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(The family, which lives in the Bay Area, doesn't want their last name used for reasons of privacy.) Gracie had socially transitioned at the age of four.\u003c/em>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There was no way I was going to raise a child who was ashamed of who they are.'\u003c/aside>\n\u003cp>\u003cem>A \u003ca href=\"http://pediatrics.aappublications.org/content/137/3/e20154358\" target=\"_blank\" rel=\"noopener\">social transition\u003c/a> is distinct from one that involves medical procedures like taking hormones or undergoing surgery. But e\u003c/em>\u003cem>ven without a medical intervention, the decision by parents to allow their children to socially transition -- to publicly live in their new gender identity -- can be agonizing. S\u003c/em>\u003cem>ince Molly was so articulate in describing her emotional journey around her daughter's transition, from denial to acceptance to gratitude, we wanted to let her tell that story in her own words.\u003c/em>\u003c/p>\n\u003cp>\u003cem>The following is an edited transcript of Molly's answers during our interview ...\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>'She Took Every Opportunity to Tell Us'\u003c/strong>\u003c/p>\n\u003cp>As soon as Gracie could tell us, it was, 'I'm a girl. I'm a sister. I'm a daughter. I'm that girl on that show. I'm that girl in that book. I'm the princess.' She took every opportunity to tell us she was a girl. She took every towel and blanket and turned it into long hair.\u003c/p>\n\u003cp>[contextly_sidebar id=\"zfCL4NYYDoEb3nH3NPCAOj9vXGj8reoz\"]We would not let her leave the house with any of those things, so it was all behind closed doors. It felt really isolating because here you have this child who's showing you all these signs of not being the way you thought they would or that society tells you they should.\u003c/p>\n\u003cp>It was really, really hard. I don't think people realize when they think about kids this age that it isn't something that they just wake up and say one day, and then you're like, \"Oh, that's what you want to be today? Great, like let's go explore that and let's be that.\" It's a battle. \u003cspan style=\"font-weight: 400\">It's difficult as a parent to watch those signs develop in your child, and to know your child's life is going to be harder because of who they are. Because of society wanting them to fit somewhere that your child is telling you they don't.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Trucks, Dinosaurs and Superheroes\u003c/strong>\u003c/p>\n\u003cp>Early on, we tried to discourage Gracie's transgender identity, and we filled her world with trucks and dinosaurs and superheroes. We refused \"girl things.\" Like, 'No, you can't be Elsa for Halloween. You have to be Superman. No, you can't have the dolls for Christmas. We're going to get you a pirate ship.' We just really tried everything we could. That's the part I'm ashamed of now.\u003c/p>\n\u003cfigure id=\"attachment_441819\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-441819 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/Gracie-1020x681.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Gracie, 7, poses for a picture in her room. (Lauren Hanussak/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>'What If He Changes His Mind?'\u003c/strong>\u003c/p>\n\u003cp>There's a lot of advice out there about following your child's lead if they're telling you that this is how they feel. But I always felt like how can I just follow their lead when I'm the one that they're looking to set those boundaries and guidelines?\u003c/p>\n\u003cp>We went to an expert. We asked, 'What if we do this? What if we let our son walk into the world in a dress with fairy wings, and crowns, and high heels, and even just in regular girl clothes? What if we let him do all of this, and he gets to express himself, and then he changes his mind, and we just went through all of this for nothing?'\u003c/p>\n\u003cp>The therapist said: \"That's not the question. The question is:\u003cbr>\nWhat if you \u003cem>don't\u003c/em> do it?\" She said, \"What will happen, and what I'm hearing when you describe the insistence of Gracie, is you're going to end up with a child who's anxious and depressed and feels ashamed.\u003c/p>\n\u003cp>As soon as I knew there was even a chance that my kid could feel ashamed of who they are, there was no way. I had to support. I had to listen. I had to let her steer a little bit. Because there was no way I was going to raise a child who was ashamed of who they are. Period. My job is to set boundaries and guidelines, but it's also to teach them to be proud of who they are no matter what, and that's what we're doing.\u003c/p>\n\u003cp>\u003cstrong>On Making the Decision to Let Gracie Become a Girl\u003c/strong>\u003c/p>\n\u003cp>Before the transition, the most incredible moments of having a child were passing us by. Life seemed sort of lackluster. You never got to see that sparkle, or that magic of a Christmas morning or a Halloween. Or just regular day-to day-happiness.\u003c/p>\n\u003cp>I got to a point where I was like, I can't do it anymore. I need to see my child light up. We were at Marshalls one day and they had a display of children's Easter dresses. I just remember thinking, 'Oh crap. How am I gonna steer you away from this?'\u003c/p>\n\u003cp>My husband was with me and we both looked at each other. We told Gracie: \"You can pick a dress.\" We let our then-son pick a dress, and Gracie would tear through the house to get to the dress the second she got home. For at least a year, she wore it all over the house . I just kicked myself for it taking so long to do that and to open the world to her like that. Also, for just caring so much about what other people would've thought.\u003c/p>\n\u003cp>\u003cstrong>Grief, Then Gratitude\u003c/strong>\u003c/p>\n\u003cp>There was a time when there was a lot of grief for me around the loss of the idea of my son. There was a point in time when I thought I may never recover from that. Now I look at pictures of Gracie as a baby and all I see is her face with the wrong haircut and the wrong clothes. It's completely shifted. There was a time when I didn't know that that would be possible.\u003c/p>\n\u003cp>But ultimately, my husband and I are both so grateful because this has given us the opportunity to lead more meaningful lives. Now we have this huge emphasis on teaching our kids about acceptance and tolerance, and being really proud of who you are and self-love. I hope that I would've emphasized those things anyway, but now there's no question.\u003c/p>\n\u003cp>I think that before the transition there was a part of Gracie that had to resign to whatever we told her, and so she was just sort of coasting.\u003c/p>\n\u003cp>Now she gets to really live.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n","blocks":[],"excerpt":"What do you do when your child tells you from the very start that they are not the gender you think they are? A mother takes us through the difficult emotional journey her family had to travel. ","status":"publish","parent":0,"modified":1548892366,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":1152},"headData":{"title":"From Denial to Gratitude: A Mom Comes to Terms With Young Daughter's Transgender Identity | KQED","description":"What do you do when your child tells you from the very start that they are not the gender you think they are? A mother takes us through the difficult emotional journey her family had to travel. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"From Denial to Gratitude: A Mom Comes to Terms With Young Daughter's Transgender Identity","datePublished":"2019-01-28T23:00:26.000Z","dateModified":"2019-01-30T23:52:46.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444911 https://ww2.kqed.org/futureofyou/?p=444911","disqusUrl":"https://ww2.kqed.org/futureofyou/2019/01/28/a-mother-comes-to-terms-with-young-daughters-transgender-identity/","disqusTitle":"From Denial to Gratitude: A Mom Comes to Terms With Young Daughter's Transgender Identity","audioTrackLength":402,"path":"/futureofyou/444911/a-mother-comes-to-terms-with-young-daughters-transgender-identity","audioUrl":"https://www.kqed.org/.stream/anon/radio/tcrmag/2019/01/BrooksTransKid.mp3","audioDuration":414000,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>\u003cem>Last year in the course of reporting the \u003ca href=\"https://www.kqed.org/futureofyou/440851/can-you-really-know-that-a-3-year-old-is-transgender\" target=\"_blank\" rel=\"noopener\">controversy\u003c/a> over socially transitioning young transgender children, I met a mother, Molly, and her then-six-year-old transgender daughter, Gracie. (The family, which lives in the Bay Area, doesn't want their last name used for reasons of privacy.) Gracie had socially transitioned at the age of four.\u003c/em>\u003c/p>\n\u003caside class=\"pullquote alignright\">'There was no way I was going to raise a child who was ashamed of who they are.'\u003c/aside>\n\u003cp>\u003cem>A \u003ca href=\"http://pediatrics.aappublications.org/content/137/3/e20154358\" target=\"_blank\" rel=\"noopener\">social transition\u003c/a> is distinct from one that involves medical procedures like taking hormones or undergoing surgery. But e\u003c/em>\u003cem>ven without a medical intervention, the decision by parents to allow their children to socially transition -- to publicly live in their new gender identity -- can be agonizing. S\u003c/em>\u003cem>ince Molly was so articulate in describing her emotional journey around her daughter's transition, from denial to acceptance to gratitude, we wanted to let her tell that story in her own words.\u003c/em>\u003c/p>\n\u003cp>\u003cem>The following is an edited transcript of Molly's answers during our interview ...\u003c/em>\u003c/p>\n\u003cp>\u003cstrong>'She Took Every Opportunity to Tell Us'\u003c/strong>\u003c/p>\n\u003cp>As soon as Gracie could tell us, it was, 'I'm a girl. I'm a sister. I'm a daughter. I'm that girl on that show. I'm that girl in that book. I'm the princess.' She took every opportunity to tell us she was a girl. She took every towel and blanket and turned it into long hair.\u003c/p>\n\u003cp>\u003c/p>\u003cp>\u003c/p>\u003cp>We would not let her leave the house with any of those things, so it was all behind closed doors. It felt really isolating because here you have this child who's showing you all these signs of not being the way you thought they would or that society tells you they should.\u003c/p>\n\u003cp>It was really, really hard. I don't think people realize when they think about kids this age that it isn't something that they just wake up and say one day, and then you're like, \"Oh, that's what you want to be today? Great, like let's go explore that and let's be that.\" It's a battle. \u003cspan style=\"font-weight: 400\">It's difficult as a parent to watch those signs develop in your child, and to know your child's life is going to be harder because of who they are. Because of society wanting them to fit somewhere that your child is telling you they don't.\u003c/span>\u003c/p>\n\u003cp>\u003cstrong>Trucks, Dinosaurs and Superheroes\u003c/strong>\u003c/p>\n\u003cp>Early on, we tried to discourage Gracie's transgender identity, and we filled her world with trucks and dinosaurs and superheroes. We refused \"girl things.\" Like, 'No, you can't be Elsa for Halloween. You have to be Superman. No, you can't have the dolls for Christmas. We're going to get you a pirate ship.' We just really tried everything we could. That's the part I'm ashamed of now.\u003c/p>\n\u003cfigure id=\"attachment_441819\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003cimg class=\"wp-image-441819 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/Gracie-1020x681.jpg\" alt=\"\" width=\"640\" height=\"427\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-1020x681.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-160x107.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-800x534.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-768x513.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-1200x801.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-1180x788.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-960x641.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-240x160.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-375x250.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/Gracie-520x347.jpg 520w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003cfigcaption class=\"wp-caption-text\">Gracie, 7, poses for a picture in her room. (Lauren Hanussak/KQED)\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>'What If He Changes His Mind?'\u003c/strong>\u003c/p>\n\u003cp>There's a lot of advice out there about following your child's lead if they're telling you that this is how they feel. But I always felt like how can I just follow their lead when I'm the one that they're looking to set those boundaries and guidelines?\u003c/p>\n\u003cp>We went to an expert. We asked, 'What if we do this? What if we let our son walk into the world in a dress with fairy wings, and crowns, and high heels, and even just in regular girl clothes? What if we let him do all of this, and he gets to express himself, and then he changes his mind, and we just went through all of this for nothing?'\u003c/p>\n\u003cp>The therapist said: \"That's not the question. The question is:\u003cbr>\nWhat if you \u003cem>don't\u003c/em> do it?\" She said, \"What will happen, and what I'm hearing when you describe the insistence of Gracie, is you're going to end up with a child who's anxious and depressed and feels ashamed.\u003c/p>\n\u003cp>As soon as I knew there was even a chance that my kid could feel ashamed of who they are, there was no way. I had to support. I had to listen. I had to let her steer a little bit. Because there was no way I was going to raise a child who was ashamed of who they are. Period. My job is to set boundaries and guidelines, but it's also to teach them to be proud of who they are no matter what, and that's what we're doing.\u003c/p>\n\u003cp>\u003cstrong>On Making the Decision to Let Gracie Become a Girl\u003c/strong>\u003c/p>\n\u003cp>Before the transition, the most incredible moments of having a child were passing us by. Life seemed sort of lackluster. You never got to see that sparkle, or that magic of a Christmas morning or a Halloween. Or just regular day-to day-happiness.\u003c/p>\n\u003cp>I got to a point where I was like, I can't do it anymore. I need to see my child light up. We were at Marshalls one day and they had a display of children's Easter dresses. I just remember thinking, 'Oh crap. How am I gonna steer you away from this?'\u003c/p>\n\u003cp>My husband was with me and we both looked at each other. We told Gracie: \"You can pick a dress.\" We let our then-son pick a dress, and Gracie would tear through the house to get to the dress the second she got home. For at least a year, she wore it all over the house . I just kicked myself for it taking so long to do that and to open the world to her like that. Also, for just caring so much about what other people would've thought.\u003c/p>\n\u003cp>\u003cstrong>Grief, Then Gratitude\u003c/strong>\u003c/p>\n\u003cp>There was a time when there was a lot of grief for me around the loss of the idea of my son. There was a point in time when I thought I may never recover from that. Now I look at pictures of Gracie as a baby and all I see is her face with the wrong haircut and the wrong clothes. It's completely shifted. There was a time when I didn't know that that would be possible.\u003c/p>\n\u003cp>But ultimately, my husband and I are both so grateful because this has given us the opportunity to lead more meaningful lives. Now we have this huge emphasis on teaching our kids about acceptance and tolerance, and being really proud of who you are and self-love. I hope that I would've emphasized those things anyway, but now there's no question.\u003c/p>\n\u003cp>I think that before the transition there was a part of Gracie that had to resign to whatever we told her, and so she was just sort of coasting.\u003c/p>\n\u003cp>Now she gets to really live.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444911/a-mother-comes-to-terms-with-young-daughters-transgender-identity","authors":["80"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_1642","futureofyou_80","futureofyou_1641","futureofyou_1018"],"featImg":"futureofyou_446328","label":"futureofyou"},"futureofyou_445189":{"type":"posts","id":"futureofyou_445189","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445189","score":null,"sort":[1540415851000]},"guestAuthors":[],"slug":"trump-administration-memo-on-sex-and-gender-is-wrong-on-all-counts-say-experts","title":"Sex and Gender Memo by Trump Administration Is Wrong on All Counts, Say Experts","publishDate":1540415851,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>Lately we've been noting the reality-bending statements made by President Trump and those in his administration on matters of the environment. \u003ca href=\"https://www.kqed.org/science/1929060/trumps-confusing-tweets-on-california-fires-now-appear-to-be-actual-policy\" target=\"_blank\" rel=\"noopener\">Fire\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1928770/no-president-trump-calif-isnt-diverting-its-water-supply-away-from-wildfires\" target=\"_blank\" rel=\"noopener\">water\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1929627/interior-secretary-ryan-zinke-says-california-fires-have-nothing-to-do-with-climate-change-hes-wrong\" target=\"_blank\" rel=\"noopener\">earth\u003c/a>, \u003ca href=\"http://www.sciencemag.org/news/2018/08/trump-s-effort-roll-back-auto-efficiency-rules-could-hinge-debate-over-safety\" target=\"_blank\" rel=\"noopener\">air\u003c/a> — you might say that for science journalists, fact-checking this presidency is now elemental.\u003c/p>\n\u003caside class=\"pullquote alignright\">'For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases.'\u003ccite>American Psychological Association\u003c/cite>\u003c/aside>\n\u003cp>Now comes a \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">New York Times report\u003c/a> that the administration is wading into a new area: the complex interplay between biology and gender. On Sunday the paper said that the Dept. of Health and Human Services wants to establish a definition of a person's gender, one that is determined “on a biological basis that is clear, grounded in science, objective and administrable,” as the paper quoted an HHS memo.\u003c/p>\n\u003cp>“Sex means a person’s status as male or female based on immutable biological traits identifiable by or before birth,” the memo said. “The sex listed on a person’s birth certificate, as originally issued, shall constitute definitive proof of a person’s sex unless rebutted by reliable genetic evidence.”\u003c/p>\n\u003cp>In other words, your genitals at birth determine your gender. End of discussion.\u003c/p>\n\u003cp>The move aims to reverse civil rights protections granted to transgender people under the Obama administration, the Times said.\u003c/p>\n\u003cp>But it would also appear to create an official position by the United States government that transgender people simply don't, well, exist.\u003c/p>\n\u003cp>And that is going to be news to the roughly \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf\" target=\"_blank\" rel=\"noopener\">1.4 million transgender individuals\u003c/a> in the country.\u003c/p>\n\u003cp>The American Psychological Association wasted no time in issuing a response to the report. On Monday, it said in a \u003ca href=\"https://www.apa.org/news/press/releases/2018/10/erase-transgender-definition.aspx\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>:\u003c/p>\n\u003cp>“For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases. Purposely ignoring this body of evidence is indefensible and certain to add to the stress and discrimination already experienced by transgender people.”\u003c/p>\n\u003cp>Dr. Stephen Rosenthal, a pediatric endocrinologist and the medical director of UCSF's Child and Adolescent Gender Center, agrees.\u003c/p>\n\u003cp class=\"p1\">\"A\u003cspan class=\"s1\"> typical transgender person has genitalia that are not in any way obviously abnormal,\" he said. \"And not in any way a clue that that person is going to end up transgender.\"\u003c/span>\u003c/p>\n\u003cp>Genitalia, he said, does not always predict gender identity, and other physical characteristics most likely contribute to people's fundamental sense of whether they are male, female or some variant. Rosenthal cited a number of studies showing \u003cspan class=\"s1\">certain parts of the brain, shaped differently in men and women, that are more closely aligned with the gender identity of transgender individuals than with their natal sex. \u003c/span>\u003c/p>\n\u003cp>Other research suggests that \u003ca href=\"https://www.kqed.org/futureofyou/the-biological-roots-of-gender-identity\" target=\"_blank\" rel=\"noopener\">genetic and endocrinological differences \u003c/a>in transgender people play a role in forming a gender identity that is different than their external sexual characteristics might indicate.\u003c/p>\n\u003cp>The HHS memo's proposition that genetic testing would clear up any dispute around a person's gender is also wrongheaded, said Rosenthal.\u003c/p>\n\u003cp>\"A\u003cspan class=\"s1\">nyone, even high school students, know that there are plenty of examples of women with female bodies, female genitalia, let's say, and an unequivocal female gender identity, who happen to have XY chromosomes,\" he said, referring to the chromosomal pair typically found in males.\u003c/span>\u003c/p>\n\u003cp>The HHS memo would also seem to ignore intersex people — those individuals born with a mix of physical characteristics typically found in only males or females. A \u003ca href=\"http://www.academia.edu/21132481/How_sexually_dimorphic_are_we_Review_and_synthesis\" target=\"_blank\" rel=\"noopener\">2000 review\u003c/a> of the scientific literature by Brown University researchers looked at these deviations from the norm in people born from 1955 on. The survey took into account \u003cspan class=\"a\">chromosomes, gonadal structure, hormone lev\u003c/span>\u003cspan class=\"a\">els, internal genital structure and external geni\u003c/span>\u003cspan class=\"a\">tal\u003cspan class=\"l6\">ia, finding that as many as 2 percent of newborns contain some biological trait normally associated with the opposite sex. \u003c/span>\u003c/span>\u003c/p>\n\u003cp>One of the researchers, the biologist Ann Fausto Sterling, put it this way in a seminal 1993 \u003ca href=\"https://www.researchgate.net/profile/Anne_Fausto-Sterling/publication/239657377_The_Five_Sexes_Why_Male_and_Female_are_not_Enough/links/00b7d525802a725b6b000000/The-Five-Sexes-Why-Male-and-Female-are-not-Enough.pdf\" target=\"_blank\" rel=\"noopener\">essay\u003c/a>:\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>If the state and the legal system have an interest in maintaining a two-party sexual system, they are in defiance of nature. For biologically speaking, there are many gradations running from female to male; and depending on how one calls the shots, one can argue that along that spectrum lie at least five sexes — and perhaps even more.