Sunday, August 7, 2016

On Our Right to Choose

I understand gender identity and sexual orientation both as potentially fluid. It's not the case that they can be made to change, so we still need to ban straightenating camps and the like, but that they can sometimes evolve over time. Or, if they're rigid, then it might be the case that our self-awareness evolves over time. Either way...

Sexual orientation isn't a choice. Absolutely. And once we feel safe enough that enough people acknowledge that, we can look at the fluidity of orientation. Sometimes it seems to shift. A person might strongly identify as gay and then meet that one person of the opposite sex that turns their head. It happens. It still doesn't make it a choice. But it is possible for things to move slightly over time. It's always a bit of a gamble to be dogmatic about who we are as stable, immutable beings. I don't think that's as contentious an idea as it once was. So, can we acknowledge that gender identity might also have the potential for fluidity?

I was recently introduced to the notion of gender identity being on a range from high to low intensity, which I find useful as a concept.

Mine is very low, but I understand the importance of identity being recognized by others. I'm an environmentalist, and that part of my identity has a much stronger intensity, which was revealed to me when someone questioned it, as in, "The fact that you don't own a car is meaningless since you've rented cars and have been a passenger in cars. You're obviously not a real environmentalist." That bothered me far more than someone questioning my gender or orientation.

So, it's vital for people to be able to present themselves as they see themselves, however that is. I could get into a whole can of worms about self-identifying as a writer or actor or expert of some field, but that's a story for another day. Being an environmentalist isn't a direct analogy, merely a means to develop empathy. It can be difficult to understand the importance of something we don't feel ourselves. It makes it no less important if we don't understand the experience; strong feelings around gender identity is not just a trend or a means to feel special. We find ways to elicit a similar emotion in ourselves in order to provoke our compassion when it's hard to understand experiences directly.

But. If gender identity is also potentially fluid over time (I don't mean gender fluid as an identity here), then there's a small chance that someone wanting surgery could have some regrets later on. In fact, it seems for some people that banking on surgery actually changing their lives for the better can lead to profound disappointment. Yet children with gender dysphoria can get hormone blockers at 11 or 12, and surgery at 16.

It feels like something we're not supposed to talk about. It's like talking about people who regret having had an abortion. If we acknowledge it, then it could make abortions harder to access, so we don't talk about it too openly even though it's a very real thing. Although it can be a difficult process, with no guarantees, I feel strongly that both should remain a legal, accessible option. For sexual reassignment surgery, regret seems relatively rare. (I can't find any numbers that I feel confident about - that aren't mired in hyperbolic language.) The few who might grieve their old self shouldn't affect the possibility of help for the many.

This is where I turn a corner into different territory. It's the case that people can get gender reassignment surgery at 16 after consistently indicating they have gender dysphoria. This surgery dramatically affects later childbearing possibilities: Although sperm and eggs can be frozen for later use, it's necessary to have further medical interventions to have children. And some people do regret the decision to have the surgery.

BUT. Young adults who feel strongly that they never want to have children can't get surgically sterilized. They too might regret the decision, and if they do, they too could freeze sperm or eggs for later use just in case. It would require further medical intervention later on, but we accept that risk with gender dysphoria. Or, as one young adult told me, "If I have the surgery now, and later on I want kids, then it forces me to adopt. And if it's difficult to adopt an infant here, I'll have to adopt an older child or a child from another country. If I really want a child, I can care for a child that already exists and doesn't have anyone else to care for it."

When children or teenagers say they identify as a different gender than indicated on their birth certificate, we don't question it. We're fully supportive. But when teenagers or young adults in their early 20s say they never want kids, we universally say, "You will when you're older." Is it the case that 16-year-olds are old enough to know who they are, or isn't it?

Or is this a false analogy? It could be the case that it's more likely for people to be sure about their gender than to be sure about their lifestyle. Yet there are teens who really want kids, and we don't warn them that hey might not when they're older, or that they'll be sorry if they have some (even though they certainly might). We want them to wait for financial and maturity reasons, not because we think they could change their minds. We all really lean in the one direction. Teenagers who fit our cultural and evolutionary norms of development are accepted as knowing their preferred future identity as a parent. Teens who don't fit, clearly don't know their own minds. Funny that.

