0:00:07 > 0:00:11Around the world, the transgender community is on the march.
0:00:11 > 0:00:12You are the new world.
0:00:12 > 0:00:16There is no normal any more. This is the new normal.
0:00:17 > 0:00:22Not all boys have a penis and not all girls have a vagina.
0:00:22 > 0:00:26Parents are facing an explosion in the number of children
0:00:26 > 0:00:28saying they were born in the wrong body.
0:00:28 > 0:00:31It was like a battle in a warzone.
0:00:31 > 0:00:35She would literally scream, "A-A-A-A-Argh!
0:00:35 > 0:00:37"I'm a boy, I'm a boy!"
0:00:37 > 0:00:41I want to be a girl, I am a girl. I'm a girl.
0:00:41 > 0:00:44I'm not comfortable in a boy body. I just want to be a girl.
0:00:46 > 0:00:50We are now told to believe children and support them in changing gender.
0:00:50 > 0:00:55There's this huge push to be, like, "OK, you know, he is a girl,
0:00:55 > 0:00:57"you need to do everything you can
0:00:57 > 0:00:59"to support that and make this kid a girl."
0:00:59 > 0:01:02If they say they're transgender, chances are they are.
0:01:02 > 0:01:06Sometimes, sir, the parent isn't part of the solution,
0:01:06 > 0:01:07they are part of the problem.
0:01:07 > 0:01:10The adult transsexual community tried to intervene
0:01:10 > 0:01:14in the destinies of children who aren't even their own.
0:01:14 > 0:01:18One top expert has now been fired for challenging the idea
0:01:18 > 0:01:20that children know best.
0:01:20 > 0:01:25A four-year-old might say that's he's a dog.
0:01:25 > 0:01:28Do you go out and buy dog food?
0:01:28 > 0:01:33Parents face terrifying choices and the stakes could not be higher.
0:01:33 > 0:01:36That child will kill themselves if they're trans
0:01:36 > 0:01:38because many trans children do.
0:01:38 > 0:01:41Is that what parents really want?
0:01:41 > 0:01:46My choices were absolutely the right thing. Totally.
0:01:46 > 0:01:48I believe that in my whole being.
0:01:48 > 0:01:51Nobody could tell me any differently.
0:02:02 > 0:02:06An Ottawa area family is sharing their remarkable story tonight
0:02:06 > 0:02:10about their little boy who knows in his heart he is a girl.
0:02:17 > 0:02:21Around the age of two and a half, she told me one night,
0:02:21 > 0:02:25"Mummy, I think God made a mistake, I'm really a little girl."
0:02:27 > 0:02:30Warner is, um...transgender.
0:02:30 > 0:02:34So she is, er...identifies as female.
0:02:36 > 0:02:40Warner had preferences for pink, sparkles.
0:02:40 > 0:02:45Even her physical mannerisms, with her hands, very flamboyant,
0:02:45 > 0:02:49wanting to be a princess, and if you took her shopping,
0:02:49 > 0:02:51she'd go right for dresses.
0:02:53 > 0:02:58I never actually, like, fitted in with being a boy.
0:02:58 > 0:03:01I don't like...
0:03:02 > 0:03:05..the games, the hair styles, the clothes.
0:03:07 > 0:03:10And I always thought from the beginning I was
0:03:10 > 0:03:12a little bit feminine.
0:03:13 > 0:03:15There's nothing wrong with being a boy,
0:03:15 > 0:03:19it's just that I don't enjoy being a boy.
0:03:19 > 0:03:22So Warner is nine years old.
0:03:22 > 0:03:26She's just at an age now where sexuality is starting to develop.
0:03:26 > 0:03:29So boy crushes and things like that are just starting to come in.
0:03:29 > 0:03:31You can be a girl who wants to be a boy,
0:03:31 > 0:03:33or a boy that wants to be a girl,
0:03:33 > 0:03:35but for me, I'm a boy that wants to be a girl
0:03:35 > 0:03:39and I'm not comfortable in a boy body.
0:03:39 > 0:03:41I just want to be a girl.
0:03:51 > 0:03:54Warner and Melissa live in Canada.
0:03:54 > 0:03:57There's, like, tonnes of people here and there's lots of support here
0:03:57 > 0:04:00and it just makes me feel really good about myself.
0:04:00 > 0:04:03A country that has led the way in passing laws
0:04:03 > 0:04:05to defend the rights of transgender people.
0:04:08 > 0:04:10I'm proud to announce that tomorrow,
0:04:10 > 0:04:14on the International Day Against Homophobia and Transphobia,
0:04:14 > 0:04:18we will be tabling a bill in the House of Commons to ensure
0:04:18 > 0:04:21the FULL protection of transgender people.
0:04:21 > 0:04:24Look at you, you're so beautiful!
0:04:24 > 0:04:26You are the new world.
0:04:26 > 0:04:30We want to show them that we are every colour of the rainbow.
0:04:30 > 0:04:33That there is no normal any more. That this is the new normal.
0:04:33 > 0:04:35CHEERING AND APPLAUSE
0:04:39 > 0:04:44In Toronto, politician and priest Cheri DiNovo leads the fight
0:04:44 > 0:04:46for transgender rights.
0:04:46 > 0:04:50I tabled, as one of my very first bills, Toby's Law,
0:04:50 > 0:04:53which would extend human rights to trans people.
0:04:53 > 0:04:55That's all it does, really.
0:04:55 > 0:04:58So it means you can't fire somebody because they're trans,
0:04:58 > 0:04:59you can't deny them medical care,
0:04:59 > 0:05:02you can't fire them or you can't not hire them,
0:05:02 > 0:05:05you can't not rent to them because they're trans,
0:05:05 > 0:05:07like human rights for everyone else.
0:05:07 > 0:05:11The next generation will grow up where they're not overtly bullied
0:05:11 > 0:05:13and harassed as trans folk.
0:05:13 > 0:05:17That might keep them alive. That's what we're aiming for.
0:05:17 > 0:05:20When you're working with someone who's trans and they've begun
0:05:20 > 0:05:24to access whatever kind of treatment is right for them,
0:05:24 > 0:05:26you see these dramatic... Like, people just blossom.
0:05:26 > 0:05:29It's gorgeous, it's lovely to watch.
0:05:30 > 0:05:33Hershel Russell is a transgender psychotherapist
0:05:33 > 0:05:35and activist in Toronto.
0:05:35 > 0:05:38He's an advocate for the gender-affirmative approach.
0:05:38 > 0:05:41The idea that parents should support and encourage children
0:05:41 > 0:05:44who say their gender is out of sync with their body.
0:05:45 > 0:05:50A mother of a gender-diverse kid asked her eight-year-old,
0:05:50 > 0:05:54"So, how come you know that you're really a boy?"
0:05:54 > 0:05:59And the child said, "I know way down deep, where the music plays."
0:05:59 > 0:06:02And I think that's so precise.
0:06:02 > 0:06:07It's non-rational, it's profound, it's beautiful, it's deep.
0:06:07 > 0:06:10THAT'S how we know what gender we are
0:06:10 > 0:06:12and very young children know that.
0:06:15 > 0:06:17I am a teenage girl.
0:06:17 > 0:06:20I'm also transgender, and I'm proud of that.
0:06:22 > 0:06:26This gender-affirmative approach is now the mainstream in Canada
0:06:26 > 0:06:28and much of the western world.
0:06:28 > 0:06:32I'm a man! Like, physically, no, but look at this.
0:06:32 > 0:06:35What do you see? Man!
0:06:35 > 0:06:39Online media and TV shows are now full of young people
0:06:39 > 0:06:43who are proud to talk about their transgender identity.
0:06:43 > 0:06:47Actually, I don't WANT to be a girl, I AM a girl.
0:06:50 > 0:06:55Parents like Melissa are encouraged to accept their child's new gender.
0:06:57 > 0:06:59Once we attended the gender-identity clinic
0:06:59 > 0:07:03and the doctors basically started telling us plain and simply
0:07:03 > 0:07:05there is no fix for children like Warner,
0:07:05 > 0:07:08um...that we needed to listen to her.