\"\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://www.scientificamerican.com/article/the-new-science-of-sex-and-gender/?fbclid=IwAR01v8tv0iW4E7ve5UEXi-9SrR2ltvAzQBS9PoREKCXREKChBMp-62KoKDU\" target=\"_blank\" rel=\"noopener\">Scientific American\u003c/a> took note of the mounting evidence of a male-female biological spectrum. \"To varying extents, many of us are biological hybrids on a male-female continuum,\" wrote the editors. \"As science looks more closely ... it becomes increasingly clear that a pair of chromosomes do not always suffice to distinguish girl/boy — either from the standpoint of sex (biological traits) or of gender (social identity).\"\u003c/p>\n\u003cp>\u003cstrong>Gender Identity: Biopsychosocial\u003c/strong>\u003c/p>\n\u003cp>California, of course, has moved beyond tying individuals' biological sexual characteristics to their gender identity. Last year, the state made it easier to officially change genders and \u003ca href=\"https://www.kqed.org/futureofyou/436110/california-third-gender-nonbinary\" target=\"_blank\" rel=\"noopener\">added a new category\u003c/a> called \"\u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>\" to the \"male\" and \"female\" options.\u003c/p>\n\u003cp>Researchers often describe the roots of gender identity as a complex mix of factors that are \"biopsychosocial.\" Surveys in recent years have revealed younger generations as accepting of more customizable views of gender, with some individuals even eschewing the pronouns \"he\" and \"she\" in favor of \"they\" to indicate the duality or fluidity of their identity.\u003c/p>\n\u003cp>Charlotte Tate, a gender researcher at San Francisco State University, said it's time to move on from debates like the one the Trump administration is trying to foster.\u003c/p>\n\u003cp>\"Historically, science about gender has contained lots of errors that needed to be corrected or discarded,\" she wrote in an email. \"Pretending that gender identity can be reduced to a person’s genitals is one of those errors that we needed to discard in order to move forward in a way that is scientifically productive.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003c/p>\n","blocks":[],"excerpt":"The notion that a person's gender is forever defined by the sex listed on their birth certificate is at odds with everything we know about the way gender identity develops.","status":"publish","parent":0,"modified":1545172942,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":25,"wordCount":993},"headData":{"title":"Sex and Gender Memo by Trump Administration Is Wrong on All Counts, Say Experts | KQED","description":"The notion that a person's gender is forever defined by the sex listed on their birth certificate is at odds with everything we know about the way gender identity develops.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Sex and Gender Memo by Trump Administration Is Wrong on All Counts, Say Experts","datePublished":"2018-10-24T21:17:31.000Z","dateModified":"2018-12-18T22:42:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445189 https://ww2.kqed.org/futureofyou/?p=445189","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/24/trump-administration-memo-on-sex-and-gender-is-wrong-on-all-counts-say-experts/","disqusTitle":"Sex and Gender Memo by Trump Administration Is Wrong on All Counts, Say Experts","path":"/futureofyou/445189/trump-administration-memo-on-sex-and-gender-is-wrong-on-all-counts-say-experts","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Lately we've been noting the reality-bending statements made by President Trump and those in his administration on matters of the environment. \u003ca href=\"https://www.kqed.org/science/1929060/trumps-confusing-tweets-on-california-fires-now-appear-to-be-actual-policy\" target=\"_blank\" rel=\"noopener\">Fire\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1928770/no-president-trump-calif-isnt-diverting-its-water-supply-away-from-wildfires\" target=\"_blank\" rel=\"noopener\">water\u003c/a>, \u003ca href=\"https://www.kqed.org/science/1929627/interior-secretary-ryan-zinke-says-california-fires-have-nothing-to-do-with-climate-change-hes-wrong\" target=\"_blank\" rel=\"noopener\">earth\u003c/a>, \u003ca href=\"http://www.sciencemag.org/news/2018/08/trump-s-effort-roll-back-auto-efficiency-rules-could-hinge-debate-over-safety\" target=\"_blank\" rel=\"noopener\">air\u003c/a> — you might say that for science journalists, fact-checking this presidency is now elemental.\u003c/p>\n\u003caside class=\"pullquote alignright\">'For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases.'\u003ccite>American Psychological Association\u003c/cite>\u003c/aside>\n\u003cp>Now comes a \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">New York Times report\u003c/a> that the administration is wading into a new area: the complex interplay between biology and gender. On Sunday the paper said that the Dept. of Health and Human Services wants to establish a definition of a person's gender, one that is determined “on a biological basis that is clear, grounded in science, objective and administrable,” as the paper quoted an HHS memo.\u003c/p>\n\u003cp>“Sex means a person’s status as male or female based on immutable biological traits identifiable by or before birth,” the memo said. “The sex listed on a person’s birth certificate, as originally issued, shall constitute definitive proof of a person’s sex unless rebutted by reliable genetic evidence.”\u003c/p>\n\u003cp>In other words, your genitals at birth determine your gender. End of discussion.\u003c/p>\n\u003cp>The move aims to reverse civil rights protections granted to transgender people under the Obama administration, the Times said.\u003c/p>\n\u003cp>But it would also appear to create an official position by the United States government that transgender people simply don't, well, exist.\u003c/p>\n\u003cp>And that is going to be news to the roughly \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf\" target=\"_blank\" rel=\"noopener\">1.4 million transgender individuals\u003c/a> in the country.\u003c/p>\n\u003cp>The American Psychological Association wasted no time in issuing a response to the report. On Monday, it said in a \u003ca href=\"https://www.apa.org/news/press/releases/2018/10/erase-transgender-definition.aspx\" target=\"_blank\" rel=\"noopener\">statement\u003c/a>:\u003c/p>\n\u003cp>“For decades, researchers have recognized that gender is not necessarily determined by a person’s biological sex assigned at birth, which can be physiologically uncertain in some cases. Purposely ignoring this body of evidence is indefensible and certain to add to the stress and discrimination already experienced by transgender people.”\u003c/p>\n\u003cp>Dr. Stephen Rosenthal, a pediatric endocrinologist and the medical director of UCSF's Child and Adolescent Gender Center, agrees.\u003c/p>\n\u003cp class=\"p1\">\"A\u003cspan class=\"s1\"> typical transgender person has genitalia that are not in any way obviously abnormal,\" he said. \"And not in any way a clue that that person is going to end up transgender.\"\u003c/span>\u003c/p>\n\u003cp>Genitalia, he said, does not always predict gender identity, and other physical characteristics most likely contribute to people's fundamental sense of whether they are male, female or some variant. Rosenthal cited a number of studies showing \u003cspan class=\"s1\">certain parts of the brain, shaped differently in men and women, that are more closely aligned with the gender identity of transgender individuals than with their natal sex. \u003c/span>\u003c/p>\n\u003cp>Other research suggests that \u003ca href=\"https://www.kqed.org/futureofyou/the-biological-roots-of-gender-identity\" target=\"_blank\" rel=\"noopener\">genetic and endocrinological differences \u003c/a>in transgender people play a role in forming a gender identity that is different than their external sexual characteristics might indicate.\u003c/p>\n\u003cp>The HHS memo's proposition that genetic testing would clear up any dispute around a person's gender is also wrongheaded, said Rosenthal.\u003c/p>\n\u003cp>\"A\u003cspan class=\"s1\">nyone, even high school students, know that there are plenty of examples of women with female bodies, female genitalia, let's say, and an unequivocal female gender identity, who happen to have XY chromosomes,\" he said, referring to the chromosomal pair typically found in males.\u003c/span>\u003c/p>\n\u003cp>The HHS memo would also seem to ignore intersex people — those individuals born with a mix of physical characteristics typically found in only males or females. A \u003ca href=\"http://www.academia.edu/21132481/How_sexually_dimorphic_are_we_Review_and_synthesis\" target=\"_blank\" rel=\"noopener\">2000 review\u003c/a> of the scientific literature by Brown University researchers looked at these deviations from the norm in people born from 1955 on. The survey took into account \u003cspan class=\"a\">chromosomes, gonadal structure, hormone lev\u003c/span>\u003cspan class=\"a\">els, internal genital structure and external geni\u003c/span>\u003cspan class=\"a\">tal\u003cspan class=\"l6\">ia, finding that as many as 2 percent of newborns contain some biological trait normally associated with the opposite sex. \u003c/span>\u003c/span>\u003c/p>\n\u003cp>One of the researchers, the biologist Ann Fausto Sterling, put it this way in a seminal 1993 \u003ca href=\"https://www.researchgate.net/profile/Anne_Fausto-Sterling/publication/239657377_The_Five_Sexes_Why_Male_and_Female_are_not_Enough/links/00b7d525802a725b6b000000/The-Five-Sexes-Why-Male-and-Female-are-not-Enough.pdf\" target=\"_blank\" rel=\"noopener\">essay\u003c/a>:\u003c/p>\n\u003cp>\u003cstrong>\"\u003c/strong>If the state and the legal system have an interest in maintaining a two-party sexual system, they are in defiance of nature. For biologically speaking, there are many gradations running from female to male; and depending on how one calls the shots, one can argue that along that spectrum lie at least five sexes — and perhaps even more.\"\u003c/p>\n\u003cp>Last year, \u003ca href=\"https://www.scientificamerican.com/article/the-new-science-of-sex-and-gender/?fbclid=IwAR01v8tv0iW4E7ve5UEXi-9SrR2ltvAzQBS9PoREKCXREKChBMp-62KoKDU\" target=\"_blank\" rel=\"noopener\">Scientific American\u003c/a> took note of the mounting evidence of a male-female biological spectrum. \"To varying extents, many of us are biological hybrids on a male-female continuum,\" wrote the editors. \"As science looks more closely ... it becomes increasingly clear that a pair of chromosomes do not always suffice to distinguish girl/boy — either from the standpoint of sex (biological traits) or of gender (social identity).\"\u003c/p>\n\u003cp>\u003cstrong>Gender Identity: Biopsychosocial\u003c/strong>\u003c/p>\n\u003cp>California, of course, has moved beyond tying individuals' biological sexual characteristics to their gender identity. Last year, the state made it easier to officially change genders and \u003ca href=\"https://www.kqed.org/futureofyou/436110/california-third-gender-nonbinary\" target=\"_blank\" rel=\"noopener\">added a new category\u003c/a> called \"\u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>\" to the \"male\" and \"female\" options.\u003c/p>\n\u003cp>Researchers often describe the roots of gender identity as a complex mix of factors that are \"biopsychosocial.\" Surveys in recent years have revealed younger generations as accepting of more customizable views of gender, with some individuals even eschewing the pronouns \"he\" and \"she\" in favor of \"they\" to indicate the duality or fluidity of their identity.\u003c/p>\n\u003cp>Charlotte Tate, a gender researcher at San Francisco State University, said it's time to move on from debates like the one the Trump administration is trying to foster.\u003c/p>\n\u003cp>\"Historically, science about gender has contained lots of errors that needed to be corrected or discarded,\" she wrote in an email. \"Pretending that gender identity can be reduced to a person’s genitals is one of those errors that we needed to discard in order to move forward in a way that is scientifically productive.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003c/p>\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445189/trump-administration-memo-on-sex-and-gender-is-wrong-on-all-counts-say-experts","authors":["80"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_80","futureofyou_1018"],"featImg":"futureofyou_445182","label":"futureofyou"},"futureofyou_445179":{"type":"posts","id":"futureofyou_445179","meta":{"index":"posts_1591205157","site":"futureofyou","id":"445179","score":null,"sort":[1540330432000]},"guestAuthors":[],"slug":"cdc-chair-on-trumps-transgender-proposal-stigma-is-not-in-the-interest-of-public-health","title":"CDC Chair on Trump’s Transgender Proposal: Stigma is ‘Not in The Interest of Public Health’","publishDate":1540330432,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The director of the Centers for Disease Control and Prevention on Tuesday suggested a \u003ca href=\"https://www.kqed.org/news/11700270/trump-move-to-redefine-gender-could-lead-to-david-and-goliath-battle-with-transgender-californians\" rel=\"noopener\" target=\"_blank\">Trump administration proposal\u003c/a> that would define someone’s sex at birth risked heightening stigma around transgender people.\u003c/p>\n\u003cp>The director, Robert Redfield, did not directly criticize the proposal. But when asked whether any such effort might hamper efforts to treat HIV, especially among transgender women, he replied: “We need to understand that stigmatizing illness, stigmatizing individuals is not in the interest of public health.”[contextly_sidebar id=\"mVeGOCjwCxD05uYuQsgkbTz0xWyggdvD\"]\u003c/p>\n\u003cp>He made the remarks in an interview with STAT Executive Editor Rick Berke at the opening session of the Milken Institute’s Future of Health Summit.\u003c/p>\n\u003cp class=\"\">Redfield said he was not involved in developing \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">the policy\u003c/a>, which was first reported by the New York Times.\u003c/p>\n\u003cp class=\"\">The proposal was criticized by scientists, who pointed out that it \u003ca href=\"https://www.statnews.com/2018/10/22/scientists-see-a-problem-with-trump-plan-on-defining-sex-biology/\">stands in contradiction to basic biology\u003c/a>, which recognizes that many individuals are born with sex chromosomes or genitalia that don’t conform to the social definitions of “male” and “female.”\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Trump addressed the issue Monday, telling reporters that the administration is “looking at it.”\u003c/p>\n\u003cp>“We have a lot of different concepts right now,” Trump said. “They have a lot of different things happening with respect to transgender right now. You know that as well as I do and we’re looking at it very seriously.”\u003c/p>\n\u003cp>The Department of Health and Human Services, which oversees the CDC, has declined to comment on the substance of the proposal directly. On Monday, the Washington Post reported that, while \u003ca href=\"https://www.washingtonpost.com/national/trump-administration-considering-different-concepts-regarding-transgender-rights-with-some-pushing-back-internally/2018/10/22/0668f4da-d624-11e8-83a2-d1c3da28d6b6_story.html?utm_term=.5da392e86f59\" target=\"_blank\" rel=\"noopener\">HHS is backing the proposal\u003c/a>, the Department of Education is pushing back.\u003c/p>\n\u003cp>Redfield also argued that stigma is harmful more broadly, saying that it interferes with actually treating a disease, such as addiction to opioids.\u003c/p>\n\u003cp>He said that the stigma around opioid use now is greater than the stigma around AIDS.\u003c/p>\n\u003cp>“It’s nothing compared to what we’re confronting with drug use,” Redfield said.\u003c/p>\n\u003cp>For him, the issue is personal — his son has been in recovery for drug use for three years.[contextly_sidebar id=\"SSyvhjTE85ossB5jaH387kntcvQgQVWT\"]\u003c/p>\n\u003cp>“I pray for him every day,” Redfield said. “People don’t realize that addiction is a medical condition, it’s not a moral failing. People don’t realize it’s a chronic medical condition.”\u003c/p>\n\u003cp>Redfield compared it to another disease, like cancer. We don’t stigmatize people whose cancer goes into remission and then flares back up, he said, so why do we stigmatize people who relapse after treatment for drug use?\u003c/p>\n\u003cp>He said that treatment for addiction should be integrated into primary care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/23/cdc-director-on-trump-transgender-proposal/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n","blocks":[],"excerpt":"The proposal has been criticized by scientists, who point out that it stands in contradiction to basic biology.","status":"publish","parent":0,"modified":1540332065,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":16,"wordCount":477},"headData":{"title":"CDC Chair on Trump’s Transgender Proposal: Stigma is ‘Not in The Interest of Public Health’ | KQED","description":"The proposal has been criticized by scientists, who point out that it stands in contradiction to basic biology.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"CDC Chair on Trump’s Transgender Proposal: Stigma is ‘Not in The Interest of Public Health’","datePublished":"2018-10-23T21:33:52.000Z","dateModified":"2018-10-23T22:01:05.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"445179 https://ww2.kqed.org/futureofyou/?p=445179","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/23/cdc-chair-on-trumps-transgender-proposal-stigma-is-not-in-the-interest-of-public-health/","disqusTitle":"CDC Chair on Trump’s Transgender Proposal: Stigma is ‘Not in The Interest of Public Health’","source":"Health","nprByline":"Ike Swetlitz, STAT","path":"/futureofyou/445179/cdc-chair-on-trumps-transgender-proposal-stigma-is-not-in-the-interest-of-public-health","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The director of the Centers for Disease Control and Prevention on Tuesday suggested a \u003ca href=\"https://www.kqed.org/news/11700270/trump-move-to-redefine-gender-could-lead-to-david-and-goliath-battle-with-transgender-californians\" rel=\"noopener\" target=\"_blank\">Trump administration proposal\u003c/a> that would define someone’s sex at birth risked heightening stigma around transgender people.\u003c/p>\n\u003cp>The director, Robert Redfield, did not directly criticize the proposal. But when asked whether any such effort might hamper efforts to treat HIV, especially among transgender women, he replied: “We need to understand that stigmatizing illness, stigmatizing individuals is not in the interest of public health.”\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>He made the remarks in an interview with STAT Executive Editor Rick Berke at the opening session of the Milken Institute’s Future of Health Summit.\u003c/p>\n\u003cp class=\"\">Redfield said he was not involved in developing \u003ca href=\"https://www.nytimes.com/2018/10/21/us/politics/transgender-trump-administration-sex-definition.html\" target=\"_blank\" rel=\"noopener\">the policy\u003c/a>, which was first reported by the New York Times.\u003c/p>\n\u003cp class=\"\">The proposal was criticized by scientists, who pointed out that it \u003ca href=\"https://www.statnews.com/2018/10/22/scientists-see-a-problem-with-trump-plan-on-defining-sex-biology/\">stands in contradiction to basic biology\u003c/a>, which recognizes that many individuals are born with sex chromosomes or genitalia that don’t conform to the social definitions of “male” and “female.”\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Trump addressed the issue Monday, telling reporters that the administration is “looking at it.”\u003c/p>\n\u003cp>“We have a lot of different concepts right now,” Trump said. “They have a lot of different things happening with respect to transgender right now. You know that as well as I do and we’re looking at it very seriously.”\u003c/p>\n\u003cp>The Department of Health and Human Services, which oversees the CDC, has declined to comment on the substance of the proposal directly. On Monday, the Washington Post reported that, while \u003ca href=\"https://www.washingtonpost.com/national/trump-administration-considering-different-concepts-regarding-transgender-rights-with-some-pushing-back-internally/2018/10/22/0668f4da-d624-11e8-83a2-d1c3da28d6b6_story.html?utm_term=.5da392e86f59\" target=\"_blank\" rel=\"noopener\">HHS is backing the proposal\u003c/a>, the Department of Education is pushing back.\u003c/p>\n\u003cp>Redfield also argued that stigma is harmful more broadly, saying that it interferes with actually treating a disease, such as addiction to opioids.\u003c/p>\n\u003cp>He said that the stigma around opioid use now is greater than the stigma around AIDS.\u003c/p>\n\u003cp>“It’s nothing compared to what we’re confronting with drug use,” Redfield said.\u003c/p>\n\u003cp>For him, the issue is personal — his son has been in recovery for drug use for three years.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“I pray for him every day,” Redfield said. “People don’t realize that addiction is a medical condition, it’s not a moral failing. People don’t realize it’s a chronic medical condition.”\u003c/p>\n\u003cp>Redfield compared it to another disease, like cancer. We don’t stigmatize people whose cancer goes into remission and then flares back up, he said, so why do we stigmatize people who relapse after treatment for drug use?\u003c/p>\n\u003cp>He said that treatment for addiction should be integrated into primary care.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/23/cdc-director-on-trump-transgender-proposal/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/445179/cdc-chair-on-trumps-transgender-proposal-stigma-is-not-in-the-interest-of-public-health","authors":["byline_futureofyou_445179"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_1521","futureofyou_1633","futureofyou_61","futureofyou_1018"],"featImg":"futureofyou_445182","label":"source_futureofyou_445179"},"futureofyou_444450":{"type":"posts","id":"futureofyou_444450","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444450","score":null,"sort":[1537204210000]},"guestAuthors":[],"slug":"doctors-group-recommends-support-for-transgender-children","title":"Major Pediatrics Group Takes Stand in Support of Transgender Youth","publishDate":1537204210,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>A doctors group took a stand in support of transgender children Monday, offering advice in what it called “a rapidly evolving” field.[contextly_sidebar id=\"ew5jSTpxA05QNe71t6m93gcXN8jJWF5a\"]\u003c/p>\n\u003cp>The American Academy of Pediatrics recommended support for kids who change their names or hairstyles to affirm their chosen gender identity. The group said children are more likely to have better physical and mental health with such support.\u003c/p>\n\u003cp>The policy describes interventions including hormones to suppress puberty and even surgery for teens on a case-by-case basis. It calls for advocacy in favor of laws protecting transgender youth from discrimination.\u003c/p>\n\u003cp>The recommendations, published in the journal Pediatrics, come at a time when the Trump \u003ca href=\"https://apnews.com/7240e9d0bfa84ed08c17e8e02765258e/Struggle-for-transgender-rights-shifts-to-health-care\" target=\"_blank\" rel=\"noopener\">administration\u003c/a> has put the brakes on such protections.