Monday, September 11, 2017

A Comparison of Ritual Sexual Abuse and Transgender Mass Hysteria: Part 2

     "The media transmits and amplifies hysteria; it refines the stories....But hysteria doesn't take root in a society until it can work its way into a community's most important institutions:  the government, the justice system, the schools, medicine...."  (Richard Beck, We Believe the Children p.107).
     This is the second part of this discussion of similarities between the sex abuse scandals of the 1980s and 1990s and the current transgender mass hysterias.   I want to repeat that I do know that children are sexually abused and that adults who have been sexually abused as children may suffer many consequences of that abuse in their adult lives.  Likewise, there are some people for whom sex reassignment medical treatments are their best option for a happy and productive life.  However, these blog posts are focused on the fact that in ritual sexual abuse/recovered memory cases and in the current burgeoning of transgender diagnoses and treatments there is a significant element of mass hysteria that ends up causing a lot of harm to patients, families, and institutions while making it more difficult for patients to get good treatment.   The first part can be found here.
     There will be two more parts, one more on important similarities between the two cases and one that looks at important differences and distinctions. All page numbers are from Richard Beck, We Believe the Children: A Moral Panic in the 1980s, 2015.

Organization of key players into official groups that promote their agenda
     In the field of child sex abuse, there was the Pre-school Age Molested Children's Professional Group (p. 40) which spread the sex abuse narrative.   In the case of ritual abuse the first conference "Day Care Center and Satanic Cult Sexual Exploitation of Children" was organized by the FBI in 1985.  Once people came together "a scattered collection of rumors took on an official institutional reality that it never would have acquired without the FBI's help".   Lists of ritualistic indicators were distributed.  "In classic paranoid style, these lists made the ordinary ("singing", "ropes", "jewelry") ominous through cataloguing and classification."  (P.121).  The FBI started doing trainings and handing out credentials which helped validate local police's belief in ritual abuse (p.123).
     Likewise, "....the professionalization of the Multiple Personality Disorder (MPD) field helped to make therapist's beliefs more durable".  Peer review made it possible for MPD advocates to create an echo chamber in which their beliefs were validated.
     Many professionals made their careers by first creating the sexual abuse scandals and then becoming part of the "solution".   Beck's chapter 3 deals with the zeal of prosecuting attorneys who bent all rules of common sense and evidence.  They succeeded in destroying families as children were taken from accused parents and placed in foster care. These children were interviewed constantly until they broke down and began to tell the stories that prosecutors wanted to hear.  Many children later recanted their false testimony.  One child said "I figured I'd never be able to go home now.  I mean I'd just called my parents everything from sexual abusers to murderers,  I mean it wasn't real, it was like being in a movie, it wasn't real"  (p. 90).
     Janet Reno made her career prosecuting a case against a couple in Miami who ran a daycare center.  The whole abuse narrative had worked its way into law enforcement, science, medical and psychological practice by this time.  "The speed and efficiency with which Janet Reno was able to obtain her convictions indicated  just how much the legal, medical, and psychiatric professions had learned, how enthusiastically they incorporated what had recently been fringe ideas as part of standard procedure" (p. 145).

     In a similar way, transgender ideology and practice has been greatly amplified by the many groups formed and conferences held where the transgender orthodoxy is spread and affirmed.  With almost no good research to support the definition and diagnosis of gender dysphoria, no good research on the drugs and surgeries used for the purpose of medical transition, and no long term studies of psychological outcomes for those who medically transitioned as opposed to those who chose not to, belief without knowledge is what is being transmitted through the transgender organizations and conferences.   WPATH is a leading organization which holds conferences and accredits transgender practitioners.   As with MPD patients and their sexual abuse narratives, the lack of any clear definitions has led to a slippery slope of medical treatment for sex reassignment to medical treatment for any kind of variant gender identity or body dysphoria  as can be seen in these analyses of the conference held in 2017.  Conferences are monitored to make sure that no alternatives to the reigning narratives are presented.   For instance, The 2017 Philly Trans Health Conference initially accepted panels on detransition and alternative ways to treat dysphoria, but cancelled these sessions two weeks before the conference citing terrorist threats as their reason, but later also saying that only people who have passed ideological muster can present. 
     The people and organizations who support the conferences mentioned above are all making their careers on the identifying and transitioning an ever growing number of people and are focusing on acquiring younger and younger patients, so that children as young as two (and their parents) are brought into the transgender fold. For instance, at the conference "Clinical Essentials for Increased Understanding of the Diverse Transgender Community" in 2016, parents were told by a physician that their pre-verbal children are trying to communicate that they are transgender.  Evidence includes little girls taking barrettes out of their hair and little boys unsnapping their onesies.

The Psychologists and Doctors
     One important factor in the growth of the sexual abuse scandals was the "discovery" that adults did not consciously remember abuse.  Multiple Personality Disorder filled that gap by positing that people could have multiple personalities and only one of them, often deeply hidden, would have knowledge of the abuse.  MPD was first listed in the DSM-III.  This allowed for the founding of The International Society for the Study of Multiple Personality and Dissociation"  which "set out to lend a credentialed air, if not actual credentials to its members."  Soon there were journals and special clinics at medical centers to treat patients with MPD (p. 127).  Psychologists were soon finding patients with ever more personalities who described increasingly bizarre childhood traumas.
     "The revised DSM-III showed just how far MPD had come."  MPD became more prominent and more exciting with therapists discovering not just two but even over 100 personalities in a single person.  It was also linked more absolutely with childhood sexual abuse. (p. 129).
     "That the "true believers, as they were sometimes called, remained at the center of the MPD movement for so long makes little sense from an academic perspective; medicine is supposed to test new theories and dismiss those that don't make a passing grade, and MPD could have been dismissed rather easily.  Medicine, however, is also a profession with political interests and considerations like any other..."(p. 130).   The variations and changes in the terms "dissociation" and "repression" made it tricky to determine the scientific validity of MPD (p. 225).
     The use of unverified medical theories to prosecute cases of sexual abuse was rampant.  Without any control group, appearances of children's anuses and hymens and other physical signs were declared evidence of sexual abuse.  Doctors who had done actual research on the variation in children's genitals were excluded from testifying at trial (p. 202).
     Clinics opened across the country treating MPD, making certain that patients were dependent and in contact with the therapists and that patients were constantly in contact with each other.  Patients came to see themselves as betrayed by their families and created surrogate families of those like themselves who were seen as the only ones they could trust (p. 223).
      Research that makes little sense or isn't really relevant to the issue is cited again and again as evidence for MPD and its symptoms.  Research on recovery of memories of childhood events could not be replicated and were arbitrary hypotheses meant to support a given thesis (p. 226-228).
      Checklists of symptoms that indicated whether people might have a repressed memory of abuse made everyone a potential patient, helping to draw people in.  Such lists include "an interest in religions, preference for baggy clothing, promiscuity, celibacy, workaholism, breast lumps, trouble sleeping, fear of closets, fear of coffins, alertness, vagueness, gambling, etc. etc. (p. 231).
     The example of Loni, a patient who became totally dependent on her therapist and her narrative of MPD and sexual abuse, who realized during a period away from her therapist that she did not really have MPD, is indicative of the need for therapists and patients to be in constant contact in order to sustain these narratives (p. 235).
      This Episode of This American Life from 2002 "An Epidemic Created By Doctors" documents a patient who had, under the influence of her therapist, come to believe she had been abused by her father, the destruction of the father's career and of her family, and her eventual realization that these recovered memories were false.  Her father is also interviewed. There is also an interview with a (different) therapist who had been trained in helping patients recover memories who eventually came to the conclusion that she had been complicit in the recovery of false memories.  Both the patient and the therapist interviewed here realized the harm they had caused to families.

