Gender-Related Treatment
Gender has become a very complex issue in the 21st-century. Post modern philosophers, queer theorists, and transgender-identified activists have created a field in which all of us dwell, whether we like it or not. A social construction at its core, “gender” is rooted in the sexual differences between males and females. Some of those differences are utterly innate and unchangeable, while others have historically been used as tools to oppress and control each other—think of women being denied the right to vote or women and children getting seats on life boats first. Some are clearly oppressive while others protect the furtherance of the species.
When it comes to “gender-related treatment,” which I call sex characteristic alteration (SCAlt) my approach is tailored to a number of different factors that each client brings, including their level of independence in the world. From my perspective, we aren’t adults until we live in a home where we pay the bills to maintain ourselves (rent, utilities, food, etc.) Yes, that means that some of us go a number of years as “legal” adults who are still dependent on others. Until we are able to take that step, we really haven’t shown that we have the skillset to succeed in life and that also means that our choices need to be made under the guidance of those who have shown that they have that capacity. When we apply this to issues of SCAlt or any permanent body modification (e.g., prominent tattoos), it means that parents are making a critical error to give their dependent children license to modify their body when they haven’t yet shown themselves capable of making their way in the world because we do not yet know what capacities they will need to be successful in the world. Modifying one’s body in ways that reduce functionality definitionally makes it less likely that a person will succeed in life.
While parents hold the line on not reducing their child’s biological, occupational, or social functionality, they need to listen carefully to what their children are telling them as wishes to engage in SCAlt are signs that something is not gong well in the child’s life and needs their parents’ attention. This is the case because we continue to lack any evidence of the existence of “transgender” or “non-binary” persons beyond their claims but we have significant evidence that there are only two sexes with a remarkably small subset of people who have disorders/differences of sexual development (DSDs). That means that we need to listen very carefully with thoughtfulness and compassion to our children because their cross-sex and non-sex identifications are frequently signs of mental health or developmental problems. Children (including dependent “adults”) do not have the depth of experience or the intellectual tools needed to investigate our world to the same degree as those who have the benefit of both greater experience and the wisdom that may come from it.
The central problem of accepting children’s transgender or non-binary claims as evidentiary is that a substantial portion of people who make these claims go on to reverse them, often after permanently damaging numerous organ systems through SCAlt. The percentages vary as do the definitions of what it means to be a sex characteristic alterer in remission (SCAltIR). What is clear is that the numbers are well above 15%, could easily exceed 30%, and those percentages do not include those who committed suicide prior to becoming a SCAltIR. People who engage in SCAlt are more than 10 times as likely to attempt suicide as the general population. Yes, the statistics often shared about parents denying SCAlt leading to the suicide of their children are unfounded.
People engaging in SCAlt often feel very good about it. Indeed, introducing cross-sex hormones at levels not intended by nature does induce chemically fueled experiences of euphoria in individuals, but, as time goes on, the problems the individual thought they were solving by engaging in SCAlt generally re-emerge. Almost all of the more than 50 youth I have worked with in this area are neurodiverse, the vast majority have autism spectrum disorder (ASD).
My goal is to minimize long-term harm by increasing self-awareness and the understanding of the concepts at play, including epistemic humility and curiosity to help my clients achieve success in their interpersonal relationships and careers. To that end, I am sharing the following documents to assist parents in helping their children who are seeking SCAlt.
Please note: reading and utilizing the suggestions in these materials IS NOT a substitute for family counseling or the mental health treatment of your child. Those are available from me separately.
Wholesome Parenting Without Punishment: Rethinking Accountability in Raising Children
Life Success Above Personal Identity Projects
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