1 00:00:05,921 --> 00:00:09,150 - Hello, my name is Arlene Istar Lev. 2 00:00:09,150 --> 00:00:11,020 I am a social worker. 3 00:00:11,020 --> 00:00:12,893 I'm going to be talking today about 4 00:00:12,893 --> 00:00:14,827 Clinical Skills Working with 5 00:00:14,827 --> 00:00:19,827 Gender Nonconforming Children and Transgender Youth. 6 00:00:20,695 --> 00:00:22,335 The first thing I just want to do is 7 00:00:22,335 --> 00:00:23,924 I just want to introduce myself so you get a sense 8 00:00:23,924 --> 00:00:26,137 of who I am and what my work is. 9 00:00:26,137 --> 00:00:29,071 In addition to being an adjunct here at Smith College, 10 00:00:29,071 --> 00:00:30,076 I've also been an adjunct at 11 00:00:30,076 --> 00:00:32,308 the State University New York at Albany 12 00:00:32,308 --> 00:00:33,741 in the Social Welfare program 13 00:00:33,741 --> 00:00:35,911 for a little over 25 years now. 14 00:00:35,911 --> 00:00:39,452 I also teach at Empire College. 15 00:00:39,452 --> 00:00:40,749 I teach a wonderful course called 16 00:00:40,749 --> 00:00:44,357 Sex and Gender in a Cross Cultural Perspective. 17 00:00:44,357 --> 00:00:48,257 My primary work is I am a therapist in Albany, New York. 18 00:00:48,257 --> 00:00:52,632 I run a business called Choices Counseling and Consulting. 19 00:00:52,632 --> 00:00:57,566 You could find us online at www.choicesconsulting.com. 20 00:00:57,566 --> 00:00:59,980 I've been an addictions counselor 21 00:00:59,980 --> 00:01:03,263 for about 30 years and I'm also am a gender specialist. 22 00:01:03,263 --> 00:01:05,699 The work I'm going to be talking to you about today 23 00:01:05,699 --> 00:01:07,241 is some of the work we do. 24 00:01:07,241 --> 00:01:10,517 Working with transgender folks and specifically working 25 00:01:10,517 --> 00:01:13,676 with children, youth and families. 26 00:01:14,013 --> 00:01:15,177 Okay. 27 00:01:18,069 --> 00:01:19,614 I've written two books. 28 00:01:19,614 --> 00:01:21,783 I want to talk about them just a little bit for you. 29 00:01:21,783 --> 00:01:22,594 The first book I wrote is called, 30 00:01:22,594 --> 00:01:25,095 "Transgender Emergence: Therapeutic Guidelines 31 00:01:25,095 --> 00:01:29,197 "for Working with Gender-variant People and their Families." 32 00:01:29,197 --> 00:01:31,158 The book came out in 2004. 33 00:01:31,158 --> 00:01:34,063 I'm working on a second edition of it right now. 34 00:01:34,063 --> 00:01:39,063 It was the first book in the field of transhealth 35 00:01:39,179 --> 00:01:41,800 and transgender studies that came 36 00:01:41,800 --> 00:01:45,216 from a clinical perspective looking at how to work 37 00:01:45,216 --> 00:01:47,748 with gender variant and transgender people 38 00:01:47,748 --> 00:01:50,412 from a nonpathologizing perspective. 39 00:01:50,412 --> 00:01:54,655 It also is immersed in a family systems orientation. 40 00:01:54,655 --> 00:01:57,855 So it looks not only at the transgender person 41 00:01:57,855 --> 00:02:00,754 but also the people who love that person 42 00:02:00,754 --> 00:02:04,094 and ways to clinically assist families 43 00:02:04,094 --> 00:02:07,172 in the healthiest emergence when 44 00:02:07,172 --> 00:02:10,630 gender issues surface in a family. 45 00:02:10,630 --> 00:02:12,080 The second book, 46 00:02:12,080 --> 00:02:13,905 "The Complete Lesbian and Gay Parenting Guide." 47 00:02:13,905 --> 00:02:18,216 I always joked is not really complete at all 48 00:02:18,216 --> 00:02:20,379 but it is a guide. 49 00:02:20,379 --> 00:02:23,876 Also the title of it is a little deceiving 50 00:02:23,876 --> 00:02:26,261 because the working title I wanted was 51 00:02:26,261 --> 00:02:29,553 how queer working with lesbian, gay, bisexual, 52 00:02:29,553 --> 00:02:31,550 and transgender families. 53 00:02:31,550 --> 00:02:33,765 At the time that the book was published, 54 00:02:33,765 --> 00:02:35,304 they were very nervous about putting 55 00:02:35,304 --> 00:02:38,339 the word transgender and bisexual on the cover of the book. 56 00:02:38,339 --> 00:02:42,300 They thought that it would not sell. 57 00:02:42,300 --> 00:02:44,072 That was the title that they came up with 58 00:02:44,072 --> 00:02:46,712 but I do want you to know that every chapter in the book 59 00:02:46,712 --> 00:02:49,146 looks at issues for transgender people 60 00:02:49,146 --> 00:02:52,406 who are becoming parents, seeking parenthood, 61 00:02:52,406 --> 00:02:54,554 fighting custody battles for their children, 62 00:02:54,554 --> 00:02:58,770 and managing the daily issues of family life. 63 00:02:58,770 --> 00:02:59,721 Okay. 64 00:03:01,828 --> 00:03:06,225 So, my clinical stance, 65 00:03:06,225 --> 00:03:07,964 this is in general. 66 00:03:07,964 --> 00:03:12,426 Working with all people who are gender-variant, 67 00:03:12,426 --> 00:03:16,967 transgender, transsexual, is that gender-variance 68 00:03:16,967 --> 00:03:21,448 is a normal expression of human diversity. 69 00:03:21,448 --> 00:03:23,549 That there is nothing specifically about 70 00:03:23,549 --> 00:03:26,716 being transgendered that is pathological. 71 00:03:26,716 --> 00:03:28,214 We could have a whole conversation 72 00:03:28,214 --> 00:03:30,958 about gender dysphoria and the DSM. 73 00:03:30,958 --> 00:03:33,925 We're not going to have that conversation today. 74 00:03:33,925 --> 00:03:36,157 That doesn't mean that people don't have issues 75 00:03:36,157 --> 00:03:38,884 or struggles in their coming out process 76 00:03:38,884 --> 00:03:41,834 and certainly in managing the complications 77 00:03:41,834 --> 00:03:43,892 of life in a transphobic culture. 78 00:03:43,892 --> 00:03:47,667 But that gender-variance itself is a normal expression 79 00:03:47,667 --> 00:03:50,231 of human diversity. 80 00:03:50,231 --> 00:03:55,231 That societal oppression is what causes the "disorder." 81 00:03:55,638 --> 00:03:58,416 I'm referring there to the old DSM diagnosis 82 00:03:58,416 --> 00:04:00,318 of gender identity disorder. 83 00:04:00,318 --> 00:04:02,720 It's not the gender expression 84 00:04:02,720 --> 00:04:05,219 that is actually causing the challenges 85 00:04:05,219 --> 00:04:07,685 but it is the social oppression. 86 00:04:07,685 --> 00:04:10,959 Now, I will say that gender dyphoria 87 00:04:10,959 --> 00:04:15,560 which is the new diagnosis in the DSM-5 exists. 88 00:04:15,560 --> 00:04:19,470 Meaning that transgender people experience dysphoria 89 00:04:19,470 --> 00:04:22,029 or I should say some transgender people 90 00:04:22,029 --> 00:04:23,876 experience dysphoria. 91 00:04:23,876 --> 00:04:27,644 That doesn't make it a pathological disturbance. 92 00:04:27,644 --> 00:04:30,843 And that family acceptance or rejection 93 00:04:30,843 --> 00:04:34,416 is a core issue for trans people 94 00:04:34,416 --> 00:04:37,817 integrating their gender identity into their lives 95 00:04:37,817 --> 00:04:40,390 in productive and meaningful ways. 96 00:04:40,390 --> 00:04:44,229 So how your spouse, how your children, 97 00:04:44,229 --> 00:04:47,300 how your parents, and to a larger extent, 98 00:04:47,300 --> 00:04:49,501 how your community and your job, 99 00:04:49,501 --> 00:04:53,531 and your family, how they treat this process of emergence 100 00:04:53,531 --> 00:04:56,509 is going to affect people's ability 101 00:04:56,509 --> 00:04:59,543 to integrate in healthy ways. 102 00:04:59,543 --> 00:05:03,844 My philosophy, my theory is that supportive systems 103 00:05:03,844 --> 00:05:07,140 based therapy for gender-variant and trans people, 104 00:05:07,140 --> 00:05:10,619 and their families will assist in the development 105 00:05:10,619 --> 00:05:13,848 and maintenance of stable healthy families. 106 00:05:13,848 --> 00:05:18,592 To translate that, what I'm saying is that being transgender 107 00:05:18,592 --> 00:05:22,492 and specifically, in terms of this workshop today, 108 00:05:22,492 --> 00:05:27,492 being a gender-variant, gender atypical child 109 00:05:27,998 --> 00:05:30,434 or being a transgender youth. 110 00:05:30,434 --> 00:05:32,927 That our goal here is the maintenance 111 00:05:32,927 --> 00:05:35,004 of healthy family relationships 112 00:05:35,004 --> 00:05:39,844 while the child develops and explores, and stabilizes 113 00:05:39,844 --> 00:05:41,741 an identity which if you think about it, 114 00:05:41,741 --> 00:05:44,549 is really what we're doing with any family that's raising 115 00:05:44,549 --> 00:05:46,484 any children in any circumstances. 116 00:05:46,484 --> 00:05:49,091 Transgender emergence is defined here as 117 00:05:49,091 --> 00:05:52,931 a normative life cycle event, a stressful one 118 00:05:52,931 --> 00:05:55,255 but part of the developmental process. 119 00:05:55,255 --> 00:06:00,040 What I'm really saying here is families deal with stuff. 120 00:06:00,040 --> 00:06:00,898 They just do. 121 00:06:00,898 --> 00:06:04,194 They deal with parents ... 122 00:06:06,733 --> 00:06:08,877 Any set of parents that are raising children 123 00:06:08,877 --> 00:06:12,183 are going to go through rough spots. 124 00:06:12,183 --> 00:06:13,745 Families divorce. 125 00:06:13,745 --> 00:06:16,150 Families deal with the birth of a child 126 00:06:16,150 --> 00:06:19,092 that has a disability that is surprising and shocking. 127 00:06:19,092 --> 00:06:22,324 People have to cope with that and learn to cope with that, 128 00:06:22,324 --> 00:06:23,695 and learn how to reframe that, 129 00:06:23,695 --> 00:06:25,862 and learn how to welcome their child. 130 00:06:25,862 --> 00:06:28,768 Their child needs to be raised in a family 131 00:06:28,768 --> 00:06:32,320 that is loving and supportive. 132 00:06:32,320 --> 00:06:36,008 The work of gender needs to become part of 133 00:06:36,008 --> 00:06:40,043 the overall work that when we think of any kind of struggle 134 00:06:40,043 --> 00:06:43,181 that a family would go through in any kind of way, 135 00:06:43,181 --> 00:06:47,816 unemployment, financial stress, 136 00:06:47,816 --> 00:06:50,120 health crisis in one of the parents. 137 00:06:50,120 --> 00:06:54,614 That our goal is development and maintenance 138 00:06:54,614 --> 00:06:57,423 of healthy, stable families and seeing 139 00:06:57,423 --> 00:07:00,822 this as part of a developmental process. 140 00:07:00,822 --> 00:07:03,957 So the specific clinical stance 141 00:07:03,957 --> 00:07:07,639 in working with children and youth, 142 00:07:07,639 --> 00:07:11,103 is to nurture the emerging gender identity 143 00:07:11,103 --> 00:07:14,238 of children and youth regardless of 144 00:07:14,238 --> 00:07:18,781 whether it is typical or atypical. 145 00:07:18,781 --> 00:07:23,118 Part of what I'm saying here is that to be a good parent, 146 00:07:23,118 --> 00:07:26,655 to be a good therapist in working with children, 147 00:07:26,655 --> 00:07:29,621 that all children regardless of whether 148 00:07:29,621 --> 00:07:32,793 their gender development appears to be typical 149 00:07:32,793 --> 00:07:35,034 in the ways that we expect gender to be 150 00:07:35,034 --> 00:07:39,104 for boys and girls or whether that development is atypical, 151 00:07:39,104 --> 00:07:44,104 our goal is to nurture the emergence of gender identity. 152 00:07:45,909 --> 00:07:48,715 To specifically develop protective strategies, 153 00:07:48,715 --> 00:07:50,784 to support children and youth who are living 154 00:07:50,784 --> 00:07:52,608 in hostile environments. 155 00:07:52,608 --> 00:07:54,887 Many of the children and youth that we work with 156 00:07:54,887 --> 00:07:57,183 are living in very hostile environments 157 00:07:57,183 --> 00:07:59,787 that either have parents that are supportive 158 00:07:59,787 --> 00:08:00,892 or in many cases, 159 00:08:00,892 --> 00:08:02,190 they have very supportive parents 160 00:08:02,190 --> 00:08:05,358 but they're in communities and educational situations 161 00:08:05,358 --> 00:08:07,462 that are supportive. 162 00:08:07,462 --> 00:08:10,458 The third one is to support families and social institutions 163 00:08:10,458 --> 00:08:13,841 to become more gender-flexible 164 00:08:13,841 --> 00:08:16,338 so that gender nonconforming children 165 00:08:16,338 --> 00:08:19,175 are integrated within their families 166 00:08:19,175 --> 00:08:22,000 and within their communities. 167 00:08:22,000 --> 00:08:24,168 To support those parents and institutions 168 00:08:24,168 --> 00:08:27,646 that are already advocating for their children. 169 00:08:27,646 --> 00:08:32,021 Since they are often isolated and under public scrutiny. 170 00:08:32,021 --> 00:08:35,158 We could argue and we're going to talk a little bit 171 00:08:35,158 --> 00:08:36,851 more later about the different kinds of parents 172 00:08:36,851 --> 00:08:39,020 but there are parents who are very, very 173 00:08:39,020 --> 00:08:40,932 supportive of their children. 174 00:08:40,932 --> 00:08:44,901 They often are scorned sometimes by their own parents, 175 00:08:44,901 --> 00:08:47,396 sometimes by community and neighbors, 176 00:08:47,396 --> 00:08:49,128 school systems that are difficult, 177 00:08:49,128 --> 00:08:52,076 so our job is to really have their backs. 178 00:08:52,076 --> 00:08:53,173 On the other hand, 179 00:08:53,173 --> 00:08:54,780 we need to be challenging families 180 00:08:54,780 --> 00:08:56,773 that are less supportive of their children 181 00:08:56,773 --> 00:09:00,173 so that we can help to integrate these children 182 00:09:00,173 --> 00:09:02,836 into their families and their communities. 183 00:09:02,836 --> 00:09:07,424 That work that the clinical stance is from an article 184 00:09:07,424 --> 00:09:10,061 that I published with Laura Alie. 185 00:09:10,061 --> 00:09:12,385 Gender nonconforming children and youth 186 00:09:12,385 --> 00:09:15,398 are first of all an emerging population. 187 00:09:15,398 --> 00:09:20,295 That 15 years ago, I've been working 188 00:09:20,295 --> 00:09:22,601 with the transgender community for over 25 years. 189 00:09:22,601 --> 00:09:26,967 Specialist, I have folks coming from hundreds of miles away 190 00:09:26,967 --> 00:09:28,540 to come to my practice. 191 00:09:28,540 --> 00:09:30,645 I would say 15 years ago, 192 00:09:30,645 --> 00:09:35,645 we had seen a small handful of transgender youth 193 00:09:36,357 --> 00:09:40,859 and virtually no families that were dealing with issues 194 00:09:40,859 --> 00:09:44,484 having young children that were exhibiting gender-variance. 195 00:09:44,484 --> 00:09:48,290 Of course, it's an emerging population. 196 00:09:48,290 --> 00:09:49,662 It's not a new issue. 197 00:09:49,662 --> 00:09:51,430 One of the pieces we have to really look at 198 00:09:51,430 --> 00:09:54,203 is what is happening in our social communities 199 00:09:54,203 --> 00:09:57,872 that is creating a space finally for transgender people 200 00:09:57,872 --> 00:10:00,508 to be out where people are talking about it. 201 00:10:00,508 --> 00:10:04,638 Twenty years ago, when I said the word 202 00:10:04,638 --> 00:10:06,251 transgender in a classroom, 203 00:10:06,251 --> 00:10:08,056 nobody knew what I was talking about. 204 00:10:08,056 --> 00:10:10,456 Ten years ago, a handful of students knew 205 00:10:10,456 --> 00:10:11,551 what I'm talking about. 206 00:10:11,551 --> 00:10:13,889 Now, every student knows what I'm talking about. 207 00:10:13,889 --> 00:10:17,930 This has become part of our social and community. 208 00:10:17,930 --> 00:10:18,917 It's in the media. 209 00:10:18,917 --> 00:10:22,101 Families are more sensitive to these issues. 210 00:10:22,101 --> 00:10:24,332 I also think part of what's happening is that 211 00:10:24,332 --> 00:10:26,602 there are parents, there is a group of parents 212 00:10:26,602 --> 00:10:29,734 that when their children come to them 213 00:10:29,734 --> 00:10:30,978 to talk about these issues, 214 00:10:30,978 --> 00:10:32,571 they're not shutting it down. 215 00:10:32,571 --> 00:10:34,948 I really do think a decade ago, 216 00:10:34,948 --> 00:10:38,450 if a child came to a parent at five years old 217 00:10:38,450 --> 00:10:43,176 and said, "I really think I'm a boy not a girl, mommy." 218 00:10:43,176 --> 00:10:44,924 I think most parents would've said, 219 00:10:44,924 --> 00:10:49,129 "You know, honey, that's just not true. 220 00:10:49,129 --> 00:10:50,390 "Go clean your room." 221 00:10:50,390 --> 00:10:52,288 I just think we would've been really not listening. 222 00:10:52,288 --> 00:10:55,424 I think parents are listening more than they ever did. 223 00:10:55,424 --> 00:10:58,034 That children are coming out younger and younger. 224 00:10:58,034 --> 00:11:00,404 We have many families that we work with 225 00:11:00,404 --> 00:11:04,396 in my office that have children that really began 226 00:11:04,396 --> 00:11:08,935 to clearly identify as the opposite gender 227 00:11:08,935 --> 00:11:10,909 than the one that they were born in 228 00:11:10,909 --> 00:11:13,540 at five and six years old. 229 00:11:13,540 --> 00:11:15,079 There are unique ethical issues working 230 00:11:15,079 --> 00:11:18,046 with children and youth who are gender nonconforming. 231 00:11:18,046 --> 00:11:19,553 What are the ways that I'm going to frame 232 00:11:19,553 --> 00:11:21,282 this workshop today is really looking at 233 00:11:21,282 --> 00:11:23,190 some of the ethical challenges 234 00:11:23,190 --> 00:11:24,854 that come up for us as professionals 235 00:11:24,854 --> 00:11:26,330 when families are coming for us. 236 00:11:26,330 --> 00:11:29,060 I always joke parents come in and they're sort of, 237 00:11:29,060 --> 00:11:31,570 "Tell me, is my child really transgender. 238 00:11:31,570 --> 00:11:34,100 "Tell me, is my child really a boy or a girl?" 239 00:11:34,100 --> 00:11:37,533 This is not like pee on a stick. 240 00:11:37,533 --> 00:11:40,011 I can tell you whether it's a boy or a girl. 241 00:11:40,011 --> 00:11:41,278 It doesn't work that way. 242 00:11:41,278 --> 00:11:46,172 It's a complicated process that takes months and years 243 00:11:46,172 --> 00:11:51,172 of their own development as a human beings 244 00:11:52,675 --> 00:11:54,455 to understand who they are. 245 00:11:54,455 --> 00:11:55,926 I mean I'm not telling them who they are. 246 00:11:55,926 --> 00:11:58,061 They're telling me who they are 247 00:11:58,061 --> 00:12:00,632 but this brings up a lot of ethical challenges for us 248 00:12:00,632 --> 00:12:04,157 that I want to really make sure that we're looking at 249 00:12:04,157 --> 00:12:05,632 and talking about those. 250 00:12:05,632 --> 00:12:07,794 It's important to know when we talk about ethics 251 00:12:07,794 --> 00:12:09,742 that there is almost no research 252 00:12:09,742 --> 00:12:11,972 on treating transitioning children. 253 00:12:11,972 --> 00:12:14,702 We have a population of young children today. 