Drop the Barbie:

Ken Zucker's reparatist treatment of gender-variant children


A report by Lynn Conway

April 5, 2007

[V 2-20-09]


Introduction by Lynn Conway

Examples of modern humane care-centers for gender variant children and teens

PFC News Bulletin from Christine Burns

Article: "Drop the Barbie! If you Bend Gender Far Enough, Does It Break?"


A 2001 Magazine Article Revisited in 2007:

"Drop the Barbie! If You Bend Gender Far Enough, Does It Break?"
By Stephanie Wilkinson, BRAIN, CHILD : The Magazine for Thinking Mothers.




See also the following reports about Zucker and his reparatist clinic at CAMH:


"Drop the doll! Toronto’s gender identity clinic aims to set kids aright when they’re young — very young", story by Gillian Morton , Xtra (Canada), 



"Boys will be girls / Gender identity clinic event disrupted by trans activists", by Audrey Gagnon, Xtra (Canada), April 12, 2007.

http://ai.eecs.umich.edu/people/conway/TS/Clarke/CAMH%20event%20disrupted%20by%20trans%20activists%204-13-07.htm (more)


"Two Families Grapple with Sons' Gender Preferences: Psychologists Take Radically Different Approaches in Therapy", by Alix Spiegel, All Things Considered, National Public Radio, May 7, 2008.



"But For Today I Am A Boy", Torontoist,



Note also that NARTH lauds Zucker, citing him as follows:

"Zucker’s priority is “helping these kids be happily male or female,” but he also acknowledges that the treatment process does, in some cases, apparently avert homosexual development . And in support of parents’ rights to avert a homosexual outcome for their children, Zucker cites a persuasive quote from Richard Green: “The right of parents to oversee the development of children is a long -established principle. Who is to dictate that parents may not try to raise their children in a manner that maximizes the possibility of a heterosexual outcome?"" - NARTH






The 2001 magazine article below contrasts (i) the emerging humane approach to raising gender variant children without psychological repression of their gender feelings vs (ii) the reparative therapy forced on such children by Ken Zucker at the Center for Addiction and Mental Health (CAMH) in Toronto, Canada.


As pointed out by Christine Burns in the PFC News bulletin below, the debate over the psychological pathologization of childhood gender variance by people like Zucker is as alive today - indeed even more alive - than when that article appeared six years ago.


Zucker and his reparative therapy:


Zucker has long been a self-proclaimed "leading figure" in the care of gender variant children.  Many hundreds of such children have been forced through his infamous facility (formerly known as The Clarke Institute) by their parents and by the centralized Canadian health care system, and have been coerced there into denying their innate gender feelings - at least while young and under the control of Zucker.


Zucker is widely-known for his insistence that feminine boys "drop the Barbie", and for his strict enforcement of traditional masculinity on boy children as a means of "curing GID". Zucker is especially focused on prevention of transsexualism, considering gender transition to be a very bad outcome. In the process, Zucker has become the darling of groups like the Catholic Education Center and the National Association for Research and Therapy on Homosexuality (NARTH) (more), which have highly promoted his work among their homophobic and transphobic constituencies.


In March 2007 NARTH published a report entitled "Gender Identity Disorders In Childhood And Adolescence: A Critical Inquiry And Review Of The Kenneth Zucker Research". In that report, NARTH lauds Zucker's reversion therapy at CAMH (aka The Clarke Institute), in which he psychologically intervenes to "cure" childhood GID, seeing it as a way to "cure" homosexuality too. The report concludes:


"Zucker’s priority is “helping these kids be happily male or female,” but he also acknowledges that the treatment process does, in some cases, apparently avert homosexual development . And in support of parents’ rights to avert a homosexual outcome for their children, Zucker cites a persuasive quote from Richard Green: “The right of parents to oversee the development of children is a long -established principle. Who is to dictate that parents may not try to raise their children in a manner that maximizes the possibility of a heterosexual outcome?"" -- NARTH, March 2007


The emergence of more modern and humane clinics:


In great contrast with Zucker's approach, a number of more modern and humane treatment centers for gender variant youth have appeared in recent years in major cities in the U.S.and Canada (see examples below). These new centers are building sound track records of helping gender variant teens, including those thrown away onto the streets by parents who couldn't "cure them" via reparative therapy. At the same time, the old-fashioned reparative methodology long used by Zucker at CAMH has failed to find adopters at other clinics. Furthermore, while a handful of psychiatrists still declare transgender people to be insane and attempt to "cure" them by psychotherapy, the vast majority of gender counselors and therapists in private practice in the U.S. engage in humane treatment of gender variant people and do NOT engage in reparative therapy - on either children or adults.


