A study on transgender children published recently in the journal Psychological Science supports the idea that their gender identification is deeply held, and not a fleeting notion or a confused sense of who they are. Sound Medicine host Barbara Lewis spoke with study author Kristina Olson, PhD, Director of the Trans Youth Project and assistant professor of psychology at the University of Washington in Seattle, to learn more about the study, and her continuing research on transgender kids.
Sound Medicine: What does it mean when a child is transgender?
Kristina Olson: Transgender, at its heart, just means that a child's gender identity, what they say they are, how they identify, is different than what you might expect from the announcement made at their birth. You can think of it as if the doctor said when they were born that they were a boy, and the child now identifies as a girl, we would consider that kid to be transgender.
SM: On the other hand, what is transgender not? What are the common misconceptions?
KO: We get a lot of common misconceptions. A lot of people wonder, for example, if we're now including people who are, like, tomboys as transgender. And no, we don't. Tomboys often are kids who are identified as female by doctors, but they also identify themselves as female. They us happen to have preferences that are for stereotypically male stuff. But those kids don't say "I am a boy."
These kids who are transgender are kids who are saying "This is who I am," and it's not just about what activities I like to play with, or what I want to do, or who my friends are. It's who I am. And that's a pretty big distinction.
And another thing people often confuse is the difference between being gay and being transgender. So one thing to remember is our kids in our study, these kids are often two, three, four, or five years of age when they're identifying as male or female. But kids don't really know anything about who they're interested in romantically at that age. This is really about gender identity, not who someone is or isn't attracted to.
SM: Traditionally, how have child psychologists and other developmental experts recommended that transgendered children and their parents handle their gender identification?
KO: Until recently the thought about transgendered kids is these are kids who are showing psychopathology. And what you needed to do is treat these kids by teaching them "No, you are a boy, and this is how boys act," and you kind of took away or punished them if they're doing girly things. There's also been a history of thinking that the parents are to blame, or there's something other people have done wrong, and so they'll use therapy to try to change the whole family dynamic.
But it's only recently that some psychologists and clinicians and doctors are starting to say "Well wait a minute, might this be what kids are really thinking, and what would happen if we actually support them in this identity? What will their lives look like?" And I will say even today it's pretty split amongst these two camps, of whether they say "support the kids the way they're claiming to be," or whether they say "no we've got to change them to be the 'right' way."
Transgender people have on average about ten times the national suicide rate. They have extreme rates of high depression, anxiety. Lots of transgendered people’s families reject them; they lose all sorts of social support. And I think that's the impetus for people saying "What if we have society change a bit, or our perceptions of these kids change a bit? Can we actually reverse those statistics?" And the families who are in my study are primarily these families.
SM: Let's talk about your new study.
KO: This is an ongoing project of tracking transgender kid’s development. Our first paper is children five through twelve who are being supported in their gender identity. That means they are going to school presenting to everybody the gender they identify as, which is not the thing that the doctor announced the day that they were born. So these are, for example, a kid who might be thought of as a "natal boy," who identifies as female, goes to school as female, looks female if you saw him on the street. These are the kind of kids that are in my study.
SM: How did your study pose questions that truly went to the core of whether these kids identify as male or female?
KO: We have a couple different kinds of tests. We not only asked them questions, but we also gave them computer tasks that measured the speed with which children associated themselves with the concepts of male and female. And it turns out that previous work has shown that if you grab any little girl of the street and she does this task, she's much more likely to think of herself as female than to think of herself as male. So this task had shown that before with the average kid on the street.
What we did is we said: what if we use that measure? Because most of the kids don't even understand what it's doing: they're just hitting some keys, sorting some pictures and words. That task tends to be really hard to fake. Kids don't know what it means. They don't understand that we're recording their speed with which they're categorizing things.
So we gave that task to our group of transgender kids. And what we found was the kids actually looked exactly like what they say they are. So if the kid is transgender and identifies as female, [their results in the study] look identical to any other child who is female -- which suggests to us they're not playing around. This really seems to be the identity that they hold for themselves.
SM: Ok, tell me a little bit about that task. What are they sorting? What are they looking at and deciding?
KO: It's called an implicit association test. Basically what happens is they're sorting pictures of boys and girls into two categories. And then along the way they're also sorting words that are related to themselves or others. So they're words like "me, my, mine," or words like "they, them, other." And they're using these two keys. So sometimes they have to categorize, for example pictures of girls as "me" using one button, and pictures of boys as "others" using the other button
Or they do the opposite: "me" and "boys," and "them" and "girls." And the idea is we're much faster, everybody, if we link them in some way to each other. So if I think of myself as female, then I'm gonna be much faster when "female" and "me" uses the same button than when "male" and "me" uses that same button. This has been used literally in hundreds of studies of different topics about race, about gender, about all kids of social categories. So we just used this one about gender identity in this particular context.
SM: Now you serve as director of an organization called the Trans Youth Project. What are you hoping to accomplish with this project, and what other types of studies are you planning?
KO: Basically this is gonna be the biggest study of transgender children development. We're recruiting children who are three through twelve, and we're hoping to follow them through their development...into the teen years, into the adult years and beyond.
And the idea there is that we can try to understand how this generation, which really is kind of the first generation of kids who are being supported in their gender identity, how are they gonna differ from previous generations?
Today's transgender adults, nearly all of them didn't begin presenting to others as their gender identity until they were already adults. These kids are having a totally different life experience. I often call them "gender pioneers." And we're interested in tracking this first generation of gender pioneers, so that ten years from now, when a parent has a transgender child, they actually can look at all the data. They can say "Well, here's what life looks like for kids who are supported in their gender identity, and here’s what life looks like for those kids who haven't been supported in their gender identity." And then they can make an informed decision for themselves, for what they're looking for.
In this cartoon, mother "Marlo Mack" explains coming to terms with and embracing her young child's gender identity. For more, visit howtobeagirlpodcast.com.