Grey Matter Episode 7: Transitioning Minors Part 2: Gender Dysphoria Zeitgeist

“Transitioning Minors Part 2: Gender Dysphoria Zeitgeist”
by Kaitlin Puccio

There is debate about whether certain psychological disorders emerge and disappear in society in waves. That is, a certain disorder will suddenly appear in large numbers in a population and then fade away, similar to the way in which fad diets function, but different in that the disorder in some ways actually manifests to a degree in individuals from excessive exposure in the public consciousness. If true, this can be harmful to those who actually suffer from the psychological disorder outside of the zeitgeist.

One argument that supports the idea of psychological disorders becoming part of the zeitgeist is that currently our society has numerous cultural issues that we didn’t have in the past. For example, there is a joke weaving rapidly through social media to the effect that no one in a Gen X high school was gluten-free or transgender, and now suddenly these issues are rampant.

The response is that these issues are more widely known and recognized now, and if we solely point to the fact that no one was gluten-free in high school in the 1980s, the argument could be easily defeated as simply having been ignorant of the issue. This presumably is where the term “woke” originated—as in we have been awakened with regard to recognizing the issue.

The counterargument is that something changed in society, leading to the issue becoming ubiquitous. For celiacs, who must avoid gluten, one unconfirmed suspicion is that the “something” that changed is wheat itself, which may be different from the wheat of years past and is thus more difficult to digest. (There is no evidence of this yet, and this does not explain celiacs’ need to avoid rye or barley, but it is one possibility that has been raised.) For the transgender issue, the “change” might be zeitgeist.

While some awareness is beneficial, too much emphasis on an issue may become harmful. For example, managing celiac disease requires that individuals eat gluten-free food to avoid damaging the lining of their small intestine, which would leave the body unable to properly absorb nutrients. It is a serious disease for a relatively small percentage of the population. With an increased awareness and understanding of celiac disease came the gluten-free fad. This was initially good for celiacs in that, for instance, restaurants started serving gluten-free food and doctors knew better how to treat symptoms, but there came a point at which too much mainstream, fad-driven discussion of the gluten-free diet made it difficult to be taken seriously as a celiac. Celiacs started to get eye rolls in restaurants when ordering gluten-free because so many people without celiac disease, non-celiac gluten sensitivity, or the more rare wheat allergy were claiming to be gluten-free and ordering gluten-free avocado toast to accompany their gluten-laden beer.

The same tipping point applies to the transgender issue. For some individuals, it really is an issue. But how many of the loudest voices we hear are really dealing with the issue, and how many are solely moving with the tide? The latter may be making it more difficult for those suffering from gender dysphoria to be taken seriously and get the treatment they need, which may include medical intervention. In particular, individuals with no background in child psychology encouraging minors to explore “being transgender” is, at the very least, unhelpful to the cause.

Assume that the goal is to find a solution that results in the least harm for the greatest number of individuals. If the status quo is that only those who have reached the age of legal majority can make the decisions necessary to facilitate gender transitioning (for reasons that would need to be delineated, such as brain development with regard to decision-making capacity and the percentage of the minor population actually affected by gender dysphoria), the correct immediate step to take in finding the solution that will result in the least harm for the greatest number of individuals may not be reevaluating what laws should exist about preventing or permitting transgender “treatments” for minors—whether that is gender reassignment surgery or otherwise—but what exceptions should be available to minors.

Perhaps those under the age of 18 (the youngest age to which this could apply would need to be discussed) who actually suffer from gender dysphoria would be able to transition sooner—assuming that transitioning is the recommended clinical “treatment” for such a psychological disorder (gender dysphoria is in the DSM)—if the laws allowed for exceptions in particular cases. Exceptions would be granted, for example, based on the recommendation of trusted psychologists (who can be trusted and what literature can be relied upon is another open question) after evaluating the minor, and of doctors after evaluating the child’s medical fitness for a particular course of treatment. Questions about whether exceptions should be granted for the minor without the consent of the parents would need to be answered. The parents’ involvement would need to be a part of the psychological evaluation of the minor as well (are the parents unreasonably unsupportive? Supportive but hesitant? Irrational? How does their behavior affect the child’s self-image and perspective on the issue?), in addition to an evaluation of the long-term effects of transitioning (aside from long-term physical effects, would the child be mentally capable of thriving in society as a transgender individual? Do the risks outweigh the benefits in this particular case?).

Creating blanket laws permitting youth transitioning that do not necessarily apply to the greater population—and that may in fact be promoting gender dysphoria in impressionable and previously unconfused minors—gives rise to opposing laws meant to prevent gender transitioning for all minors, including the small percentage that might actually benefit from such an early transition as determined by medical professionals. This is because lawmakers of the latter persuasion see the harm that is potentially done by large-scale encouragement of youth transitioning where no gender dysphoria exists on a large-scale. This blocks the line of vision of such lawmakers with respect to the few for whom gender dysphoria is a real issue.

With issues like this, there can be no indefinite moral abstractions. There needs to be a practical, applicable solution. The solution shouldn’t be imposed from the perspective of one side or the other depending on the state—or the school, or a teacher, or anyone with a political agenda and too few facts—and it shouldn’t be imposed without hearing from trustworthy and unbiased psychologists who are unconcerned with virtue signaling about the actual prevalence of the issue and the repercussions of both preventing and encouraging transitioning in minors, and hearing from those who were actually affected by gender dysphoria in their youth.

There will be cases supporting both sides that will be pointed out during discussions of possible solutions: someone who transitioned young and regrets it, someone who transitioned young and doesn’t regret it, someone who wishes he had been able to do so but wasn’t, and someone who is glad that she didn’t transition during her tomboy phase. All perspectives are important, but none should be the ultimate dictator, and personal perspectives without more cannot be a final conclusion of an argument. Before an attempt is made to come to a solution about what path allows for the least harm for the greatest number of individuals, if that is indeed the agreed-upon goal, we need to understand the underlying facts about child psychology, the prevalence of gender dysphoria in minors, and the long-term risks and benefits of transitioning at an early age—and how early is too early from a developmental rather than legal perspective is a key question.

The merits of arguments against gender transitioning for individuals under the age of legal majority are discussed further in “Transitioning Minors Part 1: Decision-Making Capacity Under Age 18.”

Copyright © 2023 Kaitlin Puccio