The winds of change are noticeable even in Zucker's back yard. For example, the Globe and Mail ran an article on May, 8, 2007 entitled "Agents of change -Transgender Canadians are coming out at younger ages, raising a host of new and sensitive issues".  This important story reported that "Transgender Canadians are coming out at younger ages than ever before. Support groups for transgender teens report growing memberships, and are sprouting up beyond the major cities in areas such as Kitchener, Ontario, and the Niagara region".  In a break with past Canadian media traditions, the article made NO mention whatsoever of Zucker's gender clinic. Thus we see that by functioning as a reparatist center for parents who wish to suppress gender variance in their children, Zucker's clinic has become irrelevant to the emerging movement to support the health and well-being of trans youth in Canada.


As we reflect on events since 2001, it appears that Zucker's methodology for "curing" gender variance by psychological reparative therapy is not going anywhere in the medical and clinical communities. Instead, Zucker's pathologization of gender variance and his gender reversion program at CAMH are being bypassed and ultimately dismissed - by the widespread  emergence of much more medically sound and humane centers for the care of gender variant children and teens.


Lynn Conway

April 5, 2007




Examples of modern humane care-centers and referral services for gender variant children and teens


Links updated 4-07-07:


1. Outreach Program for Children with Gender-Variant Behaviors and their Families at the Children's National Medical Center in Washington, D.C.:



2. Transgender Clinic of the Tom Wadell Health Center in San Francisco, CA:

3. Broadway Youth Center, Howard Brown Health Center, Chicago, IL:






4. Clinic of Norman Spack, M.D., Children's Hospital, Boston, MA:

http://www.childrenshospital.org (clinic info) (link to contact information)

http://ai.eecs.umich.edu/people/conway/TS/Young TS's/Norman Spack/Demystifying the Transgendered.html



5. The Transgender Health Program, Vancouver, Canada:




6. The 519 in Toronto, Canada:





7. Central Toronto Youth Services: Pride and Prejudice program:




8. Shelbourne Health Center, Toronto, Canada: LGBTT Youth Services





[more to be listed sometime soon]



PFC News Bulletin from Christine Burns



From: "Christine Burns"

To: "'Press for Change News Distribution'"

Sent: Wednesday, April 04, 2007 4:33 PM

Subject: US/CA: Drop the Barbie! If You Bend Gender Far Enough, Does It Break?

Although this article from "Brain, Child Magazine" was published six
years ago, and although it's more than a decade since Phyllis Burke's
book was first debated, the issue of pathologising childhood gender
behaviour is as alive today as ever.

My only issue with this article is that LGB and T thinking has moved on
a long way from the crude conflict of interest described here.

Today's trans campaigners are rejecting the empty promise that a mental
illness label was necessary for transsexual people to access health
insurance. It's unnecessary because it turned out there was a better way
of tackling that problem.

Likewise more and more LGB *and* T people also recognise how the
treatment of children in this way is a shared experience rather than a
divide. If you substitute surgical coercion for the mental variety
considered here then you could include Intersex people in the coalition
of concern too.

Indeed everyone who has ever been (or plans to be) a parent has an
interest. For this is about protecting the innocence and potential of
childhood from the unfettered power otherwise entrusted to the men given
"professional" status.

- Christine

BRAIN, CHILD : The Magazine for Thinking Mothers

Drop the Barbie! If You Bend Gender Far Enough, Does It Break?

By Stephanie Wilkinson


When Daphne Scholinski was fourteen years old, her distraught parents
had her committed to a psychiatric institute in Chicago. She had become
unmanageable, they said. She was doing poorly in school, experimenting
with drugs, defying her parents. And she would not do anything to soften
her behavior or appearance. Her hair was short, she liked playing
baseball, and she wouldn't wear dresses. At Michael Reese Hospital, her
psychiatrist gave her a diagnosis: Oppositional Defiant Disorder
complicated by Gender Identity Disorder. He placed Daphne on a behavior
modification program along with individual and group counseling

Part of Daphne's treatment consisted of cosmetics therapy: Every day,
Daphne's treatment partner became her beauty consultant, applying
lipstick, rouge, eyeliner, foundation, and eye shadow to Daphne's face.
Professional counselors talked to Daphne about ways she could appear
more feminine. Daphne was asked about her sexual fantasies. Her
friendship with another girl on her ward was treated as a problem. When
she spoke of male friends, she was told she was making progress.

