The Briefing 04-08-16

Part I

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Gender-confused kids need the truth, not hormone treatment or sex reassignment surgery

Sometimes a major cultural moment can be traced to just one edition of a magazine, one article, one headline. That seems to be the case with Scientific American, its special issue on mind released earlier this year. The cover story declares this:

“Young and Transgender: How Best to Help Them Thrive.”

In a note from managing editor Claudia Willis that is found early in the magazine, she refers to the very idea of transgender children as “a fast shifting frontier of medicine.”

And she recognizes it is one with “even more ethical and cultural minefields than are faced by transgender adults.”

Let’s just imagine now what the editor has told us. We have a cover story in Scientific American Mind that is about transgender kids and how to help them thrive. That’s what the headline declares. And we had the editor right up front declaring that this entire idea, this entire area of medicine as it’s here defined, is a fast-changing minefield “with even more ethical and cultural minefields than are faced by transgender adults.”

This is an acknowledgement that when it comes to the issue of transgender kids, there are ethical issues that aren’t even confronted when dealing merely with transgender adults—as if you can use the phrase ‘merely transgender adults.’ In the opening of the magazine’s article, Francine Russo writes that the debate is growing about how to meet what she describes as the urgent needs of transgender kids.

Now at this point we simply have to note that no previous generation of human beings has confronted any issue such as this, nor would any previous generation even have recognized it. Here you have the declaration that this is a fast-changing arena of medicine with many minefields, but it is not only about medicine—as a matter of fact it is not even primarily about medicine. It is about the moral revolution and a fundamental revolution at the level at which it is now contentious even to use categories like male and female, man and woman, boy and girl. In this article, of course, the issue is boys and girls—or at least the human beings previously known as boys and girls.

And as the author says, what we’re looking at is “psychologically and ethically the growing number of children, some as young as seven or eight seeking treatment despite uncertain medical science.”

“Uncertain medical science”—now just note this before we even going further: here is the effort to reduce this to a question of medicine. No doubt there is a medical aspect of this, but it can’t be reduced to mere medicine. Now we are told about in Los Angeles, the Center for Trans Youth Health and Development, they saw close to 400 patients we’re told in 2014, only 40 in 2008. The Center, we are told, is currently adding 3 to 4 new patients a week.

“Transgender youth,” according to the article that cites a Boston-based study of data, “face 2 or three times the risk of their peers for serious psychological issues such as depression, anxiety disorders, self-harm and suicide.”

As the author says,

“They urgently require attention.”

Now there’s a fundamental assumption behind this article, and that is that the ideology of the transgender movement makes sense. You’ll notice that the psychological or psychiatric problems cited in this have nothing to do with the transgender identity itself, but simply instead with depression, anxiety disorders, self-harm, and suicide. Those are very urgent and legitimate issues. But what is really noticeable here is the fact that the entire transgender assumption is simply taken for granted. Here are a couple of crucial paragraphs for our consideration:

“As newly alerted parents arrive at clinics with boys who sew and dress in frilly outfits and girls who would not be caught dead doing either, experts have to diagnose whether these children have gender dysphoria. In this condition people suffer distress because of a mismatch between the gender identity they experience and their biological sex as determined by chromosomes, gonads and genitals. Until 2012,” we are told, “psychiatrists classified the condition as ‘gender identity disorder.’”

But then we’re told that was a term now viewed as stigmatizing.

“Although adolescents may confuse the two,” says the report. “Gender identity is different from sexual orientation.”

In a really astounding section of the article, Norman P. Spack, identified as a pediatrician, pediatric endocrinologist, and founder of the Gender Clinic at Boston Children’s Hospital, borrows language from one of his first transgender patients to explain and this is, again quoting this doctor,

“Sexual orientation is who you go to bed with; gender identity is who you go to bed as.”

And then we find this astounding statement coming from the doctor,

“I could never predict the sexual orientation of my patients.”