\u003c/p>\n\u003cp>A \u003ca href=\"https://apnews.com/02e14dcaba1f44af8202d390794f8717/Not-just-boy-and-girl;-more-teens-identify-as-transgender\" target=\"_blank\" rel=\"noopener\">study\u003c/a> earlier this year found nearly 3 percent of U.S. youth identify as transgender or by other nontraditional gender terms.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>The doctors group, which represents 67,000 physicians who treat children and young adults, previously has made public statements in response to so-called bathroom legislation involving transgender people, but this is its first policy statement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n","blocks":[],"excerpt":"The recommendations come at a time when the Trump administration has put the brakes on such protections.","status":"publish","parent":0,"modified":1537556519,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":8,"wordCount":185},"headData":{"title":"Major Pediatrics Group Takes Stand in Support of Transgender Youth | KQED","description":"The recommendations come at a time when the Trump administration has put the brakes on such protections.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Major Pediatrics Group Takes Stand in Support of Transgender Youth","datePublished":"2018-09-17T17:10:10.000Z","dateModified":"2018-09-21T19:01:59.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444450 https://ww2.kqed.org/futureofyou/?p=444450","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/09/17/doctors-group-recommends-support-for-transgender-children/","disqusTitle":"Major Pediatrics Group Takes Stand in Support of Transgender Youth","source":"Health","nprByline":"Carla K. Johnson \u003cbr />The Associated Press","path":"/futureofyou/444450/doctors-group-recommends-support-for-transgender-children","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>A doctors group took a stand in support of transgender children Monday, offering advice in what it called “a rapidly evolving” field.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>The American Academy of Pediatrics recommended support for kids who change their names or hairstyles to affirm their chosen gender identity. The group said children are more likely to have better physical and mental health with such support.\u003c/p>\n\u003cp>The policy describes interventions including hormones to suppress puberty and even surgery for teens on a case-by-case basis. It calls for advocacy in favor of laws protecting transgender youth from discrimination.\u003c/p>\n\u003cp>The recommendations, published in the journal Pediatrics, come at a time when the Trump \u003ca href=\"https://apnews.com/7240e9d0bfa84ed08c17e8e02765258e/Struggle-for-transgender-rights-shifts-to-health-care\" target=\"_blank\" rel=\"noopener\">administration\u003c/a> has put the brakes on such protections.\u003c/p>\n\u003cp>A \u003ca href=\"https://apnews.com/02e14dcaba1f44af8202d390794f8717/Not-just-boy-and-girl;-more-teens-identify-as-transgender\" target=\"_blank\" rel=\"noopener\">study\u003c/a> earlier this year found nearly 3 percent of U.S. youth identify as transgender or by other nontraditional gender terms.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>The doctors group, which represents 67,000 physicians who treat children and young adults, previously has made public statements in response to so-called bathroom legislation involving transgender people, but this is its first policy statement.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp> \u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444450/doctors-group-recommends-support-for-transgender-children","authors":["byline_futureofyou_444450"],"categories":["futureofyou_1060","futureofyou_1","futureofyou_73"],"tags":["futureofyou_204","futureofyou_1018","futureofyou_1434"],"collections":["futureofyou_1093"],"featImg":"futureofyou_370177","label":"source_futureofyou_444450"},"futureofyou_440851":{"type":"posts","id":"futureofyou_440851","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440851","score":null,"sort":[1535312820000]},"guestAuthors":[],"slug":"can-you-really-know-that-a-3-year-old-is-transgender","title":"Is Three Too Young for Children to Know They're a Different Gender? Transgender Researchers Disagree","publishDate":1535312820,"format":"audio","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003caside>\n\u003cul>\n\u003cli>Many gender clinicians now recommend parents 'socially transition' kids who persistently express a transgender identity.\u003c/li>\n\u003cli>But research has shown most children will give up their transgender identity by the time they are adolescents.\u003c/li>\n\u003cli>Not all researchers agree, though, that this research is valid.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>Gracie is the youngest transgender person I've ever met. She's so young, she still likes to tack on \"and-a-half\" when giving her age, which is six. One day last summer, bouncing all over the grounds at day camp, she looked as delighted as you'd expect any kid would on \"Water Day.”\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://www.kqed.org/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth\">The Controversial Research on 'Desistance' in Transgender Youth\u003c/a>\u003c/aside>\n\u003cp>This is Rainbow Day Camp, in the East Bay town of El Cerrito. It was created specifically to be a safe place for transgender kids, and in fact, being transgender is so unremarkable here, when I asked Gracie what makes it “special,\" she shrugged and said:\u003c/p>\n\u003cp>“You get to do fun stuff.”\u003c/p>\n\u003cp>Her mother, Molly, tried to coax a reporter-friendly answer out of her.\u003c/p>\n\u003cp>“What is special about you, and the same as everybody else in the camp?” she prompted.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>“I don’t know,” Gracie said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What if we let our son walk into the world in a dress with fairy wings, and crowns, and high heels, and even just in regular girl clothes … and then he changes his mind?'\u003ccite>Molly, whose 6-year-old daughter, Gracie, socially transitioned at age four\u003c/cite>\u003c/aside>\n\u003cp>“You’re transgender and there’s other kids that are transgender, too...”\u003c/p>\n\u003cp>“I’m transgender and there’s other kids that are transgender, too.”\u003c/p>\n\u003cp>Ah, kids. ... But when I asked Gracie how she \u003cem>used\u003c/em> to feel, when other people thought she was a boy, she got straight to the point.\u003c/p>\n\u003cp>“It was not right to me, and I didn’t want people to say that, but they said it,” she said. “It hurted my feelings a lot.\"\u003c/p>\n\u003cp>Did it make her angry?\u003c/p>\n\u003cp>“No, it just made me sad.”\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"mailto:jbrooks@kqed.org\">Email the reporter\u003c/a>\u003c/aside>\n\u003cp>How about now?\u003c/p>\n\u003cp>“It feels happy to me.”\u003c/p>\n\u003cp>And that, in a child’s nutshell, sums up one side of a contentious debate about the right age for transgender children to begin what gender clinicians call “social transitioning.”\u003c/p>\n\u003cp>https://www.youtube.com/watch?v=IS5Yankf1GY\u003c/p>\n\u003cp>\u003cstrong>Even Three-Year-Olds\u003c/strong>\u003c/p>\n\u003cp>When I met Gracie, she was a few months out of kindergarten — pretty young for a transgender kid, I thought. Gracie lives with her parents and younger brother in a small city in the East Bay. She is already two years into her transition, having started her public life as a girl at four. The family began by discarding her boy name and referring to Gracie as “she” and “her.” She was also allowed to wear girl clothes outside the home, and her parents changed the gender on her birth certificate to avoid confusion at school.\u003c/p>\n\u003caside class=\"alignright noborder\">\u003cstrong>How young is too young?\u003c/strong>\u003cbr>\nUCSF’s Diane Ehrensaft, one of the leading proponents of socially transitioning transgender children, believes there is no minimum age, really, to pursue such a change.'For all of these interventions, our model is stages not ages,” she said. 'When a child is at the place in their life that they can get themselves in focus, help us see them, and are clear, consistent, and stable in both their representation of themselves, and also can express their desires of how they want to live their gender, that's the age.'We have seen some kids as young as two whose parents are bringing them in because they're beginning to say, ‘Me not boy. Me girl.’ Social transition can happen as soon as a child has language or the ability to communicate to us who they are.'\u003c/aside>\n\u003cp>Steps like these make up the “social” aspects of social, not medical, transitioning. The distinction is important: According to Endocrine Society \u003ca href=\"https://academic.oup.com/jcem/article/102/11/3869/4157558\" target=\"_blank\" rel=\"noopener\">guidelines\u003c/a>, patients who want to begin medical treatment like puberty blockers, hormones or surgery should be old enough to give “informed consent,” which the organization says is usually attained by 16.\u003c/p>\n\u003cp>Therapists at \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/child_and_adolescent_gender_center/\" target=\"_blank\" rel=\"noopener\">UCSF’s Child and Adolescent Gender Center Clinic\u003c/a> in San Francisco told me they’ve socially transitioned kids as young as three.\u003c/p>\n\u003cp>Diane Ehrensaft, the San Francisco Center’s mental health director and a leading proponent of early social transitioning, acknowledges this approach has been controversial.\u003c/p>\n\u003cp>“There are some people that think folks like myself, and the people at our clinic, have fallen off the deep end,” she told me. She wasn’t just talking about the religious right, either. She was referring to other mental health professionals.\u003c/p>\n\u003cp>I myself experienced a fair bit of surprise when Ehrensaft told me how young these kids are. My first, reflexive comment was a simple, \"Wow.\" This was not an uncommon reaction when I discussed this story with people in my own life, even in the progressive Bay Area.\u003c/p>\n\u003cp>Yet, when I spoke with Gracie’s mom, Molly (the family didn't want their last name used for reasons of privacy), nothing about the decision to allow her then-son to publicly make the switch to a girl, at an age when many kids are still sucking their thumbs, sounded in the slightest bit rash.\u003c/p>\n\u003cp>We spoke at Rainbow Day Camp, in a classroom set aside for interviews. The children’s art adorning the walls, the shrimpy seats — it felt like a place to talk about kickball, not the gender identity of first graders.\u003c/p>\n\u003cp>Yet here we were.\u003c/p>\n\u003caside class=\"alignright\">\u003cstrong>The Biological Roots of Gender Identity\u003c/strong>\u003cbr>\nMolly is the mother of two children, a 3-year-old boy and a 7-year-old transgender girl. The younger child is the “stereotype of what I thought having a son would be like,” she said. “He loves trucks, cars, construction, superheroes and destroying the house.”Her first child, also born male, just did not develop in the same way. Rather, from the time he acquired language on, he protested that he was really a girl. (\u003ca href=\"https://www.kqed.org/futureofyou/the-biological-roots-of-gender-identity\" target=\"_blank\" rel=\"noopener\">Continue reading)\u003c/a>\u003c/aside>\n\u003cp>“What if we do this?” Molly recalled asking a gender therapist, back when they were debating the pros and cons of letting Gracie transition. “What if we let our son walk into the world in a dress with fairy wings, and crowns, and high heels, and even just in regular girl clothes … and then he changes his mind?”\u003c/p>\n\u003cp>\"That's not the question,” the therapist told Molly. “The question is, what if you don't do it?”\u003c/p>\n\u003cp>It was only semi-rhetorical. Some gender therapists say there are serious potential dangers if adults suppress a child’s desired transition. On surveys, American transgender adults have reported attempting suicide at the startling \u003ca href=\"https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf\" target=\"_blank\" rel=\"noopener\">rate\u003c/a> of around 40 percent.\u003c/p>\n\u003cp>The stakes couldn’t have been higher, Molly knew.\u003c/p>\n\u003cp>At Rainbow Day Camp, recalling that time, she started to cry.\u003c/p>\n\u003cp>“As soon as I knew there was even a chance that my kid could feel ashamed of who they are, there was no way … ” Her voice cracked into a higher register. “I had to support, I had to listen, and I had to let her steer, a little bit, the ship. Period. No matter what.”\u003c/p>\n\u003cfigure id=\"attachment_441862\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/gracie-sliding-water-1.jpg\">\u003cimg class=\"wp-image-441862 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/gracie-sliding-water-1-1020x527.jpg\" alt=\"\" width=\"640\" height=\"331\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-1020x527.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-160x83.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-800x414.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-768x397.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-1200x620.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-1180x610.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-960x496.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-240x124.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-375x194.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-520x269.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1.jpg 1209w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gracie, six, on Water Day at Rainbow Day Camp, which was created as a safe space for transgender kids. \u003ccite>(KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘I’m a Girl’\u003c/strong>\u003c/p>\n\u003cp>Ehrensaft calls children like Gracie “persistent, consistent, and insistent” in their declarations of cross-gender identity. For Gracie, this manifested through words, wishes, and, well, practically everything.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Why would we deny for the vast majority of kids something that is basically suicide prevention?'\u003ccite>Diane Ehrensaft, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Gracie was her parents' first child. From toddlerhood on, Molly said, their son had displayed a “constant obsession and fixation on all things girl. As soon as she could tell us, it was, ‘I'm a girl. I'm a sister. I'm a daughter. I'm that girl on that show. I'm that girl in that book.’”\u003c/p>\n\u003cp>Gracie's parents weren’t on board at first.\u003c/p>\n\u003cp>“We filled her world with trucks, and dinosaurs, and superheroes, and we refused girl things,” Molly said. “Like, ‘No, you can't be Elsa for Halloween. You have to be Superman. No, you can't have the dolls for Christmas. We're going to get you a pirate ship.’”\u003c/p>\n\u003cp>They also made a rule: No girl clothing outside the house.\u003c/p>\n\u003cp>Molly tells me: “That’s the part I’m ashamed of now.”\u003c/p>\n\u003cp>\u003cstrong>'These Kids Do Come Forward'\u003c/strong>\u003c/p>\n\u003cp>Molly and her husband finally relented — they just could not deny how much happier their child felt when recognized as a girl.\u003c/p>\n\u003cfigure id=\"attachment_441832\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/Phoenix5-e1527011026777.jpg\">\u003cimg class=\"size-large wp-image-441832\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/Phoenix5-1020x1530.jpg\" alt=\"\" width=\"640\" height=\"960\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Phoenix, a transgender girl who began wearing dresses to school at age 5. She began made a complete social transition at the start of second grade. \u003ccite>(Courtesy of family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I asked: Has Gracie ever looked back?\u003c/p>\n\u003cp>Molly chuckled.\u003c/p>\n\u003cp>“If you think of gender as a spectrum, she is like a full, all-the-way girl.”\u003c/p>\n\u003cp>It’s not rocket science, Ehrensaft explained, if you really listen to the children. “A child will say: ‘Stop calling me Jane. Let me wear my dresses. Please call me she.’ That's a child making a clear statement.”\u003c/p>\n\u003cp>Kristina Olson, a University of Washington gender researcher, said parents do not always listen to what their kids are telling them.\u003c/p>\n\u003cp>“The ones that are most likely to transition are kids who for many years are very consistently saying this is who they are,” she said. ”We often see this happen for years before parents socially transition their kids.”\u003c/p>\n\u003cp>UCSF gender specialist Erica Anderson recently treated a five-year-old who had reached a point of desperation.\u003c/p>\n\u003cp>“In the bathtub, he would compare himself to his younger sister, and really start getting upset. At one point he went in the bathroom with a pair of shears — he was going to cut his penis off.”\u003c/p>\n\u003cp>“This child has been so clear for a couple of years,” Anderson said. “These kids do come forward.”\u003c/p>\n\u003cp>\u003cstrong>Changing Approaches\u003c/strong>\u003c/p>\n\u003cp>Gender clinicians who recommend social transition at such an early age call their model “gender affirmative,” and they believe their approach is now ascendant. Historically, clinicians more commonly treated transgender kids by discouraging cross-gender identity. The method was most famously practiced by longtime gender researcher Ken Zucker.\u003c/p>\n\u003cp>Zucker is now an extraordinarily controversial figure in the transgender community. He believed that an outcome in which a child becomes transgender should be avoided, if possible. You can get a glimpse of his methods in this \u003ca href=\"https://www.npr.org/2008/05/07/90247842/two-families-grapple-with-sons-gender-preferences\" target=\"_blank\" rel=\"noopener\">NPR story\u003c/a> from 2008. Zucker is counseling the family of a young boy he’d diagnosed with gender identity disorder, the term used for gender dysphoria before 2013.\u003c/p>\n\u003cblockquote>\u003cp>Zucker explained to Carol that she and her husband would have to radically change their parenting. Bradley would no longer be allowed to spend time with girls. He would no longer be allowed to play with girlish toys or pretend that he was a female character. Zucker said that all of these activities were dangerous to a kid with gender identity disorder. He explained that unless Carol and her husband helped the child to change his behavior, as Bradley grew older, he likely would be rejected by both peer groups.\u003c/p>\u003c/blockquote>\n\u003cp>Other researchers and transgender activists have criticized this approach as too close to the “conversion therapy” inflicted on gay and lesbian youth, a practice that is now illegal in a number of states, including \u003ca href=\"https://www.sfgate.com/news/article/State-bans-gay-repair-therapy-for-minors-3906032.php\" target=\"_blank\" rel=\"noopener\">California\u003c/a>.\u003c/p>\n\u003cp>[emailsignup newslettername='science' align='right']The World Professional Association for Transgender Health's guidelines for clinicians, called the \u003ca href=\"https://www.wpath.org/publications/soc\" target=\"_blank\" rel=\"noopener\">Standards of Care\u003c/a>, states that “treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth” is “no longer considered ethical.”\u003c/p>\n\u003cp>Zucker was the psychologist-in-chief and head of the gender identity clinic at a Toronto mental health hospital before administrators shut down the clinic in 2015, after a review of his practices. That was also \u003ca href=\"https://www.theglobeandmail.com/life/health-and-fitness/health/alleged-exchange-with-gender-identity-doctor-didnt-happen-camh-says/article28471923/\" target=\"_blank\" rel=\"noopener\">controversial\u003c/a>, and Zucker is suing his former employer for defamation. (Zucker declined to comment for this article. For a defense of his work, you can read Jesse Singal’s \u003ca href=\"https://www.thecut.com/2016/02/fight-over-trans-kids-got-a-researcher-fired.html\" target=\"_blank\" rel=\"noopener\">reporting\u003c/a> from 2016.)\u003c/p>\n\u003cp>\u003cstrong>Watchful Waiting\u003c/strong>\u003c/p>\n\u003cp>Zucker’s approach aside, there is another alternative to gender affirmative therapy. It’s the approach taken by the \u003ca href=\"https://www.vumc.com/branch/gender-dysphoria/\" target=\"_blank\" rel=\"noopener\">Center of Expertise on Gender Dysphoria\u003c/a> in Amsterdam, and gender specialists commonly refer to it as the “Dutch Model.”\u003c/p>\n\u003cp>This treatment sometimes involves the social transition of young children, according to Thomas Steensma, a researcher and clinician at the center. But for the most part, its counseling incorporates the idea that the vast majority of gender dysphoric children will eventually stop identifying as transgender.\u003c/p>\n\u003cp>The research literature calls these individuals “desistant.” The kids who retain their transgender identity as they grow up are dubbed “persistent.”\u003c/p>\n\u003cp>\u003cstrong>The Desistance Controversy\u003c/strong>\u003c/p>\n\u003cp>Nothing roils the world of transgender research like the topic of \u003ca href=\"https://www.kqed.org/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth\" target=\"_blank\" rel=\"noopener\">desistance\u003c/a>. Brynn Tannehill, a transgender activist who follows the research closely, said the concept is often used by anti-LGBT groups to make the case that rejecting children’s transgender identity is in their best interests.\u003c/p>\n\u003caside class=\"pullquote alignright\">'[Desistance research] is used primarily as an attack on the validity of transgender identities, which usually quickly disintegrates into a debate on whether we should exist.' \u003ccite>Brynn Tannehill, transgender activist\u003c/cite>.\u003c/aside>\n\u003cp>“It is used primarily as an attack on the validity of transgender identities, which usually quickly disintegrates into a debate on whether we should exist,” Tannehill said.\u003c/p>\n\u003cp>And yet, the fact is that just about every published study on the topic to date has found that a majority of children who once reported various degrees of gender dysphoria ended up eventually giving up their transgender identity.\u003c/p>\n\u003cp>To grasp the implications of this, remember Molly’s anxious questioning of the gender therapist: What if we go through all this, and it turns out to be just a phase? Shouldn’t we wait?\u003c/p>\n\u003cp>The gender affirmative camp says no. That’s because it doesn’t believe that the body of research on desistance, some of it conducted by Zucker and his associates, is valid.\u003c/p>\n\u003cp>Many gender researchers maintain that the current criteria for diagnosing gender dysphoria are much more stringent than in the past. Therefore, many of the studies that found so many kids had \"grown out\" of their transgender identity were actually measuring children who were \u003cem>never really transgender\u003c/em> in the first place.\u003c/p>\n\u003cp>“Some of those studies are decades old,” said gender researcher Kristina Olson. “So if you had a son in the early 1980s who liked playing with dolls and wanted to occasionally wear a dress, even today maybe you would think to bring that child to talk to a doctor about it. But that child wouldn't necessarily be transgender, because that kid doesn't necessarily think of himself as a girl.