In my last role as a school nurse there was a girl who, at the age of 11 told her parents she wanted to be a boy. So,, the parents did what they could and got help from various doctors and experts, and over the course of the next 3 years I got to know this student well, and regardless of what I thought on the matter, was able to support this student. The student knew I had a different perspective but we had a good working relationship and this student appreciated a different perspective eg I disagreed with the hormone blockers, chest compression brace and eventual male hormones.
Anyway, during this student's time here, 2 close female friends of the student decided they were trans as well. The thing is, I believed they were not trans. I knew both of them had serious family issues, including a family divorce, and had also gone through the gambit of self harm - from cutting, eating disorders etc. But the rest of the group of girls all agreed they were trans, and encouraged this.
At about the same time this was happening, Brown university came out with a study looking into ROGD (rapid onset gender dysphoria) which showed that the vast majority of the teens and young adults coming out as trans, were not actually trans. They cited various issues, including media pressure as well as underlying, unresolved psychological issues. Unfortunately, because this study was not 'affirming' of their transition, the study was withdrawn due to media pressure.
Anyway, regardless of my thoughts, these students were sent to the pediatric psychologist, who promptly refused to see them. I knew the psychologist very and and she confided in me that it's far too dangerous a minefield and she could easily lose her licence. She said that basically, any opinion that did not affirm someone as trans risked it all. A second pediatric psychologist I knew also refused to see them.
Anyway, the school decided to go along with one of the girl's requests to be called a boy. I was not happy to do this, but did ask my manager if the girl's parents were aware we were calling their daughter a boy. My manager said 'Yes' the parents were aware.
I was not convinced I was being told the truth, and about one week after being told the parents were aware, the headmaster had a talk with us in the health center, and told us that if we have any communication with the parents, not to call their daughter a boy or use her boy name ie we were told to lie to the parents.
I was not happy to do this, and quit. And now I'm in the middle of the Australian desert having new adventures.
I'm really ignorant about the subject matter based on what I've been reading from the different posts so I've been reading up and I found this study. It's sort of illogical to me anyway that if the drivers of sexuality are hormones which can be artificially introduced if necessary, producing both physical and mental effects, could individuals experiencing the desires to change, actually be in the throes of a hormone inducement? The scientific studies I've perused also seem to support that other chemicals can affect hormones and their manufacturing centers.
I think that's it's significant that in the majority of cases that emotional needs to be a different gender, is frequently accompanied by physical characteristics and behaviors that rudimentary observations can confirm the accompanying feelings. Individuals display both physical and emotional characteristics indicating to me that hormones are definitely at work!
Specializes in Psychiatry, Community, Nurse Manager, hospice.
This is a good discussion to have even if it does get out of hand sometimes.
I think we're missing some important pieces in this discussion.
I think the discussion should start with the idea that we are learning that gender really is a social construct. I don't say this to be liberal or because I believe it. It's not something I believe, it's something science is telling me.
I mean it's mind blowing. Because gender really seems like something biological. But it isn't.
There is currently no scientific way to determine whether someone is male or female. The Olympics tried to do this, and with good reason. They didn't want men ruining women's track and field for women. They couldn't find a biological standard to go by that was fair and made sense.
Its not XX vs XY. We have XX karyotype who are phenotypic males and vice versa. Folks that have all the stereotypical body parts of the one gender with all the biological functionality of the other karyotype. Put another way, sometimes the X chromosome has "maleness" on it and sometimes the Y doesn't. Look it up if you don't believe me.
It's not the quantity of testosterone or estrogen either. We tried that.
Its definitely not about body parts. Some people have body parts that look like both. Or neither.
Its obviously not about whether you make eggs or sperm. Lots of people make neither.
Gender is really a social thing. This is the hardest part for people, I think. We've believed our whole lives that gender was objectively determinable and a hard fact... but it isn't. It's subjective and soft.