Daphne spent four years in psychiatric institutions, all because she was
"an inappropriate female," she says today. Her "treatment" didn't change
her feelings about dresses or baseball or hair length. It only made her
feel insecure, as though who she was wasn't acceptable to the world. It
only made her sad.

Stubbornly gender-variant teenagers may be subjected to a regimen of
psychotropic drugs, sometimes in locked treatment centers.

Daphne's case is not unique. Across the country, there are parents who
have looked at their "gender-atypical" little girls and boys and decided
that the kids needed psychiatric treatment. The treatment for childhood
Gender Identity Disorder can consist of behavior modification and play
therapy for young children. Stubbornly gender-variant teenagers may be
subjected to a regimen of psychotropic drugs, sometimes in locked
treatment centers. According to the leading researchers in the
psychiatric community, one child in a thousand suffers from "gender
dysphoria," or intense unhappiness with their sex. The exact number is

Such treatment is causing controversy. Some parents are resisting the
suggestion from school and private therapists that their children are
ill. Instead, they're banding together to protest; they want to stop
what they see as the systematic and institutionalized practice of
looking at this atypical behavior and calling it a mental illness.
Groups like GenderPAC and GIDreform.org are petitioning the psychiatric
community to drop Gender Identity Disorder from the next edition of the
Diagnostic and Statistical Manual of Mental Disorders (DSM), the bible
of the mental health community. The controversy is pitting the
established mental health community against a group of upstart parents
who are bent on nothing less than changing society.

"Homosexuality was dropped from the list of mental illnesses in 1973,"
says one activist. "So why is GID--sometimes called
'pre-homosexuality'--still in there?"
In the early 1990s, Phyllis Burke set out on a quest to uncover the
roots of gender. As a lesbian mother, she had become sensitive to
suggestions made by others that, without a male role model, her son
would grow up not knowing how to be a man. "I wanted to be able to be a
better mother," she recalls in an interview from her home in San

"What I found was a Pandora's box."

Burke tore through records of old federal grants, spoke with dozens of
psychologists, psychiatrists, and former GID patients, traveled to
conferences, read hundreds of scholarly papers, and came to one
conclusion: GID is a sham. It's a convenient tool for the psychological
community that abets homophobia in the adult population, and it's been
used over the years as a bludgeon for unruly kids or those who refuse to
conform to gender stereotypes.

After three years of research and writing, Burke's Gender Shock:
Exploding the Myths of Male and Female was published in 1996. It quickly
became the focal point of a gender storm. In the book, Burke traces the
genesis of the GID designation and treatments back to the 1950s. In the
1970s, a psychologist at UCLA named George Rekers opened a clinic for
children. He got hundreds of thousands of dollars to fund his studies,
finding children (often through newspaper ads) and testing treatments on

All the precision of science was applied in developing these tests to
measure such things as how far the hips swayed as the child walked
across the room.

The tests--many still used today--strike Burke as Orwellian. In one, a
child being tested is asked to draw the figure of a person. Girls who
draw boys first, predominately, or in positions of power and strength,
are suspect, as are boys who draw princesses or mommies. The Barlow
Gender-Specific Motor Behavior test examines such things as how far from
the back of a chair a seated child's buttocks are--farther is
"masculine," closer is "feminine." All the precision of science was
applied in developing these tests to measure such things as the angle
between the wrist and the hand, how often a child touched his or her
hands together in front of his or her body, and how far the hips swayed
as the child walked across the room. Especially damning for boys was a
lack of hand-eye coordination.

In keeping with the behaviorist theories of the time, Rekers devised
treatments that treated gender-atypical children with an intricate
system of rewards and punishments. "Becky," a seven-year-old girl
brought to UCLA, was diagnosed with "female sexual identity
disturbance." She liked basketball and climbing and she refused to wear
dresses. She liked "rough and tumble play." In the clinic, Becky was
watched through a one-way mirror as she played in a room equipped with
two tables, one of dress-up clothes, the other of toys. Each table had
boy-appropriate toys at one end (football helmet, army belt),
girl-appropriate toys (lipstick, baby doll, Barbie) at the other. Becky
wore monitoring equipment as she played, consisting of a wristwatch-like
"counter" (similar to those worn to keep score at golf) and a
"bug-in-the-ear" through which she could hear the voice of her therapist
talking to her from behind the mirror.

