An Intriguing Idea from Cordelia Fine's "Delusions of Gender"

In Chapter 19 (titled "Gender Detectives") of her book, Delusions of Gender (which I review here), Cordelia Fine describes how children learn to sort themselves into gender categories:

Anyone who spends time around children will know how rare it is come across a baby or child whose sex is not labeled by clothing, hairstyle, or accessories. Anyone with ears can hear how adults constantly label gender with words: he, she, man, woman, boy, girl, and so on. And we do this even when we don't have to. Mothers reading picture books, for instance, choose to refer to storybook characters by gender labels (like woman) twice as often as they chose nongendered alternatives (like teacher or person). [Gelman, Taylor & Naguyen, 2004] Just as if adults were always referring to people as left-handers or right-handers (or Anglos and Latinos, or Jews and Catholics), this also helps to draw attention to gender as an important way of dividing the social world into categories.

This tagging of gender --- especially different conventions for male and female dress, hairstyle, and accessories, and use of makeup --- may well help children learn how to divvy up the people around them by sex. We've seen that babies as young as three to four months old can discriminate between males and females. At just ten months old, babies have developed the ability to make mental notes regarding what goes along with being male or female: they will look longer, in surprise, at a picture of a man with an object that was previously only paired with women, and vice versa. [Levy & Haaf, 1994] This means that children are well-placed, early on, to start learning the gender ropes. As they approach their second birthday, children are already learning to pick up the rudiments of gender stereotyping. There's some tentative evidence that they know for whom fire hats, dolls, makeup, and so on are intended before their second birthday. [Serbin, Poulin-Dubois, & Eichstedt, 2002 (PDF); Poulin-Dubois et al., 2002] And at around this time, children start to use gender labels themselves and are able to say to which sex they themselves belong. [Zosuls et al., 2009]

It's at this critical point in their toddler years that children lose their status as objective observers. It is hard to merely dispassionately note what is for boys and what is for girls once you realize that you are a boy (or a girl) yourself. Once children have personally relevant boxes in which to file what they learn (labeled "Me" versus "Not Me"), this adds an extra oomph to the drive to solve the mysteries of gender. [Martin, Ruble & Szkrybalo, 2002 (PDF); Martin & Halverson, 1981] Developmental psychologists Carol Martin and Diane Ruble suggest that children become "gender detectives," in search of clues as to the implications of belonging to the male or female tribe. [Martin & Ruble, 2004 (PDF)] Nor do they wait for formal instruction. The academic literature is scattered with anecdotal reports of preschoolers' amusingly flawed scientific accounts of gender difference:

[O]ne child believed that men drank tea and women drank coffee, because that was the way it was in his house. He was thus perplexed when a male visitor requested coffee. Another child, dangling his legs with his father in a very cold lake, announced "only boys like cold water, right Dad?" Such examples suggest that children are actively seeking and "chewing" on information about gender, rather than passively absorbing it from the environment. [Ruble, Lurye, & Zosuls, 2008]

In a later chapter, she hypothesizes that this drive to delineate gender categories, and to sort oneself into one of them, might stem from a broader human desire to belong to a group:

As we've seen, children are born into a world in which gender is continually emphasized through conventions of dress, appearance, language, color, segregation, and symbols. Everything around the child indicates that whether one is male or female is a matter of great importance. Meanwhile, at about two years of age, children discover on which side of the divide they are located. It remains to be seen, in my view, whether subtle gender differences in babies' toy preferences before they know their own sex can be explained by socialization by parents, unwitting or otherwise. But once children know their own sex, in theory they can start to take socialization into their own hands.

And it's plausible to think that they will. Gaining membership to a group, any group, normally brings a money-back guarantee of favoritism. In the infamous minimal group studies conducted by Henri Tajfel and colleagues, adults are randomly assigned to trivial groups. For example, they are asked to estimate the number of dots on an array, and then categorized as either a dot overestimator or a dot underestimator. It's hard to imagine a categorization of less psychological significance. And yet membership of even such arbitrarily assigned and short-lived social categories can engender a warm glow toward fellow dot overestimators (or underestimators) that does not extend so far as those who take a different approach to dot guesstimating.

