I wrote this in 2015. Many things have changed since then. In Australia, it’s no longer necessary for transgender children to go to the Family Court to access Stage Two treatment – cross sex hormones. In Canada, Zucker lost his job. Also, Debra Soh got her PhD and makes a living as a science journalist, promoting free speech and claiming that she has been shut down by trans activists.
Hardly the most important point – but I note that in her first article (2015) she says she is in her thirties whereas Wikipedia says that in 2018 she is 28. No wonder casual readers struggle to work out what is true.
Anyway, I found my old post in a document on my hard drive (I deleted my old blog). Soh came up in an online conversation, so I’m reposting. Here it is:
I lie awake at night thinking about the future of transitioning for my child. I agonise over unknowns: do puberty blockers have side effects that haven’t yet been documented? Are there going to be ways to prevent sterility if O takes cross-sex hormones? Will O be happy and healthy (or even survive) if we don’t allow him to take puberty blockers? How do we support O in the way that is best for him?
These are the terrible questions we are compelled to ask, and to keep asking. They are questions that need to be raised publicly. Families like ours want to be able to assess the effects of hormone blockers and we need honest answers about the risks for O in taking them, as well as the risks of not taking them. We need answers based on the best possible science and reasoning, without scaremongering.
Sometimes, I feel like finding these answers is simply too hard. But, as O’s parents, find answers we must. All of our lives and wellbeing depend on it. With my heart in my throat, I follow discussions, I talk to professionals, I talk to transgender people. I read the latest research. In the end, we will make decisions based on all these considerations. We will also be guided by a child who we love dearly, who tells us things about himself that no research will ever capture. I’m not aware of a family supporting a transgender child who does not do these things.
Last week, an article by Debra W Soh appeared in the Pacific Standard, titled ‘Why Transgender Kids Should Wait to Transition’. When I saw the link in Soh’s Twitter feed, my heart pounded. I was afraid to click on it, although I felt I had to. The article has been shared over 5100 times, and as someone with a deep interest in the title alone, I can appreciate why. Dr Soh’s profile states that she is a sex researcher and neuroscientist. Based on her professional profile, I thought she must have the results of new research, highlighting the dangers of transitioning for transgender kids.
This is not the case.
Instead, Soh’s article begins with the story of having been a ‘gender atypical little girl’:
My friends were all boys. My favorite pastimes included rough-and-tumble play and running around the house while waving my he-man sword high in the air.
People who regularly read about transgender children online (particularly the dreaded ‘comments’ section) will know what’s coming. Soh is describing the experience of being a ‘tomboy’. There is no suggestion that she or anyone else considered that she might be transgender, or even that she experienced consistent gender dysphoria. This doesn’t stop Soh wondering if today she might be labeled as trans and she is grateful that her parents did no such thing. She is now a ‘happy, straight adult.’
Soh’s story follows well-trodden terrain– you can find other examples of her particular logic here and here. Despite its speciousness, it’s not surprising that it’s a common narrative, given the blurred distinctions between gender diverse and transgender children prior to puberty. As most people reading this already know, these uncertainties are partly why prepubescent children never transition in any permanent way. Being gender fluid or gender nonconforming is not the same as being transgender, but prior to puberty, it might be difficult to make that distinction.
But Soh worries hypothetically about ‘a young child whose gender dysphoria would have desisted without intervention’.
Guess what? If a young child’s gender dysphoria desists, there is no intervention, unless acknowledging preferred names, pronouns and dress is ‘intervention’. However Soh never states clearly what she means by ‘transition’ and in most cases she conflates the socio-cultural ways in which one might support a small child, as we have with O, with the most physically invasive aspects of hormones and surgery.
At one point Soh does assert that, “Even a social transition back to one’s original gender role can be an emotionally difficult experience for children.” How does Soh know this? Based on what evidence or experience? She doesn’t say. By definition, for a transgender child, their original gender role was an “emotionally difficult experience”. I couldn’t work out what Soh meant.
