Led by the child who simply knew

December 11, 2011 1:14 PM

Led by the child who simply knew The twin boys were identical in every way but one. Wyatt was a girl to the core, and now lives as one, with the help of a brave, loving family and a path-breaking doctor’s care.
posted by AwkwardPause (81 comments total)

It's my opinion that it seems a little bit young to be considering such a major surgery, and to undergo so many hormonal treatments, but you know what? I don't know what's best for that child, and I am not a transgender. My opinion doesn't count, and it seems that her doctors don't share the same concerns, and if her parents do I'm sure they're dealing with it as best as they can. So my opinion on the matter doesn't mean anything, and neither should anyone else's insecurities in that school/town. If no female raised a complaint about Nikki using the girl's bathroom, then I don't see the problem in this other than an incredibly religious, prejudice nutcase and his posse of backers.
posted by Malice at 1:29 PM on December 11, 2011 [5 favorites]

"Jonas and Wyatt Maines were born identical twins, but from the start each had a distinct personality.

Jonas was all boy. He loved Spiderman, action figures, pirates, and swords.

Wyatt favored pink tutus and beads. At 4, he insisted on a Barbie birthday cake and had a thing for mermaids."

Brings to mind the 2009 CBS NEWS | 60 Minutes segment: The Science Of Sexual Orientation which traces the continuing research of twins, sexuality and gender identity. Video [03:20].
posted by ericb at 1:30 PM on December 11, 2011 [1 favorite]

The website for The Children’s Hospital Gender Management Service (GeMS) Clinic.
posted by ericb at 1:34 PM on December 11, 2011 [2 favorites]

What a remarkable story about a family taking a journey together, growing acceptance, and a child's courage in the face of a hostile society at large.

Thanks so much for posting. This is a truly inspiring story in a lot of ways.
posted by hippybear at 1:44 PM on December 11, 2011 [10 favorites]

Not that this matters, but she's a very pretty girl!
posted by Malice at 1:48 PM on December 11, 2011 [1 favorite]

Great piece, and the little anecdote told by the dad at the very end about walking with the two kids, well, it made me cry. What a wonderful insight for him to share!
posted by thinkpiece at 1:52 PM on December 11, 2011 [4 favorites]

Great piece. It's very interesting to read such frank assessments of the family dynamic.
posted by samthemander at 1:55 PM on December 11, 2011

Jinx, thinkpiece!
posted by samthemander at 1:56 PM on December 11, 2011

incredibly touching.
posted by facetious at 1:56 PM on December 11, 2011

Yeah, well done article.

She recently started telling some of her new friends her story. One girl replied: “Does this mean you’re going to start wearing boys’ clothes to school?’’

“No,’’ replied Nicole. “I’m male to female.’’

The girl’s reaction? “She was like, ‘Ohhhhhhhhhhhhhhh.’ ’’

Hah.
posted by furiousxgeorge at 1:56 PM on December 11, 2011 [27 favorites]

I'm of so mixed minds about these things. On one hand I do know personally what it is like to live in a gender that you don't really want . I remember what that was like when I was very young. On the other hand I know that there are some messed up parents out there (I'm not referring to the parents in the story at all) that can and do transfer some messed up expectations and freaky-deak kinks about gender down to the children. How do you tell if a child is really having wrong-body issues or just acting out something that came somehow from the parents? The answer is that you can't. The science of gender identity - let alone psychology as a whole - simply isn't good enough to tell one way or the other. This is why I am somewhat uncomfortable about tales of pre-teenage transition . I wish the science and the knowledgebase were better :(
posted by Poet_Lariat at 2:00 PM on December 11, 2011 [16 favorites]

i can't get over how lucky this kid is to have the family she has - it's like watching 'it's a wonderful life' but for real - instead of a miserable runaway suicide, we've got a little girl growing up happy and loved.
posted by facetious at 2:01 PM on December 11, 2011 [24 favorites]

This is kind of amazing, because it defies my mental picture of traits like this being genetic. Both of these kids are genetically identical. But it's pretty hard to say environmental factors made the difference, when the kids were born and raised in the same environment. It's kind of baffling, really. Where does it come from?

(Agreed with the above comments about how great it is that her family is supportive and trying to educate others about this.)
posted by knave at 2:03 PM on December 11, 2011 [2 favorites]

This is kind of amazing, because it defies my mental picture of traits like this being genetic. Both of these kids are genetically identical.

Yeah, this is incredibly interesting from a scientific perspective.

(Agreed with the above comments about how great it is that her family is supportive and trying to educate others about this.)

Agreed 100% from a human perspective.
posted by jonmc at 2:05 PM on December 11, 2011

She's an amazing child.
posted by Mavri at 2:06 PM on December 11, 2011

The really screwed up thing about this family is that they live in Maine and their last name is Maines.
posted by miyabo at 2:06 PM on December 11, 2011 [37 favorites]

Nicole is really lucky to have such awesome parents and brother. She'll go far with them at her back.

The person I pity is that one bully who shows up in the article a couple of times. I'll wager any amount that his home life is absolutely awful.

And finally, did anyone else notice that the father is a "former Republican"? Good on him.
posted by Faint of Butt at 2:12 PM on December 11, 2011 [7 favorites]

“The drugs have a great track record; we already know that these kids do fine,’’ says Spack. “There are no ill consequences.’’

I'm not aware of any drug on the market that has no negative side effects, so I'd be pretty skeptical of any doctor who says something like that. Lupron, for example, has plenty of possible negative side effects like pituitary apoplexy.

There are certainly worse drugs we give all the time, but it is irresponsible to ever describe a regimen of drugs in such as cavalier way.

Both of these kids are genetically identical.

