Issue Summary:
In recent years, especially in the last couple of years, the transgender community has been under attack in the United States and other parts of the world by people who do not understand the people they are criticizing. The actions of these people are a result of fearing the transgender community, and therefore they have been trying to restrict and “eliminate” them, as some have even publicly stated.
Being part of the transgender community is something that a relatively stable yet small percentage of the human population (roughly .5% – 1.6%) has been experiencing for at least thousands of years across all races, nations, and parts of the globe. However, for most of that time it has not been adequately studied or communicated about due to the following:
1. A lack of technological scientific means to adequately explore it.
2. Various historical cultural and religious reasons relating to lack of knowledge, lack of understanding, and the subsequent fear that has been generated by the unknown.
From fact checking organization Politifact: https://www.politifact.com/article/2023/jul/13/how-many-trans-people-are-there-in-the-us-and-why/
We are now at a point in our science and technology where it is easier to examine and study detailed human physiological and developmental factors more in depth, and the facts about sex and gender identity are really only beginning to be revealed more clearly and to be communicated on a more widespread basis.
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Q: Is being transgender an “ideology?” Or a “choice?”
A: No. It is neither one. The word ideology refers to an idea, belief, principle, theory, or manner of thinking. Being an individual who is part of the transgender community is not an idea or a thought. It is the person’s physiological state resulting from a complex interplay of genes, hormones, chromosomes, cellular composition, and fetal development factors (see articles immediately below). A person who is part of the transgender community is an individual who has multi-faceted physiological factors that affect their gender identity. These factors are part of the composition of their body and brain and help constitute who they are as a whole. Members of the transgender community are human beings who have developed in ways that make them different from the majority of people specifically in terms of the realm of gender identity, but they have developed and exist as the individuals they are, and have a right to be who they are, express who they are, and live their own lives, just like everyone else.
Most individuals who are part of the transgender community report that being part of this community is not a choice, it’s just part of who they are, but that expressing who they are outwardly in society is the only “choice” they really have in the matter. Not expressing themselves as who they are and hiding these aspects of who they are (in order to be socially accepted or to avoid abuse, for example), is technically a choice (that the rest of the population doesn’t have to make in this way), but it can make for a very difficult, limiting, lonely, and unfulfilling human existence.
From the journal Nature: https://www.nature.com/articles/518288a
From the journal Science: https://www.science.org/doi/10.1126/science.aat7693
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Q: What does “transgender” mean?
A: Transgender is an adjective to describe people whose gender identity differs from the sex they were assigned at birth.
Being transgender is NOT the same as being intersex, because intersex individuals are often born with visually ambiguous external genitalia which makes it difficult to assign them to a single sex at birth. With intersex babies, it is still common for parents and doctors to choose a sex to assign to the baby, often involving surgery, which may or may not subsequently correspond to the growing child’s own sense of gender identity.
Transgender individuals, on the other hand, are NOT born with visually ambiguous external genitalia. They are visually assessed at birth and given a male or female designation on that basis alone. However, as can be understood from the above research articles, the traditional binary concept of sex and gender are far more complex than they have been seen and understood to be in the past. Although research is just beginning to be done in more depth on how sex and gender identity develop in humans, it is at least revealing so far that there are more factors involved than simply externally visible genitalia. What all these factors are exactly (including fetal development factors, genes, hormones, chromosomes, cell composition, etc.) and how they function together to result in an individual’s external and internal sex and gender identity is still being explored.
However, it is helpful to consider both intersex and transgender individuals to understand that people’s bodies and brains do not necessarily fall neatly into those traditional binary categories. Nature is in reality more complex than that, and with some individuals more so than others. For all of us, only some of the manifestations of sex and gender identity are externally visible. And some of the traditionally perceived external indicators of sex and gender identity (such as delicately framed or strongly framed body types or facial features) are not in fact accurate indicators for all people. The documentary Every Body by Julie Cohen is about a group of real intersex individuals, which for these current purposes, provides an excellent introduction to the fact that a lack of acknowledgment still exists about there being more to sex and gender identity than what we can see at a glance (for ages 15+):
The Every Body documentary can be found on Prime Video, Apple TV, Peacock Premium Plus, Fandango at Home, YouTube, and GooglePlay Movies.