0:07:08 > 0:07:13Well, we listened to Warner and we knew what we needed to do.
0:07:13 > 0:07:16These attitudes have coincided with a steady increase
0:07:16 > 0:07:19in young people attending gender clinics in Canada.
0:07:19 > 0:07:22# On the hillside stands a lady
0:07:22 > 0:07:26# Who she is I do not know... #
0:07:26 > 0:07:29But not everyone agrees with this approach.
0:07:29 > 0:07:33Modern ideas of gender diversity and gender fluidity can feel like
0:07:33 > 0:07:37a long way from traditional childhood and parenting.
0:07:39 > 0:07:42Can you lend me a few Pokemon cards?
0:07:42 > 0:07:46- Why?- Because. I want to battle you.
0:07:46 > 0:07:49Some parents aren't comfortable with simply agreeing
0:07:49 > 0:07:52to their child's demand to switch gender.
0:07:53 > 0:07:56One Christmas, I guess it was his second birthday,
0:07:56 > 0:07:57he really wanted a dress.
0:07:57 > 0:08:00All he wanted for Christmas was a red dress.
0:08:00 > 0:08:04So I...bought him a red dress.
0:08:04 > 0:08:09And, er...he wore that dress all the time.
0:08:09 > 0:08:12It's a really scary world as a parent of a child
0:08:12 > 0:08:16who identifies differently gender-wise.
0:08:16 > 0:08:19There's this huge push to be, like,
0:08:19 > 0:08:22"OK, some days they feel like they're a girl.
0:08:22 > 0:08:25"OK, he is a girl, you need to do everything you can
0:08:25 > 0:08:27"to support that and make this kid a girl."
0:08:27 > 0:08:31And that wasn't an approach we were comfortable with as a family,
0:08:31 > 0:08:34to say, "OK, you like pink? OK, that means you're a girl.
0:08:34 > 0:08:37"You're going to be a girl."
0:08:37 > 0:08:40Um...and at the same time, we weren't comfortable saying,
0:08:40 > 0:08:44"You're natally male, so you need to be a boy."
0:08:44 > 0:08:47In our own family,
0:08:47 > 0:08:51if I were to let my kids do everything they wanted to do
0:08:51 > 0:08:55and affirm to everything, there would be Pokemon posters everywhere
0:08:55 > 0:09:00and no-one would ever get dressed and we would eat only McDonald's.
0:09:01 > 0:09:04Meredith took her son to see a psychologist
0:09:04 > 0:09:06at a clinic in Toronto.
0:09:08 > 0:09:12Dr Kenneth Zucker is one of the world's foremost child psychologists,
0:09:12 > 0:09:15specialising in gender dysphoria,
0:09:15 > 0:09:19a condition where a person is unhappy with their biological sex.
0:09:21 > 0:09:26We received a referral and I spoke with Dr Zucker.
0:09:26 > 0:09:29My child was diagnosed with gender dysphoria.
0:09:29 > 0:09:32Euphoria means you're happy about something.
0:09:32 > 0:09:34Dysphoria means you're unhappy.
0:09:34 > 0:09:37Children as young as two or three,
0:09:37 > 0:09:41up through the end of adolescence,
0:09:41 > 0:09:47will come in because either the child himself or herself
0:09:47 > 0:09:53is expressing an intense unhappiness about being a boy or a girl...
0:09:53 > 0:09:57I feel like there wasn't this big push to just talk about gender,
0:09:57 > 0:10:01gender, gender, it was more just, you know, "How was your week?
0:10:01 > 0:10:06"What did you do this week? Oh, I see you're wearing blue shoes today.
0:10:06 > 0:10:10"Do you want to talk, what made you choose the blue shoes over the pink shoes?"
0:10:15 > 0:10:18For three decades, Zucker and his team treated more than
0:10:18 > 0:10:21a thousand children at Toronto's child gender clinic
0:10:21 > 0:10:25at the Centre for Addiction and Mental Health, CAMH.
0:10:26 > 0:10:30He doesn't agree with the gender-affirmative approach
0:10:30 > 0:10:32promoted by many transgender activists.
0:10:35 > 0:10:38Identity is a process.
0:10:38 > 0:10:44It's complicated, it takes a long period of time, in a sense,
0:10:44 > 0:10:47to know who a child really is.
0:10:47 > 0:10:55A four-year-old might say that he's a dog.
0:10:55 > 0:11:00Um...do you go out and buy dog food?
0:11:01 > 0:11:07Being lesbian, gay, bisexual, er...trans or queer is who one is.
0:11:07 > 0:11:14To tell a child that who they are is wrong, we consider abusive.
0:11:14 > 0:11:18Zucker became a target for transgender activists,
0:11:18 > 0:11:22who have increasingly influenced policy in Canada.
0:11:22 > 0:11:25It became clear to me that the therapist didn't think
0:11:25 > 0:11:27that my trans identity was really real,
0:11:27 > 0:11:29that it was an issue associated with my social life
0:11:29 > 0:11:33and if that was fixed, then I would be fixed of my gender identity.
0:11:37 > 0:11:41Zucker was accused of trying to cure transgender children.
0:11:41 > 0:11:44The same way that psychologists used to try and cure gay people
0:11:44 > 0:11:47of their homosexuality.
0:11:47 > 0:11:51He was accused of practising conversion, or reparative therapy.
0:11:54 > 0:11:56Drop the Barbie, that's the short version of it.
0:11:56 > 0:12:00So we will work hard to actively discourage the child
0:12:00 > 0:12:02from playing with certain kinds of toys,
0:12:02 > 0:12:05wearing certain kinds of clothes, having certain kinds of friends.
0:12:05 > 0:12:08So we will police the child's leisure activities
0:12:08 > 0:12:11and force them in a particular gender direction.
0:12:11 > 0:12:14That's straight up what we now call reparative therapy.
0:12:14 > 0:12:16Although the people doing it don't use those words.
0:12:16 > 0:12:17That's their problem.
0:12:17 > 0:12:20I completely reject the allegation
0:12:20 > 0:12:24that I've ever practised
0:12:24 > 0:12:26conversion therapy.
0:12:26 > 0:12:29I practise what I would call
0:12:29 > 0:12:33developmentally-informed therapy.
0:12:35 > 0:12:40In June 2015, supported by gender-affirmative doctors,
0:12:40 > 0:12:42Cheri DiNovo pushed through a new law
0:12:42 > 0:12:44banning conversion therapy in Ontario.
0:12:44 > 0:12:48A review was launched into Zucker's clinic
0:12:48 > 0:12:50and six months later, it was shut down.
0:12:52 > 0:12:54Banning conversion therapy has had a huge impact.
0:12:54 > 0:12:57In fact, the impact is still being felt.
0:12:57 > 0:13:00One of our largest mental health institutions
0:13:00 > 0:13:02changed their entire programming,
0:13:02 > 0:13:04scrapped what they were doing, started again.
0:13:04 > 0:13:09Dr Kenneth Zucker, one of the world's leading authorities
0:13:09 > 0:13:12on gender dysphoria, was fired.
0:13:13 > 0:13:16That was clearly on the cards from a very long time ago.
0:13:16 > 0:13:18We were very supportive of that decision.
0:13:18 > 0:13:21That's the way the professional studies and research is going.
0:13:21 > 0:13:24It was time for CAMH to catch up with the rest of the world,
0:13:24 > 0:13:25and we're glad they did.
0:13:26 > 0:13:29But many of Zucker's patients were shocked.
0:13:29 > 0:13:32When the news actually came out that the clinic was closed
0:13:32 > 0:13:36and he was let go, I was very surprised and pretty angry.
0:13:38 > 0:13:43Yeah, it was very shocking. I was very, very shocked at that.
0:13:43 > 0:13:45I think for my husband and I, we were kind of, like,
0:13:45 > 0:13:47"OK, so, now what?"
0:13:47 > 0:13:50We've worked with these people for a year and a half,
0:13:50 > 0:13:52my kid is comfortable coming here,
0:13:52 > 0:13:57he's comfortable with his therapist, so, what's going to happen?
0:13:58 > 0:14:01And there was a warning for parents too.
