Targeting Gender Nonconforming Youth

Photograph Source: brian kusler – CC BY 2.0

The U.S. has been a battlefield over cultural values for nearly 50 years. In states throughout the country, the religious right — together with local Republicans — have built an influential political movement to impose their moral values. Donald Trump’s appointment of two conservatives to the Supreme Court has emboldened the religious right to press its moralistic campaign against their primary target, abortion, a woman’s right to determine her pregnancy.

In keeping with the right’s policy of targeting the weakest among us, they are now aggressively moving against young people (i.e., children and teenagers) who are struggling over their sexual identity. As psychiatrist Jack Drescher, MD, clinical professor, psychiatry, Columbia University, explained, “[C]hildren serve as proxies for the competing value systems of adults.”

The current culture war against gender nonconforming — transgender or transsexual — youth began in 2015 and 2016 when lawmakers in a handful of states sought to bar transgender students access to bathrooms. “These attacks on transgender youths tend to seize on whatever can be sensationalized to the general public,” notes Ryan Thoreson, a Yale Law School lecturer and an LGBT rights researcher at Human Rights Watch.  By 2019 and this year, he adds, “I think, the issue they’ve chosen to seize upon is basic healthcare for trans kids.”

Over the last few years, two things have intensified the battle over youthful sexual identity. First, the scope of “issues” that states are seeking to impose restrictions on gender nonconforming kids have increased; and, second, the number of states actively pursuing such policies have increased.


The following outlines some of the actions being undertake to repress gender nonconforming youths and the states involved.

Bathroom bills

§  North Carolina – in 2016, it adopted the Public Facilities Privacy & Security Act – what became known as the “bathroom bill” — that required transgender people in state-run buildings use the bathrooms, changing rooms and showers that corresponded to the sex on their birth certificates; in 2017, under a legal challenge from the ACLU and the Obama administration, the state removing the restrictions on restroom use.

§  Washington – seeking to update its indecent exposure law making a person guilty of indecent exposure if a person is a “biological” male or female and “intentionally makes any open and obscene exposure of his person in a restroom facility that is designated for use by the opposite sex.

§  Other states – that National Conference of State Legislatures (NCSL) identifies 15 states (in addition to Washington) that have considered bathroom bills.

Medical treatment of transgender youth

§  South Dakota – the House passed legislation that bans state doctors from treating transgender children with hormones and sex reassignment surgery. Under the proposed law, doctors would receive misdemeanor charges if they are caught giving transgender children under 16 years old hormone treatment. The bill also bans them from performing “castration” or vasectomies on children in that age range.

§  Florida – would make performing gender reassignment therapy a felony.

§  Oklahoma – would strip physicians, nurses and other healthcare professionals of their licenses if they participate in gender reassignment procedures.

§  South Carolina — would strip physicians, nurses and other healthcare professionals of their licenses if they participate in gender reassignment procedures.

§  Missouri — proposed laws that ban healthcare providers from performing gender reassignment treatments and would classify parents who sign off on the treatments as child abusers.

§  Colorado — proposed laws that ban healthcare providers from performing gender reassignment treatments in order to “protect minors from mutilation and sterilization.”

Restrict school activities

 §  South Dakota – the legislature is considering a bill that could prevent transgender students from playing on high school sports teams based on their gender identity.  It would make the gender on a student’s birth certificate the “sole determinant” of their “sexual identity” for participating in high school athletics.

§  Other actions – the NCAL identifies efforts in by 14 states (including South Dakota) hat would limit transgender students’ rights at school.

Child custody

§  Texas — a bill would allow the court to disregard whether a parent or guardian acknowledges (or declines to acknowledge) a child’s gender identity in decisions regarding custody.

It must be acknowledged that against the efforts by Republican-controlled states to restrict the rights of gender nonconforming young people, many states have passed laws that protect the rights of trans youth and other people.


Gender nonconforming people have been part of America since before the country was a nation.  Genny Beemyn, in “Transgender History in The United States,” notes that in the 1620s Thomas/Thomasine Hall, an English servant in colonial Virginia, “claimed to be both a man and a woman and, at different times, adopted the traditional roles and clothing of men and women.” At trial in 1629 concerning her/his scandalous behavior, the court ordered Hall to wear both a man’s breeches and a woman’s apron.  Beemyn also notes that in Middlesex County, MA, in 1692, charges were filed against an individual named Mary Henly for wearing “men’s clothing” because such behavior was “seeming to confound the course of nature.”

