Part Three: Response to “When Children Say They’re Trans”
7/9/18: PART THREE
This is Part Three of a four part series, plus a reader-friendly summary, in response to Jesse Singal’s article, “When Children Say They’re Trans.” While this might seems like a lot to write about one article, the original piece was about 12,700 words, and there is a lot wrong with it.
3: Tone-Deaf Ignorance
I think Singal focuses on restricting care for trans teens because he is ignorant to what our community’s pressing problems are. Based on documentation of his conversations with trans people, I can only label it willful ignorance; he has had the chance to listen to, and learn from, transgender people. Look no further than the dearth of trans voices in his Atlantic piece for proof that he doesn’t prioritize our views on our own experiences. If he better understood, and cared about, what it was like to be trans he would not write this “concern-trolling” article that puts trans youth in more danger.
A: Blah, Blah, Blah. I Can’t Hear You!
A previous social science editor, and current contributing writer, at New York Magazine, Jesse Singal has used his professional status to build up credibility in regards to covering the transgender community. In the two years prior to publishing this piece in The Atlantic, Singal had written two notable trans-related articles: one also on the topic of gender-affirming healthcare and the other defending a professor who compared being transgender and transracial.
These two pieces drew criticism from the trans community. The former article was particularly critiqued because of data analysis that Singal later admitted was a misinterpretation of a study’s findings.
The first sign of willful ignorance related to this piece came on the part of The Atlantic. The editors must’ve thought he seemed like a good choice based on his previous work. To come to that conclusion, they clearly ignored the uproar from trans people against those pieces. Then, they failed to listen to the trans community when we objected, back in February, to their publishing of Singal’s work.
Not only is Singal cisgender, but he also has no formal education in gender studies. As many trans people can probably tell you, we are expected to have a PhD level explanation of gender theory ready at a moment’s notice to explain why we are not cis. Never in any of his published pieces does Singal reference gender theory. Rather, he uses his space to critique trans people’s decisions without a legitimate understanding of the social context in which we exist. These voids make it clear why we need a transgender person to write stories about the trans community.
B: Alternative Universe
It seemed as though Singal’s article was set in another universe in which parents are eager to embrace their child’s trans identity, and doctors are ready to prescribe hormones at a moment’s notice. He failed to accurately present the current state of gender-affirming care for teens, and missed the mark on what’s important for going on for trans folks in this space and time.
Though Singal recognizes that trans people have been denied gender affirming care historically, he argues that the opposite problem is developing today. Laura Edwards-Leeper, the doctor Singal relies on to validate his concern about trans care being too available, “ worries that treatment practices are trending toward an interpretation of affirming care that entails nodding along with children and adolescents who say they want physical interventions rather than evaluating whether they are likely to benefit from them.”
This criticism, Edwards-Leeper later elaborates, in based on her experiences at conferences where colleagues recognize that current methods can be “retraumatizing” for patients. As I noted in Part Two, denouncing the current style of readiness assessments doesn’t mean that doctors are not going to put new systems in place.
There are Edwards-Leeper’s fears and then there is the reality of pediatric care. In a response article published on The Atlantic’s website, Ashley Fetters writes, “Youth gender specialists across the country believe one of the most common obstacles standing between kids with gender dysphoria or gender-identity questions and the care that would set them up for their best possible health outcomes are unhelpful primary-care pediatricians.”
Fetters explains that this is mostly a result of doctors being uneducated, and therefore lacking confidence, about how to help kids who are questioning their gender. These majority of doctors who are not at the conferences with Edwards-Leeper are still in the dark about gender affirming care. Singal misses an opportunity to note this systematic context. In large part, kids and their parents are challenged to find a doctor who can discuss trans healthcare with confidence.
The approach Singal takes when discussing parents is similar to his view on doctors. Yes, he recognizes that “For far too long, parents, as well as clinicians, denied the possibility that trans kids and teens even existed, let alone that they should be allowed to transition.” He goes on to, however, pretend like parental resistance is something society has left in the past. A few paragraphs later, he says, “the transition process for a persistently dysphoric child typically looks something like the following…” He describes the process of socially transitioning, starting puberty blockers, then cross-sex hormones at some point down the line.
Although this is standard medical care for trans youth, this is often not what happens. Parents are still largely skeptical of their gender-questioning children, especially in more conservative parts of the country. Though the data in the area of trans youths’ parental support is limited, it aligns with my personal experience talking to trans youth in the U.S. and Canada. In a TransPulse study conducted in Ontario, Canada, 34% of trans youth reported having strongly supportive parents versus 25% who were somewhat supportive, and 42% who were not very or not at all supportive. Keep in mind, this data only comes from youth who weren’t too scared of their parents’ reaction to come out to them.
A lack of parental support means that kids often miss the chance to take blockers, and sometimes have to wait until they’re 18 before seeking any gender-affirming care. And, as I reported in the previous section, even if parents are supportive and attempt to seek care, it can be hard to find competent providers.
The disparities between what the trans community knows and what Singal pretends is the case are deeply troubling. His ignorance allows him to glorify parents, like Claire’s, who are skeptical that their children are “really trans.”
Trans writer, Thomas Page McBee, asserts that this “ Parenting Story” is an all too common trope in the media’s coverage of trans youth. McBee goes on to write:
“In the Parenting Story, the hero is the parent — and their heroic act is not abandoning their child in a society that wishes trans kids didn’t exist. How challenging, how painful, integrating us into a family must be for Joe and Jane! The reader is left with a deeper empathy for these parents — presumably straight, cisgender people like themselves — than of the trans child. Never mind that it’s empathy for trans people that could help reshape the culture that marginalizes us, and spearhead demand for policy that could change (or even save) our lives.”
