Does Gender Nonconformity Need Medicating?

Why the T with the GNC?

Back in April, North Carolina introduced a bill many described as anti-trans, the Youth Health Protection Act. The bill, which was never advanced, aimed to “protect” minors from puberty blockers and cross-sex hormones because kids, the Republican sponsors said, “are incapable of comprehending” the long-term implications of such medical interventions. Opponents of the bill argued that kids know who they are, and that medical interventions are safe, effective, and life-saving.

But that bill was about so much more than the efficacy of medical interventions. It encapsulates the cultural confusion of what gender is, what’s normal, and who should have agency over children’s lives: their parents, the state, or kids themselves.

The North Carolina bill dictated that if a “government agent” like a teacher saw a minor who exhibited “symptoms of gender dysphoria, gender nonconformity, or otherwise demonstrates a desire to be treated in a manner incongruent with the minor’s sex,” that teacher would be required to “notify, in writing, each of the minor’s parents, guardians, or custodians.”

I understand this notifying part as less about hating trans people than as a reaction to schools secretly facilitating kids’ social gender transitions, and kids being heavily influenced by social and traditional media; they want to restore power to parents who are often told that if they don’t blindly affirm a child’s desires they’re being transphobic.

But I think the most telling part of the language is the conflation of gender dysphoria—severe impairment at a mismatch between gender identity and sex—with gender nonconformity: the upending of gender norms. (Meanwhile, they’re promoting the retrograde idea that there is one particular way to be treated that’s congruent with your sex, so this language should upset trans advocates and feminists equally.)

This conflation of gender dysphoria with gender nonconformity isn’t just a problem for these poorly educated senators. It’s a national dilemma, with many people believing that they understand the lifetime implications of a child being drawn to the gender role of the opposite sex, and that gender nonconformity is a problem that needs fixing.

For many, “gender nonconforming” has become a gender identity unto itself, rather than a description of behaviors or proclivities. Some clinics offer “Transgender and Gender Nonconforming Care,” implying that kids who don’t conform to gender stereotypes may require medical intervention. The American Psychiatric Association, which has a history of pathologizing normal variations in behavior, has a guide for “Working With Transgender and Gender Nonconforming Patients,” as if they are all the same. Some politicians, parents and children may be learning to see transgender identity, gender nonconformity and gender dysphoria as inextricably linked, forgetting that even many people who identify as transgender don’t want to be medicated, either.

Are they linked? Sometimes, yes! And also sometimes no. While there does seem to be some relationship between childhood gender nonconformity and homosexual orientation and/or transgender identity, not following the gender rules isn’t predictive of any one outcome. From interviewing dozens of adults who had been tomboys, I noticed almost identical childhood stories. They diverged at puberty, when some women feminized and others, if they were allowed to, doubled down on their masculinity.

If they were young enough to access the technology, some transitioned. If they were older, they mostly went on to be butch lesbians. Meanwhile, there’s research showing the bulk of young children who initially identity as transgender, and who are not socially transitioned, desist, and later identify as gay. It’s very hard to understand how this childhood nonconformity will manifest in adulthood, beyond the consistent self-confidence I observed in adult females who’d defied gender norms when they were kids.

Most importantly, there is plenty of research showing that gender nonconformity, when accepted and supported, can be a boon. Research shows that kids who defy gender norms are more creative, more academically successful, more flexible. A 2020 study from the University of Cambridge, on the relationship between gender conformity and academic performance, shows that gender nonconforming children may hold academic advantages. “Girls who reject these restrictive feminine norms tend to show higher levels of motivation and performance,” it noted. Psychological androgyny—possessing both traditionally masculine and feminine personality traits—is linked to being more emotionally flexible, having higher self-esteem, and more satisfaction in marriage.

As nuts as the language of this North Carolina bill was, the Left is just as eager to squelch anyone who veers away from norms—not of gender, but of how we think and talk about this population. They are quick to punish anyone who wants to question not just the gender-affirming model but the idea that biological sex doesn’t exist or doesn’t matter, which is just as intolerant and anti-scientific.

Gender is a murky subject, but there are a few things that do seem clear. There has been a massive increase in referrals to gender clinics and in diagnoses of gender dysphoria, in a population that many who’ve worked with gender-diverse kids for years have rarely seen before—mostly teenage girls (and some boys) with no history of gender nonconformity, often presenting with other diagnoses like depression or autism. There has also been an increase in detransitioners, who likely were incapable of comprehending the long-term implications of medical transition, or didn’t understand themselves and their own gender nonconformity yet, or whose dysphoria would have been better resolved with therapy and not medicine.

We need more acceptance for gender nonconformity, more understanding not only that it is natural but that it can be an advantage. Let’s not assume that gender nonconforming kids need to be medicated. Let’s assume that they need to be celebrated.

[Photo is, apparently, a GNC flag, from Wikimedia]