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November 2, 2015

Study: Trans kid’s gender implicit; govt report condemns conversion therapy

A recent study found that the gender identity of trans children is as implicit as the gender identity of cis children. A study with 32 transgender children, ages 5 to 12, indicates that the gender identity of these children is deeply held and is not the result of confusion about gender identity or pretense. The study, led by psychological scientist Kristina Olson of the University of Washington, is one of the first to explore gender identity in transgender children using implicit measures that operate outside conscious awareness and are, therefore, less susceptible to modification than self-report measures and older studies by researchers who conflated trans and gender diverse children. The findings will be published in Psychological Science, a journal of the Association for Psychological Science.

I interviewed Olson about the study’s findings:

Cristan Williams: How was it that you became interested in working with trans children?

Kristina Olson: My area of expertise is understanding how children think about social groups, including race, gender, social class, etc, so I’ve always wanted to better understand a variety of children’s experiences. Transgender children are an especially interesting group because they are one of the only cases where a child is claiming an identity, that everyone doesn’t believe that child has. I was interested in understanding how children think about this group membership, how they do (or don’t) convince others of that identity, and what the implication are for their understanding of gender more broadly. In addition, a friend’s child was socially transitioning and I was learning just how little psychologists understood about transgender children’s development, yet this is clearly an important and timely topic to study. My hope then became that I could contribute both to scientific understanding of gender identity, and to the broader public’s understanding of the experiences and needs of transgender children.

Williams: A Fox News pundit compared kids who are trans to kids who think they’re dogs and cats saying, “You know, look, at a point when I was a child, I thought I was a cocker spaniel… And there’s a point when we have these fantasies where we think we’re Superman, where we can fly, where we’re the cat.” Would you please explain the difference between a trans kid and a kid who thinks they’re Superman and why do you think the children in your study aren’t just confused?

Olson: We have now used a wide range of measures to assess transgender children’s gender identities. We use some measures—ones we call explicit measures—where we directly ask children about their identities. We also use more indirect measures—what are called ‘implicit’ measures to assess identity. The latter are tests that are hard, if not impossible, for young children to fake. Most of the kids don’t even realize that we are assessing identity, nor that we are measuring their response speed. These tasks measure children’s associations between their view of themselves and their gender. Using both kinds of measures, we find the same conclusion—the these prepubescent, socially-transitioned, transgender kids who say they are girls, look like girls on all types of measures; the kids who say they are boys, look like boys on all types of measures. Therefore, we can conclude that these kids are not just pretending or playing around (as a child might pretend to be a Superman), rather, deep down, they appear to think of themselves as a girl (or a boy), just as much as any other girl (or boy).

Williams: The New York Times recently cited The Sissy Boy Syndrome (1987) to claim that most “gender dysphoric” children are not trans. In fact, the research published in that book looked at gender expansive children, not trans children. In other words, the study merely looked at boys who were deemed to behave in a “feminine” manner. Would you please explain the difference between a gender expansive child (such as a tomboy) and a gender dysphoric child (such as Jazz Jennings)? Also, would you please comment on why conflating “trans kids” with “gender expansive” kids can be problematic to research?

Olson: At the moment, my research group is examining the differences in experiences of what might be called “transgender children” (those who claim a male/female identity that is not the one assumed by their sex announced at birth) and what I often call “gender nonconforming children”. One of the problems of the Sissy Boy Syndrome study and many of the other longitudinal studies, is that they did not distinguish children based on their claimed identity, for example, conflating children who claim to be versus claim they wish they were a particular gender. There is already a bit of published data suggesting that of the larger group of gender diverse children, the ones who actually claim to be a member of the “other” gender (i.e., those who say I AM a girl!) are the ones who will likely identify as transgender adults, while those who do not make this identity claim (those who say, for example, I wish I was a girl because then kids at school would say it was ok to wear dresses) will not. One of our goals is to recruit groups of children who claim a transgender identity or not and to track them across development. Only with this careful prospective work will this question be able to be definitively answered, but right now it sure looks like one of the biggest mis-statements out there is that these old studies are relevant to discussions of transgender children when in fact, most of those children, it appears, were never transgender to begin with.

