May 12, 2008
The battle over infants with cross-gender desires:
NPR Radio's All Things Considered just had an interesting feature on two six-year old boys who identify with and want to be girls. It's something that might be diagnosed as gender identity disorder or GID and the programme looks at how the two psychologists dealt with the issue in very different ways.
One psychologist, Ken Zucker, suggested that the family encourage their son to only associate with traditionally male toys and activities to encourage him to be more comfortable with his born sex, while the other, Diane Ehrensaft encouraged the family to allow their son to explore his cross-gender interests.
Whatever your immediate reaction to these approaches the psychologists in the programme make interesting points on both sides of the debate:
Ehrensaft sees transgenderism as akin to homosexuality, she says, she thinks Zucker's therapy — which seeks to condition children out of a transgender identity — is unethical.
But that isn't how Zucker sees it. Zucker says the homosexuality metaphor is wrong. He proposes another metaphor: racial identity disorder.
"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," Zucker says.
If a black kid walked into a therapist's office saying he was really white, the goal of pretty much any therapist out there would be to make him try to feel more comfortable being black.
Gender identity disorder is a controversial area. The diagnosis requires "a strong and persistent cross-gender identification" and significant distress related to the birth gender.
Some cross-gender people feel they are being labelled as mentally ill for having atypical gender desires and suggest that any associated distress is because they have to live in a society that marginalises their life choices.
There are some proponents that maintain that any cross-gender identification is an illness, although these are often the same people that think that being gay is a disorder and run 'treatment centres' for homosexuality.
Perhaps unsurprisingly, it seems Zucker's work is quoted rather favourably by many of these organisations - something that has given him a bad name amongst some parts of the the LGBT community. Although, from what I can make out, he's never associated himself with any of these views or organisations.
The mainstream professionals who defend the GID diagnosis usually suggest that the distress, rather than the desire itself, is key and this legitimises its classification and treatment. From this point of view, happy and adjusted transgender people would not be considered to have a disorder.
The program is well worth listening to as it tackles many of these thorny issues of gender politics.
Incidentally, the producer is Alix Spiegel, who produced 81 words, one of the finest documentaries on the history of psychiatry I've ever heard.
It looks at the how homosexuality was de-listed as a mental illness, but is more than that, it's also a moving story from Spiegel's family. The remarkable thing was that the the two were inextricably linked.
I've mentioned it before on Mind Hacks, but I highly recommend it if you've not encountered it before.
Link to NPR programme on cross-gender desires in children.
Link to audio archive of 81 words (click 'Full Episode' for free stream).