Now here we see the ideology of the moral revolution, the ideology the LGBT movement, the idea that sexual orientation is either, on the one hand, a biologically determined reality, or, on the other hand, simply a matter of social construction. Here you have that in a head-on confrontation with modern medicine, with children very much at the forefront of the arena. But then we find this amazing statement:

“Gender dysphoria is more than just rejecting the social and cultural roles assigned to a given gender. Many kids push back against those norms as when a young boy rejects macho roughhousing to playing house or a girl prefers toy soldiers to dolls without any discomfort regarding sexual or gender identity.”

In other words, the gender dysphoria described here requires distress or an uncomfortability experienced by the child. And that’s why the report says, for some children, there is a nagging painful conviction that the gender they are forced to present to the world does not reflect their true self.

But the really important impact of this article has to do with what it reveals about parents and the larger society dealing with transgender issues, and with modern medicine trying to either join the moral revolution or to lead it. The central issue confronted in this cover story is what should be done when very young children present themselves as transgender.

There are at least three different medical avenues that are described here. One is hormone suppression; that would be given to children before puberty that would prevent them from entering puberty in terms of the development that would come with their biologically assigned sex. The other is hormone replacement; and that means that a boy would be given hormones in order to achieve female characteristics and likewise a female would be given male hormones to do the opposite. Then there is of course gender reassignment surgery. The question is, at least in terms of this article, what is the right medical approach with a child? And here, remember, we’re not just talking about those who are experiencing a transgender identity; we’re not talking about adults; we’re not even talking in the main about older teenagers; we’re talking about very young children.

Another interesting aspect in this article is the fact that the ideology of the transgender movement has now led at least some parents, as are indicated in this article, to actually want their child, having presented him or herself as transgender, to stay with that new gender identity. They actually resist, some parents, the child returning to the gender identity of the biologically assigned sex. That’s an astounding statement, and very revealing in terms of the confusions of our age. Dr. Spack is quoted in the article as saying,

“Some parents are so convinced their child is trans that they don’t want their child to have any natural hormones. These parents bring their kids in as young as seven or eight. If we did that,” said the doctor, “We’d take away the one true test of gender, puberty. If the kid accepts the body to get it puberty, how can the parents say my child is in the wrong body?”

Now once again, just pause for a moment and recognize that no previous generation of human beings living anywhere, at anytime, could even understand here what we are talking about. While we’re looking at the seismic moral implications of all of this, we need to recognize that this very article addresses the issue of infertility. To state the matter plainly, children who have either the hormone replacement therapy or who have some kind of gender reassignment surgery are permanently unable to have children. That makes common biological sense, but it seems to be an astounding insight in this article. The writer tells us,

“One of the thorniest issues about age is whether an 11 or even 14-year-old can understand the implications of a treatment that means he or she can never have biological children.”

So according to this article, when would medical practitioners rightly turn to a child or young teenager and decide that there is genuine gender dysphoria that should lead to either the hormonal or the surgical treatment? The words that are used in this article is that the children are to present themselves in terms of a transgender identity in ways that are insistent, consistent, and persistent over time.

Now keep that in mind when we read this, the most astounding sentence in the entire article. Please listen carefully.

“Among children under the age of about 12 who cross-identify”—in terms of how they dress and behave—“only a minority will continue to see themselves as transgender after puberty.”

That’s an astounding statement. To put it another way, this article tells us that a majority of children age 12 or under that experience this kind of transgender identity, a majority will not persist in this transgender identity after early adolescence. Frankly, it’s hard to imagine an insanity greater than this. Here you have the admission that a majority of these kids 12 and under who present themselves as having a transgender identity don’t even persist in it until they even get through early adolescence. Frankly, that’s good news; but how horrifying to imagine that there are medical practitioners who believe the right thing is to use hormone exchange therapy or surgical interventions for children even younger! What is this insanity that we have absorbed as a civilization? It is a tragic indication of the massive confusion of our age.

In terms of that confusion, we need clarity. And for that we should be very thankful for a statement that has come from the American College of Pediatricians. This is a smaller group than the American Pediatric Association, but it’s a very important group because it represents sanity on this issue. These pediatricians and their colleagues put out a statement recently with eight very important points. Eight points, we should say, of sanity and moral clarity

“1. Human sexuality is an objective biological binary trait: “XY” and “XX” [speaking of chromosomal identity] are genetic markers of health – not genetic markers of a disorder.”

