Thinkable Futures, Permissible Forms of Life: Listening to Talk about Trans Youth and Early Gender Transition

This is a time of expanding futures for transgender youth who are able to “buy time” by blocking puberty and transitioning young. Twenty years of clinical literature indicates that suppressing puberty can be lifesaving for trans youth, allowing them to avoid the distress and harm associated with transgender lives writ large. A growing number of “gender affirming” clinics now offer young trans people greater autonomy over their bodies, their futures, and their future bodies. Yet there remain troubling disparities, with indications that clinics are primarily serving white middle class trans youth and that autistic trans youth face delays. This thesis is a discourse analysis of 18 interviews with international health and mental health clinicians and 10 interviews with key stakeholders. Drawing from the literature of queer temporalities, sociological work on time and social power, queer and trans of colour critique, critical disability studies, critical autism studies, and transgender studies, I use an “interpretive repertoire” analysis to ask: How have puberty suppression and early gender transition become thinkable futures for trans youth? This thesis finds that the conditions of possibility that make early transition possible for some, are the same that foreclose it for others. The discourses of maturity and cognitive age, the expected “chrononormative” narrative, and the discourses of crisis and the “race against time”, each work to make outsiders of autistic and racialized trans youth in particular. While there is much to celebrate in the new futures available to trans youth, I argue that puberty blockers currently function as a “switchpoint” moving privileged trans youth onto a track toward even greater privilege, and widening the gap in life opportunities. This thesis introduces the concept of “the temporality of privilege” and calls for greater attention to the political implications augured by the contemporary scene of gender-affirming care for trans youth.ThesisDoctor of Philosophy (PhD)We are in a time of expanding futures for transgender youth who are able to “buy time” by blocking puberty and transitioning to a new gender while young. Clinical research and literature suggest this as a lifesaving option for trans youth, allowing them to avoid distress and harm. Yet there remain troubling disparities with this treatment. Many clinics report they are primarily serving white middle class trans youth and there are some indications that autistic trans youth may be stalled or delayed in the process. I report on a discourse analysis of 18 interviews with health and mental health clinicians across six countries, in addition to 10 interviews with community level experts. I draw on a range of theory and an “interpretive repertoire” analysis to theorize how these futures become thinkable and possible for trans youth, while considering the political implications and unforeseen consequences for those youth unable to benefit

A critical commentary on follow-up studies and “desistance” theories about transgender and gender non-conforming children

Background: It has been widely suggested that over 80% of transgender children will come to identify as cisgender (i.e. desist) as they mature, with the assumption that for this 80%, the trans identity was a temporary “phase.” This statistic is used as the scientific rationale for discouraging social transition for pre-pubertal children. This article is a critical commentary on the limitations of this research and a caution against using these studies to develop care recommendations for gender non-conforming children. Methods: A critical review methodology is employed to systematically interpret four frequentlycited studies that sought to document identity outcomes for gender non-conforming children (often referred to as “desistance” research). Results: Methodological, theoretical, ethical, and interpretive concerns regarding four “desistance” studies are presented. The authors clarify the historical and clinical contexts within which these studies were conducted to deconstruct assumptions in interpretations of the results. The discussion makes distinctions between the specific evidence provided by these studies versus the assumptions that have shaped recommendations for care. The affirmative model is presented as a way to move away from the question of, “How should children’s gender identities develop over time?” toward a more useful question: “How should children best be supported as their gender identity develops?” Conclusion: The tethering of childhood gender diversity to the framework of “desistance” or “persistence” has stifled advancements in our understanding of children’s gender in all its complexity. These follow-up studies fall short in helping us understand what children need. As work begins on the 8th version of the Standards of Care by the World Professional Association for Transgender Health, we call for a more inclusive conceptual framework that takes children’s voices seriously. Listening to children’s experiences will enable a more comprehensive understanding of the needs of gender non-conforming children and provide guidance to scientific and lay communities

“Building a Person”: Legal and Clinical Personhood for Autistic and Trans Children in Ontario