Twins are not genetically identical, random mutations can be present in one twin and not anther, but even among identical parts of the genome, gene expression itself varies thanks to things like epigenetics.
posted by melissam at 2:12 PM on December 11, 2011 [6 favorites]

"no ill consequences" is not the same as "no negative side effects to the drugs"
posted by hippybear at 2:14 PM on December 11, 2011 [2 favorites]

For another look at a transgender identical twin check out the documentary Red Without Blue. (available on netflix streaming)
posted by mindless progress at 2:15 PM on December 11, 2011 [2 favorites]

Setting aside the girl's comment about being rid of her penis, it feels a little backwards to have the story spelled out like, if you like pink things and dolls and accessories you are a girl, and if you like GI Joe sports and shooting things you're a boy.
posted by Houstonian at 2:16 PM on December 11, 2011 [39 favorites]

How wonderful, and perhaps how exceedingly fortunate, that she was literally born with the person who could be her protector and advocate from the start -- her brother.

“Dad, you might as well face it,’’ Wayne recalls Jonas saying. “You have a son and a daughter.’’

[...]

“I love having a sister,’’ says Jonas, who acknowledges being protective of her. “We have a very strong relationship.’’
posted by scody at 2:19 PM on December 11, 2011 [6 favorites]

"no ill consequences" is not the same as "no negative side effects to the drugs"

No ill consequences to me means you can pause puberty so kids can decide later without any consequences, which is clearly untrue.
posted by melissam at 2:22 PM on December 11, 2011

Jonas was all boy. He loved Spiderman, action figures, pirates, and swords.

This is a great story, but I hate that it starts with one of the most blatant cliches of gender stereotypes. I hate, hate, hate hearing that someone is "all boy." Being "all boy" is always defined as liking culturally approved boy things. Makes me feel bad for tall the half-boys, and quarter-boys out there. And God save the 1/10 boys. I'm glad the article is very supportive of Nicole, but what about all the kids who were born with boy parts, identify as boy, and couldn't give a damn about Spiderman, action figures, pirates, and swords? Or the girls who love those things?
posted by Alexander Hatchell at 2:25 PM on December 11, 2011 [75 favorites]

What happens to their development (brain, body) if someone chooses to stop blocking puberty without going forward on any kind of gender reassignment? I would think there are definitely consequences to pausing puberty for years but allowing the body/brain to keep growing. You don't grow up in a vacuum, all of the growth process is influenced by hormone levels.
posted by knave at 2:26 PM on December 11, 2011 [1 favorite]

The really screwed up thing about this family is that they live in Maine and their last name is Maines.

And the dad's name is Wayne.
posted by resurrexit at 2:28 PM on December 11, 2011 [13 favorites]

I would think there are definitely consequences to pausing puberty for years but allowing the body/brain to keep growing. You don't grow up in a vacuum, all of the growth process is influenced by hormone levels.

The converse of this observation is that in the US puberty is starting earlier and earlier... Makes me wonder what hormone or hormone analogs are creeping into our daily intake to inspire such a thing. It's happening too much in developed countries, not enough in other parts of the world, for it to be evidence of evolution in the human genome.
posted by hippybear at 2:29 PM on December 11, 2011

This is a great story, but I hate that it starts with one of the most blatant cliches of gender stereotypes.

It's really hard to write on this stuff without going for the stereotypes. I mean, "Her parents knew Nicole was a girl because...."

Beyond, "because she says so" (which is reason enough, when the person knows what they mean by it), it's hard to fill in that space. What characteristics do you describe to distinguish a boy and a girl without stereotypes of some kind?
posted by furiousxgeorge at 2:31 PM on December 11, 2011 [2 favorites]

Wow, I can only hope to be as amazing a parent one day. After a day spent with my bigot of a mother and her constant, hateful "It's a choice" about anyone who isn't hetero or gender normative, it gives me so much hope to see those who are able to rise above their fear and just, well, love.

That said, n'thing those who are sick of the boys like trucks/girls like dolls crap.
posted by Wantok at 2:32 PM on December 11, 2011 [1 favorite]

What characteristics do you describe to distinguish a boy and a girl without stereotypes of some kind?

Feeling like a penis is part of your nature, and feeling like a vagina is part of your nature. That seems to be about all that is required. If you feel your plumbing is alien to you, there's something going on which likely requires investigation. Everything else is cultural trappings.
posted by hippybear at 2:36 PM on December 11, 2011 [7 favorites]

"This is kind of amazing, because it defies my mental picture of traits like this being genetic. Both of these kids are genetically identical. But it's pretty hard to say environmental factors made the difference, when the kids were born and raised in the same environment. It's kind of baffling, really. Where does it come from?"

It's not that black-and-white.

Especially with sexual differentiation, a great deal occurs developmentally during gestation that is the combination of genetics, environment, and chance. Sex differentiation, and the related orientation, comes from a cascade of hormonal activity during gestation.

And sexual differentiation occurs across a large anatomical spectrum and at all levels of physiology. It's simply wrong to say that because of, say, the Y chromosome, someone is male or because of certain primary sexual anatomy, or because of some brain differentiation. Each of those is a piece of a whole person, and each of those can be more or less differentiated sexually. In a sense, all people are intersexed because pretty much no one has maximal sexual differentiation in every possible way in the same direction.

Think about things like, say, coat patterning on animals. For instance, calico cats. That's the combination of two different genes controlling pigmentation, and some of the cells which grow hair express one of those, and some the other. And then how those cells propogate across the surface of the embryo during gestation is regular but also partly random. All this combines to produce a coat pattern that is unique to each cat, even when, as in the case of cc, the first cloned cat and its clone parent (both were calicos, of course), are genetically identical.

Identical twins are genetically identical. So they share the exact same genetic basis, and, insofar as that's the case, they will be very much alike. In many ways, identical. But not in every way...because the end result is not exclusively determined by the genes. It's also determined by epigenetics, and by the biochemical environment, and by the physical environment, and by chance. And this is, in my opinion, especially so with the case of sexual differentiation, given both how it progresses and how far-reaching it is.
posted by Ivan Fyodorovich at 2:36 PM on December 11, 2011 [12 favorites]

Feeling like a penis is part of your nature, and feeling like a vagina is part of your nature. That seems to be about all that is required. If you feel your plumbing is alien to you, there's something going on which likely requires investigation. Everything else is cultural trappings.