Children, it turns out, are also susceptible to an in-group bias to prefer what belongs to their group. Recent work by Rebecca Bigler and colleagues has shown that this is especially the case when groups are made visually distinct, and authority figures use and label the groups. In one study, three- to five-year-old preschoolers in two child-care classrooms were randomly assigned to the Blue group or the Red group. Over a three-week period all the children wore a red or blue T-shirt every day (according to the group to which they'd been assigned). In one classroom, the teachers left it at that. The color groups were not mentioned again. But in the other classroom, the teachers made constant use of the two categories. Children's cubbies were decorated with blue and red labels, at the door they were told to line up with Blues on this side and Reds on that side, and they were regularly referred to by group label ("Good morning, Blues and Reds"). At the end of the three weeks, the experimenters canvassed each child's opinion on a number of matters. They found that being categorized as a Red or a Blue for just three weeks was enough to bias children's views. The children, for example, preferred toys they were told were liked by their own group and expressed a greater desire to play with other Red (or Blue) children. While some forms of favoritism were common to all the children, more was seen in kids from the classroom in which teachers had made a bigger deal out of the Red versus Blue dichotomy.

Just imagine how powerfully exactly the same psychological mechanisms can drive in-group pride and out-group prejudice when it comes to gender. In the young child's world, gender is the social category that stands out above all others, right from the start. Conventions of clothing and accessories mean that gender is extremely obvious visually, and boys and girls may be regularly labeled and organized ("Now it's the boys' turn to wash their hands") by gender, especially in early education settings. And, unlike adults and older children, younger children don't tend to have other social categories like jock, doctor, Christian or artist with which to identify. The drive for group belonging may explain why young children insist on girlish or boyish behavior or dress even in the face of parental displeasure, suggest Diane Ruble and colleagues.

This theory is really interesting to me, and I particularly like the idea that it's not a particular set of gender-related traits that are innate, but rather 1) the capacity to distinguish the sexes, and to know one's own sex, and 2) the drive to find one's place in the social group in which one lives. In our large, mobile, relatively fluid but still highly gendered society, gender roles are probably going to be the first social identities that suggest themselves to a child.

I like this theory, because it explains a lot of the same things that "hard-wiring" theories of gender explain, but it's much more flexible. Which is good, considering that gender norms have changed, a lot, throughout history and today's conceptions of the Eternal Feminine or the Eternal Masculine sometimes conflict with these past notions of masculine and feminine.

(One trivial example: pink and blue. Pink used to be for boys, because it was like a softer version of red, while blue, the color of the Virgin's veil, used to be for girls. Now, of course, it's the other way round).

There is one thing that the book doesn't address, that I'd like what Fine (or any of those developmental psychologists she cites) thinks about it: given that the usual course is for children to discover what sex they are, and then become interested in learning, and correctly performing, the gender role corresponding to that sex, why do some children choose a different sex to emulate?

I can remember that, while I did not always think of myself as having gender (or even as being human) throughout my entire childhood, when I did think in those terms I always knew two things: 1) I was a girl, and 2) I was, and wanted to be, like a boy. And when I grew up, I would be a woman who was like a man. Furthermore, this wasn't just who I was in the absence of any gender self-socialization; I self-socialized in very much the way Fine describes. I just chose to learn, and conform to, the masculine role.

That sort of thing --- why you would choose to imitate people of the other sex, rather than your own --- isn't answered. And neither is the related matter of how transgenderedsexual* people form their gender identities --- they often have strong senses of themselves as sexed, gendered beings, but the sex and gender categories they feel they belong to are not the ones assigned to them at birth.

*Edited 1/23/11 to reflect Juliet's preference, stated in comments, for "transsexual" over "transgendered."

More Proposed DSM Revisions

Besides the unification of all the autism-spectrum conditions under a single, simplified definition (which I generally consider a Good Thing, despite the reservations I mentioned in my earlier post; this post of Amanda Forest Vivian's captures what I think is good about it quite well) and the elimination of Rett's Disorder from the DSM entirely, the DSM-V revisions include lots of other interesting ideas.