As Becky played, she was interrupted from time to time and told to press
the wrist counter if she had only played with girls' toys since the last
time she heard the doctor's voice. Becky grew anxious to accumulate
points to please her doctor. In this way, Becky was supposed to be
trained to develop an aversion to masculine playthings. Other parts of
Becky's therapy consisted of having a team of four therapists come into
her bedroom at home to watch, take notes on a clipboard, and time her
with a stopwatch as she played with her toys. After seven months, she
was declared cured, now showing "a decrease in excessive aggression and
an increase in general compliance."

Parents who brought their children to Rekers had to agree to participate
in the "curing" of them. "Kraig," a four-year-old who participated in
the UCLA Feminine Boy Project, was also monitored in the clinic's
play-observation room. Only this time, it was his mother who wore the
bug-in-the-ear, listening for her behavioral cues from the folks behind
the wall. While playing, "Kraig would have seen her suddenly jerk
upright, and look away from him toward the one-way window," Burke
reports (based on transcripts of his case):
His mother was being prompted, through the earphones, by the doctor. She
was told to completely ignore him, because he was engaged in feminine
play. Kraig would have no understanding of what was happening to his
mother. On one such occasion, his distress was such that he began to
scream, but his mother just looked away. His anxiety increased, and he
did whatever he could to get her to respond to him, but she just looked
away. She must have seemed like a stranger to have changed her behavior
toward him so suddenly and for no apparent reason . . . He was described
as being in a panic, alternating between sobs and "aggressing at her,"
but again, when his distraught mother finally looked at him and began to
respond, she stopped mid-sentence and abruptly turned away, as if he
were not there. Kraig became so hysterical, and his mother so
uncomfortable, that one of the clinicians had to enter and take Kraig,
screaming, from the room.

Kraig's treatment continued in this vein. He was also put on the "token
system" at home. Inappropriate, feminine behaviors earned him a red
token, masculine ones, a blue token. Each red token earned him a
spanking from his father. After more than two years of treatment,
Kraig's behavior had turned around. He was now described by his mother
as a "rough neck," and he no longer cared if his hair was neat or his
clothes matched. But when he was eighteen, after years of being held up
(under a pseudonym) by Rekers as "the poster boy for behavioral
treatment of boyhood effeminacy," Kraig attempted suicide, because he
thought that he might be gay.

Five years after publication, Gender Shock is out of print, yet it still
serves as a touchpoint for the anti-GID activists. Burke remains
concerned that this "shocking pocket of psychiatric practice" is still
thriving. "The government is still subsidizing this," she says. "Since
the 1970s, more than $1.5 million has been awarded from the National
Institutes of Mental Health for the study of children who don't meet the
gender norms. George Rekers--the same man who declared Susan Smith sane,
by the way--still believes that girls who don't wear dresses are
disturbed. These clinics have a vested interest in finding these
children and 'treating' them--it's their livelihood. There are still
cases of teenagers being hospitalized against their will for GID."

These are children who pray to God to change them into the opposite sex.

When Ken Zucker looks at a little boy wearing his mother's high-heels,
he sees something very different than what Phyllis Burke sees. Zucker,
the leading figure in the treatment of Gender Identity Disorder in
children today, is psychologist-in-chief and head of the Child and
Adolescent Gender Identity Clinic at the Centre for Addiction and Mental
Health in Toronto. To Phyllis Burke, he is everything that's wrong with
the mental health establishment.

A native New Yorker, Zucker has a full beard and eyes that crinkle when
he smiles. He looks like an illustration for a sixties-era therapist,
sympathetic and compassionate. He contends that what he's doing is
saving children from a lifetime of rejection and depression.

Children with GID are noticeably disturbed, Zucker insists. They are not
really kids who just happen to be more open to the play-styles of the
opposite sex. "I would remind the gender critics that these children
aren't really showing flexibility in their gender behavior. In most
cases, the kids with GID are as rigidly stereotypical as normal
children--only they've adopted the rigid roles of the opposite sex from
what they were born with. There is no joy in their play. They're
struggling, experiencing social ostracism and difficulty establishing
friendships with children of their own gender. These are children who
pray to God to change them into the opposite sex."

Moreover, for children to have a chance to fit in when they're teenagers
and adults, treatment must start young--even as young as three or four
years old.

"Developmental studies show that children work on their gender identity
when they're little," he says. "So if one believes that feeling content
with their gender is important for proper development, one has to think
about how to facilitate that happiness."