Very important.

“2. No one is born with a gender. Everyone is born with a biological sex. Gender (an awareness and sense of oneself as male or female) is a sociological and psychological concept; not an objective biological one.”

Now again, that’s very important, and it flies in the face of this medical revolution described in Scientific American Mind.

“3. A person’s belief that he or she is something they are not is, at best, a sign of confused thinking.”

This is such refreshing candor and clarity. Here you have a group of pediatricians willing to say the biological sex is what we are. There’s more to us, but there is never less to us, and it’s not a disease to be created biologically male or female.

“4. Puberty is not a disease and puberty-blocking hormones can be dangerous.”

That’s also very important to know. Resisting puberty is resisting the plan and purpose of God. Point number five from these doctors:

“As many as 98% of gender confused boys and 88% of gender confused girls eventually accept their biological sex after naturally passing through puberty.”

Now let’s look at those numbers again. As many as 98% of gender confused boys and 88% of gender confused girls eventually returned to their biological sex as their gender identity. Again, that’s massively good news, and it certainly calls into question the moral sanity—not to mention the medical sanity and morality—of treating transgender children as if they are going to continue to understand themselves as transgender.

“6. Children who use puberty blockers to impersonate the opposite sex will require cross-sex hormones in late adolescence.” They go on to warn, “Cross-sex hormones (testosterone and estrogen) are associated with dangerous health risks including but not limited to high blood pressure, blood clots, stroke and cancer.

“7. Rates of suicide are twenty times greater among adults who use cross-sex hormones and undergo sex reassignment surgery, even in Sweden which is among the most LGBQT – affirming countries.

“8. Conditioning children into believing a lifetime of chemical and surgical impersonation of the opposite sex is normal and healthful is child abuse.”

So here you have moral sanity that has been so lacking among so many. Here you have a group of pediatricians willing to say that biological sex is not a problem; that gender identity has to be brought into alignment with biological sex; that doing anything other than this is not only moral nonsense, it is medical malpractice. They go on to cite that, again, 98% of gender confused boys and 88% of gender confused girls, without any kind of intervention, eventually returned to their gender identity as their biologically assigned sex. We’re also told that those who receive the cross hormone treatments and sexual reassignment surgery are actually not happier on the other side, but they bring on a far greater risk of suicide. Furthermore, this very important eighth point reminds us that leading anyone, including especially children, into believing that a lifetime of chemical and surgical impersonation of the opposite sex is normal, well, they go on to say that is child abuse. Think of the moral clarity in that statement. What the transgender movement represents is “a lifetime of chemical and surgical impersonation of the opposite sex.”

Pastorally, Christians should be heartbroken over anyone of any age who experiences what’s described here as ‘gender dysphoria.’ They deserve our care and our concern, indeed, the Christian worldview demands it. But we also have to understand that that care and concern and compassion must be based in truth. And, as the Bible and the biblical worldview make abundantly clear, we do not love people by telling them something other than the truth. These doctors have spoken the truth. Leading anyone to believe that a lifetime of chemical and surgical impersonation of the opposite gender, that that’s normal and healthful, it is not only child abuse when applied to children, it is abuse when applied to anyone of any age. Christians must not be complicit in this confusion.

I’ve given so much attention to these issues today because they are on the front pages of our papers, but also they’re on the front lines of ministry. There will not be a church that will not be touched by this challenge, that will not have to answer some of these questions. There isn’t a pastor probably already who hasn’t at least at some distance had someone ask the question, what should we do with our child experiencing what’s described here as ‘gender dysphoria.’ It might be that eventually, almost every family—even though the statistical numbers here represented are exceedingly small—the larger cultural momentum is very, very large. Perhaps no family will be untouched by this over time.