These include:

- Adding Binge Eating Disorder to the Eating Disorders category

- Eliminating amenorrhea (loss of one's mentrual period) from the criteria for Anorexia Nervosa, which would finally allow men who meet all of the remaining criteria to be diagnosed with full-blown anorexia rather than with the vague, often-minimizing label Eating Disorder Not Otherwise Specified

- Adding a childhood mood disorder called Temper Dysregulation with Dysphoria, which would be characterized by irritability and frequent temper tantrums; this disorder is meant as an alternative diagnosis for many of the children who are (or would be) now diagnosed with bipolar disorder

- Consolidating the personality disorders into five broad, yet-to-be-determined categories

- Adding "Hypersexual Disorder" and Paraphilic Coercive Disorder (in which the person is turned on by the idea of raping another person) to the Sexual and Gender Identity Disorders category

- Expansion of the DSM-IV's Substance-Related Disorders category (which included substance dependence and abuse) to a broader Addiction and Related Disorders category, which will include non-chemical, "behavioral" addictions like gambling; Internet addiction was considered for inclusion in this category, too, but ultimately discarded

Some of these proposed changes --- the two eating-disorder changes I mentioned, as well as the decision to remove some problematic wording from the criteria for anorexia, for instance --- are unadulterated Good Things, and were very much needed. (I'd actually argue, along with Rachel and her commenters, that the reforms to the anorexia criteria didn't go far enough; that BMI should not be the gauge of severity of anorexia because it misses those people who might be restricting their eating and obsessing about food, weight and body image just as severely as someone with diagnosable Severe Anorexia, but who, due to individual metabolic variation, never become underweight.) Others, like the addition of Temper Dysregulation with Dysphoria as a new childhood disorder, the concept of "risk syndromes" for psychosis and dementia, are a mixed bag. They might be helpful, or they might result in more people being marginalized, losing autonomy and/or being pressured to take powerful antipsychotic medications for illnesses that, in the case of the risk syndromes, aren't even present and may never be.

Also in the mixed-bag category is the DSM-V's formulation of Gender Identity Disorder (renamed Gender Incongruence, in an attempt to be less stigmatizing), which it splits into two main categories, one for children and one for adolescents and adults. Good things about the new criteria include the aforementioned move toward value-neutral language, its acknowledgement that sex and gender, even for transgendered people, aren't always binary (there's a long history of doctors "gatekeeping" sexual reassignment surgery, hormone therapy and other medical procedures associated with transition, restricting these things to those trans people who conformed most rigidly to the conventional role of their chosen gender) and its stress on whatever the individual trans person wants as the desired outcome. What's not as good is the retention of the notion of autogynephilia --- sexual fetish as motivation for transition --- in the category of Transvestic Fetishism, and the presence of stricter, gender-binary-enforcing language in the criteria for pediatric Gender Incongruence.

Finally, the creation of Hypersexuality as a new sexual disorder strikes me as colossally wrongheaded. Like sexual addiction --- which is not recognized in the DSM-IV, but which has gained popular acceptance in the addiction-recovery community --- this category would be inherently biased against people with unconventional sexualities: kinky people, swingers, polyamorists, even, depending on how conservative a community the person being evaluated comes from, gay and bisexual people. I also disapprove of the existence of this category for the same reason I disapprove of Hypoactive Sexual Desire Disorder: merely wanting/having sex to a greater or lesser degree than most people do isn't pathology, it's variation.

Dutch Study Finds Autistics Might Be Overrepresented Among Trans People

A recent article on Left Brain/Right Brain summarized this study presented at the International Meeting for Autism Research (IMFAR), which screened children and teens referred to the Amsterdam Gender Identity Clinic between April of 2004 and December of 2007 for autistic features. This screening included "a psychodiagnostic assessment, interviews with the child[ren] or adolescents, interviews with the parents about developmental history and current functioning, and information from the teacher." With youngsters already diagnosed with an ASD, researchers used a Dutch translation of Lorna Wing's Diagnostic Interview for Social and Communication Disorders, 10th revision (DISCO-10).

