Outline · [ Standard ] · Linear+ A Matter of Identity

[Graeme]

The following article has been transcribed from a full-page article in the Melbourne’s Child magazine. This magazine is free and is readily available from most child-care centres, preschools, commercial playgrounds and anywhere where young children and their parents or grandparents can be found. Similar magazines exist in the other capital cities of Australia so I expect this article is also available in those places.

I was so impressed by this article that I thought I should share it. It may contain some typos, for which I take full responsibility. I’m looking forward to next month’s magazine to see what letters this generates.

There was also a set of resources at the end of the article which I haven't transcribed.

Graeme

A Matter of Identity

Klay Lamprell investigates the issue of transgenderism, or gender dysphoria, in children.

By the time Josh Martin* was 18 months old, it became clear to his parents that he was not as ‘macho’ as some other boys his age. He showed a preference for soft colours, quiet play, girl dolls and tidiness. He was also more advanced than his male peers in language skills and dexterity. By the time he was two, Josh was refusing to wear boys’ clothes or shoes. He wanted his nails painted and would not have his hair cut. His parents, Jan a dentist and Andrew an academic, were, as they put it, “alert but not alarmed”.

“We had no expectations that our son would be a rough and tumble sort of kid. Josh has an older sister, Amy, and he adored her from when he was a baby. And his father is a gentle man. I do admit it was a challenge when he wanted to wear dresses to preschool. We were very worried for him in terms of a social life and pressure from other adults. That was why we went with him to a psychiatrist. Not to find out what was ‘wrong’ with him and ‘fix’ it but to help tailor our parenting strategies to his temperament. As that point we thought it was a passing stage.”

The first psychiatrist the family saw believed that Josh was responding to parental relationship issues. “He was very Freudian,” says Jan. “According to him it was all about some sort of resentment Josh had towards his father and an over-identification with me. He practically insisted that there was something dreadful in our relationship that made Josh this way. So we had relationship counselling, but in the end we both agreed that the guy was looking for something that wasn’t there. We finally found someone who dealt with gender-identity issues. Over the years, as Josh’s behaviour has remained more feminine than masculine, we have accepted that he is transgender.”

The term transgenderism, or gender dysphoria, refers to people whose sense of maleness or femaleness does not match the gender of their sexual organs. With the rise of lesbian, gay and bisexual communities, there is increasing cultural acceptance that gender is a spectrum, with maleness at one end, femaleness at the other and a range of behaviour and sensibilities in between and beyond. However, transgenderism is not about sexual orientation and sexual attraction. It is about the gender with whom a person identifies.

In the bad old days, not so long ago, it was believed that gender could be programmed into a child. Stringent social expectations of gender behaviour were imparted by families, peer groups, educational institutions and religious organisations. The consequences for acting outside the norms ranged from alienation and verbal or physical punishment, to shock therapy and institutionalisation. Extremely high suicide rates as well as drug and alcohol abuse amongst the transgender community point to a lack of success in attempts at conditioning.

In the famous so-called John/Joan case in the late sixties, doctors at John Hopkins Hospital in the USA decided to turn a baby boy into a girl after a badly botched circumcision. From the time of the operation through to adolescence, John/Joan, whose real name was David Reimer, was subjected to psychological and hormonal conditioning to secure his identity as a female. Born an identical twin, his brother became the ‘control’ in the experiment. While the twin grew up a boyish boy, John/Joan appeared to be a happy, healthy and ‘normal’ girl. Medical and psychiatric communities used the case to argue that conditioning can beat nature’s intentions, and sex reassignment became a stock standard treatment for babies who were born with genital problems.

It wasn’t until 1997 when it was discovered how desperately unhappy John/Joan had been all his life, and how painfully he had struggled with his compromised sexuality, his gender identity and the expectations of his family. In March 2004, David Reimer committed suicide.

The nature/nurture debate continues. To what extent is a child born with gender dysphoria and to what extent is gender identity affected by upbringing? Essentially we know close to nothing about how a gender identity becomes established. In the last couple of decades, autopsy-based research has indicated a possible pre-natal cause for gender dysphoria. Medical authorities note that hormone ‘washes’ act on the body of the foetus and the brain, but there is discussion over whether and how this ‘hardwires’ the brain for gender identity. There is also discussion on the chromosomal variations that influence the process of determining sexual identity. At the very least, it is now accepted that gender dysphoria is probably the result of a complex interchange of biological and environmental factors.

