The "Transgender Child" Is Born
Blame gender doctors for the social transition fad that started around 2000
Sherry and Paul Lipscomb were bipolar and fought with each other viciously, sometimes violently. In the summer of 2000, they enrolled their son in first grade in suburban Ohio. The boy, who weighed about double what would be considered healthy, wore pull-ups because he didn’t use the toilet. He often fell into violent rages. He’d been diagnosed with Asperger’s syndrome, obsessive-compulsive disorder, bipolar illness, and gender identity disorder (GID).
Sherry and Paul were trying to enroll him in school as a girl.
The local child welfare agency took custody and placed the boy with a foster family.
The Lipscombs had already been working with a transgender support group in Cleveland. Now they connected with MTF Riki Wilchins at GenderPAC, who alerted the media and called on transgender people worldwide to harass the child welfare agency.
Randi Barnaby, an MTF lawyer, represented the parents. He predicted a “protracted and bitter” custody battle. The Lipscombs did not cooperate with the child welfare agency’s investigation.
The Lipscombs’ other lawyer, Mark Narens, appeared on the Massachusetts-based radio show Gender Talk to promote the parents’ legal fund and vilify the foster parents for trying to potty train the boy.
One of the Gender Talk hosts said the child welfare agency was being allowed to “commit genocide.” The other sermonized about the importance of respecting people’s gender and exclaimed, “that’s what this case is about, recognizing that this respect has to start at an early age.”
That was in September. By November, the boy was still in foster care. The Advocate reported that his father, Paul, was planning to transition to female.
This post is about the early days of socially transitioning young kids, from around 2000 to 2008.
The growth in this practice corresponded with the advent of puberty blockers as gender medicine, first in the Netherlands and then in the US. Some of the first American kids to try puberty blockers were also the first to have been socially transitioned a few years earlier.
Dutch Delay (1987-2001)
Peggy Cohen-Kettenis, a Dutch psychologist who treated teens with GID, suspected that trans people would be better off if they transitioned younger. She teamed up with two endocrinologists, one of whom was also a psychiatrist, to study blocking puberty at age 12.
(I’m drawing from a scientific history of the Dutch Protocol by Michael Biggs.)
In 1996, three million people viewed a British TV documentary called The Wrong Sex, in which three boys on the brink of puberty sought blockers in Amsterdam because they wanted to be girls.
In 1998 the Dutch researchers published a study on a girl dubbed FG. From age five she wanted to be a boy. Her father sent her to therapy. She didn’t change; at some point she began feeling attracted to girls. At age 13, around 1987, Cohen-Kettenis’s collaborator prescribed a puberty blocker. She stayed on blockers until age 18, when she began transitioning.
At a London conference that year, American gender poobah John Money praised Cohen-Kettenis’ contribution as “the bravest.”
The Dutch researchers opposed social transition of pre-pubescent kids. They framed blockers as a tool to keep kids’ options open for longer. But their tool did something else: it reduced the time parents had to think about their kids’ GID diagnosis before making medical decisions. If they said no to blockers then their kids (particularly their sons) would undergo natural changes they couldn’t fully reverse later.
In 2001, the gender medicine lobbyist group HBIGDA (today known as WPATH) included puberty suppression in version 6 of its practice manual, the Standard of Care. Now all the scowling activists and plugged-in clinicians – and those three million people who watched The Wrong Sex – were on notice that the world had changed.
Parents would have to decide whether to treat their kids with gender medicine before they were 12 years old.
Transed in the USA (2000-06)
A different GID intervention, social transition, started percolating throughout the US around 2000.
In 2000, Gay and Lesbian Advocates and Defenders (GLAD) sued a school system on behalf of a socially-transitioned 12-year old boy who wanted to dress like a girl. He lived in Brockton, a working class suburb of Boston, and was being raised by his confused but supportive grandparents. His therapist endorsed the social transition. The kid won his lawsuit.
A California preschool girl persuaded everyone to call her a boy around 2002, and a therapist backed her up.
Jazz Jennings started seeing a pro-transition gender therapist, Marilyn Volker, at age 3, around 2003, in Miami. He socially transitioned in 2005.
Oprah hosted a trans-kid episode in 2004. It’s not online, but apparently she pushed hard for social transition. A disgusted Christian blogger quoted her as saying to a skeptical parent: “this will be your holiest hour as a parent, being able to allow your son to be himself and to love him as he is.”
