Trans kids, trans adults – some thoughts.

I tweeted the following a short while ago: “Let’s be careful when arguing for the necessary care for trans kids that we don’t erroneously assume being a trans adult must be terrible.” and it had a number of retweets so I thought it might be useful for me to make my position clearer in something more than 140 characters!  It basically boils down to this:

There is nothing wrong with being trans. Full stop. Period.

My argument is not that there is nothing wrong with being trans (but of course being cisgender is better). Or that there is nothing wrong with being trans (but of course one will certainly want to pass or blend in as much as possible). Simply that there is nothing wrong with being trans. Indeed my position is that there might be (whisper it) something good about being trans – in that it necessarily means that one will have led an at least somewhat considered life.  After all, people having those thoughts about gender may well also have also considered such things as friends, relations, occupation and the such as part of that – without simply taking on the roles that have been thrust upon one from birth.

Of course there can be difficulties with being trans. There can be discrimination and prejudice and this can be exacerbated if one has intersections of race, class, age, ability, etc., which are also discriminated against. However, it is worth being cautious with the idea that trans people almost inevitably face discrimination or prejudice regarding their trans identity or practice, as for many trans people any prejudice faced is not always as bad as one might think. This means that I spend a good deal of time in clinic each day speaking to people who are surprised at how little discrimination and prejudice they have faced when they were certain that for their family, friends, job or location such discrimination would be inevitable. Indeed, for many people I see the concern and associated delay in transition due to fear of prejudice has done more damage than the discrimination they have faced, which may be very little or none.

Notwithstanding this, there are of course people who face serious, tragic, prejudice; and also people worn down by discrimination and microaggressions which act like a sort of psychic grindstone. This is not to say that in these instances transition has not been successful, indeed on balance such people are usually certain in their path, but that these things are nonetheless not to be disregarded. The question becomes then: Should we treat trans kids early as a means of ameliorating any such prejudice or discrimination they may face?

My answer is that this is the wrong argument to make.

Consider that we wouldn’t dream of changing a child’s skin colour because of fear of racism and rightly so; Similarly, it is quite often suggested that trans people shouldn’t be parents because their children may face discrimination. In both of these cases it is the discrimination which should be tackled rather than the person with the perceived ’difference’. To always treat children purely so they do not get discriminated against is a slippery slope with eugenics somewhere a little further down. (As a sidebar it’s worth noting that there are complex somewhat analogous arguments around cochlear implants for profoundly deaf people too.) Of course all these arguments risk turning young people’s lives into political footballs and aside from the fact that trans issues are, sadly, political (as are women’s issues, sexuality issues, etc.,) we don’t really want to use kids in this way.

So. Trans kids do need help, I don’t think anyone could disagree with that. The question is what help? The problem with using the term trans kids (as I have done here for ease of reading – and to make this point) is that it elides children with teenagers and suggests a prioi that they are certainly trans[sexual]. There are different arguments which apply to each of these things which I’ll save for another post, but basically the younger children are the less formed their final identity and so the more careful we should be not to make a mistake which they may later come to regret. Indeed as there are a variety of different ways to be trans, all of which are fine, it is really important to find the best one for that person – rather than one which pressure from trans groups, medicine, psychology, family, friends, etc., push the young person towards.

There is, of course, no neutral option here. Obviously giving kids cross-sex hormones does something, as does doing nothing at all. Giving GNRHa (puberty blockers) also does something in that, while it allows for a period during which puberty is suppressed, so it also prevents puberty at roughly the same time as one’s peers. Any and all of these things has various costs and benefits which must be weighed by all involved. Simply always treating with cross-sex hormones (these are different from GNRHa) and surgeries isn’t an option as not all trans kids wish to pursue transition into adulthood and some trans kids (and indeed adults) find it difficult having made a transition, with all that involves, to say; ‘Actually, no I’d like to transition back’. When I see people in my clinic who do say this I am always incredibly impressed by the strength that must take. As I see adults, (albeit some who have only just become adults) who struggle with this, when I think that some children are also able to tell people they would like to transition back I am in awe of them and those who support them.

So, to the matter in hand. It seems entirely reasonable to me to give some trans kids GNRHa to stop puberty and buy (a finite amount of – bone mineral problems can arise) time in which to decide a way forward. Some kids will need cross sex hormones, some counselling, some watchful waiting, some will need other things. Many will need all of these things at different times. The reasons for this should be personal to each individual – with internalised transphobia ruled out as a driver for treatment as whatever we give trans people, GNRHa included, they will always be trans. We should not give, and advocate for, treatment simply because otherwise the person ‘might end up trans’ – that’s an ok outcome too. A fundamentally ok outcome – with no ifs, buts, or maybes.

So by all means let’s do what is best for, and with, younger trans people and let’s advocate for treatment including GNRHa – but in order to do that let’s not use arguments which try to eradicate trans adults; or arguments which suggest that a trans person is in some way lesser than a cisgender [looking] person; or that state that it would necessarily be terrible to be a trans adult (it isn’t).

In fact let’s try not exclude or marginalise anyone as we fight for the rights of everyone. We all deserve that respect surely?