Mini-Symposium on Sex and Gender: Foucault and the Construction of Transgender Children

by Heather Brunskell-Evans

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Thirty years ago, ‘the transgender child’ would not have made sense to the general public, nor would it have made sense to young people. Today, children and adolescents declare themselves transgender, the NHS refers some children for ‘gender-affirming’ therapy, and laws and policy are invented which uphold young people’s ‘choice’ to transition and to authorize the stages at which medical intervention is permissible and desirable.

The current narrative of the transgender child has numerous, attendant strands: although previously unrecognized, children born in ‘the wrong body’ are alleged to have always existed; parents are ‘brave’ when they accept their daughter is ‘really’ a boy (and vice versa); active cultural support of children’s gender self-identification helps revolutionize hide-bound, sexist and outdated ideas about gender; and medical intervention is a sign of a tolerant, liberal and humane society. What is the provenance of such a narrative? On what scientific medical/ psychological/philosophical bases are these composite ‘truths’ founded?

Liberal Wisdom 

A small event serves to illustrate the ubiquity of the current liberal wisdom that the transgender child is real and that transitioning children is progressive. A young woman in her early twenties does odd jobs for me in the garden. She is fascinated by the fact that I am an academic who analyzes sex, gender and sexuality, but at the same time I am skeptical about current knowledges,  politics and ethics of transitioning children.

One day, during moments when I took her cups of tea and chatted, she questioned me about my critical views. She informed me that in ancient times shamans revered sex-indeterminate individuals as nearer to gods than other mortals. In the present day, men dressing as women is an expression of their ‘feminine side’, thus demonstrating that feminine men have existed throughout time.  I assured her that I can understand a spiritual perspective that honors gender indeterminacy. It seems to me that freezing masculinity and femininity is restrictive of the range of human expressions open to men and women.  I quipped, truthfully, that as a heterosexual woman I always find men who are uncomfortable with masculinity far more attractive at every level of human connection than their less self-reflexive peers.

My friend was perplexed by what she judged to be my contradictory perspective – my acknowledgement that masculinity is restrictive for men and yet my avowed critical analysis of the theory and practice of transitioning children. Each of my replies was unsatisfactory to her, but rather than deterring her, they provoked further questions. Surely, she probed, to be opposed to transitioning children is tantamount to resurrecting the patriarchy? The moment her assessment was out of her mouth, I knew I had fallen into the (by now) familiar rabbit hole when casual discussion about transgenderism occurs. A dichotomy is erected, blocking any other view or thoughtful exploration: progressive people are supportive of transitioning children; critics are bigots wedded to traditional gender roles. Experience has taught me that once ethics are framed in this way – a direction of travel usually arrived at with great alacrity and in this instance about four minutes – there is no gainsaying my interlocutor’s belief in her own alleged moral and political high-ground. In contrast, I become immediately aligned with transphobia and likened to the kind of person who, ‘back in the day’, would have opposed lesbian and gay rights.

What I would have liked to have replied on this occasion is that whilst I share my friend’s aspiration for freedom from gender (indeed I have worked to this end all my private and professional life), we have a moral obligation, particularly with regard to children and adolescents, to open transgender doctrine to critical scrutiny. To truly defend progressivism, we would need to examine the following: Are the sex-indeterminate men of ancient times the same kinds of person as 21st century men who identify as women? What relation does transgender doctrine propose exists between biological sex and gender? What kinds of persons do lobby groups, such as Mermaids and Gendered Intelligence, assert transgender children are? What are the long-term consequences for children of social and/or medical transition? Do the doctors and the lobbyists fulfill their shared declared aim of releasing children from gender oppression, and if not, why not?  What are the consequences for all children of the narrative that it is possible to be ‘born in the wrong body’?

In order to examine the component parts that make up the narrative of the transgender child as a real, ahistorical, naturally occurring figure I use the genealogical method of the philosopher Michel Foucault who traces histories of the present power/knowledge/ ethics relations out of which sex and gender identities emerge.

The Making of The Transgender Adult

The identity of the transgender child cannot be fully understood outside of the history of the making of the transgender adult, since the transgender child is its off-shoot.

