The first part of a fascinating series on gender identity and young children aired yesterday on All Things Considered. I am always drawn to these stories and, more importantly, the analyses of what could possibly be at work in a young child's desire to live as a different gender than he or she was born. What struck me in this report was the way in which one Gender Identity Disorder specialist justified his recommendations for how to treat a young boy. First some back story, the young boy preferred playing with girls, dressing up like a girl and playing with toys designed for girls, such as Barbies. The parents began to really become concerned when their son was badly hurt at a playground by older boys (age 10), who wanted to "punish" him for playing with Barbie dolls. (This is exactly the kind of gender disciplining that Foucault-inspired scholars point out to illustrate their work).
The mother became understandably distressed by this and resolved to take her son to Dr. Ken Zucker.
Bradley's school referred her to a psychologist in Toronto named Dr. Ken Zucker, who is considered an expert in gender identity issues. After several months of evaluation, Zucker came back with a diagnosis. Bradley, he said, had what Zucker called gender identity disorder.What is so disturbing about this therapy is that it resembles the movements to cure gay people of their homosexual tendencies. Hence, the message of this therapy is overtly normative: young boys should not want to be young girls. If young boys are indulged to act like young girls, they will be harmed physically by other boys. Zucker's therapy is an ode to the old school "you must be cruel to be kind" therapeutic model--to say the least. When I heard about Bradley's story, I couldn't help but think of a lovely and heartbreaking film, entitled Ma Vie en Rose, which depicts a young boy in the suburbs of Paris beginning to act like a girl and the punishment visited upon not only him, but his family.
Gender identity disorder is a label given to children who believe themselves to be born into the wrong biological body. This diagnostic label encompases a range of behaviors — and the label itself is controversial. But, in general, what characterizes children like Bradley is that they are more than just effeminate boys, or masculine girls, who are gay. These are children who genuinely believe they are girls even though they have a male body — or boys, even though they have a female body.
Zucker, who has worked with this population for close to 30 years, has a very specific method for treating these children. Whenever Zucker encounters a child younger than 10 with gender identity disorder, he tries to make the child comfortable with the sex he or she was born with.
So, to treat Bradley, Zucker explained to Carol that she and her husband would have to radically change their parenting. Bradley would no longer be allowed to spend time with girls. He would no longer be allowed to play with girlish toys or pretend that he was a female character. Zucker said that all of these activities were dangerous to a kid with gender identity disorder. He explained that unless Carol and her husband helped the child to change his behavior, as Bradley grew older, he likely would be rejected by both peer groups. Boys would find his feminine interests unappealing. Girls would want more boyish boys. Bradley would be an outcast.
Carol resolved to do her best. Still, these were huge changes. By the time Bradley started therapy he was almost 6 years old, and Carol had a house full of Barbie dolls and Polly Pockets. She now had to remove them. To cushion the blow, she didn't take the toys away all at once; she told Bradley that he could choose one or two toys a day.
"In the beginning, he didn't really care, because he'd picked stuff he didn't play with," Carol says. "But then it really got down to the last few."
As his pile of toys dwindled, Carol realized Bradley was hoarding. She would find female action figures stashed between couch pillows. Rainbow unicorns were hidden in the back of Bradley's closet. Bradley seemed at a loss, she said. They gave him male toys, but he chose not to play at all.
"He turned to coloring and drawing, and he just simply wouldn't play with anything. And he would color and draw for hours and hours and hours. And that would be all he did in a day," Carol says. "I think he was really lost. ... The whole way that he knew and understood how to play was just sort of, you know, removed from his house."
His drawings, however, also proved problematic. Bradley would populate his pictures with the toys and interests he no longer had access to — princesses with long flowing hair, fairies in elaborate dresses, rainbows of pink and purple and pale yellow. So, under Zucker's direction, Carol and her husband sought to change this as well.
"We would ask him, 'Can you draw a boy for us? Can you draw a boy in that picture?' ... And then he didn't really want us to see his drawings or watch him drawing because we would always say 'Can you draw a boy?'" Carol says. "And then finally after, I don't know, a month or two, he just said, 'Momma, I don't know how. ... I don't know how to draw a boy.'"
Carol says she finally sat down and showed him. From then on, Bradley drew boys as directed. Male figures with anemic caps of hair on their heads filled the pages of his sketchbook.
Now to the specific analogy that Zucker uses to justify his approach:
Because [Diane] Ehrensaft sees transgenderism as akin to homosexuality, she says, she thinks Zucker's therapy — which seeks to condition children out of a transgender identity — is unethical.
But that isn't how Zucker sees it. Zucker says the homosexuality metaphor is wrong. He proposes another metaphor: racial identity disorder.