Williams: Unfortunately, some hate groups draw upon media tropes casting trans people as predators to support attacking equal rights for trans children. Have you found anything in your own (or another’s) research that suggests that being trans predisposes children to predatory behaviors?

Olson: Nothing I’ve studied is relevant at all to this question, nor have I read any work linking transgender people to predatory behaviors.

Williams: I’ve noticed that sometimes people can talk past each other when we use terms like “gender identity” or “gender role”. Within trans discourse, “gender identity” can mean any one of three things:

A.) One’s subjective experience of one’s own sexed body attributes;
B.) One’s sexed persona within the context of a social grouping; or,
C.) Both A and B.

Outside of trans discourse, some claim that “gender identity” is the experience of one’s gender role, which is problematic from a trans perspective since we tend to view “gender role” as a particularly pernicious aspect of sexism. Within trans discourse, one’s gender role refers to one’s cultural gender function. In sexism, “gender roles” function to promote a culturally perceived sex-segregated society. Being placed into a role is something that is done to people and in this sense, nobody can choose to live in a gender role. Should society deem that one is a male, that person will be placed into a male role by culture; should society deem that one is female, that person will be placed into a female role by culture. Since it is society and not personal agency that is the proscriptive agent, gender roles aren’t chosen and much of trans discourse is situated around ways of challenging and undermining these culturally constructed functions.

Within trans discourse, when one conflates gender identity with gender role, one is making the argument the trans women transitioned because they wanted to function as part of an oppressed class and trans men transitioned because they wanted to function as part of an oppressor class. In reality, we trans people experience anything from significant annoyance to crippling debilitation connected with Categories A and/or B, as defined above.

In order for trans people to better understand what you as a researcher mean when you talk about the “gender identity” of trans children, what was your operating definition for “gender identity” for your study?

Olson: In our study, we defined “gender identity” as the identity the child claims in everyday life. In our sample, it happens that the group we worked with claimed the binary ends of the gender identity spectrum, so all of our children claimed a male or female identity in their everyday life. However, you may have seen in the paper that when we follow-up and give kids more possible answers e.g., “boy, girl, both, neither, it changes over time, or I don’t know”, a few kids, both in our transgender group and our controls groups, give non-binary answers. We’ll be curious, as we follow these and now a much larger group of children into the future, whether the identity they claimed early in childhood is or is not related to their identity claims later in life.

Williams: You used implicit testing to understand the automatic – and therefore, unconscious – awareness of trans children’s gender identity. In her book, Delusions of Gender, Cordelia Fine wrote:

[Implicit tests] connect representations of objects, people, concepts, feelings, your own self, goals, motives and behaviors with one another. The strength of each of these connections depends on your past experiences (and also, interestingly, the current context): how often those two objects, say, or that person and that feeling, or that object and a certain behavior have gone together in the past.

When you measured the gender identities of the children in your study, you found that transgender children showed a strong implicit identification with their expressed gender. In other words, when you looked at the data from trans girls, their implicit gender showed the same pattern as the data from cis girls and the data from trans boys showed the same pattern as data from cis boys.

Are you merely saying that cis and trans girls like dollies or are you speaking to something much deeper than toy preferences?

Olson: To be clear, the implicit measure is not about toy preferences—it’s literally an association between concepts like me, my, and mine, with either photos of boys or photos of girls. That is, the implicit measure merely associates the speed with which they associate themselves with the concept of males or the concept of females. And yes, we did find that cis girls and trans girls associated themselves with female to an equal extent.