      Those who have followed the rise of transgender ideology and practice will recognize many parallels with the rise of MPD that Beck documents.  Clinics are opening all over the country and the world to diagnose and treat gender dysphoria.  The number of clinics and the number of diagnoses has gone up exponentially, with a 1,000% rise in transgender diagnoses in the UK in just five years, and over 40 clinics in the United States dedicated to gender transition services, most opening in the past five years.  Cross sex hormones can be accessed with only self diagnosis much more widely, for instance Planned Parenthood has become the major provider in the United States.
      Why has a formerly rare condition become so much more common?  Why have the criteria by which sufferers are diagnosed continued to change so rapidly?  No longer does a person need to spontaneously announce at a very young age that they are "really" the opposite sex and persist in that belief into adulthood and go through several years of therapy and live as the opposite sex for an extended period before receiving sex reassignment surgery.  Now, there are no requirements, no evaluation, no waiting period--all these are denigrated as "gate keeping" and professionals are expected to just accept whatever a patient says at face value and provide the treatment that is asked for.  Now, a person's feeling of their gender is seen as both fixed and immutable, such that a two year old is seen as having a fixed gender identity.  Assertions about the essential quality of gender identity exist side-by-side with assertions that gender identity is changeable from day to day.  A recent Internet post reads "....when I'm male, I go by Steve.  When I'm female, I go by Amy.  When I'm neither or both, I gov by Amy-Steve...."  There are over one hundred gender identities listed on Genderfluid Support. and doctors who before were treating people who felt like they were the opposite sex.  Doctors like Olson-Kennedy will provide drugs and surgeries for any identity they are presented with, as people go on their "gender journeys" as this excerpt from the 2017 UPATH  conference shows.  Not only are there over one hundred gender identities, there is also the new phenomenon of adolescent girls becoming transgender in a group, so a group of four girlfriends suddenly are a group of four boyfriends.  I've talked with a parent in my community about a parallel situation to the one reported in the letter documented above. This proliferation of genders and of diagnoses and treatments really should raise some red flags, as they are increasingly in the realm of the absurd.
     Do people who have sex reassignment surgeries and hormone treatments to change their body so that it corresponds to the "real" gender in their minds then go on to live happy lives?  Some seem to.  However, these treatments often do not lead to the "cure" that was promised.  Even after years of drugs and surgery, patients may remain unsatisfied.  One transwoman later had their nose and ears amputated.  People who are fully supported by family and friends still go on to commit suicide, indicating that likely there were undiagnosed and unexplored mental health issues.  You can read some of these stories here, here, and here
     Many people have changed their minds about their diagnoses, gender identity ideology, and their own transitions.  Such a change would be impossible under the theory that biological sex is a social construct and gender identity is an immutable aspect of the brain.  Those who detransition frequently speak of other conditions that they now think motivated their desire to transition.  What I Needed:  An Open Letter to Therapists From A Detrasnsitioner, gives a good idea of how therapists can fail patients who present with self diagnosed gender identities.   This survey of 211 detransitioners gives a good overview of the experience of females who transitioned and later re-identified as female.  Detransitioners often come to believe that transgender ideology is a cult.  Discussion of transition regret, of people who are happy that they did not go through medical transition and no longer identify as transgender, and of detransition is actively suppressed by transgender activists and ignored by psychologists, and surgeons.  Two scheduled panels at the recent Philly Trans Health Conference that dealt with detransition and alternative way to handle gender dysphoria were cancelled at the last minute under pressure from transgender activists.  Here is a report on what happened by one of the presenters who was banned. 
     None of this has been taken seriously by the liberal media or by the professionals who are profiting in both money and fame.  This in itself is a sign that we are in the grip of a mass hysteria.

     The first part can be found here.

The author is a scientist. She has a child who identifies as transgender.  She knows that this is a complex and difficult subject and welcomes reasoned discourse.

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Saturday, September 2, 2017

A comparison of ritual sexual abuse and transgender mass hysterias: Part I

     "The media transmits and amplifies hysteria; it refines the stories....But hysteria doesn't take root in a society until it can work its way into a community's most important institutions:  the government, the justice system, the schools, medicine...."  (Richard Beck, We Believe the Children p.107).

  I recently finished reading Richard Beck's 2015 book We Believe the Children:  A Moral Panic in the 1980s.  Beck chronicles the satanic ritual abuse cases brought against family members and daycare center workers; scandals that involved children claiming to have been forced to make pornographic films in other cities, kill all classroom pets, dig up graves, and being sexually abused in satanic rituals.  Beck tracks the ensuing panic throughout the country and the involvement of law enforcement, doctors, psychologists, and schools in spreading the beliefs that fueled the mass hysteria, including the doctrines of the infallibility of children's testimony, multiple personality disorder and recovered memories.  He shows how evidence and science were disregarded, replaced instead by the rhetoric of true believers in these shocking tales of abuse.

     I was reminded, on almost every page, of the way transgender ideology has swept through families, psychology, medicine, the legal system, schools, and other institutions without regard to evidence, logic, or negative outcomes.  In both cases, there is some possible truth at the bottom on which a house of cards can be built.  Certainly there are children who have been sexually abused and adults whose lives have been deeply affected by a history of childhood sexual abuse.  Likewise, there are children and adults who are uncomfortable with their sexuality and the constraints of gender norms and who suffer various forms of dysphoria.  But, these known facts cannot account for the amazing proliferation of symptoms and beliefs that constitute a mass hysteria.  I think it worthwhile to remind ourselves of  how these mass hysterias have manifested themselves in the past and still are working today.  I will go through some of the topics Beck covers that have parallels in the current spread of transgender ideology and practice.   Of course, the two situations have important differences, but I am focusing here on the similarities. Page numbers in parentheses are from the first edition Beck, 2015.

Adults influencing children in order to get them to agree to the narrative the adults are seeking and/or coming to support narratives of which they were initially skeptical
    This was a major feature of the daycare abuse scandals.  Police, therapists, and parents interviewed children as young as 3 for hours, often telling them that they already knew what had happened, until the child, who had initially denied that he or she had experienced or witnessed abuse, came up with a story of abuse at daycare or at the hands of relatives or friends.  Then they were made to repeat these stories, elaborate on them, and have them reinforced and solidified in their minds. (see Introduction and many other examples throughout the book).
     Similarly, doctors like Olson-Kennedy has been recorded giving an account of using this technique on a child who did not initially agree that she was really a boy.   Laws have been passed in many states that promote transgender identities in young people by making it illegal for psychologists to do anything but affirm and support a transgender identity, even when symptoms may not suggest that this is the right diagnosis.  It is rare to find anyone whose trans identity follows the "classic" narrative so often repeated in the press in which a child spontaneously claims a feeling of being born in the wrong body, insisting for many years that he or she is really the opposite sex with no prompting from parents, social media, friends, teachers, psychologists or other authority figures.  Although a few of these "classic" cases exist, children who are gender stereotype non-conforming are frequent targets for transitioning by parents or led to believe by teachers and peers, that their gender stereotype non-conformity is necessarily a sign that they are "really" the opposite sex. Here is a discussion of this phenomenon from an LGB perspective.   In adolescents and young adults,  it is often a case of social contagion, ideological belief, or a case in which clear symptoms of depression, trauma, or schizophrenia are fit into a transgender framework.  This study of female detrransitioners gives a good overview of the causes of transition.

