“Schizophrenic” teens and transgendered teens: Some observations

About a Boy, by Margaret Talbot, features in the March 15 edition of the New Yorker Magazine. The author writes about the growing numbers of teenagers–increasingly female ones– who are being surgically transgendered. The New Yorker only posts a small part of the article on the link I’ve provided. Do your own sleuthing to obtain this article, or, better yet, buy it in the name of sociological research. If you don’t already know anyone through your network of friends and relatives who has opted to become transgendered, trust me, you will. It is likely that a friend’s daughter is about to become your friend’s son. Through my own network of friends and relatives, I have personally met four cases, all of them female, who have started or have completed, the transition to male.

Why am I talking about transgender themes on my schizophrenia* blog? Because, as  someone who believes in the value of psychotherapy, who is skeptical of brain and body transforming medications and surgical interventions (electroshock), there is something very alarming indeed about the acceptance by the very young (and perhaps more reluctantly by their parents), of costly and dangerous cosmetic surgical interventions that have lifelong implications. A lifetime of drugs, a body that in other contexts is considered mutilated (think of the outcry surrounding female genital circumcision) and no going back. Homosexuality doesn’t call for medications or surgery, but transgender interventions do.  It is ironic that on the one hand, mental health activists are condemning the widespread medicating and over medicating of children and adults, electroshock for depression, and the dearth of access to psychotherapy, and on the other hand, under eighteens and young adults are clamoring for surgery, medications, and declaring that childhood trauma is not the issue here. I’ll bet that a sound argument can be made that these teens and young adults have trauma issues and that these issues should be explored in great depth before rushing into no going back decisions. But, that argument isn’t being raised.

I recently met with a MTFT transgendered person, who got her surgery done in Thailand by a Thai doctor who has done hundreds of these operations in his lengthy career. Because of this person’s age (60) and the fact that she had many years to consider her choice, the surgeon waived the ten year time frame that the decision process is supposed to take.

Medical misgivings aside, it is interesting that all the parents of the teens in the article are divorced, and the small sample of people I know who have transgendered, have parents who are divorced or never married. Coincidental or not coincidental? Transgendering is like saying I am now almost physically equal to a male or female and I will become more like the absent parent.

Years ago, when the baby boomer generation started getting divorced in droves, we were fed then latest societal myth about the effect of divorce on the child. Children are enormously resilient, we were told.  And it was in our interests to believe that myth. It was, after all, tailored to us and our needs, and the last thing anyone wants to feel about divorcing when children are involved, is guilty. The resiliency myth soothed our guilt. Well, now we are beginning to see one change that can happen in this day and age when children grow up with a remote male or female presence, secure in the knowledge that genders are equal, nourished by an increasingly daring Internet pop culture, and a slavish rejection by key opinion leaders of agreed cultural norms that that were built up over centuries norms.

Back to The New Yorker article: “But Danielle, a lawyer who had studied literary theory in graduate school, told me that she found herself puzzling over Aidan’s desire to transition. ‘I feel like of lot of these kids, including my daughter, might be going through identity struggles, a lot of them are trying on roles.’ We were having coffee at a pie shop in the Mission, at a long communal table. (At one point, the college student who’d been studying across from us politely interrupted to say that she, too, was about to transition to male.) Talking about Aidan, Danielle slipped back and forth between ‘she’ and ‘he,’ saying, ‘I’m still not convinced that it’s a good idea to give hormones and assume that, in most cases, it will solve all their problems. I know the clinics giving them out think they’re doing something wonderful and saving lives. But a lot of these kids are sad for a variety of reasons. Maybe the gender feelings are the underlying causes, maybe not……………….Danielle said that she had met many teenagers who seemed to regard their bodies as endlessly modifiable, through piercings, or tattoos, or even workout regimens. She wondered if sexual orientation was beginning to seem boring as a form of identity; gay people were getting married and perhaps seemed too settled……….’The kids who are edgy and funky and drawn to artsy things—these are conversations that are taking place in dorm rooms,’ Danielle said. ‘There are tides of history that wash in, and when they wash out they leave some people stranded. The drug culture of the sixties was like that and the sexual culture of the eighties, with AIDS. I think this could be the next wave like that, and I don’t want my daughter to become a casualty.’

Danielle thinks that “Aidan” is going through an identity struggle. Just as many people believe that a young person presenting as “schizophrenic” is also going through an identity struggle. The acquiescence to patients groups for the two conditions by psychiatry is telling. The DSM-5 continues to cling to the stigmatizing schizophrenia diagnosis, despite the opposition of those so labelled, but it has done away with the Gender Identity Disorder diagnosis, and replaced it with the more obfuscating term “Gender Dysphoria.” One group is listened to by psychiatry, the other is not.