But that doesn't describe all transgendered people, it's not just about plumbing. Some do not desire the surgery and will transition almost entirely in terms of what you describe as cultural trappings.
posted by furiousxgeorge at 2:39 PM on December 11, 2011 [6 favorites]

What characteristics do you describe to distinguish a boy and a girl without stereotypes of some kind?

Feeling like a penis is part of your nature, and feeling like a vagina is part of your nature. That seems to be about all that is required. If you feel your plumbing is alien to you, there's something going on which likely requires investigation. Everything else is cultural trappings.

What I don't understand about this thinking is that it seems to say if culture did not exist, men and women would be completely the same. Which is not true, since every culture has a marked difference between men and women. And like furiousxgeorge said, it's not all about the plumbing.
posted by trogdole at 2:44 PM on December 11, 2011 [6 favorites]

I said nothing about surgery in my response.
posted by hippybear at 2:45 PM on December 11, 2011

Let me clarify, I'm not interested in deciding who is or is not transgender, but I think you have some sex v. gender confusion going on there. Some transgender folks have no issue with their plumbing whatsoever, it goes beyond just not wanting surgery.

The point of my question was, how do you write about them? Nicole's gender expression is described in the article as distinctly stereotypically feminine in many ways in contrast with her brother. You can not sum up the difference between them with preference for different organs. So the difficulty is in writing about that while acknowledging the stereotypes are socially constructed anyway and you can't use them as your only guide, they are only part of the picture.
posted by furiousxgeorge at 2:53 PM on December 11, 2011 [3 favorites]

Well, I'd say that our language is failing us in some measure, then. Because transgender is separate from transvestitism is separate from genderfuck... and none of those seem to take in well the idea of a man who is a man but who has no medical interventions to make himself into a woman but who wants to be recognized by the culture at large as female.
posted by hippybear at 2:57 PM on December 11, 2011 [1 favorite]

I think you will find that transgender is the word for that.
posted by furiousxgeorge at 3:00 PM on December 11, 2011 [7 favorites]

I share similar feelings to Poet in that when I hear stories of young children undergoing reassignment, I'm of mixed feelings. On the one hand, the increasing number of these stories demonstrate, I think, the increasing acceptance of transgendered folks and a greater appreciation for the complexity of gender. On the other hand . . I remember my own gender non-conformity in toddlerhood and early school age and how I sort of just. . . transitioned out of it. I think a lot of gay folks go through similar experiences of identifying strongly with the opposite sex (possibly out lack of visible "role models" that are like us?). But here I am, 29 years old and as comfortable in my biological sex and gender as anyone could be. I'm not sure how things would be different if I were given the real opportunity to make such a huge decision prior to my teenage/young adult years.
posted by flamk at 3:05 PM on December 11, 2011 [9 favorites]

While every culture might have marked differences between men and women, they are not nearly identical in all cultures. While this is a heartwarming story, I'm always afraid when these link being an awkward fit with culturally encoded gender subjectivity with a need for physical change to match the codes you identify with.

My inner queer-theorist (who doesn't get much airing out, honestly) wonders whether there is any pushing to make the child "match" rather than, say, letting biological boys play with Barbies without being made to feel wrong and, and when sex attraction starts being a thing, work out their own identifications and affinities. When the brother said, "Dad, you have a son and a daughter" that doesn't leave a lot of room for there being two very different sons.
posted by LucretiusJones at 3:06 PM on December 11, 2011 [12 favorites]

Many gays and lesbians had gender-nonconforming childhoods. Oh, whoops, just saw what flamk said. That. I'm uncomfortable that this fact is not part of the conversation.
posted by Wordwoman at 3:08 PM on December 11, 2011 [1 favorite]

So my opinion on the matter doesn't mean anything, and neither should anyone else's insecurities in that school/town. If no female raised a complaint about Nikki using the girl's bathroom, then I don't see the problem in this other than an incredibly religious, prejudice nutcase and his posse of backers.

Then why give your opinion when you appear to know fuck all about trans people and transition? It's not 'a little bit young'--let's ignore the whole equation of transition with surgery thing--if you read the article, you'll note that she's been discussing surgery on some level since the age of five.

Let's drop the 'not a real girl' implication, either. Sure, boys shouldn't be policing the girls bathroom at school, and maybe that was your point, but trans people should get to fucking pee without harassment, regardless of who's policing the what bathroom.
posted by hoyland at 3:20 PM on December 11, 2011 [1 favorite]

On the other hand . . I remember my own gender non-conformity in toddlerhood and early school age and how I sort of just. . . transitioned out of it.

But the clinic addresses that. "The effects of the blockers - an injection given monthly to prevent the gonads from releasing the unwanted hormones - are reversible; patients can stop taking them and go through puberty as their biological sex. This is critical, Spack says, because a “very significant number of children who exhibit cross-gender behavior’’ before puberty “do not end up being transgender.’’

Granted you've given hormones (but not until it's time for puberty to start) but there is still time to see if cross-gender sticks, for lack of a better word. But this certainly something one would enter into with a great deal of caution.

This was a great article.
posted by shoesietart at 3:22 PM on December 11, 2011 [4 favorites]

Many gays and lesbians had gender-nonconforming childhoods. Oh, whoops, just saw what flamk said. That. I'm uncomfortable that this fact is not part of the conversation.

It's mentioned in the article, even. The fact that many heavily gender non-conforming children turn out not to be trans is why hormone blockers are seen as a serious boon. The idea is that you can stall long enough for the kid to figure things out with a greater degree of certainty. (Never mind that it's so hard to get trans-related care that the 'average' gender non-conforming adolescent isn't going to get access to hormone blockers. In the US, you basically have to happen to live in one of a few places, for a start.)
posted by hoyland at 3:25 PM on December 11, 2011 [2 favorites]

This is a great story, but I hate that it starts with one of the most blatant cliches of gender stereotypes.