254 00:12:14,702 --> 00:12:17,077 They're socially transitioning. 255 00:12:17,077 --> 00:12:18,978 Sometimes as young as five or six, 256 00:12:18,978 --> 00:12:22,848 often seven, eight, nine, ten years old, prepuberty. 257 00:12:22,848 --> 00:12:25,188 I want to be clear I'm not talking about hormones. 258 00:12:25,188 --> 00:12:26,826 I'm not talking about surgery. 259 00:12:26,826 --> 00:12:28,588 I'm just talking about social transition 260 00:12:28,588 --> 00:12:30,084 where they're changing the pronouns. 261 00:12:30,084 --> 00:12:31,629 They're changing their names 262 00:12:31,629 --> 00:12:36,629 and they're often going to school in the opposite gender 263 00:12:36,756 --> 00:12:38,999 from the one in which they were assigned at birth. 264 00:12:38,999 --> 00:12:42,737 But we really don't yet have any research 265 00:12:42,737 --> 00:12:46,199 on how these affirmative practices are going. 266 00:12:46,199 --> 00:12:47,978 Research is ongoing right now 267 00:12:47,978 --> 00:12:50,242 but it's going to be another five to ten years 268 00:12:50,242 --> 00:12:52,147 before we really do have good research. 269 00:12:52,147 --> 00:12:54,752 We do however, have growing evidence-base research 270 00:12:54,752 --> 00:12:56,077 on transgender youth. 271 00:12:56,077 --> 00:13:01,077 We have excellent research on young teens 272 00:13:03,719 --> 00:13:08,719 who are properly assessed, who begin a transition process, 273 00:13:09,132 --> 00:13:12,269 who start on hormones and most of this comes out 274 00:13:12,269 --> 00:13:15,732 of The Netherlands, and following a group 275 00:13:15,732 --> 00:13:17,775 of young transgender youth 276 00:13:17,775 --> 00:13:20,800 over a period of five to ten years. 277 00:13:20,800 --> 00:13:22,079 It's important to know, 278 00:13:22,079 --> 00:13:25,485 these kids are doing phenomenal. 279 00:13:25,485 --> 00:13:27,742 With proper screening and treatment, 280 00:13:27,742 --> 00:13:32,742 transgender people are able to come out 281 00:13:33,092 --> 00:13:36,322 and actualize their identities at much younger ages, 282 00:13:36,322 --> 00:13:37,964 and the results that we're seeing 283 00:13:37,964 --> 00:13:39,598 are really quite phenomenal. 284 00:13:39,598 --> 00:13:42,362 I have two quotes here that I just want to share. 285 00:13:42,362 --> 00:13:44,735 The first one from Esben Pirelli, 286 00:13:44,735 --> 00:13:47,311 who is a therapist in Norway. 287 00:13:47,311 --> 00:13:49,809 "Children with gender dysphoria 288 00:13:49,809 --> 00:13:53,444 "are referred to in the literature as gender disturbed, 289 00:13:53,444 --> 00:13:55,114 "but it might be better to ask 290 00:13:55,114 --> 00:14:00,114 "why some expressions of gender disturb?" 291 00:14:00,184 --> 00:14:05,144 What is it about children who exhibit cross-gender behaviors 292 00:14:05,144 --> 00:14:08,281 or express cross-gender desires, 293 00:14:08,281 --> 00:14:12,198 or the little girl who wants to cut her hair very short, 294 00:14:12,198 --> 00:14:15,331 the little boy who likes to play with girls, 295 00:14:15,331 --> 00:14:17,204 things and toys, and clothing. 296 00:14:17,204 --> 00:14:19,769 As we'll talk about people are much more uncomfortable 297 00:14:19,769 --> 00:14:21,736 with little boys doing this. 298 00:14:21,736 --> 00:14:24,441 We have to look at why do some expressions 299 00:14:24,441 --> 00:14:26,969 of gender disturb us? 300 00:14:26,969 --> 00:14:29,878 The second one from Gerry Mallon whose been working 301 00:14:29,878 --> 00:14:32,943 with transgender youth for many decades. 302 00:14:32,943 --> 00:14:34,686 Why are gender-variant children 303 00:14:34,686 --> 00:14:38,982 so disturbing to people, especially parents? 304 00:14:38,982 --> 00:14:42,148 What is it that happens to us as parents 305 00:14:42,148 --> 00:14:46,250 when children are exhibiting gender-variant behaviors? 306 00:14:46,250 --> 00:14:48,387 Just a couple of things before I dive in 307 00:14:48,387 --> 00:14:51,602 to talking specifically about children and youth, 308 00:14:51,602 --> 00:14:54,124 what I want to do is just frame this 309 00:14:54,124 --> 00:14:57,536 because I know that many of you who are listening to this, 310 00:14:57,536 --> 00:15:00,978 I know some of you are gender specialists 311 00:15:00,978 --> 00:15:03,346 and are curious about what I have to say about this 312 00:15:03,346 --> 00:15:04,910 but some of you who are listening 313 00:15:04,910 --> 00:15:06,685 have absolutely no background 314 00:15:06,685 --> 00:15:10,414 at all in working with transgender people. 315 00:15:10,414 --> 00:15:14,458 I want to just create a blueprint for looking at this. 316 00:15:14,458 --> 00:15:16,482 When I'm using the term transgender, 317 00:15:16,482 --> 00:15:21,334 it's as a general term which includes a lot of people. 318 00:15:21,334 --> 00:15:23,067 Sometimes some of those people might not want 319 00:15:23,067 --> 00:15:27,839 to be included under that rubric. 320 00:15:27,839 --> 00:15:29,540 We'll talk about that in a second. 321 00:15:29,540 --> 00:15:31,909 Most simply transgender people cross over, 322 00:15:31,909 --> 00:15:33,469 that's what the word trans means, 323 00:15:33,469 --> 00:15:36,246 the commonly held boundaries of what society 324 00:15:36,246 --> 00:15:38,913 deems appropriate for males and females. 325 00:15:38,913 --> 00:15:41,216 In the broadest sense of the word, 326 00:15:41,216 --> 00:15:46,215 we're looking at men who are more feminine 327 00:15:46,215 --> 00:15:48,825 in their appearance or dress or manner, 328 00:15:48,825 --> 00:15:52,362 than we think men should be. 329 00:15:52,362 --> 00:15:54,896 Women who are more masculine in their appearance 330 00:15:54,896 --> 00:15:57,728 than we think women should be than 331 00:15:57,728 --> 00:16:00,398 what our image of women is in our culture. 332 00:16:00,398 --> 00:16:02,409 I want to say cultures because 333 00:16:02,409 --> 00:16:04,408 this is really true cross culturally 334 00:16:04,408 --> 00:16:06,136 or the rules are different cross culturally 335 00:16:06,136 --> 00:16:07,837 in each different culture. 336 00:16:07,837 --> 00:16:10,145 It is true that virtually every culture, 337 00:16:10,145 --> 00:16:13,206 men and women have different expectations 338 00:16:13,206 --> 00:16:17,588 of dress and behavior and even emotional life. 339 00:16:17,588 --> 00:16:19,382 In the loosest term, 340 00:16:19,382 --> 00:16:22,563 transgender includes everybody that's deviating. 341 00:16:22,563 --> 00:16:25,561 In the most specific terms, 342 00:16:25,561 --> 00:16:27,758 when we're talking about what people refer 343 00:16:27,758 --> 00:16:30,254 to as the transgender umbrella. 344 00:16:30,254 --> 00:16:32,330 We're looking at people who are gender-variant. 345 00:16:32,330 --> 00:16:34,468 We're looking at people that are gender atypical. 346 00:16:34,468 --> 00:16:36,229 Some people prefer that term 347 00:16:36,229 --> 00:16:38,072 and people who are gender nonconforming. 348 00:16:38,072 --> 00:16:42,065 Nonconforming is I think a less judgmental term 349 00:16:42,065 --> 00:16:45,746 than either variant or atypical. 350 00:16:45,746 --> 00:16:49,942 It could infer people who are purposely nonconforming. 351 00:16:49,942 --> 00:16:51,457 But when we're talking about children, 352 00:16:51,457 --> 00:16:53,919 we're talking about people who, for lack of a better word, 353 00:16:53,919 --> 00:16:55,326 I'm going to say naturally 354 00:16:55,326 --> 00:16:57,556 or authentically are nonconforming 355 00:16:57,556 --> 00:17:00,521 just as the child's identity is emerging, 356 00:17:00,521 --> 00:17:03,560 what they're interested in does not seem to be typical 357 00:17:03,560 --> 00:17:07,260 of what we expect boys or girls to be interested in. 358 00:17:07,260 --> 00:17:10,534 People who are transgender, people who are transsexual, 359 00:17:10,534 --> 00:17:12,204 I'm going to talk more about that in a second. 360 00:17:12,204 --> 00:17:14,405 People who are cross dressers generally, 361 00:17:14,405 --> 00:17:16,977 when we're speaking about cross-dressers in this culture, 362 00:17:16,977 --> 00:17:19,279 we're talking about men who wear women's clothing 363 00:17:19,279 --> 00:17:23,941 because in our culture, in US culture 364 00:17:23,941 --> 00:17:26,657 and western cultures, western-European cultures, 365 00:17:26,657 --> 00:17:30,628 the expectation is that women can pretty much 366 00:17:30,628 --> 00:17:32,865 these days dress anyway they want 367 00:17:32,865 --> 00:17:36,896 and the social ramifications are less. 368 00:17:36,896 --> 00:17:39,526 Now, I want to be really clear when women deviate 369 00:17:39,526 --> 00:17:42,662 to an extreme place. 370 00:17:42,662 --> 00:17:47,662 There are absolutely pressures socially 371 00:17:48,248 --> 00:17:52,178 and I would argue limited job opportunities, 372 00:17:52,178 --> 00:17:55,755 and there are definitely ramifications in employment 373 00:17:55,755 --> 00:17:56,984 and in the social world. 374 00:17:56,984 --> 00:17:58,186 There's no question about that 375 00:17:58,186 --> 00:18:03,186 but not to the extreme that it is for males who cross dress. 376 00:18:03,320 --> 00:18:06,157 Generally speaking, when we use the term cross-dresser, 377 00:18:06,157 --> 00:18:09,465 we're talking about people who are born as males, 378 00:18:09,465 --> 00:18:14,465 who are living as men and who wear women's clothing 379 00:18:14,470 --> 00:18:17,270 for pleasure, wear women's clothing some of the time. 380 00:18:17,270 --> 00:18:19,431 Not all of the time, sometimes wear women's clothing 381 00:18:19,431 --> 00:18:21,070 because it's erotic for them. 382 00:18:21,070 --> 00:18:22,902 Sometimes just because they like dressing 383 00:18:22,902 --> 00:18:24,238 in women's clothing. 384 00:18:24,238 --> 00:18:26,951 I want to really be clear that the reason that women 385 00:18:26,951 --> 00:18:29,119 have so much more freedom of dress today 386 00:18:29,119 --> 00:18:31,890 than men do is because of feminism. 387 00:18:31,890 --> 00:18:33,350 I think sometimes that gets lost. 388 00:18:33,350 --> 00:18:35,053 This one's in a classroom, I asked, 389 00:18:35,053 --> 00:18:36,891 "Why do you think women have more freedom?" 390 00:18:36,891 --> 00:18:38,497 Nobody could find the answer. 391 00:18:38,497 --> 00:18:40,366 To me the answer is so obvious 392 00:18:40,366 --> 00:18:45,366 that the feminist movement created a set of freedoms 393 00:18:45,532 --> 00:18:47,403 within an oppressive culture 394 00:18:47,403 --> 00:18:50,939 that women have in terms of dress today 395 00:18:50,939 --> 00:18:53,833 that most men do not have. 396 00:18:53,833 --> 00:18:56,777 Intersex, two-spirit, a word use often 397 00:18:56,777 --> 00:19:00,085 in Native American cultures to express 398 00:19:00,085 --> 00:19:03,386 the overlap of male/female identities. 399 00:19:03,386 --> 00:19:07,358 Often used also to include people we would call 400 00:19:07,358 --> 00:19:09,586 lesbian, gay or bisexual people. 401 00:19:09,586 --> 00:19:13,661 The belief system is is that two-spirit people 402 00:19:13,661 --> 00:19:17,465 carry the spirit of both men and women. 403 00:19:17,465 --> 00:19:20,197 That gives them a unique position 404 00:19:20,197 --> 00:19:23,143 within their cultural context of understanding 405 00:19:23,143 --> 00:19:25,232 the social world in which they live in. 406 00:19:25,232 --> 00:19:27,135 The term transmen, we're talking about people 407 00:19:27,135 --> 00:19:29,272 that are born female 408 00:19:29,272 --> 00:19:31,909 that are transitioning or living as men. 409 00:19:31,909 --> 00:19:35,407 The term transgender women, male to female. 410 00:19:35,407 --> 00:19:38,719 People who are born male and are living as females. 411 00:19:38,719 --> 00:19:42,389 Some people prefer the term transmasculine 412 00:19:42,389 --> 00:19:46,148 or transfeminine and looking at it 413 00:19:46,148 --> 00:19:48,921 as a spectrum of gender of which direction 414 00:19:48,921 --> 00:19:51,258 people are moving in. 415 00:19:51,258 --> 00:19:53,929 Gender benders, people who bend genders. 416 00:19:53,929 --> 00:19:55,502 Sometimes because it's fun 417 00:19:55,502 --> 00:19:56,703 and they enjoy doing that. 418 00:19:56,703 --> 00:20:00,542 They like to mix gender and people who blend gender. 419 00:20:00,542 --> 00:20:02,305 Some people identify as bigender, 420 00:20:02,305 --> 00:20:04,069 being both male and female 421 00:20:04,069 --> 00:20:06,050 or containing both of those of parts. 422 00:20:06,050 --> 00:20:11,050 Gender queer, a term I will identify more deeply later on 423 00:20:12,679 --> 00:20:16,329 but also this idea of the overlap between 424 00:20:16,329 --> 00:20:19,356 both male and female as well as the overlap 425 00:20:19,356 --> 00:20:23,695 between sexual orientation and gender identity, 426 00:20:23,695 --> 00:20:24,862 and third sex. 427 00:20:24,862 --> 00:20:27,232 This umbrella is a broad umbrella. 428 00:20:27,232 --> 00:20:29,236 I do want to say one thing about the word transsexual. 429 00:20:29,236 --> 00:20:31,604 I'm not going to be using that term a lot today 430 00:20:31,604 --> 00:20:34,679 because I think it's a complicated term. 431 00:20:34,679 --> 00:20:39,072 It's a heavy term to be putting on children and youth. 432 00:20:39,072 --> 00:20:41,086 I think it's a perfectly lovely term 433 00:20:41,086 --> 00:20:44,516 for people who want to use that term as adults. 434 00:20:44,516 --> 00:20:46,891 Transsexuals are people who believe that 435 00:20:46,891 --> 00:20:49,853 their physiological body does not represent their true sex. 436 00:20:49,853 --> 00:20:54,657 Most transsexual people desire sexual reassignment surgery 437 00:20:54,657 --> 00:20:57,169 or what we more often called these days, 438 00:20:57,169 --> 00:20:59,900 gender confirmation surgeries. 439 00:20:59,900 --> 00:21:01,572 Again, it doesn't mean that children and youth 440 00:21:01,572 --> 00:21:04,330 are not thinking about things or talking about these things. 441 00:21:04,330 --> 00:21:06,475 I also think it's important when we're talking 442 00:21:06,475 --> 00:21:09,415 about transsexuals particularly post-transition adults. 443 00:21:09,415 --> 00:21:13,294 People prefer to simply be referred to 444 00:21:13,294 --> 00:21:16,186 in the gender that they're living in as men or as women, 445 00:21:16,186 --> 00:21:19,818 not as transsexual women or transsexual men, 446 00:21:19,818 --> 00:21:22,158 regardless of their surgical status. 447 00:21:22,158 --> 00:21:24,763 Now, certainly, I could say a lot more about that 448 00:21:24,763 --> 00:21:28,022 but I'm not going to because I want to have us focus 449 00:21:28,022 --> 00:21:30,766 more on children's issues. 450 00:21:30,766 --> 00:21:33,893 I do want to talk for a second about genderqueer. 451 00:21:33,893 --> 00:21:38,332 Genderqueer is a new term used, 452 00:21:40,193 --> 00:21:43,147 I want to say primarily with folks under 30, 453 00:21:43,147 --> 00:21:45,150 although I once said that at a workshop 454 00:21:45,150 --> 00:21:46,218 and had somebody raise their hand 455 00:21:46,218 --> 00:21:48,218 and said, "I'm 40 and I identify as genderqueer." 456 00:21:48,218 --> 00:21:49,722 I don't want to limit it to that. 457 00:21:49,722 --> 00:21:51,513 It's a relatively new term 458 00:21:51,513 --> 00:21:55,957 that looks at gender identities other than man or a woman. 459 00:21:55,957 --> 00:21:58,859 Sometimes people use the term non-binary. 460 00:21:58,859 --> 00:22:02,232 Outside of the gender binary system 461 00:22:02,232 --> 00:22:06,273 that poses people as either male or female. 462 00:22:06,273 --> 00:22:09,569 It's an overlap or it can be use as an overlap 463 00:22:09,569 --> 00:22:12,000 of looking at gender identity. 464 00:22:12,000 --> 00:22:13,810 My core sense of gender, 465 00:22:13,810 --> 00:22:16,413 how I know myself to be male or female. 466 00:22:16,413 --> 00:22:19,283 And my romantic sexual orientation, 467 00:22:19,283 --> 00:22:24,278 my attraction to males, females or both. 468 00:22:24,278 --> 00:22:26,387 Sometimes people talk about two or more genders 469 00:22:26,387 --> 00:22:28,956 using the term bigender or pangender. 470 00:22:28,956 --> 00:22:31,189 Bigender meaning two. 471 00:22:31,189 --> 00:22:34,556 Pangender meaning all which there includes 472 00:22:34,556 --> 00:22:36,323 also transgender identity so you know 473 00:22:36,323 --> 00:22:38,803 that one sexual attraction is to men 474 00:22:38,803 --> 00:22:42,340 specifically transgender men for example. 475 00:22:42,340 --> 00:22:45,370 Non-gendered, people who identify as not having a gender 476 00:22:45,370 --> 00:22:49,470 being agender, and moving between genders. 477 00:22:49,470 --> 00:22:54,470 Having fluidity of gender, third gender, or other-gendered. 478 00:22:54,745 --> 00:22:58,491 Genderqueer, Julie Tilsten says, 479 00:22:58,491 --> 00:23:01,255 "To queer something is an emergent process 480 00:23:01,255 --> 00:23:04,693 "of disrupting expected norms in such a way 481 00:23:04,693 --> 00:23:08,235 "that new possibilities emerge and standard, 482 00:23:08,235 --> 00:23:13,235 "unquestioned practices become open for interrogation." 483 00:23:13,361 --> 00:23:15,874 What I'm going to do is show you a video 484 00:23:15,874 --> 00:23:17,469 called, "Put this on the Map," 485 00:23:17,469 --> 00:23:21,333 of young people talking about genderqueer 486 00:23:21,333 --> 00:23:23,248 and talking about these overlaps 487 00:23:23,248 --> 00:23:26,418 and the truth is that they say it so much better 488 00:23:26,418 --> 00:23:29,808 than I can say it. 489 00:23:34,862 --> 00:23:38,813 What I'm going to do is I'm going to go over 490 00:23:38,813 --> 00:23:42,561 looking at what is sexual identity. 491 00:23:42,561 --> 00:23:45,070 I'm going to be looking at four specific 492 00:23:45,070 --> 00:23:47,738 components of sexual identity. 493 00:23:47,738 --> 00:23:52,371 Biological sex, gender identity, gender role expression 494 00:23:52,371 --> 00:23:54,575 and sexual orientation. 495 00:23:54,575 --> 00:23:56,803 I want to be clear that I'm not using 496 00:23:56,803 --> 00:23:59,813 the term sexual identity in the way 497 00:23:59,813 --> 00:24:02,160 that we use it colloquially 498 00:24:02,160 --> 00:24:05,881 that as a synonym for sexual orientation. 499 00:24:05,881 --> 00:24:09,720 Sexual orientation are desire for men or women 500 00:24:09,720 --> 00:24:13,828 or both or neither is part of our sexual identity 501 00:24:13,828 --> 00:24:17,192 but it is not actually in the way that I'm using it. 502 00:24:17,192 --> 00:24:19,395 It's not actually a synonym for it. 503 00:24:19,395 --> 00:24:22,168 I've tried to find another term besides sexual identity 504 00:24:22,168 --> 00:24:24,663 to talk about this but it's difficult. 