Gender Identity

A few days ago the Guardian published a piece about the growing row between transgender activists and feminists about what it means to be a woman. The impending Gender Recognition Act proposes demedicalising gender recognition, so that individuals would simply be able to self-identify without any need to be assessed by clinicians. Currently, to change gender, a diagnosis of gender dysphoria is required and the individual must live in the chosen gender for two years to be able to change their gender. Radical feminists argue that trans-women do not share the experiences of natal women. This is a complex and controversial issue.

An interesting question concerns the ontological status of “gender identity”. Is it a psychological condition, or does it have a physiological basis? Transgender lobbyists argue that gender identity is a separate and distinct thing in itself, that can exist apart from biological sex. Certainly, there is empirical evidence to support a biological explanation of gender dysphoria in certain narrowly prescribed circumstances. For example, there is a reasonably well-established correlation between the use of certain sorts of medication for morning sickness by women and the incidence of gender dysphoria in their children, thought to be attributable to hormonal interference with a stage in the development of the foetus. However, this explanation by no means explains all cases of gender dysphoria (or even a majority of them).

For many it seems that the notion of gender as an objective state that exists apart from biological sex is important, because it underpins the claim that gender is not merely a state of mind, and hence cannot be diagnosed as a type of psychological disorder. This is a very understandable position: for most of us being trans is never a matter of conscious choice. However, the question of what it means to have a certain gender identity is still a vexed one. Is gender identity an objective thing-in-itself, or is it simply an expression of our desires? One might allow adults to define themselves as whatever they like, although if that self-definition entails obligations for others then whether and how society regulates such self-definition is a complex question. But what of children? The Guardian article cited above reports the concerns of feminists that children who express anxiety about their gender identity are vulnerable and not able to make good choices at a very early stage in their development. There is a strand of thought that says many children who express gender identity concerns at a young age may, without intervention, simply grow up to be gay. And we all know that children go through phases of feeling very differently about all sorts of aspects of their personalities. Proponents of such views argue that steering the child into a transgender identity at an early age may not be in their long-term best interests.

An additional complication comes through parents. Many parents live vicariously through their children, and often make bad decisions on behalf of their children in pursuit of their own agenda. Parents love their child to be different, and transgender issues are the cause celebre of the moment. Is it just hysterical conservatives who are concerned about this? Is it transphobic to question the determination of some to champion the differentiation of children into a trans identity? Another piece in the same issue of the Guardian provides a fascinating insight into the work of the Gender Identity Development Service (GIDS), based at the Tavistock and Portman NHS Foundation Trust, which is the only clinic in the UK devoted to helping young people with gender identity issues. Dr Bernadette Wren, head of psychology at the Trust, is quoted as saying

“Some parents don’t like the stand we take which is a more watchful, waiting one. They want to make the affirmation really early and support their child’s social transition, their legal change, their name, that kind of thing… We cannot be too sure in promoting physical intervention for young people when we feel there are development possibilities in which they may come to feel differently.”

The Guardian notes that “it seems an increasing number of children are warming to this view”, and expressing the feeling that its not that they are the “wrong” gender, but that they feel somewhere between genders. It is currently a small number, but it is growing.

One of the things that I can testify with certainty is that being trans is complex. To me, the notion of being “a woman trapped in a man’s body” is logically not supportable (for reasons explained elsewhere), but my experience – and that of countless others – assures me that my dysphoria about gender is neither a choice nor something that can be “cured”. Making sense of what all of this means is a very difficult challenge. It seems to me that the work of careful, thoughtful, watchful practitioners like those at the Tavistock and Portman Trust is needed more than ever. When I was growing up in the early 1970s, the world was a very different place and we knew so little about the medical and psychological issues associated with gender identity. The decisions that people make can have far-reaching and permanent consequences – surgical intervention can permanently remove the possibility of fathering a child for MTF transsexuals. Children are complex and anybody who has been a parent will know that between 5 and 15 huge changes take place, psychologically as well as physically. What we need above all else is to be compassionate to children, and to listen to their concerns and their fears. But as adults we have to respond intelligently, with evidence and after careful consideration. It may by that in another four decades time we will have really started to understand this complex condition of gender dysphoria, and the best of modern understanding may seem distinctly primitive.

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