The problem is, one component of gender identity (as opposed to biological sex) is cliche stereotypes. And plenty of transgender people choose to keep their respective genitals- a surgically created penis dubious and the current conversion of a penis to female genitals leaves much to be desired as far as sexual functioning.

And a crucial part of this girl's affirmation that she -was- a girl was the same stuff I dealt with as a biological female when I was deciding what to take and reject. If it was -just- a matter of plumbing, they'd be a lot closer to the people who want to amputate a limb because having a leg feels wrong.
posted by Phalene at 3:28 PM on December 11, 2011 [1 favorite]

His parents had no idea what was going on. They had barely heard the term “transgender.’’ Baffled, they tried to deflect Wyatt’s girlish impulses by buying him action figures like his brother’s and steering him toward Cub Scouts, soccer, and baseball.
[...]
“As a conventional dad, hunter, and former Republican, it took me longer to understand that I never had two sons,’’ he told them. “My children taught me who Nicole is and who she needed to be.’’

I think my favorite thing about this story is that the parents were people who came into this situation not knowing much about gender identity and maybe being kind of wary about accepting Nicole's assertion that she was a girl, but who've learned and adapted because they wanted to do what was best for their kids.

On the other hand . . I remember my own gender non-conformity in toddlerhood and early school age and how I sort of just. . . transitioned out of it. I think a lot of gay folks go through similar experiences of identifying strongly with the opposite sex (possibly out lack of visible "role models" that are like us?). But here I am, 29 years old and as comfortable in my biological sex and gender as anyone could be. I'm not sure how things would be different if I were given the real opportunity to make such a huge decision prior to my teenage/young adult years.

Yeah, I know what you mean. I'm straight, cis, and pretty comfortable with that, but I have a distinct memory of being really young--too young to really have an understanding of how sex and gender tied together--and wondering why and how everyone had decided I was a girl. I didn't act like "a girl" (i.e., in the way that other girls I knew acted), I didn't dress like a girl, and I had the vague idea that there was more to it than that, but be damned if I knew what.

Still, I think this:
When Wyatt was 4, he asked his mother: “When do I get to be a girl?’’ He told his father that he hated his penis and asked when he could be rid of it. Both father and son cried.
...is kind of in a different neighborhood from that. The article doesn't really go much into the way that medical and psychological professionals approach this, but my understanding is that there's a lot of psychological and medical evaluation and re-evaluation, and that the decision to start reassigning early started gaining acceptance because waiting can carry a fair amount of psychological and physical risk.

The converse of this observation is that in the US puberty is starting earlier and earlier... Makes me wonder what hormone or hormone analogs are creeping into our daily intake to inspire such a thing. It's happening too much in developed countries, not enough in other parts of the world, for it to be evidence of evolution in the human genome.

Emphasis mine--couldn't that be the cause? From an evolutionary standpoint, I'd think it makes sense that growing up in a resource-abundant environment would trigger earlier puberty; if there's enough food to sustain more people, then starting to procreate sooner is more desirable. I mean, this is a trend that started to be noticed in the 1840s.
posted by kagredon at 3:29 PM on December 11, 2011 [3 favorites]

couldn't that be the cause?

It could also be the soup of estrogen-analogues we swim in every day as part of modern food packaging and modern medicine.
posted by hippybear at 3:33 PM on December 11, 2011 [1 favorite]

Every day since the 1840s?
posted by kagredon at 3:33 PM on December 11, 2011 [1 favorite]

Many gays and lesbians had gender-nonconforming childhoods. Oh, whoops, just saw what flamk said. That. I'm uncomfortable that this fact is not part of the conversation.

It's mentioned in the article, even.

It is not mentioned in the article that a history of childhood gender non-conformity is an extremely common experience among gays and lesbians who grow up to be comfortable with their genders. I think this is a weird omission.
posted by Wordwoman at 3:36 PM on December 11, 2011

Twins are not genetically identical, random mutations can be present in one twin and not anther, but even among identical parts of the genome, gene expression itself varies thanks to things like epigenetics.

Wouldn't identical twins have the same 'epigentic' profile as well? Also your link doesn't talk about epigenetics, but rather talks about stochastic processes in the expression of various genes that regulate other genes.

The converse of this observation is that in the US puberty is starting earlier and earlier... Makes me wonder what hormone or hormone analogs are creeping into our daily intake to inspire such a thing.

Why does everyone want to pin this on pollution or toxins or whatever? Puberty is triggered by body mass, and obviously kids in the first world get more to eat. They actually grow taller then kids from decades ago or kids in developing countries. So why is it surprising that they would go through puberty earlier? People who are malnourished can go through puberty much later.
posted by delmoi at 3:37 PM on December 11, 2011 [4 favorites]

I would think there are definitely consequences to pausing puberty for years but allowing the body/brain to keep growing. You don't grow up in a vacuum, all of the growth process is influenced by hormone levels.

I'm not at all an expert, but I'm thinking from personal experience that this is what elite sports-people do all the time (and not always drug-aided). Just yesterday, I was talking with my grandmother about my training regime at 14-17 years, and my niece's similar demands now. None of us took hormone-blocking drugs, but I and now she certainly developed in a different way (much, much slower and with completely different bodies) from our peers. I can't see it has harmed us, and I am thinking early humans could have gone in both directions, adapting to different opportunities. The East-block athletes back in the day went through the same, but much more extremely.

From a scientific point of view, this is an amazing case, providing a new angle on several issues. Thanks for the link.
posted by mumimor at 3:38 PM on December 11, 2011

It's not about trans kids, but just to state the extremely obvious, Middlesex does an awfully good job of shining a light on the complex inner worlds beneath the "assigned role" of kids sorting out gender identity issues.
posted by thinkpiece at 3:55 PM on December 11, 2011

Every day since the 1840s?

