I Am Jazz: Susan Bradley Rides Again!

Jazz Jennings

For those of you who saw last week’s I Am Jazz episode involving a podcast debate, you need to be aware of some misleading, false, and scientifically incorrect statements by Susan Bradley, a Toronto child psychiatrist who was the guest expert. The question at issue was whether children should postpone puberty using blocking drugs to give them more time to recognize their congruent gender and to decide about transsexual transition. Bradley is skeptical about this practice and believes that most children will automatically become cisgender as they mature. The approach she opposes is known as affirmative therapy. In this approach, transgender kids who are consistent, insistent, and persistent in their transgender behavior and expression are given the opportunity for a social transition prior to puberty. Affirmative therapy may include puberty blockers to provide time for them to recognize their congruent gender and deal with social issues. Contrary to Bradley’s view, reports from current studies of affirmative treatment for trans kids seem to indicate that it is going well so far.

Who is Susan Bradley? Susan Bradley formed the Clarke Institute in 1972 in Toronto to deal with children who she diagnosed as being transgender. The Clarke Institute later became the gender clinic at the Canadian Addiction and Mental Health (CAMH) center. The center was run by none other than Ken Zucker who published a book and several articles with Bradley and is known to practice “reparative therapy” on children. The CAMH center was recently disbanded and its leader was fired.

Here are four of Bradley’s problem statements:

1. The initial misleading statement by Bradley was that she identified herself not as a member of the former CAMH but only as a member of the Clarke Institute. A five-minute Google search would have revealed this misrepresentation. Google shows that Clarke Institute became the gender clinic at CAMH. The producer of the podcast should have known about this but probably wanted to avoid this literal “showstopper.” Many people know about the infamous CAMH but few know about its ancestry from the Clarke Institute. If she had been introduced as a former principal in CAMH, the debate would probably have been about CAMH and “reparative therapy,” not about affirmative treatment for transgender children.

Modern “reparative therapy” for kids usually involves three procedures (1) using coercive jawboning by the therapist and parents to try to convince the child of their “correct” gender based on cisgender culture, (2) operant conditioning, using rewards and punishments to change the gender behavior of a child and (3) only providing access to cisgender “appropriate” toys.

Operant conditioning schemes involve giving the children poker chips for cisgender behavior, and withdrawing them for “improper” behavior. The chips can ultimately be traded for rewards. The psychology terms for these procedures are reinforcement and response withdrawal of reinforcement. It has a long history in psychiatry after it became influenced by B.F. Skinner. You may remember him from Psychology 101 for the Skinner box used to test rats and pigeons on their learning and perception abilities. This was a time when psychiatry was gradually abandoning the use electroshock therapy, insulin shock therapy and electrical punishment using, human “cattle prods” and looking for more humane methods of changing behavior. Operant conditioning was seen as a better way to change behavior but it was equally ineffective as the treatments it replaced although less injurious. Subjects would change their behavior as long as they were in the training environment (Skinner box, gender clinic/home) but their behavior would revert to previous patterns outside of these environments.

1. Bradley’s second misleading statement was about the outcome of her patients at CAMH. She said from her research it could be concluded that most transgender children did not continue being transgender beyond early adulthood and so it made little sense to treat them with affirmative therapy and hormone blockers in childhood. This statement is undercut by the recent findings that a significant number of the CAMH patients were not transgender at all.

After the dissolution of the CAMH gender clinic, subsequent investigation indicated that many of the children in the CAMH “gender” center were not transgender at all. I have written about this in a previous post. Many of the children were actually “pre-homosexual” but since homosexuality was no longer treatable under the DSM/ICD coding after 1972, the kids were coded as transgender so that they could be treated under Canadian socialized medicine. Pre-homosexual kids do not present as transgender kids. Transgender kids are usually withdrawn and do not act out. They are concerned about their gender. Pre-homosexual kids are aggressive in their pursuit of sex with same sex children and do not really care about gender much at all. They may crossdress to be sexually attractive to same sex children. That gave some unscrupulous therapists the opportunity to deliberately misdiagnose them. People crossdress for all sorts of reasons, many of them unrelated to gender including theatrical presentations, political protest and being accepted into vocations and the military. The pre-homosexual children crossdressed to attempt to have sex.

Until laws against reparative therapy started to be passed around 2010-2011, researchers openly reported their deliberate misclassifications in their published papers. But such reports have totally disappeared. The problem of reparative has not gone away as illustrated in a recent Williams Institute report. In the United States, nine states, the District of Columbia and 32 localities ban the use of reparative “therapy” for children. The Williams Institute estimated that at least 20,000 of today’s children will receive such treatment before the age of 18 from healthcare providers and 57,000 will receive such treatment from religious sources. It is not clear how many are transgender and how many are LGB.

1. Bradley also made the statement that her recommended treatment for transgender children was “gentle discouragement” which is different from the harsh jawboning and other “treatments” that are typically used. She cited no clinical report that indicates that gentle discouragement has any effect. In the discussion, it was correctly pointed out by Jazz that culture, by itself, provides considerable discouragement of transgender behavior through social rejection.
2. The last statement she made which really riled me up was that “there is no proof that transgender children are born this way”. Readers of my blog posts and books know that there is considerable evidence that being transgender is a result of a genetic behavior predisposition that conflicts with the gender behavior category which is assigned at birth based on sex. We have no way of knowing whether the genetic predisposition is present at birth but it is certainly there in early childhood at 2-4 years old. There are a few incidental reports of it at 18 months. I do not think that she knows the literature. I would send her copies of my books, if I thought she would read them.

In conclusion, I have written blogs here about the studies of children who continue or discontinue transgender behavior as they grow up. As far as I am concerned, all of the studies are flawed, especially those from CAMH. Although transgender children may hide, delay, postpone, and defer their transgender behavior into adulthood it is always likely to appear sometime. As far as we know in Western culture, being transgender is forever.

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Tags: featured, Identity, opinion, Transgender, Transition

Category: Transgender Body & Soul, Transgender Opinion