In 2004, “a handful of kids” attended the Trans-Health Conference in Philadelphia.
In 2006, a 5-year old boy was living as a girl in south Florida. [Edit 3/13/2024: I think this kid is Jazz Jennings under a pseudonym.] Volker told a reporter that other trans kids had navigated nearby schools incognito in the past. The boy’s mother had attended the Trans-Health Conference earlier that year:
“[G]ender-variant children was a main topic and the subject of panels such as one titled ‘How Young Is Too Young?’ Most parents at the conference seemed to agree that it’s never too early to support a child as a transsexual, even at age five.”
By 2006, Los Angeles public schools required that teachers respect kids’ pronouns.
After that it was no surprise when parents identified their kids as trans and pretended they were the opposite sex, because the idea was all over the media.
The Blockers Are Coming (2006-08)
Puberty blockers as gender medicine debuted in the US national media in 2006. (American doctors may have started prescribing them a few years before that without fanfare, judging by some hints in later media coverage.)
Within two years, at least eight major outlets published stories about “transgender children” that discussed puberty blockers:
New York Times (Dec. 2, 2006): Supporting Boys or Girls When the Line Isn’t Clear, by Patricia Leigh Brown
ABC (April 27, 2007): My Secret Self, hosted by Barbara Walters
Newsweek (May 20, 2007): Rethinking Gender: What Makes Us Male or Female? (no byline)
CNN (June 24, 2007): news segment presented by Kara Finnstrom
Time Magazine (Nov. 8, 2007): The Gender Conundrum, by Laura Fitzpatrick
Boston Globe (March 30, 2008): Q&A with Dr. Norman Spack, by Pagan Kennedy
National Public Radio (May 7, 2008): Two Families Grapple with Sons’ Gender Identity, by Alix Spiegel
The Atlantic Monthly (Nov. 2008): A Boy’s Life, by Hanna Rosin
Boston Children’s Hospital opened a blocker-dispensing child gender clinic in February 2007. It was the first of its kind outside Europe. The clinic’s director, endocrinologist Norman Spack, was quoted in four of those eight early stories: Time, NPR, the Globe, and the Atlantic’s. In a fifth, NYT’s, the reporter drew a hypothetical that Spack favored (a girl cuts herself in early puberty because she’s trans) and interviewed a teacher and a father from the Boston area.
Boston Children’s brought in over a billion dollars in revenue and had about $1.5B in assets in 2006. Today those figures are about $2.5B and $8B. That hospital was a behemoth looking to grow. I’m guessing its PR people had some interaction with media outlets behind the scenes and strategized with Spack about how to pitch his work.
Children’s Hospital Los Angeles employed a Medical Director of Transgender Services by 2007: Melvin Belzer, a physician who’d trained in primary care and adolescent medicine. He appeared in the CNN piece plus an MSNBC trans-kids story in 2007 that didn’t mention blockers. His colleague at CHLA, Jo Olson (today known as Johanna Olson-Kennedy), appeared in ABC’s story.
Yes, the LA gender doctors mugged for the TV cameras while the Boston gender doctor stuck to print. In the end, gender medicine is all about upholding stereotypes.
That ABC show is the infamous 20/20 episode that introduced the world to Jazz Jennings, then age 6. One of the mothers featured in the 2008 Atlantic piece says she bought a computer to research trans kids after watching that episode.
Here’s how the eight media outlets covered the major questions related to trans kids.
Are puberty blockers safe?
Today evidence suggests that puberty blockers inflict long-term damage on kids’ cognition, bones, and more; the FDA warns they may cause dangerous brain swelling. In 2017, NPR reported on harrowing body-breakdown among women who’d been treated as kids with blockers for precocious puberty.
Since “trans kids” of the 2000s were the first US cohort treated with blockers at the age of normal puberty, one might have reasoned back then that the risks were unknown.
The first two puberty blocker stories, from the NYT and ABC, don’t address their risks or side effects.
Newsweek: “(Blockers have no permanent effects.)”
CNN: “Dr. Belzer does not believe the drugs have serious side effects.”