AbstractIn the 1960s and 1970s, psychologists at the University of California, Los Angeles, operated two behaviour modification programs: one aiming to eliminate “feminine” behaviours in male-bodied children (“conversion therapy”), and one targeting autistic children’s so-called problem behaviours (applied behavioural analysis or ABA). The head of the autism program referred to his work as “building a person.” Decades later in Ontario, a radically incommensurate legal context sees conversion therapy banned while ABA receives millions of funding dollars. Drawing on legislation, case law, media, and clinical literature, I argue that the process of trans communities wresting themselves out from under conversion therapy involved discursively shifting fromhavinga condition tobeinghuman—a process of “building a person”—still incomplete for autistic communities. While legal reforms protect some trans youth from harmful therapies, this does not extend to autistic trans youth, leading us to question at whose expense a rights-bearing trans person was built.</jats:p

Autistic Disruptions, Trans Temporalities

The desire for transgender futures has grown exponentially in recent years, but many of these futures are traps, concealing a demand to assume normative and neoliberal priorities in exchange for citizenship and belonging. This article argues that some of these traps might be undone through autistic disruption. Dwelling with the life writing and memoir of individuals both autistic and trans, it suggests that, by choice or by circumstance, autistic-trans narratives defy the chrononormative mandate of the able-minded future. By claiming autism and gender nonconformity as mutually inclusive, foregrounding alternative sensorealities, and interrupting the incitement to get better, this article argues that cripping trans time through autistic disruption offers what Gossett, Stanley, and Burton call a “trap door”: a route of escape from the normate trans future and a way for autistic life to insist on its own continuation and survivance.</jats:p

Suicidality among trans people in Ontario: Implications for social work and social justice

While transgender and transsexual (trans) communities have been documented to experience high rates of suicidality, little attention has been paid to how this may vary based on experiences of social injustice. Using survey data from the Trans PULSE Project (n=433), we estimated that suicidal thoughts were experienced by 36% of trans Ontarians over the past year, and that 10% attempted suicide during that time. Moreover, we documented that youth and those experiencing transphobia and lack of support are at heightened risk. Suicidality varied greatly by medical transition status, with those who were planning to transition sex, but who had not yet begun, being most vulnerable. Recommendations are made for improving wellbeing in trans communities, through policy advocacy, service provision, access to transition care, and fostering accepting families and communities.Bien qu’on ait déjà établi que les membres des communautés transgenre et transsexuels (trans) connaissaient des taux de suicidabilité élevés, on n’a que très peu porté attention jusqu’ici à la façon dont ces taux pouvaient varier en fonction d’expériences d’injustice sociale. À partir des données d’un sondage du projet « trans PULSE » (n = 433), on estime à 36 % la part des Ontariens trans qui ont eu des idées suicidaires dans la dernière année et à 10 % ceux qui ont fait une tentative de suicide durant la même période. La documentation recueillie permet d’établir que les jeunes et ceux qui ont subi des manifestations de transphobie ou qui ont manqué de soutien sont encore plus à risque. La suicidabilité varie beaucoup en fonction du statut médical de transition, les plus vulnérables étant ceux qui souhaitent changer de sexe sans avoir encore amorcé le processus de transition. Les auteurs formulent des recommandations pour améliorer le bien-être des communautés trans par des modifications des politiques à leur égard, par la prestation de services, par l’accès à des soins de transition et par la constitution de familles et de communautés d’accueil

‘Community control’ in CBPR: Challenges experienced and questions raised from the Trans PULSE project

Newer forms of community-based participatory research (CBPR) prioritize community control over community engagement, and articles that outline some of the challenges inherent in this approach to CBPR are imperative in terms of advancing knowledge and practice. This article outlines the community control strategy utilized by Trans PULSE, an Ontario-wide research initiative devoted to understanding the ways in which social exclusion, cisnormativity (the belief that transgender (trans) identities or bodies are less authentic or ‘normal’), and transphobia shape the provision of services and affect health outcomes for trans people in Ontario, Canada. While we have been successful in building and supporting a solid model of community control in research, challenges have emerged related to: power differentials between community and academic partners, unintentional disempowerment of community members through the research process, the impact of community-level trauma on team dynamics, and differing visions about the importance and place of anti-racism work. Challenges are detailed as ‘lessons learned’ and a series of key questions for CBPR teams to consider are offered. </jats:p