\"\u003c/p>\n\u003cp>Ehrensaft said that her San Francisco clinic sees “a tiny, tiny proportion” of clients who stop identifying as transgender after transitioning.\u003c/p>\n\u003cp>Even the Amsterdam clinic’s Thomas Steensma, who firmly believes most gender dysphoric kids will \u003cem>not\u003c/em> grow up to be transgender, acknowledged the earlier studies probably included “milder cases” that are “hard to compare with the clinical samples we see now in our clinics.”\u003c/p>\n\u003cfigure id=\"attachment_441834\" class=\"wp-caption alignright\" style=\"max-width: 720px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/James.jpeg\">\u003cimg class=\"size-full wp-image-441834\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/James.jpeg\" alt=\"\" width=\"720\" height=\"960\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/04/James.jpeg 720w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-160x213.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-240x320.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-375x500.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-520x693.jpeg 520w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Olivia, a transgender girl who socially transitioned when she was four, and her brother, James, who transitioned when he was eight. \u003ccite>(Courtesy of family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nevertheless, he said, “The only evidence I have from studies and reports in the literature ... is that children who struggle with gender incongruence … will not all persist into adolescence.\"\u003c/p>\n\u003cp>Talking to Steensma over Skype, he seemed bemused by the fact that the “Dutch model” is now considered conservative compared to what has taken hold in America. After all, his Amsterdam clinic had been a pioneer in the medical treatment of transgender youth, especially in the use of puberty blockers, which delay the onset of secondary sex characteristics.\u003c/p>\n\u003cp>But what about the \u003cem>social transitioning\u003c/em> of young kids?\u003c/p>\n\u003cp>\"It's not a 'yes' or a 'no' in our opinion, but a 'maybe,' Steensma told me.\u003c/p>\n\u003cp>I wondered if there was any real argument between him and Ehrensaft, after all. So I described to him the case of persistent, insistent, consistent Gracie.\u003c/p>\n\u003cp>A slam dunk for social transition?\u003c/p>\n\u003cp>Steensma said no.\u003c/p>\n\u003cp>“We would counsel them ... that it's okay to express your feelings, your interests, to show your behaviors. But with certain steps like a name change, or a pronoun change, with a result that maybe others will only perceive you as a girl — that's somewhere where we say, ‘Okay, maybe you should explore things without taking steps that are hard to reverse.’”\u003c/p>\n\u003cp>There are mental health professionals in the U.S. who agree. Dr. Jack Drescher is a clinical professor of psychiatry at Columbia University; he served on the American Psychiatric Association's committee that revised the diagnosis of gender identity disorder in 2013. He said gender affirmative therapists have never proven they can successfully identify those kids who will stick with transgender identity.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There are some people that think folks like myself, and the people at our clinic, have fallen off the deep end.”\u003ccite>Diane Ehrensaft, UCSF\u003c/cite>\u003c/aside>\n\u003cp>He also says there’s no evidence to back a corollary belief, that kids who might later need to “detransition” back to their original gender will not suffer any long-lasting psychological effects.\u003c/p>\n\u003cp>“This is what they believe, but it's not based on research,” he said of gender affirmative clinicians. “This is a meme, not really a piece of scientific finding.”\u003c/p>\n\u003cp>Steensma concurred: “If a child transitions, it is not just, ‘Oh, we do the transition and we go on with our life.’ It has a huge impact on the child, on the family and their environment.’”\u003c/p>\n\u003cp>The current Standards of Care, issued by the World Professional Association of Transgender Health in 2011, are more or less in accordance with this view, as even Ehrensaft acknowledges. The guidelines describe “relatively low persistence rates” as “relevant” to helping parents weigh the decision to socially transition. The standards also state that “a change back to the original gender role can be highly distressing.”\u003c/p>\n\u003cp>The one thing everyone in the field agrees on is more research is needed. Almost every gender specialist I spoke with cited Kristina Olson’s longitudinal study at the University of Washington as critical to answering some of these hotly debated unknowns. Olson recently received a $1 million grant from the National Science Foundation, which she's using to expand the study.\u003c/p>\n\u003cp>Preliminary research coming out of the project has already provided good news for the families of transgender kids. In a pair of studies published over the last several years, Olson and her colleagues found that socially transitioned children and adolescents between the ages of 3 and 14 did \u003ca href=\"https://www.kqed.org/stateofhealth/153172/transgender-children-living-openly-are-doing-well-study-shows\" target=\"_blank\" rel=\"noopener\">not experience\u003c/a> any more depression than separate control groups of peers and siblings, as well as the general population.\u003c/p>\n\u003cp>The transgender health association is now gearing up to revise the Standards of Care. Both Steensma, known for “watchful waiting,” and Ehrensaft, of the gender affirmative school, are on the committee in charge of the section about children. The jockeying to influence the direction of the committee has already begun, as evidenced by the critical \u003ca href=\"https://www.tandfonline.com/doi/full/10.1080/15532739.2018.1456390\" target=\"_blank\" rel=\"noopener\">commentaries\u003c/a> now appearing in academic \u003ca href=\"https://www.tandfonline.com/doi/abs/10.1080/15532739.2017.1414649\" target=\"_blank\" rel=\"noopener\">journals\u003c/a>.\u003c/p>\n\u003cp>“My prediction is that there will be more endorsement of social transitions at earlier ages, without the cautionary tales,” Ehrensaft said of the upcoming revision.\u003c/p>\n\u003cp>\u003cb>Not Just Numbers\u003c/b>\u003c/p>\n\u003cp>When it comes down to it, when we talk about the controversy over socially transitioning young kids, we are talking about risk analysis. Which is more disruptive and potentially harmful: to deny children their genuinely felt gender identity in the present moment, until the adults are \u003cem>absolutely sure\u003c/em> it will stick? Or to validate a child’s persistent, consistent and insistent protestations that ‘\u003cem>Hey, someone has made a terrible mistake here,\u003c/em>’ even if they eventually decide they no longer feel that way?\u003c/p>\n\u003cp>Ehrensaft, at least, is clear on the answer:\u003c/p>\n\u003cp>“Why would we deny for the vast majority of kids something that is basically suicide prevention?”\u003c/p>\n\u003cp>As a parent, I wonder: If my daughter became incandescently happy when allowed to change her name and take on other aspects of being transgender — as happy as Molly describes Gracie becoming when recognized as a girl — what would I do? If some statistics indicated my child might one day switch back, but my deepest parental instincts told me to trust her joyfulness, could I ignore the latter?\u003c/p>\n\u003cp>At Rainbow Day Camp, I spoke to James, a 9-year-old transgender boy who’d transitioned during second grade. He told me matter-of-factly that he’d been bullied by older kids, who’d called him an “It.”\u003c/p>\n\u003cp>After he transitioned, his mother said, “There was just this comfort that came about him, and comfort's something that you can't really fake. He’s [just] a happier kid.”\u003c/p>\n\u003cp>Similarly, before Gracie’s transition, family life was “lackluster,” Molly recalled. The constant tension drained the joy out of childhood for everybody.\u003c/p>\n\u003cp>“You never got to see that sort of sparkle, or that sort of magic of, like, a Christmas morning, or a Halloween, or just regular day-to-day happiness,” Molly said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>“Now she gets to really live.”\u003c/p>\n\n","blocks":[],"excerpt":"Many gender clinicians now recommend transgender kids as young as three be allowed to live publicly as the gender they identity with, even though studies have shown most kids won't stay transgender as they grow older. ","status":"publish","parent":0,"modified":1554749296,"stats":{"hasAudio":false,"hasVideo":true,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":99,"wordCount":3721},"headData":{"title":"Is Three Too Young for Children to Know They're a Different Gender? Transgender Researchers Disagree | KQED","description":"Many gender clinicians now recommend transgender kids as young as three be allowed to live publicly as the gender they identity with, even though studies have shown most kids won't stay transgender as they grow older. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Is Three Too Young for Children to Know They're a Different Gender? Transgender Researchers Disagree","datePublished":"2018-08-26T19:47:00.000Z","dateModified":"2019-04-08T18:48:16.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440851 https://ww2.kqed.org/futureofyou/?p=440851","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/08/26/can-you-really-know-that-a-3-year-old-is-transgender/","disqusTitle":"Is Three Too Young for Children to Know They're a Different Gender? Transgender Researchers Disagree","source":"Transgender Issues","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/2018/08/brooks20180827.mp3","audioTrackLength":423,"path":"/futureofyou/440851/can-you-really-know-that-a-3-year-old-is-transgender","parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003caside>\n\u003cul>\n\u003cli>Many gender clinicians now recommend parents 'socially transition' kids who persistently express a transgender identity.\u003c/li>\n\u003cli>But research has shown most children will give up their transgender identity by the time they are adolescents.\u003c/li>\n\u003cli>Not all researchers agree, though, that this research is valid.\u003c/li>\n\u003c/ul>\n\u003c/aside>\n\u003cp>Gracie is the youngest transgender person I've ever met. She's so young, she still likes to tack on \"and-a-half\" when giving her age, which is six. One day last summer, bouncing all over the grounds at day camp, she looked as delighted as you'd expect any kid would on \"Water Day.”\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"https://www.kqed.org/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth\">The Controversial Research on 'Desistance' in Transgender Youth\u003c/a>\u003c/aside>\n\u003cp>This is Rainbow Day Camp, in the East Bay town of El Cerrito. It was created specifically to be a safe place for transgender kids, and in fact, being transgender is so unremarkable here, when I asked Gracie what makes it “special,\" she shrugged and said:\u003c/p>\n\u003cp>“You get to do fun stuff.”\u003c/p>\n\u003cp>Her mother, Molly, tried to coax a reporter-friendly answer out of her.\u003c/p>\n\u003cp>“What is special about you, and the same as everybody else in the camp?” she prompted.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“I don’t know,” Gracie said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'What if we let our son walk into the world in a dress with fairy wings, and crowns, and high heels, and even just in regular girl clothes … and then he changes his mind?'\u003ccite>Molly, whose 6-year-old daughter, Gracie, socially transitioned at age four\u003c/cite>\u003c/aside>\n\u003cp>“You’re transgender and there’s other kids that are transgender, too...”\u003c/p>\n\u003cp>“I’m transgender and there’s other kids that are transgender, too.”\u003c/p>\n\u003cp>Ah, kids. ... But when I asked Gracie how she \u003cem>used\u003c/em> to feel, when other people thought she was a boy, she got straight to the point.\u003c/p>\n\u003cp>“It was not right to me, and I didn’t want people to say that, but they said it,” she said. “It hurted my feelings a lot.\"\u003c/p>\n\u003cp>Did it make her angry?\u003c/p>\n\u003cp>“No, it just made me sad.”\u003c/p>\n\u003caside class=\"alignright\">\u003ca href=\"mailto:jbrooks@kqed.org\">Email the reporter\u003c/a>\u003c/aside>\n\u003cp>How about now?\u003c/p>\n\u003cp>“It feels happy to me.”\u003c/p>\n\u003cp>And that, in a child’s nutshell, sums up one side of a contentious debate about the right age for transgender children to begin what gender clinicians call “social transitioning.”\u003c/p>\u003c/p>\u003cp>\u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutube'>\n \u003cspan class='utils-parseShortcode-shortcodes-__youtubeShortcode__embedYoutubeInside'>\n \u003ciframe\n loading='lazy'\n class='utils-parseShortcode-shortcodes-__youtubeShortcode__youtubePlayer'\n type='text/html'\n src='//www.youtube.com/embed/IS5Yankf1GY'\n title='//www.youtube.com/embed/IS5Yankf1GY'\n allowfullscreen='true'\n style='border:0;'>\u003c/iframe>\n \u003c/span>\n \u003c/span>\u003c/p>\u003cp>\u003cp>\u003cstrong>Even Three-Year-Olds\u003c/strong>\u003c/p>\n\u003cp>When I met Gracie, she was a few months out of kindergarten — pretty young for a transgender kid, I thought. Gracie lives with her parents and younger brother in a small city in the East Bay. She is already two years into her transition, having started her public life as a girl at four. The family began by discarding her boy name and referring to Gracie as “she” and “her.” She was also allowed to wear girl clothes outside the home, and her parents changed the gender on her birth certificate to avoid confusion at school.\u003c/p>\n\u003caside class=\"alignright noborder\">\u003cstrong>How young is too young?\u003c/strong>\u003cbr>\nUCSF’s Diane Ehrensaft, one of the leading proponents of socially transitioning transgender children, believes there is no minimum age, really, to pursue such a change.'For all of these interventions, our model is stages not ages,” she said. 'When a child is at the place in their life that they can get themselves in focus, help us see them, and are clear, consistent, and stable in both their representation of themselves, and also can express their desires of how they want to live their gender, that's the age.'We have seen some kids as young as two whose parents are bringing them in because they're beginning to say, ‘Me not boy. Me girl.’ Social transition can happen as soon as a child has language or the ability to communicate to us who they are.'\u003c/aside>\n\u003cp>Steps like these make up the “social” aspects of social, not medical, transitioning. The distinction is important: According to Endocrine Society \u003ca href=\"https://academic.oup.com/jcem/article/102/11/3869/4157558\" target=\"_blank\" rel=\"noopener\">guidelines\u003c/a>, patients who want to begin medical treatment like puberty blockers, hormones or surgery should be old enough to give “informed consent,” which the organization says is usually attained by 16.\u003c/p>\n\u003cp>Therapists at \u003ca href=\"https://www.ucsfbenioffchildrens.org/clinics/child_and_adolescent_gender_center/\" target=\"_blank\" rel=\"noopener\">UCSF’s Child and Adolescent Gender Center Clinic\u003c/a> in San Francisco told me they’ve socially transitioned kids as young as three.\u003c/p>\n\u003cp>Diane Ehrensaft, the San Francisco Center’s mental health director and a leading proponent of early social transitioning, acknowledges this approach has been controversial.\u003c/p>\n\u003cp>“There are some people that think folks like myself, and the people at our clinic, have fallen off the deep end,” she told me. She wasn’t just talking about the religious right, either. She was referring to other mental health professionals.\u003c/p>\n\u003cp>I myself experienced a fair bit of surprise when Ehrensaft told me how young these kids are. My first, reflexive comment was a simple, \"Wow.\" This was not an uncommon reaction when I discussed this story with people in my own life, even in the progressive Bay Area.\u003c/p>\n\u003cp>Yet, when I spoke with Gracie’s mom, Molly (the family didn't want their last name used for reasons of privacy), nothing about the decision to allow her then-son to publicly make the switch to a girl, at an age when many kids are still sucking their thumbs, sounded in the slightest bit rash.\u003c/p>\n\u003cp>We spoke at Rainbow Day Camp, in a classroom set aside for interviews. The children’s art adorning the walls, the shrimpy seats — it felt like a place to talk about kickball, not the gender identity of first graders.\u003c/p>\n\u003cp>Yet here we were.\u003c/p>\n\u003caside class=\"alignright\">\u003cstrong>The Biological Roots of Gender Identity\u003c/strong>\u003cbr>\nMolly is the mother of two children, a 3-year-old boy and a 7-year-old transgender girl. The younger child is the “stereotype of what I thought having a son would be like,” she said. “He loves trucks, cars, construction, superheroes and destroying the house.”Her first child, also born male, just did not develop in the same way. Rather, from the time he acquired language on, he protested that he was really a girl. (\u003ca href=\"https://www.kqed.org/futureofyou/the-biological-roots-of-gender-identity\" target=\"_blank\" rel=\"noopener\">Continue reading)\u003c/a>\u003c/aside>\n\u003cp>“What if we do this?” Molly recalled asking a gender therapist, back when they were debating the pros and cons of letting Gracie transition. “What if we let our son walk into the world in a dress with fairy wings, and crowns, and high heels, and even just in regular girl clothes … and then he changes his mind?”\u003c/p>\n\u003cp>\"That's not the question,” the therapist told Molly. “The question is, what if you don't do it?”\u003c/p>\n\u003cp>It was only semi-rhetorical. Some gender therapists say there are serious potential dangers if adults suppress a child’s desired transition. On surveys, American transgender adults have reported attempting suicide at the startling \u003ca href=\"https://williamsinstitute.law.ucla.edu/wp-content/uploads/AFSP-Williams-Suicide-Report-Final.pdf\" target=\"_blank\" rel=\"noopener\">rate\u003c/a> of around 40 percent.\u003c/p>\n\u003cp>The stakes couldn’t have been higher, Molly knew.\u003c/p>\n\u003cp>At Rainbow Day Camp, recalling that time, she started to cry.\u003c/p>\n\u003cp>“As soon as I knew there was even a chance that my kid could feel ashamed of who they are, there was no way … ” Her voice cracked into a higher register. “I had to support, I had to listen, and I had to let her steer, a little bit, the ship. Period. No matter what.”\u003c/p>\n\u003cfigure id=\"attachment_441862\" class=\"wp-caption aligncenter\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/gracie-sliding-water-1.jpg\">\u003cimg class=\"wp-image-441862 size-large\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/gracie-sliding-water-1-1020x527.jpg\" alt=\"\" width=\"640\" height=\"331\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-1020x527.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-160x83.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-800x414.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-768x397.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-1200x620.jpg 1200w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-1180x610.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-960x496.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-240x124.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-375x194.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1-520x269.jpg 520w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/gracie-sliding-water-1.jpg 1209w\" sizes=\"(max-width: 640px) 100vw, 640px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Gracie, six, on Water Day at Rainbow Day Camp, which was created as a safe space for transgender kids. \u003ccite>(KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>\u003cstrong>‘I’m a Girl’\u003c/strong>\u003c/p>\n\u003cp>Ehrensaft calls children like Gracie “persistent, consistent, and insistent” in their declarations of cross-gender identity. For Gracie, this manifested through words, wishes, and, well, practically everything.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Why would we deny for the vast majority of kids something that is basically suicide prevention?'\u003ccite>Diane Ehrensaft, UCSF\u003c/cite>\u003c/aside>\n\u003cp>Gracie was her parents' first child. From toddlerhood on, Molly said, their son had displayed a “constant obsession and fixation on all things girl. As soon as she could tell us, it was, ‘I'm a girl. I'm a sister. I'm a daughter. I'm that girl on that show. I'm that girl in that book.’”\u003c/p>\n\u003cp>Gracie's parents weren’t on board at first.\u003c/p>\n\u003cp>“We filled her world with trucks, and dinosaurs, and superheroes, and we refused girl things,” Molly said. “Like, ‘No, you can't be Elsa for Halloween. You have to be Superman. No, you can't have the dolls for Christmas. We're going to get you a pirate ship.’”\u003c/p>\n\u003cp>They also made a rule: No girl clothing outside the house.\u003c/p>\n\u003cp>Molly tells me: “That’s the part I’m ashamed of now.”\u003c/p>\n\u003cp>\u003cstrong>'These Kids Do Come Forward'\u003c/strong>\u003c/p>\n\u003cp>Molly and her husband finally relented — they just could not deny how much happier their child felt when recognized as a girl.\u003c/p>\n\u003cfigure id=\"attachment_441832\" class=\"wp-caption alignright\" style=\"max-width: 640px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/Phoenix5-e1527011026777.jpg\">\u003cimg class=\"size-large wp-image-441832\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/Phoenix5-1020x1530.jpg\" alt=\"\" width=\"640\" height=\"960\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Phoenix, a transgender girl who began wearing dresses to school at age 5. She began made a complete social transition at the start of second grade. \u003ccite>(Courtesy of family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>I asked: Has Gracie ever looked back?\u003c/p>\n\u003cp>Molly chuckled.\u003c/p>\n\u003cp>“If you think of gender as a spectrum, she is like a full, all-the-way girl.”\u003c/p>\n\u003cp>It’s not rocket science, Ehrensaft explained, if you really listen to the children. “A child will say: ‘Stop calling me Jane. Let me wear my dresses. Please call me she.’ That's a child making a clear statement.”\u003c/p>\n\u003cp>Kristina Olson, a University of Washington gender researcher, said parents do not always listen to what their kids are telling them.\u003c/p>\n\u003cp>“The ones that are most likely to transition are kids who for many years are very consistently saying this is who they are,” she said. ”We often see this happen for years before parents socially transition their kids.”\u003c/p>\n\u003cp>UCSF gender specialist Erica Anderson recently treated a five-year-old who had reached a point of desperation.\u003c/p>\n\u003cp>“In the bathtub, he would compare himself to his younger sister, and really start getting upset. At one point he went in the bathroom with a pair of shears — he was going to cut his penis off.”