Transgender adults repeatedly claim that their gender was not aligned with their ‘assigned’ sex at birth. The concept of assigned sex suggests that when babies are born, an evaluative judgement is made, one that can mis-recognize the sex of the child. However, the phrase ‘assigned’ is only relevant to intersex people, about 0.05% of the population, whose genitalia at birth are ambiguous (or approximately 1.7% if the percentage includes later discovery for example of intersex chromosome composition, gonadal structure, hormone levels, and/or the structure of the internal genital duct systems).  The fact that a tiny percentage of people are born intersex – the category of person referred to by my gardening friend – does not negate the fact that with very little exception babies occupy a sex-category, male or female, based on objective, observed reality. Since male and female are discernible biological categories Robert Jensen, professor of journalism, asks: “What does it mean for someone unambiguously female to claim as an adult she is in fact male (or vice versa)?” I ask: What is the political and social context out of which such a claim, bizarre to the ears of the general public 30 years ago, apparently now makes sense?

In the 1970’s and 1980’s a paradigm shift in thought about sex and gender occurred, primarily brought about by feminist activists, theorists and philosophers,  which drove a wedge between biological sex (the division between male and female based on reproductive capacity) and social gender (‘masculinity’ and ‘femininity’). At the same time,  Foucault’s idea that homosexuality has been historically pathologized by medicine as a means of heteronormative social control was used by the lesbian and gay movement to critique the cultural designation of heterosexual men and women as psychologically healthy in contrast to homosexuals designated deviant.  The ‘pathological homosexual’ was found not to be an objective naturally occurring type of person, but a socially constructed identity reified as if natural.

A small transgender movement had also sprung up alongside the lesbian and gay movement in the 1970’s and 1980’s, and although connected, nevertheless retained different aims, aspirations and politics. Janice Raymond, professor of women’s studies and medical ethics, describes the possibilities for transgender self-identification during this period. Although the number of individuals identifying as transgender was minimal, it began to grow in line with the development of new medical technologies – hormone treatment, breast implants and the construction of artificial cavities for vaginas – that attempted to simulate the opposite anatomical sex.  During the 1980’s and 1990’s, queer theory was developed which built upon the lesbian and gay examination of gender identities and the pathologisation of same-sex attraction. The sociologist Sheila Jeffreys points out that queer politics very quickly became less about the original gay and lesbian movement’s analysis of sex and gender and structures of oppression, and more about the rights to play with and transgress gender norms.

By the end of the 1990’s, partly because of the potential for networking created by the internet, the transgender movement became firmly established. It began to make the following claims, overturning the epistemological insights and political possibilities of the sex/gender distinction: gender is not socially constructed but inherent; the biological division of human beings into two-sexed categories is socially constructed;  medical ‘sex transition’ is a human right; transgender people are marginalized and oppressed by the same heterosexism that had discriminated against lesbian and gay people; transgenderism is transgressive and thus axiomatically progressive.

The philosopher Terri Murray argues the current transgender movement gives the appearance of progressivism but is not a natural sequel to feminist and gay liberation.  Rather, in reifying gender it gives credence to the very gender myths that lesbian and gay activists originally spurned. LGBTQ+ is divisive of the once-powerful countercultural movement, reinforcing the myth that men and women are “different species of human being, not just reproductively, but mentally – with different desires, different needs, different aptitudes, and different minds.”

The Making of the Transgender Child 

During the same period that the transgender movement was gathering political traction, the transgender child was beginning to make its debut. Since the 1990’s, organizations such as Gender Identity Research and Education Society (GIRES) and Mermaids spearheaded demands for early medical intervention on the grounds it would spare gender nonconforming or gender defiant children the future trauma of reaching adulthood in ‘the wrong body’. These organizations were joined in 2008 by Gendered Intelligence, a lobby group that queers childhood.

In a newly published book Inventing Transgender Children and Young People edited by myself and my colleague Michele Moore, Professor of Disability Studies, I use the method of genealogy to trace the complex interrelationship between these lobby groups and the UK’s national health service clinic for children, the Gender Identity Development Service (GIDS) at the Tavistock. At the beginning of 2019, the GIDS Multi-disciplinary Team responded to public concern about, amongst other issues, the clinic’s administration of puberty blockers and cross-sex hormones to children and young people by explaining the basis for its decision making. Senior members of the GIDS team tell us: transgender identity can be a born property, and transgender identities have existed throughout history; transgender identities have been suppressed historically; it is an example of today’s more progressive society that these identities can now be expressed, and their suffering alleviated.

The GIDS team demonstrates a shocking lack of the history of ideas that informs its own affirmative practices. Its alleged multi-factorial approach is in effect driven by a single theoretical construct: it has at its core the issue of ‘identity’, defined by transgender theory and lobbying.  The idea that transgenderism is an internal, pre-social phenomenon that has existed throughout history is not an evidenced fact but a proposition. The clinic has no credible scientific basis for the theory it applies in a radical and experimental way to children, referring some physically healthy and phenotypically normal children and young people for dangerous, off-label drug treatment, with life-long deleterious consequences, including sterility.