Over the last twenty years, Zucker has published reams of papers in
professional journals, contributed chapters on GID to psychiatric
textbooks on childhood mental illnesses, and in 1995 published his own
handbook (with colleague Susan Bradley), Gender Identity Disorder and
Psychosexual Problems in Children and Adolescents. He works as a
clinician as well, evaluating the children who are brought to him from
all over Canada and the United States. He appears in the media
frequently as an expert on gender issues in children.

The Gender Identity Clinic has treated over 500 children since the
mid-1970s. Six times as many boys as girls are treated. It is not a
diagnosis that is made lightly, Zucker says. For a child to be
accurately diagnosed with GID, he or she must demonstrate cross-gender
behavior in a persistent fashion. "This is not a sometime thing, it's
all the time and intense," Zucker says.

Treatment for GID at Zucker's clinic builds on the behaviorist model
used in the UCLA studies that Burke wrote about. Zucker and his
colleagues try to uncover the psychodynamics in the family that might be
at the root of the child's gender distress. Girls may develop GID, he
believes, because they've formed the perception that being a girl is
weak or dangerous. One little girl he saw recently, for example, had
witnessed her mother being assaulted by the mother's boyfriend. A boy,
on the other hand, in a family where the mother is suffering from
depression and is emotionally unavailable, might make an effort to act
like a girl to get closer to her.

While he won't go so far as to pin the blame for GID on parents, they
are at fault, he believes, when they ignore or reinforce their two- or
three-year-old's cross-gender behavior. "Most parents think it's cute
and just a phase. So for a stretch of time it's tolerated or reinforced.
Then when it comes time to go to nursery school and the boy wants to
wear a dress, they get worried and come to us."

Is there such a thing as a "pre-homosexual" child--one who is all but
destined to become gay? If so, is there any way to divert that child's
path away from an adult homosexual identity or lifestyle?

The first step in treatment at the Gender Identity Clinic, then, is to
generate a hypothesis about what is leading the child to think that
being the other sex would make him or her happier. Then Zucker confers
with the parents on a treatment plan, usually consisting of sessions
between a therapist and the parents in addition to individual counseling
with the child. The therapist tries to help the parents resolve whatever
difficulty in the family may be causing the child's gender confusion and
tries to help the child accept and embrace his or her gender.

Parents are encouraged to set limits on the cross-gender behavior of the
child. "We urge them to say, 'Let's figure out what other things you can
do besides play with that doll,'" Zucker says. "In some situations, we
have to work hard with parents' own issues about gender. Could be a
mother who's had difficulty with the men in her life and has a lot of
mixed feelings toward men. That gets translated to the boy, and her fear
that he'll grow up to be like those men causes him to reject being a

GID treatment can last from one to several years, Zucker says. It ends
when the parents feel their goals have been reached (or when the
insurance runs out). Success is marked by a lessening of the child's
preoccupation with the other gender, cessation of cross-dressing, and
the establishment of friendships with a member of the same sex.
Does cross-dressing, even repetitive and intense, mean a child is gay?
Can we even talk about "gay" kids in the years before their secondary
sex characteristics and grown-up sexual urges surface? Is there such a
thing as a "pre-homosexual" child--one who is all but destined to become
gay? If so, is there any way to divert that child's path away from an
adult homosexual identity or lifestyle?

Asked how gender-atypical behavior in children relates to their later
sexual orientation, scientists and therapists nearly always invoke the
work of Dr. Richard Green. In 1987, Dr. Green published the results of
his longitudinal study of boys called The "Sissy Boy" Syndrome and the
Development of Homosexuality. He followed forty-four gender-variant boys
from childhood to young adulthood. Seventy-five percent of the boys grew
up to identify themselves as homosexual or bisexual. (Note that the
opposite isn't necessarily true. Not all gay men were effeminate as
children, despite the evidence here that most effeminate boys will grow
up to be gay.)

So what's the point of treating them at all?

"At this point, I cannot make any statement about how therapy affects
later sexual orientation," Zucker says, clearly choosing his words
carefully. "But certainly many parents bring their children to me
because they would prefer that they not grow up to be gay." He points
out that the children studied by Green underwent no therapy for their
gender confusion. "At my clinic, we've seen four times the number of
children, many of them beginning at age three"--about fours years
younger than the average child in Green's study.

He pauses. "My job is to help them accept their gender. The success of
treatment is subjective; it has to be defined by the parents. If the
child is treated early enough, the outcome is much more likely to be

It's the possibility of misdiagnosis that worries the anti-GID
activists. Is the real cause of these children's distress internal or
external? How easy is it to distinguish between the boy who is sad
because he feels he is a girl trapped in a boy's body (as the DSM
definition suggests), and the boy who is made to feel sad or ashamed
because he prefers the dress and play usually associated with girls? The
former is a problem within the child; the latter, many argue, is a
problem with society. The former, if it persists into adulthood, is
symptomatic of transsexuality, the latter (if the longitudinal studies
of Green and others are accurate) may presage homosexuality--or may be
just a phase. These are very different conditions. Does it make sense to
treat all these kids the same?