\u003c/p>\n\u003cp>“This child has been so clear for a couple of years,” Anderson said. “These kids do come forward.”\u003c/p>\n\u003cp>\u003cstrong>Changing Approaches\u003c/strong>\u003c/p>\n\u003cp>Gender clinicians who recommend social transition at such an early age call their model “gender affirmative,” and they believe their approach is now ascendant. Historically, clinicians more commonly treated transgender kids by discouraging cross-gender identity. The method was most famously practiced by longtime gender researcher Ken Zucker.\u003c/p>\n\u003cp>Zucker is now an extraordinarily controversial figure in the transgender community. He believed that an outcome in which a child becomes transgender should be avoided, if possible. You can get a glimpse of his methods in this \u003ca href=\"https://www.npr.org/2008/05/07/90247842/two-families-grapple-with-sons-gender-preferences\" target=\"_blank\" rel=\"noopener\">NPR story\u003c/a> from 2008. Zucker is counseling the family of a young boy he’d diagnosed with gender identity disorder, the term used for gender dysphoria before 2013.\u003c/p>\n\u003cblockquote>\u003cp>Zucker explained to Carol that she and her husband would have to radically change their parenting. Bradley would no longer be allowed to spend time with girls. He would no longer be allowed to play with girlish toys or pretend that he was a female character. Zucker said that all of these activities were dangerous to a kid with gender identity disorder. He explained that unless Carol and her husband helped the child to change his behavior, as Bradley grew older, he likely would be rejected by both peer groups.\u003c/p>\u003c/blockquote>\n\u003cp>Other researchers and transgender activists have criticized this approach as too close to the “conversion therapy” inflicted on gay and lesbian youth, a practice that is now illegal in a number of states, including \u003ca href=\"https://www.sfgate.com/news/article/State-bans-gay-repair-therapy-for-minors-3906032.php\" target=\"_blank\" rel=\"noopener\">California\u003c/a>.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"emailsignup","attributes":{"named":{"newslettername":"science","align":"right","label":""},"numeric":[]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>The World Professional Association for Transgender Health's guidelines for clinicians, called the \u003ca href=\"https://www.wpath.org/publications/soc\" target=\"_blank\" rel=\"noopener\">Standards of Care\u003c/a>, states that “treatment aimed at trying to change a person’s gender identity and expression to become more congruent with sex assigned at birth” is “no longer considered ethical.”\u003c/p>\n\u003cp>Zucker was the psychologist-in-chief and head of the gender identity clinic at a Toronto mental health hospital before administrators shut down the clinic in 2015, after a review of his practices. That was also \u003ca href=\"https://www.theglobeandmail.com/life/health-and-fitness/health/alleged-exchange-with-gender-identity-doctor-didnt-happen-camh-says/article28471923/\" target=\"_blank\" rel=\"noopener\">controversial\u003c/a>, and Zucker is suing his former employer for defamation. (Zucker declined to comment for this article. For a defense of his work, you can read Jesse Singal’s \u003ca href=\"https://www.thecut.com/2016/02/fight-over-trans-kids-got-a-researcher-fired.html\" target=\"_blank\" rel=\"noopener\">reporting\u003c/a> from 2016.)\u003c/p>\n\u003cp>\u003cstrong>Watchful Waiting\u003c/strong>\u003c/p>\n\u003cp>Zucker’s approach aside, there is another alternative to gender affirmative therapy. It’s the approach taken by the \u003ca href=\"https://www.vumc.com/branch/gender-dysphoria/\" target=\"_blank\" rel=\"noopener\">Center of Expertise on Gender Dysphoria\u003c/a> in Amsterdam, and gender specialists commonly refer to it as the “Dutch Model.”\u003c/p>\n\u003cp>This treatment sometimes involves the social transition of young children, according to Thomas Steensma, a researcher and clinician at the center. But for the most part, its counseling incorporates the idea that the vast majority of gender dysphoric children will eventually stop identifying as transgender.\u003c/p>\n\u003cp>The research literature calls these individuals “desistant.” The kids who retain their transgender identity as they grow up are dubbed “persistent.”\u003c/p>\n\u003cp>\u003cstrong>The Desistance Controversy\u003c/strong>\u003c/p>\n\u003cp>Nothing roils the world of transgender research like the topic of \u003ca href=\"https://www.kqed.org/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth\" target=\"_blank\" rel=\"noopener\">desistance\u003c/a>. Brynn Tannehill, a transgender activist who follows the research closely, said the concept is often used by anti-LGBT groups to make the case that rejecting children’s transgender identity is in their best interests.\u003c/p>\n\u003caside class=\"pullquote alignright\">'[Desistance research] is used primarily as an attack on the validity of transgender identities, which usually quickly disintegrates into a debate on whether we should exist.' \u003ccite>Brynn Tannehill, transgender activist\u003c/cite>.\u003c/aside>\n\u003cp>“It is used primarily as an attack on the validity of transgender identities, which usually quickly disintegrates into a debate on whether we should exist,” Tannehill said.\u003c/p>\n\u003cp>And yet, the fact is that just about every published study on the topic to date has found that a majority of children who once reported various degrees of gender dysphoria ended up eventually giving up their transgender identity.\u003c/p>\n\u003cp>To grasp the implications of this, remember Molly’s anxious questioning of the gender therapist: What if we go through all this, and it turns out to be just a phase? Shouldn’t we wait?\u003c/p>\n\u003cp>The gender affirmative camp says no. That’s because it doesn’t believe that the body of research on desistance, some of it conducted by Zucker and his associates, is valid.\u003c/p>\n\u003cp>Many gender researchers maintain that the current criteria for diagnosing gender dysphoria are much more stringent than in the past. Therefore, many of the studies that found so many kids had \"grown out\" of their transgender identity were actually measuring children who were \u003cem>never really transgender\u003c/em> in the first place.\u003c/p>\n\u003cp>“Some of those studies are decades old,” said gender researcher Kristina Olson. “So if you had a son in the early 1980s who liked playing with dolls and wanted to occasionally wear a dress, even today maybe you would think to bring that child to talk to a doctor about it. But that child wouldn't necessarily be transgender, because that kid doesn't necessarily think of himself as a girl.\"\u003c/p>\n\u003cp>Ehrensaft said that her San Francisco clinic sees “a tiny, tiny proportion” of clients who stop identifying as transgender after transitioning.\u003c/p>\n\u003cp>Even the Amsterdam clinic’s Thomas Steensma, who firmly believes most gender dysphoric kids will \u003cem>not\u003c/em> grow up to be transgender, acknowledged the earlier studies probably included “milder cases” that are “hard to compare with the clinical samples we see now in our clinics.”\u003c/p>\n\u003cfigure id=\"attachment_441834\" class=\"wp-caption alignright\" style=\"max-width: 720px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/James.jpeg\">\u003cimg class=\"size-full wp-image-441834\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2020/04/James.jpeg\" alt=\"\" width=\"720\" height=\"960\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2020/04/James.jpeg 720w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-160x213.jpeg 160w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-240x320.jpeg 240w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-375x500.jpeg 375w, https://ww2.kqed.org/app/uploads/sites/13/2020/04/James-520x693.jpeg 520w\" sizes=\"(max-width: 720px) 100vw, 720px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Olivia, a transgender girl who socially transitioned when she was four, and her brother, James, who transitioned when he was eight. \u003ccite>(Courtesy of family)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Nevertheless, he said, “The only evidence I have from studies and reports in the literature ... is that children who struggle with gender incongruence … will not all persist into adolescence.\"\u003c/p>\n\u003cp>Talking to Steensma over Skype, he seemed bemused by the fact that the “Dutch model” is now considered conservative compared to what has taken hold in America. After all, his Amsterdam clinic had been a pioneer in the medical treatment of transgender youth, especially in the use of puberty blockers, which delay the onset of secondary sex characteristics.\u003c/p>\n\u003cp>But what about the \u003cem>social transitioning\u003c/em> of young kids?\u003c/p>\n\u003cp>\"It's not a 'yes' or a 'no' in our opinion, but a 'maybe,' Steensma told me.\u003c/p>\n\u003cp>I wondered if there was any real argument between him and Ehrensaft, after all. So I described to him the case of persistent, insistent, consistent Gracie.\u003c/p>\n\u003cp>A slam dunk for social transition?\u003c/p>\n\u003cp>Steensma said no.\u003c/p>\n\u003cp>“We would counsel them ... that it's okay to express your feelings, your interests, to show your behaviors. But with certain steps like a name change, or a pronoun change, with a result that maybe others will only perceive you as a girl — that's somewhere where we say, ‘Okay, maybe you should explore things without taking steps that are hard to reverse.’”\u003c/p>\n\u003cp>There are mental health professionals in the U.S. who agree. Dr. Jack Drescher is a clinical professor of psychiatry at Columbia University; he served on the American Psychiatric Association's committee that revised the diagnosis of gender identity disorder in 2013. He said gender affirmative therapists have never proven they can successfully identify those kids who will stick with transgender identity.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There are some people that think folks like myself, and the people at our clinic, have fallen off the deep end.”\u003ccite>Diane Ehrensaft, UCSF\u003c/cite>\u003c/aside>\n\u003cp>He also says there’s no evidence to back a corollary belief, that kids who might later need to “detransition” back to their original gender will not suffer any long-lasting psychological effects.\u003c/p>\n\u003cp>“This is what they believe, but it's not based on research,” he said of gender affirmative clinicians. “This is a meme, not really a piece of scientific finding.”\u003c/p>\n\u003cp>Steensma concurred: “If a child transitions, it is not just, ‘Oh, we do the transition and we go on with our life.’ It has a huge impact on the child, on the family and their environment.’”\u003c/p>\n\u003cp>The current Standards of Care, issued by the World Professional Association of Transgender Health in 2011, are more or less in accordance with this view, as even Ehrensaft acknowledges. The guidelines describe “relatively low persistence rates” as “relevant” to helping parents weigh the decision to socially transition. The standards also state that “a change back to the original gender role can be highly distressing.”\u003c/p>\n\u003cp>The one thing everyone in the field agrees on is more research is needed. Almost every gender specialist I spoke with cited Kristina Olson’s longitudinal study at the University of Washington as critical to answering some of these hotly debated unknowns. Olson recently received a $1 million grant from the National Science Foundation, which she's using to expand the study.\u003c/p>\n\u003cp>Preliminary research coming out of the project has already provided good news for the families of transgender kids. In a pair of studies published over the last several years, Olson and her colleagues found that socially transitioned children and adolescents between the ages of 3 and 14 did \u003ca href=\"https://www.kqed.org/stateofhealth/153172/transgender-children-living-openly-are-doing-well-study-shows\" target=\"_blank\" rel=\"noopener\">not experience\u003c/a> any more depression than separate control groups of peers and siblings, as well as the general population.\u003c/p>\n\u003cp>The transgender health association is now gearing up to revise the Standards of Care. Both Steensma, known for “watchful waiting,” and Ehrensaft, of the gender affirmative school, are on the committee in charge of the section about children. The jockeying to influence the direction of the committee has already begun, as evidenced by the critical \u003ca href=\"https://www.tandfonline.com/doi/full/10.1080/15532739.2018.1456390\" target=\"_blank\" rel=\"noopener\">commentaries\u003c/a> now appearing in academic \u003ca href=\"https://www.tandfonline.com/doi/abs/10.1080/15532739.2017.1414649\" target=\"_blank\" rel=\"noopener\">journals\u003c/a>.\u003c/p>\n\u003cp>“My prediction is that there will be more endorsement of social transitions at earlier ages, without the cautionary tales,” Ehrensaft said of the upcoming revision.\u003c/p>\n\u003cp>\u003cb>Not Just Numbers\u003c/b>\u003c/p>\n\u003cp>When it comes down to it, when we talk about the controversy over socially transitioning young kids, we are talking about risk analysis. Which is more disruptive and potentially harmful: to deny children their genuinely felt gender identity in the present moment, until the adults are \u003cem>absolutely sure\u003c/em> it will stick? Or to validate a child’s persistent, consistent and insistent protestations that ‘\u003cem>Hey, someone has made a terrible mistake here,\u003c/em>’ even if they eventually decide they no longer feel that way?\u003c/p>\n\u003cp>Ehrensaft, at least, is clear on the answer:\u003c/p>\n\u003cp>“Why would we deny for the vast majority of kids something that is basically suicide prevention?”\u003c/p>\n\u003cp>As a parent, I wonder: If my daughter became incandescently happy when allowed to change her name and take on other aspects of being transgender — as happy as Molly describes Gracie becoming when recognized as a girl — what would I do? If some statistics indicated my child might one day switch back, but my deepest parental instincts told me to trust her joyfulness, could I ignore the latter?\u003c/p>\n\u003cp>At Rainbow Day Camp, I spoke to James, a 9-year-old transgender boy who’d transitioned during second grade. He told me matter-of-factly that he’d been bullied by older kids, who’d called him an “It.”\u003c/p>\n\u003cp>After he transitioned, his mother said, “There was just this comfort that came about him, and comfort's something that you can't really fake. He’s [just] a happier kid.”\u003c/p>\n\u003cp>Similarly, before Gracie’s transition, family life was “lackluster,” Molly recalled. The constant tension drained the joy out of childhood for everybody.\u003c/p>\n\u003cp>“You never got to see that sort of sparkle, or that sort of magic of, like, a Christmas morning, or a Halloween, or just regular day-to-day happiness,” Molly said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>“Now she gets to really live.”\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440851/can-you-really-know-that-a-3-year-old-is-transgender","authors":["80"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_491","futureofyou_1605","futureofyou_1275","futureofyou_80","futureofyou_1504","futureofyou_1018"],"featImg":"futureofyou_441819","label":"source_futureofyou_440851"},"futureofyou_441784":{"type":"posts","id":"futureofyou_441784","meta":{"index":"posts_1591205157","site":"futureofyou","id":"441784","score":null,"sort":[1527087002000]},"guestAuthors":[],"slug":"the-controversial-research-on-desistance-in-transgender-youth","title":"The Controversial Research on 'Desistance' in Transgender Youth","publishDate":1527087002,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The phenomenon of transgender children \"growing out of\" their transgender identity by the time they are adolescents or adults is called “desistance” by gender researchers.\u003c/p>\n\u003cp>For decades, follow-up studies of transgender kids have shown that a substantial majority -- anywhere from 65 to 94 percent -- eventually ceased to identify as transgender.\u003c/p>\n\u003caside class=\"alignright\">One study found that older children, girls, and those kids who reported more intense gender dysphoria were more likely to stick with their transgender identity as adolescents.\u003c/aside>\n\u003cp>These findings have become part and parcel of the \"How young is too young?\" debate over \"social transitioning,\" the term for allowing kids to publicly live as their identified gender in every way short of medical treatment.\u003c/p>\n\u003cp>If most kids will eventually cease to be transgender, some clinicians have reasoned, isn’t it more prudent to take the least disruptive path in coping with a child's gender dysphoria? That way, if or when kids later stop identifying as transgender, they will have less to “undo.”\u003c/p>\n\u003cp>In recent years, though, a new school of thought has emerged. Many gender specialists now believe that the best course for a transgender child is often “social transition,” where kids as young as three are allowed to change their names, pronouns and style of dress to match the gender they identify with.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cstrong>Looking at the Research\u003c/strong>\u003c/p>\n\u003cp>One reason many researchers believe it’s unnecessary to delay the social transition of a child is that they don’t think the research on desistance is valid. In other words, they think the number of children who \"grow out of\" their transgender identity has been vastly overblown.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The only evidence I have from studies and reports in the literature ... is that not all transgender children will persist in their transgender identity'\u003ccite>Thomas Steensma, VU University Medical Center, Center of Expertise on Gender Dysphoria\u003c/cite>\u003c/aside>\n\u003cp>This school of thought holds that because the criteria for a diagnosis of gender dysphoria (previously called gender identity disorder) was less stringent in the past, the earlier desistance studies included a large cohort of children who today would not be diagnosed with gender dysphoria, gay boys who may have been experimenting with different ways of expressing gender but who were never really transgender in the first place.\u003c/p>\n\u003cp>“The methodology of those studies is very flawed, because they didn't study gender identity,” said Diane Ehrensaft, director of mental health at UCSF’s Child and Adolescent Gender Clinic. “Those desistors were, a good majority of them, simply proto-gay boys whose parents were upset because they were boys wearing dresses. They were brought to the clinics because they weren't fitting gender norms.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"//datawrapper.dwcdn.net/8gbLb/1/\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>In Amsterdam, clinicians at the Center of Expertise on Gender Dysphoria are much more cautious about recommending social transitions because of the statistics on desistance. Thomas Steensma, a researcher and clinician at the center, acknowledges these studies probably included some kids who would not be diagnosed with gender dysphoria today. Nevertheless, despite the problems with the way they classified children, \"the only evidence I have from studies and reports in the literature ... is that not all transgender children will persist in their transgender identity,\" Steensma said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Why are we asking a child to conform to something that is not them because society hasn't done its learning yet?'\u003ccite>Diane Ehrensaft, UCSF\u003c/cite>\u003c/aside>\n\u003cp>In 2013, Steensma co-authored an oft-cited \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23702447\" target=\"_blank\" rel=\"noopener\">study\u003c/a> that examined 127 adolescents, all of whom had displayed various levels of gender dysphoria as children. The researchers found that 80 of the children had desisted by the ages of 15 and 16. That works out to 63 percent of kids who basically stopped being transgender -- a lower rate than in previous studies, but still a majority.\u003c/p>\n\u003cp>Some clinicians criticize this study, however, on methodological grounds, because the researchers defined anyone who did not return to their clinic as desisting. Fifty-two of the children classified as desistors or their parents did send back questionnaires showing the subjects' present lack of gender dysphoria. But 28 neither responded nor could be tracked down.\u003c/p>\n\u003cp>“You can't do that in scientific studies,” Ehrensaft said. “You have to have your subjects in front of you and know who they are. You can't just assume somebody is in a category because you don't see them anymore.”\u003c/p>\n\u003cp>In addition, 38 of the 127 kids were originally designated “subthreshold” for gender identity disorder, meaning they did not fulfill all the criteria for meeting the official diagnosis.\u003c/p>\n\u003cp>This, according to Erica Anderson, a gender clinician at UCSF, makes the desistance findings even more suspect.\" [It] begs the question of whether these kids were actually divergent [in their gender identity] before the study selected them,” she said.\u003c/p>\n\u003cp>Steensma stands by the study’s methodology. But interestingly, he added that citing these findings as a measure of desistance is wrongheaded, because the study was never designed with that goal in mind.\u003c/p>\n\u003cp>“Providing these [desistance] numbers will only lead to wrong conclusions,” he said.\u003c/p>\n\u003cfigure id=\"attachment_441933\" class=\"wp-caption alignright\" style=\"max-width: 385px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/Ehrensaft.jpg\">\u003cimg class=\" wp-image-441933\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/Ehrensaft-1020x1528.jpg\" alt=\"\" width=\"385\" height=\"577\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-1020x1528.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-800x1198.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-768x1150.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-801x1200.jpg 801w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-1180x1768.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-960x1438.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-240x360.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-375x562.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-520x779.jpg 520w\" sizes=\"(max-width: 385px) 100vw, 385px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Diane Ehrensaft, director of mental health at UCSF's gender clinic. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Rather, he says, the researchers wanted to see if they could find predictors of persistence. Which they did: The study found that transgender children who were older, born female, and reported more intense gender dysphoria were more likely to stick with their transgender identity than younger children, natal boys and those with less pronounced gender dysphoric traits.