Well, if you're suggesting that our modern times of plenty started nearly 200 years ago, you'll find you're mistaken there.

So we're probably both wrong about the source of the decreasing of puberty.
posted by hippybear at 3:56 PM on December 11, 2011

It's not like your body has a clock that can detect how old it is. People don't have rings you can measure to see how old you are. What else, other then weight and height could we use to determine when to go through puberty? If we're taller and fatter then we used to be, of course people will go though puberty earlier. It's only because people are freaked out about sex that this is a problem.
posted by delmoi at 4:02 PM on December 11, 2011

Wouldn't identical twins have the same 'epigentic' profile as well? Also your link doesn't talk about epigenetics, but rather talks about stochastic processes in the expression of various genes that regulate other genes.

No. The Nature editorial that that original article was referring to is better, but it's paywalled, but it discusses how stochasticity can affect epigenetics. Epigenetic expression can be modified by environment in the womb and later in life, but it can also just be random from what I understand.

Epigenetic mechanisms can easily be integrated into a model of phenotypic variation in multicellular organisms, which can explain some of the phenotypic differences among genetically identical organisms. MZ twin discordance for complex, chronic, non-Mendelian disorders such as schizophrenia, multiple sclerosis or asthma could arise as a result of a chain of unfavorable epigenetic events in the affected twin. During embryogenesis, childhood and adolescence there is ample opportunity for multidirectional effects of tissue differentiation, stochastic factors, hormones and probably some external environmental factors (nutrition, medications, addictions, etc.) (39,43) to accumulate in only one of the two identical twins (Fig. 2) (30,33).

posted by melissam at 4:15 PM on December 11, 2011 [1 favorite]

It's not like your body has a clock that can detect how old it is.

In point of fact there are many such clocks. Google AMPK or Hayflick limit, or telomere shortening or apoptosis for starters
posted by Poet_Lariat at 4:15 PM on December 11, 2011 [4 favorites]

It's not like your body has a clock that can detect how old it is.

I think it's pretty well established by this point that the pineal gland serves as a general aging clock for the body. Experiments in mice involving transplants have shown this to be largely true.
posted by hippybear at 4:20 PM on December 11, 2011 [3 favorites]

If we're taller and fatter then we used to be, of course people will go though puberty earlier. It's only because people are freaked out about sex that this is a problem.

They used to think % body fat was the trigger, but now scientists know it's not that simple:

This review weighs the evidence for and against the hypothesis that ovulation is regulated by a critical amount of body fat. The evidence supporting this hypothesis is correlative, and most of it stems from observations made in humans. On balance, the evidence from human studies does not support the hypothesis, however, and the results of animal studies argue strongly against it. In the latter regard, a variety of experimental approaches have been tried in both adult and peripubertal females of several species, and the results almost uniformly show little relationship between fatness and ovulation. There is no doubt that ovulation can be regulated somehow in relation to whole-body energy balance and that fat stores are an important component of energy balance, but there is no reason to accord body fat a direct causal role in regulating ovulation.

If you want to spend the rest of your day reading this, this paper is a pretty good survey of the MASSIVE amount of things being investigated as the cause for earlier puberty.
posted by melissam at 4:25 PM on December 11, 2011 [3 favorites]

"This is kind of amazing, because it defies my mental picture of traits like this being genetic. Both of these kids are genetically identical. But it's pretty hard to say environmental factors made the difference, when the kids were born and raised in the same environment. It's kind of baffling, really. Where does it come from?"

I always considered being transgender a birth defect, just like a cleft palate or what have you. During fetal development, the brain and the body got out of sync, and we do what we can medically to correct the body to match the brain.
posted by kafziel at 4:45 PM on December 11, 2011

This is kind of amazing, because it defies my mental picture of traits like this being genetic. Both of these kids are genetically identical.

Even if they were genetically identical (which is a can of worms all by itself) the interaction between the two fetuses and the mother's hormones at various stages of development can never be identical.

I recommend Between XX and XY in almost all of these discussions, so apologies for sounding like a broken record, but as a society I think our next biggest challenge is going to be moving beyond the gender binary.

That, or relearning subsistence farming, of course.
posted by odinsdream at 5:02 PM on December 11, 2011 [2 favorites]

melissam: "No ill consequences to me means you can pause puberty so kids can decide later without any consequences, which is clearly untrue."

Questions of whether delaying puberty has no negative consequences aside, I can promise you from personal experience and from discussions with many, many friends that not delaying puberty in cases where the child is genuinely transsexual can be extraordinarily harmful, with effects that can last for the rest of your life.
posted by ArmyOfKittens at 5:05 PM on December 11, 2011 [10 favorites]

"I Am Jazz" is a heartwarming look at a transgender 11-year-old: "One of my biggest fears right now is facing puberty," she told The Advocate. "Ever since I was younger I had nightmares about growing facial hair and having hair all over my body. Now that the time has come where this situation might occur, I'm getting nervous and desperate to take hormones to prevent puberty from happening."
posted by furiousxgeorge at 5:27 PM on December 11, 2011 [1 favorite]

One of my close friends has a 17 year old transgender daughter - this clinic has been a godsend for them both.

We knew since birth that this "boy" was different. Even as a little kid, he would disobey parents and brave the social opprobrium of peers to sneak girl's clothes to change into at school. Although it seems clueless in retrospect, most people - myself included - thought this was a matter of the child being gay.

I started thinking that it might be a transgender issue rather than a matter of being gay about four years ago. I started reading about transgender issues here on mefi and elsewhere. I was looking for more information that might be helpful to my friend as she and her son approached adolescence, with sexual identity and gender issues accelerating. I read about these hormonal blockers and mentioned them to my friend. She began a process of exploring transgender issues too, and seeking help - and found this clinic. It's so fortunate to be within an hour of one of the few places in the country that helps kids and their families.