"GID means that here is a child who is born into the wrong body. But gay
kids' behavior in early childhood can mimic the behavior of the GID
child. But they're really just normal gay boys."

So says Catherine Tuerk, a psychotherapist and nurse who runs a support
group for parents of gender-atypical children in the greater Washington
D.C. area. Tuerk knows about homophobia and the clinical treatment of
GID from first-hand experience. She and her husband, a psychoanalyst,
have a gay son, now 33, who as a child demonstrated all the classic
signals of GID--the cross-dressing, the hatred of rough-housing, the
preference for girl playmates. Fearing that he would become homosexual
(and petrified that they had somehow contributed to their child's
"disturbance"), the Tuerks subjected Joshua to an intense regimen of
psychoanalysis and therapy between the ages of eight and twelve, and
again when he was a teenager, all geared toward keeping his interests in
feminine things at bay.

"Now I realize that we had abused him by placing him in therapy. The
advice we took from the psychiatric community was truly abusive."

It seemed to work. Josh told his parents he was not and never would be
homosexual. He knew how much it meant to them that he do "boy" things,
so every evening when his father was due home from the office, he'd go
outside by himself and kick a football around, even though he hated it.
He dated girls. He tried to keep his parents' anxiety at bay. Finally,
he went away to college--and came back from his junior year abroad to
tell his parents he was gay.

"We were devastated. It took us a long time to accept it," she says.
"But now I realize that we had abused him by placing him in therapy. The
advice we took from the psychiatric community was truly abusive."

Tuerk has undergone an energetic atonement, first by joining and later
becoming president of her local Parents, Families and Friends of
Lesbians and Gays (PFLAG) chapter, then by founding the support group
for parents of "gentle boys." Every month for the last three years, she
and a clinical psychiatrist have led parents in discussions designed to
move them from fear, anger, and grief over their children's possible
homosexuality to acceptance.

She is open about the damage her past mistakes have inflicted on her
relationship with Josh. And Josh has spoken and written about the anger
left over from his "treatment." "I spent the first twenty years of my
life absolutely hating myself," says Josh today. "After I accepted that
I was gay, I spent five years feeling angry with my parents--my mother
in particular. Now I feel angry at the situation, the mistakes they made
because they didn't know any better."

Other adult "survivors" of GID treatment are equally resentful of the
society that forced treatment on them. Daphne Scholinski, the girl who
underwent cosmetics therapy, was released at the age of eighteen ("just
when my insurance ran out," she notes dryly). She felt no different than
when she was admitted, even though her mental health counselors declared
her "cured." For years afterwards, she says, she was wary of the world
and intensely unsure of her place in it. She came close to suicide. As
she writes in her memoir of those years, The Last Time I Wore a Dress,
"In the hospital, I lost my ability to trust myself. In any interaction,
I'm always thinking, I must be the one screwing up." Far from changing
her, Daphne's treatment only delayed her acceptance of herself as a gay
woman, she says. She couldn't think of herself as a lesbian until she
was an adult.

These days, she is mostly sad and bewildered that she had to endure
treatment for Gender Identity Disorder: "I still wonder why I wasn't
treated for my depression, why no one noticed I'd been sexually abused,
why the doctors didn't seem to believe that I came from a home with
physical violence. Why the thing they cared the most about was whether I
acted the part of a feminine young lady. The shame is that the effects
of depression, sexual abuse, violence: all treatable. But where I stood
on the feminine/masculine scale: unchangeable. It's who I am."

The battle over GID is intensely personal and unpleasant at times.
Scientists are hardly neutral parties in the gender wars. Phyllis Burke
reports that one researcher into gender identity, upon learning she was
a lesbian, said to her, "I guess you don't like to think of yourself as
a freak." Activists in the anti-GID community call Zucker's work "a
tragedy of the highest magnitude."

Zucker himself, asked his opinion of Gender Shock, admits that he
"totally blocked out" his hours-long interview by Burke. He dismisses
her book as "simplistic" and "not particularly illuminating," the work
of a journalist whose views shouldn't be put into the same camp as those
of scientists like Richard Green or himself. When her book was
published, in 1996, Burke says, she began receiving threats. Fear for
her own and her son's safety caused her to stop speaking publicly about
the subject. She accuses Zucker of engaging in "doubletalk" and arguing
his findings "in bad faith."