0:14:01 > 0:14:05So-called conversion therapy could risk the life of their child.
0:14:05 > 0:14:08Only gender-affirmation could save them.
0:14:10 > 0:14:13Parents who'd say, "It's my value system, it's my way or the highway,
0:14:13 > 0:14:15"this is what I say, and what I say goes,"
0:14:15 > 0:14:18are the parents who will lose their children.
0:14:18 > 0:14:21And they will lose them either because that child will move away from home
0:14:21 > 0:14:24and not have anything to do with them,
0:14:24 > 0:14:26or that child will kill themselves if they're trans.
0:14:26 > 0:14:29Because many trans children do.
0:14:29 > 0:14:32Is that what parents really want of their children?
0:14:32 > 0:14:36Because a child is who the child is.
0:14:38 > 0:14:42Zucker's dismissal sent shock waves through the scientific community.
0:14:42 > 0:14:46More than 500 clinicians and academics from around the world
0:14:46 > 0:14:52signed a petition in protest at the politicisation of gender therapy.
0:14:52 > 0:14:56People are now probably fairly terrified
0:14:56 > 0:14:59of taking any stance that is out of step
0:14:59 > 0:15:02with what trans activists are demanding.
0:15:02 > 0:15:04They will certainly look and say,
0:15:04 > 0:15:07if somebody as prominent as Ken Zucker could lose his job
0:15:07 > 0:15:11for being reluctant to join the trans bandwagon,
0:15:11 > 0:15:15what could happen to me if I expressed any reservations?
0:15:15 > 0:15:21Sex and gender research has been political for decades.
0:15:21 > 0:15:26Makes it more interesting, but also, er...
0:15:28 > 0:15:30..more and more dangerous.
0:15:36 > 0:15:40The issue of gender identity has always been controversial.
0:15:40 > 0:15:44In the 1950s, former American GI Christine Jorgensen
0:15:44 > 0:15:47caused a sensation by having an early form
0:15:47 > 0:15:49of gender-reassignment surgery.
0:15:50 > 0:15:54I don't have any plans at the moment and I thank you all for coming,
0:15:54 > 0:15:57but I think it's too much.
0:15:57 > 0:16:01Until recently, the ability to transition to the opposite sex
0:16:01 > 0:16:04was mostly confined to adults.
0:16:04 > 0:16:06But with changes in attitude
0:16:06 > 0:16:08spreading through TV and social media,
0:16:08 > 0:16:12the focus has now turned to children and young people.
0:16:14 > 0:16:19I'm very fortunate to be on HRT already,
0:16:19 > 0:16:21so, yeah, it's been six months,
0:16:21 > 0:16:23I take two of these bad boys a day.
0:16:23 > 0:16:27Modern medicine can now supply hormone-blockers
0:16:27 > 0:16:30to stop children going through puberty.
0:16:30 > 0:16:33Meaning that's a boy might never develop the attributes of a man.
0:16:35 > 0:16:38I finally got my T blockers
0:16:38 > 0:16:41that inhibit the production of testosterone, so it slows it down,
0:16:41 > 0:16:44makes it weaker and it prepares my body, basically.
0:16:44 > 0:16:47Depending on when they started puberty,
0:16:47 > 0:16:50some 16-year-old genetic males
0:16:50 > 0:16:53would have so many severe masculinising effects,
0:16:53 > 0:16:56whether it's facial hair, facial bone structure,
0:16:56 > 0:17:00vocal change, Adam's apple, you name it,
0:17:00 > 0:17:04that to wait until 16 to then give them oestrogen
0:17:04 > 0:17:07would be like just feminising a male figure.
0:17:08 > 0:17:12And modern surgery can create realistic breasts,
0:17:12 > 0:17:15penises and vaginas to order for young adults.
0:17:21 > 0:17:24As soon as I could start forming an opinion about myself,
0:17:24 > 0:17:26around two or three years old,
0:17:26 > 0:17:29I could tell that I was not a typical boy.
0:17:32 > 0:17:36At around four years old, I was taking a bath
0:17:36 > 0:17:40and I remember saying, "I know I'm supposed to be happy with who I am,
0:17:40 > 0:17:42"but I'm not happy with what I am."
0:17:44 > 0:17:46Ella was born biologically male,
0:17:46 > 0:17:51but is now a fully-transitioned 17-year-old transgender woman.
0:17:51 > 0:17:54In the US, there are now 40 gender clinics
0:17:54 > 0:17:56for children and adolescents.
0:17:56 > 0:18:00Ella was helped to transition by Dr Norman Spack
0:18:00 > 0:18:02from Boston Children's Hospital,
0:18:02 > 0:18:04where he's set up America's first clinic
0:18:04 > 0:18:06to medically treat transgender children.
0:18:08 > 0:18:11I had the tools to do this.
0:18:11 > 0:18:13It wasn't, as we say, rocket science,
0:18:13 > 0:18:19it's just so rewarding to watch these kids give birth to themselves.
0:18:19 > 0:18:22I just felt like a midwife, you know.
0:18:22 > 0:18:25I was so young when this was all happening
0:18:25 > 0:18:29that really I only had, like, what was going on in my head.
0:18:29 > 0:18:31I didn't know what my parents thought about it.
0:18:31 > 0:18:34All that I was met with was, you know,
0:18:34 > 0:18:37"That's OK, we're here for you. We support you."
0:18:37 > 0:18:41When we would go on vacation, they would let me present as a girl
0:18:41 > 0:18:44and they would let me play dress-up in the house.
0:18:45 > 0:18:47Ella was never a boy.
0:18:47 > 0:18:49I mean, she might've had male genitalia,
0:18:49 > 0:18:52but she was a girl from the moment she was born.
0:18:54 > 0:18:55When she was ten,
0:18:55 > 0:18:58Ella's parents took her to a transgender summer camp.
0:18:58 > 0:19:02One of 20 that have sprung up across North America.
0:19:02 > 0:19:04There's all of these kids,
0:19:04 > 0:19:06transgender girls and transgender boys.
0:19:06 > 0:19:09And I think it was really the first time that I felt like I belonged
0:19:09 > 0:19:13in a social setting since I was really, really young.
0:19:13 > 0:19:16Transgender camps help children like Ella
0:19:16 > 0:19:20make a social transition to the opposite gender.
0:19:22 > 0:19:25That was when I really learned, like, you can transition
0:19:25 > 0:19:29and you can use female pronouns and change your name.
0:19:29 > 0:19:32I don't have to go home after school and put on a dress,
0:19:32 > 0:19:34I can wear a dress the whole day.
0:19:34 > 0:19:37Look at the sky. It's so pretty!
0:19:37 > 0:19:41I saw her run off to camp after she transitioned and I thought,
0:19:41 > 0:19:43"Ah! That's just like a girl running."
0:19:43 > 0:19:45Instead of, "Look at my son, he runs like a girl!"
0:19:45 > 0:19:48- Right.- It was finally the world was aligned.
0:19:48 > 0:19:50She got to be who she was.
0:19:50 > 0:19:52And it wasn't awkward.
0:19:52 > 0:19:55- What was awkward was having her having to present as a boy.- Right.
0:19:57 > 0:20:00The risk of not being able to transition early enough, I think
0:20:00 > 0:20:04that's where you start entering into a world of mental health issues.
0:20:04 > 0:20:06A child does need a lot of support at that point.
0:20:06 > 0:20:11And I just think it can break a kid, even if it's not suicide.
0:20:11 > 0:20:15At the age of 12, Ella took puberty-blockers.
0:20:15 > 0:20:18The next step was to take the hormone oestrogen
0:20:18 > 0:20:21to give her adult female features.
0:20:21 > 0:20:25Still a teenager, Ella then considered the final,
0:20:25 > 0:20:27most irreversible step.
0:20:29 > 0:20:33Ella had been looking at herself in the mirror.
0:20:33 > 0:20:37She was 16 and she had been on oestrogen for over two years.
0:20:37 > 0:20:39She was despondent.
0:20:39 > 0:20:42In the one sense, she was feminising beautifully,
0:20:42 > 0:20:47on the other hand, what was the value of putting off...
