Pierre Brouard is a clinical psychologist, the acting director of the Centre for Sexualities, AIDS and Gender at UP, a board member of PATHSA and sits on the executive of the Sexuality and Gender Division of PsySSA. He writes this in his personal capacity.
I’ve been thinking a lot about recent debates and controversies about trans youth. The debates centre around some of the following ideas: trans youth don’t really know who they are; trans youth should be discouraged from acting on their feelings and identity too soon; there is an uptick in trans identifying youth due to greater publicity about gender diversity; we should encourage trans youth to remain open to other ways of being.
These all sound depressingly familiar to me, because they echo how gay and lesbian youth used to be (and sometimes still are) treated. In language which has the default of denial rather than acceptance. And this informs my allyship, as an older gay man who was once a gay teenager, for trans and gender diverse people, especially youth. Let me break this down, explaining how each statement has been applied to gay and lesbian youth and how toxic this can be.
This is feedback that so many young gay and lesbian people get when they try to come out in their teens. Teenagerhood is a time of turbulence, they say. Your brain is still developing, your frontal lobe is still a work in progress. You MAY have feelings for the same sex, but this doesn’t have to define you. Yes you kissed a boy/girl but teenage experimentation is normal. Don’t close the door on being heterosexual, there is time to discover yourself. Perhaps you are just bisexual. Of course there is enough of a germ of truth in all of these statements to give them a kind of authority and gravitas, especially when they come from adults with power. But the cumulative effect of them is this: we are trying to persuade you that you are “not really” gay or lesbian because we don’t like it for you, and we don’t like it for us. It’s homo-anxious if not homo-phobic.
This is linked to the previous statement, but it also goes to the idea that because you “don’t really know who you are” you should refrain from experimenting, or acting out your feelings for someone else, because you may become “used to” those behaviours, and they will become reinforced. We have this idea that orientation-questioning youth are “unstable” in their identity and so we discourage them from being sexually active or doing anything which might “cement” their identity. It holds these young people to a higher standard of behaviour, and is morally inflected. At its core, non-normative sex is discomforting for people to think about. So gay youth are desexualized and oversexualized in the same breath.
This is an old trope, as common for gay and lesbian youth as for trans and gender diverse youth. Anxieties about a rise in gay/lesbian identifying young people are built on contagion theories: the idea that exposure to homosexuality leads to homosexuality, that a core identity is just the sum of series of “influences” rather than a deep part of who a person unconsciously is. The effect of this is to trivialize the gay/lesbian identity, to reduce it to an “effect” rather than to see it as an entire way of being. It’s disrespectful and demeaning. And it feeds into predator tropes – that gay and lesbian adults are groomers. Or that adult “enablers” have sinister intentions.
In effect, this asks the gay and lesbian young person to foreclose any certainty about themselves. It asks them to “put on hold” their desires and feelings, to press pause on self-expression. It is a lot to ask of a young person, any person in fact, to expect them to not just press pause, but actively pursue ways of being and acting which do not feel congruent. To “remain open” is to invite in other experiences, even if they are extremely discomforting. When YOUR way of being is not seen and heard, the exhortation to remain open to other experiences is a negation and a denial of one’s selfhood. It is experienced profoundly as a rejection.
This is why I feel an allyship with trans and gender diverse youth. Indeed some may change their minds as they grow older, and yes a tiny number do de-transition[1] over time, but is the answer a denial of affirmative services and support, a refusal to even countenance puberty blockers, a default stance which primarily questions rather than accepts? For sure some proponents of the “wait and see” approach believe their approach is loving and caring, and they will advocate for careful and intensive exploration of identity. But questions can be asked about their supposed neutrality, which can mask an ideological stance.
On the question of what is ‘affirmative’ I stand with the view that “affirmative clinical approaches are characterized by listening to and respecting a child’s individual identity, and supporting them without pre-defined expectations, whilst valuing all identities and expressions as equally valid”. Unlike some interviewed in the recent Cass Review, I do not see non-affirmative approaches as ‘neutral’, and affirmative approaches as ‘ideological’.
In fact as a gay man reflecting back on his youth, the ideology of many of the “wait and see” and “first do no harm” proponents around trans and gender diverse youth is starkly clear to the young person in the room. Doubting and caution are experienced as criticism, and with good reason, in my experience.
[1] Detransitioning is a complex and multifaceted issue, often driven by external pressures like societal stigma, lack of support, and personal safety concerns. It is important to understand these factors and separate them from genuine changes in gender identity, much like distinguishing external pressures from authentic self-discovery in gay youth.
"I started an exciting journey earlier this year when I launched my private speech therapy practice in Cape Town. I knew that I wanted the main focus of my practice to be gender affirming speech therapy, but what I didn’t realise was how much learning about gender affirming care and preparing myself to work with the trans and nonbinary population would move me. I have always been a passionate ally, and when I became aware of what a shortage there was of gender affirming clinicians, and even more so, gender affirming speech therapists, I knew I wanted to help fill this gap with my new practice.
When I graduated from university in 2011, the Speech Therapy curriculum didn’t include anything about gender affirming voice and communication therapy. This meant that to be adequately prepared to provide an excellent service, I had a lot of learning to do. I was extremely lucky to have fantastic guidance from a friend and old lecturer of mine, who could point me in the right direction and offer support and advice I think what surprised me the most in the process is how much I learnt about myself - reflecting on my life and realising how oppressive the binary gender system has been for me. I have realised that some things I have really struggled with, especially as a child, were rooted in my own gender dysphoria. Realising just how much of a spectrum gender is, including my own, has given me insights and have led me to understand myself so much better.
Things that didn’t make sense before make a lot more sense now. I am humbled and I am honoured to say that gender affirming voice and communication therapy has become my main speciality and focus. This is a movement that is one of the most important things I have come across, and I am so grateful to everyone who is a part of this community for creating awareness and dialogue and fighting so hard for equality in the face of so much resistance. I believe there is so much that the world can learn from the trans and non binary community."
PATHSA is an interdisciplinary health professional organisation working to promote the health, wellbeing and self-actualisation of trans and gender diverse people.
info@pathsa.org.zaSouth Africa
