How to help transgender children is just one fascinating topic to be discussed at Israel’s first-ever conference on transgender issues, to be held at Tel Aviv University on Friday and Sunday. Ofer Sapir, a clinical and educational psychologist who guides children of diverse genders, tells Haaretz about the challenges in tackling such problems, even in a tolerant place like Tel Aviv.
What age groups are we talking about?
“Gender diversity can be encountered at any age, even 2 or 3, and when I think about this question, I wonder where it comes from. Just like many regular children at 2 or 3 know what their gender is, identifying themselves as boys or girls – and we know it’s significant when they say something they know about themselves – it’s the same with gender-diverse children at that age.
“In many cases they know what their gender is. It’s important to realize that gender diversity isn’t a problem and doesn’t require any psychological assistance. Sometimes, automatically sending to therapy a child showing gender diversity is the problem, pointing to society’s problem with the issue.”
What problems do these children usually face?
“Gender-diverse children aren’t essentially different from other children. Their psychology is the same, including the things they identify with, their intellect, their emotional makeup, their relations with their peers, or any other psychological or interpersonal variable.
“Given that, as with other children with unique features in the environment they live in, especially differences perceived negatively by society – such as gay, Palestinian or refugee children, and even being a girl rather than a boy – children on the transgender spectrum are exposed to greater risks in our society, even in Tel Aviv, a very open city in this context.
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“They may experience sensations such as loneliness and a sense that no other children are like them. They may encounter rejection and misunderstandings. They lack adult role models and peers who share their experiences. They don’t even have a place in the language – such as with children who don’t identify with the binary gender of boy or girl – and Hebrew is particularly hard in this context.
“As a result of all these and other factors, such children may suffer from gender dysphoria – difficulties, tension and distress arising from society’s binary gender delineation and the expectations associated with it – amid depression, anxiety and other distress, even to the point of suicidal thoughts. As with facing other challenges and sources of distress, family and community support is very important.
“It’s also important to accompany them on their journey and give them a sense of belonging. When parents feel that their difficulties are being addressed, they’re calmer and can handle the situation better while providing support for their child. There’s often a need to work with a team that provides the right information and emotional support.”
A trying out of roles
What are the challenges in such treatment?
“First, there is an internal challenge in accepting that gender is a fluid and variable thing, not a universally natural one, as well as the fact that a binary division of genders isn’t natural and permanent but a social construct. Also, such awareness will only partly address the issue if you don’t share such insights with a child’s caregiver.
“Without this, a caregiver will always have the approach of someone who is ‘normal’ encountering the ‘abnormal,’ even if this is done with empathy. Another challenge is not to get bogged down with questions of ‘reality or play?’ regarding a child’s words and actions.
“Often, with adults encountering gender-diverse children, there's a division between what belongs to the adult world, which is serious and reality-based, and what belongs to a child’s world, which allows the freedom of playacting. Adults feel and think, ‘You children are free to play as much as you want – be dragons, lions or even a mother and a baby – but the question of gender identity belongs in the adult world, in reality.’ In playing with gender-diverse children, we’d like adults to see gender-based games as a trying out of roles, as curiosity, as the working out of anxieties and so on.”
Regarding society’s approach to the challenge of gender-diverse children, Sapir gives an example: “Parents meet their kindergarten teacher before kindergarten begins. Their child is 5. They tell her that their child is transgender and has been identifying as a boy for two and a half years.
“That’s how everyone addresses him and so should she. The teacher says there's no problem but the child must directly ask her to address him as a boy, stressing that this must be the child’s choice and he must ask for it himself. This is a trivial request by the parents, encountering the teacher’s opposition, expressing itself in the posing of a condition. We can sense the teacher’s anxiety around this topic, which makes it hard for her to treat the parents’ request as a simple one.
“Hidden behind her words is the thought that maybe these parents are unbalanced or inexperienced, somehow pushing their child in a direction he or she hasn’t chosen, so the child must be protected from the parents’ lack of boundaries. This isn’t unusual thinking in such cases. Many people, professionals in particular, believe that young children wouldn’t initiate a gender definition on their own.
“In any other case, such a reaction by the teacher would be considered unprofessional and insulting. We could compare this to a child who has a comfort object used as a prop that he or she might need while settling in, and the parents ask the teacher to let it be used without challenging the child or making him or her uncomfortable.
“Moreover, there is a misunderstanding and unacceptance of the need for privacy. The teacher, because of her own difficulties, is actually asking the child to verbally open up the issue before they know each other. She can tell herself she’s worried about the range of choices the child has, but actually she’s being invasive and insulting, expressing a transphobic position. In this case, the parents were left baffled.”
“In many cases, parents of gender-diverse children have gone through their own process, as well as with their child and environment, and when they meet teachers and people in the helping professions, they encounter gaps in knowledge and emotions. When facing professionals, this could be become extremely paradoxical. Often, the parents are blamed for this gap, with claims that they went too fast with their child and made rash decisions.”
What would you say to people who claim that many children have a phase in which they identify with a gender other than the one they were designated with, and this passes?
“This is possible, but the opposite is also possible. The question is in what way we send our children messages that what they express is legitimate or not. Considering whether this is a passing phase or not is an expression of society’s difficulties.
“Let’s imagine a child who identifies with the gender he was born into. For him or her, it’s not a question of whether this identification is transitory or not, and he or she can play and experience and be free to give expression and just be. Raising the question of whether this is a passing phase shines a spotlight that doesn’t come from the child, making it hard for the child to do what they want without external agendas and anxieties.”
Sapir notes that in recent years there has been a shift in public attitudes on this topic, but there is still a lot of work to do. “Therapists increasingly recognize the existence of this ‘phenomenon’ and its nonpathological nature, and support various expressions of gender, which is wonderful,” he says.
“But they still have great difficulties accepting that gender isn’t something ‘natural’ and that the binary division into two genders is a social construct, as well as accepting that we’re all under a restrictive gender-defining umbrella, with all its attendant expectations of us.
“A great change has occurred in Israel thanks to the organization Brit Haleviot of parents of children on the transgender spectrum, similar to other changes accomplished by parents’ groups such as Four Mothers. Parents have great clout in our society, and when they fight for their children, it has an impact.”