\u003c/p>\n\u003cp>Steensma and colleagues also culled one very specific indicator of future persistence: When asked when they were children, “Are you a boy or a girl?” those who answered the opposite of their birth sex were found more likely to have retained their gender identity in adolescence. The desistors, on the other hand, tended to merely \u003cem>wish\u003c/em> they were the opposite sex.\u003c/p>\n\u003cp>“(E)xplicitly asking children with GD (gender dysphoria) with which sex they identify seems to be of great value in predicting a future outcome for both boys and girls with GD,” the study says.\u003c/p>\n\u003cp>Today, Steensma cautions that this question is not a litmus test for which children will persist in their transgender identity. He believes that gender identity in kids is still developing, and that it’s responsive to what occurs at different life stages. He also says it’s possible that a social transition could lead to persistence where it otherwise might not have occurred.\u003c/p>\n\u003cp>“That's not something we can answer,” he said. “It's something we have to study and find out.”\u003c/p>\n\u003cp>\u003cstrong>‘It’s Time to Teach Society’\u003c/strong>\u003c/p>\n\u003cp>Another contentious topic in the transgender community is what the literature calls “detransitioning,” or reverting back to one's natal gender.\u003c/p>\n\u003cp>The current Standards of Care written by the World Professional Association for Transgender Health cautions that “a change back to the original gender role can be highly distressing” The guidelines use that assertion as a reason to be cautious about early social transitioning.\u003c/p>\n\u003cp>But the cautionary language, Ehrensaft points out, is based on one qualitative study, coauthored by Steensma, which looked at the dilemma of just two Dutch girls who’d transitioned when they were in elementary school and wanted to switch back. She doesn’t think it’s particularly relevant.\u003c/p>\n\u003cp>“The stress [of detransitioning] comes from microaggressions and lack of acceptance in the environment,” she said. “If we offer social support and opportunities for children over time, we don’t have any evidence that [detransitioning] will be damaging for them.”\u003c/p>\n\u003cp>Ehrensaft believes the conventional treatment of transgender children has been based, for the most part, on traditionally negative views of gender nonconformity. So, she believes, the burden is now on the culture to see transgender children as they really are.\u003c/p>\n\u003cp>“Why are we asking a child to conform to something that is not them because society hasn't done its learning yet?”she says. “It's time to teach society.”\u003c/p>\n\u003cp>\u003cstrong>Toward the Nonbinary\u003c/strong>\u003c/p>\n\u003cp>One of the more interesting takes I heard on persistence and desistance came from UCSF gender clinician Erica Anderson, who is transgender herself. She views the very notion of measuring persistence/desistance as something of a fool’s errand, because such definitions are mediated by changing cultural norms, the self-perceptions of children and the ways that researchers interpret them.\u003c/p>\n\u003cp>“We’ve got kids of varying sophistication levels of language trying to explain to other people who have no experience [being transgender],\" Anderson said, \"and it’s being driven by shifting professional understanding or consensus and culture. You’ve got moving parts. In that context we’ve got a dynamic situation where kids who might say ‘I’m a girl’ might have said five years ago ‘maybe I’m a girl.’ ”\u003c/p>\n\u003cp>Ehrensaft herself doesn’t even like to use the terms persistence and desistance. Those words imply something fixed — a binary state of yes or no. But younger generations of transgender people — and even \u003ca href=\"https://fusiondotnet.files.wordpress.com/2015/02/fusion-poll-gender-spectrum.pdf\" target=\"_blank\" rel=\"noopener\">younger generations\u003c/a> in the general population — see gender as more protean, even customizable. Of nearly 28,000 respondents to the \u003ca href=\"http://www.ustranssurvey.org/\" target=\"_blank\" rel=\"noopener\">2015 U.S. Transgender Survey\u003c/a>, more than one-third said they were some form of \u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>. That means they may identify as both male and female, neither male nor female, or \u003cem>sometimes\u003c/em> male, \u003cem>sometimes\u003c/em> female.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>This, in theory, could solve a lot of problems. After all, if the gender fluidity trend continues, perhaps many people will have no unitary gender to \"persist\" or \"desist\" from.\u003c/p>\n\n","blocks":[],"excerpt":"For decades, follow-up studies of transgender kids have shown that a substantial majority eventually ceased to identify as transgender. But some gender researchers say that research is faulty.","status":"publish","parent":0,"modified":1527220854,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":37,"wordCount":1631},"headData":{"title":"The Controversial Research on 'Desistance' in Transgender Youth | KQED","description":"For decades, follow-up studies of transgender kids have shown that a substantial majority eventually ceased to identify as transgender. But some gender researchers say that research is faulty.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"The Controversial Research on 'Desistance' in Transgender Youth","datePublished":"2018-05-23T14:50:02.000Z","dateModified":"2018-05-25T04:00:54.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"441784 https://ww2.kqed.org/futureofyou/?p=441784","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/05/23/the-controversial-research-on-desistance-in-transgender-youth/","disqusTitle":"The Controversial Research on 'Desistance' in Transgender Youth","source":"Transgender Issues","path":"/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The phenomenon of transgender children \"growing out of\" their transgender identity by the time they are adolescents or adults is called “desistance” by gender researchers.\u003c/p>\n\u003cp>For decades, follow-up studies of transgender kids have shown that a substantial majority -- anywhere from 65 to 94 percent -- eventually ceased to identify as transgender.\u003c/p>\n\u003caside class=\"alignright\">One study found that older children, girls, and those kids who reported more intense gender dysphoria were more likely to stick with their transgender identity as adolescents.\u003c/aside>\n\u003cp>These findings have become part and parcel of the \"How young is too young?\" debate over \"social transitioning,\" the term for allowing kids to publicly live as their identified gender in every way short of medical treatment.\u003c/p>\n\u003cp>If most kids will eventually cease to be transgender, some clinicians have reasoned, isn’t it more prudent to take the least disruptive path in coping with a child's gender dysphoria? That way, if or when kids later stop identifying as transgender, they will have less to “undo.”\u003c/p>\n\u003cp>In recent years, though, a new school of thought has emerged. Many gender specialists now believe that the best course for a transgender child is often “social transition,” where kids as young as three are allowed to change their names, pronouns and style of dress to match the gender they identify with.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cstrong>Looking at the Research\u003c/strong>\u003c/p>\n\u003cp>One reason many researchers believe it’s unnecessary to delay the social transition of a child is that they don’t think the research on desistance is valid. In other words, they think the number of children who \"grow out of\" their transgender identity has been vastly overblown.\u003c/p>\n\u003caside class=\"pullquote alignright\">'The only evidence I have from studies and reports in the literature ... is that not all transgender children will persist in their transgender identity'\u003ccite>Thomas Steensma, VU University Medical Center, Center of Expertise on Gender Dysphoria\u003c/cite>\u003c/aside>\n\u003cp>This school of thought holds that because the criteria for a diagnosis of gender dysphoria (previously called gender identity disorder) was less stringent in the past, the earlier desistance studies included a large cohort of children who today would not be diagnosed with gender dysphoria, gay boys who may have been experimenting with different ways of expressing gender but who were never really transgender in the first place.\u003c/p>\n\u003cp>“The methodology of those studies is very flawed, because they didn't study gender identity,” said Diane Ehrensaft, director of mental health at UCSF’s Child and Adolescent Gender Clinic. “Those desistors were, a good majority of them, simply proto-gay boys whose parents were upset because they were boys wearing dresses. They were brought to the clinics because they weren't fitting gender norms.”\u003c/p>\n\u003cp>\u003c!-- iframe plugin v.4.3 wordpress.org/plugins/iframe/ -->\u003cbr>\n\u003ciframe src=\"//datawrapper.dwcdn.net/8gbLb/1/\" width=\"100%\" height=\"500\" scrolling=\"yes\" class=\"iframe-class\" frameborder=\"0\">\u003c/iframe>\u003c/p>\n\u003cp>In Amsterdam, clinicians at the Center of Expertise on Gender Dysphoria are much more cautious about recommending social transitions because of the statistics on desistance. Thomas Steensma, a researcher and clinician at the center, acknowledges these studies probably included some kids who would not be diagnosed with gender dysphoria today. Nevertheless, despite the problems with the way they classified children, \"the only evidence I have from studies and reports in the literature ... is that not all transgender children will persist in their transgender identity,\" Steensma said.\u003c/p>\n\u003caside class=\"pullquote alignright\">'Why are we asking a child to conform to something that is not them because society hasn't done its learning yet?'\u003ccite>Diane Ehrensaft, UCSF\u003c/cite>\u003c/aside>\n\u003cp>In 2013, Steensma co-authored an oft-cited \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/23702447\" target=\"_blank\" rel=\"noopener\">study\u003c/a> that examined 127 adolescents, all of whom had displayed various levels of gender dysphoria as children. The researchers found that 80 of the children had desisted by the ages of 15 and 16. That works out to 63 percent of kids who basically stopped being transgender -- a lower rate than in previous studies, but still a majority.\u003c/p>\n\u003cp>Some clinicians criticize this study, however, on methodological grounds, because the researchers defined anyone who did not return to their clinic as desisting. Fifty-two of the children classified as desistors or their parents did send back questionnaires showing the subjects' present lack of gender dysphoria. But 28 neither responded nor could be tracked down.\u003c/p>\n\u003cp>“You can't do that in scientific studies,” Ehrensaft said. “You have to have your subjects in front of you and know who they are. You can't just assume somebody is in a category because you don't see them anymore.”\u003c/p>\n\u003cp>In addition, 38 of the 127 kids were originally designated “subthreshold” for gender identity disorder, meaning they did not fulfill all the criteria for meeting the official diagnosis.\u003c/p>\n\u003cp>This, according to Erica Anderson, a gender clinician at UCSF, makes the desistance findings even more suspect.\" [It] begs the question of whether these kids were actually divergent [in their gender identity] before the study selected them,” she said.\u003c/p>\n\u003cp>Steensma stands by the study’s methodology. But interestingly, he added that citing these findings as a measure of desistance is wrongheaded, because the study was never designed with that goal in mind.\u003c/p>\n\u003cp>“Providing these [desistance] numbers will only lead to wrong conclusions,” he said.\u003c/p>\n\u003cfigure id=\"attachment_441933\" class=\"wp-caption alignright\" style=\"max-width: 385px\">\u003ca href=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/Ehrensaft.jpg\">\u003cimg class=\" wp-image-441933\" src=\"https://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2018/05/Ehrensaft-1020x1528.jpg\" alt=\"\" width=\"385\" height=\"577\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-1020x1528.jpg 1020w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-160x240.jpg 160w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-800x1198.jpg 800w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-768x1150.jpg 768w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-801x1200.jpg 801w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft.jpg 1920w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-1180x1768.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-960x1438.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-240x360.jpg 240w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-375x562.jpg 375w, https://ww2.kqed.org/app/uploads/sites/13/2018/05/Ehrensaft-520x779.jpg 520w\" sizes=\"(max-width: 385px) 100vw, 385px\">\u003c/a>\u003cfigcaption class=\"wp-caption-text\">Diane Ehrensaft, director of mental health at UCSF's gender clinic. \u003ccite>(Lauren Hanussak/KQED)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Rather, he says, the researchers wanted to see if they could find predictors of persistence. Which they did: The study found that transgender children who were older, born female, and reported more intense gender dysphoria were more likely to stick with their transgender identity than younger children, natal boys and those with less pronounced gender dysphoric traits.\u003c/p>\n\u003cp>Steensma and colleagues also culled one very specific indicator of future persistence: When asked when they were children, “Are you a boy or a girl?” those who answered the opposite of their birth sex were found more likely to have retained their gender identity in adolescence. The desistors, on the other hand, tended to merely \u003cem>wish\u003c/em> they were the opposite sex.\u003c/p>\n\u003cp>“(E)xplicitly asking children with GD (gender dysphoria) with which sex they identify seems to be of great value in predicting a future outcome for both boys and girls with GD,” the study says.\u003c/p>\n\u003cp>Today, Steensma cautions that this question is not a litmus test for which children will persist in their transgender identity. He believes that gender identity in kids is still developing, and that it’s responsive to what occurs at different life stages. He also says it’s possible that a social transition could lead to persistence where it otherwise might not have occurred.\u003c/p>\n\u003cp>“That's not something we can answer,” he said. “It's something we have to study and find out.”\u003c/p>\n\u003cp>\u003cstrong>‘It’s Time to Teach Society’\u003c/strong>\u003c/p>\n\u003cp>Another contentious topic in the transgender community is what the literature calls “detransitioning,” or reverting back to one's natal gender.\u003c/p>\n\u003cp>The current Standards of Care written by the World Professional Association for Transgender Health cautions that “a change back to the original gender role can be highly distressing” The guidelines use that assertion as a reason to be cautious about early social transitioning.\u003c/p>\n\u003cp>But the cautionary language, Ehrensaft points out, is based on one qualitative study, coauthored by Steensma, which looked at the dilemma of just two Dutch girls who’d transitioned when they were in elementary school and wanted to switch back. She doesn’t think it’s particularly relevant.\u003c/p>\n\u003cp>“The stress [of detransitioning] comes from microaggressions and lack of acceptance in the environment,” she said. “If we offer social support and opportunities for children over time, we don’t have any evidence that [detransitioning] will be damaging for them.”\u003c/p>\n\u003cp>Ehrensaft believes the conventional treatment of transgender children has been based, for the most part, on traditionally negative views of gender nonconformity. So, she believes, the burden is now on the culture to see transgender children as they really are.\u003c/p>\n\u003cp>“Why are we asking a child to conform to something that is not them because society hasn't done its learning yet?”she says. “It's time to teach society.”\u003c/p>\n\u003cp>\u003cstrong>Toward the Nonbinary\u003c/strong>\u003c/p>\n\u003cp>One of the more interesting takes I heard on persistence and desistance came from UCSF gender clinician Erica Anderson, who is transgender herself. She views the very notion of measuring persistence/desistance as something of a fool’s errand, because such definitions are mediated by changing cultural norms, the self-perceptions of children and the ways that researchers interpret them.\u003c/p>\n\u003cp>“We’ve got kids of varying sophistication levels of language trying to explain to other people who have no experience [being transgender],\" Anderson said, \"and it’s being driven by shifting professional understanding or consensus and culture. You’ve got moving parts. In that context we’ve got a dynamic situation where kids who might say ‘I’m a girl’ might have said five years ago ‘maybe I’m a girl.’ ”\u003c/p>\n\u003cp>Ehrensaft herself doesn’t even like to use the terms persistence and desistance. Those words imply something fixed — a binary state of yes or no. But younger generations of transgender people — and even \u003ca href=\"https://fusiondotnet.files.wordpress.com/2015/02/fusion-poll-gender-spectrum.pdf\" target=\"_blank\" rel=\"noopener\">younger generations\u003c/a> in the general population — see gender as more protean, even customizable. Of nearly 28,000 respondents to the \u003ca href=\"http://www.ustranssurvey.org/\" target=\"_blank\" rel=\"noopener\">2015 U.S. Transgender Survey\u003c/a>, more than one-third said they were some form of \u003ca href=\"https://www.kqed.org/futureofyou/335790/boy-girl-both-neither-a-new-generation-overthrows-gender\" target=\"_blank\" rel=\"noopener\">nonbinary\u003c/a>. That means they may identify as both male and female, neither male nor female, or \u003cem>sometimes\u003c/em> male, \u003cem>sometimes\u003c/em> female.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>This, in theory, could solve a lot of problems. After all, if the gender fluidity trend continues, perhaps many people will have no unitary gender to \"persist\" or \"desist\" from.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/441784/the-controversial-research-on-desistance-in-transgender-youth","authors":["80"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_80","futureofyou_1018"],"featImg":"futureofyou_441804","label":"source_futureofyou_441784"},"futureofyou_440806":{"type":"posts","id":"futureofyou_440806","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440806","score":null,"sort":[1523656607000]},"guestAuthors":[],"slug":"federal-government-awards-1-million-for-study-of-transgender-children","title":"Federal Government Awards $1 Million for Study of Transgender Children","publishDate":1523656607,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The first large-scale, national study of transgender children, including some as young as 3, is poised to expand thanks to a five-year, $1 million grant awarded Thursday by the National Science Foundation to the professor leading the project.\u003c/p>\n\u003cp>University of Washington psychologist Kristina Olson, 36, was named winner of the NSF's annual Alan T. Waterman Award, the government's highest honor for scientists still in the early phases of their careers. The NSF said the choice was unanimous, and noted that pediatricians are already using her findings to raise awareness about gender diversity.\u003c/p>\n\u003cp>While the award citation honors Olson for a broad range of her research on children's perceptions, she has become best known as creator and leader of the TransYouth Project, which is widely considered the most ambitious long-term study of transgender children being conducted in the U.S.\u003c/p>\n\u003cp>Launched in 2013, the project has recruited more than 300 children ages 3-12 from 45 states, with the goal of tracking their development over 20 years. The NSF grant will help Olson maintain the study as many of the children go through adolescence; she hopes to continue it into their adulthood.\u003c/p>\n\u003cp>\"'Transgender children' is a category we have so little scientific knowledge about,\" says Olson. \"I'm interested in their experience of feeling you are in a social category that other people don't think you're a part of.\"\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Some of the study's early findings were reported two years ago in the journal Pediatrics — notably that the 73 children being tracked at that time had rates of depression and anxiety no higher than non-transgender children in control groups. The trans children were supported by their families and allowed to live openly as the gender they identify with — suggesting to Olson that family support was a key to avoiding the mental health problems identified in studies of other transgender youths.\u003c/p>\n\u003cp>\"In a very scientific way, our study shows that this group of kids is doing really, really well,\" she said in a telephone interview.\u003c/p>\n\u003cp>She hopes the NSF grant will enable her to expand the study to encompass youths who are in the process of gender transition but haven't completed it. Some of the funds will be used for Olson's work on other topics, including race and inequality, and also to support research opportunities for undergraduates.\u003c/p>\n\u003cp>The TransYouth Project received positive coverage following the Pediatrics article, but Olson's research also has been the target of criticism. An article last year in The Federalist, a conservative online magazine, asserted that it was \"utterly ridiculous\" to open a study on gender identity to a 3-year-old child \"who is just learning to use the bathroom, spell his name, and the days of the week.\"\u003c/p>\n\u003cp>However, Olson said children of that age, whether transgender or not, show awareness of gender identity in many ways, through their self-descriptions, what they wear, who they prefer to play with.\u003c/p>\n\u003cp>\"People frequently compare early-identifying trans children with those who go through phases of believing they are cats or dinosaurs or who have imaginary friends,\" Olson wrote recently. \"Yet decades of work on gender development suggests these are precisely the ages at which nearly all kids are coming to understand their own and others' gender identities.\"\u003c/p>\n\u003cp>Olson said some critics incorrectly concluded that gender-altering surgery is being performed on the prepubescent children in her study.\u003c/p>\n\u003cp>She also stresses that the parents of the children already had decided to help them make a gender-identity transition — she's not the one advocating for that. Even before she met the children, they were identifying with a gender different from the one they were born with — often adopting a new name, and different clothing, toys, activities and friends.\u003c/p>\n\u003cp>Among those skeptical of the study is Andrew Walker, a parent of two small children who is director of policy studies for the Southern Baptist Convention's Ethics & Religious Liberty Commission.\u003c/p>\n\u003cp>\"I am highly suspect of allowing children to be mature agents in determining this level of self-understanding,\" he said. \"That seems to be highly problematic and borderline reckless... putting drastically catastrophic decisions about a child's life in the child's hands.