So the question then becomes... who gets to make the decision about which gender each person is? And I think that's the easier part. Because once you realize that gender is subjective, most folks will understand that it should be up to the individual. Just like each person can best tell you for themselves whether they prefer the city or the country, mountains or beach, etc, etc.
It might even be a choice. For some of us, maybe it never felt like a choice. It just feels like who we are. But we do get to decide even that... to a certain extent... don't we?
About dysphoria...
Dysphoria has social causes too.
When our feelings about who we are and/or what we want meet with criticism and disapproval from the outside world it creates a dissonance that is often experienced as chronic unhappiness.
So gender dysphoria is going to be a real thing as long as we are confused about what gender really is.
When you understand that gender is subjective, it is not a problem if someone tells you he is a boy and then decides later she is a girl and then decides later he is a boy again. Neither one is more true than the other. I would think young people would do this a lot as they "find their way" "get to know themselves" or as I see it experiment with different options to see what they prefer.
But older people might do it also.
The only real conundrum I see is with young people who want to defer male puberty. Male puberty remodels the body in a way that is hard to come back from. Boys who want to defer male puberty are also too young to legally make their own decisions medically. Thats a conundrum. Right now, their parents have to figure it out.
Should that continue? I don't know. But we have to think about it. And I think we'll know later when we have data as the children that were permitted to defer male puberty get older.
Btripping, if gender becomes a social construct and fluid as you suggest, doesn't that using today's metrics for intelligent people, place those individuals at a disadvantage in numerous ways?
In reality we judge intelligence based on behaviors and interactions which are governed by objectivity and emotional stability. Eg even Einstein would be judged harshly if he was exhibiting say manic behaviors and lability. What does it say overall about individuals vascilating between genders? If emotional instability is questionable in an individual, don't we have social criterion re judging those individuals.
Re the athletes, I remember reading about Castor Semenyor and Dutti if I'm spelling their names correctly..... they are still being questioned? What about the East Germans? Drechler and Koch and currently the Greek woman, the east European athletes, and the grandaddy, Bruce Jenner? A decathlete like Jenner is as close to Superman as you can possibly get.... re masculinity! Emotional instability? Marrying the Kardashian mother? Doesn't that further reinforce the brain scrambling? Bruce Jenner the crux of maleness, Superman, marries the Kardashian mother?
My point being that if gender is attached to social choices instead of biology, that is a massive can of worms to negotiate re societal current norms.
I am lucky through grandparents to be able to access Danish, Swedish and British societies and it's only in America that I see these discrepancies. And, I do not see the level of intelligence or liberal acceptance here, as in Northern Europe. Whereas both are like trends or achievements in America, in Northern Europe they are by products. Eg, Danish women are difficult, but do not subscribe to the politically correct trend in America of how we interact with each other. You are not likely to be Coumoed and pretty much the same in Britain and Ireland. Women want to be desired and pursued in these countries(unless you actually have personal knowledge of these societies, no grief please) Sweden is difficult to judge. Women appear more practical there.
How using societal trends theory/construct will gender morphers be taken seriously especially in America where politics, religion and entertainment seems to drive the acceptable behaviors? It's not like in Europe where culture dictates behaviors, modulated by education and liberalism.
Specializes in Psychiatry, Community, Nurse Manager, hospice.
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Btripping, if gender becomes a social construct and fluid as you suggest
I'll stop you right there and clarify that I am not suggesting that gender has become or should become or will become a social construct. I am asserting that it is and always has been a social construct.
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doesn't that using today's metrics for intelligent people, place those individuals at a disadvantage in numerous ways?
In reality we judge intelligence based on behaviors and interactions which are governed by objectivity and emotional stability.
2 things about this part.
1. It seems like you are asking me if people are going to think gender fluid and gender questioning people are stupid. The answer is probably yes. But we've always called the people we oppress stupid, and we tend to convince ourselves very firmly that this is true. And then we deny them access to resources which frustrates their ability to succeed which then just proves our point. American enslavement of African people is a great example of this.
