Who knows what a four-year-old truly wants? Anyway, this is an attempt to put a fuller version of the known facts in the public domain and raise some questions.
The first — which is the line advanced by Mermaids, a charity for transgender youngsters, and some trans activists — is that a transphobic legal system and local authorities have taken a girl away from her mother and forced her to live as a boy.
A petition has been started , which states: A recent court case has ruled a young trans girl to be removed from her mother and forced to live in her assigned gender. The mother has done nothing but provide support her child in being who she really is and has given her all the love and care in the world to allow her to live out as her true and authentic self.
The judgment gives a very different view: When J is four, contact arrangements break down. F wants to re-establish contact. The mother claimed F was violent, which the court could not corroborate there was one, apparently mutually heated, incident involving leaning through a car window. One anonymous call Mermaids say this was malicious claimed the mother was using skunk in front of J, and that he had head-butted other children. In May information was communicated to social services from their own Housing Department which was entirely in conflict with the information they had previously received.
It perhaps requires to be re-emphasised that J was at this stage 4 years of age. The mother takes J out of school, citing the bullying.
In January , an assessment concludes that J is not at significant risk of harm. Part of the rationale is that his mother is receiving support from Mermaids. The judge is damning about this: When all this is properly analysed it is clear that flares of concern were being sent from a whole raft of multi disciplinary agencies.
They did not question her assertions. Did no one ask her? There was no independent or supportive evidence that J identified as a girl at all, indeed there was a body of material that suggested the contrary. In other words, M uses the prevailing orthodoxy — that gender identity is a measurable, objective phenomenon, and can be accurately gauged in a young child — to suggest that anyone challenging her is bigoted. By October , M has problems with everyone else involved in the case.
As the case progresses, she makes complaints against some of the professionals involved. M says she has been advised to do this by the Tavistock Clinic. However what struck me forcibly, both then and indeed at this final hearing, was that M spoke of J only in the somewhat opaque and convoluted argot of social work and psychology. The mother heavily coaches Leo, and at one point says that she asks him every morning what gender he is.
As the journalist Jesse Singal noted, that interview made no distinction between gender dysphoria — the intense feeling of alienation from your sexed body that is normally assumed to be the foundation of transsexuality — and more general gendered preferences about toys, clothes and so on.
In the case of J, the evidence of dysphoria comes from his mother: There is a slightly groan-worthy section where the judge suggests that liking SpongeBob suggests he is now happy to be living a boy. Initially every two minutes he would say he did not like his floppy bits flopping around. This somewhat took [F] and [P] aback. When considered alongside his comments and his behaviour towards his mother in contact eg.
He makes this clear whether or not his father is around and would not seem to be influenced by him. She remains convinced J wants to be a girl, and is being prevented from expressing his true identity by his father, and now the state.
She suggests to the court that J is only playing along, as he has got the message he must act like a boy to return to her care. I formed the impression that he had not reached an absolute conclusion that J will continue to identify as a boy, though he thought this the more likely outcome.
Whether J chooses to present as a girl or not, ought to be his choice. This is not a case about gender dysphoria, rather it is about a mother who has developed a belief structure which she has imposed upon her child.
Rather, it seems the other way round — here is a boy whose mother diagnosed him with gender dysphoria herself, and made him live as a girl. The one trying to force a gender identity on to J appears to be his mother.
Aha, you might think: The whole thing is rigged! This does not seem to be the case, as he writes: In other words, the judge believes that gender non-conforming children exist. Unfortunately, it has become something of a taboo to suggest that children do not develop a stable gender identity until later in their development, and that many very young children who appear to be gender non-conforming actually grow up not to be trans, but simply gay or lesbian.
This figure is estimated at 80 per cent. There is a fine balance to be struck here. How do we best support the children who will grow up to be happy trans adults, while not inappropriately influencing the others into a course that involves lifelong medical treatment, and usually sterilisation? Clothes, toys, names and even pronouns all signal to children and the wider world what gender they are.
There is no neutral choice. They are largely a one-way ticket. There is also evidence that socially transitioning young children increases the likelihood they will stay in their new gender. To me, this sounds like a legitimate subject for public debate. On the other hand, there has been a huge rise in the number of child gender identity referrals, up from 94 in to more than last year. No one can say for sure if this reflects a previously hidden problem coming to light — whether previous under-diagnosis is being corrected — or whether children are influenced by the higher profile of transgender celebrities like Laverne Cox and Caitlyn Jenner, and perhaps by older trans children in their own schools.
Why would over-diagnosis be an issue? Because it would mean subjecting children to serious, unnecessary medical interventions. The interventions involved in sex reassignment are non-trivial. So, for example, if a birth female starts sex change early in puberty, that person will avoid growing breasts that he would later want surgically removed. A birth male who starts sex change early in puberty will avoid having the voice and body hair patterns become male-like, features that are very difficult to undo once set in the body.
But as I said, these interventions are not trivial, and many are not easily reversible. This is particularly true for females who undergo male hormonal puberties by taking testosterone. So you want to make sure you get right your calculation of who will benefit. Detransitioning brings its own mental health complications and risks.
The rates are very low, but that might be due to the medical gatekeeping currently in place. Yet these questions are rarely discussed. Added to that, gender affects all of us: In this case, the judge suggests that fear of being labelled transphobic prevented several child protection agencies from pursuing their concerns about J: The parents of deaf children often campaign for better treatment, and so do the parents of transgender children.
But that identity itself, and the attention it brings, will be attractive to some people regardless of the actual situation of their child.
Others are worried that we are funnelling thousands of children into a system which often results in lifelong medicalisation, with treatments which are as yet largely untested. The drugs used are often prescribed off-label, eg HRT drugs. All this is happening in an evidence vacuum, because the acceptance of childhood transition socially and medically is such a recent phenomenon.
Nature magazine recently reported on a large-scale study looking at the best treatment options for gender non-conforming teenagers. I think we can all agree with that. And the case of J shows why more research is needed. Both competing interpretations suggest real harm has been done to a child: We need more evidence, and we need a public debate.