The Cross-Wired Mind Motivating Gender Identity

"It is possible that kids who have a tendency to get obsessed or fixed on something may latch on to gender."
"Just because kids are saying something doesn't necessarily mean you accept it, or that it's true, or that it could be in the best interests of the child. A four-year-old might say that he's a dog -- do you go out and buy dog food?"
Dr. Kenneth Zucker, psychologist, past director, gender-identity clinic, Centre for Addiction and Mental Health, Toronto

"Autistic adolescents struggling to deal with their quirky cerebral wiring do not need to be told they are 'a girl trapped in a boy's body' or vice versa."
"[However], many parents are buying into this completely unscientific hypothesis."
Dr. Susan Bradley, former chief of psychiatry, Hospital for Sick Children, Toronto

"[A diagnosis of autism] should not exclude the potential for GD [gender dysphoria] treatment [inclusive of cross-sex hormones]."
Newly published guidelines aimed at the medical community

"Children and adolescents with autism spectrum disorders may be less aware of the social restrictions against expressions of gender variance and therefore less likely to avoid expressing these inclinations."
"It could also be theorized that excessively rigid or 'black and white' thinking could result in such a child's rigidly interpreting mild or moderate gender nonconforming inclinations as more intense or absolute."
Dr. John Strang, Children's National Health System, Washington

Getty Images    “It is possible that kids who have a tendency to get obsessed or fixed on something may latch on to gender” 

 

Medical science is constantly on the move, with new theories taking the place of old ones, usually after a struggle when those invested in the beliefs that are being contested take umbrage until such time as the evidence in support of the new theory becomes too persuasive to continue to resist. Perhaps there are as few puzzling phenomena to ponder as the dichotomy between those who believe that gender always has a fixed biological basis identifying children whose sex is determined by physical characteristics and those who believe that sex identity is fluid and can be whatever the child wants or believes it to be, despite those physical identity prompts.

But when a belief becomes widespread and accepted within society at large and the greater medical community, woe betide the scientific mind whose opinionated theory differs from that accepted norm. In Western societies there has been a steadily growing movement to allow children from infancy forward to declare their preferred gender, irrespective of their presentation at birth as male or female. If a little girl insists she is really a boy or a little boy yearns to be a girl, their declarations are taken at face value, owing in no small part to the efforts of the transgender and LGBTQ community whose voice has grown steadily louder and authoritative over the years.

A group that was once pitilessly hounded and discriminated against, once victims of violence, now lives in a gentler social climate that accepts their differentiated presence, as that society turned on itself driven by guilt, to become a more accepting society. And as acceptance became mainstream, the previously hard-done-by community of gays and lesbians, transgender and others become more abrasively vocal, demanding their just due as respected members of society. And there was an inevitable branching out to offer 'support' and advice to puzzled parents of children with confused gender identities.

Simultaneously, medical specialists in gender disorder clinics are facing a phenomenon of higher-than-anticipated numbers of children with autism spectrum disorder. Concurrently, recent studies have discovered that young people suffering from autism are eight times likelier to exhibit "gender variance", interpreted as the desire to be viewed as the sex opposite to what they have been identified with, in comparison to normally developing children harbouring no such confusion. Out of these studies comes the controversial opinion that autistic traits of fixation could be responsible for convincing children they are a sex other than the one they reject.

Dr. Kenneth Zucker, who brings that message, was summarily dismissed after 30 years as director of the gender identity clinic in Toronto at the Centre for Addiction and Mental Health, because his views deviated so egregiously with the prevailing accepted view that children's voice on the matter should be accepted. But he has not been silenced, and continues to voice his opinion despite the anger that voice is drawing from the LGBT community. Several studies suggest that autism and gender dysphoria co-occur more frequently than can be attributed to chance in adolescents. 

 

A child with autism looks out a window at the Xining Orphan and Disabled Children Welfare Centre, China. The Atlantic

A ground-breaking study led by Dr. John Strang of the Children's National Health System in Washington, D.C. two years ago, discovered variance in gender to be eight times commoner in children with autism spectrum disorder, and seven times more likely to occur in children with ADHD. Although the conclusion may to some seem clear enough, the reason, is not. Autism, it has been noted, is described as "social blindness", and children are uninhibited by social expectations, leading to their unaware state of avoidance resulting in impulsive behaviour.

Dr. Zucker's theory leads to his belief that traits so common in autism of "fixating" could be responsible in influencing children to believe that are the wrong sex. While he was director of the Toronto clinic, an external review came to the conclusion that some of his practices were not "in step with the latest thinking", with his published research suggesting that 80 percent of children treated for gender dysphoria see that condition lifting by the time they reach high school, when they finally accept their "assigned-at-birth" gender.

Children on the autism spectrum are over-represented at his gender diversity clinic, feels Dr. Stephen Feder, co-director of the Children's Hospital of Eastern Ontario. "Our approach is still affirmative. But we perhaps take a bit more time to make sure that we get to know the kid as well as we possibly can. It doesn't change the overall approach. I think we're just even more vigilant about making sure we're responding to the appropriate needs of the kid. The issue of obsessiveness certainly comes up", said Dr. Feder.

However, he points out, when asked about their feeling of gender with obsessions of the past, adolescents "really identify it as quite different. This is not about interests. It's about how they see themselves. At the end of the day, we feel it's inappropriate to turn around and say, well if you're autistic , that probably explains your gender. The risk is that people will say, aha, that explains it And I think we want to move away from that."