The Debate on Trans Teens: Compassion Is Needed on All Sides

We need dialogue and common humanity, not polarized thinking.

Posted Dec 02, 2018

My recent article on Rapid Onset Gender Dysphoria (RODG) has elicited a fierce controversy, a dark Twitter storm, and a lot of strong feelings. 

The debate

For those who are just discovering the controversy, the basic claim of those concerned with ROGD is that cultural shifts, novel social pressures, and new idioms of distress may underlie the unprecedented numbers of young adolescents who now wish to identify as trans.  Proponents of RODG  as a tentative diagnostic construct see these rates as distinct from the cases of gender dysphoria that present earlier in childhood.  ROGD proponents do not question the existence of gender dysphoria, a condition which is increasingly recognized as leading to healthy outcomes with transition and acceptance. Many trans activists who are still fighting for their right to be recognized find ROGD claims offensive, and reminiscent of homophobic and discriminatory discourses of “contagion” when LGBT rights were not recognized. Countless struggling parents, in turn, find in ROGD a reassuring explanation for their child’s unexpected (and from their perspective, very scary) behaviour, while trans activists find the parents unsupportive or hostile.   At extreme ends of this spectrum, paranoid conspiracy theorists dismiss the concept of transgender identity as a liberal plot and promote transphobic and homophobic hate speech, while radical transactivists instil fear and frustration in many other groups (including many GLBT and feminist circles) through language policing, mass call-out, and a different kind of hate speech directed at the “cis” norm.  Meanwhile, a rising number of cisgendered young people are growing up with the historical novel, highly confusing notion that gender is made up, and in many instances, that it is bad.

The mess

In a previous post (the second in this series), I responded to the common concerns raised by skeptics and critics about the validity and methodology of Dr. Littman’s  initial study on ROGD.  I do not address these here.

In this post, I discuss the storm raised by my article in light of a central concern in my research and writings: the human tendency to think in simplistic, polarized terms, and to rally accordingly against an imagined enemy at the cost of our common humanity. 

Trans people have a lot to teach us about the perils of having to defend one’s existence, and the dangers of thinking in clear-cut, too binary terms. Parents and clinicians, in turn, have a lot to teach us about the complexity of caring for others, and the dangers of giving vulnerable people what they think they want in all instances.  This controversy has a lot to teach us about how confused we all here.   

Let’s begin with Twitter storms.

The storms

The former Dean of Harvard Medical School, whom I quote in my last post, warns against the outrage and “indiscriminate attacks” that generally ensue on social media when politically charged topics are examined in research and translated in popular science.  Social media is humanity on steroids. It brings out the best and worst of our nature and our visceral urge to defend our tribe with exponential magnitude. 

As the storm picked up, I received dozens, then dozens, then dozens more emails, tweets, comments, and links to ad hominem blog posts from very different people who seemed to share one fundamental experience: they were scared, exhausted, frustrated, and desperate to be heard.  Many were from parents; all of them desperate to help their children cope with desires, pains, and fears they had never seen coming; doing their utmost to understand what happened as they no longer recognized their child. Others were from clinicians and detransitioners, thanking me for presenting a perspective they felt so many were scared to voice. Many others still were from trans persons, voicing their anger and exhaustion at having to defend their right to live in the healthy body they know is right for them.

The problem

What the human mind does best is attend to what it is already primed to fear and desire. We tend to see in the world what a complex web of prior experiences, genetic dispositions, and evolutionary pressures makes us want to see, while remaining blind to the rest. These dispositions are most often biased toward threat, danger, and tribalistic group affiliations, and make us really bad at considering the ‘other side’. Cognitive scientists call this self-evidencing, but this is an old story, told in countless traditions of wisdom from Buddhism and Stoicism to the Talmud and psychoanalysis.  That readers on “both sides” only saw in my article what already confirmed their fears reminded me of these old stories. It also reminded me that I should have known better.

Dialogue, not debate

Knowing this much, I want to make my intent very clear. My aims are for the many sides of this immense controversy to embrace their common humanity and consider their different perspectives with compassion.  I owe this insight on the importance of perspective to a young trans person who initially voiced hostility toward me on Twitter — a person who spoke in anger, but was also showing wit, intelligence, humor, eloquence, and something resembling patience.  Wanting them to know their views were important in the conversation, I spoke of the importance of healthy debate. Their poignant reply helped me remember that dialogue, and not debate between false enemies is what is most needed here.

“A "healthy debate" exists for you," they wrote, “but not for me. For you, this is your field of study. For me and people like me, you are one of many, many people we have to justify ourselves to. Try to have a little perspective."

We have much to learn from this brave, patient testimony. I sincerely invite all those who feel comfortable — or rather, scared — in their insistence on dismissing all trans experiences as false to consider what it must be like to have to continually justify one’s existence and legitimacy as a person to many, many people, all the time.

I also invite all those who bravely asserted their strength in being recognized as trans to consider the perspectives of the many parents, clinicians, and researchers who have a different understanding of vulnerability — a perspective borne from years of experience in the intricacies of care and responsibility for the well-being of others.

The difficulties of empathizing with 'power' and responsibility 

The most difficult act of compassion for those who feel comforted in the feeling that they are powerless is to gain a perspective on the vulnerability of those they perceive to be in positions of 'power.' It takes becoming a parent, a teacher, a manager, a nurse, or a physician to learn this. With each increment in power, one gains responsibility and liability of increasing scope, scale, and consequences.  If you are young, powerless and angry, imagine if you will what it is like to be a manager, doctor, or professor in the age of social media, when from the hundreds, perhaps thousands of people you have a duty to serve and satisfy each year, it takes a single dissatisfaction and a single email, tweet or Facebook post — a single act of anger — to annihilate your career, social, family, and financial life in a day.