As to the question of toy preferences, we did also assess their preferences for peers and for toys associated with each of the two binary ends of the gender spectrum and again found similarity between cis and trans girls and between cis and trans boys. As you pointed out, these were just example items—we might have selected any number of different items that are culturally associated with gender. These ones just happen to have been the focus of previous work on gender development. We do not think that there’s something special about dolls or trucks, and we certainly know that culture and socialization determine which colors or clothes or toys are associated with each gender, so our primary conclusion is that across lots of measures of gender development, socially-transitioned, prepubescent transgender girls looks just like other (cisgender) girls, and the same for boys.

Williams: I understand that you are considering doing a larger study. Can you talk about why you want to expand your research?

Olson: We are currently recruiting a sample of what we hope will be more than 200 transgender and gender nonconforming kids all over the United States and Canada. To date we’ve worked with more than 150 of them. Our goal is to track these kids from prepubescence through adulthood, to shed some light on the similarities and unique paths of the development, and to answer some age old questions—are there aspects of identity, preferences, etc that help predict adult identification? What role does early parental support and/or social transitions play in determining mental health, well-being, and identity?

Williams: What are the possible implications of your work for so-called “reparative” or “conversion” therapies that seek to convert trans children into cis children?

Olson: I am not currently working with any children in either type of therapy, and these therapies are increasingly outlawed in many states and provinces. However, my reading of the literature is that these therapies, much like gay conversion therapy are not, and have not been “successful” (in quotes because that’s from the perspective of the people doing the therapy—it’s clearly controversial what success would really mean). Because we don’t focus on those kids in our current work, we can’t ever make conclusions about the impact of those therapies on those kids. What we will be able to say is the opposite—what is the impact of support as we do have children in our study who have a diverse history of levels of support from their families and communities. We think by focusing on children who are receiving support we might be able to understand some of the factors that might contribute to good health, happiness, and well-being amongst transgender and gender diverse children. Our hope would be that 10 years from now, our studies will be helpful to parents of tomorrow’s 5 year old transgender children, allowing them to make an informed decision about supporting their child’s identity.

Ending Conversion Therapy: Supporting and Affirming LGBTQ Youth

Being gay is not a disorder. Being transgender is not a malady that requires a cure. – Vice Admiral Vivek H. Murthy, 19th U.S. Surgeon General
As Olson notes, trying to force transgender children into becoming cisgender children is becoming increasingly outlawed.  In fact, the text in New Jersey’s law banning LGBT conversion therapy notes that the American School Counselor Association, American Psychoanalytic Association and the American Academy of Child and Adolescent Psychiatry all condemn ex-trans therapy.

American School Counselor Association:

It is not the role of the professional school counselor to attempt to change a student’s sexual orientation/gender identity but instead to provide support to LGBTQ students to promote student achievement and personal well-being.  Recognizing that sexual orientation is not an illness and does not require treatment, professional school counselors may provide individual student planning or responsive services to LGBTQ students to promote self-acceptance, deal with social acceptance, understand issues related to coming out, including issues that families may face when a student goes through this process and identify appropriate community resources.

American Psychoanalytic Association:

As with any societal prejudice, bias against individuals based on actual or perceived sexual orientation, gender identity or gender expression negatively affects mental health, contributing to an enduring sense of stigma and pervasive self-criticism through the internalization of such prejudice; and psychoanalytic technique does not encompass purposeful attempts to ‘convert,’ ‘repair,’ change or shift an individual’s sexual orientation, gender identity or gender expression. Such directed efforts are against fundamental principles of psychoanalytic treatment and often result in substantial psychological pain by reinforcing damaging internalized attitudes.

American Academy of Child and Adolescent Psychiatry:

Clinicians should be aware that there is no evidence that sexual orientation can be altered through therapy, and that attempts to do so may be harmful. There is no empirical evidence adult homosexuality can be prevented if gender nonconforming children are influenced to be more gender conforming. Indeed, there is no medically valid basis for attempting to prevent homosexuality, which is not an illness. On the contrary, such efforts may encourage family rejection and undermine self-esteem, connectedness and caring, important protective factors against suicidal ideation and attempts. Given that there is no evidence that efforts to alter sexual orientation are effective, beneficial or necessary, and the possibility that they carry the risk of significant harm, such interventions are contraindicated.

