Monday, August 04, 2014

An Open Letter To Margaret Wente

Dear Ms. Wente,

I thought that as a journalist you were supposed to do some research before you go writing stories.  In the case of your August 2, 2014 column in The Globe and Mail, it is painfully obvious that you haven't even bothered to try.
As a child, Lindsay Leigh Bentley desperately wanted to be a boy. She refused to wear dresses and adored going hunting with her dad. She loved sticks, guns, motorcycles and monsters. She chopped the hair off her Barbies. Her parents had to cut her own hair short because she refused to let them brush it. Her best friends were boys. In childhood pictures, she looks fierce, and tough as nails. 
These days, her worried parents would probably hustle her off to the nearest gender-identity clinic.
Had you done even the slightest bit of actual research, you would have discovered that there is very little that is so simple about the treatment of Transgender youth.  The World Professional Association for Transgender Health Standards of Care (WPATH SOC) would have been a good place to start.  (Take note of this reference, we will be coming back to it)
...But it is also the story of advocacy run amok, in which a small but militant group of activists has managed to strong-arm well-meaning people into believing that gender is not innate but “assigned,” that those who are “trapped in the wrong body” would be happier with radical hormone treatments and mutilating surgery, and that children as young as one or two should be pushed along a path whose implications they are far too young to understand.
Wow ... how many twists and lies can you put into a single paragraph, Margaret?  Let's start enumerating them:

1.  radical hormone treatments
2.  mutilating surgery
3.  children as young as one or two are being pushed along this path

I'm going to start with the last one.  Children as young as one or two?  Care to cite actual examples of transgender children that young?  A quick survey of the literature that I am familiar with shows a handful of grade school aged transgender cases, and a couple of surgeries done at the age of 16.

Second you choose to refer to the constructive surgery that are available to transsexuals as "mutilating" surgeries.  I can assure you that if you discovered a penis growing where there shouldn't be one, you'd want it removed too.  From the perspective of a transsexual, the gender surgeries that are available are not "mutilation" at all, and are perhaps better characterized as reconstructive surgeries, in much the same way that such surgeries are thought of when applied to Intersex individuals.

As for hormone treatments being "radical", cross-sex hormone replacement therapy has been available since the 1950s or earlier, using exactly the same drugs used to treat hypogonadism hardly what any of us would call "radical" at this point in time, with several decades of successful use.  Even the drugs which can be used to suppress puberty in transgender youth have been around since the mid-1990s - nearly twenty years now.  While it is relatively recent that the general public has become aware of these treatments, I would hardly call the long time work of Dr. Spack, who has been working with transgender youth since the 1970s radical or new.

I would like to bring something to your attention, Ms. Wente.  It is from the WPATH SOC document I mentioned earlier.

Roles of Mental Health Professionals Working with Children and Adolescents with Gender Dysphoria
The roles of mental health professionals working with gender dysphoric children and adolescents may include the following:
Directly assess gender dysphoria in children and adolescents (see general guidelines for as- sessment, below).
Provide family counseling and supportive psychotherapy to assist children and adolescents with exploring their gender identity, alleviating distress related to their gender dysphoria, and ameliorating any other psychosocial difficulties.
Assess and treat any co-existing mental health concerns of children or adolescents (or refer to another mental health professional for treatment). Such concerns should be addressed as part of the overall treatment plan.
Refer adolescents for additional physical interventions (such as puberty suppressing hor- mones) to alleviate gender dysphoria. The referral should include documentation of an as- sessment of gender dysphoria and mental health, the adolescent’s eligibility for physical inter- ventions (outlined below), the mental health professional’s relevant expertise, and any other information pertinent to the youth’s health and referral for specific treatments.
Educate and advocate on behalf of gender dysphoric children, adolescents, and their families in their community (e.g., day care centers, schools, camps, other organizations). This is par- ticularly important in light of evidence that children and adolescents who do not conform to socially prescribed gender norms may experience harassment in school (Grossman, D’Augelli, & Salter, 2006; Grossman, D’Augelli, Howell, & Hubbard, 2006; Sausa, 2005), putting them at risk for social isolation, depression, and other negative sequelae (Nuttbrock et al., 2010).
Provide children, youth, and their families with information and referral for peer support, such as support groups for parents of gender nonconforming and transgender children (Gold & MacNish, 2011; Pleak, 1999; Rosenberg, 2002).

Assessment and psychosocial interventions for children and adolescents are often provided within a multi-disciplinary gender identity specialty service. If such a multidisciplinary service is not available, a mental health professional should provide consultation and liaison arrangements with a pediatric endocrinologist for the purpose of assessment, education, and involvement in any decisions about physical interventions.
I want to bring to your attention items 2 and 3, which have been highlighted and are italicized.  Take a long, careful read through them.  I think you will find that in both cases, the therapist is undertaking a role of both great responsibility and greater caution.  No ethical treatment provider is going to be "pushing" anything unless there is good reason for it, and substantial corroborating material to back it up.