Time:
“There isn't enough evidence yet to determine the long-term effects of artificially delayed puberty, but the FDA has noted no serious side effects in the nearly 20 years hormone blockers have been used in the U.S. to treat early-onset puberty in the short term. Although some U.S. studies show that interrupting puberty can weaken bone density, preliminary findings by the medical center of the Free University in Amsterdam, which has prescribed hormone blockers for about 80 children since 1987, don't suggest any such problems. The blocker treatment is also easily reversible: puberty begins as soon as drug use is discontinued. …
“Still, there is evidence that hormone blockers can cause infertility. Cheryl Sisk, the head of neuroscience at Michigan State University, who studies the impact of pubertal hormones on neural development, adds that it's also too soon to know how delaying puberty plays into brain growth.”
Globe:
“The effects of these puberty-blocking drugs are reversible; that is, patients can later change their minds.”
NPR:
“Spack explains that the blockers only affect the gonads, the organs responsible for turning boys into men and girls into women.”
Atlantic:
“Blockers are entirely reversible; should a child change his or her mind about becoming the other gender, a doctor can stop the drugs and normal puberty will begin.”
Self-Harm
Proponents of child gender medicine argue, without evidence, that it prevents self-harm. A recent study showed that it did not prevent suicide. The media of 2006-08 was credulous.
NYT:
“[Blockers are] hormones used to delay the onset of puberty in cases where it could be psychologically devastating (for instance, a girl who identifies as a boy might slice her wrists when she gets her period).”
ABC:
“Many [trans kids] grow up hating their bodies, falling victim to high rates of depression, drug abuse, violence and suicide.”
Time:
“It's a parent's nightmare dilemma: experts say there's a fifty-fifty chance your child will attempt suicide before age 20. Should you opt for an experimental medical treatment that might prevent it?”
Globe:
“CHILDREN HAVE CUT themselves. In some cases, 9- or 10-year-old kids have staged suicide attempts.”
“SPACK: … If a girl starts to experience breast budding and feels like cutting herself, then she’s probably transgendered. If she feels immediate relief on the [puberty-blocking] drugs, that confirms the diagnosis.”
Atlantic:
“‘We get these calls from parents who are just frantic,’ [Spack’s colleague, Laura Edward-Leeper] says. ‘They need to get in immediately, because their child is about to hit puberty and is having serious mental-health issues[.]’”
These unwell 11-year olds in 2008 may have been socially transitioned years earlier (CNN features one such girl). If so, their fragility could be seen as a verdict on that protocol – but instead it’s depicted as a sign the kids are really trans and will benefit from gender medicine.
Untangling Trans from Gay
Some of the pieces report that most gender nonconforming kids grow up to be gay and not trans, but they toss that data out undigested. Likewise, they touch on the idea that violating stereotypes is OK, but don’t explain how that relates to trans – except to claim there’s a difference between wanting to be a boy and saying you are a boy.
A mother states on ABC:
“There’s a big difference between a child saying I want to be a girl, and a child saying I am a girl.”
Spack in the Globe:
“All I know is that when I see preadolescents, they have been dressing in the underwear of the other sex for years.”
CNN:
“[Belzer] says this has nothing to do with being gay or straight, these children consistently maintain that they're the opposite sex, long before sexuality develops.”
The Atlantic comes close to getting it. The reporter quotes Catherine Tuerk, a DC-area therapist, speculating about some parents’ comfort with “the transgender label.” She considers it:
“Tuerk believes lingering homophobia is partly responsible for this, and in some cases, she may be right. When [a trans-supportive father] saw two men kissing at the conference, he said, ‘That just don’t sit right with me.’ In one of [Kenneth] Zucker’s case studies, a 17-year-old girl requesting cross-sex hormones tells him, ‘Doc, to be honest, lesbians make me sick … I want to be normal.’ In Iran, homosexuality is punishable by death, but sex-change operations are legal—a way of normalizing aberrant attractions.”
But then the piece tailspins:
“Overall, though, Tuerk’s explanation touches on something deeper than latent homophobia: a subconscious strain in American conceptions of childhood. You see it in the hyper-vigilance about ‘good touch’ and ‘bad touch.’ Or in the banishing of Freud to the realm of the perverse. The culture seems invested in an almost Victorian notion of childhood innocence, leaving no room for sexual volition, even in the far future.”