0:20:47 > 0:20:48Actually, I don't like the term,
0:20:48 > 0:20:51they call it SRS, sex-reassignment surgery,
0:20:51 > 0:20:54but I call it affirmation surgery.
0:20:54 > 0:20:57Because you're not changing someone's sex, really.
0:20:57 > 0:20:59You're changing their body.
0:20:59 > 0:21:02The day that I had surgery, I finally felt at peace
0:21:02 > 0:21:06because I could finally be able to look in the mirror
0:21:06 > 0:21:09and see a girl looking back at me.
0:21:11 > 0:21:14Not all boys have a penis
0:21:14 > 0:21:16and not all girls have a vagina and not...
0:21:17 > 0:21:19Yeah, that's just...
0:21:19 > 0:21:22I don't know how else to say it, but, you know,
0:21:22 > 0:21:24anyone who wants to be a boy can be a boy
0:21:24 > 0:21:27and anyone who wants to be a girl can be a girl.
0:21:29 > 0:21:32Around the world, gender clinics have been swamped
0:21:32 > 0:21:35by young people like Ella, determined to transition.
0:21:35 > 0:21:38And often supported by their parents.
0:21:41 > 0:21:45In just five years, the UK's main child gender clinic
0:21:45 > 0:21:49has seen in increase in referrals of more than 1,000%.
0:21:51 > 0:21:55Many people are now convinced that a girl can simply be born
0:21:55 > 0:21:58in a boy's body, and vice versa.
0:21:58 > 0:22:00But is it really so simple?
0:22:04 > 0:22:06When I work with families,
0:22:06 > 0:22:10I try to understand a child...
0:22:10 > 0:22:13on a case-by-case basis.
0:22:13 > 0:22:19There are different pathways that can lead to gender dysphoria,
0:22:19 > 0:22:26but it's an intellectual and clinical mistake
0:22:26 > 0:22:32to think that there's one single "cause"
0:22:32 > 0:22:36that explains all gender dysphoria.
0:22:36 > 0:22:38# Sleep no more
0:22:38 > 0:22:40# Sleep no more
0:22:40 > 0:22:44# Sleep no more, Fair Rosa... #
0:22:44 > 0:22:48Gender dysphoria can be a disturbing childhood condition.
0:22:53 > 0:22:56I didn't think it was a phase because there was
0:22:56 > 0:23:03a lot of things combined and he was so into, like, everything girlie.
0:23:03 > 0:23:08It seemed like he didn't know that he's a boy.
0:23:09 > 0:23:11Dalia's son, Kareem,
0:23:11 > 0:23:14displayed the classic symptoms of gender dysphoria.
0:23:16 > 0:23:20I started to get concerned when he was starting to draw
0:23:20 > 0:23:24self-portraits, like, kids always draw their family.
0:23:24 > 0:23:26And at the time, it was me and my mom and him,
0:23:26 > 0:23:30and it would just always be three girls in the picture.
0:23:30 > 0:23:32And he did that a lot, like, obsessively.
0:23:32 > 0:23:34He did, like, hundreds of them.
0:23:34 > 0:23:37And then it was that, combined with a lot of other things
0:23:37 > 0:23:43that made me decide to ask my doctor, like, "Hey, is that normal?"
0:23:46 > 0:23:50Dalia and Kareem were referred to Dr Zucker's Toronto clinic
0:23:50 > 0:23:51before it was shut down.
0:23:53 > 0:23:56His team didn't take what Kareem was saying at face value.
0:23:58 > 0:24:03They would observe Kareem and I interacting.
0:24:03 > 0:24:06The style of therapy was playing
0:24:06 > 0:24:08and they would play with him
0:24:08 > 0:24:11and interpret his issues and help guide him through them.
0:24:13 > 0:24:19Play is a window into a child's internal world.
0:24:19 > 0:24:25And it's through their play that they can tell you
0:24:25 > 0:24:28what they're thinking and what they're feeling.
0:24:30 > 0:24:33They didn't want to obsessively focus on the gender
0:24:33 > 0:24:35and what toys he plays with.
0:24:35 > 0:24:38What they did tell me was, like, say, for example,
0:24:38 > 0:24:42don't fill a room with, like, Barbie's and, you know,
0:24:42 > 0:24:45butterflies and put him in it and just only go in that direction,
0:24:45 > 0:24:48and don't force him to only be with boy toys.
0:24:48 > 0:24:50Just be, you know, neutral.
0:24:50 > 0:24:52Just be whatever. Just have all toys.
0:24:54 > 0:24:56The psychologists at Zucker's clinic
0:24:56 > 0:24:59were looking for any hidden causes of Kareem's behaviour.
0:25:01 > 0:25:06You're always trying to think about what these behaviours mean.
0:25:06 > 0:25:07You're trying to...
0:25:09 > 0:25:11..understand what is the relationship between
0:25:11 > 0:25:16the surface behaviour and the underlying feelings?
0:25:16 > 0:25:23Just because little kids say something doesn't necessarily
0:25:23 > 0:25:29mean that you accept it, or that it's true.
0:25:29 > 0:25:33Or that it's in the best interests of a child.
0:25:36 > 0:25:38Zucker believes there may be many reasons
0:25:38 > 0:25:41a child insists they should be the opposite sex.
0:25:45 > 0:25:48At CAMH, Dr Zucker just explored, you know,
0:25:48 > 0:25:52let's look at the full picture, let's look at the family.
0:25:53 > 0:25:56It just didn't feel like the only focus was the gender
0:25:56 > 0:26:00or one outcome, it was just helping us.
0:26:01 > 0:26:05During therapy, Dalia shared more about her son's upbringing.
0:26:05 > 0:26:08Dalia came from a very traditional family
0:26:08 > 0:26:11and she was unmarried when she gave birth to Kareem.
0:26:13 > 0:26:17I was really young when I had my son and, um...
0:26:17 > 0:26:21my parents were really ashamed of me for that,
0:26:21 > 0:26:24and weren't very proud of him either.
0:26:26 > 0:26:32The gender piece with my son is possibly a symptom of other...
0:26:35 > 0:26:38..things that are confusing him, things that are difficult for him.
0:26:38 > 0:26:41Unable to cope, at one point, Dalia moved out,
0:26:41 > 0:26:44leaving Kareem with her family.
0:26:44 > 0:26:47Kareem has lost a lot of important people in his life
0:26:47 > 0:26:50because his family relationships have been really rocky.
0:26:50 > 0:26:52Like, he lost me for a period of time,
0:26:52 > 0:26:54he lost my mom for a period of time.
0:26:54 > 0:26:58He has been tossed around and he hasn't been able to hold on
0:26:58 > 0:26:59to those important people.
0:26:59 > 0:27:05It's possible that the reason Kareem is, you know,
0:27:05 > 0:27:10gravitating towards these feminine, ultra-feminine tendencies,
0:27:10 > 0:27:14um...is a way of being closer to me.
0:27:14 > 0:27:17Because he has fear to lose me.
0:27:18 > 0:27:22Zucker believes a whole range of psychological issues can manifest
0:27:22 > 0:27:25themselves in a child's obsession with changing their gender.
0:27:27 > 0:27:32Taking any behaviour in isolation
0:27:32 > 0:27:34when thinking about gender dysphoria
0:27:34 > 0:27:37is not the way that I think about it.
0:27:37 > 0:27:39The mental health of children,
0:27:39 > 0:27:41adolescents and adults is very important.
0:27:41 > 0:27:45In one extreme case, Zucker treated a young girl
0:27:45 > 0:27:49who had tragically witnessed her own mother being murdered.
0:27:49 > 0:27:53Afterwards, the girl then became convinced she was a boy.
0:27:56 > 0:27:59This youngster really struggled with having lost her mother
0:27:59 > 0:28:05and she developed the belief that,
0:28:05 > 0:28:10"If I had been a boy and not a girl, I would've been stronger
0:28:10 > 0:28:15"and I would've been able to have saved my mom."
0:28:15 > 0:28:20And by being a boy, she would be safe herself
0:28:20 > 0:28:25and not be a target of male aggression.
0:28:27 > 0:28:32There's also evidence of a link between gender dysphoria and autism.
