides it is better to hide in plain sight than be who they know themselves to be. All that Meyer sees is someone who was once falsely diagnosed as transgender but who is in ‘fact’ a happy well adjusted person. In short Meyer sees what he wants to see and  uses these observations to entrench the status quo.

In conclusion I would say that it was highly irresponsible of these people to publish a report that has the possibility to do so much harm to so many people. Even more damning is the fact that by their own account they had every intention of making the report widely available to the general public.They thus published the report in a form that would make it more likely to be ‘picked up’ by mainstream media without considering the very real effects on the LGBT community. The effect of this report could be that decades of progress is undone and that people in desperate need of treatment are denied this treatment. I strongly suspect that these scientists have a very conservative political agenda and that they are using their (by their own admission) inconclusive and uncertain scientific results to advance what I can only conclude is their own political agenda.

 

*The internet has done wonders for our community. Up until the wide scale adoption of the internet our community was isolated. We were all isolated from each other and it was almost impossible to find other transgender people. We were a bunch of individuals all thinking we were the only people in the world with this ‘problem’ and had no way of connecting with others. Now there are forums, websites, whole online communities where we can speak to others, get support, realise we are not alone and find that we are not as abnormal as we used to think. This has led to something of an explosion of transgender people around the world. We are more visible, more audible and less afraid than ever before. This is not because the internet has allowed for a more permissive society. rather it is because the internet has revolutionised communications and peer to peer communities. It has allowed us to give expression to ourselves.

Please note that I have deliberately engaged as little as possible with the truth or falsehood of the research findings. I have preferred to look at the logic and arguments presented as these seem to be more fruitful. By the writers own admissions the data is poor and therefore I do not believe that this is a fruitful line of discussion.