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Q: How and when does a person know they may be transgender?
A: People may feel discomfort or confusion as their assigned sex/gender even in early life. Young children often demonstrate characteristics of and preference for behaviors, dress, etc. of the opposite gender. Some people may not experience that until later in childhood or adolescence. Some may not experience it until they are an adult. However, many transgender individuals report that even if they didn’t fully recognize or understand it until they were adults, they often remember having some awareness or feelings of discrepancy between their assigned sex/gender and the gender they felt they were as a person (often referred to as “gender dysphoria”) even as a young child. In short, the timing may follow a different course for every individual.
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Q: If a child feels a consistent discrepancy between their assigned gender and the gender they feel they naturally are, how do they and/or their parents proceed?
A: It is important to point out that most parents are still generally mystified about the situation and don’t know how to proceed. Since transgender people comprise a small percentage of the population, many parents have not encountered the situation before and don’t know anyone who is transgender or who has had a child who has expressed gender dysphoria. This is critical to mention because others in society have assumed that parents may be intentionally encouraging this confusion and discrepancy in their child regardless of the child’s nature. Some people who lack knowledge about the situation even use the term “child abuse” unless a parent responds to the child’s sense of discrepancy with anything other than long-term denial, “correction,” and punishment of the child.
Being transgender is an expression that comes from the child. Not the parents. It is a natural self-expression of that child.
To give these parents a voice here, these are some parents of trans children who describe what the experience with their child has been like:
In terms of proceeding in a healthy way with a child who expresses gender dysphoria, speaking with a doctor familiar with transgender health care is the first step if possible. The World Professional Association for Transgender Health (WPATH) is an interdisciplinary professional and educational organization devoted to transgender health. Their mission is “to promote evidence-based care, education, research, public policy, and respect in transgender health.” They have established Standards of Care for the Health of Transgender and Gender Diverse People, the latest version of which is version 8. In addition to WPATH, according to GLAAD, “Every major medical association and leading world health authority supports health care for transgender people and youth.”
Click here to see the official statements regarding transgender health care from all of these organizations.
If a child has expressed that they feel a discrepancy between their assigned sex/gender and who they are inside, and their family and doctor are aware and involved, treatment at first mainly focuses on monitoring and supporting the child’s mental health and making small social changes that the child desires to make that may help them feel more like themselves, such as clothing, hair, etc. Depending on how small changes go, the child may wish to make more changes as they explore adjusting their outer gender expression. They may want to use a new nickname or name, for example. They may want to let friends or their teacher know that they are transitioning to their gender identity.
There are NO surgeries recommended for young children who are exploring transitioning their gender. By the time the child is prepubescent, working closely with medical supervision and going based on how the child feels they want to proceed, the doctor may prescribe puberty blockers to the child simply in order to delay the onset of puberty until the child knows how they wish to proceed at that stage. This supportive type of care based on a person’s current needs is called “gender-affirming health care.” Per the World Health Organization, gender-affirming care includes a range of social, psychological, behavioral, and medical interventions “designed to support and affirm an individual’s gender identity.”
At puberty a child may decide with their doctor that they would like to try hormone therapy to experience the physical changes that would be more typical of their age for their gender identity. There is still NO surgery recommended for adolescent trans children with the only exception in some cases being what is called “top” surgery, which is the surgical reduction or augmentation of breast tissue. However, this surgery is also available to and utilized by non-trans (cis) teenagers.
NOTE: The term “cis” or “cisgender” simply means “non-transgender.” The Latin prefix “cis-” means the opposite of the Latin prefix “trans-” and that is how that term came to be used as it is. It refers to someone who feels congruence, or correctness, with the sex/gender they were assigned at birth and therefore has no need or desire to change to any other gender designation. This describes the vast majority of people in terms of their gender. It is never any kind of “slur” or negative statement. It simply allows for the distinction between people who are transgender and people who are not.
The only time other types of gender-affirming surgery are made an option (except possibly in extremely rare cases) is after a child has become an adult and they have been assessed thoroughly, have gone through a long period of gender-affirming care, and are certain that is the course of action they want to take. At that point it is their legal decision to make, but it is still done within a careful medical evaluation and supervision process.