Three-plus centuries later, in 1952, George Jorgensen, a 26-year-old former private in the U.S. Army, traveled to Denmark and sought out medical assistance from Dr. Christian Hamburger, an endocrinologist, to perform what was then known as a “sex change” operation.  Returning to New York as Christine Jorgensen, her daring gained a famous Daily News headline: “Ex-GI Becomes Beauty.”

A reportedly meek, retiring guy left New York and a glamorous, sexy gal returned.  In popular “before” and “after” photos from the period, it appears that a male was not merely transformed into a female, but a butterfly was liberated from its caterpillar self. The new Jorgensen appears with high cheekbones, long eyelashes, full, painted lips, wearing a stylish hat and often wrapped in a full-length fur coat.

Over a three-year period, Dr. Harry Benjamin provided hormone therapy to Jorgensen as part of her gender reassignment procedure. Jorgensen took full advantage of her newfound celebrity, becoming a successful entertainer, crafting an inviting stage presence that endeared her to audiences throughout the U.S. and the world.  A modern chanteuse, she entertained her audiences with dance, humorous commentary and song, singing “I Enjoy Being a Girl.”

Six decades later, two very different public men underwent what is currently known as “gender reassignment surgery,” morphing from males to females.

Bruce Jenner, an Olympic decathlete gold medal–winner became Caitlyn Jenner; Bradley Manning, a U.S. Army information specialist was convicted in July 2013 of violations of the Espionage Act; he released a reported 750,000 classified — or unclassified but sensitive — military and diplomatic documents; he became Chelsea Manning

Something profound is at play. The meaning of “sexual identity” – however defined – is changing.  A half-century ago gay and lesbian activists launched an ultimately successful campaign to overturn the traditional, patriarchal model of acceptable sexual identity and practice.  Now, as adult transsexual and other gender nonconforming adults are successfully battling to further reconfigure the nation’s sexual culture, the religious right has targeted nonconforming young people to hold the line on traditional gender order.

Recent scholarly studies have revealed just how “normal” the once “abnormal” has become.  In 2019, the Proceedings of the National Academy of Sciences (PNAS) published a critical study, “Similarity in transgender and cisgender children’s gender development.”  One of its findings is suggestive as to how sexual culture changes through the experience of transgender kids aged 3 and 12.  It reports:

… transgender children strongly identify as members of their current gender group and show gender-typed preferences and behaviors that are strongly associated with their current gender, not the gender typically associated with their sex assigned at birth.

The study’s lead author, Selin Gülgöz, PhD, Department of Psychology, University of Washington, reports that “the overwhelming finding is that transgender children … show strong identification with their current gender, and they show strong preferences for toys, clothing, and peers typically associated with their current gender, and not their assigned sex.” Drescher, a psychiatrist, cautions: “This study does not answer the question of why some children develop a transgender identity, or a cisgender identity, for that matter.”

“Sex is a biological categorization based primarily on reproductive potential, whereas gender is the social elaboration of biological sex,” argue Penelope Eckert (Stanford) and Sally Penelope McConnell-Ginet (Cornell). They insist, “there is no single objective biological criterion for male or female sex.”  Going further, they note: “Sex is based in a combination of anatomical, endocrinal and chromosomal features, and the selection among these criteria for sex assignment is based very much on cultural beliefs about what actually makes someone male or female.”  Eckert and McConnell-Ginet adhere to an analysis shared by others that “an individual may develop a gender identity different from the one initially assigned on the basis of anatomical criteria.”  By “assigned on the basis of anatomical criteria” they mean a new-born child’s external genitalia.

Kristen Schilt (Chicago) and Laurel Westbrook (Grand Valley) clarify Eckert and Sally McConnell-Ginet argument, noting that gender is based on “cultural schemas about the naturalness of a binary gender system in which there are two, and only two, genders that derive from biological (chromosomes and genitalia).”  As they argue, “heterosexuality – like masculinity and femininity – is taken for granted as a natural occurrence derived from biological sex.”  Going further, the authors note that “gender order is hierarchal, which means there is consistently a higher value on masculinity than on femininity.” This is a defining feature of patriarchy and the binary – male/female — medical model of sexuality shared by traditionalist and the medical established.