      During the sexual abuse scandals, children's sexual abuse narratives were strengthened by sending them to retreats such as Heart to Heart.  At this retreat, children did not need to bring up sexual abuse themselves; it was introduced by a charismatic psychic who had a vision of an abused girl. (P. 184).   As Beck notes, the narratives of abuse were drawn out of the children by intensive questioning by authority figures,  but these abuse narratives could not have solidified without the support of parents "who do the crucial work of reinforcing those allegations in their well-intentioned efforts to be supportive." (p. 204).
     Likewise, kids who have been identified as transgender have their identities reinforced by sending them to camps such as Rainbow Day Camp where they can go to be together and be affirmed in their transgender identities and narratives along with their parents.

     It was not just the children who eventually gave in and told stories of ritual abuse.  Adults who were accused of sexually abusing children often ended up making false confessions in order to support the narratives of the children, even their own children.   Paul Ingram, a police officer who had gone through sexual abuse training became caught up in allegation of abuse of his children.   He was well primed by his fellow police officers and his own beliefs to confess yet said at one point "Boy, it's almost like I'm making it up, but I'm not".  His allegations against himself got more and more bizarre and included satanic ritual abuse and many murders (p. 188-189).    Even when confronted later with evidence that his confessions were false, Paul Ingram maintained that they were true.  Beck comments that the false beliefs about himself that Ingram generated "at great personal cost" would have been hard to relinquish along with the benefits.  "It allowed him to say and believe that his daughters always told the truth no matter how crazy their stories became" (p. 191).
     I believe there is a similar dynamic going on between parents and their transgender children.  In order to justify the diagnosis and treatment, stories are told by parents about their kids' play habits, clothing choices, hair preferences, and statements about their preferred sex.  The narratives are remarkably similar and often feature tropes such as the little boy trying to cut off his penis with scissors, though I have never seen an account that resulted in a visit to an emergency room.  Parent narratives have the parent always walking in just on time to prevent harm, the realization that their son is transgender and that they must start him on the road to sex reassignment.  There are many such stories; you can read some herehere, and here.   In a similar way to the child sexual abuse scandals, parents, teachers, and psychologists seek to make the children's statements fit a prefabricated narrative.  The children are rewarded when they comply with much more care and attention from parents and other adults.  The children in the ritual abuse scandals became symbols of the failure of society to protect them and became "special" children who would now require a lifetime of special psychological care and attention to deal with their trauma.

     Parents are coerced into supporting the transgender child narrative with assurances that their child will kill herself if she is not immediately transitioned and the narrative of the heroic care that such a special child will require from her parents.  The suicide narrative appears in Transgender Support organizations and from the psychological community.  Parents help spread the panic by falsely reporting suicides, like the viral thread claiming 8 transgender child suicides and one on life support after Donald Trump's election.  Once parents embark on the process of transitioning their children, a process that involves changing the way they are dressed, their name, and their pronouns, as well as chemical sterilization, surgeries to amputate healthy sex organs, and a lifelong regimen of steroid hormones, it is certainly in the parents' interest to be the most determined cheerleaders for the truth of this narrative, as the alternative, that they have had their children chemically sterilized, their sexual parts amputated, and administered dangerous drugs in service of a fantasy, would be just too painful.

Children, Parents, and Therapists Go From Ordinary to Heroic
     Beck writes of the parents at McMartin School in Manhattan Beach, CA "The case offered opportunity for personal and political transformation, a chance to become fiery activists....More generally, McMartin lent a sort of heroic glow to the very idea of parenting..."  One mother is quoted as saying "We have learned that there is no such thing as too much parental love and reassurance to a child who has been molested" (p. 96).  Of  course, these children had not actually been molested.
    Multiple Personality Disorder (MPD) became a popular diagnosis.  This allowed adults to suddenly remember having been sexually abused as children and gave these adults a heroic, survivor narrative.  It gave "victims" an identity that defined them and gave them the life work of recovering from these newly remembered traumas (P. 217).  After discovering through recovered memories that they had been abused, life became a series of crises that could go on for ten years and more as they went through prescribed stages to become whole and healthy (p. 218).  The book The Courage to Heal gave victims, therapists, social workers and others invested in recovered memories of sexual abuse a refutation proof narrative.  "No one fantasizes abuse...Believe the survivor....You must believe that your client was sexually abused, even if she sometimes doubts it herself....Be willing to believe the unbelievable."  (p. 219).
     Psychologists got to share in these dramas as well.  "Like their patients, therapists found the high drama of recovered memory work intoxicating....the outlaw status of their project held at a wary arm's length by psychiatry, until all of sudden it wasn't also made it easy for therapists to think of themselves along the lines of nineteenth-century psychiatric pioneers whose genius would eventually induce an awed respect in society at large (p. 229).

     The heroic narrative is also central to people who transition and their parents.  There are dozens of TED talks, for instance, that all send the parental message of loss, love and overcoming, like this one.  Transition narratives include years of suffering, most often from an unknown cause, until suddenly a sufferer learns about transgenderism and all the pieces fall into place.  The person now knows that their discomfort and unhappiness with their lives comes from being born in the wrong body and they can become whole and healthy by transitioning.  This process is heroic as it involves all sorts of physical pain and risk from surgery and drugs, it involves confrontations with family and friends who may be skeptical, it involves bringing lawsuits to force at least the semblance of belief in the transgender ideological position in schools and work places.  The process of becoming who "they really are" can go on for decades as they go through the stages of changing names, pronouns, official records, learning to act feminine or masculine, and of course seeing the effects of the steroid hormones and the many surgeries that are needed to finally be able to "pass" as the opposite sex.  There are legions of Facebook pages and other social media in which people document all the steps of their transitions, their goals, their successes and setbacks as they try to achieve these goals and there are many Internet sites telling people what these goals should look like.  Here is one such Transition Roadmap and Time Table.

Part 2 of this comparison will look at the roles of schools, doctors, clinics, psychologists, academia, and law makers in influencing and spreading mass hysteria.  it will also examine the two cases from the perspective of feminism.

The author is a scientist.  She has a child who identifies as transgender.  She knows that this is a complex and difficult subject and welcomes reasoned discourse.

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Thursday, May 18, 2017

Transexual Murders in the U.S.--Are they hate crimes?

 Transgender murders gets a lot of attention in the press and are heavily emphasized by the trans-activist community with Transgender Day of Remembrance and many press reports keeping count of the year's transgender murders.  The implication is that these murders are hate crimes.  There has been one conviction and sentencing for the murder of a transgender person under U. S. hate crimes law.    Joshua Vallum  was sentenced to 49 years in prison for killing his ex-girlfriend Mercedes Williamson.  Vallum, a gang member, killed Williamson because he feared that his fellow gang members would discover that he had dated a transwoman.

The trans-activist community gets upset when anyone suggests that the murders of transpeople are more properly looked at as associated with prostitution, drugs, domestic violence, or robbery.
These murders are tragic for the victims whose lives are cut short and who always have hopes, dreams, and aspirations for their lives.  The murders are tragic for the family and friends of the victims.  The question I want to ask is how these murders can best be prevented.  To do that, we can't just assume that they are hate crimes.  We have to do our best to look at the specific circumstances of each murder.

I looked at transgender murders for the year 2014 in the U.S., hoping that police investigations, arrests, and trials would have been completed and we would have a good picture of what happened in each case.  The names came from the Wikipedia page listing transgender murder victims. Here is a brief outline of the victims and the outcomes of the cases, if known.  If anyone has more accurate information about arrests or trials of perpetrators please let me know and I will correct or update this blog

Yazmin Shanchez:  Race: Black.  Yazmin was shot and her body partially burnt.  Yazmin had a history of arrests for prostitution, cocaine and other charges.  Yazmin had been seeing Terry Brady, the man charged with the murder.    Brady had an extensive prior criminal record and was sentenced to life in prison for the murder.  The motive was Brady's anger that Shanchez had publicly outed him as gay.

