This series on BBC’s “Transgender Kids: Who Knows Best?” is co-authored by HJ Hornbeck and Siobhan O’Leary. It attempts to fact-check and explore the documentary’s many claims concerning gender variant youth. You can follow the rest of the series here:

1. Part One: You got Autism in my Gender Dysphoria!
2. Part Two: Say it with me now…
3. Part Three: My old friend, eighty percent
4. Part Four: Dirty Sexy Brains

 

---

 

Say it with me now…

…Kenneth Zucker was not “fired by transgender activists.” He was fired after a review of his practice by his peers in psychiatry.

There are quite a few questionable claims within BBC’s “Transgender Kids: Who Knows Best?” Perhaps the most glaring is who they decided could answer the hypothetical question posed in the title: Kenneth Zucker, whose public statements have the dubious distinction of being refutable by his own research; and Ray Blanchard, the father of a unfalsifiable transsexual taxonomy that characterized trans women as either self-hating gay men or as sexual fetishists.

Not to put too fine a point on it, but calling this balanced is a bit like calling in an arsonist to lecture about fire safety.

This documentary recycles numerous specious claims that I’ve discussed elsewhere in my work. This puts me in an awkward position, since the temptation is to simply say “start from June, and just read every single post I’ve done on trans issues.” Seriously–the documentary parses like someone began with Julia Serano’s guide of pitfalls to avoid in this conversation and then said, “yeah, let’s do all 8 of that.”

For instance, the narrator at one point asserts that gender affirmative healthcare models have been advanced by “transgender activists.”¹ While not false by any stretch of the imagination, the documentary also attributes to transgender activists Ken Zucker’s firing², the unseating of Zucker’s aversion methodology³, “unnecessary meddling” with children⁴, and reinforcing gender stereotypes⁵. It completely fails to mention the academic criticism involved in all these points, a persistent theme throughout the work.

It’s a wonder how us activists get anything done, with how busy we are meddling with families, getting doctors fired, their methods discredited, and somehow bearing sole responsibility for reinforcing cultural gendered stereotypes despite being outnumbered by cisgender people 500:1. Make no mistake–the documentary is repeatedly poisoning the well when it mentions “transgender activists”–no attribution made to us is ever complimentary. And it also makes sure that anyone who supports gender affirmation is understood by an unknowing audience to be inherently anti-science, even though the model is supported by evidence, and even though many activists know the science and many scientists do at least some activism to propagate it.

Compare the above claims made by the documentary to my previous response to Jesse Singal’s well-paid concern trolling. Quoting Singal, I previously wrote:

To them, the real scandal here is how CAMH responded to a sustained campaign of political pressure: by allowing a vital scientific question — vital not only to gender-dysphoric and transgender young people, but to anyone who is a parent or will one day become one — to be decided by activists on the basis of flimsy, anonymous allegations. They think the activists’ claims about the clinic are unfounded, and argue that the controversy has more to do with adult agendas than with genuine concern for gender-dysphoric children and youth.

Pay attention to the wording–this theme is pervasive throughout Singal’s publishing career on trans issues. The opponents of Zucker’s conversion methods aren’t scientists, they’re “activists.” There’s no research to discredit Zucker’s methodology, just “anonymous allegations.” Zucker hasn’t been pushing nonsense garbage, he’s asking “vital scientific questions.” There exists no controversy between researchers of gender diversity on the basis of empirical testing, it’s just “adult agendas.”

In other words, there’s no attempt to investigate the reasons behind the controversy–opponents are simply dismissed out of hand as being unscientific under the assumption that activists don’t know the science.

Lo-and-behold! John Conroy, the producer of this public fleecing we’re calling a documentary says the exact same thing eight months later.

Narrator: Zucker became a target of transgender activists, who have increasingly influenced policy in Canada.⁶

Narrator: Zucker was accused by transgender activists of trying to “cure” transgender children, the same way psychologists used to try and cure gay people of their homosexuality. He was accused of practicing conversion–or reparative–therapy.⁷

Narrator: A review was launched into Zucker’s clinic six months [after the conversion therapy ban], and was shut down.⁸

Then compare that story to the professional handwringing of Sarah Ditum six weeks ago:

But in his decades-long career, Zucker supported hundred of children and adolescents with gender identity disorder (GID), some of whom went on to live happily in their birth sex and some of whom eventually had sex reassignment surgery (SRS). The allegations against him stem from an external review commissioned by his employer, the Centre for Addiction and Mental Health in Toronto (CAMH) – a review which was withdrawn from CAMH’s website after investigations showed that many claims were unsubstantiated and one key charge was demonstrably false. As the journalist Jesse Singal wrote: “it’s hard not to come to an uncomfortable, politically incorrect conclusion: Zucker’s defenders are right. This was a show trial.”