No, the author is not alluding to the sexual dysfunction caused by gender medicine. I honestly can’t tell what she’s getting at.
What makes someone trans?
Trans identity is not innate. Gender doctors mislead patients, judges, and reporters on this point by citing hypotheses that have already been studied — over and over since at least the 1970s — and shown not to bear out. Despite the lack of scientific evidence supporting “gender identity,” journalists of 2006-08 did not interrogate it.
NYT:
“The biological underpinnings of gender identity, much like sexual orientation, remain something of a mystery, though many researchers suspect it is linked with hormone exposure in the developing fetus.”
ABC:
“No one knows why children like Jazz are transgender. There are only theories. Some scientists suggest that a hormone imbalance in their mother’s womb gives these children’s brains the wrong gender imprint.”
Newsweek:
“So what's different in transgender people? Scientists don't know for certain. Though their hormone levels seem to be the same as non-trans levels, some scientists speculate that their brains react differently to the hormones, just as men's differ from women's. But that could take decades of further research to prove.”
CNN:
Finnstrom (voiceover): Dr. Belzer says it happens early in development. But no one knows why.
Belzer: Whether it's genetic or in utero, or early infant exposure to certain hormones or certain chemicals.
The Atlantic:
“Scattered studies have looked at brain activity, finger size, familial recurrence, and birth order. One hypothesis involves hormonal imbalances during pregnancy.”
The Atlantic also states, without attribution, that “the research [into trans etiology] is in its infancy.” This is a lie that gender doctors repeated in that era as an excuse for lacking evidence.
NPR, the Globe, and Time say nothing about etiology. They just take it as a given that some kids are trans.
Body Horror
The journalists present the un-medicated body as an object of dread.
NYT (quoting a trans-identified boy): “It feels like a nightmare I’m a boy.”
On CNN, a mother says when puberty hit, her daughter “started emotionally disappearing.” She had “always felt trapped in the wrong body,” according to the voiceover.
NPR (quoting the teen sister of a trans-identified boy):
"To go through the process of the gender that you're really not ... that must be the most scariest most disgusting thing ... I can't even imagine what that's like.”
ABC (mother of a trans-identified boy speaking):
“I can’t think of a worse birth defect as a woman than to have a penis.”
Time:
“If a child doesn't identify with his or her biological sex, the onset of puberty … can make that child feel like ‘part of a real-life horror story ... because the wrong parts are changing.’”
Globe:
“SPACK: [Y]ou lose opportunities if you wait. [One of my patients, a] transgender girl from the UK, was destined to be a 6-foot-4 male.”
Atlantic:
“One mother who’d found out about [puberty blockers] too late cried, ‘The guilt I feel is overwhelming.’”
The Spack/Zucker Binary
Gender identity is an article of faith. John Money conjured it, and by 2006 he’d been disgraced. When modern gender doctors and civil rights lawyers discuss it, they use wordplay to make it seem more tangible than it is.
Yet the media of 2006-08 doesn’t question the idea of gender identity. When they interview an expert who opposes early social transition, it’s often the psychologist Kenneth Zucker. Zucker believes gender identity is real and can be molded by pressuring kids to embrace gender stereotypes.
The media thus presents a false choice to the reader: GID kids can either pretend to be the wrong sex or pretend to have a different personality.They can’t just carry on, for example, as boys who violate stereotypes and never worry about their “gender identity.”
NYT:
“Some doctors disapprove of blockers, arguing that only at puberty does an individual fully appreciate their gender identity.”
“Catherine Tuerk, a nurse-psychotherapist … says parents are still left to find their own way. She recalls how therapists urged her to steer her son into psychoanalysis and ‘hypermasculine activities’ like karate. She said she and her husband became ‘gender cops.’”
Time:
“Others worry about intervening with children before their gender identity is fully formed. … ‘Gender development is a multifactorial process that evolves,’ [Zucker] says.”
The parents featured on CNN let their daughter pretend to be a boy until puberty because it made her “comfortable.” Medical transition (the story isn’t clear about what steps she’s taken) is how they maintain the ruse. There’s no discussion of why they didn’t encourage her to live as a non-stereotypical girl.
NPR’s story is structured as a kind of face-off between Zucker and a pro-transition therapist, Diane Ehrensaft. It interviews similar families who worked with one or the other.