Kandy Hall:  Race: Black.  Found murdered in a field.  Kandy had four arrests for prostitution.  Not solved. 

Mia Henderson:  Race: Black.  Henderson had several prior arrests for prostitution and was killed in an area known as a "hotbed" for drugs and prostitution.  Shawn Oliver, the man charged, was acquitted.  He claimed they had consensual sex the day before.  Henderson, whose birth name was Kevin Long, was mourned by brother Reggie Bullock.  Reggie took a lot of heat from the transgender community for referring to Henderson through his own experience with a brother, rather than calling Henderson a sister.

Zoraida "Ale" Reyes:   Race: Mexican American immigrant.  Reyes and Parkerson, the murderer, met online and agreed to meet to have sex.  He says he accidentally strangled Reyes during a consensual encounter in a car.  Randy Parkerson was convicted of second degree murder and sentenced to 15 years to life.

Tiffany Edwards: Race: Black.   Quamar Edwards, the murderer, shot Tiffany Edwards after giving her a ride and then deciding not to have sex.  Tiffany wanted money and they came to blows.  Both had extensive criminal records.

Alejandra Leos:  Race: Latina.  Leos was shot and killed by Marshall Pegues after a lover's quarrel.  Pegues was indicted for first degree murder.  I have not seen any follow-up to this case.

Aniya Parker:  Race: Black.  Parker was shot in the head in a drug related crime. Ulises Carcamo was convicted of murder and sentenced to 50 years.  Eric Carrillo, who was a minor at the time of the killing, testified in the case and got a plea deal.  He pleaded no contest to a manslaughter charge and was sentenced to nine years.

Ashley Michelle Sherman:  Race: Black.  Ashley , also known as Tajshon, had an arrest record for prostitution and commercial sex and well as being reported as the victim of harassment and abuse.  This murder is unsolved.

Breana "Gizzy" Fowler:  Race: Black.  Mallory Porter shot Breana and later was arrested, took a plea deal and was sentenced to 15 years for the murder.  The two had met for sex.  I could not tell from the reporting what happened. Some reports say the two already knew each other, some say that Mallory thought Breana was a female and was surprised and scared to find out he was anatomically male.  Fowler presented as a male known as Gizzy to his friends, but had an online persona as a female named Breana.  

Deshwanda Sanchez:  Race: Black. Sanchez was shot by Robert Spells while pounding on a door for help.  The two knew each other, but police did not disclose what sort of relationship they had.  Robert James Spells was arrested and charged with murder during the course of a robbery.  He is facing 30 years to life and also is charged with sex trafficking an 11 year old girl.  It is not clear if Deshwanda's transgender status played a role in this crime.

The accounts that police, reporters, friends, and witnesses put together are always flawed by the fact that the murder victim does not get to speak.  The murderer, even when he confesses, still gets to tell his story and there is another side that we do not hear.  However, certain patterns stand out.  All transgender murders reported in the U. S. in 2014 were people of color.  There are many white transwomen, but they are not murder statistics.  Transmen are also not being murdered.

The situation with the murders of these transgender people of color is complex.  Two of these murders were unsolved at the time of this writing.   Multiple factors are involved in each case.  How can we tell, from a crime or a pubic health perspective, what the risk factors are?  What are the rates of murder in the cities where these murders occurred?  for men?  prostitutes in general?  women?  those involved in the drug world?

None of these murders is a clear cut hate crime in which the perpetrator decided to kill  a transgender person specifically because they were trans.  However, in two of the cases, Deshwanda Sanchez and Breana Fowler, the trans identity of the victim may have played a part.  If not for the trans identity or the presentation as a woman at the time of the murder, these crimes fall into familiar patterns of drug deals and prostitution, sexual meet ups, and robberies gone wrong or some kind of domestic dispute.

On the other hand, many female prostitutes are murdered every year and though these are not prosecuted as hate crimes, many could be.  Prostitutes are frequent targets of serial killers for instance and these killings would fit the definition of hate crimes if women are considered a targeted group.  However, this would require a change in police and prosecutor perceptions and practice when any prostitute is murdered.

In general the press reports are frustrating to read.  Trans-activists highlight what they call mis-gendering and dead naming of the victim.  Their focus is on getting the press and the police to use the gender the victim currently identifies as and the name the victim is currently using.  They complain that they may not know of the death of a friend because police used genitals to identify the victim's sex and report a legal name that may be different from the name current friends use.

On the other hand, reporting that uses a victim's gender presentation and name associated with the current gender identity may mean that family and old friends do not know of the death.  Family and old friends often only know the victim based on their personal experiences from the past.  So, a brother will mourn the death of the brother he grew up with, not the transgender woman he never knew.  It seems wrong to insist that only the most current gender identity and name be used, as that obscures the fact that the person has a history which includes a gender change. 

Also, a very broad definition of transgender may label people as trans who do not identify themselves as transgender. This further confuses the picture.  In reporting on these cases, press and police, to the extent they are able, have an interest in all the facts that may be relevant.  These facts include the birth name and sex as well as the current preferred gender identity and name.

How can such murders be prevented?  Are they best prevented by campaigns that humanize trans people and call for tolerance of difference?  Certainly such campaigns can be beneficial.  However,  would these particular murders have a better chance of being prevented by programs that help people leave prostitution or get clean from drugs, or give them job skills, or help them go to college?  Can life be made safer for those working as prostitutes?  Given that all the perpetrators were men and almost all had histories of crime and violence, would focusing more of our attention on perpetrators of violence help to reduce crimes such as those reported here?

Despite frequent claims to the contrary and the difficulty of finding reliable figures, transgender people do not appear to have the highest murder rate of any group.  The focus on gender identity may obscure more important underlying patterns of violence.  These calculations show that their murder rate is below that of both men and women in the U. S.  It is very difficult to get reliable statistics as there is considerable disagreement about who qualifies as transgender and many murders are not well investigated or are not reported in the press.  Clearly, we need to be more careful in gathering evidence and reporting statistics.

Many of the murdered transwomen were connected with prostitution, which is known to be a dangerous profession with high level of violence, including murder, perpetrated against them.  The murder rate for those involved in prostitution is particularly high as is the rate for those involved in illicit drug dealing.  Again, it is difficult to get reliable statistics on these rates, but this page gives some context and a death rate of 204/100,000 for prostitutes, which is a much higher rate than those calculated in the previous link for women, men, and transwomen.  It does suggest that these particular murders should not immediately be assumed to be "trans" murders, but need to be evaluated in the contexts of the particular communities these people lived in, in terms of poverty, race, and occupation.  How can we work to prevent future murders if we refuse to look carefully at the evidence that we have about the context of the murders of transwomen of color?

Tuesday, May 9, 2017

The Science of Male, Female, And Transgender Difference

This post is not directly related to the Privacy Matters case, but it does relate to the issue of the diagnosis of gender dysphoria.  Consider this entry a work in progress, as new studies come out on this topic fairly often.  The reason for looking, however briefly, at some of the studies done so far is that they are rather widely discussed in the press and because the claims made about these studies are put forth to justify policy decisions.  The main question for this post is whether any scientific studies give us an adequate basis for such decisions.

Preliminary Conclusion
There is no scientific consensus and no reliable research on brain features or physiological responses that can identify transgender individuals or predict, based on brain scans, who is or will later identify as transgender.  In general, sample sizes are too small, alternate hypotheses have not been examined, the definition of who is transgender, controlling for other mental health conditions, and many other factors are not considered.  Trans advocates often complain that there are not enough of them to get the sample sizes needed for a reliable scientific conclusion based on good statistical evidence.  This is likely true.  At the moment, transgender brain science cannot be a meaningful aspect of the conversation and we need to look elsewhere in our attempts to form just policies.