Coming on the heels of Olson’s study, the Substance Abuse and Mental Health Services Administration (SAMHSA), a branch of the U.S. Department of Health and Human Services, published a report condemning “conversion” or “reparative” therapies. As part of its report, SAMHSA released the following professional consensus on gender identity and gender expression in youth:

Consensus on Efforts to Change Gender Identity

  • There is a lack of published research on efforts to change gender identity among children and adolescents; no existing research supports that mental health and behavioral interventions with children and adolescents alter gender identity.
  • It is clinically inappropriate for behavioral health professionals to have a prescriptive goal related to gender identity, gender expression, or sexual orientation for the ultimate developmental outcome of a child’s or adolescent’s gender identity or gender expression.
  • Mental health and behavioral interventions aimed at achieving a fixed outcome, such as gender conformity, including those aimed at changing gender identity or gender expression, are coercive, can be harmful, and should not be part of treatment. Directing the child or adolescent to conform to any particular gender expression or identity, or directing parents and guardians to place pressure on the child or adolescent to conform to specific gender expressions and/or identities, is inappropriate and reinforces harmful gender stereotypes.

While the report notes that there are studies that claims that most gender-nonconforming children do not transition when they grow older, the report also notes that those studies, “were based on clinical samples of youth and many of the researchers categorized youth no longer attending the clinics (whose gender identity may be unknown) as no longer gender dysphoric, and so this research likely underestimates the percentage of youth.” Moreover, the report notes that these studies often conflate gender nonconforming children with trans children and thus suggests, “that the inclusion in study samples of many children with diverse gender expressions who may not have gender dysphoria” seems to explain the discrepancy between older studies (such as the one the NY Times cited) and newer research with modern distinctions between gender diverse and trans children. The SAMHSA report notes that implicit gender indicators, such as those used in Olson’s research, are likely effective in differentiating between gender diverse and trans youth.

Importantly, the report goes on to note that non-binary children should be able to embrace emerging non-binary gendered identities. “Transgender identities and diverse gender expressions do not constitute a mental disorder, [and] variations in gender identity and expression are normal aspects of human diversity, and binary definitions of gender may not reflect emerging gender identities.”

The report hits home just how dangerous it is to force trans adolescents into conversion therapy. “Because there is scientific consensus that gender dysphoria in adolescence is unlikely to remit without medical intervention, even those who support gender identity change efforts with pre-pubertal children generally do not attempt such efforts with adolescents experiencing gender dysphoria.” The report notes that there is no proof that conversion therapy works on trans youth, “No research has been published in the peer reviewed literature that demonstrates the efficacy of conversion therapy efforts with gender minority youth, nor any benefits of such interventions to children and their families.”

Even right wingers at this year’s Southern Baptist Conference made the news when they publicly acknowledged that conversion therapy doesn’t work. Even so, the Conference still maintained that being anything other than heteronormatively straight is sinful and that all LGBT people should ritualize repression as part of their faith.


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Cristan Williams
Cristan Williams
Cristan Williams is a trans historian and pioneer in addressing the practical needs of the transgender community. She started the first trans homeless shelter in the South and co-founded the first federally funded trans-only homeless program, pioneered affordable healthcare for trans people in the Houston area, won the right for trans people to change their gender on Texas ID prior to surgery, started numerous trans social service programs and founded the Transgender Center as well as the Transgender Archives. Cristan is the editor at the social justice sites TransAdvocate.com and TheTERFs.com, is a long-term member and previous chair of the City of Houston HIV Prevention Planning Group.