The DISCO series of diagnostic interviews, which I hadn't heard of before seeing this article, focus on early developmental history and are conducted between the diagnostician and the potentially autistic person's parent or other caregiver. It is used not so much to diagnose autism as to uncover "the pattern over time of the skills and impairments that underlie the overt behaviour."

In Chapter 28 of the Handbook of Autism and Pervasive Developmental Disorders, which describes and evaluates all the different tools available for diagnosing autism, Catherine Lord and Christina Corsello say:

[T]he first version of the DISCO was developed to assess the pattern of development in individuals with ASDs and their individual needs (Wing et al., 2002). The primary purpose of the DISCO is not to provide a diagnostic classification. Rather, the instrument was designed to obtain information on behaviors relevant to autism for the purpose of assisting clinicians in determining a child's development in different areas as well as his individual needs (Leekam, Libby, Wing, Gould, & Taylor, 2002). It is based on the concept of a spectrum of disorders rather than categorical diagnoses.

The DISCO is an investigator-based interview in which the interviewer asks questions designed to elicit descriptions of behavior and makes coding decisions based on the information provided. ... The DISCO includes items covering behavioral manifestations of the deficits associated with ASDs, including social interaction, communication, imagination, and repetitive activities. In addition, it includes items designed to assess developmental levels in a variety of domains. Many of these items are based on the Vineland Adaptive Behavior Scales [link] (Sparrow et al., 1984). There is also a section on atypical behaviors that are not specific to autism. These include unusual responses to sensory stimuli, differences in attention and activity level, challenging behaviors, and other psychiatric disorders. Items relating to developmental delay are rated on a 3-point scale, as "delay," "minor delay," or "no problem." An actual age is coded for some of the developmental items. Atypical behaviors receive codes for "current" and "ever" and are rated as "severe," "minor," or "not present."

So, while other tests might be better suited to answer the question "Does this person have autism?" the DISCO seems to be more geared toward answering the question "What does this person's autism look like?"

Anyway, the researchers did a full psychodiagnostic workup on those children and teens who turned up at the clinic without having been evaluated for autism before, and quizzed the parents of those kids who had previously been evaluated in the above-described manner.

They found that 6% of the 233 young people referred to the clinic (14 people or so) had some kind of ASD. This rate --- which the LB/RB blogger point out is about six times the rate at which autism occurs in the general population --- remained consistent regardless of gender-identity outcome: kids who ended up with a diagnosis of full-blown Gender Identity Disorder were no more or less likely to be autistic than the kids diagnosed with GID-NOS or the kids discharged without any diagnosis.

Most interestingly, the people who did end up with dual diagnoses of ASD and GID included both sexes, which, if that finding is replicated in larger studies of autism prevalence among trans or otherwise gender-variant people, could come into conflict with Simon Baron-Cohen's Extreme Male Brain theory of autism, which hypothesizes a direct relationship between fetal testosterone levels, masculinity, and autism. A high proportion of autistic trans men and butch women would thus be in accordance with theory, but not trans women or feminine men.

"Autogynephilia" and the Clinical Gaze

Starting last fall, when I wrote these posts on the American Psychiatric Association's ongoing project of drafting/revising the DSM-V, I've been kicking around a draft of a third post in that vein, this time concentrating on the doings of the Sexual and Gender Identity Disorders Work Group.

As you might infer from how long it's taken me to write said post, this entails opening up a huge can of worms.

I've also found I'm in way over my head with a lot of the issues involved, so I think I will intentionally avoid delving too deep into them; instead, I will point you to other people's writings that I've found illuminating.

Briefly, what's at stake is whether trans sexualities and gender identities will continue to be seen as "disordered" --- whether the category of Gender Identity Disorder* will be retained in the DSM-V. While the Gender Identity Disorders sub-workgroup is reportedly consulting trans advocacy organizations as part of its literature-review process, the makeup of the larger workgroup, and the prominence in leadership positions of two of its particularly worrisome members, introduces a strong bias towards viewing transgenderism and -sexuality as pathogies.