I will look at a few of the studies of male/female brain differences and transgender physiological responses to illustrate the kinds of research that are being done, the difficulties with these studies, and what they would need to overcome in order to produce reliable results.  I start with a recent large scale review article.

Research on Overall Differences and Similarities Between Male And Female Brains and Bodies
The paper Sex Beyond The Genitalia:  The Human Brain Mosaic published in 2015 is a meta-analysis of many studies looking at the question of male and female brains.  The Abstract reads

Whereas a categorical difference in the genitals has always been acknowledged, the question of how far these categories extend into human biology is still not resolved. Documented sex/gender differences in the brain are often taken as support of a sexually dimorphic view of human brains (“female brain” or “male brain”). However, such a distinction would be possible only if sex/gender differences in brain features were highly dimorphic (i.e., little overlap between the forms of these features in males and females) and internally consistent (i.e., a brain has only “male” or only “female” features). Here, analysis of MRIs of more than 1,400 human brains from four datasets reveals extensive overlap between the distributions of females and males for all gray matter, white matter, and connections assessed. Moreover, analyses of internal consistency reveal that brains with features that are consistently at one end of the “maleness-femaleness” continuum are rare. Rather, most brains are comprised of unique “mosaics” of features, some more common in females compared with males, some more common in males compared with females, and some common in both females and males. Our findings are robust across sample, age, type of MRI, and method of analysis. These findings are corroborated by a similar analysis of personality traits, attitudes, interests, and behaviors of more than 5,500 individuals, which reveals that internal consistency is extremely rare. Our study demonstrates that, although there are sex/gender differences in the brain, human brains do not belong to one of two distinct categories: male brain/female brain.

This study comes to similar conclusions as others.  There is no such thing as a female brain in a male body or vice versa, because brains are not dimorphic.  Moreover, the authors state in the Discussion that "Another noteworthy observation is that the size of the sex/gender difference in some regions varied considerably between different datasets (Table S1). This finding is in line with previous reports that the existence and direction of sex/gender differences may depend on environmental events and developmental stage (4, 5)".

The paper The landscape of sex-differential transcriptome and its consequent selection in human adults is being posted in my Facebook feed by various groups.  I read the original paper. The authors find that over 6,500 genes are differently expressed in males and females.  This points to the physical reality of biological differences between males and females beyond obvious differences in reproduction organs.  Since virtually every human cell in a person's body has the exact same genome, it is noteworthy that the genes may be expressed differently in different tissues in males and females.  The authors, Moran Gershoni and Shmuel Pietrokovski looked at differential expression in order to better understand human evolution and especially the persistence of genes that can produce negative effects such as infertility.  They hypothesize that such gene alleles (alleles are variants of a particular gene that codes for a particular protein) could persist if they were important for one sex, even if deleterious for the other.  Most genes they tested were expressed the same in men and women.  However, among the ones that had sex differentiated expression (SDE), "the most sex-differentiated tissue, with 6123 SDE protein-coding genes, is the breast mammary glands....This suggests major differences in the physiology and sex genetic architecture of this tissue. We found 1145 genes to be SDE in non-mammary gland tissues. The most differentiated of these tissues, with over 100 SDE genes, are the skeletal muscle, two skin tissues, subcutaneous adipose, anterior cingulate cortex, and heart left ventricle...."   These differences in gene expression lead to biological differences between males and females.  The authors postulate that infertility and various sex-biased human diseases could result from this differential expression, especially when the traits expressed are critical for reproductive or other functions in one sex and not in the other.  The mammary glands are a good example of this disparity.  Known differences between males and females in musculature, fat deposition, and heart anatomy are supported by these results as well.  While this study was not meant to support or refute a biological basis for transgenderism, it does make clear that to practice good medicine and for an understanding of human evolution the distinction between males and females is essential.

Research on Disorders of Sexual Development (DSD)
In their review article "Research Supporting the Biologic Nature of Gender Identity" in Endocrine Practice (2014), Sarawat et al. set out to find evidence that transgender identity is based in biology.  The authors conclude in part "Studies of DSD patients and neuroanatomical studies provide the strongest evidence for an organic basis to transgender identity."  Here I examine one of the studies used to support their conclusion, Reiner and Gearhart's  "Discordant Sexual Identity in Some Genetic Males with Cloacal Exstrophy Assigned to Female Sex at Birth."  published in 2004.  Cloacal Exstrophy is an extreme condition in which the whole pelvic area is abnormal.  Organs may be outside the body, the bladder and intestines are not distinct, and in genetic males the penis is severely atrophied or absent, though testes are normal.
     This study looked at 16 genetic male patients.  All had extensive neo-natal surgeries to repair damage.  Fourteen of them were castrated and surgically given facsimiles of female external sexual anatomy.  Parents were told to raise them as females and to make sure they never found out that they were genetically male.  Two parents refused the sex reassignment surgeries for their sons.  These sons identified as males.  The authors used a variety of questionnaires and interviews with patients and their parents.  The patients varied in age from 5 - 12 when first enrolled in the study and a follow-up was done between 3 to 6 years later.  Patients were not told anything about their medical history; they were told that the study was meant to assess psychosocial development.
     Unfortunately, not a lot of data is presented.  However, of the 14 males who received sex reassignment surgery, 8 had declared themselves male either spontaneously (2) or after being told of their birth status by parents.  All patients who knew of their birth status began identifying as males.  One would not discuss sexual identity.  Five patients continued to identify as female and those who were adolescent were taking estrogen. 
     The authors rated the patients on questions about toy choice, rough and tumble play, interest in marriage, sex of friends, and wishes to be a boy.  The scale ran from 1 - 5, with 1 being a typical female response and 5 being a typical male response.  Though these are idiosyncratic criteria, the results showed that most of the patients fell into the male range (I counted this as an average score above 3).  The two whose average scores were below 3 identified as female.   Both parents and patients were asked to list the child's three favorite activities during age 5 - 8.  Most mentioned sports of various sorts.  Only one mentioned reading and music.  Interesting to me was that in 5 of the cases there was no overlap between the parent and child responses and in 5 more cases there was only one overlap.  I mention this because often the parent is used as the authority who declares if the child is content with his sexual identity.  The authors could not ask the patients directly because the birth sex was supposed to be a secret.  It seems significant that none of the parents of patients identifying as female would allow their children to participate in follow-up interviews.  They answered all questions themselves.
     Patients who ended the study identifying as males were more likely to be sexually active, discuss sex and sexual attraction, and to date.  Patients who identified as female did not discuss sex or sexual attraction and none of them dated, even though 4 of them were aged 16 - 19.  Though they were not part of this study, girls with cloacal exstrophy known to the authors all identified as female and did express interest in dating and sexual relationships.
      This limited study supports a general view that genetic males with normal hormonal response at birth tend to identify as male and engage in what we think of as typical male behaviors, despite being castrated close to birth and being assigned to be raised as females.  Lack of a penis and testosterone after infancy did not inhibit these typical patterns.  This certainly suggests that male genetics and male typical behaviors have some sort of natural basis.  The authors were very concerned that 100% of patients who learned their birth histories switched their identification to male.  Would this also happen with the 5 who still identified as female if they knew the truth? 
     Even though cloacal exstrophy is not an intersex condition, the authors come to the same conclusion that has become common with many of those conditions.  It is better to leave the kids alone and not attempt to reassign sex based on the absence of a functional penis.  The patients who later identified as male all wished for testosterone and to have penis reconstruction surgery.  In conclusion, this paper offers some evidence that male genetics coupled with normal hormone status at birth is associated with male-typical behaviors.  It does not offer evidence supportive of the biological reality of a transgender identification.  The authors realize that it is very hard to separate cultural, parental, and natural factors.  They admit there are many "imponderables".  