The past thirty years have been witness to the invention of two identities for the transgender child: the first is that of the unfortunate victim ‘born in the wrong body’, i.e. whose gender self-identification requires medical diagnosis and hormone treatment (GIRES and Mermaids); the second is that of the revolutionary adolescent who bravely sensitizes the older generation, including trained clinicians, to the subtleties, complexities and politics of gender (Gendered Intelligence). These seemingly contrasting identities are still evolving and taking shape, but are increasingly synthesized into the one figure that we know today, ‘the transgender child’, who is invested by the GIDS with the capacity to consent to hormone therapy and for whom any dissent on the part of a clinician would be classified as conversion or reparative therapy.

Elsewhere, I demonstrate the relationship between the law and medicine in discursively producing the figure of the transgender child.  Considerable social, political and legal changes have occurred in response to transgender lobbying, and there is increasing acquiescence by governments to demands for transgender rights. Not only does the UK legal system now enshrine the legal fiction that transgenderism exists and that adolescents can be competent to consent to life-changing medical intervention, by 2020 all children will be taught in schools that transgender identity is inherent and that they and their brothers, sisters and friends may have been born in the wrong body. Shelley Charlesworth, a former BBC journalist, analyses the materials that convey these messages in programs already taught within some primary schools.

In conclusion, the consequences of the ‘transgender child’ is not only felt by the children and young people who access the clinic’s services but by the nation’s children from primary school upwards. As a society, parents need to be alert to this phenomenon, and refute the attribution that any critical reflection aligns them with bigotry and homophobia.

The Confused Ethics of Transitioning Children 

The transgender child is not a naturally occurring, pre-discursive figure but a newly constructed category of person forged out of the following: psychoanalysis, psychology and queer theory; lobby groups and transactivism;  and misdirected liberal values. These combined relations of knowledge, power, and ethics construct the composite picture of the transgender child. This identity is no more objective and no less political than the ‘pathological homosexual’ that conventional liberal wisdom is now happy to consign to the dustbin of history.

I suggest that ‘the transgender child’ should be equally rejected and consigned.  By subsuming the multifactorial sociological, psychological and familial context within which a child identifies as transgender under an overall model of affirmation (a model that it is allegedly transphobic or anti-trans for sociologists, philosophers and psychologists to question), the gendered intelligence offered by transgender doctrine to children, parents, doctors and society not only endorses the very gendered norms of masculinity and femininity it purports to revolutionize but exposes children to lasting physical harm. Medical procedures are carried out based on a child’s subjective feeling for which there is no scientific test and where clinical diagnosis is based on the child’s self-report. In contrast to the idea that transitioning children is progressive and humane, I conclude it is politically reactionary and an egregious abrogation of adult responsibility to fulfill their duty of care, played out on and through the bodies of children.

16 Comments »

  1. The “invention” of the transgender child has coincided with a wide range of highly lucrative malfeasance in health care in western societies. A transgender child is a cash cow in the same way a heroin addict is a cash cow. Years and years of therapy on a weekly basis at egregious hourly rates. Consultations on hormone treatments and elaborate surgeries. More therapy for managing one’s identity after transition. (I had a transgender friend – an adult – that was contemplating a transition, and was surprised to learn the whole process costs as much as a house in a real estate bubble.) We are one woke election from passing those costs from private interests to taxpayers, and then the sky is the limit for what these folks can charge for these services, which are increasingly being construed as a human right, something someone should be entitled to regardless of the cost, without which they cannot experience what it means to be fully human. This is the ideological process by which every aspect of American life has been converted to a profit center. A college education did not cost a quarter of a million dollars until after it was a “human right” and subsidized by the government. Outpatient surgeries did not cost $100,000 before they were a “human right.” They’ve run out of the obvious categories, and now we have gender wars. The next human rights emergency will probably be even more ridiculous than convincing children who still believe in Santa Claus and the Tooth Fairy that they were born with the wrong peepee.

    Folks have gone way beyond the invention of a transgender child, however. We were at a Barnes and Noble a couple weeks ago, where a teenage employee looked very much like a woman from a distance, complete with manicured nails and long hair, only to turn around and have a full goatee. How is there no adult in their world to tell them that this will be as good as it gets for them? Every adult in their life has failed them catastrophically.