"These kids being locked up for pre-homosexuality have no voice, no
lobby. As a culture, we've got to do something, we've got to stop eating
our kids alive."

The fight has also created some odd bedfellows. Groups that in most
other causes would be allied, such as homosexuals and transsexuals, are
pitted against one another over GID. The reason comes down largely to
money. Transsexuals know that in order for an insurance company to pay
for a sex-change operation they must be diagnosed with a recognized
psychiatric illness. You can't just want to change from man to
woman--you have to have the mental illness to make it medically
necessary. GID--at least as an adult disorder--needs to stay on the
books for that reason. But that leaves some transsexual groups on the
same side of the fence as NARTH, the National Association for the
Research and Therapy of Homosexuality, a non-profit organization with
links to the Christian right, dedicated to the prevention of
homosexuality and composed of psychiatrists, psychologists, and social

The fight to remove GID from the books has stalled, despite ongoing
lobbying by the National Gay and Lesbian Task Force, GIDreform,
Scholinski, and GenderPAC. According to transgender activist and
Executive Director of GenderPAC Riki Wilchins (born a man, s/he now
identifies with no single gender), representatives from American
Psychiatric Association have refused to meet with the coalition allied
against GID, always claiming that they are "too busy" or that decisions
about the DSM are made "from the bottom up."
"What they're saying is that it's still okay to pathologize gender
independence," Wilchins says. "These kids being locked up for
pre-homosexuality have no voice, no lobby. As a culture, we've got to do
something, we've got to stop eating our kids alive."

Until the psychological community changes its practices, adds Tuerk,
parents who are worried about the behavior of their children should
tread carefully. "It's unsafe to go to just any practitioner," she says.
"The majority of them rely on ideas and practices established twenty
years ago. You could end up with the same bad advice we got."
The safest course of action for parents of gender-atypical children
seems to be to urge their children to divide their lives between their
public selves and their private selves. The goal is to provide a safe
space for these children, a place where they can act upon their impulses
without being mocked or attacked.

Phil and Teri Melese, for instance, have taught their eight-year-old son
Etienne that dresses are okay to wear inside the house, but not outside.
If he feels the need to dress-up outside, he wears a big T-shirt, long
enough to mimic a dress but acceptable as boy-wear.

"It's really clear what society accepts and doesn't accept," says Teri
Melese. "We try to make him aware that he's okay, but that society
doesn't always accept some of the things he'll want to do."

This "feel good and fit-in" approach, Catherine Tuerk says, is far more
humane than trying to quash every manifestation of gender-atypical
behavior. "My husband likens it to being Jewish in an anti-Semitic
culture," she says. "You're still Jewish, but you don't wear your
yarmulke outside."

Maybe it seems dishonest to maintain this public/private schism. But
parents who buck society's expectations can land themselves even bigger
problems. Take the case of the Lipscomb family. In the fall of 2000,
just after the start of the school year, an anonymous phone call was
made to the Franklin County Children's Services in Columbus, Ohio. The
caller told the social worker that she believed a little boy in the
local elementary school, Zachary Lipscomb, was being mistreated by his
parents. The boy wasn't receiving the medication prescribed for his
attention deficit disorder. He didn't go to the therapy he was assigned
to. But what was worse, his parents had just enrolled him in first
grade--as a girl. They had decided, they said, to support their child's
life-long insistence that he was really a she. The Department of Social
Services sprang into action. They received an emergency court order and
promptly removed Zachary/Aurora Lipscomb from the custody of his

"That case raises complicated philosophical issues," Zucker says. "Do
parents have the right to raise their child in whatever sex they see
fit? God knows what the answer is. My main argument is that by letting
him live as a girl at such a young age, they're assuming he could not
grow up to be happy as a boy. Six is just too early to close the door."

What the Lipscomb case does show is that our culture is more rigid about
gender roles than we may believe. And that there is evidence that we're
doing a disservice not only to children diagnosed with a bogus mental
illness, but to all children who feel constrained by traditional gender
roles, Burke argues. Studies at the University of California at Berkeley
show that infants' brains at birth are identical--but that the brains of
adult men and women are different. To Burke, that means what parents and
others do with children literally affects the structure of a child's
brain. Brain-imaging studies show that the brains of gender-atypical
people are larger and more complex than those of gender-rigid people.
Loving parents who want the best for their children, therefore, ought to
encourage a broad range of behaviors and identities.
"Otherwise children end up as half of who they could be," she says. "We
have to learn to stop being threatened by children who are
gender-independent. The idea of gender as flexible and cosmetic should
be applied to all people, not just gay people. Then parents can stop
worrying about children who don't conform."