505 00:24:24,663 --> 00:24:27,004 So I don't know what other term to use 506 00:24:27,004 --> 00:24:28,642 that is encompassing in the way 507 00:24:28,642 --> 00:24:32,183 the term sexual identity is encompassing, 508 00:24:32,183 --> 00:24:35,007 and all of these terms are part of the handout 509 00:24:35,007 --> 00:24:37,348 we have on definition so you can look at that. 510 00:24:37,348 --> 00:24:41,085 Multiple components of sexual identity are sex 511 00:24:41,085 --> 00:24:42,785 which includes our chromosomes, 512 00:24:42,785 --> 00:24:45,531 our physiology, our genitalia. 513 00:24:45,531 --> 00:24:48,323 Our gender identity, our sense of our self 514 00:24:48,323 --> 00:24:52,270 as a man or as a woman so core sense of self. 515 00:24:52,270 --> 00:24:54,398 It's very unusual for someone not to 516 00:24:54,398 --> 00:24:56,562 have a sense of themselves as a man 517 00:24:56,562 --> 00:24:58,775 or as a woman, as a male or as a female. 518 00:24:58,775 --> 00:25:02,006 Again, this may or may not hook up 519 00:25:02,006 --> 00:25:03,713 with your physical body parts 520 00:25:03,713 --> 00:25:06,715 but that core sense of I know who I am, 521 00:25:06,715 --> 00:25:08,807 I think is almost universal. 522 00:25:08,807 --> 00:25:13,487 Our gender role, how masculine or feminine we are, 523 00:25:13,487 --> 00:25:16,715 how we perform or dress or the manners we have. 524 00:25:16,715 --> 00:25:18,619 Our sexual orientation, 525 00:25:18,619 --> 00:25:21,567 the directionality of our sexual desires. 526 00:25:21,567 --> 00:25:23,691 One of the ways I think about sexual orientation 527 00:25:23,691 --> 00:25:25,766 is walk into a party. 528 00:25:25,766 --> 00:25:27,071 Are you more attracted to men? 529 00:25:27,071 --> 00:25:28,438 Are you more attracted to women? 530 00:25:28,438 --> 00:25:29,602 Are you more attracted to ... 531 00:25:29,602 --> 00:25:31,506 Are you equally attracted to both 532 00:25:31,506 --> 00:25:33,003 or are you attracted to both? 533 00:25:33,003 --> 00:25:34,875 Are you attracted to neither? 534 00:25:34,875 --> 00:25:36,579 I really want to point this out 535 00:25:36,579 --> 00:25:38,448 because I'm going to ... 536 00:25:38,448 --> 00:25:40,211 this part I'm going to be doing now 537 00:25:40,211 --> 00:25:42,520 and probably 10 or 15 minutes, 538 00:25:42,520 --> 00:25:44,687 I have spent three or four hours 539 00:25:44,687 --> 00:25:48,360 just sussing out these different parts of self, 540 00:25:48,360 --> 00:25:51,106 the sex gender identity, gender role, 541 00:25:51,106 --> 00:25:53,791 has nothing to do with actually talking 542 00:25:53,791 --> 00:25:55,333 about our erotic identities, 543 00:25:55,333 --> 00:25:56,564 about what we do in bed, 544 00:25:56,564 --> 00:25:57,629 about what we like to do in bed, 545 00:25:57,629 --> 00:25:59,266 about what positions we like, 546 00:25:59,266 --> 00:26:02,603 how playful or unplayful we are. 547 00:26:03,340 --> 00:26:05,398 I always joke, I'm happy to come back 548 00:26:05,398 --> 00:26:07,846 and talk about what we do in bed. 549 00:26:07,846 --> 00:26:08,939 No one ever hires me to do that. 550 00:26:08,939 --> 00:26:10,914 They always want me to talk about this 551 00:26:10,914 --> 00:26:13,411 but I think that we need to be looking at the fact 552 00:26:13,411 --> 00:26:14,783 that when we talk about sex, 553 00:26:14,783 --> 00:26:16,717 we could talk for hours about this 554 00:26:16,717 --> 00:26:18,510 and not actually ever get around 555 00:26:18,510 --> 00:26:23,510 to talking about our actual sexual behaviors. 556 00:26:24,660 --> 00:26:26,023 Okay. 557 00:26:26,023 --> 00:26:29,197 Biological sex is the physiological makeup 558 00:26:29,197 --> 00:26:30,393 of the human body, 559 00:26:30,393 --> 00:26:33,731 referred to as our biological or a natal sex. 560 00:26:33,731 --> 00:26:35,506 Natal meaning where it starts 561 00:26:35,506 --> 00:26:40,366 so we're born and we are identified or assigned 562 00:26:40,366 --> 00:26:45,311 as either a male or a female, a boy or a girl, 563 00:26:45,311 --> 00:26:48,182 Our biological sex is very complex 564 00:26:48,182 --> 00:26:50,388 includes our genetics and our hormones. 565 00:26:50,388 --> 00:26:53,716 and includes our morphology, what we actually look like, 566 00:26:53,716 --> 00:26:56,792 our biochemistry and our anatomy, 567 00:26:56,792 --> 00:26:59,830 As well as how these things affect 568 00:26:59,830 --> 00:27:02,765 not only the physiology of the body 569 00:27:02,765 --> 00:27:07,765 but also the differentiation of the human brain. 570 00:27:08,963 --> 00:27:12,376 My trick question is always how many sexes are there? 571 00:27:12,376 --> 00:27:15,110 I know if you're taking a test, 572 00:27:15,110 --> 00:27:17,148 you would know the right answer is two. 573 00:27:17,148 --> 00:27:20,285 Sometimes people start thinking three. 574 00:27:20,285 --> 00:27:25,285 Well, I guess intersex people are a third sex 575 00:27:26,055 --> 00:27:27,991 in different cultures around the world. 576 00:27:27,991 --> 00:27:31,251 People actually identify five sexes or six sexes 577 00:27:31,251 --> 00:27:33,124 so the idea that there's only two sexes 578 00:27:33,124 --> 00:27:36,133 is not a universal idea. 579 00:27:36,133 --> 00:27:37,694 But for our purposes here, 580 00:27:37,694 --> 00:27:39,272 what's important to understand is 581 00:27:39,272 --> 00:27:41,297 that approximately two percent, 582 00:27:41,297 --> 00:27:44,200 1.8% is the statistic that I've heard 583 00:27:44,200 --> 00:27:47,308 of infants born are born with ambiguous 584 00:27:47,308 --> 00:27:49,747 genitalia or an intersex condition. 585 00:27:49,747 --> 00:27:51,749 The difference there is that sometimes 586 00:27:51,749 --> 00:27:55,384 people can have an intersex condition 587 00:27:55,384 --> 00:27:58,152 that does not necessarily change their physiology 588 00:27:58,152 --> 00:28:00,220 so you wouldn't necessarily know that at birth. 589 00:28:00,220 --> 00:28:03,262 Or you can be born with ambiguous genitalia 590 00:28:03,262 --> 00:28:07,365 that would highlight to the medical professionals there 591 00:28:07,365 --> 00:28:10,332 that something is different with this child. 592 00:28:10,332 --> 00:28:15,332 In the culture that we live in here in the US, 593 00:28:15,650 --> 00:28:20,650 most children that are born with intersex conditions 594 00:28:20,705 --> 00:28:24,604 are assigned a female sex. 595 00:28:24,604 --> 00:28:25,976 I just want to make it really clear 596 00:28:25,976 --> 00:28:28,410 that all children are assigned to sex. 597 00:28:28,410 --> 00:28:30,282 We think about it like we have a sex 598 00:28:30,282 --> 00:28:34,026 but actually we're all assigned a sex. 599 00:28:34,026 --> 00:28:37,164 The children who are assigned female 600 00:28:37,164 --> 00:28:39,365 that have ambiguous genitalia 601 00:28:39,365 --> 00:28:41,264 or some kind of intersex condition, 602 00:28:41,264 --> 00:28:44,141 it's generally done because people ... 603 00:28:44,141 --> 00:28:46,993 When I say people here I mean medical professionals 604 00:28:46,993 --> 00:28:51,993 determine that the boy's penis is going to be too small. 605 00:28:52,772 --> 00:28:56,244 Sometimes they say, too small to urinate standing up. 606 00:28:56,244 --> 00:28:58,039 They surgically operate on the child 607 00:28:58,039 --> 00:29:00,520 to become a girl. 608 00:29:00,520 --> 00:29:04,686 This is a area of absolutely huge conflict. 609 00:29:04,686 --> 00:29:06,822 It's a topic I could probably talk about 610 00:29:06,822 --> 00:29:10,695 for an hour without stop. 611 00:29:10,695 --> 00:29:13,530 I don't want to do that. 612 00:29:13,530 --> 00:29:15,761 What I do want to do is just make a couple of points 613 00:29:15,761 --> 00:29:18,462 is that intersex people are generally 614 00:29:18,462 --> 00:29:20,769 an invisible population. 615 00:29:20,769 --> 00:29:23,357 Usually, when I have an audience and I ask 616 00:29:23,357 --> 00:29:25,309 how many people here knows someone who's intersex? 617 00:29:25,309 --> 00:29:27,842 I get maybe one person raising their hand 618 00:29:27,842 --> 00:29:29,614 and even that's unusual. 619 00:29:29,614 --> 00:29:31,142 We don't talk about this. 620 00:29:31,142 --> 00:29:34,040 Oftentimes, children are reassigned 621 00:29:34,040 --> 00:29:37,284 and the parents never talked to the children about it. 622 00:29:37,284 --> 00:29:40,421 Lots of times, the parents are very poorly informed 623 00:29:40,421 --> 00:29:42,393 when they are given permission 624 00:29:42,393 --> 00:29:44,321 to have the child have surgery. 625 00:29:44,321 --> 00:29:45,350 You know when doctors come in, 626 00:29:45,350 --> 00:29:46,338 when you have a new baby born 627 00:29:46,338 --> 00:29:48,955 and say there's a problem and we need to do surgery, 628 00:29:48,955 --> 00:29:52,026 very few parents are in a position at that point 629 00:29:52,026 --> 00:29:53,797 to be saying, "Wait. I want to go home 630 00:29:53,797 --> 00:29:55,942 "and do some research about it." 631 00:29:55,942 --> 00:29:58,766 I wrote an article called intersexuality in the family 632 00:29:58,766 --> 00:30:03,368 where my brilliant suggestion about 633 00:30:03,368 --> 00:30:05,315 how we need to reform the treatment 634 00:30:05,315 --> 00:30:09,519 of intersex babies is point number one. 635 00:30:09,519 --> 00:30:12,211 Encourage the parents to take their baby home 636 00:30:12,211 --> 00:30:14,691 and get to know their baby and love their baby. 637 00:30:14,691 --> 00:30:18,419 There are almost no medical situations 638 00:30:18,419 --> 00:30:20,059 that require immediate ... 639 00:30:20,059 --> 00:30:21,993 I would say there are no medical situations 640 00:30:21,993 --> 00:30:23,832 that require immediate surgery. 641 00:30:23,832 --> 00:30:25,802 There are some situations that require treatment 642 00:30:25,802 --> 00:30:26,969 but not surgery. 643 00:30:26,969 --> 00:30:29,607 There's no reason to be doing surgery on newborn babies. 644 00:30:29,607 --> 00:30:32,898 What we need to be doing is bonding with children 645 00:30:32,898 --> 00:30:35,347 and having parents become educated about what to do. 646 00:30:35,347 --> 00:30:36,682 Hopefully, that will be a change that 647 00:30:36,682 --> 00:30:38,805 we will see in the decades to come. 648 00:30:38,805 --> 00:30:40,788 Most of them are assigned female. 649 00:30:40,788 --> 00:30:44,787 The trend that's preferred these days is intersex. 650 00:30:44,787 --> 00:30:47,321 Sometimes you'll see the term DSD 651 00:30:47,321 --> 00:30:50,488 or disorders of sexual development. 652 00:30:50,488 --> 00:30:52,458 That was a term developed with the hope 653 00:30:52,458 --> 00:30:57,458 of being able to talk to medical professionals 654 00:30:58,260 --> 00:31:00,896 in this field in a language that maybe 655 00:31:00,896 --> 00:31:05,138 they would understand more than terms like intersex. 656 00:31:05,138 --> 00:31:06,665 Some people find the term disorders 657 00:31:06,665 --> 00:31:08,568 of sex development very offensive 658 00:31:08,568 --> 00:31:11,377 and it's been suggested particularly by Mickey Diamond 659 00:31:11,377 --> 00:31:15,277 that we use the term instead differences of sex development. 660 00:31:15,277 --> 00:31:16,557 What I want to say is really 661 00:31:16,557 --> 00:31:19,319 the most important clinical issues. 662 00:31:19,319 --> 00:31:23,559 As a therapist in this field is looking at the impact 663 00:31:23,559 --> 00:31:26,458 of early surgeries on later sexual functioning 664 00:31:26,458 --> 00:31:28,861 and what happens with the medical trauma 665 00:31:28,861 --> 00:31:30,922 in the invisibility. 666 00:31:30,922 --> 00:31:32,495 This is a population that's dealing with 667 00:31:32,495 --> 00:31:34,102 a tremendous amount of shame. 668 00:31:34,102 --> 00:31:36,336 I want to be really clear that being born 669 00:31:36,336 --> 00:31:37,924 with an intersex condition 670 00:31:37,924 --> 00:31:40,999 is not in anyway a psychosocial crisis 671 00:31:40,999 --> 00:31:44,008 and may not have any challenges with the child 672 00:31:44,008 --> 00:31:45,303 in terms of gender identity. 673 00:31:45,303 --> 00:31:46,850 I know that that sounds bizarre. 674 00:31:46,850 --> 00:31:48,782 It seems like of all people, this population, 675 00:31:48,782 --> 00:31:50,981 shouldn't they really have trouble 676 00:31:50,981 --> 00:31:52,718 with their gender identity like it's unclear 677 00:31:52,718 --> 00:31:54,217 whether they're boys or girls. 678 00:31:54,217 --> 00:31:56,087 That to me speaks more than anything 679 00:31:56,087 --> 00:31:59,757 of how we really understand that gender identity is core. 680 00:31:59,757 --> 00:32:02,393 That regardless of what one's genitalia looks like, 681 00:32:02,393 --> 00:32:05,527 people have a sense of whether they're boys or girls. 682 00:32:05,527 --> 00:32:09,238 The real issue is we need to focus in on here 683 00:32:09,238 --> 00:32:11,734 has to do with sexual functioning, 684 00:32:11,734 --> 00:32:16,734 medical trauma, family communication around these issues. 685 00:32:17,946 --> 00:32:20,779 Hopefully, looking at ways we can change the system 686 00:32:20,779 --> 00:32:24,580 and get more family therapist, social workers, 687 00:32:24,580 --> 00:32:28,186 child psychologist into the consulting room 688 00:32:28,186 --> 00:32:32,285 when babies are born with these conditions. 689 00:32:32,285 --> 00:32:33,704 Okay, the second area I want to talk 690 00:32:33,704 --> 00:32:35,991 about is gender identity which is where 691 00:32:35,991 --> 00:32:37,598 we're going to spend most of the day today. 692 00:32:37,598 --> 00:32:39,030 Gender Identity. 693 00:32:39,030 --> 00:32:40,593 Gender is a social construct 694 00:32:40,593 --> 00:32:43,669 that divides people into "natural" categories 695 00:32:43,669 --> 00:32:46,801 of men and women that is assumed 696 00:32:46,801 --> 00:32:49,847 to derive from their physiological bodies. 697 00:32:49,847 --> 00:32:52,570 What I'm saying is the baby is born, 698 00:32:52,570 --> 00:32:55,414 we look at the baby, we say, "Is it a boy or a girl?" 699 00:32:55,414 --> 00:32:57,146 Actually, these days we do that on a sonogram 700 00:32:57,146 --> 00:32:58,754 long before the baby is born. 701 00:32:58,754 --> 00:33:00,854 What are we looking for? 702 00:33:00,854 --> 00:33:02,558 What we're really looking for is a penis. 703 00:33:02,558 --> 00:33:04,387 If we see a penis, we say that's a boy. 704 00:33:04,387 --> 00:33:06,894 If we don't see a penis, we say that it's a girl. 705 00:33:06,894 --> 00:33:10,092 Then we make assumptions about who that child 706 00:33:10,092 --> 00:33:13,960 is going to be based on their physiological body. 707 00:33:13,960 --> 00:33:16,770 Now, for most people, our gender identity 708 00:33:16,770 --> 00:33:19,371 is congruent with our assigned sex 709 00:33:19,371 --> 00:33:21,711 meaning you're born, look at the sonogram. 710 00:33:21,711 --> 00:33:22,852 Look at the sonogram. 711 00:33:22,852 --> 00:33:25,150 They say it's a girl. 712 00:33:25,150 --> 00:33:27,505 Here's your new baby. 713 00:33:27,505 --> 00:33:29,116 Your baby's a girl. 714 00:33:29,116 --> 00:33:31,219 We dress the baby in pink. 715 00:33:31,219 --> 00:33:34,388 We do a whole bunch of socially construed ways 716 00:33:34,388 --> 00:33:37,020 of raising that ways child to be a girl. 717 00:33:37,020 --> 00:33:40,296 Most of us say, "Yeah, I'm a girl. That's okay." 718 00:33:40,296 --> 00:33:42,595 We're not really in argument with that. 719 00:33:42,595 --> 00:33:44,528 A small percentage of the population, 720 00:33:44,528 --> 00:33:46,834 how small is questionable. 721 00:33:46,834 --> 00:33:50,766 It says that identity is not congruent with who they are. 722 00:33:50,766 --> 00:33:52,902 Again, what we're going to be talking about 723 00:33:52,902 --> 00:33:57,145 is sometimes people are aware of this at very young ages. 724 00:33:57,145 --> 00:33:59,516 Gender role is the expression 725 00:33:59,516 --> 00:34:01,544 of masculinity and femininity. 726 00:34:01,544 --> 00:34:04,586 What we used to refer to as sex roles 727 00:34:04,586 --> 00:34:05,850 for those of you who are listening 728 00:34:05,850 --> 00:34:08,659 who took women studies classes back in the '70s and '80s. 729 00:34:08,659 --> 00:34:11,294 Gender role is probably a clearer term. 730 00:34:11,294 --> 00:34:15,528 Gender roles are socially dictated and reinforced. 731 00:34:15,528 --> 00:34:18,228 That means that the society we live in 732 00:34:18,228 --> 00:34:21,693 tells us what roles girls and boys should play. 733 00:34:21,693 --> 00:34:24,140 Now, you know I'm in my mid50s and growing up, 734 00:34:24,140 --> 00:34:26,171 in the time that I grew up, 735 00:34:26,171 --> 00:34:27,744 it was very, very clear. 736 00:34:27,744 --> 00:34:29,834 There are little children's books 737 00:34:29,834 --> 00:34:32,504 that says things girls like to cook 738 00:34:32,504 --> 00:34:34,340 and boys like to do sports. 739 00:34:34,340 --> 00:34:37,650 That system is breaking down a little bit 740 00:34:37,650 --> 00:34:39,754 again, thanks to feminism. 741 00:34:39,754 --> 00:34:44,153 But it still exists in very harsh and strong ways 742 00:34:44,153 --> 00:34:47,898 that we often forget that. 743 00:34:47,898 --> 00:34:52,297 Gender roles are also enacted and performed. 744 00:34:52,297 --> 00:34:56,696 What I mean by that is consciously or unconsciously, 745 00:34:56,696 --> 00:34:59,379 we all wear our gender. 746 00:34:59,379 --> 00:35:03,735 We literally, dress in the morning 747 00:35:03,735 --> 00:35:08,239 and we put on our gender. 748 00:35:08,239 --> 00:35:11,719 We put on earrings 749 00:35:11,719 --> 00:35:14,886 or when we go to the store to buy eyeglasses, 750 00:35:14,886 --> 00:35:18,084 there's a male section and a female section 751 00:35:18,084 --> 00:35:23,032 of what eyeglasses boys and girls should wear. 752 00:35:23,032 --> 00:35:25,103 I just was looking the other day at the eye store 753 00:35:25,103 --> 00:35:28,771 and they had glasses for very little children. 754 00:35:28,771 --> 00:35:31,842 There was pink and there was blue. 755 00:35:31,842 --> 00:35:36,414 These ways of dressing ourselves, 756 00:35:36,414 --> 00:35:40,752 when women say, "I shop at this store 757 00:35:40,752 --> 00:35:43,420 "but I never shop at that store." 758 00:35:43,420 --> 00:35:44,006 What is it? 759 00:35:44,006 --> 00:35:45,517 What is it about those stores 760 00:35:45,517 --> 00:35:47,623 that those are not my kinds of clothing. 761 00:35:47,623 --> 00:35:48,823 I don't dress like that. 762 00:35:48,823 --> 00:35:50,192 I don't look like that. 763 00:35:50,192 --> 00:35:52,250 That so much of what we think of 764 00:35:52,250 --> 00:35:56,164 when we think of how we dress is actually gendered. 