Auntie Doesn’t Know Best

Back when I was a kid, the BBC was known affectionately as “Auntie”. It had this rather Mary Poppins air of a benevolent older relative who was wise and caring but also gave you lots of presents. Unfortunately everyone gets old, and “Auntie” is now more like that elderly relative who has grown grumpy after too many years reading the Daily Mail. “Auntie” has married a beer-swilling, racist lout called Nigel, and all she seems to do these days is rant about the state of the world and the behavior of kids today.

A prime example of this was last night’s documentary about trans kids. It was, as Susie Green of Mermaids said on the Breakfast show today (the coverage begins at around 2:45), rather like running a documentary with some old guy complaining that doctors don’t recommend leeches and blood-letting as a treatment any more. Kenneth Zucker, the man who was portrayed as a heroic campaigner against political interference in medicine, has been thoroughly discredited by his peers, but the BBC is still billing him as a leading expert in the field.

Also on that Breakfast show is a Canadian trans woman who had been a patient at Zucker’s clinic. She explained that one of the “treatments” that Zucker recommended to “cure” trans girls was for parents to always watch the child while she went to the toilet to make sure that she always stood up to pee. The only real mystery with Zucker is how it took so long for the Canadian government to shut him down.

I spent yesterday afternoon working with a group of staff from Bristol Mental Health (including one psychiatrist who is an actual a gender specialist) looking at ways to educate their staff in trans issues. They were all mental health professions. They understand that you can’t “cure” someone of being trans, or gay for that matter, by making them ashamed of who they are. But some of the staff we need to train, not to mention the staff at the two local charities I will be doing training for this month, may have seen that BBC program. That means we’ll need to put a lot of effort into dispelling the nonsense they will have been fed. I’m going to get some practice in by starting on you lot.

Let’s start with a few facts.

  1. Trans kids are not normally put through any surgery until they are 18
  2. Trans kids are not normally given any hormone treatment until they are 16
  3. “Puberty blocker” drugs are not given to trans kids until they start puberty
  4. Once a patient comes off puberty blockers, puberty will continue as normal, they do not “change the sex” of the patient
  5. Puberty blockers were invented to treat kids with early onset of puberty, and no one questions their use or safety in such cases

Nevertheless we continue to see the media claim that very young children are given actual medical treatment. The BBC did this in a Newsnight show on Wednesday. I’ll come back to why this happens later.

Moving on to more theoretical stuff, I want to make it very clear that gender performance and gender identity are not the same thing. There is a huge difference between a young child, assigned female at birth, playing football, and that same child saying they are a boy. Any reputable gender specialist or trans activist will tell you this. Sadly the media keeps pushing the nonsense about toys and a preference for pink. One of the reasons that Zucker is no longer respected in the profession is that he uses things like what toys you play with and whether you like pink or blue as diagnostic of your being trans.

Interestingly, anti-trans activists such as Sarah Ditum and Helen Lewis regularly accuse gender clinics and trans activists of using things like your toy preferences as a diagnostic indicator. It doesn’t matter how often we say we don’t, they still insist that we do. And yet the one man in the field who does make this fundamental error is the man whom they hold up as the real expert.

The inevitable result of confusion between gender performance and gender identity is that kids who are not trans, know they are not trans, and say they are not trans, get diagnosed as trans, or at least get referred to gender clinics. The generous interpretation of Zucker’s work was that he didn’t understand the distinction and kept making the same mistake. The less generous interpretation is that he knew damn well what he was doing, and knew that he could make a lot of money off worried parents by diagnosing kids as trans, sure in the knowledge that he could later claim to have “cured” them.

Another thing to bear in mind is that gender identity isn’t simple. Some kids who end up in gender clinics will have very clear and strong ideas about who they are. Others will be unsure and need someone to talk to. Many of them will decide, having had time to think about things and talk to psychiatrists, that they don’t need full binary gender transition. They may want nothing at all, or they may want something partial, such as social transition. Others will, of course, insist on getting every bit of treatment they can as soon as they can, but by no means all of the kids who go to gender clinics end up having medical treatment because the point of their going to the clinic is to find out what is right for each individual child.

Back now to this oft-repeated claim of actual medical intervention for very young children. It doesn’t happen, so why do people want you to think that it does?

Well, as I explained, a large proportion of the kids who get referred to gender clinics don’t end up going through full transition, or indeed any transition. Some are misdiagnosed by people like Zucker. Others simply decide that it isn’t right for them. There are claims that the number who don’t go on to opt for full medical transition are as many as 80% of all referrals. That’s not a huge problem as far as I’m concerned. I’d like to see better diagnosis so that kids who do not need referrals are not getting them, but I do want to see kids who are unsure given the chance to talk things over and maybe end up as non-binary adults. The idea that every person who is taken on by a gender clinic must have full medical treatment is ridiculously out-dated.

The media, of course, love quoting that 80% statistic. And they do so alongside the claims of medical treatment for the very young because they want you to believe that those 80% of kids who “grow out of it” have already been subjected to irreversible medical treatment before they get the chance to decide that’s not for them.

There you see the structure of the lie: kids are sent to gender clinics because of what toys they play with, kids are subjected irreversible medical treatment at a very young age, those kids then regret what has been done to them. None of this is true.

Why should anyone concoct such a bizarre fable? Let’s forget about the 80% of kids who don’t need medical transition for the moment and focus on the 20% who do. What about them? They currently have a chance of long and happy lives in the gender that feels natural to them. The point of all of this hoo ha — the lies, the concern trolling and the moral panic — is to shut down gender clinics for kids and prevent that 20% of patients from getting the treatment they badly need.

So that’s my take-away. Don’t worry about the 80% (or whatever % it actually is once people like Zucker are stopped from practicing), those kids don’t have anything bad done to them. Worry about the 20% whose access to treatment is under threat.

By the way, if you want to know what effect this sort of scare-mongering has on actual trans kids and their families, read this.

And of you want to complain to the BBC about the program, this tells you how to do it.

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2 Responses to Auntie Doesn’t Know Best

  1. Catherine Butler says:

    Very well said indeed.

  2. Jazzlet says:

    Thank you for a lucid exposition at a time when you are so busy.

Comments are closed.