Last week, members of the transgender community were up in arms about the fact that a controversial psychiatrist, Dr Kenneth Zucker, was to be given a documentary on BBC2 from which to air his views on the treatment of gender variant children (BBC2 Thursday, 9pm This World, Transgender Kids: Who Knows Best.
The doctor was dismissed from his post at one of the world's leading gender clinics, Toronto's CAMH, following a review of his practices, and the clinic was subsequently closed down. The documentary sought to examine his claim that the dismissal was unfair and politically motivated due to the transgender community pressing for a gender affirmative approach and a belief that his methods had fallen short of what is deemed to be current best practice.
Although risking a very real and venomous backlash from the LGBT community and trans activists, the BBC decided to proceed with its transmission of the documentary, unleashing a twitter storm.
I think even the most balanced of viewers would have to agree that the documentary tended to side with Zucker's views, rather than the more modern thinking held by some practitioners of gender care for children. Indeed one of the key criticisms of the programme, from the transgender community, was the lack of representation given to those more modern views.
Supported by his Toronto allies, Ray Blanchard and Devita Singh, Zucker shared his thoughts about trans girls developing into gay men, suggesting that this was a much more favourable outcome than becoming a trans woman.
He inferred that parents shouldn't 'give in' to bullying and 'idle' threats of suicide from their children, even going so far as to compare a child's expression of being transgender to being a dog, and I quote: "If your 4 year old said he was a dog, you wouldn't go out and buy dog biscuits".
In the programme, Zucker found scientific comfort in the PhD of his protege Devita Singh which, although uncontrolled, un-randomised and severely open to bias (Zucker's patients, Zucker's unit and Zucker doing the assessments using Zucker's assessment methods), claims to show desistence rates of 88% in feminine boys. Turns out, a third of the boys who took part didn't even have Gender Identity Disorder (GID) in the first place. Yet another example of flawed data, to add to a surprisingly long list of widely quoted papers, that more often than not are introduced in a bid to 'dispel the transgender myth'.
The real problem for gender variant children is that reliable prospective data still doesn't exist and so decisions on whether or not to treat are made on the basis of the data that is out there. The fact that it is widely acknowledged by those in the field as being flawed, appears to be a mere inconvenience.
Fortunately, a modicum of sense was introduced into the debate in the paternal form of Dr Norman Spack, retired Paediatric Endocrinologist from the Boston children's unit who is very much of the opinion that trans children should be allowed to flourish in their chosen gender until such a time that medical intervention is required.
Interestingly enough, most practitioners, including Zucker's team, would agree that children that are strongly dysphoric in their gender are very unlikely to desist and should be taken seriously.
In response to the criticism leveled at the BBC that the documentary failed to adequately deliver the counter argument to Zucker's position, the following morning, the debate continued on BBC Breakfast. I was invited to take part, along with Victoria Richardson, a trans woman who experienced 'reparative therapy' in Canada in her earlier years and Susie Green, CEO for the children's charity Mermaids, whose own child is transgender. None of those present supported Zucker's views and instead an attempt was made to deliver a more balanced view of gender care in the modern world.
As a gender specialist, my position is clear (and plain to see for those who wish to read some of my earlier blogs). Each and every child is different and should be treated accordingly. Very often, by the time patients visit my clinic they have been through a long drawn out process and, together with their support network, they need urgent care. They should NOT be assessed according to a check list, they should NOT be dismissed based on statistics that would and should, quite frankly, be laughed at in any other setting.
It will be interesting to see how things move forward from this. There is no doubt that a man of Zucker's experience has a contribution to make to the debate, but rather than using his knowledge to steer the outcomes to best fit with his own view of gender variant children, surely it is the gender variant children themselves who should be the ones to guide us.