0:28:32 > 0:28:36One study found that children with gender dysphoria
0:28:36 > 0:28:39are seven times more likely to be on the autistic spectrum
0:28:39 > 0:28:42than children from the general population.
0:28:44 > 0:28:50It's possible that kids who have a tendency to get obsessed
0:28:50 > 0:28:53or fixated on something
0:28:53 > 0:28:56may latch on to gender.
0:28:56 > 0:29:00Dalia believes that her son's complex problems
0:29:00 > 0:29:03may ultimately have a simple explanation.
0:29:07 > 0:29:11I think that my son may happily identify as gay one day.
0:29:11 > 0:29:12I think that that is...
0:29:12 > 0:29:18And I think he has definitely some confusion with his...gender,
0:29:18 > 0:29:21but that may not be born inside of him,
0:29:21 > 0:29:23that may be just because of what society expects,
0:29:23 > 0:29:25that may be because of traumas he's been through.
0:29:25 > 0:29:26There's lots of different ways.
0:29:26 > 0:29:30So I don't think that it would be responsible
0:29:30 > 0:29:34to just run with it if he said, "I want to be a girl."
0:29:34 > 0:29:36CONGREGATION SING
0:29:39 > 0:29:43But for campaigners like Cheri DiNovo, it is simply wrong
0:29:43 > 0:29:46to link transgender children with mental illness.
0:29:47 > 0:29:49She believes that transgender people
0:29:49 > 0:29:52have always been a normal part of human society.
0:29:54 > 0:30:00Philip reluctantly baptises a black African trans person
0:30:00 > 0:30:03as the first Christian.
0:30:03 > 0:30:06We've got the conversion of the Ethiopian eunuch
0:30:06 > 0:30:09as the very first Christian.
0:30:09 > 0:30:12That's pretty freaking queer, I think.
0:30:12 > 0:30:16So this God, really, is trans from the beginning.
0:30:18 > 0:30:20Going right back to our first nations
0:30:20 > 0:30:23who had shamans who were both male and female,
0:30:23 > 0:30:26there have always been trans people with us,
0:30:26 > 0:30:28there have been always homosexual people with us,
0:30:28 > 0:30:31there have always been bisexual people with us.
0:30:33 > 0:30:38I believe that areas in gender identity and expression
0:30:38 > 0:30:41are not psychiatric differences,
0:30:41 > 0:30:44they are differences in the human condition.
0:30:45 > 0:30:48Transgender activists are now campaigning to stop
0:30:48 > 0:30:50gender-dysphorian children
0:30:50 > 0:30:53being considered a medical or psychiatric problem.
0:30:56 > 0:30:58It's not about mental health,
0:30:58 > 0:31:01so why does it belong in a mental health institution?
0:31:01 > 0:31:04This is one of the things we're hearing more and more emphatically
0:31:04 > 0:31:06from families who have gender-diverse kids,
0:31:06 > 0:31:09"We don't want mental health assistance.
0:31:09 > 0:31:12"Yes, we do want to get together with other families like ours,
0:31:12 > 0:31:15"but we don't want to see the psychologist or psychiatrist.
0:31:15 > 0:31:16"Our kid's just fine, thank you."
0:31:16 > 0:31:20If they say they're transgender, chances are they are,
0:31:20 > 0:31:23so let's make a safe space for them to explore that.
0:31:24 > 0:31:27The death of an Ohio teenager has sparked national outrage,
0:31:27 > 0:31:29with reports the teen committed suicide
0:31:29 > 0:31:32after being shunned for being transgender.
0:31:32 > 0:31:37The suicide of 17-year-old Leelah Alcorn made headline news
0:31:37 > 0:31:41around the world and changed the terms of the entire debate.
0:31:41 > 0:31:43On social media, her parents were blamed
0:31:43 > 0:31:47for trying to suppress her transgender identity.
0:31:47 > 0:31:50#LeelahAlcorn's parents should be ashamed.
0:31:50 > 0:31:52Charges should be brought.
0:31:53 > 0:31:56Her death highlighted the shockingly-high rates of suicide
0:31:56 > 0:31:58amongst transgender people.
0:32:00 > 0:32:03According to a survey from 2010,
0:32:03 > 0:32:0741% of 7,000 transgender people questioned
0:32:07 > 0:32:08had attempted suicide.
0:32:08 > 0:32:12Once again, the choice facing parents seemed stark.
0:32:12 > 0:32:15You either support your child's transgender identity,
0:32:15 > 0:32:17or you risk losing them.
0:32:19 > 0:32:22I would argue to the parents who are frightened of trans children
0:32:22 > 0:32:26and that their children might be trans, I would argue,
0:32:26 > 0:32:30do you want your child to be safe? Do you want your child to grow up?
0:32:30 > 0:32:33Do you want them free from suicidal ideation?
0:32:33 > 0:32:37Do you want them free from, you know, excessive trauma?
0:32:37 > 0:32:40And if they yes, then work with your child
0:32:40 > 0:32:44to be what your child really is.
0:32:46 > 0:32:51In Toronto, the gender clinic run by Dr Zucker was heavily criticised.
0:32:51 > 0:32:54They were accused of preventing kids from transitioning,
0:32:54 > 0:32:57stigmatising them and driving them towards suicide.
0:32:58 > 0:33:00Charges they strongly deny.
0:33:03 > 0:33:08If I don't transition my kid, I'm going to have a dead kid.
0:33:08 > 0:33:13I think that's...clinically unsophisticated.
0:33:13 > 0:33:16We know that a stigma does exist,
0:33:16 > 0:33:20we know that discrimination does exist, unfortunately.
0:33:20 > 0:33:24To say that everything is stigma and everything is discrimination
0:33:24 > 0:33:26would be to oversimplify what's happening.
0:33:26 > 0:33:32The clinical question is, why do they feel suicidal?
0:33:34 > 0:33:37Zucker believes that stigma is not the only reason
0:33:37 > 0:33:40why children with gender dysphoria might self-harm
0:33:40 > 0:33:42or try to take their own lives.
0:33:44 > 0:33:48The suicidality can be related to the fact that these kids
0:33:48 > 0:33:50also have other mental health problems.
0:33:50 > 0:33:51So it could simply be part of that.
0:33:51 > 0:33:56It could also be related to family vulnerability
0:33:56 > 0:33:59to mental health issues.
0:34:00 > 0:34:04Rates of suicidal feelings amongst these children are high.
0:34:04 > 0:34:07But Zucker's research suggests that they are
0:34:07 > 0:34:10no higher than for other children with mental health conditions
0:34:10 > 0:34:13like depression and anxiety, or ADHD.
0:34:17 > 0:34:20For parents, the choices can be terrifying.
0:34:22 > 0:34:25I'm just going to get some old films developed that I never got done.
0:34:27 > 0:34:30I don't know how these pictures are going to make me feel, you know.
0:34:30 > 0:34:31I really don't.
0:34:33 > 0:34:36There were good times, but there were certainly much more
0:34:36 > 0:34:38stressful times than there were good times.
0:34:38 > 0:34:41It was like a battle, like, in a warzone.
0:34:44 > 0:34:46Well, I got some disposable cameras here.
0:34:46 > 0:34:49Some of these are pretty old...
0:34:49 > 0:34:53In Toronto, Chris is getting some family photos developed.
0:34:53 > 0:34:56Pictures he couldn't face looking at for several years.
0:34:58 > 0:35:00Watching my daughter live her life,
0:35:00 > 0:35:03it was very difficult to...to...to...
0:35:03 > 0:35:06We were doing everything we could, we felt, to help her,
0:35:06 > 0:35:09I felt I could do to help her to, er...
0:35:09 > 0:35:12get the psychological help to deal with it
0:35:12 > 0:35:15and what she was struggling with inside.
0:35:15 > 0:35:19When Chris's daughter Alex was two-and-a-half years old,
0:35:19 > 0:35:21she told him she was a boy.
0:35:21 > 0:35:25But he chose to resist her demands to be treated differently.
0:35:25 > 0:35:30I wouldn't give in and so she took a very negative opinion of me
0:35:30 > 0:35:33and wanted nothing to do with me.