2. I disagree about your metrics of intelligence in general, but this is probably cultural. I think most people feel like geniuses tend to be emotionally unstable. I am surprised you used Einstein as an example because he spent a lot of his childhood with the dunce cap on in the corner, and he was a very unusual person. Geniuses often are. I could go on about what I think intelligence really is, but it would get off topic really fast.
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What does it say overall about individuals vascilating between genders? If emotional instability is questionable in an individual, don't we have social criterion re judging those individuals.
It seems like you place a high value on people being the same over time. Or their emotions being the same over time. But emotions do fluctuate and that is healthy and fine. And people also change careers, and relationships and all kinds of stuff, and that is also healthy and fine. Sometimes people vacillate between several things for a while and if it isn't causing the person distress I don't see any problem with it. If a person is distressed by their own vacillation, then it could be a problem for them but it isn't something that society should be bothered about, is it? Do we have social criteria in judging people? Well yes, of course we do. But we judge people when their behavior disrupts the social order. Like when they commit crimes or when they are disrupting the delivery of goods and services without a good cause, or being a nuisance. I'm not sure why we would judge people for feeling like a boy or a girl or somewhere in between because it doesn't hurt society at all.
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My point being that if gender is attached to social choices instead of biology, that is a massive can of worms to negotiate re societal current norms.
It's a can of worms, I guess. Most scientific discoveries are. This one isn't as can of wormsy as some of them though. Quantum mechanics for example is a big, big can of juicy fat worms. Imagine the can of worms it was for American slave owners to learn that blacks were equal and actual human beings with the same rights as whites. I'm sure they panicked. Like, how will we keep the plantation? This can't be true! But it is true, can of worms and all.
I have no problem calling people by the pronoun and name they want to be called.
I do have a problem with people being accused of being transphobic for saying that biological sex is real and for wanting to make a distinction. I had someone call me transphobic once because I told them that male and female are real sexes and something completely different from gender (which refers to identity, not biology). It was like they wanted me to ignore sex altogether (even though women have been oppressed on the basis of their sex).
I also have a problem with the fact that trans ideology often is rooting and gender stereotypes. Makeup and fashion do not define femininity. Being nurturing also does not make a person feminine.
I know I am going to get attack from some posters, but I do think certain aspects of the trans movement have gone too far.
It seems like you place a high value on people being the same over time. Or their emotions being the same over time. But emotions do fluctuate and that is healthy and fine.
*I find that people are the same in almost every way. Culturally, emotionally or psychologically. It's what makes them so predictable!
And people also change careers, and relationships and all kinds of stuff, and that is also healthy and fine. Sometimes people vacillate between several things for a while and if it isn't causing the person distress I don't see any problem with it. If a person is distressed by their own vacillation, then it could be a problem for them but it isn't something that society should be bothered about, is it?
*Society is bothered by lability. They are unpredictable which creates the other category leading to the judgement and abuse of the people's rights. Society wants to categorize to encapsulate comprehension.
Do we have social criteria in judging people? Well yes, of course we do. But we judge people when their behavior disrupts the social order. Like when they commit crimes or when they are disrupting the delivery of goods and services without a good cause, or being a nuisance. I'm not sure why we would judge people for feeling like a boy or a girl or somewhere in between because it doesn't hurt society at all.
*Society seriously frowns upon differences evidenced by racism, hate crimes etc.
It's a can of worms, I guess. Most scientific discoveries are.
* Maybe in the scientific community they will be affecting or the previous theories that will be proven wrong but not to the general public who very likely will not know the context.
I disagree about your metrics of intelligence in general, but this is probably cultural. I think most people feel like geniuses tend to be emotionally unstable. I am surprised you used Einstein as an example because he spent a lot of his childhood with the dunce cap on in the corner, and he was a very unusual person. Geniuses often are.
* I certainly don't see anything unusual in the behaviors you described. Logically, I only expect discoveries from quiet, insulated thoughtful people and would immediately because of personal bias, question strongly anything meaningful from an opposite personality.