Soh never defines the age of the children she’s concerned about. Four year olds? Twelve year olds on the cusp of puberty? Seventeen year olds? As most people reading this would know, children with persistent gender dysphoria at puberty do not ‘transition’, medically or otherwise. At this point, they might be prescribed hormone blockers, which are reversible: if you stop taking them, puberty commences.
If gender dysphoria still exists four, five or six years later – in other words, at the end of childhood – cross-sex hormones will be an option for some. Still fewer consenting adults – those with substantial funds – might choose surgery.
The whole premise of Soh’s article is more than alarmist, it’s just plain wrong, for several reasons.
Firstly, trans children do wait to transition, because they have to. All people legally taking cross-sex hormones will have undergone rigorous medical and psychiatric assessment. For children, these assessments will likely have gone on for a number of years. In Australia, sixteen to eighteen year olds must have this stage of their treatment approved by the Family Court. Promoting the idea that irreversible sexual transitions can take place at the drop of a hat is pernicious for the trans people and their families involved.
Secondly, Soh states that ‘research has shown that most gender dysphoric children outgrow their dysphoria, and do so by adolescence’. This is incorrect, because there are no studies that have ever been completed with accurate data on ‘’persisters and desisters”. The article that she links to is recent, but the statistics in the abstract have been discredited. However, the idea that most gender dysphoric children “change back” is a persistent misconception.
You can acquaint yourself with some of the issues to do with the assertion that “most children outgrow their dysphoria” by looking at findings and analyses from the Dutch research here. One of the main issues with this research is that it wasn’t longitudinal: if children didn’t come back to the clinic, researchers assumed that they no longer experienced gender dysphoria. Other possibilities, such as lack of money or support – or simply moving away – don’t seem to have been considered. Unfortunately, the Dutch findings have been cited in hundreds of articles since, until the assertion that “most kids change back” has become conventional wisdom. It is not, however, good science.
Referring to research by Kenneth Zucker, as Soh does, is also problematic to say the least. Zucker and his colleagues at the Toronto Centre for Addiction and Mental Health have worked for many years to decrease cross-gender behaviours and identification in children. Zucker and fellow researchers claim a high success rate in encouraging kids not to express gender nonconformity, because that is their aim. If this sounds like the ‘conversion therapy’ recently banned in some states of the US, that’s because it is. Zucker’s clinic is currently under review and is not accepting new patients.
It’s probably clear by now that Soh’s article enraged me. She is far from the only commentator to use dubious logic and outdated data to support her views about treatment for transgender children. You can find articles like that all over the internet. My overriding problem with this article is that Soh published her opinion under the guise of being informed by her work as a neuroscientist and sex researcher.
Implicitly, Soh is claiming that she has privileged information about the risks of transitioning for young transgender people. If she has ever conducted any study of trans children, or written any meta-analysis, this is not cited. Instead, she links to old data conducted by other researchers and tells an anecdote about her childhood. Even in an op-ed, this is dishonest, because she implies that her opinion is an informed one.
Given the subject of this blog, it’s ironic to take issue with the pronoun that Soh uses throughout her article – and it’s not even a gendered one! Soh uses ‘I’ throughout her piece, which only works if she’s either telling her personal story or telling us about her scientific work. As good researchers know, it’s fundamentally flawed to form a general theory based on specific personal experience, but this is what Soh has done. On the basis of being an informed expert, Soh is advising parents and others who care about transgender children on how to help them – as well as warning her readers that many are getting it wrong. This message has reached thousands and thousands of people, including some that are desperate for answers.
I’ve taken the time to write this because articles like Soh’s distress and confuse people, like myself, who are trying to navigate their way through information and misinformation in an effort to support their children. There would be no problem if Soh had published her personal opinion in a blog as a private citizen – but then she wouldn’t have received her 5100 shares, would she?