0:35:33 > 0:35:34I mean, she even told me once,
0:35:34 > 0:35:37"You'll never walk me down the aisle when I get married.
0:35:37 > 0:35:40"You're not going to do that.
0:35:40 > 0:35:42"You're not going to see my kids."
0:35:42 > 0:35:46My choices were absolutely the right thing. Totally.
0:35:46 > 0:35:49I believe that in my whole being.
0:35:49 > 0:35:52Nobody can tell me any differently.
0:35:52 > 0:35:54I know I made the right choice!
0:36:08 > 0:36:10The hair was already starting to be cut.
0:36:10 > 0:36:12Where we had it long and now she's starting to cut.
0:36:12 > 0:36:15So this was the starting of the hair-cutting.
0:36:15 > 0:36:18She would just say, "Get it shorter. Shorter."
0:36:18 > 0:36:20She didn't say, "I want to get a haircut like a boy."
0:36:20 > 0:36:23She would just get it shorter and get it shorter.
0:36:23 > 0:36:26There, she's starting to look more like a boy.
0:36:26 > 0:36:29And again, the hair is still long,
0:36:29 > 0:36:32but some people might look at this and say,
0:36:32 > 0:36:34"Well, she doesn't really look like a boy there,"
0:36:34 > 0:36:37but that's only because we just didn't give into it.
0:36:37 > 0:36:40We would refer to her as a her.
0:36:40 > 0:36:43She would start screaming and freaking out and yelling
0:36:43 > 0:36:47just because we used that gender reference towards her.
0:36:47 > 0:36:51She would literally scream, "A-A-A-A-A-A-A-A-Argh!
0:36:51 > 0:36:53"I'm a boy, I'm a boy!"
0:37:02 > 0:37:06Around that age, between, I would say, like, seven, eight,
0:37:06 > 0:37:09was when I really started to, like, hate myself.
0:37:09 > 0:37:13I was mad at, just, like, I guess, my life situation,
0:37:13 > 0:37:17which was that I was a girl and I was in a girl's body,
0:37:17 > 0:37:19but I didn't want to be a girl.
0:37:19 > 0:37:22Or at least I thought I didn't. I wanted to be a boy.
0:37:22 > 0:37:28In my mind, I...thought that maybe
0:37:28 > 0:37:31I wanted to be a boy because
0:37:31 > 0:37:35of what I was interested in, or how I pictured myself.
0:37:36 > 0:37:40I looked at her and I said, "Alex, you're a girl."
0:37:40 > 0:37:45And as soon as I did that, her face started to twist and grimace
0:37:45 > 0:37:49and she visually got very angry and then she stood in front of me
0:37:49 > 0:37:52with her fists clenched and then she started to...
0:37:52 > 0:37:57proceeded to punch herself in her, er...her genitals, her vagina,
0:37:57 > 0:38:01and started yelling, "I'm a boy, I'm a boy, I'm a boy!"
0:38:03 > 0:38:05And it just floored me.
0:38:05 > 0:38:08I just knew at that moment that this was not tomboy,
0:38:08 > 0:38:10there's something else going on here.
0:38:10 > 0:38:16In my heart, I knew that she was born a girl, she's a girl.
0:38:16 > 0:38:18That's the way I looked at it.
0:38:19 > 0:38:22I guess to people that don't know me, I look like a boy,
0:38:22 > 0:38:27so I must be a boy, or I should be a boy.
0:38:27 > 0:38:30I was never happy with the fact that I was a girl,
0:38:30 > 0:38:34but I wasn't happy with the fact that I was a girl
0:38:34 > 0:38:35who wanted to be a boy.
0:38:37 > 0:38:40Chris took Alex to Dr Zucker's clinic.
0:38:43 > 0:38:45When I went to CAMH, I always looked forward to it
0:38:45 > 0:38:47because it seemed like a happy time
0:38:47 > 0:38:51and I'd just chew gum and say, "I don't know," to all their questions!
0:38:51 > 0:38:53So, yeah.
0:38:53 > 0:38:57And that went on for about, I would say, like, two years,
0:38:57 > 0:38:59until I kind of opened up more.
0:39:02 > 0:39:05Let's see if there's any chance that this child
0:39:05 > 0:39:10could feel comfortable with their biological sex.
0:39:10 > 0:39:12Let's see if we can teach this girl
0:39:12 > 0:39:14that there are a lot of ways to be a girl.
0:39:14 > 0:39:17Some girls like Barbie's and some do not.
0:39:17 > 0:39:19Some girls like dresses and some do not.
0:39:19 > 0:39:21Both are equally acceptable.
0:39:21 > 0:39:27I don't have to play Barbie dolls to be a girl, um...
0:39:27 > 0:39:30I can play hockey or soccer
0:39:30 > 0:39:35with other girls who like hockey or soccer.
0:39:35 > 0:39:38CHEERING
0:39:39 > 0:39:41I think that when I joined the baseball team,
0:39:41 > 0:39:46I saw these other girls who maybe were more tomboy.
0:39:46 > 0:39:48They liked to do sporty things
0:39:48 > 0:39:51and I never really had come across that before.
0:39:51 > 0:39:58It was then, for me, a moment where I started to accept myself
0:39:58 > 0:40:03for who I was, which was being a girl that also had boy interests.
0:40:05 > 0:40:11I realised it's not as big a deal as I was making it in my head.
0:40:11 > 0:40:18And I think that helped along the road with my, um...self-acceptance.
0:40:18 > 0:40:23At 12 years old, she, of her own volition, accepted who she was.
0:40:23 > 0:40:27She came to her mother and said, "I want to grow my hair long
0:40:27 > 0:40:29"and I want to go shopping for girls' clothes."
0:40:31 > 0:40:34It just was earth-shattering, um...
0:40:34 > 0:40:37and a huge weight came off my shoulders
0:40:37 > 0:40:40that maybe we had turned the corner
0:40:40 > 0:40:43after this, in my opinion, long battle.
0:40:43 > 0:40:45I mean, it lasted six years.
0:40:45 > 0:40:50A lot of kids that struggle with gender identity or transgenderism,
0:40:50 > 0:40:54they also tend to have, you know, other issues,
0:40:54 > 0:40:58whether it's anxiety that they deal with, or depression.
0:40:58 > 0:41:00I also had OCD.
0:41:00 > 0:41:05So it was kind of like a collective of therapy in terms of that.
0:41:05 > 0:41:09I didn't believe that a child of that age, four, five, six,
0:41:09 > 0:41:11seven, eight years old could really understand the complexity
0:41:11 > 0:41:13of the gender issue.
0:41:13 > 0:41:18What does a three-year-old really know about gender at that age?
0:41:20 > 0:41:24Cases like Alex, where children do not transition, are common.
0:41:24 > 0:41:27Many overcome their gender dysphoria.
0:41:28 > 0:41:31But what this means is another source of controversy
0:41:31 > 0:41:33in the transgender debate.
0:41:35 > 0:41:37Studies from Europe and North America
0:41:37 > 0:41:40suggest around 80% of children with gender dysphoria
0:41:40 > 0:41:43eventually accept their biological sex.
0:41:45 > 0:41:49The 80% desistance rate is so wearisome.
0:41:49 > 0:41:51It has been taken apart so many times.
0:41:51 > 0:41:57Some of those research studies took place in the 1980s.
0:41:57 > 0:42:01Things have changed around how gender is expressed.
0:42:01 > 0:42:05We don't know. We don't know how a child is going to grow up.
0:42:05 > 0:42:10In a recent study, Zucker's colleague, Devita Singh,
0:42:10 > 0:42:13looked at the outcomes of more than 100 boys who attended the clinic.
0:42:15 > 0:42:1888% of them eventually desisted.
0:42:20 > 0:42:23Some of the boys who desisted were just as severe
0:42:23 > 0:42:26in their gender dysphoria, in their cross-gender behaviour,
0:42:26 > 0:42:29as some of the boys who persisted.
0:42:29 > 0:42:32So if we went back in time and looked at two boys,
0:42:32 > 0:42:34one who desisted and one who persisted,
0:42:34 > 0:42:36they could look equally severe.
