Alice Dreger, a professor of bioethics, revised her views on gender dysphoria after receiving a letter from a mother of a “pink boy” – one “whose manner of play and dress has often tended toward what’s common in girls”:
The approach I called “therapeutic” seeks to see a child’s gender dysphoria evaporate, if at all possible. This typically involves strictly limiting the child’s access to gender-atypical activities and trying to help the child adjust to fit a social environment that (supposedly) requires gender divisions. It also often involves family therapy. Though it would seem to promise to make a child more comfortable with his body, there’s very little data that the therapeutic approach “works.” Moreover, the proponents of it have tended to be obsessed with measuring outcomes in terms of ultimate gender identity and sexual orientation rather than ultimate well-being, which surely is what should really matter.
By contrast, the approach I called “accommodating” seeks to prepare the gender dysphoric child for a transgendered life—a life that will ultimately involve hormonal and surgical sex change. Though it seems superficially more gender progressive, the problem I have with this approach is that it may end up sending more children down a high-medical-intervention path than is really necessary to maximize well-being in the population of children who go through gender dysphoria.
“You’ve done a good job of outlining the warring factions,” Sarah told me. But, she added, “I think that there is a third, quieter point of view:
the perspective that, sure, transgender kids exist, but really, most of these gender-nonconforming kids are just kids who don’t fall to the most-masculine or most-feminine ends of the spectrum, and that’s okay. They don’t need treatment, they don’t need sexual reassignment, they just need a supportive home life, schools with anti-bullying protocols, and therapy for any harassment they face for being different.”
I felt kind of stupid reading Sarah’s message, because I realized that I had, in fact, left out this approach. I had targeted my article to parents who report that their male children are insisting they are girls or that their female children are insisting they are boys. But the truth is, as Sarah was suggesting, that a lot of “gender nonconforming” kids don’t have a simple story of being “trapped in the wrong body.” They are expressing more subtle, more complex, and more varied messages of self. What they need isn’t therapy; what they need is to know that it’s OK to be gender non-conforming. It’s perfectly OK be a male who has feminine-typical interests, behaviors, and desires, or a female who has masculine-typical interests, behaviors, and desires.
(Video: A father tells the story of his “pink boy” wanting a pink bicycle.)