    I feel like the 60s generation has cheated the kids they taught out of happiness with their nihilism, and behavior like this, six figures of student debt, a portfolio of abortions and attitudes that make someone a bad candidate for marriage, the desire to binge-watch dystopian fantasies on Netflix, etc. are all products of the same garbage narrative. The 60s generation experiences none of the consequences though, whereas younger generations are just completely and utterly lost in the world.

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  2. Gender dysphoria (previously Gender Identity Disorder) has become a fashionable form of mental illness and the psych trades have gone along with it. There is a reluctance on the part of the educated relativist to say ‘that’s nuts’. Like the so-called Children’s Crusades and the Sects of the Flaggelants this too will run its course.

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  3. I feel like the 60s generation has cheated the kids they taught out of happiness with their nihilism, and behavior like this

    Every generation has blamed the preceding generations, without exception(listen to the Living Years by Mike and the Mechanics). This is to be expected since parenthood is in part controlling, directive and prescriptive until the child’s faculties have matured to the point where they can responsibly direct their own lives., And all parents make mistakes. Therefore some of the younger generation carry with them unresolved hurt and resentment against the parent generation.

    And then the younger generation repeat the process, to be blamed in turn. Is any generation uniquely to blame? I doubt it and I have not seen anyone make a documented case for such a proposition.

    The problem is that we have a short time horizon that only extends to our parent generation. Therefore they loom large in our lives and dominate our judgements. Blaming them is the natural consequence. To think that we are better is a natural delusion.

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    • While I generally agree with your cyclical view of history, I don’t think of the 60s generation as merely bad parents or people with awful, illogical opinions. I think they are one of the worst generations in American history for the extent to which they have destroyed social institutions and nuked goodwill. This isn’t a sentimental observation. The 60s generation has left the humanities in ruins with their disdain for wisdom cultures, and medical ethics is a sort of collateral damage there too. They’ve produced an epic amount of pseudoscience and ensured that it is deeply entrenched in academia. They’ve trashed political discourse and made government function more like a commercial bank than anything else. They’ve trashed journalism and cultural commentary by punishing anyone with a contrarian perspective. They’ve trashed public education and subordinated literacy and numeracy to being “progressive.” I don’t think a single generation is going to repair or reverse all of this nonsense, because it’s not purely a cultural phenomenon. Future generations are going to have to change virtually everything about the way our systems work (or, more accurately, don’t work) to reverse what Baby Boomers have done relentlessly in the span of 50+ years. Millennials and a fraction of Generation Z are going to be some sort of deranged, enduring laboratory for 60s ideas, and history will judge the 1960s cruelly for that. But there will be a lot of misery in the meantime. I’m sure we are 10 years removed from many of these kids on the “gender spectrum” becoming seriously self-destructive and hateful. That’s usually what happens when people make catastrophically bad decisions in their youth and realize how path-dependent life can be. That’s why we should take care that our social institutions do not become collectively mentally ill. The great thing about this period in time, however, is that the people pushing these ideas like to publish a lot. So future historians will know the names of the monsters responsible for these atrocities and they can become case studies for posterity on how happiness and excellence are impossible without virtue on both a micro and macro level.

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  4. …this too will run its course.

    Yes. As researchers, over the next generation or so, document the consequences the extent of the harm will begin to become apparent and consensus will begin to turn against these practices. But that will leave a lot of damage in its wake.

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    • Blaming a whole generation is bit like blaming all Jewish people or all gay people or all black people. It’s bigotry.

      I’m from the 60’s generation and I can assure you from personal experience that we had all the human variety possible.
      My college room-mate was a Republican, Catholic and fought in Viet Nam, unlike me He never touched marijuana and I used it frequently. He wore a tie and jacket to classes (some students did that back then), while I put on a tie as little as possible and no longer even own one.

      So if you want to blame radical leftists from the 60’s, fine, but be specific please because even on the radical left people ranged from tremendously idealistic kids willing to burn their draft card and go to jail (and they put them in jail in cells with rightwing thugs with the consequences that you can imagine.) to people who just wanted to break windows and discharge their anger and resentment against society.

      Study the 60’s please. Study the distinct tendencies among young people, some constructive, some negative, some hedonistic, some very disciplined, some infantile, some very thoughtful. Otherwise, as I said above, you are just engaging in another form of bigotry.

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  5. I conclude it is politically reactionary and an egregious abrogation of adult responsibility to fulfill their duty of care, played out on and through the bodies of children.

    Well put. It is an experiment with people’s lives that will have life long consequences. It is an ad hoc, poorly planned, poorly motivated experiment without controls that no ethical researcher would ever conduct.