Again, I reference Claire’s story because it is the example Singal leads with, using it to frame the rest of his argument. Singal writes that “Heather and Mike [Claire’s mom and dad] bought time by telling [Claire] they were looking but hadn’t been able to find [a provider] yet.” He later adds, “Heather thinks that if she and Mike had heeded the information they found online, Claire would have started a physical transition and regretted it later.”
I want to highlight two important points from Claire’s story. First, I’m troubled by the fact that the parents, and Singal, are under the impression that allowing a gender- questioning child to visit a specialist will mean an immediate prescription for hormones. As I wrote in Part Two, this is not how gender-affirming care for teens works. If she had talked with a gender specialist and/or therapist, Claire probably would’ve been able to gain an even better understanding of her gender before deciding if a physical transition was right for her.
Second, I need to point out how Singal uses Claire’s conclusion that she is cisgender to celebrate her parents’ reluctance to find her care. Here Singal is, as Robyn Kanner writes, “attempting to provide hope to parents that their child who says they’re trans might not be.” This “hope” will only encourage already-wary parents to put off seeking affirming care for their kids.
Encouraging parents to be cautious matters greatly for kids who express a desire to medically transition, but, unlike Claire, don’t start identifying as cisgender. If Claire hadn’t changed her thoughts about being trans, we could only see Heather and Mike as getting in the way of their child’s well-being (though I would argue they still did by not allowing Claire to fully explore and understand all the options).
Preventing trans youth from talking to a gender specialist can have serious consequences. A 2014 study by The American Foundation of Suicide Prevention found that, “Respondents who experienced rejection by family and friends, discrimination, victimization, or violence had elevated prevalence of suicide attempts.” Blocking teens from the care they desire certainly falls under familial rejection.
In addition, data from the aforementioned TransPulse Project shows that 72% of trans youth with supportive parents were satisfied with life, compared to 33% who did not have fully supportive parents. The same project shows youth with supportive parents have much better mental health than those with not fully supportive parents. Rates for depressive symptoms were 23% and 75% respectively; for considerations of suicide in the past year rates were 34% and 70% respectively; and for attempts of suicide in the past year the rates show 4% and 57% respectively.
Parents who refuse to do their best to find their trans child gender-affirming care when it is asked for cannot be considered supportive. They are refusing to respect the legitimacy of their child’s experience. This data highlights how irresponsible it is for Singal to celebrate the choices of Claire’s parents. It is clear how this story can, and will, encourage parents in similar situations to try to wait out their trans kids’ “phase” instead of giving them respect and access to appropriate care.
Conveniently, Singal does not include any stories about trans people whose health was put in peril by parents who refused to seek gender-affirming care. The only two trans teens he interviews, included towards the end of the piece, had parents who allowed them to talk to a professional about their gender questioning experience. Trans kids who live with parents who aren’t supportive are among the most vulnerable members of the trans community, and they go unrecognized.
Another story that is notably absent from Singal’s piece is a happy trans adult. In the context of this article, adults would show that being trans is not a phase. The only adults we get to hear about here are cisgender detransitioners whose trans identities faded out over time. Readers new to the topic may be left wondering if trans adults exist; after all, being trans is seen as new fad by many.
It is maddening that Singal fails to use any of his 12,739 words to tell these two types of prominent and important stories from our community. Imagining up some alternate universe may be a fun thought experiment for Singal, but it is highly irresponsible journalism.
C: Social Transition
One of the biggest problems I have with this article is that Singal and The Atlantic decided it was appropriate to focus solely on medical transitions. As I’ve written before, trans people are so much more than our transitions. But, not only that, our transitions (if we choose them) are so much more than our medical transitions (if we choose them). Singal absolutely fails to give social transitions any merit. The whole piece is concerned about when and if adults should let kids receive gender-affirming medical care. But what about other forms of affirmation?
Socially transitioning can be especially powerful for kids who have not yet started puberty. In an earlier piece, Singal writes, “more and more clinicians are embracing what is known as the “gender-affirming” approach. In this model, if young children’s claims about their gender identity are ‘insistent, persistent, and consistent,’ these claims are taken as face-value evidence that the child is actually trans, and should be socially transitioned with little delay.”
This quote shows how Singal has medicalized the entire scope of transitioning, and unnecessarily so. He writes as if kids need the doctor’s word that they are “actually trans” in order to experiment with a different name and/or pronouns and/or gender presentation. Letting a child explore their gender identity is low risk and high reward; they can become more confident with who they are, while also gaining insight to if they want to pursue gender-affirming care.
Singal, however, seems afraid that socially transitioning can lead kids down the transgender road of no return. Alex Barasch writes, “[I]n his tacit praise of the parents [like Claire’s] who waited and his decision to foreground misguided transitions, Singal reinforces the notion that simply allowing children to entertain the possibility puts them on an inexorable path to transness...”
In contrast to Singal’s fearful take, a social transition can go a long way towards improving a kid’s mental health. Data from multiple studies shows how affirming language, such as using correct name and pronouns with a transgender young person can reduce suicidality and improve mental health and hope for the future. To highlight some of the most startling data, a University of Texas study found that trans teens who could use their chosen name in all aspects of their life, “experienced 71% fewer symptoms of sever depression, 34% decrease in thoughts of suicide, and a 65% decrease in suicidal attempts.”
All the problems with Singal’s piece could be fixed if he wasn’t willfully ignorant of the actual experiences of people in the trans community. I know all you media moguls are reading this, so here’s a request: instead of making us labor towards educating cis writers like Singal, how about hiring trans authors who are well-versed in the community’s priorities? Let me know what you think.
Click the link to read Part Four.