The story of Keira Bell, the 23-year-old British girl who at the age of 16 began the transformation into a male and who now regrets the choice, is circulating all over the world. Keira accused the London clinic where she had started her the transition, of not having investigated sufficiently the reasons for her request to change sex and of having approved a desire that a young person of that age is unable to express in full awareness; she also denounced the excessive speed with which children and adolescents undergo hormonal therapy to change sex.
Keira's case has brought into the spotlight a very complex but little debated issue: the treatment of gender dysphoria in adolescents and children. This issue is thoroughly presented in the above mentioned book, which gives voice to concerns about therapeutic approaches to transgender children; therapies that are spreading from England and the Netherlands to other states. The curators, Moore, honorary professor at the School of Health and Social Care at the University of Essex, UK, and publisher of the international journal Disability and Society, and Evans, philosopher and social theorist, with particular experience in the medical field, especially with regard to the sexual body and gender, have been studying the subject for years and are committed to spreading a critical awareness of the phenomenon of transgenderism and gender dysphoria.
A book that helps to reflect on sex change
The book contains essays and reflections by academics, psychiatrists and parents, as well as young adults who regret having embarked on the process of transition from biological sex to perceived sex, and aims to demonstrate that transgenderism is not a biological reality, but an 'invented' concept with no basis in neuroscience, psychology or psychiatry. The authors argue that there is little evidence to support claims that the brain is sexual and no evidence that some fetuses develop with mismatched brains and bodies. In particular, the authors observe: "the idea that transgenderism is an internal, pre-social phenomenon that has existed throughout history is not an evidenced fact, but a proposition”.
Ideological propaganda or scientific freedom?
Ideological propaganda would act as a shield for the medical practices used to support the transition to sex change; practices which, as Moore and Evans' text highlights, are also carried out in adolescents and young children and consist in the administration of drugs to block puberty, while the person has to decide which gender to belong to. This is what happens in England, in London, with the contribution of the National Health Service, at the Tavistock Centre, the clinic responsible for the treatment of gender dysphoria even in pediatric age and which in recent years has recorded a significant increase in the number of children treated, and currently presents long waiting lists.
The book deals with the controversial medical practice of administering hormones to healthy children and adolescents, with an average age of around 12 years, putting them at risk of infertility, to support their perception of a gender identity different from the biological sex. The treatment also goes as far as surgery to eliminate secondary sexual characteristics, in order to 'accompany' and prepare the transition, even anatomical, to the opposite sex.
The text focuses its attention on how the positive affirmation harms children. By ‘positive affirmation’ we mean the undisputed acceptance of the desire, manifested by children, to belong to a gender other than biological; at the same time parents are advised to support this idea of the child, which is considered more real than his physical conformation. The ‘positive affirmation’ is often accompanied by a “social transition”: children can take on a new name, adopt pronouns and clothing associated with the opposite sex and gain access to previously forbidden spaces. Moreover, during this process, transgender children become famous: they are testimonials of courage and emancipation.
However, the authors of the book point out that if pandering to the acquisition of a new identity can ‘freeze development' by preventing sexuality from maturing, it can also increase confusion in the child due to the misalignment of body and mind development.
What can be done then?
For years many people have wondered what can be done to counteract this phenomenon. The book tries to give an answer by highlighting first of all the need to bring out of the 'spiral of silence' the critical voices of what seems to be the dominant mentality, both in the socio-cultural and in the medical-scientific field, which is moving towards an increasing acceptance of the transition process from pediatric age. In fact, the fear of being accused of obscurantism, bigotry, transphobia, leads many to keep beliefs, perplexities and fears about this topic to themselves.
Moreover, it should be remembered that, as reported in an article published in the scientific medical journal Lancet in 2018, the biological sex is determined immutably by two specific chromosomes at the moment of conception, while gender is a social expression. Certainly the profound suffering that situations such as gender dysphoria and the discomfort of not accepting one's biological sex create in the person are a real problem. But the manipulation of puberty with the use of drugs created for other purposes is also an actual problem. However, the consequences of irreversible and hazardous invasive medical interventions should be rigorously evaluated.
Without denying the complexity of the issue, it would be desirable to have a society that listens, safeguards and protects young people by accompanying them in a process of growth in the healthy development of the perception of their body and their image, helping them to appreciate themselves as they are. Parental figures must be role models in this process within an adult society that, instead of promoting “freedom of choice” should protect the most fragile members from self-harm.