0:42:36 > 0:42:40But over time, they had two very different outcomes.
0:42:40 > 0:42:47What I think is very important for parents to know,
0:42:47 > 0:42:54little kids can present with extreme gender dysphoria,
0:42:54 > 0:42:57but that doesn't mean they're all going to grow up
0:42:57 > 0:42:59to continue to have gender dysphoria.
0:42:59 > 0:43:02Some will, but a lot won't.
0:43:05 > 0:43:08And there is now evidence that childhood gender dysphoria
0:43:08 > 0:43:11could be linked to homosexuality in later life.
0:43:12 > 0:43:17Studies have shown that between 60% and 80% of boys who desist
0:43:17 > 0:43:20turn out to be gay or bisexual adults.
0:43:21 > 0:43:25The great majority of children who show significant cross-gender
0:43:25 > 0:43:28behaviour in childhood end up as ordinary gay men
0:43:28 > 0:43:30and not as transsexuals.
0:43:30 > 0:43:35Trans activists don't like the high rate of desistance talked about
0:43:35 > 0:43:39because if you know that 80% of gender-dysphoric children
0:43:39 > 0:43:41are going to end up as ordinary gay men,
0:43:41 > 0:43:43I'm going to encourage all of them
0:43:43 > 0:43:46to try and adapt to their anatomic sex,
0:43:46 > 0:43:49and the handful that are destined to be transsexuals
0:43:49 > 0:43:52no matter what will sort themselves out later.
0:43:53 > 0:43:58I've heard some parents say after their child transitioned,
0:43:58 > 0:44:01"Well, at least they're not gay."
0:44:01 > 0:44:06Because the child has transitioned to the other gender
0:44:06 > 0:44:09and therefore, in terms of their sexual attraction,
0:44:09 > 0:44:11it'll be heterosexual.
0:44:11 > 0:44:16So an interesting issue as to what extent religious
0:44:16 > 0:44:23or cultural factors that are anti-gay are part of the mix.
0:44:24 > 0:44:27But Zucker's critics believe policy shouldn't focus
0:44:27 > 0:44:29on the children who desist,
0:44:29 > 0:44:32but on the minority who go on to be transgender adults.
0:44:34 > 0:44:39It's interesting when you look at the debate between how do we manage
0:44:39 > 0:44:44gender dysphoria in children knowing that 60-80% will not continue.
0:44:44 > 0:44:46The experts will use the same studies and they'll say,
0:44:46 > 0:44:52"Well, listen, um...20-40% will continue.
0:44:52 > 0:44:54"And, so, what about them?"
0:44:59 > 0:45:02At the heart of the debate about transgender children
0:45:02 > 0:45:06is the idea that your brain can be at war with your body.
0:45:07 > 0:45:10The easiest way to think about the difference between gender and sex
0:45:10 > 0:45:12is to think that gender's between your ears
0:45:12 > 0:45:14and sex is between your legs.
0:45:14 > 0:45:17For example, when I was born, the midwife saw me, said,
0:45:17 > 0:45:19"It's a girl," and they were wrong.
0:45:21 > 0:45:25In its most simple form, some might call it a caricature,
0:45:25 > 0:45:27transgender people have been described as having
0:45:27 > 0:45:31a pink, female brain inside a blue, male body,
0:45:31 > 0:45:33or vice versa.
0:45:34 > 0:45:38The idea that you might have a blue body and a pink brain,
0:45:38 > 0:45:43for me, means you completely misunderstand what makes a brain.
0:45:43 > 0:45:47Gina Rippon is a professor of neuroimaging
0:45:47 > 0:45:51and the author of a major study into gender and the human brain.
0:45:51 > 0:45:54There aren't any parts of the brain which you can really call
0:45:54 > 0:45:56uniquely male or female.
0:45:56 > 0:45:59If you picked up any brain, looked at it in detail,
0:45:59 > 0:46:01you would not be able to tell the difference.
0:46:01 > 0:46:03You'd not be able to tell whether
0:46:03 > 0:46:06that brain had come from a man or a woman.
0:46:06 > 0:46:10So, could someone be born with a brain that is somehow
0:46:10 > 0:46:12a different gender from their biological sex?
0:46:14 > 0:46:17Well, if you look at the brains of newborn babies, you could not
0:46:17 > 0:46:21tell that the child that contained that brain was male or female.
0:46:21 > 0:46:25So we don't have a brain that is born either male or female.
0:46:26 > 0:46:29The only way you can really understand the brain
0:46:29 > 0:46:31is to know about the world it's grown up in,
0:46:31 > 0:46:34not just the sex of its owner.
0:46:35 > 0:46:38Boys often display gender dysphoria by growing their hair,
0:46:38 > 0:46:42wearing dresses and playing with dolls,
0:46:42 > 0:46:44thinking this makes them a girl.
0:46:44 > 0:46:48But are these stereotypical behaviours innately female?
0:46:49 > 0:46:53I think the transgender movement is reinforcing gender stereotypes
0:46:53 > 0:46:57because one of the things that transitioning people say
0:46:57 > 0:46:59is they feel they've been born in the wrong box
0:46:59 > 0:47:01and therefore they need to change from one to the other.
0:47:01 > 0:47:04But nobody seems to challenge the concept that actually,
0:47:04 > 0:47:06there's something wrong with having boxes.
0:47:06 > 0:47:10There are all sorts of other factors that you should be thinking about
0:47:10 > 0:47:12before you jump to the conclusion,
0:47:12 > 0:47:15which is rather an 18th-century conclusion,
0:47:15 > 0:47:17that men and women have different brains.
0:47:20 > 0:47:23What the science tells us is that it's our relationship with
0:47:23 > 0:47:27the world around us that largely forms our ideas of gender.
0:47:28 > 0:47:30We live in a gendered world
0:47:30 > 0:47:33and that gendered world will change our brains.
0:47:33 > 0:47:37So we're not born with a male brain or a female brain,
0:47:37 > 0:47:41we're born with a brain that gets immersed in a gendered world
0:47:41 > 0:47:44and a gendered world produces a gendered brain.
0:47:46 > 0:47:50Anybody who wants to use the narrative,
0:47:50 > 0:47:54"I have a girl's brain in a boy's body,"
0:47:54 > 0:48:00it just so oversimplifies the data that, er...
0:48:02 > 0:48:08You have to understand that narrative more, er...
0:48:08 > 0:48:12as a political or a psychological argument
0:48:12 > 0:48:16than a reflection of science.
0:48:16 > 0:48:19Here's one of the things that's lovely about being transgender,
0:48:19 > 0:48:22we mess with everyone's theories about gender.
0:48:22 > 0:48:25There's the biological theory of gender,
0:48:25 > 0:48:26if you were born a woman, you are a woman
0:48:26 > 0:48:29and you have deep nurturing feelings and you're this, that and the other.
0:48:29 > 0:48:31Oh, we messed with that one!
0:48:31 > 0:48:35Then there's this social construction theory of gender.
0:48:35 > 0:48:37You are the gender you are because your mummy told you to be
0:48:37 > 0:48:40and your school told you to be and the media told you to be,
0:48:40 > 0:48:43the social construction of gender. We messed with that one!
0:48:43 > 0:48:45We messed with everyone's ideas about gender
0:48:45 > 0:48:46and that's fine with me.
0:48:49 > 0:48:52Despite the lack of agreement about what is happening to children
0:48:52 > 0:48:54with gender dysphoria,
0:48:54 > 0:48:58the gender-affirmative approach has now become almost universal.
0:49:01 > 0:49:04In Canada, this change has coincided with
0:49:04 > 0:49:07a rise in sex-reassignment surgery
0:49:07 > 0:49:10of nearly 400% since 2010.
0:49:12 > 0:49:16No-one, no-one, least of all me, no-one is suggesting children
0:49:16 > 0:49:19should have surgical alterations to their bodies. Please don't.
0:49:19 > 0:49:22Um...but children, especially younger children,
0:49:22 > 0:49:28mostly think about gender as being connected to how you behave,
0:49:28 > 0:49:31what you wear, what your hair's like, what toys you play with.