She is a wonderful Mom and has never been afraid to tackle tough issues. But even still, it is so hard to know how to do the right thing for your child, and without a clinic like this or a supportive professional, it's a difficult path. Made more so because she is a single Mom with a non-supportive bully of an ex who has used the child's sexuality as a wedge issue in custody battles.

It's a special challenge for parents - to know the right thing to do, to know how to be supportive without being leading. She has often had her parenting called into question -- by the ex, by her family members, by neighbors, by school officials. ("Just don't let him dress in girl's clothes" "You are too permissive with him" "He is too young to know these things, he can decide on his own when he is an adult" etc etc). Even professional colleagues pose challenges. She always brought her boys in to the workplace on family days. Suddenly, she has a boy and a girl ... even well-meaning people are very puzzled and confused and it results in a lot of questions. Plus, it rang true when I heard the Dad in this article say he went through a stage where he grieved the loss of the son. I think my friend has somewhat mourned this loss, too.

At any rate, this child is doing very well. Supportive Mom, supportive brother, and now in a new private school which is also very supportive. She was on hormone therapy early enough to minimize the adolescent physical male changes. She is fully living as and identifying as a girl now and most people (family, friends) range from accepting to very supportive. It's still quite a path ahead, for her and for her Mom - but headed in the right direction, I believe. I give the parents in this article huge props for their courage - not just in addressing things with their child, but also in having the courage to share their story. That's what it is going to take to raise awareness for other good-but-less-aware parents to find help for their kids.

(Please excuse me or correct me if I have been awkward or wrong in my use of language.)
posted by madamjujujive at 5:37 PM on December 11, 2011 [12 favorites]

This is a great story, but I hate that it starts with one of the most blatant cliches of gender stereotypes. I hate, hate, hate hearing that someone is "all boy." Being "all boy" is always defined as liking culturally approved boy things. Makes me feel bad for tall the half-boys, and quarter-boys out there. And God save the 1/10 boys. I'm glad the article is very supportive of Nicole, but what about all the kids who were born with boy parts, identify as boy, and couldn't give a damn about Spiderman, action figures, pirates, and swords? Or the girls who love those things?

There are trans women who are tomboyish, who are lesbians, who like pirates and swords and don't want to wear make-up or ruffles. There are trans men who are sort of femme-y, there are trans men who are gay. IME, these folks are sometimes invisible in the discourse around trans issues, partly because there is a HUGE pressure on trans folks to point to obvious, gender stereotyping things to "prove" that they are trans, and there's also a lot of pressure to "prove" transness by pointing to something foundational, immutable, genetic, "essential" - because we live in a society where it's not enough to say "I really feel strongly that I am not the gender I was assigned at birth, I understand that this is a big deal and I would like to go through the process to change" - you have to jump through twenty gazillion hoops, usually hoops that are held by people with really TERRIBLE ideas about gender.

It shouldn't surprise anyone that if you are a trans woman, you feel the social pressure to "perform" gender correctly especially strongly, or even that being able to perform stereotypical girlness might be a source of pride or pleasure. Many of us non-trans people have I think had similar experiences - I got a big kick out of wearing dresses and heels at one point even though that's not something that's ever been a big part of my gender identity, because hey, there I was doing it right!!

I think one way that cis-gender/straight society tries to recuperate trans folks and queer folks is to assimilate us to cis and straight narratives about gender - a trans woman who likes girlie things is taken as proof (is forced to be proof) that there is some kind of deep down essential true femininity.

I think it's great that folks can transition young.
posted by Frowner at 5:55 PM on December 11, 2011 [21 favorites]

(The thing is, it's stupid to try to hold up our time-bound, socially and environmentally- conditioned lives as "proof" of something eternal and essential. In a hundred years (assuming that industrial society is around in a hundred years) we will all experience gender totally differently - I bet that people's reasons for transitioning will be different, the results will be different, the people who transition will be different. Maybe people who want to transition today would not want to transition in Future World, maybe folks who are happy with their gender today would feel that it was vital to transition at some other time. But since we live today, since we only get one shot at life in the bodies that we have, everyone should absolutely have the ability to safely live in the gender that they feel is the right one - we shouldn't dink around trying to figure out "essential truths" about something as social and time-bound as gender.)
posted by Frowner at 6:00 PM on December 11, 2011 [5 favorites]

There are trans women who are tomboyish, who are lesbians, who like pirates and swords and don't want to wear make-up or ruffles.

Isn't it hard to like pirates and not like ruffles?
posted by hippybear at 6:01 PM on December 11, 2011 [16 favorites]

Then why give your opinion when you appear to know fuck all about trans people and transition? It's not 'a little bit young'--let's ignore the whole equation of transition with surgery thing--if you read the article, you'll note that she's been discussing surgery on some level since the age of five.

Let's drop the 'not a real girl' implication, either. Sure, boys shouldn't be policing the girls bathroom at school, and maybe that was your point, but trans people should get to fucking pee without harassment, regardless of who's policing the what bathroom.

Wow, you need to settle down there.

I didn't say I knew 'fuck all' about trans people. I have several friends who are male to female and one female to male. I said I am not transgender myself. What the hell did I say that made you so angry?

My point was that the opinions of the Christian group, the father and the random bully shouldn't matter because they don't know the situation, the same that anyone on the outside wouldn't understand it.

Of course she should get to pee in comfort. That's pretty much what I said. The only people who had a problem was the bully, the bully's father (or grandfather, I can't remember which the article said) and the Christian group backing their complaint.

Chill out.
posted by Malice at 6:14 PM on December 11, 2011 [2 favorites]

A whole lot of drug trips, and one clever argument about evolution, have taught me to try and look at everything in life and the universe in terms of a spectrum.

At the far end, you can tell red from blue. As individuals and mental health professionals, it really is possible to categorize some people into male and female (as sex and/or gender). Red and Blue.

What we seem to miss too often is the amazing shades of purple that actually define what those other colors mean.