I have no problem calling people by the pronoun and name they want to be called.
I do have a problem with people being accused of being transphobic for saying that biological sex is real and for wanting to make a distinction. I had someone call me transphobic once because I told them that male and female are real sexes and something completely different from gender (which refers to identity, not biology). It was like they wanted me to ignore sex altogether (even though women have been oppressed on the basis of their sex).
I also have a problem with the fact that trans ideology often is rooting and gender stereotypes. Makeup and fashion do not define femininity. Being nurturing also does not make a person feminine.
I know I am going to get attack from some posters, but I do think certain aspects of the trans movement have gone too far.
I feel like this as well but I have to accept my ignorance and defer to more educated theories.
Maxim: I don't walk in those shoes! Judge not least ye be judged!
I think it’s non of my business as an RN to diagnose trans vs not trans. If they want to be addressed with male pronouns, I would address them that way.
As a very wise teacher pointed out to me at one time, the only thing a child owns is his or her name. It's fundamental to our identity, and identity is still forming through our young years. Given the rate of suicide and attempted suicide among transgender youth, it's not an insignificant issue. I agree it's complicated, but good care begins with respecting the identity of your client.
Honestly, it sounds like you (and your pediatric patients) are better off with you in the desert. No offense, and maybe you're just trying to stir the pot, but I am like super confused as to how you think you're qualified to assign genders or decide what pronoun another person should be using.
Well, its not our place to judge... anybody. And I find that after reading the entire thread, that this is pretty much a nurse on a witch hunt of sorts, and its sad, because this is a hunt against the LGBTQ community.
For all we know, the parents were simply not okay with her being trans, much the same as you would likely not be okay with your own daughter being trans.
Look. I don't know what the deal is, really. I hate to even say what has already been said, but it needed to be said. Homophobia is a real issue, and it exists even in the most well intentioned people.
So instead of going on a tirade against you, let me just explain a little more about the LGBTQ rights movement, and how people come to their own conclusions, and also how administrators of schools and hospitals handle parental bigotry.
First, LGBTQ stands for Lesbian, Gay, Bisexual, Trans, and Questioning. Haha lots of people think the Q means queer. Nope. It means questioning.
So, most people know that a Lesbian is, by and large, a woman, attracted primarily to women. A Gay man is by and large, a man attracted mostly to other men. In many cases, lesbians and gay men are ONLY attracted on a homosexual level, but there can be sexual attraction to the opposite sex, it would just not ever be acted on, because its still gross, on a very deep level. Most straight people might have a strong attraction to certain people of the same sex but not want sex with that person, while still being aroused by a visual stimuli of said person. Thats not uncommon and it doesnt make you bi.
Bisexual means that a person can be attracted to either sex and really doesnt have any gross out factor either way. It's just being attracted to and wanting sex with members of either sex.
Bisexual people can also sometimes be trans. And trans people can sometimes be bisexual. I like to use the word pansexual to refer to a bisexual transgender person. Thats just me. My pansexual, bisexual, transgender friend laughs heartily when I use this and it doesnt seem to phase him. He started out a lesbian, and married his wife. They both became men, and went from a married lesbian couple to a married gay couple. Now he is married to a woman. I have no idea if she was born female or not. It's none of my business.
So trans just means that you didn't get assigned the right genitals at birth. Some people have ambiguous genitalia, and this can also add to gender confusion. A doctor can see a larger than average labia major and a long privy parts and say "Its a boy." That can be a bad thing if thats not a scrotum and a member. The child lives with having the smallest "member" ever, and feels horrible. Really, he is a she. For a male that has ambiguous genitalia, he may have a very small member, even button sized, and undescended testicles. This can easily lead to a misdiagnosis of his gender.
So (s)he will grow up wondering why she hasn't gotten boobs yet or started her period, and find out medically, in her teens, that she is male.