\"\u003c/p>\n\u003cp>He also questioned the appropriateness of investing federal funds in \"what is ultimately an ideological, contestable issue — the notion of gender fluidity.\"\u003c/p>\n\u003cp>Olson said the vitriol directed at her, via email and social media, became so extreme that she avoided talking to the media for about eight months.\u003c/p>\n\u003cp>\"It doesn't feel good to have people saying negative things about you,\" she said. \"You just have to keep going.\"\u003c/p>\n\u003cp>Cheryl Kaiser, chair of the UW psychology department, described Olson's foray into the project as a \"striking act of bravery.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Olson is the first psychologist to receive the Waterman Award, which was established by Congress in 1975.\u003c/p>\n\n","blocks":[],"excerpt":"The first large-scale, national study of transgender children, including some as young as 3, is poised to expand thanks to a five-year, $1 million grant awarded Thursday by the National Science Foundation.","status":"publish","parent":0,"modified":1535389209,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":22,"wordCount":821},"headData":{"title":"Federal Government Awards $1 Million for Study of Transgender Children | KQED","description":"The first large-scale, national study of transgender children, including some as young as 3, is poised to expand thanks to a five-year, $1 million grant awarded Thursday by the National Science Foundation.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Federal Government Awards $1 Million for Study of Transgender Children","datePublished":"2018-04-13T21:56:47.000Z","dateModified":"2018-08-27T17:00:09.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440806 https://ww2.kqed.org/futureofyou/?p=440806","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/04/13/federal-government-awards-1-million-for-study-of-transgender-children/","disqusTitle":"Federal Government Awards $1 Million for Study of Transgender Children","source":"Health","nprByline":"David Crary\u003cbr />Associated Press","path":"/futureofyou/440806/federal-government-awards-1-million-for-study-of-transgender-children","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The first large-scale, national study of transgender children, including some as young as 3, is poised to expand thanks to a five-year, $1 million grant awarded Thursday by the National Science Foundation to the professor leading the project.\u003c/p>\n\u003cp>University of Washington psychologist Kristina Olson, 36, was named winner of the NSF's annual Alan T. Waterman Award, the government's highest honor for scientists still in the early phases of their careers. The NSF said the choice was unanimous, and noted that pediatricians are already using her findings to raise awareness about gender diversity.\u003c/p>\n\u003cp>While the award citation honors Olson for a broad range of her research on children's perceptions, she has become best known as creator and leader of the TransYouth Project, which is widely considered the most ambitious long-term study of transgender children being conducted in the U.S.\u003c/p>\n\u003cp>Launched in 2013, the project has recruited more than 300 children ages 3-12 from 45 states, with the goal of tracking their development over 20 years. The NSF grant will help Olson maintain the study as many of the children go through adolescence; she hopes to continue it into their adulthood.\u003c/p>\n\u003cp>\"'Transgender children' is a category we have so little scientific knowledge about,\" says Olson. \"I'm interested in their experience of feeling you are in a social category that other people don't think you're a part of.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Some of the study's early findings were reported two years ago in the journal Pediatrics — notably that the 73 children being tracked at that time had rates of depression and anxiety no higher than non-transgender children in control groups. The trans children were supported by their families and allowed to live openly as the gender they identify with — suggesting to Olson that family support was a key to avoiding the mental health problems identified in studies of other transgender youths.\u003c/p>\n\u003cp>\"In a very scientific way, our study shows that this group of kids is doing really, really well,\" she said in a telephone interview.\u003c/p>\n\u003cp>She hopes the NSF grant will enable her to expand the study to encompass youths who are in the process of gender transition but haven't completed it. Some of the funds will be used for Olson's work on other topics, including race and inequality, and also to support research opportunities for undergraduates.\u003c/p>\n\u003cp>The TransYouth Project received positive coverage following the Pediatrics article, but Olson's research also has been the target of criticism. An article last year in The Federalist, a conservative online magazine, asserted that it was \"utterly ridiculous\" to open a study on gender identity to a 3-year-old child \"who is just learning to use the bathroom, spell his name, and the days of the week.\"\u003c/p>\n\u003cp>However, Olson said children of that age, whether transgender or not, show awareness of gender identity in many ways, through their self-descriptions, what they wear, who they prefer to play with.\u003c/p>\n\u003cp>\"People frequently compare early-identifying trans children with those who go through phases of believing they are cats or dinosaurs or who have imaginary friends,\" Olson wrote recently. \"Yet decades of work on gender development suggests these are precisely the ages at which nearly all kids are coming to understand their own and others' gender identities.\"\u003c/p>\n\u003cp>Olson said some critics incorrectly concluded that gender-altering surgery is being performed on the prepubescent children in her study.\u003c/p>\n\u003cp>She also stresses that the parents of the children already had decided to help them make a gender-identity transition — she's not the one advocating for that. Even before she met the children, they were identifying with a gender different from the one they were born with — often adopting a new name, and different clothing, toys, activities and friends.\u003c/p>\n\u003cp>Among those skeptical of the study is Andrew Walker, a parent of two small children who is director of policy studies for the Southern Baptist Convention's Ethics & Religious Liberty Commission.\u003c/p>\n\u003cp>\"I am highly suspect of allowing children to be mature agents in determining this level of self-understanding,\" he said. \"That seems to be highly problematic and borderline reckless... putting drastically catastrophic decisions about a child's life in the child's hands.\"\u003c/p>\n\u003cp>He also questioned the appropriateness of investing federal funds in \"what is ultimately an ideological, contestable issue — the notion of gender fluidity.\"\u003c/p>\n\u003cp>Olson said the vitriol directed at her, via email and social media, became so extreme that she avoided talking to the media for about eight months.\u003c/p>\n\u003cp>\"It doesn't feel good to have people saying negative things about you,\" she said. \"You just have to keep going.\"\u003c/p>\n\u003cp>Cheryl Kaiser, chair of the UW psychology department, described Olson's foray into the project as a \"striking act of bravery.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Olson is the first psychologist to receive the Waterman Award, which was established by Congress in 1975.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440806/federal-government-awards-1-million-for-study-of-transgender-children","authors":["byline_futureofyou_440806"],"categories":["futureofyou_452","futureofyou_73"],"tags":["futureofyou_80","futureofyou_1482","futureofyou_1018"],"featImg":"futureofyou_440815","label":"source_futureofyou_440806"},"futureofyou_439151":{"type":"posts","id":"futureofyou_439151","meta":{"index":"posts_1591205157","site":"futureofyou","id":"439151","score":null,"sort":[1517817671000]},"guestAuthors":[],"slug":"what-a-pediatrician-learned-from-a-9-year-old-transgender-child","title":"What a Pediatrician Learned from a 9-Year-Old Transgender Child","publishDate":1517817671,"format":"audio","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>The number of transgender people in America has \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf\" target=\"_blank\" rel=\"noopener\">doubled\u003c/a> in the last decade, but that doesn't mean the medical profession has caught up. Transgender patients are often unable to find quality health care. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802845/\" target=\"_blank\" rel=\"noopener\">Research\u003c/a> shows they may face stigma and discrimination, and that they can't find medical interventions like hormone therapy and/or sex reassignment surgery.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>Tell Us Your Story\u003c/h3>\n\u003cp>Are you a transgender person who has struggled to find appropriate care, or a doctor who has struggled to learn to provide care? \u003ca href=\"#health\">Tell us your story\u003c/a> in the question box at the bottom of this post. Your responses will be kept confidential and will not be shared without your permission.\u003c/p>\n\u003c/aside>\n\u003cp>Ximena Lopez is a pediatric endocrinologist at Children’s Health in Dallas, Texas, one of the few in the country who specialize in care for transgender youth. Recently she shared the story of her steep learning curve at the \u003ca href=\"http://www.tedmed.com/\">TEDMED\u003c/a> conference in Palm Springs.\u003c/p>\n\u003cp>I caught up with her afterward. The following interview, in Lopez's words, has been edited for length and clarity:\u003c/p>\n\u003cp>\u003cstrong>Parents Desperate for Help\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>I was not prepared when my first transgender child walked into my clinic. I didn’t get any training in medical school, my residency or my sub-specialty training to care for transgender children. And there were people in my clinic who questioned whether I should take the appointment. I decided to see whether I could help, but I didn't think I'd actually provide care.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>During the first appointment, the most striking thing was how desperate the parents were for help. They told me they had called 100 doctors and nobody wanted to provide treatment to stop Tyler's puberty. Then they said, 'We don't care if you experiment with our child. We will do anything for his mental health.'\u003c/p>\n\u003cp>They used a phrase that really stayed with me, 'We prefer to have a living son than a dead daughter.'\u003c/p>\n\u003cp>I knew I had to help.\u003c/p>\n\u003cp>\u003cstrong>[contextly_sidebar id=\"ypQ0S1VFkkumYcqXsE0vYCCbmOzMzDkc\"]Very Little Expertise Available\u003c/strong>\u003c/p>\n\u003cp>I went to the mental health team in my hospital for their expertise and they said, 'We have no experience whatsoever. The only time we've seen transgender patients is when they're trying to commit suicide and admitted to the psychiatric unit.'\u003c/p>\n\u003cp>Fortunately, I eventually found a specialist in Boston and a local psychiatrist to help me navigate suppressing Tyler's puberty.\u003c/p>\n\u003cp>Puberty suppression is a reversible step. It buys time to explore gender identity. So even if the child changed his or her mind later on, we could stop the puberty suppression and puberty will just restart.\u003c/p>\n\u003cp>\u003cb>It's Not a Choice\u003c/b>\u003c/p>\n\u003cp>Gender dysphoria is the conflict that exists when a person's physical or assigned gender is different than how they feel or identify. It's very clear that it's not a choice. That's what I've learned from my patients. Parents have been dealing with this for a long time. They've had years of denial -- mourning the child that they're losing, and then accepting the child they have.\u003c/p>\n\u003cp>When parents are not supportive the risk of suicide attempt can be as high as 60 percent. And when parents are very supportive it can be as low as 4 percent. The difference is just incredible, so parental support is more than critical.\u003c/p>\n\u003cp>Society should see transgender people as just normal people. I think we as humans tend to be afraid of what's different and what's new.\u003c/p>\n\u003cp>\u003cstrong>[contextly_sidebar id=\"3gWXSODBjp95u08FGWK1bohVUcxSPy5g\"]Biological Basis for Transgender Identity\u003c/strong>\u003c/p>\n\u003cp>There's very little known. There's no genetic explanation. We do know that 40 to 60 percent of identical twins are transgender. For example, if one identical twin is transgender, the odds of the other twin being transgender is 40 to 60 percent. That means there probably is a genetic link because that's a high prevalence. But it's not 100 percent. We don't know anything about the specific gene or genes.\u003c/p>\n\u003cp>The other thing is there is a new brain imaging study that is called a functional MRI (fMRI) that show subtle differences in movement in the brain between regular males and females. \u003ca href=\"http://scholar.google.com/scholar_url?url=https://www.researchgate.net/profile/Alicia_Garcia-Falgueras/publication/24377907_Sexual_differentiation_of_the_human_brain_in_relation_to_gender_identity_and_sexual_orientation/links/0046353982a9ca6d8e000000.pdf&hl=en&sa=X&scisig=AAGBfm19NmQGvQy8twJNvMaPYGD17MaCvg&nossl=1&oi=scholarr\" target=\"_blank\" rel=\"noopener\">Researchers\u003c/a> looked at transgender people before they received any hormone therapy or any treatment that could affect brain function or morphology, and transgender people have differences that put them more aligned with the gender they identify with. In other words, their brains are actually acting more like the brain that they identify with rather than their biological gender.\u003cbr>\n\u003ca name=\"health\">\u003c/a>\u003c/p>\n\u003ch2>Have you been able to find appropriate health care for your needs as a transgender person? Why or why not? Tell us your story; your responses will be kept confidential and will never be shared without your permission.\u003c/h2>\n\u003cp>[transgenderhealthcare]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: We will post Ximena Lopez's TEDMED talk here as soon as it is available.\u003c/em>\u003c/p>\n\n","blocks":[],"excerpt":"When Ximena Lopez received her first transgender child patient she had no idea how her life and practice would change. ","status":"publish","parent":0,"modified":1518032392,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":24,"wordCount":821},"headData":{"title":"What a Pediatrician Learned from a 9-Year-Old Transgender Child | KQED","description":"When Ximena Lopez received her first transgender child patient she had no idea how her life and practice would change. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"What a Pediatrician Learned from a 9-Year-Old Transgender Child","datePublished":"2018-02-05T08:01:11.000Z","dateModified":"2018-02-07T19:39:52.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"439151 https://ww2.kqed.org/futureofyou/?p=439151","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/02/05/what-a-pediatrician-learned-from-a-9-year-old-transgender-child/","disqusTitle":"What a Pediatrician Learned from a 9-Year-Old Transgender Child","source":"KQED Future of You","audioUrl":"https://www.kqed.org/.stream/anon/radio/science/2018/02/TransgenderforWEB.mp3","path":"/futureofyou/439151/what-a-pediatrician-learned-from-a-9-year-old-transgender-child","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>The number of transgender people in America has \u003ca href=\"http://williamsinstitute.law.ucla.edu/wp-content/uploads/How-Many-Adults-Identify-as-Transgender-in-the-United-States.pdf\" target=\"_blank\" rel=\"noopener\">doubled\u003c/a> in the last decade, but that doesn't mean the medical profession has caught up. Transgender patients are often unable to find quality health care. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4802845/\" target=\"_blank\" rel=\"noopener\">Research\u003c/a> shows they may face stigma and discrimination, and that they can't find medical interventions like hormone therapy and/or sex reassignment surgery.\u003c/p>\n\u003caside class=\"alignright\">\n\u003ch3>Tell Us Your Story\u003c/h3>\n\u003cp>Are you a transgender person who has struggled to find appropriate care, or a doctor who has struggled to learn to provide care? \u003ca href=\"#health\">Tell us your story\u003c/a> in the question box at the bottom of this post. Your responses will be kept confidential and will not be shared without your permission.\u003c/p>\n\u003c/aside>\n\u003cp>Ximena Lopez is a pediatric endocrinologist at Children’s Health in Dallas, Texas, one of the few in the country who specialize in care for transgender youth. Recently she shared the story of her steep learning curve at the \u003ca href=\"http://www.tedmed.com/\">TEDMED\u003c/a> conference in Palm Springs.\u003c/p>\n\u003cp>I caught up with her afterward. The following interview, in Lopez's words, has been edited for length and clarity:\u003c/p>\n\u003cp>\u003cstrong>Parents Desperate for Help\u003cbr>\n\u003c/strong>\u003c/p>\n\u003cp>I was not prepared when my first transgender child walked into my clinic. I didn’t get any training in medical school, my residency or my sub-specialty training to care for transgender children. And there were people in my clinic who questioned whether I should take the appointment. I decided to see whether I could help, but I didn't think I'd actually provide care.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>During the first appointment, the most striking thing was how desperate the parents were for help. They told me they had called 100 doctors and nobody wanted to provide treatment to stop Tyler's puberty. Then they said, 'We don't care if you experiment with our child. We will do anything for his mental health.'\u003c/p>\n\u003cp>They used a phrase that really stayed with me, 'We prefer to have a living son than a dead daughter.'\u003c/p>\n\u003cp>I knew I had to help.\u003c/p>\n\u003cp>\u003cstrong>\u003c/p>\u003cp>\u003c/p>\u003cp>Very Little Expertise Available\u003c/strong>\u003c/p>\n\u003cp>I went to the mental health team in my hospital for their expertise and they said, 'We have no experience whatsoever. The only time we've seen transgender patients is when they're trying to commit suicide and admitted to the psychiatric unit.'\u003c/p>\n\u003cp>Fortunately, I eventually found a specialist in Boston and a local psychiatrist to help me navigate suppressing Tyler's puberty.\u003c/p>\n\u003cp>Puberty suppression is a reversible step. It buys time to explore gender identity. So even if the child changed his or her mind later on, we could stop the puberty suppression and puberty will just restart.\u003c/p>\n\u003cp>\u003cb>It's Not a Choice\u003c/b>\u003c/p>\n\u003cp>Gender dysphoria is the conflict that exists when a person's physical or assigned gender is different than how they feel or identify. It's very clear that it's not a choice. That's what I've learned from my patients. Parents have been dealing with this for a long time. They've had years of denial -- mourning the child that they're losing, and then accepting the child they have.\u003c/p>\n\u003cp>When parents are not supportive the risk of suicide attempt can be as high as 60 percent. And when parents are very supportive it can be as low as 4 percent. The difference is just incredible, so parental support is more than critical.\u003c/p>\n\u003cp>Society should see transgender people as just normal people. I think we as humans tend to be afraid of what's different and what's new.\u003c/p>\n\u003cp>\u003cstrong>\u003c/p>\u003cp>\u003c/p>\u003cp>Biological Basis for Transgender Identity\u003c/strong>\u003c/p>\n\u003cp>There's very little known. There's no genetic explanation. We do know that 40 to 60 percent of identical twins are transgender. For example, if one identical twin is transgender, the odds of the other twin being transgender is 40 to 60 percent. That means there probably is a genetic link because that's a high prevalence. But it's not 100 percent. We don't know anything about the specific gene or genes.\u003c/p>\n\u003cp>The other thing is there is a new brain imaging study that is called a functional MRI (fMRI) that show subtle differences in movement in the brain between regular males and females. \u003ca href=\"http://scholar.google.com/scholar_url?url=https://www.researchgate.net/profile/Alicia_Garcia-Falgueras/publication/24377907_Sexual_differentiation_of_the_human_brain_in_relation_to_gender_identity_and_sexual_orientation/links/0046353982a9ca6d8e000000.pdf&hl=en&sa=X&scisig=AAGBfm19NmQGvQy8twJNvMaPYGD17MaCvg&nossl=1&oi=scholarr\" target=\"_blank\" rel=\"noopener\">Researchers\u003c/a> looked at transgender people before they received any hormone therapy or any treatment that could affect brain function or morphology, and transgender people have differences that put them more aligned with the gender they identify with. In other words, their brains are actually acting more like the brain that they identify with rather than their biological gender.\u003cbr>\n\u003ca name=\"health\">\u003c/a>\u003c/p>\n\u003ch2>Have you been able to find appropriate health care for your needs as a transgender person? Why or why not? Tell us your story; your responses will be kept confidential and will never be shared without your permission.\u003c/h2>\n\u003cp>[transgenderhealthcare]\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>\u003cem>Editor's Note: We will post Ximena Lopez's TEDMED talk here as soon as it is available.\u003c/em>\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/439151/what-a-pediatrician-learned-from-a-9-year-old-transgender-child","authors":["11229"],"categories":["futureofyou_1","futureofyou_73"],"tags":["futureofyou_1275","futureofyou_1244","futureofyou_685","futureofyou_80","futureofyou_656","futureofyou_1018"],"label":"source_futureofyou_439151"},"futureofyou_437981":{"type":"posts","id":"futureofyou_437981","meta":{"index":"posts_1591205157","site":"futureofyou","id":"437981","score":null,"sort":[1514052354000]},"guestAuthors":[],"slug":"a-quarter-of-california-adolescents-may-be-gender-nonconforming-so-what-does-that-mean","title":"A Quarter of California Adolescents May Be 'Gender Nonconforming.' So What Does That Mean?","publishDate":1514052354,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>You may have seen recent news of a survey finding that 27 percent of California youth ages 12 to 17 are \"gender nonconforming.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Gender nonconforming is not a synonym for transgender. Rather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example.'\u003ccite>Kristina Olson, University of Washington.\u003c/cite>\u003c/aside>\n\u003cp>That sounds pretty high. I might even put the word \"whopping\" before \"27 percent.\"\u003c/p>\n\u003cp>But I have to say, I've been covering the \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">gender story\u003c/a> for more than a year, and when I saw the headlines, I wasn't \u003cem>quite\u003c/em> sure what gender nonconforming meant. Gender terminology, like gender itself these days, can be fairly fluid.