2 Comments

  1. The following list of links is to demonstrate that there is a very large body of evidence pointing to brain differences beginning in utero as the fundamental cause of most instances of transexuality. Part of the resistance to the brain-sex theory comes directly from Dr. Anne Lawrence who critiqued two early studies in this area (clear back in 2002) but who has a personal vested interest in arguing a different basis as she has based her entire career on that different basis. This list is not even close to comprehensive.
    General Neurobiological Studies, Abstracts, Articles, and Commentary
    Long-Term Follow-Up of Transsexual Persons Undergoing Sex Reassignment Surgery: Cohort Study in Sweden
    Variants of Gender Differentiation in Somatic Disorders of Sex Development: Recommendations for Version 7 of the World Professional Association for Transgender Health’s Standards of Care
    Androgens and the evolution of male gender identity among male pseudo-hermaphrodites with 5-alpha reductase deficiency
    On the quest for a biomechanism of transsexualism: Is there a role for BDNF?
    Transgender Science: How Might It Shape the Way We Think about Transgender Rights
    A sex difference in the hypothalamic uncinate nucleus: relationship to gender identity
    Regional gray matter variation in male-to-female transsexualism.
    White matter microstructure in female to male transsexuals before cross-sex hormonal treatment. A diffusion tensor imaging study.
    White matter microstructure in transsexuals and controls investigated by diffusion tensor imaging
    The microstructure of white matter in male to female transsexuals before cross-sex hormonal treatment. A DTI study.
    A sex difference in the human brain and its relation to transsexuality.
    Sexual differentiation of the bed nucleus of the stria terminalis in humans may extend into adulthood.
    Specific cerebral activation due to visual erotic stimuli in male-to-female transsexuals compared with male and female controls: an fMRI study.
    Male-to-female transsexuals show sex-atypical hypothalamus activation when smelling odorous steroids.
    Intersex, brain differences, and the transgender tipping point
    Sexual differentiation in the developing mouse brain: contributions of sex chromosome genes
    Update on the Biology of Transgender Identity
    Sex differences in the structural connectome of the human brain
    Cortical activation during mental rotation in male-to-female and female-to-male transsexuals under hormonal treatment.
    Gender Orientation: IS Conditions Within The TS Brain
    Increased Cortical Thickness in Male-to-Female Transsexualism
    Prenatal Exposure to Female Hormones: Effect on Psychosexual Development in Boys
    Sexual differentiation of human behavior: Effects of prenatal and pubertal organizational hormones
    Frontiers in Neuroendocrinology,
    Brief Report: Female-To-Male Transsexual People and Autistic Traits
    Dr V. Drantz Lecture: Myth & Science of Sexuality
    Male–to–female transsexuals have female neuron numbers in a limbic nucleus
    Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth
    The role of androgen receptors in the masculinization of brain and behavior: what we’ve learned from the testicular feminization mutation.
    Regional cerebral blood flow changes in female to male gender identity disorder.
    Sexual Hormones and the Brain: An Essential Alliance for Sexual Identity and Sexual Orientation
    “Prenatal hormones versus postnatal socialization by parents as determinants of male-typical toy play in girls with congenital adrenal hyperplasia”
    Disorders of sex development expose transcriptional autonomy of genetic sex and androgen-programmed hormonal sex in human blood leukocytes.
    Sexual differentiation of the human brain in relation to gender identity and sexual orientation
    Changing your sex changes your brain: influences of testosterone and estrogen on adult human brain structure
    Clinical Implications of the Organizational and Activational Effects of Hormones
    Dichotic Listening, Handedness, Brain Organization and Transsexuality
    Biased-Interaction Theory of Psychosexual Development: “How Does One Know if One is Male or Female?”
    Increased Cortical Thickness in Male-to-Female Transsexualism
    Prenatal exposure to testosterone and functional cerebral lateralization: a study in same-sex and opposite-sex twin girls.
