Therapeutic Intervention For Gender Variance
Since the mid-1970s Zucker has treated about 500 preadolescent gender-variant children to "help these kids be more content in their biological gender" until they are older and can determine their sexual identity. For children assigned as males at birth, Zucker asks parents to take away their child's "feminine" toys and instruct the child not to play with or draw pictures of girls. Psychologist Darryl Hill describes Zucker's approach to gender-variant children:
Zucker and Bradley believe that reparative treatments (encouraging the child to accept their natal sex and associated gender) can be therapeutic for several reasons. They believe that treatment can reduce social ostracism by helping gender non-conforming children mix more readily with same sex peers and prevent long-term psychopathological development (i.e., it is easier to change a child than a society intolerant of gender diversity). Reparative therapy is believed to reduce the chances of adult GID (i.e., transsexualism) which Zucker and Bradley characterize as undesirable.
Zucker is at odds with gay and transgender groups, but distances himself from organizations that share this distinction. Zucker believes that failing to control a child's gender expression at a young age and seek early counseling for transgendered behavior can be considered "some type of emotional neglect." He claims some parents may have been swayed by an activist transsexual agenda and "cement...in more and more" behaviors that may not result from transsexualism. Instead Zucker advises such children work through their hatred of their bodies before being accepted as transsexuals. His work shows an 80-90% success rate in swaying children from later transsgender identification.
Zucker supports the early intervention of children with ambiguous genitalia to be assigned and reared as female, or more generally as "the gender that carries the best prognosis for good reproductive function, good sexual function, normal-looking external genitalia and physical appearance, and a stable gender identity." He published results of two patients who were male by birth but suffered ablatio penis and were shortly thereafter reassigned as females. At age 26 both denied ever feeling the desire to be male. Both patients reported more masculine behaviors and bisexuality, about which Zucker suspects that gender role and sexual orientation develop mostly before birth while gender identity development begins shortly after birth.
Zucker says parents set the goals at his clinic. "We recommend that one goal be to help the child feel more secure about his or her actual gender, another to deal with the child's emotional difficulties, and a third to help with problems in the family. It's helpful to have parents set limits on things like cross-dressing, which many parents have not done before coming to us." Zucker's follow-up of 50 treated children found that "about 10 percent are still very unhappy about their gender, still cross-dressing, and thinking about having sex reassignment surgery" as young adults. Zucker has stated that "the therapist must rely on the 'clinical wisdom' that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions."
Zucker coauthored a statistical report with J. Michael Bailey that found gays and lesbians exhibited more cross-gender activity as children. Bailey claims Zucker considers transsexualism a "bad outcome" for these children, specifically citing the risks and hassle of sex change operations.
For adolescent clients expressing gender identity disorder, Zucker's treatment protocol resembles that for adult GID, consisting of hormone replacement therapy to aid the adolescent in a social transition. Since sex reassignment surgery is not generally performed on minors in North America, Zucker's clinic does not provide recommendations for it – instead, clients are encouraged to pursue reassignment through the adult Gender Identity Clinic at CAMH, which controls funding for the procedure in Ontario.
Read more about this topic: Kenneth Zucker
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