765 00:35:56,164 --> 00:35:57,661 We're all wearing our gender. 766 00:35:57,661 --> 00:35:59,035 We put it on in the morning. 767 00:35:59,035 --> 00:36:01,093 We shop for it at the mall. 768 00:36:01,093 --> 00:36:03,235 What kind of haircut you have, 769 00:36:03,235 --> 00:36:04,808 what your eyeglasses look like, your shoes. 770 00:36:04,808 --> 00:36:08,800 I have to say this even our socks, 771 00:36:08,800 --> 00:36:12,044 our socks like what is it about our socks 772 00:36:12,044 --> 00:36:13,512 that have to be gendered. 773 00:36:13,512 --> 00:36:15,684 If you go into the boy's department, 774 00:36:15,684 --> 00:36:17,880 socks are black, socks are blue, 775 00:36:17,880 --> 00:36:20,079 socks are brown, socks are green, 776 00:36:20,079 --> 00:36:22,224 and sport socks are white. 777 00:36:22,224 --> 00:36:23,292 That's what socks are. 778 00:36:23,292 --> 00:36:24,821 You go into the girl section, 779 00:36:24,821 --> 00:36:26,292 socks are all kinds of things 780 00:36:26,292 --> 00:36:27,552 and their stripes and their colors, 781 00:36:27,552 --> 00:36:28,627 and they're bright. 782 00:36:28,627 --> 00:36:31,034 They have lace on them, why? 783 00:36:31,234 --> 00:36:32,999 Someone's going to say, "Well,size." 784 00:36:32,999 --> 00:36:36,576 Well, you could just make them in wide variety of sizes. 785 00:36:36,576 --> 00:36:37,695 I mean that's just ... 786 00:36:37,695 --> 00:36:42,644 Why do we have to mark these things as gendered? 787 00:36:42,644 --> 00:36:46,819 Our mannerisms, how we move ourselves. 788 00:36:47,373 --> 00:36:52,373 Research has shown that when women talk 789 00:36:54,160 --> 00:36:57,792 and again, the more feminine, the more girl-like, 790 00:36:57,792 --> 00:37:01,161 we tend to move our wrists more. 791 00:37:01,161 --> 00:37:06,161 We tend to, when we turn, we don't just turn our head. 792 00:37:06,560 --> 00:37:08,430 We turn our bodies. 793 00:37:08,430 --> 00:37:10,363 We know that women have a little more swing 794 00:37:10,363 --> 00:37:11,503 in their walk when they ... 795 00:37:11,503 --> 00:37:15,840 Some women have more swing in their walk when they walk. 796 00:37:15,840 --> 00:37:20,677 As I'm saying this, I encourage you all to notice this. 797 00:37:20,677 --> 00:37:23,958 When you see a woman or a young girl, 798 00:37:23,958 --> 00:37:28,618 who we perceive of as less feminine. 799 00:37:28,618 --> 00:37:30,249 What is it that we're perceiving? 800 00:37:30,249 --> 00:37:31,919 What is it that we're looking at? 801 00:37:31,919 --> 00:37:34,897 And often what it is is that she carries 802 00:37:34,897 --> 00:37:39,463 her neck and shoulders, her arms and her hands 803 00:37:39,463 --> 00:37:41,267 without these movements. 804 00:37:41,267 --> 00:37:43,672 Those movements actually create an image 805 00:37:43,672 --> 00:37:46,679 that in our culture becomes more masculine. 806 00:37:46,679 --> 00:37:47,939 It's a little hard for me to do that 807 00:37:47,939 --> 00:37:50,546 because that it's not my gender expression. 808 00:37:50,546 --> 00:37:51,980 So it's a little harder for me to do that. 809 00:37:51,980 --> 00:37:54,179 If I wasn't sort of stuck on a film right now, 810 00:37:54,179 --> 00:37:56,955 I often get up and I do a little walk back and forth 811 00:37:56,955 --> 00:38:00,045 to show how those movements change, 812 00:38:00,045 --> 00:38:02,152 how we actually perceive people. 813 00:38:02,152 --> 00:38:05,322 That's where that stereotype comes from, 814 00:38:05,322 --> 00:38:09,031 that gay men have limp wrists is because of that image. 815 00:38:09,031 --> 00:38:12,260 Well, first of all, an image that falsely connects 816 00:38:12,260 --> 00:38:15,305 gender expression and homosexual behavior. 817 00:38:15,305 --> 00:38:16,798 We'll talk about that in a minute. 818 00:38:16,798 --> 00:38:18,875 But the other thing is that it also ... 819 00:38:18,875 --> 00:38:23,875 The assumption is that someone who is a man 820 00:38:24,770 --> 00:38:29,770 who is moving more fluidly is perceived of as more feminine. 821 00:38:31,151 --> 00:38:32,015 Okay. 822 00:38:32,015 --> 00:38:34,588 Gendering can be conventional 823 00:38:34,588 --> 00:38:37,595 meaning it follows the rules of the culture 824 00:38:37,595 --> 00:38:41,467 or people can purposely bend those rules. 825 00:38:41,467 --> 00:38:46,467 That gender rules change from society to another society, 826 00:38:46,627 --> 00:38:50,498 from one culture to another. 827 00:38:50,498 --> 00:38:52,836 In contemporary US culture, 828 00:38:52,836 --> 00:38:56,036 women have tremendous freedom of dress compared to men 829 00:38:56,036 --> 00:38:58,548 who still have a very limited repertoire 830 00:38:58,548 --> 00:39:01,013 of what they can and cannot express. 831 00:39:01,013 --> 00:39:02,788 If you think about it, 832 00:39:04,602 --> 00:39:08,021 if you're in at a conference or you're in a classroom, 833 00:39:08,021 --> 00:39:11,858 and you look around at the way women are dressed 834 00:39:11,858 --> 00:39:16,858 in any social gathering somewhere between 50 and 75 835 00:39:16,868 --> 00:39:20,422 or 80% of the women are wearing pants, 836 00:39:20,422 --> 00:39:22,872 which 50 years ago really 837 00:39:22,872 --> 00:39:24,573 would've been considered cross-dressing. 838 00:39:24,573 --> 00:39:28,148 We've really shifted how we view gender roles 839 00:39:28,148 --> 00:39:31,312 and what the rules are. 840 00:39:31,312 --> 00:39:33,704 Gender identity and gender role 841 00:39:33,704 --> 00:39:36,212 are two sides of the same coin. 842 00:39:36,212 --> 00:39:38,676 That's something John Money said years ago. 843 00:39:38,676 --> 00:39:42,920 Meaning that people have a gender identity 844 00:39:42,920 --> 00:39:46,586 and they express it in their gender role. 845 00:39:46,586 --> 00:39:48,731 I have a sense of myself as a woman 846 00:39:48,731 --> 00:39:53,324 and I wear clothing and choose ways of behaving 847 00:39:53,324 --> 00:39:58,324 that illustrate myself as a woman in the world. 848 00:39:59,737 --> 00:40:04,737 However, gender role may suggest that I'm a female 849 00:40:07,340 --> 00:40:09,018 but it doesn't confirm it. 850 00:40:09,018 --> 00:40:10,781 It doesn't confirm it. 851 00:40:10,781 --> 00:40:13,792 That we perform our gender role 852 00:40:13,792 --> 00:40:17,054 in order to tell people what our gender identity is. 853 00:40:17,054 --> 00:40:19,255 Except we know that lots of people 854 00:40:19,255 --> 00:40:22,326 are hiding their true gender identity. 855 00:40:22,326 --> 00:40:26,024 What I mean here is that the (mumbling) man 856 00:40:26,024 --> 00:40:31,024 who lives as a man, who feels himself to really be a woman 857 00:40:31,840 --> 00:40:34,339 may be very closeted and not out, 858 00:40:34,339 --> 00:40:38,001 and not showing that to the world in any way. 859 00:40:40,138 --> 00:40:42,982 Dr. Jamison Green, the president of 860 00:40:42,982 --> 00:40:46,444 the World Professional Association for Transgender Health, 861 00:40:46,444 --> 00:40:48,115 has said, "I change my sex 862 00:40:48,115 --> 00:40:51,861 "so you could see me as I see myself." 863 00:40:51,861 --> 00:40:54,765 I just want each of you to think about that for a second. 864 00:40:54,765 --> 00:40:58,860 What would it mean for you if you are exactly who you are. 865 00:40:58,860 --> 00:41:03,073 You know who you are but when you were out in the world, 866 00:41:03,073 --> 00:41:06,605 walking through the world, everybody else saw you 867 00:41:06,605 --> 00:41:11,605 and used the other pronoun to identify you 868 00:41:11,810 --> 00:41:13,774 that they didn't see you. 869 00:41:13,774 --> 00:41:18,085 What would it take for you to want to be congruent 870 00:41:18,085 --> 00:41:23,085 with your inside and outside so people see you as you are. 871 00:41:24,492 --> 00:41:25,261 Okay. 872 00:41:25,261 --> 00:41:28,957 The last category here is sexual orientation. 873 00:41:28,957 --> 00:41:31,534 I always say that after we talked about gender 874 00:41:31,534 --> 00:41:33,291 and gender identity and gender roles, 875 00:41:33,291 --> 00:41:35,433 sexual orientation is just really easy. 876 00:41:35,433 --> 00:41:36,668 Like who are you attracted to? 877 00:41:36,668 --> 00:41:37,572 Do you like girls? 878 00:41:37,572 --> 00:41:38,991 Do you like boys? 879 00:41:40,605 --> 00:41:43,036 Are you asexual that you're not really attracted 880 00:41:43,036 --> 00:41:45,183 to people in any particular kind of way? 881 00:41:45,183 --> 00:41:47,149 Or you don't want to act on that? 882 00:41:47,149 --> 00:41:50,582 Are you bisexual or pansexual 883 00:41:50,582 --> 00:41:53,187 that your interest are not really controlled 884 00:41:53,187 --> 00:41:55,385 by whether people are male or female 885 00:41:55,385 --> 00:42:00,224 that that's not really not the thing that limits, 886 00:42:00,224 --> 00:42:01,427 limits is a good word there, 887 00:42:01,427 --> 00:42:02,632 your sexual orientation. 888 00:42:02,893 --> 00:42:06,171 Some people refer to people who are heterosexual 889 00:42:06,171 --> 00:42:11,008 and people who are homosexual as people who are monosexual. 890 00:42:11,008 --> 00:42:12,303 Okay. 891 00:42:14,747 --> 00:42:18,416 A couple of points that I just want to reinforce here. 892 00:42:18,416 --> 00:42:21,380 Sex and gender are not the same thing. 893 00:42:21,380 --> 00:42:23,621 That's really as we move into talking 894 00:42:23,621 --> 00:42:24,943 about children and youth, 895 00:42:24,943 --> 00:42:26,817 sex is about your physiology, 896 00:42:26,817 --> 00:42:28,860 gender is about your inner sense of self. 897 00:42:28,860 --> 00:42:32,555 When parents have a child who is identified, 898 00:42:32,555 --> 00:42:34,957 assigned at birth as a boy, 899 00:42:34,957 --> 00:42:38,422 they have expectations of what child gender will be. 900 00:42:38,422 --> 00:42:40,436 But if we really examine the fact that 901 00:42:40,436 --> 00:42:42,902 these are two separate parts of self, 902 00:42:42,902 --> 00:42:45,866 there's really nothing pathological happening with the child 903 00:42:45,866 --> 00:42:48,942 who happens to be born as a male or a female 904 00:42:48,942 --> 00:42:53,070 but is expressing a gender identity that is not matching 905 00:42:53,070 --> 00:42:54,546 their physiological sex. 906 00:42:55,224 --> 00:42:58,547 That sex gender and sexual orientation are ... 907 00:42:58,547 --> 00:43:01,512 That these categories we're talking about 908 00:43:01,512 --> 00:43:04,348 are not polarities. 909 00:43:04,348 --> 00:43:07,254 When we look at the reality that the two percent 910 00:43:07,254 --> 00:43:10,358 of the population is intersex, 911 00:43:10,358 --> 00:43:13,334 then this concept of male and female as opposites 912 00:43:13,334 --> 00:43:15,136 doesn't really make sense. 913 00:43:15,136 --> 00:43:18,871 When we look at the fact that transgender people are here. 914 00:43:18,871 --> 00:43:19,700 They exist. 915 00:43:19,700 --> 00:43:21,774 They're part of the human family. 916 00:43:21,774 --> 00:43:26,676 Then the issues of man and woman, 917 00:43:26,676 --> 00:43:29,315 of these opposites that there are men and there are women. 918 00:43:29,315 --> 00:43:30,749 There are people who are feminine. 919 00:43:30,749 --> 00:43:32,513 There are people who are masculine. 920 00:43:32,513 --> 00:43:35,457 There are people all the way through the spectrum 921 00:43:35,457 --> 00:43:39,123 that have complex ways of seeing these intersex, 922 00:43:39,123 --> 00:43:42,834 gender-variant, cross gender, androgynous 923 00:43:42,834 --> 00:43:45,991 and/or bisexual people are made invisible. 924 00:43:45,991 --> 00:43:50,433 I just want you to look at the slide which really ... 925 00:43:50,433 --> 00:43:54,243 This is heuristic way of really identifying this 926 00:43:54,243 --> 00:43:58,609 for those of you that think in pictures more than words. 927 00:43:58,609 --> 00:43:59,476 We grew up. 928 00:43:59,476 --> 00:44:01,382 We live in a world that says 929 00:44:01,382 --> 00:44:04,218 that male and female are opposites. 930 00:44:04,218 --> 00:44:07,485 That you're either a male or you're a female. 931 00:44:07,485 --> 00:44:11,424 That you're either a man or you are woman. 932 00:44:11,424 --> 00:44:14,497 That you are either masculine or feminine 933 00:44:14,497 --> 00:44:17,590 and we accept again, as I said, a number of times 934 00:44:17,590 --> 00:44:20,332 but it just bares repeating that the expectation 935 00:44:20,332 --> 00:44:23,238 is that females can go a little bit more 936 00:44:23,238 --> 00:44:25,964 to the masculine side without it being a problem. 937 00:44:27,271 --> 00:44:31,675 Males and boys are kept much more in a smaller box 938 00:44:31,675 --> 00:44:33,812 of what is acceptable behavior. 939 00:44:33,812 --> 00:44:38,417 Sexual orientation that people are either heterosexual 940 00:44:38,417 --> 00:44:43,049 or homosexual that these are inborn identities 941 00:44:43,049 --> 00:44:47,356 in the brain that were born with them. 942 00:44:47,356 --> 00:44:50,399 Despite the fact that we know that people are fluid 943 00:44:50,399 --> 00:44:51,489 throughout their lives 944 00:44:51,489 --> 00:44:53,859 that many, many, many people are bisexual, are pansexual. 945 00:44:53,859 --> 00:44:58,269 I'm sure that virtually everybody that is listening to this 946 00:44:58,269 --> 00:45:02,634 has known somebody in your life who was solidly heterosexual 947 00:45:02,634 --> 00:45:04,446 for the first 30 years of their lives 948 00:45:04,446 --> 00:45:07,443 and then came out. 949 00:45:07,443 --> 00:45:09,174 It is also true that many of us know people 950 00:45:09,174 --> 00:45:12,123 who are gay or lesbian-identified who then fell in love 951 00:45:12,123 --> 00:45:15,146 with someone of the opposite sex. 952 00:45:15,146 --> 00:45:20,146 It's a nice concept to think that these are just inborn 953 00:45:20,997 --> 00:45:24,397 but in reality, there is actually a lot of fluidity 954 00:45:24,397 --> 00:45:29,397 about sexual behavior and sexual orientation and identity. 955 00:45:31,028 --> 00:45:35,274 This next slide looks at and the best way for me 956 00:45:35,274 --> 00:45:36,848 to talk about this if you're familiar 957 00:45:36,848 --> 00:45:38,611 with the Russian Matryoshka dolls, 958 00:45:38,611 --> 00:45:40,383 the little dolls that one goes inside of the other, 959 00:45:40,383 --> 00:45:42,543 inside of the other, inside of the other. 960 00:45:42,543 --> 00:45:46,491 That when a baby is assigned male at birth, 961 00:45:46,491 --> 00:45:49,315 the assumption is is that they are a man. 962 00:45:49,315 --> 00:45:52,028 That they will grow up to be a man. 963 00:45:52,028 --> 00:45:57,028 That the assumption is is that males, men are masculine. 964 00:45:58,923 --> 00:46:00,467 In the world that we live in, 965 00:46:00,467 --> 00:46:05,467 if you are a masculine man based on the fact ... 966 00:46:09,577 --> 00:46:11,439 All that is based on the fact that you have a penis. 967 00:46:11,439 --> 00:46:13,808 That you will therefore naturally 968 00:46:13,808 --> 00:46:17,611 be attracted to feminine female women. 969 00:46:17,611 --> 00:46:20,859 Male masculine men are naturally, naturally, 970 00:46:20,859 --> 00:46:23,153 that's the sort of they're in quote 971 00:46:23,153 --> 00:46:25,661 attracted to feminine female women. 972 00:46:25,661 --> 00:46:27,987 I mean that is the jigsaw puzzle pieces. 973 00:46:27,987 --> 00:46:29,562 That's the parts that go together. 974 00:46:29,562 --> 00:46:30,997 That's the assumption we live in. 975 00:46:30,997 --> 00:46:32,496 That's the culture that we live in 976 00:46:32,496 --> 00:46:35,769 is that these things are first of all opposites, 977 00:46:35,769 --> 00:46:38,770 that they are built inside of each other naturally. 978 00:46:38,770 --> 00:46:43,770 I often tell a story that when I adopted my older son, 979 00:46:44,382 --> 00:46:49,382 I became within a week the mother of three footballs. 980 00:46:49,451 --> 00:46:52,778 Now, you know the fact that my son was 10 days old 981 00:46:52,778 --> 00:46:54,927 and probably many years away from 982 00:46:54,927 --> 00:46:58,487 potentially playing football, 983 00:46:58,487 --> 00:47:00,154 for the record, he actually never did. 984 00:47:00,154 --> 00:47:01,729 I gave away those footballs. 985 00:47:03,051 --> 00:47:05,829 It was clearly a social message. 986 00:47:05,829 --> 00:47:09,169 All of those footballs came from men in my lives. 987 00:47:09,169 --> 00:47:11,871 They all came from heterosexual men in my lives. 988 00:47:11,871 --> 00:47:13,474 Most of whom I've partnered 989 00:47:13,474 --> 00:47:15,504 with close female friends of mine. 990 00:47:15,504 --> 00:47:17,704 The message was really clear, 991 00:47:17,704 --> 00:47:20,572 listen you lesbian who is raising a child. 992 00:47:20,572 --> 00:47:22,245 I just want you to be really, really clear 993 00:47:22,245 --> 00:47:23,921 at the time I was a single parent. 994 00:47:23,921 --> 00:47:26,544 We just really, really want you to be really, really clear 995 00:47:26,544 --> 00:47:28,524 that this child is a boy. 996 00:47:28,524 --> 00:47:31,286 Boys need to be raised as boys 997 00:47:31,286 --> 00:47:34,767 and here's the football to give you a tool, 998 00:47:34,767 --> 00:47:38,495 to work with you here that the expectation we have as men, 999 00:47:38,495 --> 00:47:42,970 is that you will raise your son to be a male masculine man 1000 00:47:42,970 --> 00:47:45,903 who will be absolutely be attracted 1001 00:47:45,903 --> 00:47:48,665 to female feminine women, and be heterosexual. 1002 00:47:49,327 --> 00:47:53,111 This is really deeply ingrained in our culture 1003 00:47:53,111 --> 00:47:54,373 and how we see things. 1004 00:47:54,373 --> 00:47:55,918 You know the story I often tell is 1005 00:47:55,918 --> 00:47:59,009 I was with my younger son at the eye doctor once. 1006 00:47:59,009 --> 00:48:01,378 We're sitting in the waiting room. 1007 00:48:01,378 --> 00:48:02,594 He's playing on the floor. 1008 00:48:02,594 --> 00:48:07,296 He's probably all of three years old with a little girl. 1009 00:48:07,296 --> 00:48:09,093 They're being very, very cute with each other. 1010 00:48:09,093 --> 00:48:11,028 They're hugging each other. 1011 00:48:11,028 --> 00:48:13,632 The other mom turns around to me 1012 00:48:13,632 --> 00:48:15,864 and says, "Oh, they are so adorable. 1013 00:48:15,864 --> 00:48:18,295 "Maybe they'll get married someday." 1014 00:48:18,295 --> 00:48:21,811 Now, besides all of the incredible heteronormativity 1015 00:48:21,811 --> 00:48:25,273 of talking about the sexual and future romantic 1016 00:48:25,273 --> 00:48:27,644 attachments of three-year-olds, 1017 00:48:27,644 --> 00:48:30,622 you and I know that she never would've said that 1018 00:48:30,622 --> 00:48:32,823 if it had been two little boys doing the same thing. 