I just usually assume that this is the case with about half of trans people, right or not, because some of them arent even really trans. Thats just the illusion.
Some people have fully formed and accurately described genitals at birth, but no chromosomal testing is done, so nobody knows if they have a chromosomal abnormality, like having extra Xs, for instance.
I don't care why someone thinks they are a different gender. It's their RIGHT and that is a CIVIL matter.
So the ONLY place this ever even applies to US as health care workers, is to ask anyone with abdominal pain, if they have ovaries. Whatever just tell em you have to ask. If they do, and you overlook female problems, your facility is in BIG trouble.
Other than that, sensitivity training is an absolute must. Maybe the parents don't like us calling their grown son's husband, as an emergency contact, or mentioning that they are married, BUT OH WELL.
Maybe a parent doesnt care to call their little girl, their little boy, but oh well. Your job is not to kiss HIS parents butts.
All we do is do the intake and ask "Do you prefer to be called Mr or Ms?" "Also, do you have ovaries?" And leave it at that.
Forget the politics or your personal feelings. You don't belong in healthcare if you cant get past certain peoples personal views or lifestyles. They are still expecting high quality healthcare. Just do your job, and be sensitive to their personal preferences. It's a resident's right.
Questioning. Lastly. Questioning is someone who is curious about their sexuality, unsure about their gender preferences, etc. They could fall into the non binary zone, even. They prefer not to be called male or female. They are just in a questioning zone.
Non binary, FYI, means someone can feel masculine or feminine, and doesnt always want to be called or treated like, their own gender, in everyday situations. I mean, a non binary person thats female might want to play tackle football. don't try to change the game for the girl. Thats just her doing her man stuff. Treat "him" like one of the guys. It's not a big deal. A non binary male might want to get his nails done, and talk smack about bringing down the patriarchy. So what? Give "her" the time of her life.
Its none of our business. Personal preferences are PERSONAL. Xo
Specializes in Pediatrics, Pediatric Float, PICU, NICU.
37 minutes ago, Gillyboo said:
Well, its not our place to judge... anybody. And I find that after reading the entire thread, that this is pretty much a nurse on a witch hunt of sorts, and its sad, because this is a hunt against the LGBTQ community.
For all we know, the parents were simply not okay with her being trans, much the same as you would likely not be okay with your own daughter being trans.
Look. I don't know what the deal is, really. I hate to even say what has already been said, but it needed to be said. Homophobia is a real issue, and it exists even in the most well intentioned people.
So instead of going on a tirade against you, let me just explain a little more about the LGBTQ rights movement, and how people come to their own conclusions, and also how administrators of schools and hospitals handle parental bigotry.
First, LGBTQ stands for Lesbian, Gay, Bisexual, Trans, and Questioning. Haha lots of people think the Q means queer. Nope. It means questioning.
So, most people know that a Lesbian is, by and large, a woman, attracted primarily to women. A Gay man is by and large, a man attracted mostly to other men. In many cases, lesbians and gay men are ONLY attracted on a homosexual level, but there can be sexual attraction to the opposite sex, it would just not ever be acted on, because its still gross, on a very deep level. Most straight people might have a strong attraction to certain people of the same sex but not want sex with that person, while still being aroused by a visual stimuli of said person. Thats not uncommon and it doesnt make you bi.
Bisexual means that a person can be attracted to either sex and really doesnt have any gross out factor either way. It's just being attracted to and wanting sex with members of either sex.
Bisexual people can also sometimes be trans. And trans people can sometimes be bisexual. I like to use the word pansexual to refer to a bisexual transgender person. Thats just me. My pansexual, bisexual, transgender friend laughs heartily when I use this and it doesnt seem to phase him. He started out a lesbian, and married his wife. They both became men, and went from a married lesbian couple to a married gay couple. Now he is married to a woman. I have no idea if she was born female or not. It's none of my business.
