Wednesday, May 14, 2008

TransActive Response To J. Michael Bailey & Warren Throckmorton

On Dr. Warren Throckmorton's blog, Dr. J. Michael Bailey took issue with the position TransActive Education & Advocacy has taken on the selection of Dr. Kenneth Zucker to Chair the DSM-V Sexual and Gender Identity Disorders workgroup.

He said:
"This is an utterly false characterization of Zucker’s position. He has no desire, stated or otherwise, to prevent homosexuality. Experience and logic suggest that when people have reasonable and sound positions, they do not need to mischaracterize the positions of others they disagree with."

Dr. Throckmorton then added:
"I agree with Bailey, I have seen nothing which would suggest Zucker has a stake in the eventual sexual orientation of children. And I certainly agree with the last sentence which has some special significance to me in light of the cancellation of the APA symposium."

"In my opinion, there are some advocates who implore various audiences to trust science but really do not want this unless the outcome suits their advocacy goals."

I posted the following response to Dr.'s Bailey and Throckmorton -

I respectfully suggest that our position paper does not mis-characterize Dr. Zucker's personal beliefs or clinical approach to the treatment of gender non-conformity in children and adolescents. In support of our position, I submit the following statements by Dr. Zucker, quoted by Frank York on the NARTH (National Association for Research and Therapy of Homosexuality) website. Dr. Zucker's statements originally appeared in a 2004 issue of Child and Adolescent Psychiatric Clinics of North America.

Dr. Zucker admits that there are complex social and ethical issues surrounding the politics of sex and gender in postmodern Western culture. He notes that the "most acute ethical issue may concern the relation between GID and a later homosexual sexual orientation. Follow-up studies of boys who have GID that largely is untreated, indicated that homosexuality is the most common long-term psychosexual outcome."

The concern seems to focus on Dr. Zucker's sense that NOT treating male children for GID will most commonly result in them becoming homosexual. Do we not "treat" people for conditions in the hope of preventing what might be considered by some to be a negative outcome?

Most transgender identified (as opposed to general spectrum gender non-conforming) children do much better in every way when supported and respected for their gender identity expression. Which begs the question, is Dr. Zucker treating the child in a way that is in their best interests, or simply to satisfy the desires of parents, therapists and culture?

Furthermore, we believe that Dr. Zucker and others are using reparative & aversion techniques in treatment of GID in children and youth as a way to encourage only gender stereotypical expression and as a smokescreen for discouraging the potential of a gay or lesbian sexual orientation.

Zucker goes on to say, in the same article quoted above:
"... that clinicians have an ethical obligation to inform parents of the relationship between GID and homosexuality. Clinical experience suggests that psychosexual treatments are effective in reducing gender dysphoria and that individual counseling and parental counseling are both effective methods of treating GID."

Our experience and a significant body of research indicates that, in fact, there is very little, if any, objective correlation between core gender identity and sexual orientation. The statement by Dr. Zucker that "psychosexual treatments are effective in reducing gender dysphoria" is, to be blunt, chilling and should be a glowing red flag to any parent or caregiver who would even consider taken their child to Dr. Zucker or others who follow his treatment guidelines and methods.

Continuing from the same article:
"While Zucker perceives gender identity and sexual orientation, especially among males, to become more fixed with age, he believes the data suggest a much greater plasticity in childhood."

This belief contradicts the American Academy of Pediatrics which stated in 1999 that:
"A child's awareness of being a boy or a girl starts in the first year of life. It often begins by 8 to 10 months of age, when youngsters typically discover their genitals. Then, between 1 and 2 years old, children become conscious of physical differences between boys and girls; before their third birthday they are easily able to label themselves as either a boy or a girl as they acquire a strong concept of self. By age 4, children's gender identity is stable, and they know they will always be a boy or a girl."

The above position by the AAP is most often assumed, in our cissexist culture, to apply only to cisgender children. However, all evidence points to this being the case with the vast majority of transgender children as well. The fact that their anatomy may not match their gender identity does not, in any way, invalidate the certainty of their transgender identity.

And finally, from the same article, we have this:
And if a secure gender identity prevents the development of later homosexuality, as Zucker acknowledges as a possibility, parents should be informed of the research on the relationship between the two. Zucker’s priority is “helping these kids be happily male or female,” but he also acknowledges that the treatment process does, in some cases, apparently avert homosexual development .

And in support of parents’ rights to avert a homosexual outcome for their children, Zucker cites a persuasive quote from Richard Green: “The right of parents to oversee the development of children is a long -established principle. Who is to dictate that parents may not try to raise their children in a manner that maximizes the possibility of a heterosexual outcome?

In light of this, I must ask, Dr.'s Bailey & Throckmorton, precisely how have we mis-characterized Dr. Zucker's position regarding preventing or to use his own words, averting a homosexual outcome?