Research That Aims To Identify Differences Between Transgender Individuals And Others. 
The first topic is a series of studies on a brain region known as BSTc.  It is interesting to see the progression of the studies.

Zhou et al in 1995 looked at the volume of the central subdivision of the bed nucleus of the stria terminals (BSTc).  This research looked at 6 transexual male-to-female brains and found that the volume of the BSTc was in the female range, rather than the male range for this structure.  Kruijver et al in 2000 looked at these same brains, but evaluated the BSTc for number of neurons, rather than overall volume. In Male-to-female transsexuals have female neuron numbers in a limbic nucleus., they show that this difference also shows up in neuron number.  In 2002, Wilson et al published a study in the Journal of Neuroscience that found that the BSTc region did not sexually differentiate significantly until adulthood.  Since transsexuality is often claimed to be inborn and to manifest in very young children, it is difficult to see how the BSTc could be used as a reliable  marker to identify transexuals.

Anne Lawrence critiqued these studies in a 2007 paper.  She emphasizes that neither of the first two papers took into account whether the MtF brains studied were from homosexual or heterosexual transexuals, nor did they adequately consider whether the cross sex hormones taken by these individuals might have caused the differences observed.  She also critiques Zhou's study for fishing through the data in order to find a brain region that showed differences, rather than hypothesizing that the particular brain region focused upon should show such differences.  Thus, without  replicating these results, we cannot accept them as confirmed.

I could not find the full text of this next paper,  so I am using several articles that report on it.

Scientific American Mind, January 1, 2016
"Spanish investigators—led by psychobiologist Antonio Guillamon of the National Distance Education University in Madrid and neuropsychologist Carme Junqué Plaja of the University of Barcelona—used MRI to examine the brains of 24 female-to-males and 18 male-to-females—both before and after treatment with cross-sex hormones. Their results, published in 2013, showed that even before treatment the brain structures of the trans people were more similar in some respects to the brains of their experienced gender than those of their natal gender. For example, the female-to-male subjects had relatively thin subcortical areas (these areas tend to be thinner in men than in women). Male-to-female subjects tended to have thinner cortical regions in the right hemisphere, which is characteristic of a female brain. (Such differences became more pronounced after treatment.)"

“Trans people have brains that are different from males and females, a unique kind of brain,” Guillamon says. “It is simplistic to say that a female-to-male transgender person is a female trapped in a male body. It's not because they have a male brain but a transsexual brain.” Of course, behavior and experience shape brain anatomy, so it is impossible to say if these subtle differences are inborn."

Another report on this study in New Scientists, 2011 comments that  "Guillamon isn’t sure whether the four regions are at all associated with notions of gender, but Ivanka Savic-Berglund at the Karolinska Institute in Stockholm, Sweden, thinks they might be. One of the four regions – the superior longitudinal fascicle – is particularly interesting, she says. “It connects the parietal lobe [involved in sensory processing] and frontal lobe [involved in planning movement] and may have implications in body perception.”

The New Scientist article also mentions two other studies that might bear on this question:

"A 2010 study of 121 transgender people found that 38 per cent realised they had gender variance by age 5. White matter differences could provide independent confirmation that such children might benefit from treatment to delay puberty."

"A study by Sean Deoni‘s team at King’s College London suggests it may soon be possible to look for these differences in such children. Deoni’s team adapted an MRI scanner to be as quiet as possible so it could be used to monitor the development of white matter in sleeping infants. Using new image analysis software they could track when and where myelin – the neuron covering that makes white matter white – was laid down (Journal of Neuroscience, vol 31, p 784). Although the sample was too small to identify any gender differences in development, Deoni expects to see differences developing in the brain “by 2 or 3 years of age”."

Guillamon commented about these studies:  “Research has shown that white matter matures during the first 20 to 30 years of life,” he says. “People may experience early or late onset of transsexuality and we don’t know what causes this difference.”

Physiological Responses
Berglund et al 2008 looked at the sensitivity to the odor of certain steroid compounds using12 MTF subjects compared with controls using a variety of techniques.  They report: "In summary, albeit the present study does not provide conclusions concerning the possible etiology, it suggests that in transsexuals the organization of certain sexually dimorphic circuits of the anterior hypothalamus could be sex atypical. It adds a new dimension to our previous reports by showing that the observed effects are not necessarily learned and that a sex-atypical activation by the 2 putative pheromones may reflect neuronal reorganization."

Burke et al published Click-evoked otoacoutstic emissions in children and adolescents with gender identity disorder in 2014.  These CEOAE emissions are echo-like sounds produced in the inner ear that have different amplitudes of detection in males and females. Based on a test with 47 transgender subjects and 127 control subjects, the authors conclude in part: "Based on the assumption that CEOAE amplitude can be seen as an index of relative androgen exposure, our results provide some evidence for the idea that boys with GID may have been exposed to lower amounts of androgen during early development in comparison to control boys." 

The Archives of Sexual Behavior published a tapping experiment led by Dr. Laura Case on eight transgender men and genderqueer individuals who wanted a double mastectomy.  These eight people and eight non-transgender women were tapped with a pencil on their hands and on their upper breasts, while clothed while brain activity was recorded with a neuroimaging machine.

They found that when tapped on their upper breasts, the transgender and male-leaning genderqueer subjects had a reduced response in brain areas that are thought to make “self-other” distinctions.  The authors speculate that the low response to breast tapping is a physiological manifestation of gender dysphoria.  Case notes that  “Scientific reductionism is unlikely to yield a simple explanation for a phenomenon as complex as gender identity.”

These studies give us some preliminary results without giving us strong evidence for a biological basis or biological marker for identifying transgender individuals.  Notice that most of the researchers sound notes of caution when communicating about the significance of their studies.  They use terms like "suggests", "based on the assumption", "provide some evidence", and "we don't know".   However, these studies should serve as a base from which other researchers can try to replicate results, and go back and investigate some of the aspects that were assumed, but not known to be true--such as the association of the BSTc with sexual behavior in humans.  Finer grained studies and analyses are  needed to distinguish between homosexual and heterosexual transgender men.  We may need to control for underlying mental health issues such as depression, autism, and prior sexual trauma--all of which have been associated with female-to-male transitioners.  Age of transition and social factors also need consideration.

It is often difficult to get robust statistical and repeatable results when the number of participants is so small, and this is likely to remain a difficulty with transgender studies.

Review and Opinion Articles Frequently Cited

 Nature article "Sex Redefined" by Claire Ainsworth
This article has been frequently posted to "prove" that sex is not binary and that Science proves that transgender people are real.  The article was published in Nature 18 February 2015.

This essay focuses on intersex conditions, in which the chromosomes and/or the biology of an individual are not 100% male or female.  Intersex biology has a great variety of causes.  Depending on how intersex is defined, the occurrence is anywhere between 1% with the broadest definition to .05% with a narrower definition.  There are many types of DSD conditions (Disorders of Sexual Development), many of which do not produce any symptoms and which do not affect fertility, sexual response, or gender identity.  Many people never know they have these conditions.

The subjects covered in the Nature essay are fascinating.  Since 1990, scientists have discovered over 25 genes that affect sexual development in some way and have discovered non-genetic routes to DSDs as well.  For instance, some mothers acquire male cells from being pregnant with a male fetus and these cells may become part of her body.  Scientists have found that XX vs. XY chromosomes in cells affect more than sex hormones; they can also create metabolic differences within the body.  One woman, pregnant with her third child, was found to have a mixture of XX and XY cells in her body thought to be acquired from a conjoined twin that never developed.  In mice, it was found that production of eggs or sperm could be affected after birth if certain genes were blocked.