The attacks on Zucker have been effective. Around the world, clinicians now keep their concerns about gender affirmation to themselves: they know what the price of speaking out might be.

You know what’s interesting about plagiarism? Detecting it doesn’t involve drawing connections between the shared correct answers, but between the replication of the same mistakes.

From the CAMH review, conducted by Drs. Zinck and Pignatiello, which resulted in the closure of Dr. Zucker’s gender identity clinic: (emphasis mine)

Research knowledge and clinical guidelines have evolved, particularly in the last five years, and society’s understanding and acceptance of the diversity of gender expression and identity have changed. There appears to be a mismatch between literature research findings (including those from GIC itself), and clinical practice and approach.

…

Questions were raised by the reviewers about the information shared regarding participation in research as documentation suggested that consent obtained may not have been fully informed.

…

The current assessment and treatment approaches need to be revised. Gender variance versus gender dysphoria should be distinguished and explained. The aim to reduce suffering can be achieved with a client-centred and family supportive approach. To move towards this goal, it is recommended that WPATH, CPATH & AACAP guideline-informed care paths be utilized, across the age spectrum.

This is just a short sample of the report. In the above quoted text there are two accusations regarding the inadequacies of the methodology of the clinic: 1) No distinction between gender variant behaviour and gender dysphoric identity, a distinction which was sought out in the DSM-3 but sidelined by the same CAMH Sexologists whose work has been discredited; and 2) That the clinic had not adapted to current scientific findings. The other allegation is with respects to medical ethics. That’s without going into the other sixteen points of contention found in the report. These points stand regardless of the withdrawn testimony which Sarah Ditum falsely claims resulted in the withdrawal of the entire report.

Then, let’s get into this conversation between another therapist and Dr. Zucker, transcripted by TransAdvocate, at the June 2016 conference for the Worldwide Professional Association for Transgender Health: (emphasis mine)

Therapist B: I’m from Montreal and we’ve spoken several times. I think these “activists” as you call them, from my understanding, many of them are therapists and counselors in Ontario who have been sort of first-hand witnessing some of the iatrogenic effects, some of the negative effects, of some of the approaches of your program over the years. And I think that there’s been a lack of communication, and I think there’s been many attempts to communicate some of the concerns for probably more than a decade and I find it unfortunate that everything had to happen the way it did, but I do think that we’re not talking about “activists,” we’re talking about counselors, we’re talking about community workers that are dealing with people who [have]… internalized a lot of negative messages about their gender identity over time. And no, it’s not easy to measure those iatrogenic effects –we don’t have many studies– but, clinicians who side with the idea of validating and affirming gender identity have come to this over time; over starting out 20 years ago, cracking open your book, and cracking open the literature, and going, ‘Okay, I’m going to try this.’ and realizing that there are problems that would emerge and that we created a lot of stress and anxieties in these children. And so this polarization also comes out of clinical experience for many, many of us.

So I say again: Kenneth Zucker was not fired “by transgender activists” as both the documentary and Jesse Singal claim; nor was he “fired for challenging the gender affirmative approach” as both the documentary and Sarah Ditum claim. The clinic was reviewed by Dr. Zucker’s peers in psychiatry, and Zucker relieved for a practice considered questionable on its scientific basis. I will remind my readers that academics, not just “trans activists,” had been criticizing his work long before his firing. Ditum, Singal, and Conroy are all trying to smear trans activists as being anti-scientific. In reality, the scientific consensus was what unseated Zucker’s work and vindicated our complaints about his clinic.

Unfortunately for John Conroy, the politically loaded trope of claiming “transgender activists are against science!” was wrong when Jesse Singal and Sarah Ditum used it and it’s still wrong now. Remember this the next time you see someone accuse trans people of living in an “echo chamber”–media pundits are being paid considerably more handsome salaries than I to quote each other’s falsehoods concerning decades old pseudoscience.

This wasn’t the documentary’s only outright falsehood presented without challenge, either. My conservative count was no less than 30 falsehoods stated over the course of 60 minutes, many of which have already been the topic of discussion here.

---

 

Despite styling itself to be “questioning gender affirmation”–a process which it repeatedly characterizes as “politically unsafe” for people to do–the documentary never actually discusses what gender affirmative care is. This is, to put it mildly, an egregious oversight. That hasn’t stopped this 60-minute episode of beating-on-strawmen from winning over transphobic fans, but I expect if you’re reading this you’ll want to know what the documentary claims it is criticizing.

To that end, I managed to get a hold of Dr. Diane Ehrensaft, author of The Gender Creative Child and gender affirmative practitioner at University of California, San Francisco’s Child and Adolescent Gender Center. She answered my following questions by email:

 

Could you describe in your own words what the “gender affirmative” model is?

Dr. Ehrensaft: I’m going to paste in for you the content of slides I use to teach the gender affirmative model to others:

 

 

 

Does the gender affirmative approach make any distinction between variant behaviour and dysphoric identity in children or adolescents?