Here are some links that discuss the Sexual and Gender Identity Disorders Work Group --- and what its inclusion of Kenneth Zucker and Ray Blanchard means for trans people --- in greater detail:
Julia Serano, "Why feminists should be concerned with the impending revision of the DSM" (a guest post at Feministing.com)
Kelley Winters, "Transvestic Disorder and Policy Dysfunction in the DSM-V" (GID Reform Weblog)
Lena Dahlstrom, "Drafts from the DSM-V workgroup are out, and they're continuing to pathologize trans people" (Trans Group Blog)
Helen G, "APA Task Force reviews possible Gender Identity Disorder treatment guidelines" (Questioning Transphobia)

Now, I'd like to discuss one of the many trans-unfriendly ideas being brought to the DSM-V table: autogynephilia.

This nouveau-Greek concoction (meaning, I guess, "love of oneself as a woman") encapsulates Ray Blanchard's ideas about trans lesbians --- i.e., that they are straight men who fantasize about being women. (Blanchard also tends to refer to trans women as men: in his taxonomy, straight trans women are "homosexual transsexuals," while trans lesbians are "non-homosexual transsexuals." This can be quite confusing, apart from being just plain disrespectful to the people being talked about). Their femininity is thus taken for a sexual fetish rather than a component of their core identity.

Julia Serano has a lot to say on this topic --- not just about autogynephilia, but also about what she sees as the "sexualization" of MTF transgenderism by psychiatry.

Here's a summary of how she sees this sexualization play out (quoted from this description of a paper she presented at a 2007 conference for women in psychology, which became a chapter in her book, Whipping Girl):

The fact that MTF spectrum transgender people bear the brunt of our culture's fascination with, and demonization of, transgenderism, indicates that they are culturally marked, not for failing to conform to gender norms per se, but because they "choose" to be female and/or feminine. The notion that MTF transgender people are conceptualized within a traditionally sexist framework (i.e., one where femaleness/femininity are viewed as subordinate to maleness/masculinity) is perhaps most evident in the way that transsexual women (but not transsexual men) are hyper-sexualized in pornography and the media, wherein they are typically depicted as sex workers or as "sexual deceivers" who supposedly lure innocent straight men into sexual encounters. Implicit in all of these representations is a rigid, dualistic, heterosexual male-centered dichotomy in which only men can be viewed as legitimate sexual initiators and where womenare invariably viewed as sexual objects. In the context of this "predator/prey" dichotomy, transsexual women are consistently viewed as inviting their own sexualization by virtue of their feminine expressions and their physical transitions to female.

Understanding this predator/prey dichotomy allows us to make sense of psychological/psychiatric discourses of transgenderism, which have historically focused almost exclusively on MTF transgender individuals, while largely discounting female-to-male (FTM) transgenderism. For many decades, the diagnostic criteria devised for MTF transsexuals required them not only to be heterosexual and gender-conforming in the female role, but also to be sexually desirable in the eyes of heterosexual men. Those MTF spectrum transgender individuals who were unable or unwilling to meet all of the prerequisites for sexual object have typically been cast as sexual initiators and relegated to a distinct "paraphilic" category --- e.g., transvestic fetishism or autogynophilia. The positioning of this latter group (who are conceptualized as "men" who inappropriately fetishize female/feminine expressions in themselves) in opposition to "true" or "primary" MTF transsexuals (who are cast as willing objects of heterosexual male desire) reiterates the predator/prey dichotomy, thus preserving both the male/female and heterosexual/homosexual binaries. In this context, the invisibility and under-theorization of FTM transgenderism within psychology and psychiatry can be viewed as a direct result of the predator/prey dichotomy, which assumes that FTM spectrum individuals cannot be legitimate sexual initiators in their assigned sex (female), nor can their identified/preferred sex (male) be legitimately objectified.