Transition between genders is something that a massive amount of social pressure pushes against for any individual. So, when I hear concerns about tweens/teens who might be confused or not quite sure about transition because of what parents or doctors might have done, I try and keep that in mind. Anybody will turn away from this path if they have any serious doubts, it's painful and hard.

Full transition seems unbelievably scary, it seems like a massive sacrifice of some things. Let me talk in terms of stereotypes for a second. One of the things we expect of every girl is that they will want to have and raise children. Full SRS will make having biological children impossible for a transwoman. For transmen, there is more flexibility, but there are some tradeoffs for that too.

So, do we really think that a transgender child who has embraced a female identity doesn't understand, as a teen, that they are sacrificing one of the pillars of that (stereotypical) identity if they proceed? Think about that in terms of someone who is taking on those stereotypical roles in the rest of their identity. If all the other messages about Disney princesses and Barbie and whatever sunk in, what about the baby thing? Don't get too concerned that many women, trans or biological, will sacrifice that much if they aren't sure.

Anyway, I think hippybear and others have made some good points about how children who do not fit the gender mold are not necessarily trans, but I think people should consider that the people who really start to seriously consider transition are confident and well informed enough to know the choices they are making.
posted by furiousxgeorge at 6:22 PM on December 11, 2011 [4 favorites]

Questions of whether delaying puberty has no negative consequences aside, I can promise you from personal experience and from discussions with many, many friends that not delaying puberty in cases where the child is genuinely transsexual can be extraordinarily harmful, with effects that can last for the rest of your life.

IIRC, puberty is not just a matter of sprouting hair, hips & breasts - things that post-puberty hormone treatments can address relatively well. Things that aren't so easy to reverse such as voice changes or bone structure (especially facial bones) also happen. For a trans-girl who comes from a family where the men tend to develop very deep voices or heavy & broad facial bones, being able to control and direct the onset of puberty toward her true gender identity can make the difference between looking and sounding typically female or having a masculine appearance that can never be adequately addressed by surgery, hormones and voice coaching.
posted by echolalia67 at 7:04 PM on December 11, 2011 [3 favorites]

And finally, did anyone else notice that the father is a "former Republican"? Good on him.

As a former Republican myself, I can't wait until it's no longer a big deal what party you are or were from when dealing with such personal issues.
posted by ladygypsy at 7:16 PM on December 11, 2011 [2 favorites]

That would require the current Republican platform to actually get out of people's personal affairs, like gender, for one. Honestly I think the party's more likely to dissolve before making such a change.
posted by odinsdream at 7:37 PM on December 11, 2011 [8 favorites]

I love this story but the article reinforces a lot of problematic assumptions.

Yes, some children who are gender non-conforming grow up to not be trans. But some children who are gender non-conforming DO grow up to be trans. Why is one group's safety so much more of a concern than the other? Why are the trans kids the ones who have to "wait and see" even though cis kids know their own genders and are completely accepted in that gender identity at the exact same age? If Nicole had been assigned female at birth, nobody would give a fuck. And yet somehow, because she deviates from the norm, this allows the entire world to judge her and doubt her own thought process and sense of self. This drives me absolutely nuts.

As a trans person who was semi gender conforming in my childhood, I agree with people upthread saying this boys-like-trucks and girls-like-princesses dichotomy is incredibly harmful. I liked ballet, figure skating, horses, and gymnastics but I still identify as male. If I were cis, this would be chalked up to me being gay. But instead, this is a reason I'm "not trans". It's an incredible undermining of my identity and it really annoys me. (It also likely led to my transition being postponed until after puberty which was incredibly harrowing and difficult for me.) There is a huge difference between "I don't feel like a typical girl" and "I feel like I am not a girl, I feel like I am a boy" - these kids likely know the difference if we would just ask them.

Basically, if someone says they are a boy/girl (not just acts as a stereotypical/acceptable boy/girl) then who are we to tell them otherwise? Who is anyone to tell them otherwise? If someone feels discomfort with body part A or B, so what? If they are afraid of puberty, then why force them to go through it when we can prevent it? Why does this mean everyone suddenly judges them and makes ageist etc. remarks?

For those who are wondering, I personally know several people who have been put on hormone blockers and are perfectly fine years later. One such friend was recently allowed to start testosterone at 17 and is a wonderfully well-adjusted and happy young man. They're not that big of a deal - especially when the alternative is 10+ years of feeling like you're living in a stranger's body, watching it change and freaking out. (Though, yes, being without sex hormones gets really weird after a while. Waiting until 17 to start giving cross-hormone treatment is another problem.)
posted by buteo at 11:10 PM on December 11, 2011 [5 favorites]

When Wyatt was 4, he asked his mother: “When do I get to be a girl?’’ He told his father that he hated his penis and asked when he could be rid of it. Both father and son cried.

I can sort of relate to this, from the other side of the coin, When I was 5, I noticed that I didn't have a penis. Obviously, a monster came and ate it in the middle of the night. This freaked me out, because I really REALLY wanted my penis back.

Also, I apparently got into a fair bit of trouble in preschool because I wanted to use the boy's bathrooms, in grade school because I only wanted to read the male roles in playacting, and in 6th Grade French because I chose the extremely feminine name of 'Claude'. Even now, I refer to myself as 'technically female'. I guess I could be considered transgendered in a way, yet despite all of this, I feel no urge to go through the process of actually physically changing gender. Instead, I'm happy being my bi tomboyish self.

Hats off to Nicole and her family!
posted by spinifex23 at 12:17 AM on December 12, 2011 [2 favorites]

C'est la vie
posted by furiousxgeorge at 12:45 AM on December 12, 2011

It shouldn't surprise anyone that if you are a trans woman, you feel the social pressure to "perform" gender correctly especially strongly, or even that being able to perform stereotypical girlness might be a source of pride or pleasure. Many of us non-trans people have I think had similar experiences - I got a big kick out of wearing dresses and heels at one point even though that's not something that's ever been a big part of my gender identity, because hey, there I was doing it right!!