1019 00:48:32,823 --> 00:48:33,850 Look at how sweet they are. 1020 00:48:33,850 --> 00:48:35,627 Maybe they'll get married someday. 1021 00:48:35,627 --> 00:48:40,627 This heteronormativity, this assumption about one's body, 1022 00:48:40,963 --> 00:48:43,460 one's gender, one's sexual orientation 1023 00:48:43,460 --> 00:48:45,731 and what is appropriate is built in 1024 00:48:45,731 --> 00:48:48,498 to the very framework of our culture. 1025 00:48:48,498 --> 00:48:51,105 What I'm really saying more than anything else 1026 00:48:51,105 --> 00:48:53,567 is that there are multiple and diverse ways 1027 00:48:53,567 --> 00:48:57,763 of experiencing and expressing gender, gender role, 1028 00:48:57,763 --> 00:49:00,247 and sexual orientation that the boundaries 1029 00:49:00,247 --> 00:49:04,442 of all of these categories are fluid. 1030 00:49:04,442 --> 00:49:08,856 They're mutable and that this is not a binary. 1031 00:49:08,856 --> 00:49:13,856 Okay and here's a wonderful picture that describes that 1032 00:49:15,267 --> 00:49:19,470 in more fun ways than my little boxes. 1033 00:49:19,470 --> 00:49:24,439 The genderbread person which shows you gender identity. 1034 00:49:24,439 --> 00:49:27,709 Woman, man, or in the middle, we have gender queer, 1035 00:49:27,709 --> 00:49:30,080 gender expression, feminine, masculine. 1036 00:49:30,080 --> 00:49:31,940 In the middle, androgynous. 1037 00:49:31,940 --> 00:49:34,839 Biological sex, female, male. 1038 00:49:34,839 --> 00:49:37,584 In the middle, we have intersex and sexual orientation, 1039 00:49:37,584 --> 00:49:40,315 heterosexual, homosexual and bisexual. 1040 00:49:40,315 --> 00:49:42,484 If you look at the genderbread person, 1041 00:49:42,484 --> 00:49:45,493 what they're saying is our identity is in our minds. 1042 00:49:45,493 --> 00:49:47,929 Our orientation is in our hearts. 1043 00:49:47,929 --> 00:49:51,837 Our expression is how we dress ourselves up in the world, 1044 00:49:51,837 --> 00:49:55,637 and our sex is between our legs. 1045 00:49:55,637 --> 00:49:57,200 Okay. 1046 00:49:57,368 --> 00:49:58,978 What is the difference between 1047 00:49:58,978 --> 00:50:03,099 sexual orientation and gender identity? 1048 00:50:03,099 --> 00:50:05,346 This is from Diane Ehrensaft. 1049 00:50:05,346 --> 00:50:10,346 She says sex is who you go to bed with 1050 00:50:10,508 --> 00:50:14,988 but gender is who you go to bed AS. 1051 00:50:14,988 --> 00:50:17,060 When we talk about gender expression, 1052 00:50:17,060 --> 00:50:19,853 this genderqueer overlapping gender expression 1053 00:50:19,853 --> 00:50:21,419 and sexual orientations, 1054 00:50:21,419 --> 00:50:24,736 some research has found that transgender people 1055 00:50:24,736 --> 00:50:27,300 have unique ways of looking 1056 00:50:27,300 --> 00:50:30,602 at their sexual orientation labels. 1057 00:50:30,602 --> 00:50:34,736 People talked about being a transgender lesbian 1058 00:50:34,736 --> 00:50:38,917 or a heterosexual lesbian, or someone who is omni sexual, 1059 00:50:38,917 --> 00:50:40,508 I really like that term. 1060 00:50:40,508 --> 00:50:43,554 People who are attracted to genderqueer people. 1061 00:50:43,554 --> 00:50:44,675 I love this one. 1062 00:50:44,675 --> 00:50:47,685 Bisexual, when I'm dressed in female clothing 1063 00:50:47,685 --> 00:50:50,290 but otherwise, I'm heterosexual. 1064 00:50:50,290 --> 00:50:53,259 Again, I could spend hours literally talking 1065 00:50:53,259 --> 00:50:55,922 about how people view themselves, 1066 00:50:55,922 --> 00:51:00,835 how these different components of identity mix and match 1067 00:51:00,835 --> 00:51:03,807 in individual people to make sense of how they see 1068 00:51:03,807 --> 00:51:04,907 their sex, their gender, 1069 00:51:04,907 --> 00:51:07,402 their gender identity, their gender role. 1070 00:51:07,402 --> 00:51:11,614 The point I want to make here is this is very, very complex. 1071 00:51:11,614 --> 00:51:12,907 It's not as simple. 1072 00:51:12,907 --> 00:51:14,483 When we're talking about small children 1073 00:51:14,483 --> 00:51:16,012 and we're talking about small children saying, 1074 00:51:16,012 --> 00:51:17,999 "I know I'm not a girl. I'm a boy." 1075 00:51:18,137 --> 00:51:23,137 That who these people are going to grow up and identify as. 1076 00:51:23,454 --> 00:51:27,820 That the options that are available to them 1077 00:51:27,820 --> 00:51:29,365 are much broader than the options 1078 00:51:29,365 --> 00:51:30,988 that were available for many of us. 1079 00:51:30,988 --> 00:51:34,366 It's going to be a process of how they come 1080 00:51:34,366 --> 00:51:38,404 to define and experience themselves. 1081 00:51:38,404 --> 00:51:40,138 I also want to say that 1082 00:51:40,138 --> 00:51:42,544 there's a fluidity of these components. 1083 00:51:42,544 --> 00:51:47,544 This fluidity does not mean that one can change people 1084 00:51:49,752 --> 00:51:51,253 from the outside in. 1085 00:51:51,253 --> 00:51:52,780 So I want to be really clear about that. 1086 00:51:52,780 --> 00:51:55,258 I'm not talking about reparative therapy here. 1087 00:51:55,258 --> 00:51:59,017 What I'm talking about is that the reality of human being's 1088 00:51:59,017 --> 00:52:02,567 lives is that throughout the course of a life, 1089 00:52:02,567 --> 00:52:05,656 people often change their sense of identity. 1090 00:52:05,656 --> 00:52:07,901 We need to acknowledge that this is not just 1091 00:52:07,901 --> 00:52:11,396 about digging structurally to the core and finding out 1092 00:52:11,396 --> 00:52:16,311 exactly who we are as much as it's a process 1093 00:52:16,311 --> 00:52:21,242 of continually emerging into a sense and understanding 1094 00:52:21,242 --> 00:52:24,579 of who we are that develops and changes throughout 1095 00:52:24,579 --> 00:52:27,589 our life times in various and sundry ways. 1096 00:52:27,589 --> 00:52:32,394 Our job as clinicians is to support people 1097 00:52:32,394 --> 00:52:34,999 in emerging identities 1098 00:52:34,999 --> 00:52:37,791 and it's not just emerging identities internally 1099 00:52:37,791 --> 00:52:39,495 but as the culture changes, 1100 00:52:39,495 --> 00:52:42,003 more possibilities become available. 1101 00:52:42,003 --> 00:52:43,809 It's also important to realize that changes 1102 00:52:43,809 --> 00:52:47,143 in one area of identity can impact changes 1103 00:52:47,143 --> 00:52:49,179 in another area of identity. 1104 00:52:49,179 --> 00:52:51,644 For example, if we go back to the slide 1105 00:52:51,644 --> 00:52:54,819 that look at the different ways, 1106 00:52:54,819 --> 00:52:56,407 the components of identity. 1107 00:52:57,948 --> 00:53:00,050 I'm going to use a personal example here 1108 00:53:00,050 --> 00:53:02,591 to contextualize this. 1109 00:53:02,591 --> 00:53:04,226 I am a female. 1110 00:53:04,226 --> 00:53:06,057 You're going to have to just take my word for that. 1111 00:53:06,057 --> 00:53:07,160 I'm telling you that that's true. 1112 00:53:07,160 --> 00:53:10,764 I was born a female and I have a female body. 1113 00:53:10,764 --> 00:53:12,634 I am a woman. 1114 00:53:12,634 --> 00:53:13,726 I identify as a woman. 1115 00:53:13,726 --> 00:53:15,471 I'm comfortable with the term woman. 1116 00:53:15,471 --> 00:53:16,927 I want to be really clear here. 1117 00:53:16,927 --> 00:53:20,231 I'm not always comfortable with what other people think 1118 00:53:20,231 --> 00:53:22,044 a woman is or a woman should be 1119 00:53:22,044 --> 00:53:23,507 or how a woman should behave 1120 00:53:23,507 --> 00:53:25,613 but I'm comfortable with the term woman. 1121 00:53:25,613 --> 00:53:28,483 On the spectrum of masculine and feminine, 1122 00:53:28,483 --> 00:53:30,512 I'm more towards the feminine end 1123 00:53:30,512 --> 00:53:32,089 but certainly, there's lots of women 1124 00:53:32,089 --> 00:53:34,064 that are way more feminine that I am. 1125 00:53:34,064 --> 00:53:34,754 Okay. 1126 00:53:34,754 --> 00:53:36,952 But I would identify more to the feminine side. 1127 00:53:36,952 --> 00:53:38,824 I identify as a lesbian. 1128 00:53:38,824 --> 00:53:43,824 I am a female, a woman, a femme would be actually 1129 00:53:44,393 --> 00:53:46,826 how I would use the term for my gender identity. 1130 00:53:46,826 --> 00:53:49,842 I'm attracted to women. 1131 00:53:49,842 --> 00:53:53,830 My partner is also born female. 1132 00:53:53,830 --> 00:53:55,445 You have to take my word for that. 1133 00:53:55,445 --> 00:53:56,642 She identifies as a woman 1134 00:53:56,642 --> 00:53:59,142 but the word woman is a little more complex for her 1135 00:53:59,142 --> 00:54:01,478 than it is for me but she definitely uses that term. 1136 00:54:01,478 --> 00:54:02,988 If she has to choose between man or a woman, 1137 00:54:02,988 --> 00:54:05,054 she would use the term woman. 1138 00:54:05,054 --> 00:54:09,087 Her gender identity and expression is far more 1139 00:54:09,087 --> 00:54:11,784 to the masculine end of the spectrum than mine is. 1140 00:54:15,674 --> 00:54:17,453 She identifies as a lesbian. 1141 00:54:17,453 --> 00:54:18,100 Okay. 1142 00:54:18,884 --> 00:54:23,834 So, if she were to come to the conclusion 1143 00:54:23,834 --> 00:54:27,969 to tell me to identify as someone who is in transition, 1144 00:54:27,969 --> 00:54:29,442 female to male. 1145 00:54:29,442 --> 00:54:31,278 She was to say, "I've determined 1146 00:54:31,278 --> 00:54:33,775 "that I want to live as a male." 1147 00:54:33,775 --> 00:54:36,006 She would still be born female 1148 00:54:36,006 --> 00:54:38,421 although her identity would be male. 1149 00:54:38,421 --> 00:54:41,620 She would identify as a man. 1150 00:54:41,620 --> 00:54:44,618 She would identify possibly as a transman. 1151 00:54:44,618 --> 00:54:45,456 She would ... 1152 00:54:45,456 --> 00:54:49,095 I'm using she pronouns here because she's a she to me 1153 00:54:49,095 --> 00:54:52,358 but he would identify as a transmale 1154 00:54:52,358 --> 00:54:54,505 probably would no longer identify as butch 1155 00:54:54,505 --> 00:54:57,394 but would still identify as masculine. 1156 00:54:58,454 --> 00:55:00,849 But the term lesbian no longer fits does it. 1157 00:55:00,895 --> 00:55:03,339 Let's, for the sake of argument, say 1158 00:55:03,339 --> 00:55:07,613 that his gender identity, that his sexual orientation, 1159 00:55:07,613 --> 00:55:11,513 I'm sorry, is the same as it always was. 1160 00:55:11,513 --> 00:55:13,915 Right now, she likes women. 1161 00:55:13,915 --> 00:55:18,158 After transition, he was still primary attracted to women. 1162 00:55:18,158 --> 00:55:19,595 For the record, that can change too 1163 00:55:19,595 --> 00:55:23,562 but let's say that he is attracted to women. 1164 00:55:23,932 --> 00:55:27,767 That would sort of technically make him heterosexual, right? 1165 00:55:27,767 --> 00:55:31,294 It's a man who's attracted to women. 1166 00:55:31,294 --> 00:55:34,479 But what does that do to my sexual orientation? 1167 00:55:34,479 --> 00:55:38,407 For the sake argument, we stay together. 1168 00:55:38,407 --> 00:55:40,513 We're in a relationship still. 1169 00:55:40,513 --> 00:55:43,540 I still identify as a lesbian for the sake of argument 1170 00:55:43,540 --> 00:55:47,973 but I'm involved with a man. 1171 00:55:49,358 --> 00:55:51,995 The point of this illustration is that 1172 00:55:51,995 --> 00:55:55,428 this stuff is complicated. 1173 00:55:55,428 --> 00:55:58,765 Would my identity change from lesbian to bisexual? 1174 00:55:58,765 --> 00:56:00,637 You see here with the word genderqueer 1175 00:56:00,637 --> 00:56:03,432 is just this lovely term that just erases all 1176 00:56:03,432 --> 00:56:05,973 the complexities of it and allows both of us 1177 00:56:05,973 --> 00:56:10,076 to take on a term that still maintains a queer identity 1178 00:56:10,076 --> 00:56:12,977 and doesn't get into any of the confusing details of 1179 00:56:12,977 --> 00:56:14,351 are you a lesbian or what? 1180 00:56:14,351 --> 00:56:15,542 So all of that stuff. 1181 00:56:15,542 --> 00:56:17,080 It's a lovely term in that sense 1182 00:56:17,080 --> 00:56:19,891 but the point of my illustration is really to give you 1183 00:56:19,891 --> 00:56:23,156 the understanding that changes in one part of ... 1184 00:56:23,156 --> 00:56:26,192 The components, I always wanted to get sort of a mobile 1185 00:56:26,192 --> 00:56:28,452 that can I turn around that changes 1186 00:56:28,452 --> 00:56:32,635 in one part of identity can create potential changes 1187 00:56:32,635 --> 00:56:34,593 in other parts of her identity, 1188 00:56:34,593 --> 00:56:37,502 and how people resolve those or understand them 1189 00:56:37,502 --> 00:56:39,573 is completely unique and individual 1190 00:56:39,573 --> 00:56:44,573 so the image I just created of that couple. 1191 00:56:44,749 --> 00:56:46,837 Couple A might look like that 1192 00:56:46,837 --> 00:56:48,414 and identify as heterosexual. 1193 00:56:48,414 --> 00:56:51,579 Couple B might look like a transguy, 1194 00:56:51,579 --> 00:56:53,844 partner who used to be in a lesbian relationship 1195 00:56:53,844 --> 00:56:56,181 and they identify as genderqueer. 1196 00:56:56,181 --> 00:56:58,682 The third group of people might identify ... 1197 00:56:58,682 --> 00:57:00,784 How people are going to identify themselves 1198 00:57:00,784 --> 00:57:04,127 is going to be different. 1199 00:57:04,892 --> 00:57:07,134 Just in finishing this section up, 1200 00:57:07,134 --> 00:57:10,970 I want to say that gender is the elephant in the room. 1201 00:57:10,970 --> 00:57:14,934 People minimize gender nonconforming expression. 1202 00:57:14,934 --> 00:57:19,317 They look at the very masculine female person 1203 00:57:19,317 --> 00:57:22,811 and they say to her a butchdyke, 1204 00:57:22,811 --> 00:57:26,121 "Oh, I never really noticed you were masculine." 1205 00:57:26,121 --> 00:57:28,178 This actually happened to us. 1206 00:57:28,178 --> 00:57:31,625 Not realizing that they're actually insulting you. 1207 00:57:31,625 --> 00:57:32,763 Why didn't you realize it? 1208 00:57:32,763 --> 00:57:35,996 Why don't you see me? 1209 00:57:36,295 --> 00:57:38,099 These adorable pictures here are my children 1210 00:57:38,099 --> 00:57:39,659 when they were younger. 1211 00:57:39,659 --> 00:57:44,659 When the little boy is playing with jewelry or dress up, 1212 00:57:45,410 --> 00:57:48,239 is carrying himself in a certain way, 1213 00:57:48,239 --> 00:57:50,205 we say, "Is he gay?" 1214 00:57:50,205 --> 00:57:52,312 We're talking about little, little children. 1215 00:57:52,312 --> 00:57:57,146 Again, confusing sexual orientation and gender identity. 1216 00:57:57,146 --> 00:58:00,752 The other one is my younger son's attempt to put on lipstick 1217 00:58:00,752 --> 00:58:03,449 at about, I think, he's about two or three years old there. 1218 00:58:03,449 --> 00:58:08,365 We confuse sexual orientation and gender, 1219 00:58:08,365 --> 00:58:12,695 we confuse gender identity with gender expression. 1220 00:58:12,701 --> 00:58:14,387 We need to stop doing that. 1221 00:58:14,387 --> 00:58:15,573 Okay. 1222 00:58:15,573 --> 00:58:20,206 This is what people see gender as, black and white. 1223 00:58:20,206 --> 00:58:23,279 This is really what gender is 1224 00:58:23,279 --> 00:58:26,477 and I think this ability of helping people to see 1225 00:58:26,477 --> 00:58:30,083 that they can determine their own gender 1226 00:58:30,083 --> 00:58:32,155 and gender expression. 1227 00:58:32,155 --> 00:58:35,619 My goal here as we move in to talking about children 1228 00:58:35,619 --> 00:58:39,986 and youth is really to decenter heteronormativity. 1229 00:58:39,986 --> 00:58:42,031 Heteronormativity, I'm defining here 1230 00:58:42,031 --> 00:58:45,231 as an organizing principle that shapes our views 1231 00:58:45,231 --> 00:58:48,570 of what is normal, what normal people look like, 1232 00:58:48,570 --> 00:58:50,968 what family should look like that there's a husband 1233 00:58:50,968 --> 00:58:53,969 and a wife, and two children, and a dog. 1234 00:58:53,969 --> 00:58:55,243 It's okay to have a dog. 1235 00:58:55,243 --> 00:58:59,377 Based on heterosexual and gender normative assumptions 1236 00:58:59,377 --> 00:59:02,575 that there is institutional prejudice that reinforces it. 1237 00:59:02,575 --> 00:59:04,450 There's the boy's bathroom and the girl's bathrooms. 1238 00:59:04,450 --> 00:59:06,586 There's boy's toys and girl's toys. 1239 00:59:06,586 --> 00:59:09,502 That there's internalized shame that people 1240 00:59:09,502 --> 00:59:13,159 who are different particularly around gender feel bad 1241 00:59:13,159 --> 00:59:17,165 about themselves and that when they come into therapy, 1242 00:59:17,165 --> 00:59:22,165 seeking help that we, clinicians, come to the session 1243 00:59:22,664 --> 00:59:26,441 with all sorts of clinical assumptions about what is normal, 1244 00:59:26,441 --> 00:59:30,844 what is healthy and that's based on heteronormativity. 1245 00:59:30,844 --> 00:59:35,348 I want us to stop doing that because 1246 00:59:35,348 --> 00:59:37,378 we're going to have a lot of families coming in 1247 00:59:37,378 --> 00:59:40,453 with gender diverse children that we need 1248 00:59:40,453 --> 00:59:43,293 to be looking at in different ways. 1249 00:59:43,618 --> 00:59:44,321 Okay. 1250 00:59:44,321 --> 00:59:49,321 Now, let's focus on specific issues that children and youth 1251 00:59:50,495 --> 00:59:52,857 are bringing in to therapy. 1252 00:59:53,504 --> 00:59:58,248 Children and youth expressing gender-variant 1253 00:59:58,248 --> 01:00:02,177 or gender deviant behaviors have historically been 1254 01:00:02,177 --> 01:00:06,748 understood to be suffering from severe psychopathologies. 1255 01:00:06,748 --> 01:00:09,882 The belief system was that gender issues 1256 01:00:09,882 --> 01:00:13,986 were caused by the encouragement of cross-gender behavior 1257 01:00:13,986 --> 01:00:18,986 by mothers, and/or the absence of strong father figures 1258 01:00:19,353 --> 01:00:20,558 in the daily family life. 1259 01:00:20,558 --> 01:00:24,029 Again, when we talk about heteronormativity, 1260 01:00:24,029 --> 01:00:26,856 we talk about Freud in psychology. 1261 01:00:26,856 --> 01:00:30,724 The assumption here is that in order for a girl or a boy 1262 01:00:30,724 --> 01:00:34,736 to develop in appropriate ways as girls and boys, 1263 01:00:34,736 --> 01:00:37,610 that they need a mother and they need a father, 1264 01:00:37,610 --> 01:00:42,440 and who express opposite gender roles 1265 01:00:42,440 --> 01:00:45,045 and men should be strong and women should be nurturing. 