Quentin Van Meter, MD, is a pediatric endocrinologist and the leading conservative critic of the more mainstream approach to gender nonconforming youth, an approach supported by many academics as well as the American Media Association and the American Psychological Association. At the 2017 Teens4Truth Conference, Ft. Worth, TX, he denounced “transgender medicine” as a fraud.

Van Meter basis his critique on the work of Kenneth Zucker, PH.D., who lead Toronto’s Child Youth and Family Gender Identity Clinic, once a leading clinic “treating” children and adolescents with “gender dysphoria.”  (The American Psychiatric Association defined “gender dysphoria” as involving “a conflict between a person’s physical or assigned gender and the gender with which he/she/they identify.”)  Zucker describes his findings as follows: “Only very few trans-kids still want to transition by the time they are adults. Instead, they generally turn out to be regular gay or lesbian folks. The exact number varies by study, but roughly 60–90% of trans-kids turn out no longer to be trans by adulthood.”

Van Meter argues that Zucker “discovered that the undercurrent issue was significant psychological maladjustment to adverse childhood experiences – things like divorce, death of a sibling, sexual abuse – things the kid had internalized and used to escape their future role as a male or female for any number of reasons, such as avoidance or protection.”  Going further, he quotes Zucker: “… it’s ‘delusional to believe you’re born into the wrong body.’ If that is a persistence that goes throughout your life, then you are living in a delusional state with a delusional disorder.” He claims that every patient who has come to him claiming to be in the wrong body “has come from a totally dysfunctional family.”

The unasked question that haunts Van Meter’s argument is what about the 10 to 40 percent of the children in Zucker’s study who did not come from a “maladjusted” or “dysfunctional” family?

Missing from Van Meter consideration of Zucker is acknowledgement that he was fired — and his clinic closed — following false accusations that he had offered gender-reparative or conversion therapy to young people.  As he argued, “But to apply [the term] to [treating] a three-year-old child with gender dysphoria, in my opinion, is an absurd comparison.” Toronto’s Centre for Addiction and Mental Health (CAMH) ultimately apologized to Zucker and awarded him a hefty settlement.


In 2018, Colorado became the first state to issue a birth certificate that did not assigned “male” or “female” gender.  That year, Anunnaki Ray Marquez received an amended birth certificate that declared him “intersex” rather than “male” or “female.”

Born in 1967, Marquez’s parents assigned him a female identity at birth and, as he recalled, he was “put into therapy at three years old.”  “I am what they consider hormonally intersex. My hormones are not that of a typical female,” Marquez explained.  “My biological sex used to be diagnosed as ‘intersexuality with hormonal variations [of the ICD’s] Q56.0, hermaphroditism not elsewhere classified.’”  He now identifies as an intersex gender-nonconforming gay man and uses he/him and they/them pronouns.

“Q.56.0” is a World Health Organization classification within the International Statistical Classification of Diseases and Related Health Problems, otherwise known as the “ICD.”  The category signifies sexual ambiguity, in which an individual “possessed gonadal tissues” of both sexes.  Clinically, it is a condition in which an individual possesses “testicular and ovarian tissues” that “often manifested with ambiguous external genitalia.”

Azul Ruelas-Brissette was born in Los Angeles in the summer of 2018, the child of Jay Brissette and Miguel Ruelas.  His parents, along with others in their social network, chose to not identify their children’s gender until, as The Los Angeles Times reports, “the kids are old enough to articulate their identities on their own.”

“Gender nonconformity” is a popular, if imprecise, category that has an underlying common definition – people who do not conform to the traditional patriarchal model of male/female heterosexuality.  Various organizations define it somewhat differently.  For example, the National Geographic defines it in the following terms:

A person whose gender expression is perceived as being inconsistent with cultural norms expected for that gender. Specifically, boys or men are not “masculine enough” or are feminine, while girls or women are not “feminine enough” or are masculine. … Gender nonconformity is often inaccurately confused with sexual orientation.

The culture war over gender identity will likely only intensify with conservative and religiously inspired Republicans in the White House, Senate, Supreme Court and state houses across the country. However, the history of the last half-century represented by the growing empowerment of women, people of color and LGBTQ people speaks to deeper social forces at work.  The struggle against patriarchy and repressive moral values continues.

David Rosen is the author of Sex, Sin & Subversion:  The Transformation of 1950s New York’s Forbidden into America’s New Normal (Skyhorse, 2015).  He can be reached at; check out