That makes a lot of sense to me.

Part of the reason that I hate the gender cliches is that I never really conformed to them as a boy--or as a (cisgendered, heterosexual) man, for that matter. I couldn't give a damn about sports, I've never hunted, and don't really care about Spider-man or pirates. As a kid I sat quietly and read my books. I certainly felt "all boy," and resented any implication that being a genuine boy meant being rowdy and playing sports. Now I have a daughter who quite happily identifies as a girl, but loves to play with pick-up trucks and her toy tool box, and who is really interested in outer space. When she started preschool she quickly learned that girls are into princesses, so she added that to her list of interests, but is holding on to the other things as well. I'm pretty certain that she is "all girl," but I'm sure some would disagree.

It would have bothered me a lot less if the writer had said something like "Jonas clearly identified as a boy, and was drawn to many of our culture's stereotypically masculine interests: Spiderman, action figures, pirates, and swords. Wyatt, on the other hand, gravitated toward recognized expressions of femininity: pink tutus and beads. At 4, he insisted on a Barbie birthday cake and had a thing for mermaids." Even that might be somewhat problematic, but I would like some acknowledgement that there isn't a gene for liking pink passed down from mother to daughter, and swordsmanship isn't carried on the y chromosome. I think it's fair to say that, in general, people who identify as one gender or the other quickly figure out how that gender identity expresses itself in their society, and most will generally conform to that. If a child who is biologically male wants to wear pink tutus that is certainly a sign of potential transsexualism. But it could be eight other things as well. My five-year-old is insistent that Spider-man is for boys and princesses are for girls, but that is something that she was taught by other kids, definitely not an idea she had ever expressed before preschool. I'm trying hard to disabuse her of that notion, but here it crops up in the Boston Globe.
posted by Alexander Hatchell at 7:02 AM on December 12, 2011 [3 favorites]

By the way, non-gender conforming as I may be, I still know that Spider-man is properly spelled with a hyphen. Now I have to send two notes to the editor.
posted by Alexander Hatchell at 7:03 AM on December 12, 2011 [1 favorite]

Yes, some children who are gender non-conforming grow up to not be trans. But some children who are gender non-conforming DO grow up to be trans. Why is one group's safety so much more of a concern than the other?

Maybe medical folks would need to weigh in here, but isn't it standard practice with medical interventions that if there's a significant likelihood that a condition will be outgrown, it's good to take a wait and see attitude? Every medical intervention has risks. Have there been clinical trials -- not just anecdotes and blithe assurances -- showing that hormonal interventions for children are safe and result in better outcomes?
posted by Wordwoman at 9:14 AM on December 12, 2011 [1 favorite]

With regards to Wordwoman's sensible question, I'm having a hard time coming up with solid statistics, but stuff like this seems interesting (countered by this, which I got to from here).

Overall, transgenders suffer from a significant increased chance of suicide (and presumably all the associated misery, self-hatred, bullying etc. for the survivors), and the treatment seems to have significant positive impact.

I don't know what the side effects are, but based on what I've read I don't think I'd be inclined to gamble on anyone close to me growing out of it.
posted by YAMWAK at 9:40 AM on December 12, 2011 [1 favorite]

To make a long personal anecdote short:

When I was five, I was breaking gender stereotypical behavior... or trying to. And then, i "grew out of it" and forgot it for years, though it was always there. I started feeling it in my late teens and considered it a sort of spiritual, internal thing. Over the next several years I started feeling and expressing it more, so gradually I didn't really notice until my mid-30s. The funny thing is, all that time I was vaguely uncomfortable about transgender issues.

I was 39 before I finally had to ask myself where I was and where I wanted to be in terms of gender. Did I want to transition, and if so how? A few weeks of research and contemplation led me where I am now, which is identifying as non-binary gender but generally presenting as my birth sex. I know who I am and other people mostly don't, and I have made peace with that.

So anyway -- "growing out of it" can simply mean "learning that society thinks it's weird and/or wrong, and repressing it."
posted by Foosnark at 10:06 AM on December 12, 2011 [2 favorites]

I recently saw a documentary on the CBC about transgendered kids, I think, but not entirely sure, the girl in the article was in it.
posted by squeak at 10:58 AM on December 12, 2011

Have there been clinical trials -- not just anecdotes and blithe assurances -- showing that hormonal interventions for children are safe and result in better outcomes?

No, it's still an off-label use for most of those drugs.

I don't know what the side effects are, but based on what I've read I don't think I'd be inclined to gamble on anyone close to me growing out of it.

But that said, I'd probably do the same. There are tons of drugs we regularly give adolescents that have similar possible side effects, such as accutane or hormonal birth control. It's pretty irresponsible to say there is no downside to the blockers, but for many of these people, the costs are worth the benefits.
posted by melissam at 12:22 PM on December 12, 2011

Have there been clinical trials -- not just anecdotes and blithe assurances -- showing that hormonal interventions for children are safe and result in better outcomes?

So I don't know how to go about finding linkable full text, so you'll have to make do with the abstract, but this is the Dutch study that's always referred to on this subject. To my lay person's mind, it's about as confident-sounding as any other study concerning trans people. (To me they all read like 'Well, that seemed to work. Maybe we should keep doing it.' I have no idea if this is specific to things involving trans issues or because I don't read many psychology articles.)

There is a school of thought that because it's not really possible to say anything more concrete than 'seems to have worked out okay', you shouldn't be messing about with hormone blockers. (Though, to be honest, the one lit review I read making that argument creeped me the fuck out. Apparently, all trans people are secretly gay and rejected that to compensate for fucked up parents. Or something.)

I think the reason you don't see the 'will this kill trans kids?' question addressed is that the drugs were already in use. (Though in 'classic' use, hormone blockers are used to delay puberty when it begins too early, whereas this conversation basically assumes typical timing for the onset of puberty.) Well, that, or you might need non-trivial sample sizes.
posted by hoyland at 11:51 AM on December 13, 2011