1266 01:00:45,045 --> 01:00:50,045 There's a whole set of of rules that we, 1267 01:00:50,181 --> 01:00:52,863 not only as clinicians but as the lay public, 1268 01:00:52,863 --> 01:00:56,764 has sort of internalize at what is normal. 1269 01:00:56,764 --> 01:01:01,764 When children are exhibiting behaviors that don't fit that 1270 01:01:02,869 --> 01:01:05,040 the assumptions that we have for them. 1271 01:01:05,040 --> 01:01:07,703 We immediately start to pathologize it. 1272 01:01:07,703 --> 01:01:10,712 Again, girls can get away with a whole range of behaviors 1273 01:01:10,712 --> 01:01:13,145 before anybody gets really worried. 1274 01:01:13,145 --> 01:01:16,419 Boys have a much limited repertoire of what they're allowed 1275 01:01:16,419 --> 01:01:20,353 but this image of strong father figures 1276 01:01:20,353 --> 01:01:24,127 and nurturing mothers, for those of you listening, 1277 01:01:24,127 --> 01:01:29,127 who have studied the long and painful history 1278 01:01:29,155 --> 01:01:32,628 of reparative therapy for gay and lesbian people. 1279 01:01:32,628 --> 01:01:37,628 Understand that these are recycling of old models 1280 01:01:37,641 --> 01:01:42,641 of treatment of how we treated gay and lesbian people 1281 01:01:44,142 --> 01:01:47,549 until really the removal of homosexuality 1282 01:01:47,549 --> 01:01:50,976 from the DSM in 1973. 1283 01:01:50,976 --> 01:01:53,643 This idea that gay men became gay 1284 01:01:53,643 --> 01:01:55,889 because they didn't have strong fathers. 1285 01:01:55,889 --> 01:01:58,883 Now, almost nobody, there's still a handful of people 1286 01:01:58,883 --> 01:02:01,021 out there but almost nobody really buys 1287 01:02:01,021 --> 01:02:02,192 that kind of bullshit today. 1288 01:02:02,192 --> 01:02:04,098 We know that gay men have all kinds of fathers. 1289 01:02:04,098 --> 01:02:05,799 They have strong masculine fathers. 1290 01:02:05,799 --> 01:02:07,104 They have no fathers. 1291 01:02:07,104 --> 01:02:08,071 They have loving fathers. 1292 01:02:08,071 --> 01:02:09,305 They have gay fathers. 1293 01:02:09,305 --> 01:02:10,927 They have feminine fathers. 1294 01:02:10,927 --> 01:02:15,310 The diversity of parents raising children 1295 01:02:15,310 --> 01:02:17,901 is as diverse as any other group of people. 1296 01:02:17,901 --> 01:02:20,617 Of course, now we have many, many children being raised 1297 01:02:20,617 --> 01:02:25,617 in same sex homes, the lesbian parents and gay dad families. 1298 01:02:26,346 --> 01:02:30,383 Don't seem to particularly have any more children 1299 01:02:30,383 --> 01:02:35,383 that are gender-variant than any other group of people do. 1300 01:02:36,891 --> 01:02:39,336 I trust on some level that everybody listening to this 1301 01:02:39,336 --> 01:02:42,660 knows that this older models are crazy 1302 01:02:42,660 --> 01:02:46,171 but I don't know that we always realize how much 1303 01:02:46,171 --> 01:02:50,038 we still think about, always still assume parts of them, 1304 01:02:50,038 --> 01:02:52,376 and how we look at families. 1305 01:02:52,376 --> 01:02:54,217 I think there's a lot of subtle ways 1306 01:02:54,217 --> 01:02:58,625 that this still determines how we see people. 1307 01:02:58,942 --> 01:03:00,555 The treatments, interestingly enough 1308 01:03:00,555 --> 01:03:02,579 and I've always found this to be fascinating. 1309 01:03:02,579 --> 01:03:05,695 If you look at this literature that the theories 1310 01:03:05,695 --> 01:03:08,963 of gender acquisition really come out as 1311 01:03:08,963 --> 01:03:12,734 a psychoanalytic or psychodynamic background 1312 01:03:12,734 --> 01:03:15,968 about proper boy-girl behaviors. 1313 01:03:15,968 --> 01:03:18,739 All of the treatments are all behavioral 1314 01:03:18,739 --> 01:03:20,647 so I always find that kind of an interesting 1315 01:03:20,647 --> 01:03:23,279 little theory blend there. 1316 01:03:23,279 --> 01:03:28,118 The treatments have been justified on four grounds. 1317 01:03:28,118 --> 01:03:30,907 Number one to eliminate peer ostracism. 1318 01:03:30,907 --> 01:03:32,988 I just want you all to think about that for a second. 1319 01:03:33,418 --> 01:03:36,087 Really, that's what we do. 1320 01:03:36,087 --> 01:03:38,811 If you have an African-American kid 1321 01:03:38,811 --> 01:03:40,960 who's being picked on in school, 1322 01:03:40,960 --> 01:03:43,094 we change the African-American kid? 1323 01:03:43,094 --> 01:03:43,890 No. 1324 01:03:43,890 --> 01:03:48,039 We change the system so the system is less racist. 1325 01:03:48,039 --> 01:03:52,936 So the child has more ability to thrive in that environment. 1326 01:03:52,936 --> 01:03:55,811 If a child who uses a wheelchair 1327 01:03:55,811 --> 01:03:57,572 is getting picked on in school, 1328 01:03:57,572 --> 01:03:58,680 what do we do? 1329 01:03:58,680 --> 01:04:00,050 Throw out the wheelchair? 1330 01:04:00,050 --> 01:04:03,374 Ban the children with disabilities from going to school? 1331 01:04:03,374 --> 01:04:03,952 No. 1332 01:04:03,952 --> 01:04:05,843 What we hopefully try to do is create 1333 01:04:05,843 --> 01:04:08,370 a more accessible environment both physically 1334 01:04:08,370 --> 01:04:11,391 as well as emotionally and psychologically 1335 01:04:11,391 --> 01:04:14,589 in terms of what people understand about disabilities 1336 01:04:14,589 --> 01:04:16,386 and about human diversity. 1337 01:04:16,386 --> 01:04:18,931 It's a very odd idea that we're going 1338 01:04:18,931 --> 01:04:23,232 to eliminate peer ostracism of gender-variant children 1339 01:04:23,232 --> 01:04:25,471 by changing the gender-variant child. 1340 01:04:25,471 --> 01:04:28,467 I really think we need to look at 1341 01:04:28,467 --> 01:04:31,248 their psychological thinking about that. 1342 01:04:31,248 --> 01:04:33,514 That we treat the underlying psychopathology. 1343 01:04:33,514 --> 01:04:36,673 Again, if you're familiar with this literature, 1344 01:04:36,673 --> 01:04:40,418 the theory here is that the parents have psychopathology. 1345 01:04:40,418 --> 01:04:42,789 The theory is that the parents have mental health issues. 1346 01:04:42,789 --> 01:04:44,555 That the mother wants her little boy 1347 01:04:44,555 --> 01:04:46,892 to be very feminine in some way. 1348 01:04:46,892 --> 01:04:48,563 That the father is not rising up 1349 01:04:48,563 --> 01:04:50,464 to his masculine responsibilities. 1350 01:04:50,464 --> 01:04:51,884 That's a theory. 1351 01:04:51,884 --> 01:04:54,863 If we think that the family is pathological, 1352 01:04:54,863 --> 01:04:56,826 why are we treating the kid? 1353 01:04:56,826 --> 01:04:59,036 I mean if we really think the family is pathological, 1354 01:04:59,036 --> 01:05:01,502 and I'm not saying these families are pathological, 1355 01:05:01,502 --> 01:05:02,806 I want to be really clear. 1356 01:05:02,806 --> 01:05:04,013 But if that's your theory, 1357 01:05:04,013 --> 01:05:05,578 then it seems like you shouldn't be treating the kid. 1358 01:05:05,578 --> 01:05:07,512 You should be treating the parents. 1359 01:05:07,851 --> 01:05:10,020 I want to say that they are very blatant. 1360 01:05:10,020 --> 01:05:13,878 These people who work on these behavioral treatments 1361 01:05:13,878 --> 01:05:16,525 that they want to prevent homosexuality. 1362 01:05:16,525 --> 01:05:17,884 They say that blatantly now. 1363 01:05:17,884 --> 01:05:20,725 Homosexuality is no longer a diagnosis in the DSM. 1364 01:05:20,725 --> 01:05:25,093 I think the majority of the western world 1365 01:05:25,093 --> 01:05:27,601 is moving into an understanding that sexual orientation 1366 01:05:27,601 --> 01:05:29,398 is just part of human diversity. 1367 01:05:29,398 --> 01:05:33,841 But somehow, some people are still thinking it's okay 1368 01:05:33,841 --> 01:05:37,444 to be treating young children to limit the possibility 1369 01:05:37,444 --> 01:05:39,337 that these children will grow up to be gay 1370 01:05:39,337 --> 01:05:42,677 or lesbian, or bisexual. 1371 01:05:42,705 --> 01:05:43,718 The last one is to prevent 1372 01:05:43,718 --> 01:05:46,119 gender identity disturbances in adults. 1373 01:05:46,119 --> 01:05:47,980 I know that this is confusing 1374 01:05:47,980 --> 01:05:50,259 but many of these folks that are working on 1375 01:05:50,259 --> 01:05:53,658 these behavioral treatments see homosexuality 1376 01:05:53,658 --> 01:05:56,626 and transsexualism as a continuum. 1377 01:05:59,163 --> 01:06:02,299 Slight gender variance becomes homesexuality. 1378 01:06:02,299 --> 01:06:05,670 Extreme gender variance becomes transsexualism. 1379 01:06:05,670 --> 01:06:07,462 So we're trying to eliminate 1380 01:06:07,462 --> 01:06:11,115 this whole spectrum of behaviors that I already told you 1381 01:06:11,115 --> 01:06:13,082 are actually two different components of behavior. 1382 01:06:13,082 --> 01:06:14,576 But in their mind, 1383 01:06:14,576 --> 01:06:19,576 they're actually part of the same spectrum. 1384 01:06:20,816 --> 01:06:24,154 The WPATH standards of care 1385 01:06:24,154 --> 01:06:27,352 and if people are not familiar with WPATH, 1386 01:06:27,352 --> 01:06:30,632 I strongly encourage you to go to the website, 1387 01:06:30,632 --> 01:06:33,931 the World Professional Association of Transgender Health 1388 01:06:33,931 --> 01:06:35,658 and look at the standards of care. 1389 01:06:35,658 --> 01:06:37,905 I will have a small disclosure here 1390 01:06:37,905 --> 01:06:40,165 that I was part of the committee that wrote 1391 01:06:40,165 --> 01:06:43,175 the standards of care and I really like them. 1392 01:06:43,175 --> 01:06:44,786 I feel really good about them. 1393 01:06:44,786 --> 01:06:47,747 Anybody who's working in this field should almost 1394 01:06:47,747 --> 01:06:49,711 pretty much have memorize the standards of care 1395 01:06:49,711 --> 01:06:51,241 in terms of clinical treatment 1396 01:06:51,241 --> 01:06:53,081 because it is really the guidelines. 1397 01:06:53,081 --> 01:06:56,359 It is the standard of care. 1398 01:06:56,359 --> 01:07:00,664 It helps us determine proper and accurate care 1399 01:07:00,664 --> 01:07:03,831 for both adults and children and teens 1400 01:07:03,831 --> 01:07:06,622 who are dealing with gender issues. 1401 01:07:06,622 --> 01:07:11,622 The ethics of reparative therapy are the treatment aimed 1402 01:07:12,770 --> 01:07:15,972 at trying to change a person's gender identity 1403 01:07:15,972 --> 01:07:18,681 and expression to become more congruent 1404 01:07:18,681 --> 01:07:20,507 with the sex assigned at birth 1405 01:07:20,507 --> 01:07:23,050 has been attempted in the past without success, 1406 01:07:23,050 --> 01:07:25,251 particularly in the long run. 1407 01:07:25,251 --> 01:07:29,313 Such treatment is no longer considered ethical. 1408 01:07:29,497 --> 01:07:31,153 I want you to hear that. 1409 01:07:31,153 --> 01:07:36,153 That the standard of care written 1410 01:07:36,533 --> 01:07:41,465 by the international organization who, 1411 01:07:41,465 --> 01:07:44,863 oversees is too strong a word, 1412 01:07:44,863 --> 01:07:48,206 but who sets the bar for what 1413 01:07:48,206 --> 01:07:51,144 good transgender health looks like 1414 01:07:51,144 --> 01:07:53,242 is saying that reparative therapy, 1415 01:07:53,242 --> 01:07:56,875 that trying to take a gender-variant child 1416 01:07:56,875 --> 01:08:01,875 and making them nongender-variant is A, doesn't work. 1417 01:08:02,414 --> 01:08:04,160 It has not been successful. 1418 01:08:04,160 --> 01:08:05,595 We've seen that in studies 1419 01:08:05,595 --> 01:08:09,747 and that it is no longer considered ethical. 1420 01:08:10,963 --> 01:08:13,399 This quote may seem slightly out of context here 1421 01:08:13,399 --> 01:08:15,008 from Susan Golombek's work. 1422 01:08:15,008 --> 01:08:16,840 Susan Golombek did some of 1423 01:08:16,840 --> 01:08:18,805 the early work on lesbian parents 1424 01:08:18,805 --> 01:08:22,003 because in just a sentence or two that contextualize this. 1425 01:08:22,003 --> 01:08:24,171 Back in the day, not that long ago, 1426 01:08:24,171 --> 01:08:28,479 25 or 30 years ago, lesbian women who divorced their ... 1427 01:08:28,479 --> 01:08:31,352 Women who were divorcing their husbands 1428 01:08:31,352 --> 01:08:33,051 because they were coming out as lesbians 1429 01:08:33,051 --> 01:08:35,953 were very rarely allowed to maintain 1430 01:08:35,953 --> 01:08:38,356 custody of their children. 1431 01:08:38,356 --> 01:08:41,456 Lots of different researchers, 1432 01:08:41,456 --> 01:08:43,334 Susan Golombek did the work in the UK. 1433 01:08:43,334 --> 01:08:44,798 Charlotte Patterson did a lot of work here 1434 01:08:44,798 --> 01:08:47,696 in the United States of looking at 1435 01:08:47,696 --> 01:08:51,669 how does the sexual orientation of a parent 1436 01:08:51,669 --> 01:08:53,344 affect the sexual orientation 1437 01:08:53,344 --> 01:08:55,139 and gender identity of a child. 1438 01:08:55,139 --> 01:08:57,372 This was something Susan Golombek wrote 1439 01:08:57,372 --> 01:08:58,868 when she began. 1440 01:08:58,868 --> 01:09:00,977 It's important to note that without this research, 1441 01:09:00,977 --> 01:09:03,639 the idea of lesbian and gay parenthood 1442 01:09:03,639 --> 01:09:05,951 would not really exist today in the way that it does. 1443 01:09:05,951 --> 01:09:07,789 That adoption, and donor insemination, 1444 01:09:07,789 --> 01:09:10,790 and same sex marriage, marriage equality would not 1445 01:09:10,790 --> 01:09:13,954 really have happened without us setting the stage for this. 1446 01:09:13,954 --> 01:09:18,788 Susan Golombek says, "Whether or not the gender development 1447 01:09:18,788 --> 01:09:21,896 "of children in lesbian families would be expected to differ 1448 01:09:21,896 --> 01:09:24,560 "from that of children in heterosexual families 1449 01:09:24,560 --> 01:09:27,274 "depends on the extent to which it is possible 1450 01:09:27,274 --> 01:09:28,978 "for parents to influence 1451 01:09:28,978 --> 01:09:31,741 "the gender development of their children." 1452 01:09:31,741 --> 01:09:35,686 Now, I love that statement. 1453 01:09:35,686 --> 01:09:39,179 I find it incredibly humorous as a parent 1454 01:09:39,179 --> 01:09:42,614 of a now, 18-year-old and a now 14-year-old. 1455 01:09:42,614 --> 01:09:47,614 I can barely get my kids to eat vegetables. 1456 01:09:47,728 --> 01:09:49,468 I can barely get them to shower. 1457 01:09:49,468 --> 01:09:51,599 I can barely get them to do their homework. 1458 01:09:51,599 --> 01:09:53,265 I think I'm a pretty good parent. 1459 01:09:53,265 --> 01:09:56,167 I think my kids are doing relatively well. 1460 01:09:56,167 --> 01:10:00,041 It is very difficult to influence our children. 1461 01:10:00,041 --> 01:10:02,875 I have lots of opinions about everything 1462 01:10:02,875 --> 01:10:05,167 from how my kids like to wear their hair, 1463 01:10:05,167 --> 01:10:07,180 to how my kids like to dress, 1464 01:10:07,180 --> 01:10:08,448 to who their friends are, 1465 01:10:08,448 --> 01:10:10,146 to what things I think are important 1466 01:10:10,146 --> 01:10:11,940 for them to study or what studying means 1467 01:10:11,940 --> 01:10:13,485 or how long they should study 1468 01:10:13,485 --> 01:10:15,687 or whether or not and how much sleep they should get, 1469 01:10:15,687 --> 01:10:17,727 or how much pizza they should eat. 1470 01:10:17,727 --> 01:10:20,362 I try really hard to influence them 1471 01:10:20,362 --> 01:10:23,188 and I guess my mother try to influence me. 1472 01:10:23,188 --> 01:10:25,964 In the end, we all become who we are. 1473 01:10:25,964 --> 01:10:29,301 The point here is that parents have incredibly 1474 01:10:29,301 --> 01:10:32,640 little influence over who their children are 1475 01:10:32,640 --> 01:10:34,001 in terms of gender. 1476 01:10:34,001 --> 01:10:35,644 It just doesn't work that way 1477 01:10:35,644 --> 01:10:38,912 that you can want your little boy to play football, 1478 01:10:38,912 --> 01:10:41,250 for example, and then you have a little boy 1479 01:10:41,250 --> 01:10:44,215 in front of you who tells you who he is. 1480 01:10:44,215 --> 01:10:47,457 Who he is may not be somebody who likes to play football. 1481 01:10:47,457 --> 01:10:50,522 Our only choice as parents is whether we listen 1482 01:10:50,522 --> 01:10:53,048 or whether we don't listen. 1483 01:10:54,562 --> 01:10:56,164 Diane Ehrensaft says that, 1484 01:10:56,164 --> 01:10:58,192 "Parents have little influence 1485 01:10:58,192 --> 01:11:00,299 "over their children's gender identity 1486 01:11:00,299 --> 01:11:03,078 "but extensive influence over 1487 01:11:03,078 --> 01:11:05,198 "their children's gender health." 1488 01:11:05,198 --> 01:11:07,510 That's really the place that we're starting from here 1489 01:11:07,510 --> 01:11:10,006 is what is the work that we're going to do 1490 01:11:10,006 --> 01:11:15,006 to assist children in developing healthy gender identities 1491 01:11:15,919 --> 01:11:19,980 regardless of whether they are typical or atypical. 1492 01:11:20,419 --> 01:11:23,423 This next few slides that I'm going to do, 1493 01:11:23,423 --> 01:11:25,025 I put together a number of years ago 1494 01:11:25,025 --> 01:11:28,290 with a colleague of mine, Dr. Irene Sills 1495 01:11:28,290 --> 01:11:32,288 who is a pediatric endocrinologist in Syracuse. 1496 01:11:33,269 --> 01:11:38,269 This is how do our clients, families, children come to us? 1497 01:11:38,673 --> 01:11:40,873 What do they say? 1498 01:11:40,873 --> 01:11:44,078 My three-year-old boy insist on wearing 1499 01:11:44,078 --> 01:11:46,013 his sister's ballet costume. 1500 01:11:46,013 --> 01:11:47,744 He wants to wear it to school. 1501 01:11:47,744 --> 01:11:50,006 I don't let him but I can't stop him 1502 01:11:50,006 --> 01:11:52,845 from wearing it around the house. 1503 01:11:52,845 --> 01:11:56,390 Is there anything wrong with my son's hormones? 1504 01:11:56,390 --> 01:11:58,080 says the parent. 1505 01:11:58,804 --> 01:12:02,284 I saw my daughter go into her brother's underwear drawer 1506 01:12:02,284 --> 01:12:03,866 and put on his underpants. 1507 01:12:03,866 --> 01:12:06,124 In fact, I've seen her do this multiple times. 1508 01:12:06,124 --> 01:12:09,071 I scolded her and she cried. 1509 01:12:09,071 --> 01:12:12,275 Why is my daughter doing this? 1510 01:12:12,275 --> 01:12:15,303 My ten-year-old daughter has just started growing breasts? 1511 01:12:15,303 --> 01:12:17,466 She tells me she wants to cut them off. 1512 01:12:17,466 --> 01:12:19,635 She says she doesn't want to wear a bra, 1513 01:12:19,635 --> 01:12:22,809 get her period, or do anything feminine. 