\u003c/p>\n\u003cp>So here is the exact question that was asked of California adolescents:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">A person’s appearance, style, dress, or the way they walk or talk may affect how people describe them. How do you think other people at school would describe you? \u003c/span>\u003c/p>\n\u003cp>Very feminine\u003c/p>\n\u003cp>Mostly feminine\u003c/p>\n\u003cp>Equally feminine and masculine\u003c/p>\n\u003cp>Mostly masculine\u003c/p>\n\u003cp>Very masculine\u003c/p>\u003c/blockquote>\n\u003cp>This is a measure of what gender researchers call \"gender expression,\" or the way individuals manifest what you might call the trappings of masculinity and femininity: clothes, hair, makeup, posture. As some of the UCLA researchers involved in the survey put it, those who are \"seen as resisting dominant expectations around gender expression\" are considered gender nonconforming.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype.”\u003ccite>Alison Gill, Advocates for Youth\u003c/cite>\u003c/aside>\n\u003cp>You might think that someone who is gender nonconforming is necessarily transgender. But that is not the case.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“ ‘Gender nonconforming' \" is not a synonym for transgender,” says Kristina Olson, d\u003c/span>\u003cspan style=\"font-weight: 400\">irector of the TransYouth Project at the University of Washington. \u003c/span>\u003cspan style=\"font-weight: 400\">“R\u003c/span>\u003cspan style=\"font-weight: 400\">ather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example\u003c/span>\u003cspan style=\"font-weight: 400\">.\"\u003c/span>\u003c/p>\n\u003cp>Many people may also confound gender nonconformity with being lesbian, gay or bisexual. But Alison Gill, a consultant on gender for the nonprofit Advocates for Youth, says \u003ca href=\"http://advocatesforyouth.org/storage/advfy/documents/YRBSS.pdf\" target=\"_blank\" rel=\"noopener\">research\u003c/a> shows most gender nonconforming kids are actually heterosexual.\u003c/p>\n\u003cp>\"There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype,” she said.\u003c/p>\n\u003cp>In other words, you can be gender nonconforming without being L, G, B or T.\u003c/p>\n\u003cp>\u003cstrong>Study Results\u003c/strong>\u003c/p>\n\u003cp>The gender expression question was included on the recent \u003ca href=\"http://healthpolicy.ucla.edu/chis/Pages/default.aspx\" target=\"_blank\" rel=\"noopener\">California Health Interview Survey\u003c/a>, conducted by UCLA on a continuous basis. The telephone survey covers dozens of health topics.\u003c/p>\n\u003cp>The CHIS has been going strong since 2001, but this was the first time a question on either youth gender identity or gender expression had been included.\u003c/p>\n\u003cp>Why now?\u003c/p>\n\u003caside class=\"pullquote alignright\">'A lot of bullying is around expression and not sexuality. A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.' \u003ccite>Phil Hammack, University of California, Santa Cruz\u003c/cite>\u003c/aside>\n\u003cp>Researchers at UCLA's Center for Health Policy Research and The Williams Institute, which conducts research on sexual orientation and gender identity law, said in a health policy \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2017/gncadolescents-factsheet-dec2017.pdf\" target=\"_blank\" rel=\"noopener\">fact sheet\u003c/a> that levels of gender conformity are \"known to be a particularly salient factor in the safety and well-being of youth. Yet, data about gender nonconforming youth remain rare.\"\u003c/p>\n\u003cp>The question was asked of 1,594 adolescents, ages 12 to 17, across California.\u003c/p>\n\u003cp>There were two categories for respondents coded as gender nonconforming. One was \"highly gender nonconforming\" and the other was \"androgynous.\"\u003c/p>\n\u003cp>Male respondents who answered \"very feminine\" or \"mostly feminine,\" and female respondents who answered \"very masculine\" or \"mostly masculine,\" were categorized as \"highly gender nonconforming.\"\u003c/p>\n\u003cp>Those who answered \"equally feminine and masculine\" were coded as “androgynous.”\u003c/p>\n\u003cp>The androgynous outnumbered those who were highly gender nonconforming by more than 3 to 1.\u003c/p>\n\u003cp>Total nonconforming youth came out to 27 percent of all the adolescents queried. That \u003cspan style=\"font-weight: 400\">would equate to 796,000 gender nonconforming youth in the state of California today.\u003c/span>\u003c/p>\n\u003cp>The margin of error was about 6 percent, so that number could be substantially greater or fewer.\u003c/p>\n\u003cp>\u003cstrong>California and Gender\u003c/strong>\u003c/p>\n\u003cp>Combined surveys asking the same question in L.A., San Diego, Chicago and Florida’s Broward County provide a larger population of 9,265 youth, and that data shows high health risks associated with gender nonconformity. For example, GNC males were between two and three times more likely to attempt suicide than conforming males, and for females the rate was 1 1/2 times greater for those who were GNC.\u003c/p>\n\u003cp>While the California survey showed nonconforming youth reporting more than twice the level of severe psychological distress as their conforming peers, it showed no statistically significant difference when it came to suicidal ideation and suicide attempts.\u003c/p>\n\u003cp>Why the big difference related to suicide between nonconforming and conforming youth in the larger sample, and hardly any in the Californian-only data?\u003c/p>\n\u003cp>The California researchers speculated that the state's social environment may be contributing to better mental health outcomes.\u003c/p>\n\u003cp>“(H)igher levels of social acceptance and the presence of protective policies in California may impact rates of victimization and bullying, which, in turn, may confer some protection for gender minority youth in the state,\" reads the fact sheet.\u003c/p>\n\u003cp>\u003cstrong>The Next Frontier\u003c/strong>\u003c/p>\n\u003cp>Phil Hammack is a professor of psychology and researcher at the University of California, Santa Cruz, who specializes in sexual and gender identity. He thinks that when it comes to bullying, gender expression is the new sexual orientation.\u003c/p>\n\u003cp>“A lot of bullying is around expression and not sexuality,” he said. “A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.”\u003c/p>\n\u003cp>Even though there is much greater visibility for gender nonconforming youth, Hammack said, “the culture is in a state of anxiety around this revolution.”\u003c/p>\n\u003cp>\"This is the next frontier for us to address among people who care about young people’s well-being.”\u003c/p>\n\u003cp>The gender researchers I spoke to agreed that gender nonconformity often causes bullying and mental health distress independent of sexual orientation and gender identities.\u003c/p>\n\u003cp>\u003cstrong>A Quarrel With the Question\u003c/strong>\u003c/p>\n\u003cp>One gender researcher who doesn’t think the question resulted in precise enough data is Charlotte Tate, from San Francisco State. Tate said that because there was no question about sexual orientation on the survey, it's impossible to tease apart how much of the mental distress exhibited by GNC youth stems from being lesbian, gay or bisexual and how much from an unconventional gender expression.\u003c/p>\n\u003cp>\"So [the researchers] haven’t sufficiently demonstrated that the stress is linked to gender; it could be about sexual orientation,\" Tate said.\u003c/p>\n\u003cp>Bianca Wilson, \u003cspan style=\"font-weight: 400\">a senior public policy scholar at The Williams Institute, \u003c/span>agrees inserting a sexual orientation question would be useful to understand the \"unique and compounding levels of distress\" by non-heterosexual youth who also do differ in their gender expression.\u003c/p>\n\u003cp>In any event, there will be more data. Gill says the number of sites that have now asked the gender nonconforming question has increased to 16, and that the results will start coming in during the first half of 2018.\u003c/p>\n\u003cp>Hammack, the researcher from UC Santa Cruz, says it's obvious that gender nonconformity is booming. He recently completed a study of teen LGBT youth in the Central Valley and the Bay Area, and he was surprised to find how easy it was to sign up those who were nonconforming.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\"We had to cap the number of gender nonconforming youth who participated to make sure we got enough gender conforming youth,\" he said.\u003c/p>\n\n","blocks":[],"excerpt":"A recent survey shows 27 percent of 12- to 17-year-olds in California thought they were perceived as more or equally like the opposite sex.","status":"publish","parent":0,"modified":1514511502,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":49,"wordCount":1292},"headData":{"title":"A Quarter of California Adolescents May Be 'Gender Nonconforming.' So What Does That Mean? | KQED","description":"A recent survey shows 27 percent of 12- to 17-year-olds in California thought they were perceived as more or equally like the opposite sex.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"A Quarter of California Adolescents May Be 'Gender Nonconforming.' So What Does That Mean?","datePublished":"2017-12-23T18:05:54.000Z","dateModified":"2017-12-29T01:38:22.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"437981 https://ww2.kqed.org/futureofyou/?p=437981","disqusUrl":"https://ww2.kqed.org/futureofyou/2017/12/23/a-quarter-of-california-adolescents-may-be-gender-nonconforming-so-what-does-that-mean/","disqusTitle":"A Quarter of California Adolescents May Be 'Gender Nonconforming.' So What Does That Mean?","source":"KQED Future of You","path":"/futureofyou/437981/a-quarter-of-california-adolescents-may-be-gender-nonconforming-so-what-does-that-mean","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>You may have seen recent news of a survey finding that 27 percent of California youth ages 12 to 17 are \"gender nonconforming.\"\u003c/p>\n\u003caside class=\"pullquote alignright\">'Gender nonconforming is not a synonym for transgender. Rather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example.'\u003ccite>Kristina Olson, University of Washington.\u003c/cite>\u003c/aside>\n\u003cp>That sounds pretty high. I might even put the word \"whopping\" before \"27 percent.\"\u003c/p>\n\u003cp>But I have to say, I've been covering the \u003ca href=\"https://ww2.kqed.org/futureofyou/2017/04/24/boy-girl-both-neither-a-new-generation-overthrows-gender/\" target=\"_blank\" rel=\"noopener\">gender story\u003c/a> for more than a year, and when I saw the headlines, I wasn't \u003cem>quite\u003c/em> sure what gender nonconforming meant. Gender terminology, like gender itself these days, can be fairly fluid.\u003c/p>\n\u003cp>So here is the exact question that was asked of California adolescents:\u003c/p>\n\u003cblockquote>\u003cp>\u003cspan style=\"font-weight: 400\">A person’s appearance, style, dress, or the way they walk or talk may affect how people describe them. How do you think other people at school would describe you? \u003c/span>\u003c/p>\n\u003cp>Very feminine\u003c/p>\n\u003cp>Mostly feminine\u003c/p>\n\u003cp>Equally feminine and masculine\u003c/p>\n\u003cp>Mostly masculine\u003c/p>\n\u003cp>Very masculine\u003c/p>\u003c/blockquote>\n\u003cp>This is a measure of what gender researchers call \"gender expression,\" or the way individuals manifest what you might call the trappings of masculinity and femininity: clothes, hair, makeup, posture. As some of the UCLA researchers involved in the survey put it, those who are \"seen as resisting dominant expectations around gender expression\" are considered gender nonconforming.\u003c/p>\n\u003caside class=\"pullquote alignright\">'There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype.”\u003ccite>Alison Gill, Advocates for Youth\u003c/cite>\u003c/aside>\n\u003cp>You might think that someone who is gender nonconforming is necessarily transgender. But that is not the case.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cspan style=\"font-weight: 400\">“ ‘Gender nonconforming' \" is not a synonym for transgender,” says Kristina Olson, d\u003c/span>\u003cspan style=\"font-weight: 400\">irector of the TransYouth Project at the University of Washington. \u003c/span>\u003cspan style=\"font-weight: 400\">“R\u003c/span>\u003cspan style=\"font-weight: 400\">ather it typically refers to a much greater number of people who defy stereotypes of their sex. This term can include tomboys, for example\u003c/span>\u003cspan style=\"font-weight: 400\">.\"\u003c/span>\u003c/p>\n\u003cp>Many people may also confound gender nonconformity with being lesbian, gay or bisexual. But Alison Gill, a consultant on gender for the nonprofit Advocates for Youth, says \u003ca href=\"http://advocatesforyouth.org/storage/advfy/documents/YRBSS.pdf\" target=\"_blank\" rel=\"noopener\">research\u003c/a> shows most gender nonconforming kids are actually heterosexual.\u003c/p>\n\u003cp>\"There’s been an assumption that gender nonconforming people are gay or lesbian, but that’s not the case. It’s a stereotype,” she said.\u003c/p>\n\u003cp>In other words, you can be gender nonconforming without being L, G, B or T.\u003c/p>\n\u003cp>\u003cstrong>Study Results\u003c/strong>\u003c/p>\n\u003cp>The gender expression question was included on the recent \u003ca href=\"http://healthpolicy.ucla.edu/chis/Pages/default.aspx\" target=\"_blank\" rel=\"noopener\">California Health Interview Survey\u003c/a>, conducted by UCLA on a continuous basis. The telephone survey covers dozens of health topics.\u003c/p>\n\u003cp>The CHIS has been going strong since 2001, but this was the first time a question on either youth gender identity or gender expression had been included.\u003c/p>\n\u003cp>Why now?\u003c/p>\n\u003caside class=\"pullquote alignright\">'A lot of bullying is around expression and not sexuality. A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.' \u003ccite>Phil Hammack, University of California, Santa Cruz\u003c/cite>\u003c/aside>\n\u003cp>Researchers at UCLA's Center for Health Policy Research and The Williams Institute, which conducts research on sexual orientation and gender identity law, said in a health policy \u003ca href=\"http://healthpolicy.ucla.edu/publications/Documents/PDF/2017/gncadolescents-factsheet-dec2017.pdf\" target=\"_blank\" rel=\"noopener\">fact sheet\u003c/a> that levels of gender conformity are \"known to be a particularly salient factor in the safety and well-being of youth. Yet, data about gender nonconforming youth remain rare.\"\u003c/p>\n\u003cp>The question was asked of 1,594 adolescents, ages 12 to 17, across California.\u003c/p>\n\u003cp>There were two categories for respondents coded as gender nonconforming. One was \"highly gender nonconforming\" and the other was \"androgynous.\"\u003c/p>\n\u003cp>Male respondents who answered \"very feminine\" or \"mostly feminine,\" and female respondents who answered \"very masculine\" or \"mostly masculine,\" were categorized as \"highly gender nonconforming.\"\u003c/p>\n\u003cp>Those who answered \"equally feminine and masculine\" were coded as “androgynous.”\u003c/p>\n\u003cp>The androgynous outnumbered those who were highly gender nonconforming by more than 3 to 1.\u003c/p>\n\u003cp>Total nonconforming youth came out to 27 percent of all the adolescents queried. That \u003cspan style=\"font-weight: 400\">would equate to 796,000 gender nonconforming youth in the state of California today.\u003c/span>\u003c/p>\n\u003cp>The margin of error was about 6 percent, so that number could be substantially greater or fewer.\u003c/p>\n\u003cp>\u003cstrong>California and Gender\u003c/strong>\u003c/p>\n\u003cp>Combined surveys asking the same question in L.A., San Diego, Chicago and Florida’s Broward County provide a larger population of 9,265 youth, and that data shows high health risks associated with gender nonconformity. For example, GNC males were between two and three times more likely to attempt suicide than conforming males, and for females the rate was 1 1/2 times greater for those who were GNC.\u003c/p>\n\u003cp>While the California survey showed nonconforming youth reporting more than twice the level of severe psychological distress as their conforming peers, it showed no statistically significant difference when it came to suicidal ideation and suicide attempts.\u003c/p>\n\u003cp>Why the big difference related to suicide between nonconforming and conforming youth in the larger sample, and hardly any in the Californian-only data?\u003c/p>\n\u003cp>The California researchers speculated that the state's social environment may be contributing to better mental health outcomes.\u003c/p>\n\u003cp>“(H)igher levels of social acceptance and the presence of protective policies in California may impact rates of victimization and bullying, which, in turn, may confer some protection for gender minority youth in the state,\" reads the fact sheet.\u003c/p>\n\u003cp>\u003cstrong>The Next Frontier\u003c/strong>\u003c/p>\n\u003cp>Phil Hammack is a professor of psychology and researcher at the University of California, Santa Cruz, who specializes in sexual and gender identity. He thinks that when it comes to bullying, gender expression is the new sexual orientation.\u003c/p>\n\u003cp>“A lot of bullying is around expression and not sexuality,” he said. “A gay boy who is considered totally masculine is considered fine by his peers. But nonconforming people are getting bullied.”\u003c/p>\n\u003cp>Even though there is much greater visibility for gender nonconforming youth, Hammack said, “the culture is in a state of anxiety around this revolution.”\u003c/p>\n\u003cp>\"This is the next frontier for us to address among people who care about young people’s well-being.”\u003c/p>\n\u003cp>The gender researchers I spoke to agreed that gender nonconformity often causes bullying and mental health distress independent of sexual orientation and gender identities.\u003c/p>\n\u003cp>\u003cstrong>A Quarrel With the Question\u003c/strong>\u003c/p>\n\u003cp>One gender researcher who doesn’t think the question resulted in precise enough data is Charlotte Tate, from San Francisco State. Tate said that because there was no question about sexual orientation on the survey, it's impossible to tease apart how much of the mental distress exhibited by GNC youth stems from being lesbian, gay or bisexual and how much from an unconventional gender expression.\u003c/p>\n\u003cp>\"So [the researchers] haven’t sufficiently demonstrated that the stress is linked to gender; it could be about sexual orientation,\" Tate said.\u003c/p>\n\u003cp>Bianca Wilson, \u003cspan style=\"font-weight: 400\">a senior public policy scholar at The Williams Institute, \u003c/span>agrees inserting a sexual orientation question would be useful to understand the \"unique and compounding levels of distress\" by non-heterosexual youth who also do differ in their gender expression.\u003c/p>\n\u003cp>In any event, there will be more data. Gill says the number of sites that have now asked the gender nonconforming question has increased to 16, and that the results will start coming in during the first half of 2018.\u003c/p>\n\u003cp>Hammack, the researcher from UC Santa Cruz, says it's obvious that gender nonconformity is booming. He recently completed a study of teen LGBT youth in the Central Valley and the Bay Area, and he was surprised to find how easy it was to sign up those who were nonconforming.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"We had to cap the number of gender nonconforming youth who participated to make sure we got enough gender conforming youth,\" he said.\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/437981/a-quarter-of-california-adolescents-may-be-gender-nonconforming-so-what-does-that-mean","authors":["80"],"categories":["futureofyou_452","futureofyou_1","futureofyou_73"],"tags":["futureofyou_1275","futureofyou_1182","futureofyou_1433","futureofyou_1018","futureofyou_1434"],"featImg":"futureofyou_437990","label":"source_futureofyou_437981"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. 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You ask the questions. You decide what Bay Curious investigates. And you join us on the journey to find the answers.","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Bay-Curious-Podcast-Tile-703x703-1.jpg","imageAlt":"\"KQED Bay Curious","officialWebsiteLink":"/news/series/baycurious","meta":{"site":"news","source":"kqed","order":"4"},"link":"/podcasts/baycurious","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/bay-curious/id1172473406","npr":"https://www.npr.org/podcasts/500557090/bay-curious","rss":"https://ww2.kqed.org/news/category/bay-curious-podcast/feed/podcast","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93dzIua3FlZC5vcmcvbmV3cy9jYXRlZ29yeS9iYXktY3VyaW91cy1wb2RjYXN0L2ZlZWQvcG9kY2FzdA","stitcher":"https://www.stitcher.com/podcast/kqed/bay-curious","spotify":"https://open.spotify.com/show/6O76IdmhixfijmhTZLIJ8k"}},"bbc-world-service":{"id":"bbc-world-service","title":"BBC World Service","info":"The day's top stories from BBC News compiled twice daily in the week, once at weekends.","airtime":"MON-FRI 9pm-10pm, TUE-FRI 1am-2am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/BBC-World-Service-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.bbc.co.uk/sounds/play/live:bbc_world_service","meta":{"site":"news","source":"BBC World Service"},"link":"/radio/program/bbc-world-service","subscribe":{"apple":"https://itunes.apple.com/us/podcast/global-news-podcast/id135067274?mt=2","tuneIn":"https://tunein.com/radio/BBC-World-Service-p455581/","rss":"https://podcasts.files.bbci.co.uk/p02nq0gn.rss"}},"code-switch-life-kit":{"id":"code-switch-life-kit","title":"Code Switch / Life Kit","info":"\u003cem>Code Switch\u003c/em>, which listeners will hear in the first part of the hour, has fearless and much-needed conversations about race. Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. As a non-partisan forum, The Club brings to the public airwaves diverse viewpoints on important topics. The Club's weekly radio broadcast - the oldest in the U.S., dating back to 1924 - is carried across the nation on public radio stations and is now podcasting. Our website archive features audio of our recent programs, as well as selected speeches from our long and distinguished history. This podcast feed is usually updated twice a week and is always un-edited.","airtime":"THU 10pm, FRI 1am","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Commonwealth-Club-Podcast-Tile-360x360-1.jpg","officialWebsiteLink":"https://www.commonwealthclub.org/podcasts","meta":{"site":"news","source":"Commonwealth Club of California"},"link":"/radio/program/commonwealth-club","subscribe":{"apple":"https://itunes.apple.com/us/podcast/commonwealth-club-of-california-podcast/id976334034?mt=2","google":"https://podcasts.google.com/feed/aHR0cDovL3d3dy5jb21tb253ZWFsdGhjbHViLm9yZy9hdWRpby9wb2RjYXN0L3dlZWtseS54bWw","tuneIn":"https://tunein.com/radio/Commonwealth-Club-of-California-p1060/"}},"considerthis":{"id":"considerthis","title":"Consider This","tagline":"Make sense of the day","info":"Make sense of the day. Every weekday afternoon, Consider This helps you consider the major stories of the day in less than 15 minutes, featuring the reporting and storytelling resources of NPR. 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