Dr. Ehrensaft: Yes.  To be what we refer to as gender diverse, which includes having a gender identity (who I know myself to be as male, female, or other)  that does not match the sex assigned at birth or having gender expressions (how I do my gender—clothes, activities, etc.), or both, may come with stress or distress about being in that position, but it may not.  When it does, we recognize dysphoria, when it does not, we perceive it as gender expansiveness that is integrated and accompanied by a feeling of satisfaction and well-being.

 

In BBC’s “Transgender Kids: Who Knows Best?” Dr. Kenneth Zucker at one point says “By taking that [gender affirmative] position, I think that the activists are basically saying that there’s only one way to work with little kids, and that’s to kind of, nurse them along until they’re ready to transition into biomedical treatment.” How does Dr. Zucker’s characterization differ from your actual practice?

Dr. Ehrensaft: That is what I would call an “alternative fact.”  No one who is truly following the gender affirmative model would ever take that tack.  What we do say is that it is harmful to children to try to mold them into the gender we want them to be rather than the one they are trying to tell us they are.  In fact, it is now against legal statute to do that as a mental health professional in the state of California, where I practice, and in many other states as well.  We look for signs of insistence, persistence, and consistency in a child’s articulated sense  of their true gender, and if that true gender should happen to be a transgender one, we affirm that, allowing a child to live in their authentic gender, no matter with or without medical interventions (which are totally irrelevant to a pre-pubertal child and also up to a particular individual as to whether they would like to introduce medical interventions—puberty blockers, hormones, surgeries– to consolidate their gender self).  We use a stage rather than age model—so that if a six year old is telling us is words, deed, and action, and with consistency—I am not the gender you think I am, I am the other one (or another one), we, with careful consideration first, support that child in socially transitioning to their affirmed gender, with the understanding that young children can indeed know their gender—just as we expect young cisgender children to know that information about themselves, so, too, do we recognize the ability of  transgender children to do so.

---

 

In the documentary, gender affirmation is instead described by: 1) The parents of Zucker’s patients; 2) Dr. Zucker; 3) Ray Blanchard; and 4) The narrator–none of whom are practitioners or recipients of gender affirmation.

Contrast:

Meredith: [characterizing gender affirmation] To say, okay, you like pink? Okay that means you’re a girl, you’re gonna be a girl.⁹

Dahlia: There’s lots of different ways–I don’t think it would be responsible to just “run with it.”¹⁰

Dr. Zucker: By taking that [gender affirmative] position, I think that the activists are basically saying that there’s only one way to work with little kids, and that’s to kind of, nurse them along until they’re ready to transition into biomedical treatment.¹¹

With:

To be what we refer to as gender diverse, which includes having a gender identity (who I know myself to be as male, female, or other)  that does not match the sex assigned at birth or having gender expressions (how I do my gender—clothes, activities, etc.), or both, may come with stress or distress about being in that position, but it may not.  When it does, we recognize dysphoria, when it does not, we perceive it as gender expansiveness that is integrated and accompanied by a feeling of satisfaction and well-being.

We look for signs of insistence, persistence, and consistency in a child’s articulated sense of their true gender, and if that true gender should happen to be a transgender one, we affirm that, allowing a child to live in their authentic gender, no matter with or without medical interventions

Dr. Zucker insists us “transgender activists” think there’s “only one way,” but the method we seek to be implemented–the method supported by the scientific consensus–is specifically against a one-size-fits-all approach. If and when and may or may not are precisely the qualifiers children admitted to gender related care need, given that the one fact we can all agree one is that not all children admitted to gender related care grow up to be transgender adults.

Indeed, for the former CAMH sexologists to seriously claim that gender affirmation is trying to railroad its patients is an act so appallingly mendacious it could be an act worthy of Sean Spicer. Consider that at one point, gender gatekeeping advocate Ray Blanchard says: (emphasis mine)

“Transgender activists don’t like the high rate desistance to be talked about because if you know that 80% of gender dysphoric children are going to end up as ordinary gay men, I’m going to encourage all of them to adapt to their anatomical sex and the handful that are destined to be transsexual no matter what will sort themselves out later.” ¹²

So please, spare me the fear-mongering. It was gender gatekeeping that mandated one path for all. It was gender gatekeeping that expected transsexuals to “sort themselves out later.” And it was gender gatekeeping that employed gender stereotypes as a cudgel against the children in its care.

Ditum, Conroy, and Singal would do well to remember that.

-Shiv

---

Time stamp in documentary:

¹10:28, 30:45
²11:15
³14:47
⁴43:30
⁵46:30
⁶11:15
⁷11:36
⁸12:42
⁹8:30
¹⁰29:20
¹¹49:48
¹²43:30