Gender dysphoria is the condition of feeling that one’s emotional and psychological male or female identity does not match one’s biological sex.
The documentary film – ‘Transgender Kids: Who knows best?’ – examines the views of Canadian psychologist Kenneth Zucker, who was sacked from his job at a Toronto gender identity clinic in 2015 after an investigation found that his practices were inappropriate.
Mr Zucker believes that gender dysphoria stems from mental health problems and autism rather than being biologically driven and rejects the 'gender affirmative' approach favoured by many other experts, which says that children should be encourage to live out their chosen sex.
Transgender organisations fear that highlighting Mr Zucker's views in the programme could lead to children being targeted or treated inappropriately.
One of Mr Zucker’s comments from the documentary - ‘a four-year-old might say that he’s a dog – do you go out and buy dog food?’ – angered transgender activists and experts, who described Mr Zucker's views as ‘harmful’ and ‘destructive’.
Dr Jane Hamlin, Membership Secretary at the Beaumont Society, a national self-help body run by and for the transgender community, said, ‘I thought that [Mr Zucker’s] comment relating real live transgender children to a hypothetical child saying that he or she wants to be a dog was offensive and trivialising deep emotional traumas that so many trans people suffer.’
‘Some of the contributors to the programme expressed very narrow ideas of what it is to be a boy or a girl.
'I hope that we can get beyond the notion of "opposite sexes" and think more in terms of individuals. We should be looking for ways to reduce gender stereotypes and divisions,’ Ms Hamlin said.
The NHS guide for gender dysphoria states, ‘Gender development is complex and there are many possible variations that cause a mismatch between a person’s biological sex and their gender identity, making the exact cause of gender dysphoria unclear.'
Autism and mental health
Mr Zucker believes that children with gender dysphoria should be monitored for underlying psychological and mental health issues, and claims that children being diagnosed as transgender could in fact just be ‘fixating’ on being of the wrong sex because they are autistic.
‘It is possible that kids who have a tendency to get obsessed or fixated on something may latch on to gender. Just because kids are saying something doesn't necessarily mean you accept it, or that it's true, or that it could be in the best interests of the child,’ Mr Zucker said in the film.
Susie Green, chief executive officer of the Mermaids Foundation, which represents transgender issues, said parents of transgender children feared such comments would cause their children to be targeted and to be perceived as having mental health problems.
Dr Wenn Lawson, a psychologist and author who is a transgender man with autism himself, said he was ‘saddened’ that the debate about the validity of Mr Zucker’s views even needed to happen.
‘Children, often quite instinctively, know whether they belong in the masculine and/or feminine or somewhere in between world, from quite a young age.
‘Assessing children needlessly for umpteen issues sends a message to the child they are duds, they are bad, they are not normal. We want our children to feel good about themselves. We need to listen to them.’
Dr Lawson said that, in a case where a child’s gender dysphoria co-occurred with autism, a good practitioner would explore this from different angles and treat both conditions seperately before offering a diagnosis.
A research investigation by Spectrum, a website dedicated to the in-depth analysis of autism research, found a ‘diagnostic overlap’ between autism and gender dysphoria, as rates of autism and autism traits appear to be higher in those identifying as ‘genderqueer’ or ‘non-binary’ in gender.
Carol Povey, Director for the Centre of Autism at the National Autistic Society, said, ‘There is work to be done to understand how being autistic and transgender may interplay, including listening to the experiences of autistic trans people.
‘There is no "one type" of autistic person, and like anyone else, when an autistic person questions their born gender they should get the help and support that they need. This means being able to decide on a route that is right for them with a team of professionals who understands them and their autism,’ Ms Povey added.
Mr Zucker believes he was sacked because transgender issues are increasingly politicised. In the documentary he denies that he had practised reparative therapy with the aim to ‘cure’ children of their transgender status and calls his approach ‘developmentally informed therapy’.
A BBC statement said, ‘With a rise in the number of children being referred to gender clinics, this programme sensitively presents different views from experts and parents on gender dysphoria in children.
‘For more than 30 years Dr Kenneth Zucker ran Canada’s biggest child gender clinic and was considered a recognised authority on childhood gender dysphoria until he lost his job. He believes he was fired for challenging the gender affirmative approach.
‘This documentary examines Dr Zucker’s methods, but it also includes significant contributions from his critics and supporters of gender affirmation, including transgender activists in Canada and leading medical experts as well as parents with differing experiences of gender dysphoria and gender reassignment.’