The most astounding thing about the Scientific American article is the acknowledgment buried within the article that the vast majority of children 12 and under who experienced gender dysphoria get over it by the time they exit puberty. And then the statement coming from the group, the American College of Pediatricians, that brings eight points of very necessary clarity in the midst of so much confusion. For those doctors and for this gift of clarity, we should be very, very thankful.

Part II

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Parents reading to their children: an invaluable gift or an "unfair" advantage?

Next, speaking of children and their parents, there was a really heartwarming article that appeared recently in the Wall Street Journal. It’s by Clare Ansberry, and it has to do with children being read to by their parents. There’s another astounding statistic in this article. It turns out, according to research, a survey of 2,558 parents and children, it discovered that many children wish their parents wouldn’t stop reading to them. What are the ages of these children? Well, eight in 10 children aged 6 to 17 said they wish their parents at least occasionally still read to them, especially at bedtime or at another appropriate moment. Just consider that. I’m astounded by the age range. You’re talking about children ages 6 to 17 and, according to this study, eight out of 10 said that they still wish their parents would sometimes read to them.

The article tells us that most children can read independently, even if they read quite slowly, by the end of the first grade. And once children reach that milestone, many parents who had been reading to their children stopped doing so. They stopped reading aloud by at least age 9 saying their child is old enough to do so independently without the parent. And yet, as this article makes very clear, and as I said, there’s something really heartwarming about this. The majority of these kids want their parents to continue reading to them even if they also read alone. One little boy cited in the article, he’s a nine-year-old named Adam, he said,

“Part of me misses the snuggling up and being able to cuddle and read.”

Adam described what it was like when he was particularly tired and he said,

“I just don’t feel like reading but want to have a story read to me. I kind of like being close. It’s easier to fall asleep.”

There you have it, firsthand testimony from a nine-year-old boy about the fact that he does not want his parents to stop reading aloud to him. That’s an amazing thing on its own. It tells us that children really do value that time with parents. It also speaks to the amazing power of the story as a bond between parents and children. It also speaks to the fact that reading aloud has benefits to children of many ages that go far beyond the child hearing a story. It is a presence and attention received from the parent. It is the gift of reading aloud of sharing a story together. It is the knowledge that something far more fundamental than words are being shared in this experience.

What could possibly be wrong with this picture? Well, before leaving the issue, I need to turn to Australia, where at least one philosopher argues that it is unfair for some children to have parents who read to them, because they receive advantages that other children do not have. They are not experienced by the children’s parents who do not read to them. This philosopher goes on to argue that equity would require at least that we ask very seriously whether it is fair for parents to read to their children, because it bestows so many benefits, and those benefits are not equally and universally applied to children.

This Australian philosopher, however, goes on to give evidence about just how important reading to children is.

“The evidence shows the difference between those who get bedtime stories and those who don’t, the difference in their life chances is bigger than the difference between those who get elite private schooling and those that don’t.”

Now that would confound and even surprise many parents to be told that reading to their children a bedtime story makes a greater long-term contribution to their children’s life chances even than paying very expensive tuition for a private school education.

The New York Times also had a very interesting story about a very small library in Afghanistan in a little rural village where it turns out there are only two shelves of books. But people will ride on their bicycles or will walk miles and miles just to be able to obtain one of these books, just to borrow a book for a very limited period of time, because a book is such a precious item. The story humbles us to recognize how abundant books are around us and why we often take books so much for granted.

So as we go into the weekend, consider this: Consider how blessed we are to have access to books and libraries and bookstores. Consider the power of the printed word and the power of the book, and remember the most important issue we’ve thought about in terms of reading is what happens between parents and children when they read together, when parents read aloud to their children. It turns out that even the secular world understands just how much parents’ reading aloud to their children adds to their children’s lives. But of course, parents also understand from a biblical perspective, it adds a great deal to our lives as well. There is a reciprocity in reading that takes place when parents read aloud to their children and, of course, Christian parents understand that what we read to our children goes not only into the ears, but into their hearts and minds, meaning that we will want to be very careful about the books that we read and the stories we tell. Because they are not only stories that are remembered, they are stories that help to shape the heart.