Serano's thesis, in other words, is that the fear and hatred directed at trans women --- and the particular scrutiny the psychiatric profession directs at them --- derives from misogyny. If women are loathsome and inferior, then what kind of boy or man would choose to become a woman? The answer most commonly proposed by trans-misogynists is that such a man would have to be extremely, pathologically obsessed with sexuality (because, of course, women are sex!) of a particularly questionable stripe --- either the predatory sexuality of the transsexual "deceiver" of straight men, or the masturbatory and fundamentally narcissistic sexuality of the autogynephile.

Hopefully, you can now see where the "gaze" of my title comes in. The "autogynephilia" model does two things to the interaction between doctor and (trans lesbian) patient that skew it from a neutral, professional interaction to an exercise in sexualized power relations: first, it places the patient's sexuality on the clinical agenda, even when she has not made it an issue. Sexuality is seen as fundamental to her identity in a way that it would not be if she were cisgendered. Second, her sexuality is assumed to be wrong --- immature, paraphilic, disordered --- before anything is even said. She can therefore be silenced, or dismissed, or have her words twisted around, if what she says doesn't fit with the theory; because she is decided a priori to have deep-seated psychosexual issues, everything she says regarding her gender expression or sexuality can be considered suspect.

I think these two tendencies within this theoretical model constitute a pretty serious double standard --- the sexualities of trans women are probed and interrogated to a degree that no other sort of person's would be, unless that person had asked for help with a sexual problem. Thus, both because of a disproportionate rummaging through trans women's sexual quirks, and because of a selective attention to those trans women's own stories, the theory of autogynephilia as a cause of MtF transsexualism can't really be falsified. Nobody asks cis women if they find their own femaleness or femininity arousing, and Blanchard, Bailey and other "authorities" see no problem ignoring trans women who claim not to experience that.

*While the existence of GID as a category of mental illness perpetuates some seriously transphobic assumptions --- i.e., that trans people have something horribly wrong with them and need to be fixed, one way or another --- it also makes sex-reassignment surgery more accessible to those trans people who desire it, since by being the recommended "treatment" for the "disease" of GID, the surgery becomes much more justifiable in the eyes of insurance companies. I take this more as an indication that the U.S. health-care system sucks than a ringing endorsement by trans advocates of the medical model of transness, though.

Where Neurodiversity Meets Feminist Theory (Part II)

This post, in case it's not clear from the title, is a continuation of the previous post, which ended up being a lot longer than I anticipated. Also, because I spent all of the previous post grappling with Kristin Bumiller's taxonomy of disability-rights-promoting strategies, it will be here that I address the gender issues I alluded to at the beginning of that post.

I'm not sure if I mentioned this in the first post, but the primary sources Bumiller uses --- what she considers the founding texts of the neurodiversity movement --- and quotes liberally in her article, are blogs and websites: Neurodiversity.com, Autism Diva and Whose Planet Is It Anyway? all show up in her bibliography. It gave me particular glee to see a lengthy snippet from this old post of ABFH's reproduced in a scholarly article, complete with the citation "Autistic Bitch from Hell."* Seeing that in an academic journal made my day, and very possibly my week, too.

The context for quoting ABFH was this discussion of the Extreme Male Brain theory of autism:

While the validity of this research is subject to debate within the scientific community, it nevertheless promotes a view of autism that reinforces cultural stereotypes of gender. From a feminist perspective, the essentialist version of autism is a disturbing reconstruction of gender and disability stereotypes in the guise of new scientific knowledge. Baron-Cohen's explanation for autism has the twin effect of normalizing the condition (by suggesting that it includes all of us) while essentializing gender differences (by rooting the condition in biological maleness). On the one hand, this easily popularized idea buttresses the kind of stereotypes that the neurodiversity movement hopes to counter. For example, it furthers the idea of autistic genius as an expression of an exaggerated male attribute (Bombaci 2005). On the other hand, it is also problematic to suggest that treating autistic children is akin to treating the usual problems associated with socializing boys, an analogy that potentially reassures those who believe that mainstream education can easily respond to these children's needs.
...
A gender-based theory of autism grossly oversimplifies the enormous complexity of the autistic condition, including its range of atypical sensory, physical, psychological, and perceptual manifestations (Keane 2004). Autism is a neurological condition that fundamentally affects how a person experiences the world.