The peril of 'good' impulses 

Our species evolved to care for the weak and fight against the strong. Our cognitive modalities and cultural narratives evolved to direct our attention toward the needs of the weak and the dangers of the strong. This made us at once the most cooperative and caring of all species, but also the most violent, and the most coddling.  Think of the boundless talent, the unspeakable trauma, or the debilitating helplessness we can instill in our youth.  Honouring the needs that need to be cared for, and recognizing the impulses that need to be tamed has always been, and remains the most important challenge for our species.  This question will not be settled in our lifetime, and it will not be settled on Twitter.

Impulses, which make us act on visceral needs, are always sincere. But they are rarely wise.  We can all recognize the turmoil of a child having a violent tantrum as genuine, unbearable suffering, but few among us will recommend enabling such an impulse.  When an impulse is justified in the name of something culturally recognized as sacred, denying it becomes more counter-intuitive.

In my adolescence, I committed vandalism in schools in the name of a noble fight against racism and colonial history.  What did “history” mean to me at the time beyond an opaque justification for my confusion and misguided anger? What did I, a privileged white kid in a rich suburban school really know of racism? What I needed then was limits.  Finding the right limits is as hard a project as finding the right impulses, and the narratives that will justify them both.

Tyrannies of the few

Often throughout history, the impulses of the few have imposed unjust limits on the many.  We may call this the Tyranny of the Elite Minority. The people we now call trans have almost always occupied one of the most vulnerable positions in this picture. Norms are still slow to change in many places. In others still, they have changed quickly, while in yet other places, they are changing faster than our ability make sense of the process.

This too-fast-for-meaning social change, which was recently limited to a much slower conversation in elite universities in a western context, is now spreading to legislations and clinical practice at a dizzying pace. What resulted from this is an odd reversal of the usual terms of the Tyranny of the Minority — a historical moment in which the validity of a norm has been put into question in light of statistically rare, minority experiences.  This process remains terribly confusing for most, and increasingly destabilizing for the many.

What now?

Determining the precise rates of gender non-conforming people is an impossible task. The most extraordinarily generous figure comes from a never-published estimate presented at at an activist conference over 10 years ago, which places the rates at 1 in 500 people, or 0.2% of the population. Controversial results can be difficult to publish, and epidemiology is a very difficult enterprise. Rather than dismiss the activist figures on the unfairly strict terms of a publishing game, we might, for argument’s sake and in recognition of recent shifts, assume a much higher rate of up to 1 percent. Such a figure would represent over 3 million people in the United States, or the entire population of a city like greater Chicago. Denying such a large group the right to be gendered on their terms would indubitably be unjust.

But such a rate would still leave roughly 99% of the population identifying with their sex and gender as "assigned at birth" (a phrase which many people find confusing or non-sensical). As it stands, it is on the basis of these (likely less than) 1% experiences that a growing number of young people are coming to think of gender as necessarily ‘constructed’, and ‘fluid,' but also ‘false,' ‘oppressive,' and (especially in the case of masculinity), ‘toxic.' These new tropes circulate on social media, are being taught in gender studies classes, and are increasingly being legislated through very difficult-to-interpret definitions of gender discrimination.

The novel moral obligation to embrace this view places young people in conflict with older generations, with each other, with their own subjectivities, and in more and more cases, with their own bodies.

It is with these rapid changes in mind that we must consider the perspectives of distressed parents and teens who are fighting for meaning in a very confusing world. We must again recognize the confusion that underpins current changes.

Bringing sense back to the confusion

As a very wise person put it to me, it is difficult to understand what views of gender are being called for in this new culture. On the one hand, gender is fluid, neutral, and doesn't matter, or it isn’t a thing at all outside of false beliefs and oppressive constructs. On the other hand, gender matters so much that people will conceal, remove, or reshape their body parts to be recognized as one gender or the other. 

That a comparatively small, but widespread group of previously oppressed trans people have won the much-deserved right to be recognized and respected as such is a wonderful victory for humanism.  The cases of torn families documented by Dr. Littman tell a different story. They point, regardless of our theories, to a very rough patch in the history of gender norms that cannot be explained by parental bigotry alone, or remedied by absolute permissiveness.

The road and the child

In their CBT-based call for strategies against fragility, Jonathan Haidt and Greg Lukianoff are fond of quoting an old adage:

Prepare the child for the road, not the road for the child

With this wise proposition, comes the recognition that encouraging youth to act on all their fears and desires does not prepare them well for the challenges of a world that will always come with unpredictability, and the competing needs of people with different fears and desires. The more we give each child the road they want, the more we set them up for failure and conflict with other children, who in turn want to be given a different road.

Some will remind us that roads also need to be fixed, or expanded to new horizons. Young generations — as the trans community has done — do need to help update the Old on the kinds of roads that will work best for all in changing times. The road for gender non-conforming teens is growing more solid each day, with the help of supportive parents, clinicians, and educators. This is a good, progressive move to help a very small group of people live healthy lives. But the blueprint for this new road will not work for all, or even most children -- indeed, it cannot be used to define all the new roads onward. 

Determining who will be better off on the new road will remain a very difficult question. Children may certainly wonder if they could try living on that road, but the responsibility is on their caregivers — not the children — to help them figure out, slowly and wisely, whether this is the best choice for them.