In her bid for mayor, Helen Gym has made frequent reference to her successful enactment of a 2019 bill which purports to expand protections for trans-identified youth. Gym’s bill disallows institutions who serve youth from informing parents if their children begin identifying as transgender. It does so by classifying information such as trans-identified students’ names and pronouns as “confidential” — not to be disclosed to parents without the student’s express permission.
The bill also requires that chosen names and pronouns be honored in all record-keeping and social capacities, and that students be permitted to access the locker rooms and sports teams consistent with their gender identities. These policies apply to daycares, preschools, Head Start programs, public, private, and charter schools K-12, sports leagues, after-school programs, and every other organization which operates in service of Philadelphia’s youth. Helen Gym cites this legislation as a hallmark accomplishment of her time on City Council — one which strengthens her qualification for the Mayorship. Unfortunately for Philadelphia’s youth, these policies are badly misguided and urgently in need of review.
“Social transition” refers to a practice whereby a child is treated as if they were a member of the opposite sex via changes in a name, pronouns, and/or use of sex-specific facilities. Because it doesn’t involve medical intervention, social transition is often regarded as a neutral and low-stakes accommodation — not so consequential as to necessitate clinical assessment or parental informed consent. In reality, social transition is an active and major psychological intervention, one which carries risks that ought to be carefully weighed prior to its implementation.
It is one thing for a young person to flout stifling gender norms, identify among friends as transgender or non-binary, or dress in a way at school that is unbeknownst to their parents. It is an entirely different thing for every single adult and institution in that child’s life to send them the resolute, unambiguous message: You are transgender. To do so is to affirm that a young person’s internal sense of self is, indeed, mismatched with their anatomy. It is to emphatically endorse the idea that certain mannerisms, interests, or emotions are incompatible with one or the other sex category.
This practice goes far beyond creating an environment where students feel empowered to defy antiquated sex stereotypes or to safely identify themselves or their family members as gay. It is critical that we understand being trans as fundamentally distinct from being gay, or from non-conformity to sex-based norms. Being transgender must be understood as originating in a painful disconnect between one’s sense of self and one’s body. In some cases, this disconnect can be so insurmountable as to justify the use of cross-sex hormones, even given the elevated cardiovascular, stroke, and cancer risks associated with their use. Being gay does not require medical intervention, palliative body modification, or emerge from a painful relationship to one’s body.
Gender dysphoria is a deeply serious, often agonizing condition which requires in-depth care. It is correlated with numerous negative health outcomes and, among young people, poses a serious threat to development. While not every young person who engages in gender-experimentation experiences distress that fits a clinical definition of gender dysphoria, some certainly do. But emerging evidence has led some researchers to propose that sky-rocketing rates of trans-identification among adolescents may also be due, in part, to peer and online influences — a phenomenon sometimes termed “social contagion.”
Although available data on trans-identified youth remains limited, it is nonetheless possible to confidently discern a few trends. Female adolescents are noticeably more likely than their male counterparts to identify as transgender, and young people with autism-spectrum disorders are more likely to identify as trans than their non-autistic counterparts. Other trends have been anecdotally suggested but remain controversial. One such trend concerns a group known as “detransitioners” — that is, people who identified for a time as transgender but later stopped.
Detransitioners unite loosely around the claim that they were mistaken in believing themselves to be transgender — and that the doctors who clinically legitimized their identities did so prematurely and negligently. Some detransitioners allege that they were suffering from underlying conditions which led them to believe that they were transgender–conditions like OCD, PTSD, or disordered eating. Others say they stopped identifying as trans after realizing their gender incongruence related to being gay, or to a painful but temporary discomfort with their pubertal development. In many cases, detransitioners speak of the social backlash they suffered after detransitioning — that they were ejected from friend groups, or accused by former friends of being deceitful.
One of the more public detransitioners is K.C. Miller, who alleges that the care she received at CHOP’s gender clinic in Philadelphia failed to identify the roles that early-childhood sexual abuse and same-sex attraction played in her gender distress. After being seen at CHOP as a minor, K.C. was put on testosterone and underwent a bilateral double-mastectomy. Providers assured K.C.’s mother that her daughter’s distress was due to being trans, and that hormones and surgery would reduce the risk that K.C. might commit suicide. But in recent interviews K.C. reports that transition didn’t benefit her, and that if she could do it all over, she would seek therapy and embrace herself as a lesbian instead of transitioning. Nobody is certain how common stories like K.C.’s are, or to what extent they should inform policy. Nonetheless, they point to the shortcomings of a model which universally affirms minors who self-diagnose as transgender, and underscore the dangers of institutionally formalizing these self-diagnoses without adequate clinical assessment.
Given the lack of research from which to glean insight about how best to support trans children, and given the unclear interplay between neurodiversity, trauma, and gender dysphoria, parents are faced with an daunting challenge. Their difficulties are only compounded by policies like Helen Gym’s Bill 190558, which enable schools to initiate the social transition of their children without their knowledge. Whether a young person identifies as trans because they are experimenting, experiencing serious gender distress, suffering from an underlying mental health comorbidity, going through a “phase,” will grow up to be trans, are gay, or any combination of these possibilities–it is an unconscionable failure of safeguarding to intentionally withhold from parents any information pertinent to their children’s wellbeing. Parents must be empowered to protect and support their children.
Advocates for Helen Gym’s policies operate under the assumption that the only reason for which a minor would conceal a trans identification from their parents is fear of abuse. This assumption is, at best, painfully out of touch with adolescent psychology. It is easy for schools to unquestioningly affirm trans-identified youth. It is a far more challenging thing to earnestly parse the relevant circumstances, identify unmet psychological needs, and discern an appropriate course of action accordingly. It requires extremely poor critical reasoning to assume that social transition will be an either helpful or neutral course of action for all children who request it. Parents are uniquely poised to weigh in on the potential risks and benefits of social transition. Cases of abuse are exceptional, and they obviously entitle youth to (among many other protective measures) privacy concerning their gender identity. But treating all parents as abusive-by-default dangerously undermines the most important relationship in a child’s life — the ones they have with their parents — the quality of which is a known determinant of long-term health outcomes. Educators are neither qualified nor paid to accurately discern which children are good candidates for serious psychosocial interventions like social transition.
Helen Gym’s policies express an unbelievably insulting lack of faith in parents. They preclude the possibility of parents contributing critical insight into their child’s care. They establish a dynamic of secrecy between minors and adults. They universally determine social transition to be in the best interest of every trans-identified child — even those who may be too young or otherwise unable to grasp the meaning of the term — despite scant evidence. As the mayoral race continues, Philadelphians would be wise to hold Helen Gym to account for policies that recklessly imperil Philadelphia families.
Anne Morris is a former educator, data scientist and new mother based in the Philadelphia area.