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  6. This is an interesting read. I have not read your book, but I did read the very positive review by “a clinician at the only NHS commissioned gender service for children and young people”. Midgen does suggest reading a few clinicians from the pro-treatment side, such as Di Ceglie (the founder of GIDS), who at least in print comes across as cautious about offering medical options when he perceives there are obvious psychodynamic factors at work, and claims his support of puberty blockers is as a partially reversible treatment for severe distress that may well resolve with time. And is being assessed in a formal trial.

    I think I do have a problem with your use of “construction” as an implicit criticism of the concept of childhood gender identity disorder. If approximately 0.5% of all Americans identify as transgender across a full age range [Crissman et al 2017], then it is possible they have been lured in by publicity, since say the 1990s, to so self-identify. But the rates are the same in the over 50 y.o.s in that study. It may be coincidence that the proportion of Hijra on the Indian subcontinent is also ~0.5% of those born male – where there is strong evidence for “transgender identities [that] have been documented across many different societies and historical time”, including a long history of surgery viz castration and penectomy. In that latter setting, it seems despite a societal path existing for this small subset of men, it is certainly not the safe or comfortable lifestyle leading them into it, especially in the modern era. There will not be such a deep conceptual history in Europe and the Anglosphere because such behaviour was hidden because of legal and social sanctions.

    One is then left with the same line of thought about adult transsexuals as one has about adult homosexuals. That gender identity and sexual preference probably form relatively early, and in adults definitely are associated with psychological disease, due in some part to societal treatment, as well as, probably, developmental factors such as autism and schizophrenia. In which case, some kinds of early intervention are warranted, for some individuals, and these might include hormones – the latter being an empirical question that needs a study with long term follow-up.

    UK 10-19 y.o ~8 million * 0.5% = 40000 individuals, so 2000 patients at GIDS might be 5% of that number…

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  7. SaucySandpiper
    Millennials and a fraction of Generation Z are going to be some sort of deranged, enduring laboratory for 60s ideas,

    I arose this morning to read your strongly worded comment with a smile. There is nothing like a good dispute to dispel the morning fog 🙂 Parent and child generations are adjacent to each other and their contrary interests create friction. Their proximity allows them to see each other’s warts in all their ugly detail. The more remote generations are judged more kindly because we have better context, less detail and have not been exposed to bruising contact.

    Harsh judgements are of no use by themselves. We should assess parent generations and understand the forces that drove their trajectory so that we may choose a better trajectory. The emotions of harsh judgement clouds the judgement process and impedes learning because of the self-congratulatory nature of this(them bad, we good).

    The challenge then is to to look past the detail, ignore the emotions and instead to identify an unfolding process. What is really happening, underneath it all? Why? What drives it? These are important questions because Heather Brunskell-Evans’ insightful essay has pin-pointed one of the unfortunate outcomes of this unfolding process.

    That is my challenge to you, look for the unfolding process. What is it?

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    • Peter DO Smith,

      You’ve answered Saucysanderpiper’s attack on the 60’s generation much better than I could or did. If the issue ever arises again, I’ll try your approach.

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  8. An excellent and convincing article; well-grounded and well written.

    As to the “’60s” issue – saucysandpiper and s.wallerstein are both correct. The Sixties comprise the most problematic historical-cultural formation of the 20th century – not the best or the worst, just the most confusing, with the most uncertain of legacies. And the fact is that this legacy haunts us still – in 2020, the US may still need to make a choice between two Baby Boomers of wildly different backgrounds and temperaments.

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    • Is everyone forgetting that radical feminism – otherwise known as second wave feminism – had its beginnings in the 1960s, and radical feminists are today offering some of the most thoughtful analysis of transgenderism and its potential negative impacts on the lives of children and young people? And being denounced as ‘TERFS’ for their trouble.

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  9. Heather

    What compels parents to go along with this? This is often portrayed as part of a progressive agenda, and yet it sounds pretty homophobic to me. Gay people being born the wrong sex is an old trope. We know that Iran forces homosexuals to transition or face the death penalty. To what degree is the acceptance of transgender children being driven by parents uncomfortable with the idea that their child may be gay?

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  10. It’s ironic that the generation that came of age in the 1960s is so derided and mocked when it comes to placing blame for the lunacy of gender identity politics. In actual fact, I have found that the “boomer” generation is quite prominent among the activists who are in the front lines of combating gender ideology today — most of them radical feminists. On the other hand, “millennials” and other recent cohorts are happily in the thrall of the Trans Taliban. The decline of the organized left and of radical politics in particular has left them all but ideologically defenceless against the reactionary influence of academic queer theory and post modernist anti-materialism.

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