Gender, it turns out, is a mystery.

Despite all the seemingly obvious answers to the question "What makes a
person male or female?" no one has come up with the definitive answer.
Gender, it turns out, is a mystery. We teach our toddlers the difference
based on simple physiology: boys have a penis, girls have a vagina;
girls can have babies, boys can't. Yet we know that the boundaries of
that definition aren't rock solid: A woman can be a woman without having
a child and a man can still be a man without having a penis.

Ask adults about the distinction between male and female and they're
likely to dredge up eighth-grade biology: It's all in the chromosomes.
Of the twenty-three pairs of chromosomes in each human cell, one pair in
women is XX, while the corresponding pair in men is XY. But that too
fails as a litmus test. There are numerous women whose genetic makeup
harbors a rogue Y chromosome, and men who have none. (All of this, of
course, also leaves aside the issue of people born with ambiguous
genitalia and those born with an odd complement of sex organs--people
who used to be called hermaphrodites and are now called
"intersexuals"--such as one ovary and one testis.)

There is still no generally accepted theory in the scientific community
about whether there are biological causes of homosexuality (or
transsexuality, for that matter). Zucker notes that there is no direct
evidence that GID children have prenatal hormonal abnormalities. This
has not stopped him and others from investigating possible biological
correlations. A study that he will publish later this year, for
instance, shows that boys with GID have a higher rate of left-handedness
than non-GID children. Another study shows that boys with GID weighed
less at birth than a comparison group. Both may point to very subtle but
definitive prenatal hormonal abnormalities. Zucker believes that even if
there is a biological factor that contributes to the development of GID,
behavioral therapy such as the kind his center provides can still be
useful. Others believe that no treatment can trump nature.

According to Anne Fausto-Sterling, a professor of biology and women's
studies at Brown University, about one-and-a-half to two percent of all
babies born "do not fall strictly within the tight definition of
all-male or all-female, even if the child looks that way." And Wilchins
notes that there is a movement afoot to halt surgeries on infants who
are born with ambiguous genitalia. Like Wilchins, more people are
choosing to live outside the strict male/female dichotomy.

In society at large, gender-bending is surfacing everywhere, from
Saturday Night Live re-runs (the gender-indeterminate character "Pat"
and "Lyle: The Effeminate Heterosexual") to films like Billy Elliott.
The life of a gender-atypical person could be traced in a triple bill of
recently released movies: Ma Vie en Rose, a portrait of a little French
boy whose intense desire to be a girl causes anguish in his family; But
I'm a Cheerleader! , a satire of the (real life) treatment centers where
teenagers suspected of homosexuality are sent to learn appropriate
behavior, dress, and desires; and Boys Don't Cry, the true story of a
teenage girl named Teena Brandon who adopted the persona of a boy
(Brandon Teena) and was murdered because of it.

But pop cultural interest in gender-bending, along with the now
decades-old academic interest in Madonna, RuPaul, and "subverting the
dominant paradigm," hasn't had much effect on how middle American mamas
(or daddies) treat their offspring. How many parents--even the really
committed liberals among us--dress their baby boys in frilly pink? How
many would slip the matching floral headband on his head? How many of
them are inordinately relieved when their daughter agrees to put on a
dress to visit Grandma?

We proclaim our willingness to embrace difference in our children and to
"support them in their choices," yet we are still profoundly
uncomfortable with certain specific boundary-testing behaviors. Decades
after the idea of gender-neutral parenting came into vogue, we still
mostly conform to stereotypes in everything from the toys we provide our
toddlers to the clothes our teenagers wear or the color of the outfits
we buy for our friends' newborns.

In 1993, Anne Fausto-Sterling published a paper in the journal The
Sciences entitled "The 5 Sexes: Why Male and Female Are Not Enough." She
claims that "labeling someone a man or a woman is a social decision. We
may use scientific knowledge to help us make the decision, but only our
beliefs about gender--not science--can define our sex. Furthermore, our
beliefs about gender affect what kinds of knowledge scientists produce
about sex in the first place."

If she's right, the controversy surrounding gender identity and the
treatment of Gender Identity Disorder is not due to our incomplete
understanding of human biology. It may be that we have created the myth
of male and female and we are loathe to give it up.

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