TransActive stands 100% behind our previous statement, and we further state, unquivocally that:

Gender Identity pre-dates and is independent of Sexual Orientation in children.

Transgender identity in children is rooted in pre-natal development, as evidenced by both clinical research, historical analysis and anecdotal information.

Transgender & gender non-conforming children & youth are more well-adjusted, happier, healthier and more productive when supported in their expression of their gender identity, including allowing them, if they so desire, to transition to their target gender.

Dr. Zucker's treatment methods damage children and their families, including the one recently profiled on the NPR program.

Non-conforming gender identity, including transgender identity, is no more a 'disorder' than is cisgender identity. It is simply more rare.

Sincerely,

Jenn Burleton
Executive Director
TransActive Education & Advocacy
Portland, OR

Saturday, May 10, 2008

DSM-V & Kenneth Zucker


FOR IMMEDIATE RELEASE

TransActive Education & Advocacy strongly opposes the appointment of
Dr. Kenneth Zucker to Chair the Sexual and Gender Identity Disorders
work group that will revise and develop the fifth edition
of the American Psychiatric Association's (APA)
Diagnostic and Statistical Manual of
Mental Disorders (DSM-V).

This position is based upon his approach to clinical treatment of
transgender and gender non-conforming identity in children & youth.

Portland, OR. (May 9, 2008) - On May 1, 2008 the American Psychiatric Association (APA) released the names of those appointed to the work groups that will revise and develop the fifth edition of the APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Dr. Kenneth Zucker, who heads up the Centre for Addiction and Mental Health in Toronto, Ontario, Canada has been selected to Chair the Sexual and Gender Identity Disorders work group.

TransActive strongly opposes the appointment of Dr. Kenneth Zucker to Chair the Sexual and Gender Identity Disorders work group that will revise and develop the fifth edition of the American Psychiatric Association's (APA) Diagnostic and Statistical Manual of Mental Disorders (DSM-V). This position is based upon his approach to clinical treatment of transgender and gender non-conforming identity in children & youth.

Dr. Zucker, along with colleagues Dr. Ray Blanchard (also appointed to the DSM-V workgroup) and Dr. J. Michael Bailey are proponents of the theory that, in the vast majority of cases, gender non-conforming identity in children and youth is merely an indicator of an eventual homosexual identity in adulthood.

In a recent interview broadcast on National Public Radio (NPR), Dr. Zucker said:

“Suppose you were a clinician and a 4-year-old black kid came into your office and said he wanted to be white. Would you go with that? ... I don't think we would.”

This cavalier equating of racial identity to gender identity clearly illustrates his belief that transgender identity in children & youth is nothing more than a delusional and unrealistic fantasy.

Zucker says: "It is legitimate for parents to establish limits for their children on cross-gender behaviors. If not, the behavior is, in effect, being reinforced."


Dr. Zucker chooses to see parental support for their child's innate sense of their own gender identity as a "reinforcement of cross-gender behaviors." Again his distinctly cissexist consideration of transgender identity in children and youth as a 'behavior-centric" issue rather than an core identity issue is deeply troubling.

Zucker further believes that transgender children and youth should only be considered for puberty delaying or cross-gender hormonal treatment if they prove resistant to psychosexual treatment. This is another clear indication that Dr. Zucker does not recognize the inherent difference between gender identity and sexual orientation.

Note:
A psychosexual disorder refers to a sexual problem that is psychological rather than physiological.

Zucker has stated that a secure gender identity possibly prevents the development of later homosexuality. This raised several red flags for those of us who work with gender non-conforming children, youth and their families. TransActive's position is that "prevention of homosexuality" should not be the concern of childhood gender identity specialists.

The second and perhaps most troubling red flag is the assumption that transgender children and youth are insecure in their gender identity. This is a cissexist notion that has historically done much damage to our gender non-conforming children and is particularly of concern when expressed by the currently appointed Chair of the work group that will be developing the DSM-V.

All of the children and youth that TransActive has worked directly with are not the least bit insecure about their own gender identity. The insecurity, if any exists, comes not from within, but from their fear of how those who fail to understand them will react. We believe that Dr. Kenneth Zucker and colleagues of his such as Blanchard, Bailey, George Rekers, Warren Throckmorton and Joseph Nicolosi are some of the people these children and their families have reason to fear.

On behalf of the children, youth and families we serve, and transgender and gender non-conforming children and youth everywhere, TransActive Education & Advocacy stands opposed to the appointment of Dr. Kenneth Zucker as Chair and Dr. Ray Blanchard as a member of the Sexual and Gender Identity Disorders work group.

Jenn Burleton
Executive Director
TransActive Education & Advocacy