    Prenatal exposure to diethylstilbestrol(DES) in males and gender-related disorders:results from a 5-year study
    Chapter 5 of The Transsexual Phenomenon
    Prenatal phthalate exposure and reduced masculine play in boys
    Brain gender identity
    Current Thinking on the Etiology of Gender Dysphoria
    Gender Differences in Human Brain: A Review
    Begging the Question: Autism in Trans Men
    Largest Study to Date: Transgender Hormone Treatment Safe
    Hormone Therapy and Venous Thromboembolism Among Post-Menopausal Women
    Transsexual Gene Link Identified
    Transgender: Evidence on the biological nature of gender identity
    Networks of the brain reflect the individual gender identity
    Transsexual differences caught on brain scan
    Brain Mapping Gender Identity: What Makes A Boy A Girl?
    MTF Brains.mov
    Male-to-Female Transsexuals Have Female Neuron Numbers in a Limbic Nucleus
    The (bi)sexual brain: Science & Society Series on Sex and Science
    Transsexual gene link identified
    The catastrophically bad New York Times op-ed on transgender research, debunked
    Charlie Rose: The Brain Series – Gender Identity (an hour long video)
    Think Like A Man: Testosterone Treatment Allows Transgender Men To Think And Talk Like A Man
    (Note that the above article title is problematic in that it implies trans men are not men so only talk “like” men. But the hormonal research is interesting.)
    (Patho)physiology of cross-sex hormone administration to transsexual people: the potential impact of male–female genetic differences
    Homosexuality may be caused by chemical modifications to DNA This is important because it ties back again to hormonal in utero differences driving white matter brain structure differences.
    Sex Hormones Administered During Sex Reassignment Change Brain Chemistry, Physical Characteristics
    High-Dose Testosterone Treatment Increases Serotonin Transporter Binding in Transgender People
    Sex Hormones Administered During Sex Reassignment Change Brain Chemistry, Physical Characteristics
    The brains of men and women aren’t really that different, study finds – This study actually reinforces the neurobiological understanding of being transgender. I explain this here, in New Brain Study Reinforces Neurobiological Explanation of Being Transgender
    Sex biology redefined: Genes don’t indicate binary sexes
    A Systematic Review of the Effects of Hormone Therapy on Psychological Functioning and Quality of Life in Transgender Individuals
    For convenience, the DSM-5 clearly states, gender dysphoria is not a mental disorder.Gender Dysphoria Explanation for DSM-5
    The following link helps expose why the autogynephelia diagnosis is pure garbage, which means Bailey, Blanchard, etc., are basically full of nonsense. (Because women get aroused thinking of themselves as women too.)
    Autogynephilia in women.
    Studies, Articles, and Commentary About Trans Children’s Sense of Gender Identity
    Gender Cognition in Transgender Children
    Update: Gender Cognition in Transgender Children
    Transgender Kids Show Consistent Gender Identity Across Measures
    This Is What Happens To Transgender Kids Who Delay Puberty (Study next line below)
    Young Adult Psychological Outcome After Puberty Suppression and Gender Reassignment
    Transgender teens become happy, healthy young adults
    Allowing Transgender Youth To Transition Improves Their Mental Health, Study Finds
    Transgender kids: Painful quest to be who they are
    Center For Excellence for Transgender Health: Youth: Special Considerations
    Mom Fights for Controversial Medicine for Transgender Youth
    Free to be themselves
    Perth Year 3 student in transgender row after school cross country run
    “80 percent change back”
    A New Study About Transgender Kids Proves Something Majorly Important
    STUDY: Transgender Kids Are Not ‘Confused’ About Their Gender Identities
    Study: Trans kid’s gender implicit; govt report condemns conversion therapy
    Share this:GoogleFacebookEmailLike this:Like Loading…

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  2. […] is just as firm and central as the gender identity of a cisgender child. You can learn more on the Transadvocate website. Thanks to Josy C for the […]

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