“Too young to get a tattoo. Too young to get piercing. Too young to drink alcohol. Too young to buy cigarettes. Too young to buy guns. Want to remove your penis? Who is society to stop you?” The irony is from the conservative American transsexual Blaire White, on Twitter. The issue of so-called trans children has occupied political debates in the United States for years, and it shows no signs of regressing into oblivion anytime soon. Last month, the media company Daily Wire released a documentary in which the topic is prominent.
But Blaire herself reported, in the podcast audience in the west, from presenter Joe Rogan, who felt he was different since he was five years old. The Brazilian naturalized Swiss Roberta Close, 57 years old, who underwent sex reassignment surgery in 2020 , declared to the magazine Quem, in 2020, that “she was a girl since she was a child”. Trans adults were children once, but that is not the same as saying that this vocabulary was appropriate when they were in that age group. Apart from personal reports, is there knowledge that endorses the idea of “trans children”?
Dysphoric children exist, but to call them trans is to go against the data
Debra Soh, Canadian doctor in sex neuroscience, tells in her book of 2020 The End of Gender
(“O Fim do Gênero”, in free translation, unpublished in Brazil) about the meeting he had with the father of an alleged trans child at a cocktail party. “In my opinion, it was very likely that he didn’t have a transgender daughter — he had a gay son.” The father had authorized the boy’s puberty block, which said he wanted to be a girl. “Why would he trust me, a complete stranger, over an entire medical team that knew the child well? But I could see the pain in his eyes and I knew a part of him felt divided,” says Dr. Soh.
At first glance, the scientist’s attitude may appear to be self-important. But the statistics are on her side. Between 57 and 90% of children who say they want to be of the other sex give up of it when puberty arrives. These are the conclusions of 11 different studies that accompanied them. Gender dysphoria, as psychiatry calls this persistent desire to change sex and deep discomfort with one’s own body, has a high remission among children who manifest it, even when severe. When they reach adulthood, these people are more likely to develop an attraction to people of the same sex. So dysphoria was a sign of something — but not necessarily transsexuality.
Therefore, it would be more accurate to reserve the word “trans” only for cases where hormone treatment and possible other treatments surgical (not mandatory after hormonal) are the most medically recommended for the relief of dysphoria. This would only be the case when it is certain that there will be no dropout, which usually occurs after puberty. When a person reaches a state of sufficient maturity to be transsexual, he is no longer a child. Thus, one should not talk about trans children, but about dysphoric children, whose future is uncertain.
Brazilian norms seem adequate: only those over years old can perform sex reassignment surgeries, as established in guideline 2.265 of 2019 of the Federal Council of Medicine. On the other hand, cross hormone therapy (taking hormones of the opposite sex and, in the case of boys, also interrupting testosterone), is only allowed from 11 years, when puberty is advanced, with permission from parents or guardians. It is a solution to be considered by the medical professional, patient and family on a case by case basis, not something to be recommended for dysphoric children in general. Surgery, but also hormones, have irreversible effects.
“In many cases”, comments Debra Soh in the book, “children will say they are of the opposite sex because they want to do the things they want. the opposite sex does, and this is the only language they have to communicate that idea”. Only around five to seven years old do they learn that being male or female is a fixed characteristic that does not change based on superficialities such as appearance or preferred activities.
Evidently, if around 80% of dysphoric children give up, 20% persist. In the Netherlands, where the subject has been studied the longest, people who persist in transsexuality have a higher rate of suicide than the general population. But it is a rate comparable to that of homosexuals. In the largest study on the subject, already discussed here in Gazeta do Povo, involving more than 8,000 transsexuals accompanied in almost 50 years, sex transition treatment was associated with a drop in suicides among those transitioning from male to female (“trans women”), and did not worsen things for the other group.
Radical ideas that hurt young people radically
If we have some good indications of studies, for that so much controversy in the United States? It’s just that, over there, the guidelines vary from state to state, and between hospitals. There are places in the country where the will of parents of dysphoric minors can be overruled by the State, which offers treatment and sometimes even housing for the minor to leave home. This was the case of Yaeli Martinez, a girl from birth who was taken in by a house in the State of California and, after treatments for transitioning to masculine expression at the protests of her mother, committed suicide. The state directive is clearly under the influence of activists who think that when someone like Yaeli comes along, only the “affirmation” of what the person feels is acceptable as treatment.
Many of the ideas that circulate in identity activism go against Brazilian medical guidelines for transsexuals. Some have academic roots, such as the idea that gender is distinct and unrelated to sex. This idea, much more the result of activism within universities than of scientific research, is criticized by scientists such as Marco del Giudice, a specialist in gender differences in the human species and professor at the Department of Psychology at the University of New Mexico, in the United States.
In a book chapter by 2019 in which he reviews various methods for measuring differences between the sexes, Marco comments that “the sex-gender distinction is problematic and ultimately infeasible”, for “not only does it suggest a sharp separation between social and biological explanations; It also presupposes that it is already known whether a certain aspect of behavior is biologically or socially constructed in order to choose the appropriate term”. Things that seem entirely cultural, such as differences in career choices, have biological factors at work, for example. Thus, the distinction between sex and gender would be a distinction without real difference.
This distinction is seen in teaching materials to educate about transsexuality. The potentially most famous of these materials is the design of a doll inspired by the shape of a gingerbread cookie popular in Christmas cooking in English-speaking countries. It is highlighted in the head, heart and genital area. The identity of “gender” would be the domain of the head, this would supposedly be independent of the attraction, which is in the heart, and also of the sex, pointed in the genital area. This scheme ignores much of the research on transsexuality itself, which points out that they are actually very often interrelated aspects.
Philosophical and scientific confusions of activism generate results — often unwanted — in the real world. . Discomfort with one’s own body, which is common among teenagers, is then incorrectly interpreted as dysphoria. The word “transgender”, more amenable to ideology, started to be used more than “transsexual”, with more anchor in reality. And the term “gender” attracts radical theories that have become secondhand material on blog networks and groups that suggest that if a young person feels differently about how they express themselves, they must be “transgender” — and dysphoria is even played out. out as a necessary criterion for this. Activism websites seriously suggest that people can be “beach gender”, “cute gender”, “star gender”, among other less intelligible terms. The result is more confusion and, potentially, more suffering for a generation increasingly affected in their mental health by social media and the concomitant paradoxical isolation.
There is a tragic irony in the current greater acceptance of people with dysphoria and the possible social and biological transformations they undergo. When the taboo was greater, it caused more suffering for those people for whom transition was the best possible treatment, but at the same time it ensured that transition was not offered to whom it would be unnecessary.
Now, with politically correct vocabulary tweaks — “gender readjustment” or “confirmation” surgery instead of sex reassignment surgery, “transgender” instead of transsexual — and inclusion activism, alleged trans among young Americans exploded. They went from very few decades ago to 5% among Americans under 30 years old, according to a Pew Research Center survey. With the pressure for “affirmation” and also a fashion disconnected from dysphoria, tragic cases of giving up after hormones and surgeries are already known, especially among young females, who have always been more vulnerable to social contagions, from bulimia to LGBT self-identification. Progressive ideology is also linked to the phenomenon.
Therefore, talking about “trans children”, ignoring the details of treatment that, despite little research, rely at least on decades-old practices in psychiatry , would be an attitude that tends to feed confusion and glorify the replacement of the considered analysis of facts by the ideological fury of preaching a single solution for all cases. Diversity of ideas would be welcome even in psychiatry, where the term “gender” and its ambiguities are used without much attention to academic controversy.