The condition that garners the most medical concern is when a child is born with ambiguous genitalia such that a parent or doctor cannot easily identify the baby as male or female.  Until recently, parents and doctors would make a decision and surgery would often be used to alter the genitalia to better fit either the male or female sex.  The child would then be raised in the sex that had been picked.  This produced a variety of problems, particularly when the child later declared a gender identity at odds with the parent or doctor's choice.  Intersex adults became active in changing the view that it was necessary to do sex assignment surgery on infants or children.  They argue that if there were no health issues, such surgery could wait until children were adults able to give informed consent and could choose for themselves whether to have surgery and what sex they wished to affirm.

This essay addresses intersex conditions, both genetic and anatomical.  Sex researcher John Achermann is quoted "I think there is much greater diversity within male or female, and there is certainly an area of overlap where some people cannot easily define themselves within the binary structure."  It is statements of this sort which transgender activists use to prove that transgenderism has a biological basis.  This biological basis is then used to bolster their social and legal demands.

Transgenderism is not specifically addressed here. However, some transgender activists believe that showing biological ambiguities between males and females can also account for the feeling that you are born in the wrong body.  This claim would have to be substantiated by screening people who identify as transgender or non-binary and seeing if this identification reliably correlates with any of the 25 genes or other anatomical intersex conditions.  Would those that identify as transgender have these gene mutations at a significantly higher rate from those that identify as male or female?

Is biological determinism a valuable argument for establishing the legitimacy of transgenderism?  If we look at arguments about gay genes, which have been going on since the 1980s, we see that there is still no agreement.  Yet, articles pro and con keep appearing, such as this recent one from Newsweek.   One of the reasons for the continued disagreement is that it is very rare for one gene to "determine" anything.  There are multiple genes for most traits and these genes interact with many others to affect whether and how they are expressed.  Also, environmental factors such as upbringing, peer groups, and social situation affect expression of traits in many different ways. Homosexual identity can take many different paths and manifest at different times of life as can a transgender identity.  All these factors make it hard to "prove" anything about transgenderism from the kind of research reported in this article.

Even if such research produced positive conclusions, we still need to further ask what social and legal consequences should follow.  For instance, if a certain gene correlated with gender dysphoria in males with male anatomy, does that mean that these men are "really" and completely women?  It would seem that they are biologically ambiguous and choose to identify with and practice certain culturally female activities.  Does it follow that such men should be able to join all women's sports teams?  Does it mean that the typical anatomy, genetics, and physiological functions of over 99% of females should be disregarded and the definition of female changed so that the functions of giving birth or nursing are not considered female?  Does it follow that all men should now be able to access formerly female spaces such as showers and changing rooms?  These are typical demands of transgender activists and they use articles like "Sex Redefined" to support their case, though here as elsewhere more research is needed on both the biological and the sociological aspects of these questions.

These are not simple questions with obvious answers.  Doctors warn that there is much we do not know.  "They think that changing medical practice by legal ruling is not ideal, and would like to see more data collected on outcomes such as quality of life and sexual function to help decide the best course of action for people with DSDs...."

One important achievement of the intersex activists has been to forego medical interventions until patients were old enough to give truly informed consent.  Experience with child genital surgeries had shown that very often sexual function and response were compromised and the possibility that these surgeries might not be necessary at all was another reason to delay.  In contrast, transgender activists and their doctors are pushing for earlier and earlier drug and surgical intervention, ignoring what would seem to be relevant experience from doctors and patients from the intersex community.

Here are some more resources from Fair Play For Women

Differences between male and female part 1:  Bones and Muscles

Better Science With Sex And Gender:  Facilitating The Use Of A Sex And Gender-based Analysis in Health Research.  

     The authors argue that sex and gender-based analyses (SGBA) are important for health behavior and outcomes.  They quote Kreiger...."...our science will only be as clear and error-free as our thinking" and stress the importance of distinguishing sex and gender in order to promote better health outcomes.  To this end  they give definitions of sex and gender, suggest three ways that researchers can use SGBA in research (revisit a study or reanalyze the data, augment an existing research plan, or use SGBA from the outset), and share their experience conducting "knowledge translation workshops" on the use of SGBA.  
     The authors complicate sex by saying that not all females are alike and not all males are alike, citing chromosomal anomalies as an example of why sex is a spectrum.  They never use this distinction to make any important points about health care. They do a decent job defining gender and distinguishing it from sex and argue that sex affects gender in society in lots of ways that might be important for understanding a person's health. Women's health advocates have been stressing these links for a long time, for instance that being emotionally abused by your partner who does not consider females to be quite fully human can cause all sorts of physical symptoms. Yet, the authors don't cite examples like this. 
     The authors are concerned with turning knowledge into action (knowledge translation).  They discuss their experiences running workshops to help people incorporate SGBA into their research.  They state "Despite our best intentions to keep the format of the workshops simple and the concepts easy to understand, we often worried that participants hadn't fully grasped the concepts, or would be unable to integrate sex and gender into their work after they left the workshop."  The facilitators of these workshops felt that "hands-on" activities like asking people to stand on a line between 100% male and 100% female in order to express their own gender identities were useful.   They state further: "One of the most difficult aspects of conducting the workshops was the limited measurement tools available to suggest to participants for use in their research and programs."  This is a major difficulty for health researchers.  If they can't have an operational definition that can be measured, it is impossible to incorporate a concept like gender identity into a research program.  
     The only examples the authors use have to do with easily determined sex differences in health conditions such as stroke, mentioned in the introductory material and a longer example at the end on knee injuries and the different ways that women and men report pain and are treated. However, sex was the only variable they mentioned, not gender. If they wanted to look at gender, they could look at whether gay men or transwomen reported knee pain differently or were treated more like women than men. That would be interesting, but the authors seem a long way from that. 
    This article from 2009 was published in the International Journal For Equity in Health.  All three authors are transgender advocates and activists.  Lead author Joy L. Johnson is a trans activist whose dissertation was entitled Promoting Positive Self Identity, Health, and Safety in Transgender Children: A Children's Book For Everybody. Second author Lorraine Greaves was head of Transcare BC, and third author Robin Repta writes about ending the gender binary.  This paper, unfortunately does not forward their cause as it adds no new information, uses the usual distinctions that queer theorists and transgender activists use when discussing gender, and does not reinterpret or reconfigure known information in new and helpful ways.

Wednesday, May 3, 2017

Civil Rights in the Age of Transgender Youth: Part 2, Privacy

This blog examine issues arising from the federal lawsuit  Privacy Matters v. U. S. Department of Education.  Background and terminology can be found in the first entry on Sexual Harassment.  This suit concerns a Minnesota junior high/high school in which a male-bodied student (as defined by sex at birth) began identifying as female gender and was allowed to use female bathrooms and locker rooms. I am starting from court documents and other public statements by the contending parties, to try to understand the issues through a legal lens.

A major focus of this case is whether requiring girls to change clothes and use bathrooms in the presence of a male-bodied person is a violation of their privacy. 

Privacy is raised as a constitutional issue in the
 initial complaintThe heart of their argument is:

341. The Fifth Amendment protects citizens against violation of fundamental rights by federal actors. The Fourteenth Amendment protects citizens against violation of fundamental rights by state actors. 

342. Fundamental rights are liberty interests deeply rooted in the Nation’s history and tradition and implicit in the concept of ordered liberty.

343. Each Girl Plaintiff has a fundamental right to bodily privacy that, at a minimum, includes protection from intimate exposure, or risk of intimate exposure, of her body and intimate activities to a male. It also includes the corollary protection from intimate exposure, or the risk of intimate exposure, to a male’s body or intimate activities.

