Last night BBC2 aired a program called Transgender Kids, fronted by Louis Theroux. It is available on iPlayer, for those of you who can get such things. It is set in the San Francisco Bay Area and focuses on a number of young patients of the Child and Adolescent Gender Center at UCSF Hospital.
I should start by saying that it is one of the best documentaries about trans people I have seen. In particular the kids were given plenty of air time to speak for themselves, the parents interviewed were mostly very supportive, and the program appeared to be trying to say the right things, though because it wasn’t very explicit it is certainly open to alternative interpretations.
Having said that, there were still some fairly serious problems, starting with the use of Theroux as the presenter. He appeared to be trying to be sympathetic, but his usual screen character is that of a detached, somewhat skeptical guide to the weird and bizarre corners of humanity. Consequently he tended to present his interviewees as lab specimens rather than patients.
This wasn’t helped by the program’s obvious need to ask the questions it felt the viewers would want asked. And because this is the cis gaze we are talking about here those questions tended to be intrusive and prurient. Sadly that sort of thing is pretty much inevitable in any program made by cis people about trans people, which is why projects like Fox & Lewis’ My Genderation, made by trans people for trans people, are so valuable.
The medical staff at the hospital appeared to be very supportive, and their boss came out with a couple of very interesting comments. Firstly she claimed to have seen kids expressing clear trans gender preference as young as two years old. I can’t remember anything about being two, and have only been confident about dating my own feelings back to around five years old. It’s highly significant to have evidence of trans identity long before then.
The boss doctor also did a great job of taking down Theroux when he came out with the standard fear-mongering complaint that allowing kids to swap gender so young in life is a huge risk. “What if it turns out to be a mistake”, he asked. The doctor responded that you also have to consider the risk of not providing treatment. Given the suicide rates of trans kids, not helping them is quite likely to result in serious injury or death.
What the program didn’t get right was do a proper job of stressing the difference between puberty blockers and cross-gender hormone therapy. The purpose of puberty blockers is to give the patient the opportunity to delay the unwanted physical effects of puberty while they try out their new identity. If they are withdrawn, puberty proceeds as normal. Cross-gender hormone therapy indices puberty in the preferred gender, and therefore has permanent effects. It sounds like hormones are made available at a somewhat younger age in California than they are here, but even so the program should have made it much more clear that the younger patients were not being given irreversible treatments.
It also got back on the fear-mongering track with one of the older trans kids. The girl and her parents were understandably worried about what the future might hold. At 14 you are thinking about boyfriends, and possibly about marriage and children. Young trans people clearly don’t have the same prospects as cis kids of the same age. At this point there was no friendly doctor to step in and ask, “ah, but what sort of life will they have if they don’t transition?” The assumption is that you’ll have a terrible life as a trans person, and a better future if you live the rest of your life as a lie, knowing that you had a chance of authenticity and turned your back on it, and worrying that all of your friends would abandon you if they knew the truth. Of course when I was a kid the argument was generally, “you’d be better off dead than transitioning”, so I guess we’ve made progress.
What could have been the best part of the program was the variety of different attitudes that kids had. There was little Camile who at 5 was absolutely adamant that she was a girl, but in contrast there was Cole/Crystal who was very happy being a girl at home, but equally figured they’d probably grow up to be an effeminate man. There was a young trans boy who had just had top surgery but didn’t see the need for anything else. And even Camile’s parents, faced with the question as to what they’d say if their daughter changed her mind later in life, simply said they’d accept it and support her decision.
All of this should have resulted in an emphasis on the variety of trans experience, and on the need for each patient to find the solution that fits them best. However, because this was never explicitly stated, and because Theroux came over as unable to get his head around all of this, the program could easily be seen as setting one type of trans experience against another, and perhaps holding Cole/Crystal up as as the sane version.
Thankfully, because the kids and their parents were so great, I think the program was still very positive overall. As someone (I think Helen Belcher) said on Twitter, one thing it did do very effectively was give the lie to the idea that being trans was an adult phenomenon, probably something to do with a perverted sex drive.
The final positive thing that came out of it was that everyone I knew on Twitter started banging on about the need to support the UK’s only charity for families with trans children, Mermaids. Hopefully they will have got some money out of it. I note with some concern that they were left off the BBC’s own list of sources of support, and I don’t believe that can have been an accident.