"Suppose you were a clinician and a 4-year-old black kid came into your office and said he wanted to be white. Would you go with that? ... I don't think we would," Zucker says.
If a black kid walked into a therapist's office saying he was really white, the goal of pretty much any therapist out there would be to make him try to feel more comfortable being black. They would assume his mistaken beliefs were the product of a dysfunctional environment — a dysfunctional family or a dysfunctional cultural environment that led him or her to engage in this wrongheaded and dangerous fantasy. This is how Zucker sees gender-disordered kids. He sees these behaviors primarily as a product of dysfunction.
The mistake the other side makes, Zucker argues, is that it views gender identity disorder primarily as a product of biology. This, Zucker says, is, "astonishingly naive and simplistic."
This analogy is well chosen and is powerful in persuading people--who don't further consider this--that there is something legitimate about Dr. Zucker's approach. He is also right to counter critics that gender identity is not solely an event of biology. I agree with him on that score, and yet, I draw such wholly different conclusions than he does about how to think about transsexualism.
The problem with his analogy--if we look closely at it--is that it assumes that there is something fixed, pure, or natural about race. What the analogy invites us to do is imagine that an unproblematic "black" boy comes into the office of a psychologist and demands to be altered, biologically, into a "white" boy. We think of someone like Michael Jackson and then . . . .voilà, we think of this young boy as ill. He is suffering from a dysfunctional culture--as Zucker points out--and so his desire to become "white" is a dysfunctional reaction to a racist culture that prizes whiteness over blackness.
And yet, look at what Zucker is assuming here: that racial identity never involves choice. He is playing on a unsophisticated cultural understanding of race as "black" or "white," and therefore overlooking the reality of "mixed raced" people or the fact that one's racial identity can so often be ambiguous (is he middle eastern? Latino? Asian?). The fact that we call someone "black" is indeed reflective of our pathological need to put people in neat boxes. Racial identity is as thoroughly a product of culture--institutions, practices, and ideas--as gender identity or sexual identity is. There is a biological component of race, but where we draw the line between one race and another is totally artificial and culturally constructed. We don't look for an underlying genetic signature--expressed phylogenetically--to demarcate "black" from "Asian" or "middle-eastern." Racial labels do not solely point out biological features. Quite simply, race and racial identity are cultural constructs.
And, so because race is far from straightforward or natural, Zucker's analogy belies his deeper need to maintain these all-too-culturally-constructed labels, i.e. "black people" are black, "white" people are white, "boys" are boys and "girls" are girls. His analogy plays on our more liberal sympathies that we should create a culture that values "black" boys as much as "white" boys, but it then uses this liberal sympathy for ends quite opposed to the humanitarian ones in the racial identity analogy. When we carry over the reasoning here, we are to see that boys should not become girls [if they are traumatized by a dysfunctional family (an overbearing father? or overly liberal gender-bending parents?) or a dysfunctional cultural environment (an overly rigid understanding of masculine traits? or, more likely, a overly androgynous culture that blurs the boundaries between appropriate masculine and feminine behavior)]. So what are we to do if little boys want to be little girls because they like feminine things and feminine behaviors more? Train it out of them and force them to face up to their given and natural identity as boys. Likewise, we should help "black" boys deal with their given and natural identity as "black."
Zucker's view completely takes choice out of racial and gender identity and it ignores the fluid nature of these identities. When we start thinking more clearly about how complex race and gender are: these identities are interactions between biology and culture and these categories are fluid and not categorical, then his racial identity analogy falls apart. Why couldn't a young black woman say that she doesn't want to be "black"? That wouldn't necessarily mean she wants to bleach her skin or pass as white. It could mean that she was rejecting certain cultural practices that are deemed black. It could mean she didn't want to be rigidly defined as a member of the group "black people." A psychologist, it seems to me, would really need to listen more closely to what she was saying than assume she was looking for a pathological way to cope with racism. Or, what if a woman who has a Syrian father and a Mexican woman --and looks Latina and reflects the cultural practices and manners of speech of young women in Latino communities, shows up in Zucker's office and says, "I don't want to be a Latina?" Surely the right answer is not: you are just responding unhealthily to a culture that is oppressive to Latinos.
Gender and racial identities are fluid, complex, interactive. What inspires Bradley above to play with Polly Pockets or delight in Pink is not just a dysfunctional cultural milieu that is blurring the boundaries between masculine and feminine. Nor is it just hormonal abnormalities. What is going on here is a complex negotiation that only highlights how fluid and complex gender and race are. Bradley defies our categories. He threatens other boys and worries his parents. But, the pathology is not in Bradley.