Professor Louis Gooren, who runs the largest gender dysphoria clinic in the world in Holland, sees children as young as five years of age. “Some children start out not to behave ever as a person of the biological sex they seem to belong to, and they always behave like people of the opposite sex. They become extremely squeamish when they are put in a category of the biological sex. Parents see that, and mostly the parents are the biggest supporters of these interventions. They say, ‘It’s hopeless, we cannot fit our child into the category of sex you would think the child belongs to’.”

General manager of The Gender Centre in NSW, Elizabeth Riley, sees families with pre-adolescent and teenage kids. “That’s when the children themselves are beginning to identify why that have felt so different all their lives,” she says. “If you talk to transgender people, almost without exception they will tell you that they knew with certainty they had a gender-identity issue from the age of around nine or 10. When it becomes clear that this behaviour is not going away, parents come to us to help sort through the prejudices and work out strategies to protect their children at school and to manage issues with peers.”

For Josh Martin, acceptance from his parents has softened the blows he suffers by begin a ‘girly’ boy. “Obviously gender can be influenced by upbringing,” say his mother Jan, “but I don’t it can be completely erased. We’re not talking about a male toddler who pops on a frock occasionally, or a little girl who acts like a tomboy. Nor is this about teenage dabbling into varied sexuality. We’re talking about children who continually, even under the duress of discrimination and abuse, behave in ways that are outside of society’s gender norms.

“Josh is now 17. He wears boys’ and girls’ clothing. He isn’t gay. He says he is attracted to girls, though he hasn’t had a girlfriend because girls don’t find effeminate men attractive. We worry for him in terms of relationships, but we feel really good that from the beginning we were steady in our love and support for him. He is a secure, intelligent and very funny young man. He just likes to get around in a dress.”

* Real names have not been used.

Key Terms

While these definitions are the most commonly accepted in the transgender community, some are subject to ongoing debate and discussion.
Sex: The biological status of male or female.
Gender: the social construction of one’s sex. In our society one’s sex is expected to correspond to one’s gender, that is, if you are female you are supposed to have a feminine gender.
Gender Identity: a person’s internal sense of being female, male, or both or neither. This is communicated to others by one’s gender expression – clothes, hairstyle, mannerisms, etc. Society prescribes arbitrary rules or gender roles (how one is expected to and not expected to dress act, think feel, relate to others etc.) based on one’s biological sex.
Transgender: an umbrella term for those whose gender identity or behaviour falls outside of stereotypical gender norms. Transgender people are those who do not identify with the gender assigned to them at birth. This includes those who identify with the opposite gender to their biological sex, that is, someone who is born anatomically ‘female’ but feels this is at odds with their inner sense of being male. There are other transgender people who do not identify with either sex/gender or may feel bi-gendered, challenging the notion that there are only two mutually exclusive genders.
Transsexual: those individuals who are born anatomically male or female but have profound identification with the gender opposite to that assigned to them at birth. Many, though not all, opt for surgery and hormone treatment to correspond to their internal concept of self.
Transphobia: refers to the fear and hatred of transpeople that take place in the form of harassment, violence and abuse towards those who are or are perceived to be transgender.
Affirming Gender/Transition: the process of adopting a lifestyle and/or body that matches a person’s sense of their gender. The process may take some time, involve a number of different by related processes and may or may not involve surgery.
Intersex: a biological condition where a person is born with reproductive organs and/or sex chromosomes that are not exclusively male or female. The previous term for intersex was hermaphrodite.

[Graeme]

Some related news....

A girl in theory, a boy inside
By Lucy Beaumont
April 13, 2006
Source: The Age Newspaper


David Reimer was raised as a girl until he was 12.
Photo: REUTERS

A famous sex change still raises questions about gender.

THE opening line is shocking. "This is the story of a boy whose penis was burnt off." What happened next imbues the nature-nurture debate with personal and tragic significance.

Dr Money and the Boy with No Penis, a British documentary to screen on SBS, tracks the players in one of psychiatry's most famous cases: the baby boy who was turned into a girl then a boy again, his twin brother and the scientist determined to prove his gender theories through them.

The story of Bruce/Brenda/David Reimer and his brother Brian - often called the John/Joan case - has been told many times. At first, research papers hailed it a success. Later examinations revealed the pain behind it. Following the sad end to the brothers' story, this documentary, made 18 months ago for the BBC's Horizon science program, is the final chapter and a cautionary tale.