With respect to early childhood transition (which you are trying to use to invoke the bogeyman of fear), the SOC also has some very interesting commentary on that subject as well:
Some children state that they want to make a social transition to a different gender role long before puberty. For some children, this may reflect an expression of their gender identity. For others, this could be motivated by other forces. Families vary in the extent to which they allow their young children to make a social transition to another gender role. Social transitions in early childhood do occur within some families with early success. This is a controversial issue, and divergent views are held by health professionals. The current evidence base is insufficient to predict the long-term outcomes of completing a gender role transition during early childhood. Outcomes research with children who completed early social transitions would greatly inform future clinical recommendations.

Mental health professionals can help families to make decisions regarding the timing and process of any gender role changes for their young children. They should provide information and help parents to weigh the potential benefits and challenges of particular choices. Relevant in this respect are the previously described relatively low persistence rates of childhood gender dysphoria (Drummond et al., 2008; Wallien & Cohen-Kettenis, 2008). A change back to the original gender role can be highly distressing and even result in postponement of this second social transition on the child’s part (Steensma & Cohen-Kettenis, 2011). For reasons such as these, parents may want to present this role change as an exploration of living in another gender role, rather than an irreversible situation. Mental health professionals can assist parents in identifying potential in- between solutions or compromises (e.g., only when on vacation). It is also important that parents explicitly let the child know that there is a way back.

Regardless of a family’s decisions regarding transition (timing, extent), professionals should counsel and support them as they work through the options and implications. If parents do not allow their young child to make a gender role transition, they may need counseling to assist them with meeting their child’s needs in a sensitive and nurturing way, ensuring that the child has ample possibilities to explore gender feelings and behavior in a safe environment. If parents do allow their young child to make a gender role transition, they may need counseling to facilitate a positive experience for their child. For example, they may need support in using correct pronouns, maintaining a safe and supportive environment for their transitioning child (e.g., in school, peer group settings), and communicating with other people in their child’s life. In either case, as a child nears puberty, further assessment may be needed as options for physical interventions become relevant.
If I was to distill this to a simple, short statement to a therapist it is this:  Proceed with caution.

While you seem to think it is the "wild west" out there when it comes to dealing with transgender youth, Margaret, it is anything but.  The professionals involved in the treatment of transgender people (youth and adults alike) are thoughtful, committed people who have the best interests of their clients at heart.   There are serious and long standing issues to consider, and they do not always have a clear path forward.
But transgenderism is also a fad that has been spread by social media and embraced by individuals (and families) as the explanation for their confusion, loneliness and dysfunction.
How dare you accuse people who are trying desperately to live authentic lives - in the face of a society that is profoundly hostile to their mere existence - of being "a fad".  You make this accusation based upon what evidence?  None.  It is pure conjecture on your part.  Yes, the Internet and Social Media have unquestionably made it enormously easier for transgender people to gather information and gain access to the resources needed to facilitate transition.  Calling it a fad is the height of ignorance on your part Ms. Wente, and I think you owe your readers and the Transgender community as a whole an apology for making such a gross slur without so much as the slightest bit of intelligible material to back it up.
One skeptic is Camille Paglia, the formidable cultural critic and dissident feminist. “Transgenderism has taken off like a freight train and has become nearly impossible to discuss with the analytic neutrality that honest and ethical scholarship requires,” she said in an interview with FeministTimes.
Oh?  So, for an authority on Transgender issues, you go to a feminist who just happens to be "a skeptic"?  Wow, that's so compelling.  Why didn't you take the time to contact and discuss things with a transsexual feminist as well?  Oh wait, someone like Julia Serano might just have taken to task your very assumptions.
You’ve got to be brave to say that these days. Today, anyone who dares to question the march of transgender rights is labelled as transphobic.
No, I don't think you know enough to be transphobic, Ms. Wente.  I'll just call you ignorant.
These days, that makes them bigots. Transgender activists (male-to-female, in this case) insist that they are entitled to all the rights and privileges of those who were born biologically female. This is not an academic point. Male-to-female transsexuals have insisted on their right to work at rape-crisis centres, for example – a claim that has been bitterly contested by the women who run these places, and worry how their clients who have been violently abused by men might react.
Wait ... what?  So, you don't think that transsexuals get raped?  You actually buy this entire fear line about trans women "because we aren't born female we can't possibly know what it's like" nonsense that the RadFem crowd has been spewing?  You are more gullible than I had thought.

A woman is a woman, regardless of what she was born with between her legs.  Arguing that because someone was "born male" they don't have insight into what it is to experience rape is, well, condescending and ignorant.

Ms. Wente, you would do all of us a great favour if you spent some time actually researching the subjects that you choose to write about before you start spouting off.  For those of us with actual knowledge and experience in these subjects, your ignorance is appalling.  For the public who at large might actually expect you to have some useful insights, you are misleading them through your ignorance.

- MgS

p.s.  Since you are no doubt going to pull up the usual laundry list of objections, please review the following:  Fighting Back Against Anti-Transgender Talking Points before you start spewing

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