So trans just means that you didn't get assigned the right genitals at birth. Some people have ambiguous genitalia, and this can also add to gender confusion. A doctor can see a larger than average labia major and a long privy parts and say "Its a boy." That can be a bad thing if thats not a scrotum and a member. The child lives with having the smallest "member" ever, and feels horrible. Really, he is a she. For a male that has ambiguous genitalia, he may have a very small member, even button sized, and undescended testicles. This can easily lead to a misdiagnosis of his gender.
So (s)he will grow up wondering why she hasn't gotten boobs yet or started her period, and find out medically, in her teens, that she is male.
I just usually assume that this is the case with about half of trans people, right or not, because some of them arent even really trans. Thats just the illusion.
Some people have fully formed and accurately described genitals at birth, but no chromosomal testing is done, so nobody knows if they have a chromosomal abnormality, like having extra Xs, for instance.
I don't care why someone thinks they are a different gender. It's their RIGHT and that is a CIVIL matter.
So the ONLY place this ever even applies to US as health care workers, is to ask anyone with abdominal pain, if they have ovaries. Whatever just tell em you have to ask. If they do, and you overlook female problems, your facility is in BIG trouble.
Other than that, sensitivity training is an absolute must. Maybe the parents don't like us calling their grown son's husband, as an emergency contact, or mentioning that they are married, BUT OH WELL.
Maybe a parent doesnt care to call their little girl, their little boy, but oh well. Your job is not to kiss HIS parents butts.
All we do is do the intake and ask "Do you prefer to be called Mr or Ms?" "Also, do you have ovaries?" And leave it at that.
Forget the politics or your personal feelings. You don't belong in healthcare if you cant get past certain peoples personal views or lifestyles. They are still expecting high quality healthcare. Just do your job, and be sensitive to their personal preferences. It's a resident's right.
Questioning. Lastly. Questioning is someone who is curious about their sexuality, unsure about their gender preferences, etc. They could fall into the non binary zone, even. They prefer not to be called male or female. They are just in a questioning zone.
Non binary, FYI, means someone can feel masculine or feminine, and doesnt always want to be called or treated like, their own gender, in everyday situations. I mean, a non binary person thats female might want to play tackle football. don't try to change the game for the girl. Thats just her doing her man stuff. Treat "him" like one of the guys. It's not a big deal. A non binary male might want to get his nails done, and talk smack about bringing down the patriarchy. So what? Give "her" the time of her life.
Its none of our business. Personal preferences are PERSONAL. Xo
Your overall message and intention is great and the support that is needed, but a few of your details/descriptions are not completely on point and accurate, which could cause more fuel for the bigoted people that you are trying to educate.
For instance bisexual doesn’t mean “It's just being attracted to and wanting sex with members of either sex. “ It doesn’t solely have to do with who you want to have sex with.
Also, by and large the Q in LGBTQ does in fact stand for queer according to several reputable LGBTQ organizations. And to say half of trans people may have just been declared the wrong sex at birth by the doctor also isn’t accurate.
The feminist in me won’t even touch calling football “her doing her man stuff” LOL all of that to say that I appreciate the message and education that you are trying to provide, but it is also important for that information to be as accurate as possible.
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guest1163268
2,215 Posts
Very interesting read!
I'm really ignorant about the subject matter based on what I've been reading from the different posts so I've been reading up and I found this study. It's sort of illogical to me anyway that if the drivers of sexuality are hormones which can be artificially introduced if necessary, producing both physical and mental effects, could individuals experiencing the desires to change, actually be in the throes of a hormone inducement? The scientific studies I've perused also seem to support that other chemicals can affect hormones and their manufacturing centers.
I think that's it's significant that in the majority of cases that emotional needs to be a different gender, is frequently accompanied by physical characteristics and behaviors that rudimentary observations can confirm the accompanying feelings. Individuals display both physical and emotional characteristics indicating to me that hormones are definitely at work!
https://www.documentcloud.org/documents/20460201-evans-2014-prenatal-bisphenol-a-exposure-and-maternally-reported-behavior-in-boys-and-girls