I highlighted in bold text the part of that passage I found most useful; indeed, apart from its mere inaccuracy, that tradeoff is the thing that most bothers me about Baron-Cohen's idea. Yes, it provides a way to think of autism as just another flavor of human experience, and one not all that different from the other flavors, but it does this by splitting human experience in two --- male experience and female experience --- and claiming autism as belonging to the male. Autism, then, might "include all of us," but only if "all of us" are men. Women, apparently, are "them," yet again. (And autistic women are not women).

The rest of the passage was hard for me to decipher. The dichotomy Bumiller sets up at the end of the first paragraph seems like both of its branches are going the same place. Her "one hand" option has Baron-Cohen's theory "buttress(ing) ... stereotypes the neurodiversity movement hopes to counter" --- i.e., the theory works against the interests of actual autistic people --- and her "other hand" has the "problematic" aspect of making people complacent about mainstream education's adequacy for autistic students --- i.e., the theory works against the interests of actual autistic people, which presumably include more and better educational supports. This doesn't seem to be a dichotomy so much as the "other hand" gives a specific example of the general trend held in the "one hand." There is, indeed, a stereotype that autistics --- autistic children in particular, but it is also applied to adults --- don't really need any special help at all, and aren't really experiencing any distress when they are overloaded; they're just bratty and looking for attention/throwing a tantrum. So maybe all she needed to do was drop the either/or phrasing and instead phrase it as "trend x, with examples y and z."

The other thing I found interesting about this article was her treatment of gender variance in autism. It came up in the larger context of normalization strategies, and the need to ask whether a given strategy is really in the best interest of the disabled person in whose name it's being implemented. She brought up ABA, which she mentioned is often used simply to get autistics to appear more "normal":

This tendency [of caregivers to try to get their disabled clients to appear as "normal" as possible, and value/reward them according to how successful they are at it] is particularly strong when applied to people with autism, whose disability is in fact medically defined by an inability to understand social conventions. The social development of children with autism is often measured in terms of their progress toward acquiring normal social skills (Gross 2003). Since autism is a form of bodily difference that interferes with the person's ability to process information (sensory, language, tactile, and visual) in a typical fashion, children learn to cope by either imitating norms of behavior or making sense of the world within their unique perceptual systems (Nikopoulos and Keenan 2004).
...
There is enormous pressure on parents to seek intensive behavioral training because autistic persons' lives are replete with situations where their differences matter. In their lives at home, school, and work, they constantly encounter reactions, usually negative, to their failure to conform to and understand social norms. Even relatively minor differences in social behavior are met with disapproval and rejection and are sometimes grounds for exclusion.

One of the "norms of behavior" that autistics frequently violate is gender-role compliance. I like the way Bumiller describes it:

School-age children with autism often develop likes or dislikes for possessions without attributing relevance to gender demarcation. For example, a boy could become attached to a Barbie lunch box because it relieves stress to repetitively fiddle (sic) with the latch mechanism. When professionals see such preferences as merely gender inappropriate behavior they are disregarding the child's own conception of gender relevance and/or attachments to objects that reduce anxiety. (emphasis mine)

I like her conception of gender variance in autism as simply the failure to attribute gender significance to every tiny detail of one's manner, appearance, taste and choice of hobbies. I've said before that I think gender is one of the most intensively socialized pieces of behavior a person can learn, so it would certainly follow that people who aren't very good at social learning in general would tend to develop a much smaller repertoire of gender signals. A corollary that I failed to add earlier, which I think Bumiller is getting at in the above passage, would be that people who aren't good social learners wouldn't learn to invest as many things with gendered (or other social) meaning. To someone who hasn't been marinating all their life in a culture where gender takes on such a monstrously huge significance (or someone who can't absorb that culture's messages very well), it becomes just another bit of personal data, like having blue eyes or being short. It won't have any bearing on most of the choices that person makes in their daily life.