Producer Sanjida O'Connell says the program's aim is to tell the family's story and explore the science of conjecture. "Science is supposed to put forward a theory that's proved or disproved, then people move on," she says. "Whereas, of course, scientists are humans too. They have their own biases."

Louise Newman, chair of the Royal Australian and New Zealand College of Psychiatrists' child and adolescent faculty, says the case remains controversial.

"It's one of the biggest questions in developmental theory: How much of our personality and sense of identity, including sexual or gender identity, is under biological control as opposed to social and cultural."

In 1966 Canadian twins, Bruce and Brian Reimer, aged seven months, went to a hospital to be circumcised. During the procedure electrical equipment malfunctioned and burnt off Bruce's entire penis.

"It was like a little burnt piece of string, right up to the crotch," remembers their mother Janet in the documentary. "I said, 'Oh my god, what are we going to do now?' "

Without modern plastic surgery options, the Reimers remained uncertain until they saw a television interview with Dr John Money, a sexologist from Johns Hopkins University in Baltimore.

The family were desperate for guidance. He had a theory to prove; that a baby's gender was neutral for the first two years and dependent on whether it was raised as a male or female. In the Reimer twins, he had a ready-made subject in Bruce and a control subject in Brian. Bruce had surgery and Dr Money instructed his parents to raise him as a girl, never revealing his original gender.

In the years that followed Dr Money quizzed the twins, now called Brenda and Brian, on their differences. By 1972, Dr Money declared the transition a success, trumpeting his theory of gender neutrality in his book Man and Boy, Woman and Girl.

"Dr Money can't be blamed for coming up with a theory that many scientists now believe was wrong," says producer Sanjida O'Connell of the now retired doctor who declined to be interviewed for the program.

Back at the Reimers', young Brenda was displaying "masculine" and aggressive behaviour, eschewing dolls in favour of cars and trucks.

The program's dramatic reconstructions show that Dr Money's interviews with the twins grew more explicit and distressing. As adults, the twins alleged that the doctor bullied them into stripping naked and adopting sexual positions.

"If that happened then it's obviously a terrible thing to do to a child," O'Connell says. "But I don't think he was a monster. He was trying to do the best he could but wasn't flexible enough to realise that his theory wasn't working."

Aged 12, with Dr Money pushing her to have surgery to construct a vagina, Brenda threatened to kill herself. Her parents finally resolved to tell her and Brian the truth. Brenda decided to live as a boy, adopting the new name of David. He would later have more surgeries, marry and become a stepfather. But both twins remained traumatised.

With hindsight, says Louise Newman, it's clear that the experiment was doomed to fail. "This was a trauma that (David) never got over. He was embittered, had no help, rejected help. Then he had the permanent effects of having taken hormones."

In 2000, John Colapinto's book, As Nature Made Him, revealed the painful extent of the experiment's failure. The Horizon program includes interviews with David conducted in 2000 for a film about intersex babies. By 2004, both brothers were dead.

Scientists are still trying to determine what makes us male or female. Associate Professor Vincent Harley, head of human molecular genetics at Melbourne's Prince Henry's Institute of Medical Research is at the forefront of research into the genetics of sex. "We're tackling (the question) at a number of levels. It depends on what kind of sex you mean, whether you're talking about their brains, their gonads or their role in the world," he says.

Some genes have already been identified as involved in controlling the development of testes or ovaries. Genes expressed differently in male and female brains, well before birth and before hormones come into play, are "a starting point to look for differences in gender identity".

Forty years after Brian became Brenda, Professor Harley says that "the search continues", adding that "people's gender identity is unlikely to be as malleable as was thought then".

A case like Brian Reimer's would be handled very differently today, says Louise Newman. "It's a terribly outmoded assumption, that being a castrated male means being a female," she says.

Gender identification would also be measured against different yardsticks. "What we have now are less rigid definitions of what's gender-appropriate behaviour," Newman says. "It wouldn't be a matter of 'You like Barbies, therefore you're a girl. You like trucks therefore you're a boy.' Children aren't like that. But in Money's day that wouldn't have been acknowledged."

David Reimer had his own theory about masculinity.

"What makes you a man is you treat your wife well, you put a roof over your family's head, you're a good father. Things like that add up much more to being a man than just 'Bang! Bang! Bang! Sex!'," he told author John Colapinto. "I guess John Money would consider my children's biological fathers to be real men. But they didn't stick around to take care of the children. I did. That, to me, is a man."

Dr Money and the Boy with No Penis airs Sunday, April 16, at 8.30pm on SBS.