1514 01:12:22,809 --> 01:12:25,048 Is my daughter gay? 1515 01:12:25,048 --> 01:12:28,378 Again, we see there the overlap of gender 1516 01:12:28,378 --> 01:12:31,854 and sexual orientation, and the confusion of the parent 1517 01:12:31,854 --> 01:12:32,915 trying to figure this out. 1518 01:12:32,915 --> 01:12:34,731 My teenage son ran away from home 1519 01:12:34,731 --> 01:12:36,196 and has been living in New York City. 1520 01:12:36,196 --> 01:12:37,897 He's been taking estrogen pills 1521 01:12:37,897 --> 01:12:40,399 from some people he knows who are not doctors. 1522 01:12:40,399 --> 01:12:43,593 He says he is a woman and wants to have surgery. 1523 01:12:43,593 --> 01:12:46,952 How can I help my child? 1524 01:12:47,401 --> 01:12:48,992 What did I do wrong? 1525 01:12:48,992 --> 01:12:51,145 Why is my child like this? 1526 01:12:51,145 --> 01:12:53,844 Is there something wrong with my genes? 1527 01:12:53,844 --> 01:12:58,010 My husband's genes, the father's chromosomes? 1528 01:12:58,010 --> 01:13:00,350 The sperm donor's genetics? 1529 01:13:00,350 --> 01:13:01,521 I love that one. 1530 01:13:01,521 --> 01:13:03,425 Is my child gay? 1531 01:13:03,425 --> 01:13:04,825 Can you fix it? 1532 01:13:04,825 --> 01:13:06,825 Will he grow out of it? 1533 01:13:06,825 --> 01:13:10,194 Should I make her wear girly clothes? 1534 01:13:10,194 --> 01:13:12,988 Should he play more sports? 1535 01:13:12,988 --> 01:13:16,267 My husband blames me for not disciplining him. 1536 01:13:16,267 --> 01:13:19,507 My wife blames me for not accepting him. 1537 01:13:19,507 --> 01:13:21,404 My mother wants me to send him 1538 01:13:21,404 --> 01:13:24,412 to a treatment deprogramming center. 1539 01:13:24,412 --> 01:13:29,250 My priest or minister wants me to exercise or heal him. 1540 01:13:29,250 --> 01:13:33,118 The school won't let me let him wear those clothes. 1541 01:13:33,118 --> 01:13:34,881 The Department of Social Services 1542 01:13:34,881 --> 01:13:37,858 or Child Protective Services won't let me 1543 01:13:37,858 --> 01:13:39,561 let him wear those clothes. 1544 01:13:39,561 --> 01:13:41,884 Luckily, we're not seeing that as much as we used to. 1545 01:13:41,884 --> 01:13:44,530 There were some cases back 10-15 years ago, 1546 01:13:44,530 --> 01:13:47,235 where CPS really did step in and remove children 1547 01:13:47,235 --> 01:13:50,326 who were gender-variant from their parents. 1548 01:13:51,473 --> 01:13:53,066 Parents are coming in. 1549 01:13:53,066 --> 01:13:53,908 They're upset. 1550 01:13:53,908 --> 01:13:54,897 They're disturbed. 1551 01:13:54,897 --> 01:13:57,978 They want us to help them figure out what is going on. 1552 01:13:57,978 --> 01:13:59,044 What do we know? 1553 01:13:59,044 --> 01:14:01,115 How will we able to help them? 1554 01:14:01,115 --> 01:14:03,049 One of the things that we know 1555 01:14:03,049 --> 01:14:07,152 is that most adults who are transgender tell us 1556 01:14:07,152 --> 01:14:10,085 that they knew when they were young. 1557 01:14:10,085 --> 01:14:12,160 I think that's a really important thing for us 1558 01:14:12,160 --> 01:14:13,315 to keep in mind. 1559 01:14:13,315 --> 01:14:16,687 That most transgender adults did not come to 1560 01:14:16,687 --> 01:14:19,555 that realization at the age of 20 1561 01:14:19,555 --> 01:14:22,834 but at three, or five, or seven, or nine, 1562 01:14:22,834 --> 01:14:24,827 they knew that they were different 1563 01:14:24,827 --> 01:14:26,542 and they knew it had something to do with their gender. 1564 01:14:26,542 --> 01:14:28,343 They may not have had the language for it. 1565 01:14:28,343 --> 01:14:30,037 They may not have had words for it. 1566 01:14:30,037 --> 01:14:31,409 That over and over again, 1567 01:14:31,409 --> 01:14:33,736 adult transgender clients tell me 1568 01:14:33,736 --> 01:14:37,681 they prayed to God that they would wake up in the morning 1569 01:14:37,681 --> 01:14:42,681 in the opposite sex. 1570 01:14:44,189 --> 01:14:47,930 The other thing that we know which is a contradiction 1571 01:14:47,930 --> 01:14:51,632 is that gender nonconformity during childhood 1572 01:14:51,632 --> 01:14:55,871 does not inevitably continue into adulthood. 1573 01:14:55,871 --> 01:15:00,871 There are lots of children who are atypical as children 1574 01:15:01,597 --> 01:15:05,172 in terms of their gender expression, their gender role, 1575 01:15:05,172 --> 01:15:07,851 their gender play, their choice of clothing, 1576 01:15:07,851 --> 01:15:10,385 how much they are like or unlike 1577 01:15:10,385 --> 01:15:12,688 other boys or girls their own age. 1578 01:15:12,688 --> 01:15:17,557 But when they go into puberty, this changes. 1579 01:15:17,557 --> 01:15:20,756 When they go into adulthood, it changes. 1580 01:15:20,756 --> 01:15:23,330 Very feminine woman as I used to be a tomboy 1581 01:15:23,330 --> 01:15:25,230 when I was a kid but that just changed. 1582 01:15:25,230 --> 01:15:27,601 We could have all kinds of conversations about 1583 01:15:27,601 --> 01:15:30,331 obviously society's reinforces 1584 01:15:30,331 --> 01:15:31,673 and supports those kinds of changes. 1585 01:15:31,673 --> 01:15:35,901 But accepting that many, many, many people 1586 01:15:35,901 --> 01:15:38,805 are expressing themselves in a way that is 1587 01:15:38,805 --> 01:15:41,315 more or less authentic to who they are. 1588 01:15:41,315 --> 01:15:44,013 That we need to understand that although 1589 01:15:44,013 --> 01:15:47,216 most transgender people knew when they were young, 1590 01:15:47,216 --> 01:15:49,878 not all gender-variant children will grow up 1591 01:15:49,878 --> 01:15:51,487 to identify as transgender. 1592 01:15:51,487 --> 01:15:54,654 So sorting out those populations become 1593 01:15:54,654 --> 01:15:59,654 I think an important part of work that we're doing. 1594 01:15:59,990 --> 01:16:03,567 Many gender nonconforming children actually identify as gay. 1595 01:16:03,567 --> 01:16:05,733 We have a lot research to back this up. 1596 01:16:07,609 --> 01:16:10,410 There's a lot of criticisms I could give about the research. 1597 01:16:10,410 --> 01:16:13,008 The research was done first of all 25 years ago 1598 01:16:13,008 --> 01:16:15,416 when options to be transgender did not exist 1599 01:16:15,416 --> 01:16:16,915 in the same way they do now. 1600 01:16:16,915 --> 01:16:20,743 The research took place at time that as these young children 1601 01:16:20,743 --> 01:16:22,743 were growing into adulthood, 1602 01:16:22,743 --> 01:16:25,585 they were also was the hayday of the early days 1603 01:16:25,585 --> 01:16:27,283 of the gay liberation movement. 1604 01:16:27,283 --> 01:16:32,283 Coming out as gay was a happening thing at that time. 1605 01:16:34,100 --> 01:16:35,737 There was a place for them to be 1606 01:16:35,737 --> 01:16:39,473 where coming out as transgender really in the mid80s, 1607 01:16:39,473 --> 01:16:41,808 there may not have been as clear a place to be that. 1608 01:16:41,808 --> 01:16:46,517 We have some evidence that children 1609 01:16:46,517 --> 01:16:48,946 who are gender nonconforming, that some of these chldren 1610 01:16:48,946 --> 01:16:50,444 grow up to be gay. 1611 01:16:50,444 --> 01:16:51,540 We have some evidence that some of these children 1612 01:16:51,555 --> 01:16:52,722 grow up to the be trans. 1613 01:16:52,722 --> 01:16:54,289 We have evidence that some of these children 1614 01:16:54,289 --> 01:16:56,755 grow up not be gay or trans, 1615 01:16:56,755 --> 01:17:01,694 and seem to exhibit fairly typical gender identities 1616 01:17:01,694 --> 01:17:05,799 as well as a fairly heteronormative sexual orientations. 1617 01:17:05,799 --> 01:17:08,492 We also know that children and youth are vulnerable 1618 01:17:08,492 --> 01:17:11,421 and their identities are still shifting and forming. 1619 01:17:11,421 --> 01:17:15,842 We have increasing evidence that the brain 1620 01:17:15,842 --> 01:17:18,379 does not really reach its full maturity 1621 01:17:18,379 --> 01:17:22,475 until the early 20s. 1622 01:17:22,475 --> 01:17:27,475 The joke in my household with two teenage children 1623 01:17:27,885 --> 01:17:30,521 is why are they behaving that way? 1624 01:17:30,521 --> 01:17:32,723 Well, they have no frontal lobe. 1625 01:17:32,723 --> 01:17:34,997 That's why they're behaving that way. 1626 01:17:34,997 --> 01:17:36,824 I don't mean that in a disparaging way 1627 01:17:36,824 --> 01:17:39,822 as much as I mean it in a sort of gallows humor 1628 01:17:39,822 --> 01:17:44,300 as a parent trying to survive my children's adolescence. 1629 01:17:44,300 --> 01:17:47,905 There really is a truth that they are developing. 1630 01:17:47,905 --> 01:17:49,607 They're trying to figure out the world 1631 01:17:49,607 --> 01:17:52,273 and they're doing that in the best ways 1632 01:17:52,273 --> 01:17:54,170 that they know how. 1633 01:17:54,170 --> 01:17:57,607 We'll just share a clinical story many years ago. 1634 01:17:57,607 --> 01:17:59,880 I was working with young boy. 1635 01:17:59,880 --> 01:18:02,020 He's about 14 years old. 1636 01:18:02,020 --> 01:18:04,046 He had come to me because 1637 01:18:04,046 --> 01:18:07,290 he identified himself as transgender 1638 01:18:07,290 --> 01:18:08,932 after he had gone online 1639 01:18:08,932 --> 01:18:11,300 and looked up some information. 1640 01:18:11,300 --> 01:18:14,871 I had gone to his parents who were not well educated 1641 01:18:14,871 --> 01:18:17,835 about this issue but were pretty supportive 1642 01:18:17,835 --> 01:18:20,629 but wanted him to go to therapy. 1643 01:18:20,629 --> 01:18:22,140 They didn't really want to talk about this at home. 1644 01:18:22,140 --> 01:18:25,915 I was given my job to explore this with him. 1645 01:18:25,915 --> 01:18:29,910 We spent a number of months in therapy 1646 01:18:29,910 --> 01:18:32,252 talking about sexual orientation, 1647 01:18:32,252 --> 01:18:34,656 talking about gender identity, 1648 01:18:34,656 --> 01:18:39,386 and there was one point in therapy. 1649 01:18:39,386 --> 01:18:41,053 You know I'm just going to share this with you 1650 01:18:41,053 --> 01:18:46,053 because I know that talking about one's gut as a therapist 1651 01:18:47,795 --> 01:18:50,395 is probably not evidence-base research. 1652 01:18:50,395 --> 01:18:52,876 But I've been doing the work I do for a long time. 1653 01:18:52,876 --> 01:18:56,402 My gut was telling me for a number of reasons 1654 01:18:56,402 --> 01:18:59,445 that I didn't really think that this young person 1655 01:18:59,445 --> 01:19:04,185 was "really a girl" in the way that people talk about that. 1656 01:19:04,185 --> 01:19:07,025 But I thought he was dealing with sexual orientation 1657 01:19:07,025 --> 01:19:11,827 and being attracted to males but he was a young developer. 1658 01:19:11,827 --> 01:19:14,359 He hadn't really hit puberty yet 1659 01:19:14,359 --> 01:19:19,359 and was not able to really identify sexual orientation 1660 01:19:20,001 --> 01:19:23,734 but that's kind of where I thought this was going. 1661 01:19:23,734 --> 01:19:28,734 At one point in our clinical conversation, 1662 01:19:34,509 --> 01:19:38,549 I'm going to name a town here when I say this 1663 01:19:38,549 --> 01:19:40,954 that may or may not be a town all of you know 1664 01:19:40,954 --> 01:19:43,651 but the point of the name of the town 1665 01:19:43,651 --> 01:19:46,057 is that it is a small town. 1666 01:19:46,057 --> 01:19:49,891 That's the point, relatively small town. 1667 01:19:49,891 --> 01:19:53,370 He says to me in session, 1668 01:19:53,370 --> 01:19:56,303 "I'm not like any of the other boys I know. 1669 01:19:56,303 --> 01:20:00,171 "I'm not like any of the men that I know." 1670 01:20:00,171 --> 01:20:04,230 We talked about how and why and what does that look like. 1671 01:20:04,230 --> 01:20:06,246 I'm just more gentle. 1672 01:20:06,246 --> 01:20:08,817 I like more pretty things. 1673 01:20:08,817 --> 01:20:12,452 I'm interested in the kinds of things I'm interested in 1674 01:20:12,452 --> 01:20:16,179 from horticulture to art are just not the kinds of things 1675 01:20:16,179 --> 01:20:17,726 that any of the boys I know are interested in. 1676 01:20:17,726 --> 01:20:19,219 They're all interested in sports. 1677 01:20:19,219 --> 01:20:21,029 I'm not interested in sports. 1678 01:20:21,029 --> 01:20:23,856 I said to him the world is full of a lot of men 1679 01:20:23,856 --> 01:20:25,730 that are like that. 1680 01:20:25,730 --> 01:20:29,582 He said to me, "Not in East Greenbush." 1681 01:20:31,721 --> 01:20:35,439 I said to him, "You're 14 years old." 1682 01:20:35,439 --> 01:20:37,843 "In a few years and I know when you're 14, 1683 01:20:37,843 --> 01:20:39,949 "18 feels like a really long time away 1684 01:20:39,949 --> 01:20:43,019 "but in a very few short years, 1685 01:20:43,019 --> 01:20:46,386 "you're going to be able to leave East Greenbush 1686 01:20:46,386 --> 01:20:48,718 "and go out into the world. 1687 01:20:48,718 --> 01:20:51,624 "I assure you that there 1688 01:20:51,624 --> 01:20:54,326 "are men in the world who are like you." 1689 01:20:54,326 --> 01:20:59,326 He said, "It seems that maybe I should hold off 1690 01:20:59,998 --> 01:21:04,998 "on living as a girl until I have more life experiences." 1691 01:21:06,542 --> 01:21:08,540 I don't want you to hear that story 1692 01:21:08,540 --> 01:21:09,898 because that's an unusual story. 1693 01:21:09,898 --> 01:21:11,708 The majority of people that come to me 1694 01:21:11,708 --> 01:21:15,405 with gender issues determine and I agree 1695 01:21:15,405 --> 01:21:19,178 that they are indeed transgender. 1696 01:21:19,178 --> 01:21:22,854 However, we defined that term and that social 1697 01:21:22,854 --> 01:21:25,091 and medical transitions are a good thing. 1698 01:21:25,091 --> 01:21:27,462 But I want to share with you that story 1699 01:21:27,462 --> 01:21:30,460 because children and youth can only work 1700 01:21:30,460 --> 01:21:32,834 with the knowledge that they have access to 1701 01:21:32,834 --> 01:21:35,936 which means that it's a knowledge in their immediate world 1702 01:21:35,936 --> 01:21:38,260 as well as the vast amount of information 1703 01:21:38,260 --> 01:21:41,009 they're getting online but as we all know, 1704 01:21:41,009 --> 01:21:42,593 where they're going online 1705 01:21:42,593 --> 01:21:44,045 and where they're getting information 1706 01:21:44,045 --> 01:21:45,872 may or may not be accurate. 1707 01:21:45,872 --> 01:21:48,545 It may not show all of the options 1708 01:21:48,545 --> 01:21:50,371 that are available for them. 1709 01:21:51,049 --> 01:21:52,050 What do we know? 1710 01:21:52,050 --> 01:21:54,591 We know that trans children and youth 1711 01:21:54,591 --> 01:21:57,226 who cannot actualize themselves are at high risk 1712 01:21:57,226 --> 01:21:59,381 for mental health problems and addictions. 1713 01:21:59,381 --> 01:22:01,563 We have excellent research, 1714 01:22:01,563 --> 01:22:06,563 more on LGB than LGBT but the T knowledge 1715 01:22:07,495 --> 01:22:09,397 is increasing the researches. 1716 01:22:09,397 --> 01:22:11,330 It is increasing all the time. 1717 01:22:11,330 --> 01:22:16,330 Children who are in repressive, oppressive social situations 1718 01:22:16,509 --> 01:22:18,480 are at high risk for depression. 1719 01:22:18,480 --> 01:22:20,042 They're at high risk for anxiety. 1720 01:22:20,042 --> 01:22:23,051 They're at high risk for homelessness. 1721 01:22:23,051 --> 01:22:24,752 They're at high risk for HIV. 1722 01:22:24,752 --> 01:22:27,186 They're at high risk to drug and alcohol abuse. 1723 01:22:27,186 --> 01:22:30,092 They're at high risk for getting beat up in school. 1724 01:22:30,092 --> 01:22:33,249 They're at high risk for being abused. 1725 01:22:33,524 --> 01:22:35,789 That we know that LGBT youth 1726 01:22:35,789 --> 01:22:40,391 often feel isolated and vulnerable. 1727 01:22:40,391 --> 01:22:43,166 We know there's a high incidence of substance abuse 1728 01:22:43,166 --> 01:22:45,273 among these population that there 1729 01:22:45,273 --> 01:22:48,473 are school violence directed at them. 1730 01:22:48,473 --> 01:22:50,310 We know that there's a high risk of pregnancy 1731 01:22:50,310 --> 01:22:52,478 which again may seem contradictory 1732 01:22:52,478 --> 01:22:57,478 that a young girl for example who identifies as gay 1733 01:22:57,847 --> 01:22:59,377 might have a higher risk of pregnancy 1734 01:22:59,377 --> 01:23:00,654 than a straight girl. 1735 01:23:00,654 --> 01:23:04,088 We talked about the limitations of the frontal lobe. 1736 01:23:04,088 --> 01:23:07,096 Sometimes because the girl identifies as a lesbian 1737 01:23:07,096 --> 01:23:09,718 or because she identifies as genderqueer, 1738 01:23:09,718 --> 01:23:11,964 or because she identifies as transgender, 1739 01:23:11,964 --> 01:23:14,694 she's actually not going to take the same precautions 1740 01:23:14,694 --> 01:23:18,827 regarding pregnancy as a girl who is heterosexual would do. 1741 01:23:18,827 --> 01:23:23,212 Because in her mind, I'm not really straight 1742 01:23:23,212 --> 01:23:24,147 so I can't get pregnant. 1743 01:23:24,147 --> 01:23:27,882 It's not always clear but again, the frontal lobe, 1744 01:23:27,882 --> 01:23:32,882 we know that young people do not think 1745 01:23:33,210 --> 01:23:35,988 using their frontal lobe that they do a lot of 1746 01:23:35,988 --> 01:23:39,016 their thinking from their emotional centers. 1747 01:23:39,016 --> 01:23:42,589 They may or may not be using the same kind of precautions. 1748 01:23:42,589 --> 01:23:47,589 Risk of HIV infection at great vulnerability of prostitution 1749 01:23:48,297 --> 01:23:50,803 and being runaways, and school-leavers, 1750 01:23:50,803 --> 01:23:52,664 and all of the research that we have 1751 01:23:52,664 --> 01:23:56,207 shows that this is more intense for children of color 1752 01:23:56,207 --> 01:23:57,876 than it is for white children. 1753 01:23:57,876 --> 01:24:01,684 These are pretty serious issues of concern. 1754 01:24:04,411 --> 01:24:06,114 Okay. 1755 01:24:06,644 --> 01:24:09,083 Let's talk for a minute about the trajectory 1756 01:24:09,083 --> 01:24:11,557 of gender nonconformity so what happens? 1757 01:24:11,557 --> 01:24:13,153 We have a child who 1758 01:24:13,153 --> 01:24:15,597 is exhibiting gender nonconforming behavior. 1759 01:24:15,597 --> 01:24:20,080 What is this likely to become as a the child matures? 1760 01:24:23,571 --> 01:24:27,507 Historically, most of the studies we did were with boys. 1761 01:24:27,507 --> 01:24:29,300 Some of that had to do with funding 1762 01:24:29,300 --> 01:24:31,008 and some of that had to do with the fact 1763 01:24:31,008 --> 01:24:33,809 that more parents bring boys in to treatment 1764 01:24:33,809 --> 01:24:38,215 because again, boys have a much smaller repertoire behaviors 1765 01:24:38,215 --> 01:24:41,317 that are considered normal, 1766 01:24:41,317 --> 01:24:44,588 that are considered heteronormative for them to behave in. 1767 01:24:44,588 --> 01:24:46,795 When they step outside of those, 1768 01:24:46,795 --> 01:24:48,583 they're much more easily brought into treatment. 