Wednesday, January 28, 2009

Won't someone please think of the children?!?!?!?!?

Some years ago, I won't say how many, I had a disagreement with my 6th grade teacher. She accused me of talking, and I hadn't. Since she was threatening me with rather dire punishment, I told her, to her face, that she had told a lie. Well, of course this did not go ever well with her, and I quickly found myself in the principal's office. The result was, I was referred for testing to find out what was wrong with me.

Over the course of several months, I was sent to a number of offices where I received an array of tests, all designed to determine exactly why I was having trouble. In addition to psychological exams, I also had my vision and hearing tested.

Of course, what was wrong was simple. I had what would the DSM-IV would label as "Gender Identity Disorder in Children." Of course, it would be my contention that I had Harry Benjamin Syndrome, which is a completely different matter. Unfortunately, at that time, and in that place, those who saw me were not quite so enlightened. And for that reason, I was not willing to reveal certain things to them anyway. Simply put, I knew better than to do so.

I do wonder if one of the people I saw didn't have some suspicions. My mother made some rather odd remarks in later years about what he told her. What she said simply did not sound quite right, and knowing my mother, she might well have been trying to hide the true facts from me. But, I do recall, on at least one occasion, deliberately lying to a psychologist. And given what she did with what I did say, I shudder to think about what would have happened if I had told the truth.

She asked me what seemed a relatively benign question. If I had three wishes, what would they be. Well, of course, the first one would have been to be a girl. Of course, that was not a safe answer, and I knew it. I made up three answers, that I thought would be benign...."To have more friends, to have a million dollars, and for three more wishes." The last one was a common answer among my friends when we pondered this question...and no, I didn't tell them my first wish would be to become a girl either.

Well, what I thought was safe, turned out to be anything but. She took the first answer as an indication that I felt isolated. And she took the third as proof that I did not like to follow the rules. I can only imagine what she would have written if I had told the truth.

Times have changed, at least for some. Much research has been done on children who show signs of having some issue with their gender. In fact, it has been suggested that one of the primary reasons that "Gender Identity Disorder in Adolescents and Adults" is listed in the DSM-IV is so that therapists can continue to treat children in an effort to prevent that mental illness.

One of the leading proponents of treating children with gender issues is Kenneth J. Zucker who practices at the notorious Centrefor Addiction and Mental Health aka the Clarke Institute. Yes, the same place where Ray Blanchard practices.

Zucker is also leading the American Psychiatric Association committee that is revising the section of the Diagnostic and Statistical Manual dealing with "gender idenitity disorder." Many find this disturbing because of his association with people like Blanchard, Michael Bailey, and Anne Lawrence.

Zucker is the leading proponent of the use of reparative therapy to treat children with gender issues. He has made the claim that he is able, using psychoanalytic techniques, to prevent children with gender identity disorder from becoming adult transsexuals. Now, reparative therapy is what is commonly used by the ex-gay movement to "cure" homosexuals. Ironically, the American Psychiatric Association has condemned its use with adults, but makes an exception for those like Zucker who apply it to children.

But the question remains, can Zucker's approach prevent someone from growing up to be transsexual or HBS? According to Zucker, most of those he treats go on to become homosexual, "rather than transsexual." He cites this as a success. But there is a major problem with Zucker's that has been pointed out by a least two of those who might otherwise be seen as part of the same group. In the absence of treatment, most children who exhibit what is termed "gender identity disorder" grow up to be homosexual anyway. Both Michael Bailey, and more recently Alice Dreger has admitted this. In fact, in a recent article Dreger seems to openly disagree with Zucker's approach.

She compares Zucker's "try to make them normal" approach, which supposedly tends to make the child homosexual rather than transsexual, and the "accomodation" approach, which allows the child to be "what they feel they are," but which can lead to later problems when the child realizes that he or she is really homosexual, and finds both somewhat lacking. Instead she endorses a third approach.

This approach, which was developed by Peggy Cohen-Kettenis is not so concerned with the child's gender issues, as much as the child's functioning as well as the family situation. It recognizes that most children will not go on to be transsexual or HBS, but if they do, the child is supported in this decision and is assisted in preparing for sex reassignment.

As much as I have disagree with Dreger in the past, surprisingly, on this issue, she seems to be the voice of reason. Zucker's approach accomplishes little, if anything, other than probably leaving the child who really is HBS feeling confused and guilty. The accommodation approach works fine if the child really is HBS, but since that is difficult to verify, it may cause problems if the child later decides to follow a homosexual path.

Unfortunately, many who work in this field are less concerned about the health and welfare of the children than they are about pushing their own agendas. Zucker is part of the larger group that is dominated by the rather bizarre views of Ray Blanchard who has made a career out of trying to discredit people who are HBS. The fact that Zucker considers it "preferable" that a child identify as gay rather than HBS or transsexual is part of this. It is widely believed that Blanchard simply represents the disdain that many older gay men have for transsexuals.

And many who push the accomodation approach have their own agendas. While this is clearly the best approach for the child who truly is HBS, unless that can be firmly established, it may result in worse problems.

Clearly, this is any area where much research is needed. But those doing the research need to approach the subject with truly open minds, leaving behind the sort of prejudice and stubborness that has caused so much heartache in the past. One only has to look at the results of John Money's mistreatment of David Reimer to see how tragic such an approach can be.

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