In summary, gender-affirming care is evidence-based and has been developed by medical experts from various specialties (physicians, psychologists, endocrinologists, etc.) who have worked together to create standards of care that are reasonable and effective, have the true health and well-being of every patient as the highest priority, and ensures expert medical supervision and support at every stage of the process. It is not something that anyone (child or adult) can simply walk into a medical office (and absolutely never at a school of course) and request and the request is granted. It is a long process of specialized medical assessment, evaluation, and support in stages, and is solely driven by the person who is consistently reporting feeling the discrepancy between the gender they were assigned at birth by an exterior visual check and who they feel is who they actually are. It is a lengthy and thorough process because all parties want to be sure this is the appropriate treatment for the patient.
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Q: What are the consequences for people with gender dysphoria of not being assessed and treated with gender-affirming care if the case warrants it medically?
A: A person who is refused appropriate gender-affirming care is being denied the ability to more safely and authentically express who they truly are in the world. They are forced to hide themselves and live a life they consistently feel is not their own. This leads to multiple mental health repercussions, such as high levels of anxiety, depression, and suicidal ideation. This occurs even in children, which is one reason parents are often desperate to find appropriate medical care for their child.
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Q: What is the rate of regret for transgender individuals who have received gender-affirming care?
A: According to a recent study (Oct, 2024), adolescents participating in an ongoing longitudinal study who had been receiving gender-affirming care were asked to report their own satisfaction levels with that care. Results showed very high reported levels of satisfaction with the care, and very low levels of regret after receiving the care.
From the JAMA Pediatrics: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2825195
From the Today Show : https://www.today.com/health/health/gender-affirming-care-admiral-rachel-levine-rcna17677 (Note: Only the first minute of the first video is relevant to this topic. For the rest, scroll below to the article and its other videos.)
An excellent review of gender-affirming care from the Human Rights Campaign: https://www.congress.gov/118/meeting/house/116284/documents/HHRG-118-JU10-20230727-SD020.pdf
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Q: Is there any truth to the claim that people in the transgender community engage in “grooming” children and/or are sexually abusive to children?
A: No. Research has shown that there is no correlation between being an LGBTQ+ person and committing sexual abuse of children. Crimes of this sort have not been shown to be associated with LGBTQ+ people in any greater proportion than the percentage of the population that they comprise, which is to say they are no more likely than anyone else to commit these types of crimes.
From fact checkers Politifact: https://www.politifact.com/article/2022/may/11/why-its-not-grooming-what-research-says-about-gend/
From the journal Pediatrics: https://publications.aap.org/pediatrics/article-abstract/94/1/41/59154/Are-Children-at-Risk-for-Sexual-Abuse-by?redirectedFrom=fulltext
An important article to read in conjunction with the above articles for greater context, is the following about the rates of violence against people who are LGBTQ+:
From the U.S. Department of Justice: https://bjs.ojp.gov/library/publications/violent-victimization-sexual-orientation-and-gender-identity-2017-2020
Transgender and gender nonconforming people suffer a disproportionate amount of violence for simply being who they are. Black transgender women suffer the highest rates of violence and loss of life. From the Human Rights Campaign: https://reports.hrc.org/an-epidemic-of-violence-2023
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Q: Is being transgender harmful to anyone?
A: Not any more so than being a person who is fully in alignment with the gender they were assigned at birth. Being transgender is a natural physiological state that happens to be different in some ways from the natural physiological states of the majority of people. Neither is inherently harmful. What causes harm is not who you are, but how you act. It is harmful to act in ways that hurt another individual, including not treating others with basic human respect and dignity.
Transgender individuals simply want to live their lives. Being and expressing who they are — even if it is different from how many other people may be — doesn’t hurt anyone. It allows them to be accepted for who they are, and live authentic, peaceful, constructive lives. On the whole, the transgender community is more than happy to give everyone else that same freedom to simply be who they are without doing harm to others.
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Q: What is a transgender community “ally”?
A: An ally of the transgender community is someone who accepts and supports members of the transgender community as fellow human beings who deserve respect, dignity, love, and equal human rights, and helps them stand strong against prejudice, disinformation, discrimination, and abuse. An ally can be a family member, friend, coworker, neighbor, teacher, acquaintance, or even a stranger who stands by and supports those in the transgender community and treats them with respect and compassion.
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