The Globe can’t imagine any approach to gender-confused kids besides gender medicine. “[E]ven now, decades after doctors performed the first sex changes in America, there's little help for transgender children.”
The Atlantic shuttles back and forth between the trans-kid phantasmagoria and Zucker’s stern warnings. Like the other outlets, it does not consider the idea of allowing a kid to defy gender norms while also impressing on them that they can’t change sex.
Legal Non-Problems
Gender doctors prescribe blockers “off-label,” meaning the US Food and Drug Administration had approved them for a different condition (precocious puberty). Drugmakers can’t legally advertise off-label uses. But the law against drumming up off-label business doesn’t apply to doctors.
Consumer protection laws ban doctors from misleading the public about products and services, but the government agencies that enforce those laws tend not to view high-brow media blitzes like Spack’s as advertising.
Give the Parents What They Want
It may be a coincidence that social transitioning caught on as a GID protocol at the same time puberty blockers emerged as gender medicine. But it may not be. The two trends could have fueled each other.
Knowing that gender medicine was an option for 12-year olds might have inspired clinicians, activists, and parents to view children as trans because suddenly there were gender-medical decisions to be made about them.
Then socially-transitioned kids were desperate to stave off puberty, driving their parents to seek blockers. Their panic validated the theory that some kids were truly trans. And so the idea of blockers inspired social transition, and social transition amped demand for blockers, which increased their profile …
Trans activists were also part of this feedback loop. They egged parents on to transition their kids — and not just the hapless Lipscombs. Other local trans support groups welcomed parents whose kids had been diagnosed with GID (though not all members advised transitioning). In 2007, the FTM-run Gender Odyssey held a conference in Seattle aimed at families with trans kids.
The Atlantic describes trans adults at a 2008 Philadelphia conference attended by parents of trans-identified kids:
“‘Is there anybody out there,’ asked Dr. Nick Gorton, a physician and trans-man from California, addressing a room full of older transsexuals, ‘who would not have taken the [puberty blocker] shot if it had been offered?’ No one raised a hand.”
Journalists, too, contributed to the feedback loop. From the British documentarians in 1996 to Oprah in 2004 and Barbara Walters in 2007, they all seeded the idea of “trans kids” in parents.
And most importantly, gender doctors fueled the frenzy by diagnosing kids with GID. As I wrote last week, GID was incoherent but worked like a magnet, pulling gender-nonconforming kids toward it if they exhibited any mental problems. If gender doctors like Kenneth Zucker hadn’t planted childhood GID in the DSM years earlier and cultivated it into a regularly-diagnosed disorder, parents wouldn’t be trying to cure it. The Lipscombs were lost anyway, but their ramble into the Cleveland trans scene seems to have been inspired by a GID diagnosis.
If gender doctors like Kenneth Zucker hadn’t planted childhood GID in the DSM years earlier and cultivated it into a real-seeming disorder, parents wouldn’t be trying to cure it.
Yet for all the obvious external influences on families, the lore about the early days of blockers puts parents in the driver seat. In the Netherlands, we often hear that FG’s father rejected her masculinity because he was “traditional” and “Italian” — as though Peggy Cohen-Kettenis, with her itch to experiment on kids, wouldn’t have also pushed puberty blockers on a hippie father.
In the US, the media portrayed parents as rabidly demanding, but the gender doctors’ PR machine was whirring in the background.
In the UK, parent groups Mermaids and GIRES seemed to be taking the lead — but gender doctors followed suspiciously close behind them (see pp 183-84, describing a conference slapped together supposedly in response to a GIRES protest).
In the early media coverage of puberty blockers, the term “affirm” didn’t come up until 2008. Here’s the Atlantic:
“Clinically, men who become women are usually described as ‘male-to-female,’ but Spack, using the parlance of activist parents, refers to them as ‘affirmed females’—’because how can you be a male-to-female if really you were always a female in your brain?’”
This lingo is totally grassroots, we’re told; yet the first time it appears in a major outlet, it’s in the mouth of a gender doctor.
I am so tired of this sham/scam having a life of its own, and a very protected and revered one, at that! I would have failed every undergraduate course if I had used this logic and lack of source of information evaluation. People are being harmed by this and it needs to stop.
We need to convene the GC historians conference.