344. The fundamental right to bodily privacy is deeply rooted in the Nation’s history and tradition and has long been recognized in the United States Constitution and federal and state statutory and common law.

345. The fundamental right to bodily privacy is also implicit in the concept of ordered liberty because a government that compels its citizens to disrobe or attend to intimate activities in the presence of the opposite sex violates the core of personal liberty.

346. Such an abridgement of fundamental rights is presumptively unconstitutional and can only be justified if it survives strict scrutiny under which the law must serve a compelling state interest by the most narrowly tailored means. (p. 57 - 58).

Legal Background
Right of Privacy is defined as "the right of a person to be free from intrusion into or publicity concerning matters of a personal nature....NOTE: Although not explicitly mentioned in the U.S. Constitution, a penumbral right of privacy has been held to be encompassed in the Bill of Rights, providing protection from unwarranted governmental intrusion into areas such as marriage and contraception. A person's right of privacy may be overcome by a showing that it is outweighed by a compelling state interest."  

The aspect of Right of Privacy most applicable to the situation in which a male-bodied person enters a female space is "Intrusion of Solitude", defined as
 "Intruding upon another's solitude or private affairs, physically or otherwise, is subject to liability if this intrusion would be considered highly offensive to a reasonable person. This type of invasion of privacy is commonly associated with "peeping Toms," someone illegally intercepting private phone calls, or snooping through someone's private records."

Ordered Liberty is the view that fundamental constitutional rights are not absolute but are determined by a balancing of the public (societal) welfare against individual personal rights...."ordered liberty" describes a polity that has reconciled the conflicting demands of public order and personal freedom. 

Legal cases that address the issue of intimate contact between male-bodied and female-bodied people tend to involve strip and cavity searches in prisons and the right to get a pat down from a same sex TSA person at the airport.  In general, court decisions have upheld a view that such searches should be done by a person of the same sex as the person being searched unless a compelling reason such as lack of a same sex personal or an emergency situation makes this difficult or impossible.  This article examining court cases concerned with
Cross Gender Strip Searches of Prisoners gives perspective on the wide range of decisions that have been handed down.  

Incidents involving transgender people have caused controversy.  In the UK, female guards refused to strip search a male prisoner who claimed to be female, but was not undergoing any hormone or surgical treatment.  A recent TSA incident involved a male-bodied airline passenger going through the body scanner.  A button is pushed  indicating whether the scan will be of a male or female.  The male-bodied person identifying as female was flagged by the system and subjected to a pat down for a gun or weapon in the genital area.  Typically, such procedures must be done by an official of the same sex as the one being searched. A  person claiming a transgender identity causes confusions for which we presently have no agreed upon standards.

Perspectives of ADF and ACLU
The conservative Alliance Defending Freedom and the Liberal ACLU take on cases that often are very similar.  For instance, both litigate cases defending free speech on campuses. The two organizations cite the same constitutional amendments and the concept of ordered liberty in defending the rights of their clients.  Above, the ADF cites the right of privacy in the fifth and fourteenth amendments and the concept of ordered liberty in defending the privacy rights of girl plaintiffs. 

The ACLU has used these same concepts in their litigation.  For instance, in this amicus brief (p. 22-23) the ACLU invokes the fifth amendment and ordered liberty when defending Apple from FBI attempts to force them to write code enabling the FBI to hack into iPhones.  On the issue of  student dress code the ACLU cites a need to balance public goods with personal freedoms:  "Many school districts claim stringent dress codes increase their emphasis on academics, disperse gang activity, and reduce pressures stemming from socioeconomic status. But they can also violate a student’s First Amendment right to freedom of expression and a parent’s Fourteenth Amendment right to raise their children as they choose."  In an amicus brief for Vacco v. Quill (1996), The ACLU argued in favor of a terminally ill patient's right to die with dignity using the fourteenth amendment right to privacy and the concept of ordered liberty.   

The Plaintiffs' core privacy argument in this case hinges on the assertion that girls are being compelled by the government, in the guise of the U. S. Department of Education and the Virginia School District in Minnesota, to disrobe and perform other intimate bodily functions in the presence of a male-bodied person and are being exposed to a male-bodied person disrobing.  Plaintiffs deny that there are overriding government interests to compel this loss of bodily privacy and that other available remedies are not being used.  The ACLU sees this lawsuit as part of a larger "anti-trans strategy".  Their position was stated in an opinion piece in the New York Times by ACLU attorney Alexandra Brodsky, in October, 2016.  Brodsky wrote:

"The focus on privacy marks a shift in anti-trans strategy. Earlier efforts, like North Carolina’s House Bill 2, which limited bathroom access, relied on a dangerous myth that prohibiting discrimination against transgender people would allow predatory men to enter women’s restrooms. That approach is giving way to a new focus on privacy — narrowly defined to include only non-transgender women and girls....But the fake-feminist privacy argument is apparently more tolerable to liberal minds — and perhaps more dangerous for that reason."

As noted in the Complaint: 107. Under the District Policy, any student in any District school, pre-school through 12th grade, has unrestricted access to private facilities based on the students’ professed gender identity. 108. A student need not provide the District any medical or psychological confirmation of a diagnosis of gender dysphoria. 109. This Policy authorizes males to enter female-specific private facilities and vice versa for students aged three to eighteen (P. 23).  
If we examine the Incidents on Record link list of over 60 reported incidents of male-bodied people in female locker rooms, bathrooms, showers, and changing rooms we can get a sense of what the situation is like in the United States.  These newspaper articles of reported incidents include: 

34 incidents reported male-bodied persons, dressed in women's clothes
28 of the incidents involved videotaping and recording of women and girls using the   toilet, showering, or changing clothes.
27 of the perpetrators targeted underage girls
11 perpetrators had a prior history of violence and/or sexual offenses
9 of the incidents were rapes or physical sexual assaults
7 perpetrators identified themselves as transgender.

The types of incidents reported ranged from spying on girls under or through bathroom stalls, videotaping, rape and assault. Suspects were variously charged with invasion of privacy, sexual assault, child pornography, unlawful use of a concealed camera for purposes of sexual gratification, eavesdropping, capturing or distributing images of an unclothed person, using a computer to commit a crime, aggravated sexual exploitation of a minor, and more.

This list of incidents is enough to establish that violation of privacy has occurred in female intimate spaces and that the risk of sexual predators masquerading as transgender or actually living as transgender females is not a "dangerous myth" but a documented fact. Concerns about privacy grade into concerns about safety, as spying with a computer tablet camera can devolve into more serious child pornography charges.  In addition, it is surprising that Ms. Brodsky characterizes the protection of women and girls from unwanted male voyeurism in their intimate spaces as "fake-feminist", as this is a long standing issue in feminist communities. 

Augmenting the charges of violation of the right to privacy, Plaintiffs bring charges related to religious freedom, using both the U.S. and Minnesota Religious Freedom Restoration Act statutes. These religious issues will be the focus of the next blog entry.  The crux of this case is how sex is properly defined under the law.  The Defendants assert that inner gender identity should be the unquestioned standard, and the Plaintiffs assert a standard based on genital anatomy.  A future blog entry will look at this question from a variety of perspectives.

Update:  Privacy Matters withdrew the suit voluntarily as the Trump administration withdrew the Obama era directive mandating that "sex" be changed to "gender identity" in Title IX and the school made accommodations to protect the privacy of the girls.  Privacy Matters retained the right to refile the suit.

The author is a scientist.  She has a child who identifies as transgender.  She knows that the law is an imperfect instrument and that judges are influenced by their own prejudices and ideologies.  Nevertheless, the law gives us an important venue for presenting facts, asking questions, and making decisions that can illuminate important social issues.

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