Tough fluidity: complex considerations for trans youth.

Author:Goemans, Deborah June

Snips and snails

And puppy-dogs' tails

That's what little boys are made of.

Sugar and spice

And all that's nice

That's what little girls are made of.

Last year was a big year for "Jan." She was in first grade and her parents had agreed to let her transition from her assigned gender, which was male, to the gender she identifies as, which is female. This is an enlightened age and Jan lives in an enlightened country (South Africa), and so her elementary school principal gathered the students and their parents around and informed everyone that Jan was now going to live as "a girl with boy bits."

Jan's mother explained how we're all different and that she, Jan's mother, is different because she has one foot bigger than the other. After the adults finished speaking, they asked if any of the children had questions. Two boys raised their hands. The first said he felt sorry for Jan.

"Oh?" said the principal. "But you know Jan wants to live as a girl and not a boy."

"Yes," he replied, "but that's not why I'm sorry. I'm sorry for Jan because her mom has one foot bigger than the other." And the other little boy? He said he knew exactly how Jan felt because he was half-fish.

The teachers didn't know how to respond to an identity they hadn't heard of, but okay--transgender, gender-fluid, half-fish--they weren't going to judge. The gob-smacked response of the adults to the innocence of a child identifying as half-fish (because his mother said he swims like a fish) reveals why gender identity is such a hot topic; it's part evolutionary debate, part human rights issue, part kindness and respect, and part sociological Wild West as we grapple with changing norms, changing language, and changing expectations.

A quick lesson to start. Many people confuse gender identity with sexual preference, but they're two different things: gender identity is one's own body image--the element that makes a boy identify as a boy, a girl identify as a girl, a girl identify as a boy, or vice versa--while sexual preference is the sexual identity of the person with whom one wants to have sex. So, your sexual identity may be cisgender male (with penis and testes intact) but your sexual preference can be gay.

Sexual identity is clearly complex, but everyone has a sex that is determined by three things:

1) The sex chromosomes--XY for boys and XX for females, and sometimes other variants, such as when girls have one X chromosome or an extra X chromosome and boys have an extra X chromosome. The chromosomes govern the synthesis of various hormones responsible for forming the gonads (the ovaries or testes), the genitals (the vagina and the penis), and the sexual parts of the brain. Our sex chromosomes are set at conception and do not change throughout our lives. Their action, however, can be influenced by hormones, including hormones administered by physicians.

2) The sexual organs are undetermined during the first seven weeks of gestation. During this period, the basic architecture of the fetus is laid out fish-like: head to tail, right and left, and ventral to dorsal, and the tissues for the gonads are essentially there and starting their journey, but it's not visually obvious if they will produce female or male sexual organs, or both, or neither. Over the next five weeks in utero, we can see the sexual organs beginning to develop. This process, known as differentiation, is controlled, for the most part, by hormones under the...

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