28 October 2016

Would you let your child change their gender?

Get ready for the new culture war: the question of how old children should be before they're allowed to change gender.

When do children really know who they are? It’s a question that has been at the front of my mind over the past week. I’ve been reading Andrew Solomon’s Far From the Tree, a richly reported study of children with identities that their parents struggle to understand. In contrast to “vertical identities” (such as race or first language), which are usually shared by the whole family, children who are gay or deaf, or have Down’s syndrome or schizophrenia, often don’t share those attributes with their parents. Solomon calls these “horizontal identities”. Consequently, these children need to find their communities outside the family unit, which can be a distressing experience for both them and their parents. The parents love them, but they can’t ever truly understand what it’s like to be them. They live in a world that their families cannot enter.

I’m glad that writers as sensitive as Solomon have sketched out this terrain, because an almighty storm is brewing over transgender children. There is an element of a new culture war starting up, now that gay marriage is legal in the UK and US. But it’s also about the increase in the numbers involved: what was once a niche subject, with debate largely limited to specialists in the field, has started to make its way on to newspaper front pages. (There were two cases in one recent weekend.) Every year since 2010, the specialist Tavistock and Portman NHS Foundation Trust in London has recorded 50 per cent rises in the number of children with gender issues. In the past year alone, referrals doubled from 697 to 1,398. The majority of patients, 913, were biologically female – in contrast to the adult population, in which trans women (who were assigned male at birth) outnumber trans men.

The idea that a small but significant number of children don’t want to live in the gender assigned to them will take some getting used to. I have been asking around schools, and more and more of them are dealing with the question of how best to support pupils who want to transition socially by changing their name and presentation. Many teachers feel ill-equipped to deal with the challenge and there is a postcode lottery because of the lack of consensus about what rights such children should have. Some schools will let anyone wear a skirt; others insist that it’s for girls only. Communal changing rooms and segregated toilets present a similar challenge. Many parents would not want their teenage daughter to share a locker room with a classmate with a penis; trans activists point out that it’s hard enough to deal with puberty without being singled out and made to feel like a freak, too. Support is patchy. Currently, there is a huge gulf between what a child can expect at, say, a state secondary school in laid-back Brighton and at a faith school in a religious area.

Yet there is a bigger question, and it is one that progressives have been dancing around for years. Are all of these children really transgender? Or are some of them channelling other issues (depression, autism, realising that they are gay) into a self-diagnosis with something they have read about on the internet, or heard from celebrities or older pupils? One worker in the sector, who didn’t want to be named, said that her caseload is now dominated by children with gender issues. One of her relatives is a teenager who is talking about transitioning. “She has this identity that gets her attention and a feeling of ‘this is my tribe’,” the worker said. “But she says she doesn’t want bottom surgery, she wants children. Yet it’s more acceptable to be a trans man than a butch lesbian.”

I can’t overstate how sensitive the matter is. You have, on the one hand, a group of people who felt profound pain through their adolescence and want to spare anyone else going through that. There are high rates of suicide and self-harm among transgender people, so many trans activists argue that more acceptance is a matter of life and death. On the other hand, you have parents who have seen their children go through phases before and wonder if this is just another – except this one might lead to lifelong medication and surgery. They talk of the year their toddler spent insisting she was a horse; or how they, too, were convinced that they were a boy at the age of four, despite being assigned female at birth. Is this different?

Trans activists find this offensive, drawing a distinction between their deeply held beliefs about their identity and such flippant examples. The most ardent of them condemn any parents who don’t give unequivocal and immediate support to a child who wants to transition socially – comparing them to religious families that won’t accept their children are gay.

To counter this, the most dogmatic parents argue that the trans activists are peddling a lie that you can transform, swanlike, from one sex to another – and fear that any child who so much as likes pink (if they’re a boy) or pirates (if they’re a girl) could be frogmarched down a path that ends in having their breasts or testicles removed. They warn of regretful youngsters growing up to sue their parents and the doctors involved.

Unsurprisingly, given these views, each side accuses the other of perpetrating child abuse. Neither can intuitively understand the other, because no one has unmediated access to anyone else’s true self. And both arguments have merit. There are undoubtedly unhappy children suffering because they cannot express themselves the way they want. Equally, given that an estimated 80 per cent of gender-nonconforming children grow up to be non-trans adults (and many are gay or lesbian), we mustn’t railroad any vaguely nonconforming child into undergoing treatment that ends in lifelong hormone prescriptions and surgery.

When do children really know who they are? Until we have a better answer, we can’t avoid young people being harmed.