1769 01:24:48,583 --> 01:24:50,098 I'll give you an example of that. 1770 01:24:50,098 --> 01:24:53,031 I had a family come to see me. 1771 01:24:53,031 --> 01:24:54,635 I don't want to label the family 1772 01:24:54,635 --> 01:24:57,473 but they were a incredibly heteronormative family 1773 01:24:57,473 --> 01:25:00,907 in terms of how gender was seen in their family. 1774 01:25:00,907 --> 01:25:04,808 Dad worked at a very typical male profession. 1775 01:25:04,808 --> 01:25:06,678 Mom was a stay at home mom. 1776 01:25:06,678 --> 01:25:08,816 They were definitely a family that believe 1777 01:25:08,816 --> 01:25:10,646 that women cook and men mowed lawns, 1778 01:25:10,646 --> 01:25:12,311 and et cetera, et cetera. 1779 01:25:12,311 --> 01:25:13,886 They had four children. 1780 01:25:13,886 --> 01:25:17,991 A youngest one of whom was exhibiting in their eyes 1781 01:25:17,991 --> 01:25:21,295 enough gender nonconformity that they brought him in 1782 01:25:21,295 --> 01:25:24,122 to see a specialist. 1783 01:25:24,122 --> 01:25:25,992 In my interviewing the family, 1784 01:25:25,992 --> 01:25:29,470 and my working with the child, 1785 01:25:29,470 --> 01:25:32,607 I, basically, saw nothing about this child 1786 01:25:32,607 --> 01:25:34,306 where that was atypical at all. 1787 01:25:34,306 --> 01:25:35,841 He seem like a pretty typical boy. 1788 01:25:35,841 --> 01:25:37,396 He dressed like a pretty typical boy. 1789 01:25:37,396 --> 01:25:39,643 He identified as feeling like a pretty typical boy. 1790 01:25:39,643 --> 01:25:42,344 The only thing that was different about him 1791 01:25:42,344 --> 01:25:44,774 was that he really liked to play with barbie dolls. 1792 01:25:44,774 --> 01:25:48,190 He would steal the barbie dolls from his sister's room. 1793 01:25:48,190 --> 01:25:50,749 His father would punish him for that. 1794 01:25:50,749 --> 01:25:53,916 His punishment became this increasing issue 1795 01:25:53,916 --> 01:25:55,889 in the family where he was really being 1796 01:25:55,889 --> 01:25:58,100 highly reprimanded and spanked 1797 01:25:58,100 --> 01:25:59,461 for stealing these barbie dolls. 1798 01:25:59,461 --> 01:26:01,861 He still kept stealing the barbie dolls. 1799 01:26:01,861 --> 01:26:04,103 They were concerned that these meant 1800 01:26:04,103 --> 01:26:07,341 have really serious meaning that 1801 01:26:07,341 --> 01:26:11,206 they wanted me to figure out. 1802 01:26:12,111 --> 01:26:15,147 My treatment plan, a brilliant therapist that I am, 1803 01:26:15,147 --> 01:26:17,706 was that they should buy him some barbie dolls 1804 01:26:17,706 --> 01:26:20,342 and stop worrying so much about what that means 1805 01:26:20,342 --> 01:26:21,918 that a boy would play with barbie dolls. 1806 01:26:21,918 --> 01:26:24,680 I mean the idea that that was really the only thing 1807 01:26:24,680 --> 01:26:26,691 about this child that could be considered 1808 01:26:26,691 --> 01:26:28,594 at all gender nonconforming. 1809 01:26:28,594 --> 01:26:33,463 But here, Diane Ehrensaft's quote I said earlier 1810 01:26:33,463 --> 01:26:35,129 about gender health. 1811 01:26:35,129 --> 01:26:38,832 That this child is being made to think bad things about 1812 01:26:38,832 --> 01:26:40,235 who he is and what he likes. 1813 01:26:40,235 --> 01:26:44,772 He's being forced to question his gender 1814 01:26:44,772 --> 01:26:47,176 in a way that he was not questioning his gender. 1815 01:26:47,176 --> 01:26:48,781 He just wanted to play with barbie dolls. 1816 01:26:48,781 --> 01:26:52,713 Sometimes parents make a bigger deal about this 1817 01:26:52,713 --> 01:26:54,304 than is necessary. 1818 01:26:54,304 --> 01:26:56,116 That's something we also need to look at. 1819 01:26:56,116 --> 01:26:58,625 The newer studies are actually looking at 1820 01:26:58,625 --> 01:27:00,715 both girls and boys which is good. 1821 01:27:00,715 --> 01:27:02,360 Studies being what they are, 1822 01:27:02,360 --> 01:27:04,228 these range of what we're seeing 1823 01:27:04,228 --> 01:27:09,228 but somewhere between 12 and 27% of the boys and girls 1824 01:27:09,295 --> 01:27:14,202 that have been on studies on the last 5 to 10 years 1825 01:27:14,202 --> 01:27:18,211 show a persistence rate of gender dysphoria into adulthood, 1826 01:27:18,211 --> 01:27:22,775 about one out of four kids. 1827 01:27:23,078 --> 01:27:25,110 However, and this is really important, 1828 01:27:25,110 --> 01:27:28,490 the persistence of gender dysphoria into adulthood 1829 01:27:28,490 --> 01:27:30,645 appears much higher for adolescents. 1830 01:27:30,645 --> 01:27:34,217 That means when you see a child who is five years old 1831 01:27:34,217 --> 01:27:36,263 who is gender nonconforming, 1832 01:27:36,263 --> 01:27:39,662 there's a one in eight or one in four chance 1833 01:27:39,662 --> 01:27:42,601 that this child will continue to be gender nonconforming 1834 01:27:42,601 --> 01:27:45,534 through childhood, through adolescence and into adulthood. 1835 01:27:45,534 --> 01:27:50,145 But when you see a child who is already a teenager 1836 01:27:50,145 --> 01:27:52,547 who is entering their teenage years, 1837 01:27:52,547 --> 01:27:54,809 who is expressing gender dysphoria. 1838 01:27:54,809 --> 01:27:58,584 Who is expressing pain and discomfort around their gender, 1839 01:27:58,584 --> 01:28:01,643 there's a much higher chance that that child 1840 01:28:01,643 --> 01:28:04,750 is going to grow up to identify as transgender 1841 01:28:04,750 --> 01:28:09,750 and request tranmedical treatments 1842 01:28:09,880 --> 01:28:12,500 to support a gender transition. 1843 01:28:12,500 --> 01:28:16,904 This is the work of my colleague, Kelly Winter. 1844 01:28:16,904 --> 01:28:21,354 What Kelly Winter says is that when we look at 1845 01:28:21,354 --> 01:28:25,076 the research of desistance. 1846 01:28:25,076 --> 01:28:26,739 In other words, what they mean by desistance 1847 01:28:26,739 --> 01:28:30,249 is which children actually stopped 1848 01:28:30,249 --> 01:28:33,275 so we have a gender-variant child and then the research 1849 01:28:33,275 --> 01:28:37,084 is showing that if one out of four continues. 1850 01:28:37,084 --> 01:28:40,161 That means three out of four don't continue. 1851 01:28:40,161 --> 01:28:41,358 Those are the desistors. 1852 01:28:41,358 --> 01:28:45,086 Those are the children who go on again to develop 1853 01:28:45,086 --> 01:28:47,989 what somebody out there considers typical, normal, 1854 01:28:47,989 --> 01:28:52,527 heteronormative identities regarding their gender. 1855 01:28:52,527 --> 01:28:53,907 What she's saying is that 1856 01:28:53,907 --> 01:28:58,612 we've conflated a number of issues, 1857 01:28:58,612 --> 01:29:00,435 we've conflated in a number of subsets 1858 01:29:00,435 --> 01:29:02,585 of populations into one. 1859 01:29:02,585 --> 01:29:04,582 Now, one of the first ones I just want to mention 1860 01:29:04,582 --> 01:29:06,986 is a number of these kids just drop out of treatment. 1861 01:29:06,986 --> 01:29:09,949 To conclude those children as desistors, 1862 01:29:09,949 --> 01:29:11,213 I mean we don't know that 1863 01:29:11,213 --> 01:29:12,854 because their parents pulled them out of therapy 1864 01:29:12,854 --> 01:29:14,754 or because they didn't want to go back to therapy. 1865 01:29:14,754 --> 01:29:17,460 Of course, tells us nothing about whether or not, 1866 01:29:17,460 --> 01:29:20,263 they have a typical or atypical gender identity 1867 01:29:20,263 --> 01:29:21,866 five, or ten or fifteen years later. 1868 01:29:22,139 --> 01:29:24,170 That's something we need to know. 1869 01:29:24,170 --> 01:29:26,404 What Kelly Winter is saying is that 1870 01:29:26,404 --> 01:29:31,404 the conflated subsets, the nested subsets 1871 01:29:31,904 --> 01:29:35,601 and she's here talking also about for some reason 1872 01:29:35,601 --> 01:29:37,648 little Matryoshka dolls seemed to be very important 1873 01:29:37,648 --> 01:29:40,413 in the gender for people that talk about gender. 1874 01:29:40,413 --> 01:29:44,759 That one inside of the other that we're confusing children 1875 01:29:44,759 --> 01:29:48,519 who are socially transitioned with children 1876 01:29:48,519 --> 01:29:52,230 that are gender dysphoric with children that are diagnosed 1877 01:29:52,230 --> 01:29:54,992 with gender identity disorder or gender dysphoria. 1878 01:29:54,992 --> 01:29:57,466 with gender nonconforming kids. 1879 01:29:57,466 --> 01:30:00,139 That these are really different populations 1880 01:30:00,139 --> 01:30:02,964 that children who are gender nonconforming 1881 01:30:02,964 --> 01:30:06,776 may indeed be gay, may indeed be straight, 1882 01:30:06,776 --> 01:30:11,153 may indeed grow up to have or not have gender issues, 1883 01:30:11,153 --> 01:30:13,557 that children depending on where you are, 1884 01:30:13,557 --> 01:30:15,648 the children are being diagnosed. 1885 01:30:15,648 --> 01:30:18,550 So are we looking just at a population who is diagnosed 1886 01:30:18,550 --> 01:30:20,248 who fits diagnostic criteria. 1887 01:30:20,248 --> 01:30:23,462 Are we looking at a broader range like that child 1888 01:30:23,462 --> 01:30:25,288 who wants to play with barbie dolls. 1889 01:30:25,826 --> 01:30:28,803 Are we looking at children that are in pain? 1890 01:30:28,803 --> 01:30:31,196 We talk a lot about gender dysphoria. 1891 01:30:31,196 --> 01:30:34,706 We don't talk enough about gender euphoria. 1892 01:30:34,706 --> 01:30:38,908 Not all children who exhibit a typical behavior are in pain. 1893 01:30:38,908 --> 01:30:40,870 Actually some of them are quite happy 1894 01:30:40,870 --> 01:30:42,477 with their gender-variance. 1895 01:30:42,477 --> 01:30:43,915 So who are we looking at? 1896 01:30:43,915 --> 01:30:46,616 Are we just looking at people who transitioned 1897 01:30:46,616 --> 01:30:49,045 as young children into teenage years. 1898 01:30:49,045 --> 01:30:52,553 Or are we looking at children that are growing up 1899 01:30:52,553 --> 01:30:54,619 in homes who are socially transitioning 1900 01:30:54,619 --> 01:30:56,187 would not be possible for a whole bunch 1901 01:30:56,187 --> 01:30:58,793 of different kinds of reasons. 1902 01:30:58,793 --> 01:31:02,725 They are again, they appear to be desistors. 1903 01:31:02,725 --> 01:31:06,327 They appear to be people who are normative 1904 01:31:06,327 --> 01:31:09,712 but we don't really know the outcome of that down the road. 1905 01:31:10,539 --> 01:31:11,471 Okay. 1906 01:31:11,471 --> 01:31:14,439 There are three potential outcomes 1907 01:31:14,439 --> 01:31:18,773 that I see for gender nonconforming youth. 1908 01:31:18,773 --> 01:31:21,822 One is that gender variance is an expression 1909 01:31:21,822 --> 01:31:25,820 of gender diversity and its potentiality in all children. 1910 01:31:25,820 --> 01:31:30,820 Meaning that all children, all children are capable 1911 01:31:32,000 --> 01:31:36,398 of exploring gender at little boys are as interested 1912 01:31:36,398 --> 01:31:39,704 or potentially as interested in playing with glitter 1913 01:31:39,704 --> 01:31:42,402 and wearing high heel shoes and playing with lipstick. 1914 01:31:42,402 --> 01:31:45,867 And little girls are capable of exploring and being 1915 01:31:45,867 --> 01:31:48,002 interested in things that are traditionally 1916 01:31:48,002 --> 01:31:50,515 considered masculine whether that's carpentry 1917 01:31:50,515 --> 01:31:55,515 or mowing the lawn or playing sports whatever that is. 1918 01:31:56,085 --> 01:32:00,343 We need to broaden the definitions and understandings 1919 01:32:00,343 --> 01:32:03,261 of what gender-variance means and understand 1920 01:32:03,261 --> 01:32:07,222 that in a gender-health world, in a healthier world, 1921 01:32:07,222 --> 01:32:10,859 that all children will express a diversity of genders. 1922 01:32:10,859 --> 01:32:13,808 That gender variance can also be an early expression 1923 01:32:13,808 --> 01:32:15,943 of homosexuality or bisexuality. 1924 01:32:15,943 --> 01:32:18,301 Now, again, we have really good research 1925 01:32:18,301 --> 01:32:22,246 that shows that this is true but even research aside, 1926 01:32:22,246 --> 01:32:24,776 we have the narratives and stories 1927 01:32:24,776 --> 01:32:29,776 of thousands of gay and lesbian people 1928 01:32:29,952 --> 01:32:33,321 that talk about being gender variant as youth. 1929 01:32:33,321 --> 01:32:35,723 These are not people who identify as transgender 1930 01:32:35,723 --> 01:32:39,467 but they are people who identify as gay, as lesbian. 1931 01:32:39,467 --> 01:32:43,571 In some case, bisexual who express and talk about, 1932 01:32:43,571 --> 01:32:47,603 again, in a colloquial way, we always knew, 1933 01:32:47,603 --> 01:32:48,907 they always knew. 1934 01:32:48,907 --> 01:32:52,244 There's actually a website that shows pictures 1935 01:32:52,244 --> 01:32:56,784 that people posted of themselves as young children. 1936 01:32:56,784 --> 01:32:59,985 The little boy who is sitting on the bed. 1937 01:32:59,985 --> 01:33:02,977 He's about seven years old drinking a glass of water 1938 01:33:02,977 --> 01:33:06,160 in what is perceived of as a feminine position, 1939 01:33:06,160 --> 01:33:08,655 the little girl who is in the cowboy outfit. 1940 01:33:08,655 --> 01:33:10,532 Looks like there's a little butch 1941 01:33:10,532 --> 01:33:12,696 and the gay and lesbian community takes 1942 01:33:12,696 --> 01:33:14,491 this great pride in saying, 1943 01:33:14,491 --> 01:33:18,073 "Look, we always knew that 1944 01:33:18,073 --> 01:33:20,406 "I was different from a younger age." 1945 01:33:20,406 --> 01:33:22,634 Of course, what they're really talking about is gender here 1946 01:33:22,634 --> 01:33:25,675 not sexual orientation because these issues 1947 01:33:25,675 --> 01:33:28,671 get conflated in our cultural understanding. 1948 01:33:28,671 --> 01:33:33,671 They're often used as signs to say, 1949 01:33:34,044 --> 01:33:35,824 "Yes, I always knew I was gay." 1950 01:33:35,824 --> 01:33:39,193 Look back studies show that there does seem 1951 01:33:39,193 --> 01:33:44,033 to be some evidence that and I want to be really clear here, 1952 01:33:44,033 --> 01:33:49,033 not all of us who are lesbian or gay-identified 1953 01:33:49,725 --> 01:33:53,850 expressed gender-variance but a certain portion of people 1954 01:33:53,850 --> 01:33:56,269 who grew up to be gay or lesbian also exhibit 1955 01:33:56,269 --> 01:34:00,677 gender variance in childhood and youth. 1956 01:34:00,902 --> 01:34:02,779 The third one is that gender-variance 1957 01:34:02,779 --> 01:34:05,643 is an early expression of transgenderism 1958 01:34:05,643 --> 01:34:08,686 with or without gender dysphoria, 1959 01:34:08,686 --> 01:34:10,792 with or without gender dysphoria. 1960 01:34:10,792 --> 01:34:15,363 I make the point I made earlier about gender euphoria. 1961 01:34:15,363 --> 01:34:18,295 That sometimes when we're looking at children 1962 01:34:18,295 --> 01:34:21,002 who are expressing gender-variance particularly, 1963 01:34:21,002 --> 01:34:23,572 I'm going to say extreme gender-variance, 1964 01:34:23,572 --> 01:34:25,830 it is often an expression of transgenderism. 1965 01:34:25,830 --> 01:34:28,470 Part of our goal is to figure out which group 1966 01:34:28,470 --> 01:34:30,869 these kids belong to is to help them understand 1967 01:34:30,869 --> 01:34:32,304 which group they belong to 1968 01:34:32,304 --> 01:34:34,746 and help their parents understand the fluidity 1969 01:34:34,746 --> 01:34:37,177 between these identities. 1970 01:34:37,177 --> 01:34:39,451 Here's the controversies we have. 1971 01:34:39,451 --> 01:34:40,811 How do we assess that? 1972 01:34:40,811 --> 01:34:45,756 What assessment tools do we have to look at, to talk to ... 1973 01:34:45,756 --> 01:34:49,484 I remember talking with a female child a number of years ago 1974 01:34:49,484 --> 01:34:52,993 who is ten years old, who said, "You know I know I'm a boy." 1975 01:34:52,993 --> 01:34:55,003 I said, "Well, how do you know you're a boy?" 1976 01:34:55,003 --> 01:35:00,003 She said, "Because I like to play football." 1977 01:35:02,537 --> 01:35:05,133 I'm not sure that liking to play football means 1978 01:35:05,133 --> 01:35:07,001 that you're definitely a boy 1979 01:35:07,001 --> 01:35:09,576 but that was the only language this ten-year-old had 1980 01:35:09,576 --> 01:35:12,415 to talk about her identity was actually something 1981 01:35:12,415 --> 01:35:15,251 that really is not about identity but it's about ... 1982 01:35:15,251 --> 01:35:16,517 I mean if we change the world 1983 01:35:16,517 --> 01:35:17,723 so that girls could play football, 1984 01:35:17,723 --> 01:35:18,886 and there was a girl football team, 1985 01:35:18,886 --> 01:35:20,888 would you still want to be a boy? 1986 01:35:20,888 --> 01:35:22,444 How do we assess this? 1987 01:35:22,444 --> 01:35:25,255 I think here's that ethical dilemma for us as clinicians. 1988 01:35:25,255 --> 01:35:26,999 What if we're wrong? 1989 01:35:26,999 --> 01:35:27,722 What if we're wrong? 1990 01:35:27,722 --> 01:35:30,825 What if I'm making decisions for families? 1991 01:35:30,825 --> 01:35:33,465 I'm not making the decision for families 1992 01:35:33,465 --> 01:35:35,164 but I'm the expert. 1993 01:35:35,164 --> 01:35:38,579 The families are coming to me to talk to me. 1994 01:35:38,579 --> 01:35:40,544 What if the advise I'm giving 1995 01:35:40,544 --> 01:35:42,114 or the judgments that I'm making 1996 01:35:42,114 --> 01:35:43,604 or the assessments that I have 1997 01:35:43,604 --> 01:35:48,604 or the evaluation that I provide for this family is wrong? 1998 01:35:48,688 --> 01:35:50,288 How do we support parents? 1999 01:35:50,288 --> 01:35:53,618 How do we advocate in schools for parents? 2000 01:35:53,618 --> 01:35:58,459 How do we protect children from violence and abuse? 2001 01:35:58,663 --> 01:36:01,624 There's a lot that we don't know. 2002 01:36:01,624 --> 01:36:03,090 Most importantly, 2003 01:36:03,090 --> 01:36:06,474 we don't know the outcome for any children. 2004 01:36:06,474 --> 01:36:10,874 We don't know for sure what any child outcome 2005 01:36:10,874 --> 01:36:15,874 is going to be because we simply cannot know that. 2006 01:36:16,440 --> 01:36:20,215 What we do know is that all children 2007 01:36:20,215 --> 01:36:25,215 are hindered by binary views of gender and the socialization 2008 01:36:26,253 --> 01:36:28,189 that comes from that. 2009 01:36:28,189 --> 01:36:31,327 I'm going to show you a video here 2010 01:36:32,119 --> 01:36:33,899 of children not gender-variant. 2011 01:36:33,899 --> 01:36:37,899 Children talking about gender ...