As you might expect, this failure to take every opportunity to perform one's assigned gender is taken as another autistic "deficit" in social skills:

The process of teaching children to understand social cues, such as teaching children to smile when they are happy to see someone, is often broadened to areas like gender appropriateness, in which children are forced to conform to conventions that are irrelevant to them. Many adolescents with autism consider themselves to be gender neutral, and when confronted with the prospect of dating either withdraw socially or choose to be regarded as androgynous. In social skills training, young autistic persons are explicitly taught about the relevance of gender performance to finding sexual partners. For example, books designed to teach autistic adolescents about sexuality often list specific examples of how potential dates will perceive their appearance or behavior as masculine or feminine. These instruction manuals for entering intimate relationships explain that gender performances have social meaning and tell why they are important to rituals of dating and marriage.

I will probably post later about my wishlist for such a reference book, but in itself I don't see explanation of gender performance as a bad thing. The important thing would be that the book isn't heteronormative or sexist --- that, though it should say what people will likely think of certain gestures, speech patterns or clothing choices, it should not contain any value judgment on those choices. And it should be aware that whoever is reading the book might well have a different goal in mind than they would --- my high-school self would have been looking to convey a masculine self-image, whether to male or female potential dates.

*The one thing I've experienced comparable to that would have to be when my Spenser professor let it slip that one of the earliest Spenser critics was named Batman. (Stephen Batman, also spelled Bateman. The professor hypothesized that he became "Bateman" because scholars felt silly citing Batman as their authority. I don't know why; I'd certainly be interested to know what the Dark Knight thinks about sixteenth-century English poetry).

"Reparative Therapy" Still Being Used on Gender-Variant Kids

I was surprised to read, in this entry on Shiva's blog, that today, in 2008, children who display gender-atypical behavior can be put through intensive behavior-modification regimes to get the "correct" gender role drilled into them.

When I saw that, I had a strange sense of deja vu. A lot of the rhetoric used in support of these therapies --- and the actual treatment itself --- strongly resembles the language and techniques used in George Alan Rekers and O. Ivar Lovaas's now-infamous 1974 use of painful punishments to suppress young boys' preferences for feminine clothing and activities.

Here is Kenneth Zucker (whose invitation to speak before England's Royal Society of Medicine is the occasion for Shiva's post) on the necessity of preventing children from growing up to become transsexual or transgendered (quoted in J. Michael Bailey's 2003 book The Man Who Would Be Queen):

Zucker thinks that an important goal of treatment is to help the children accept their birth sex and to avoid becoming transsexual. His experience has convinced him that if a boy with GID (Gender Identity Disorder) becomes an adolescent with GID, the chances that he will become an adult with GID and seek a sex change are much higher.
...
Failure to intervene increases the chances of transsexualism in adulthood, which Zucker considers to be a bad outcome. ... Why put boys at risk for this when they can become gay men happy to be men?

Now, here's Lovaas and Rekers, in 1974:

It appears to be the case, in boys at least, that substantial deviation from appropriate sex-role behavior at age 5 yr leads to substantial gender problems in adulthood in the majority of cases (cf. Green and Money, 1969). Adult cross-gender problems not only develop early in childhood, but also contribute developmentally to difficulties in social relationships, so that by adulthood, the syndrome is frequently accompanied by other serious emotional, social and economic maladjustments. ... A third reason for treating (gender-variant children) is that intervention on deviant sex-role development in childhood may be the only effective manner of treating (i.e., preventing) serious forms of sexual deviance in adulthood ...

I don't detect much difference at all between those two passages in terms of the fundamental attitude toward unusual gender expressions or sexualities. Both stress that "deviance" must be nipped in the bud, extinguished while the person is still a malleable child, that society might be spared the *horror* of a gender-variant adult. Really, the only thing that suggests to me that these are not passages from the same era is the inclusion in the first quote of gay manhood as an acceptable outcome for a feminine boy. (I'm sure that Rekers and Lovaas would have considered that, too, a "maladjustment").

As I said in a comment on Shiva's post, the same bigotry towards gender variance is evident now as was common thirty-five years ago; the line separating acceptable difference from pathology has just moved a little.