It's hard for us breeders to understand, but we must accept that experience. It might shift over time; it is possible, but we can't make people live today planning their lives on the off-chance that they'll feel dramatically different decades from now.

Here's the thing. We have a serious population problem, as Suzuki explains here:

If we need to curb our population growth, and there are some teenagers and young adults who want to take permanent action to avoid having children, why in the world do we prevent them? Why make them wait until they're well into their 30s? They can get sexual reassignment surgery or an abortion at 16 (not that the two are in any way related), but have to wait two more decades to get a 20-minute, low risk procedure: a tubal ligation or vasectomy. If we care about the future of our species, then we should want to reduce our population. So, we should actually offer a cash incentive to teenagers willing to be sterilized!

This article details some stories of frustration, as does this one, and this one, and this one. We have the choice to get pregnant, to terminate a pregnancy, and to temporarily avoid a pregnancy, but doctors aren't comfortable with a simple permanent solution until we're almost unable to procreate. Get comfortable, already!

Also check out this Big Think article: "Do Humans have a Moral Duty to Stop Procreating."


The Mound of Sound said...

Although the Suzuki clip is captioned "population growth" he's really getting at GDP growth, our addiction to exponential growth in production and consumption. In the postwar West we have adopted an orthodoxy of 3% annual growth in GDP. If you run that through any online interest calculator at intervals of 50, 100, 200 and 300 years you'll see how insane that modest 3% growth becomes.

This is very timely as tomorrow marks Earth Overshoot Day 2016, the date on which mankind has consumed a full year's supply of biomass and other renewable resources. Last year it fell on August 13th, the year before on August 19th. Each year increases our excessive demand on our planet's finite resources. The rest of the year, almost five months this year, we rely on conjuring tricks to devour the planet's reserves that results in desertification from soil exhaustion, deforestation, loss of biodiversity, the collapse of global fisheries and the increasing accumulation of waste and pollution of all sorts. We're now using the resources of 1.7 planet Earths. This is the life we're living and our civilization is utterly dependent on its continuation and constant increase. The minute we stop - or are stopped - it's collapse for us. It's the result of 30+ years of doing things "because we can" with utter disregard for whether we should, in the process adding credence to the theory that intelligent life is self-extinguishing.

It's crunch time, Marie.

Marie Snyder said...

It certainly is. We're just going to ignore it, insisting it's nowhere near as close as the IPCC and others suggest. There will be time, there will be time...

Lorne said...

As The Mound indicates, Marie, our situation is dire, yet I doubt that Earth Overshoot Day will garner any attention in the MSM. They, like the majority of people, seem quite willing to go willfully and blindly on, lest anyone or anything should upset the apple cart of continuous growth and our apparent need for endless convenience..

Dr Sarah said...

What cases do you know of in which a 16-year-old has had gender reassignment surgery? That sounds suspiciously like a transphobic propaganda myth. My guess is that, if such cases even exist, they're going to be a) very rare and b) used only for incredibly severe cases where even a combination of social and hormonal transitioning isn't sufficiently controlling the gender dysphoria symptoms. I don't think that's really analogous to allowing a child of that age to make a final decision about procreation, because, in the case of procreation, there are so many temporary and reversible ways to prevent it.

I'm very much in favour of people who don't want children deciding not to have them, but I think there's got to be a middle ground between "Hassle people who don't want children about changing their minds" and "Be fine with people making irrevocable decisions about this in their teenage years". I wouldn't support sterilisation for a teen either, unless there's some really rare and exceptional circumstance, and I can't think what that would be.

Marie Snyder said...

@ Dr. Sarah: I'm a teacher and have actual students who have had surgery while still in high school. It's rare relative to the cis population for sure, but I'm not sure how rare it is for the number of trans kids. I'm not sure it's a matter of "severe" cases, and I'm not really sure what that means. These guys won't lose their breasts with just hormones and therapy. Is it better just to wear a painful binder for the rest of their lives? You make a good point about there being mainly temporary ways to prevent procreation, but they all come with side effects. Is it better to have a simple operation than to take pills for thirty years?

But, more to the point of the post, at what age is it reasonable for people to have this choice? Some doctors say, "After you've already had some kids" or they want to wait until the mid-30s. You don't think it should be allowed for teenagers, but how about early 20s? At what age should people be allowed to make permanently life-altering decisions that only affect their own lives?