0:49:31 > 0:49:34So for them, as long as they can socially transition,
0:49:34 > 0:49:36they usually just feel a whole lot happier.
0:49:37 > 0:49:39By taking that position,
0:49:39 > 0:49:42I think that the activists are basically saying
0:49:42 > 0:49:47that there's only one way to work with little kids,
0:49:47 > 0:49:50and that's to kind of nurse them along
0:49:50 > 0:49:52until they're ready to transition
0:49:52 > 0:49:55and need biomedical treatment.
0:49:55 > 0:49:59There is evidence that the younger a child is socially transitioned,
0:49:59 > 0:50:02the more likely they are to persist in their feelings
0:50:02 > 0:50:04of being the opposite gender.
0:50:04 > 0:50:07Many believe this will result in more children
0:50:07 > 0:50:10receiving hormone therapy and later surgery.
0:50:11 > 0:50:14You don't want to, for example,
0:50:14 > 0:50:16recommend surgery for anybody...
0:50:18 > 0:50:22..where you are worried that they're going to regret it.
0:50:22 > 0:50:27Because surgery is irreversible.
0:50:30 > 0:50:33The assumption from the outset was that
0:50:33 > 0:50:36if I said I was transgender, then I must be.
0:50:36 > 0:50:40Nobody, at any point, questioned my motives.
0:50:40 > 0:50:43The only cure for this would be hormones and surgery.
0:50:46 > 0:50:49Lou - not her real name - was born a girl.
0:50:49 > 0:50:52As a child she experienced gender dysphoria,
0:50:52 > 0:50:55which intensified with the onset of puberty.
0:50:57 > 0:51:00I became very self-conscious of my body.
0:51:00 > 0:51:03I was developing breasts
0:51:03 > 0:51:06and periods, which,
0:51:06 > 0:51:08for me, felt like there was...
0:51:10 > 0:51:14..an alien crawling out of the inside of my body.
0:51:14 > 0:51:15I...
0:51:15 > 0:51:20became very depressed.
0:51:20 > 0:51:22I thought the only explanation
0:51:22 > 0:51:25for my gender dysphoria
0:51:25 > 0:51:28must be that I was actually a man.
0:51:30 > 0:51:33I was struggling with self-harm and had attempted suicide
0:51:33 > 0:51:36on a number of occasions,
0:51:36 > 0:51:39and was very much told
0:51:39 > 0:51:42by the community that if you don't transition,
0:51:42 > 0:51:46you will self-harm and you will kill yourself.
0:51:46 > 0:51:49I became convinced that my options were
0:51:49 > 0:51:51transition or die.
0:51:52 > 0:51:55I didn't understand
0:51:55 > 0:52:02that the degree of disconnect from and hatred of my body
0:52:02 > 0:52:06could be considered a mental health problem.
0:52:08 > 0:52:12In the UK, the medical approach is similar to Canada.
0:52:12 > 0:52:14A child can begin hormone blockers at 9,
0:52:14 > 0:52:17they can receive sex hormones at 16
0:52:17 > 0:52:19and have surgery at 18.
0:52:20 > 0:52:23At 20, Lou had her breasts removed
0:52:23 > 0:52:24in a double mastectomy,
0:52:24 > 0:52:26a decision that now haunts her.
0:52:29 > 0:52:33The darkest moment was when I realised
0:52:33 > 0:52:36that I had actually
0:52:36 > 0:52:38looked normal for a girl,
0:52:38 > 0:52:42that I had actually been slim and pretty,
0:52:42 > 0:52:45that my body hadn't been grotesque,
0:52:45 > 0:52:47the way I thought it was.
0:52:47 > 0:52:51Now, as a result of having transitioned,
0:52:51 > 0:52:55I will always have a female body that is freakish.
0:52:55 > 0:52:58I will always have a flat chest and a beard.
0:52:58 > 0:53:02And there's nothing I can do about that.
0:53:02 > 0:53:05Are there people who sometimes go ahead with transition,
0:53:05 > 0:53:08a physical transition, and regret it? Yes, there are.
0:53:08 > 0:53:10There are not very many of them.
0:53:10 > 0:53:14It's well under 4%, it's probably closer to 2%,
0:53:14 > 0:53:16but somehow this group of people are being given
0:53:16 > 0:53:19a huge amount of attention, which...
0:53:19 > 0:53:22in comparison to the people for whom it's gone absolutely great,
0:53:22 > 0:53:24who are feeling terrific about it.
0:53:24 > 0:53:28Lou only agreed to do this interview anonymously.
0:53:28 > 0:53:32She has received extreme abuse when discussing her story online.
0:53:34 > 0:53:36I've received death threats.
0:53:36 > 0:53:42People are terrified of being accused of being transphobic.
0:53:42 > 0:53:45Nobody wants to question the received knowledge
0:53:45 > 0:53:47that transition is the only option,
0:53:47 > 0:53:50because nobody wants to be the one person
0:53:50 > 0:53:52that puts their head up and says,
0:53:52 > 0:53:55"Hang on, I don't think this is all right."
0:53:58 > 0:54:02They want to get rid of boys' and girls' sports teams,
0:54:02 > 0:54:03and many people aren't aware of that.
0:54:03 > 0:54:07To get rid of those boundaries - and that's not OK.
0:54:08 > 0:54:11Canada is at the forefront of defending the rights
0:54:11 > 0:54:13of gay, lesbian and transgender people.
0:54:14 > 0:54:18But the debate over how to deal with gender dysphoria in children
0:54:18 > 0:54:20is polarising opinion.
0:54:20 > 0:54:24And sometimes, sir, the parent isn't part of the solution.
0:54:24 > 0:54:26They are part of the problem.
0:54:26 > 0:54:29New legislation in the province of Alberta
0:54:29 > 0:54:32states that parents have no right to be told if their children
0:54:32 > 0:54:35want to adopt another gender at school.
0:54:37 > 0:54:40The whole attitude around trans children in our educational system
0:54:40 > 0:54:44we're working towards should be, and is becoming,
0:54:44 > 0:54:48that it's the safety of the child that is first and foremost,
0:54:48 > 0:54:50their paramount concern.
0:54:50 > 0:54:54Not the safety of the parents or the parents' prejudices or thoughts.
0:54:57 > 0:54:59It's my child. So, whose child is it anyway?
0:54:59 > 0:55:02I guess that's what we're talking about. Whose child is it?
0:55:02 > 0:55:05Is it my child? Is it the government's child?
0:55:05 > 0:55:06Is it society's child?
0:55:06 > 0:55:09And how much of a say do I have for their life?
0:55:09 > 0:55:11I think the parent, you know,
0:55:11 > 0:55:15should have the right to bring up the child the way they see fit,
0:55:15 > 0:55:17that's why they're the parent.
0:55:17 > 0:55:20It's their responsibility, it's their child.
0:55:20 > 0:55:23I am very protective of and concerned for
0:55:23 > 0:55:26children of my own community,
0:55:26 > 0:55:28the children who are going to grow up to be people like me.
0:55:28 > 0:55:32I think that's a fundamental adult responsibility.
0:55:32 > 0:55:37What we're talking about here is not the adult trans community
0:55:37 > 0:55:39taking control of its own destiny,
0:55:39 > 0:55:43but the adult transsexual community trying to intervene
0:55:43 > 0:55:47in the destinies of children who aren't even their own.
0:55:47 > 0:55:50If I was talking to
0:55:50 > 0:55:52a gender dysphoric girl
0:55:52 > 0:55:56who hated her body the way I hated mine,
0:55:56 > 0:56:00I would tell her to get out into the mud,
0:56:00 > 0:56:01to climb trees,
0:56:01 > 0:56:06to find ways of inhabiting her body on her terms.
0:56:09 > 0:56:12Expressing doubt about the gender-affirmative approach
0:56:12 > 0:56:14to children is now risky.
0:56:15 > 0:56:18Accusations of transphobia are common.
0:56:18 > 0:56:21In Canada, one of the world's leading authorities
0:56:21 > 0:56:24on gender dysphoria was fired.
0:56:24 > 0:56:26A lot of people who are professionals,
0:56:26 > 0:56:29and would be perfectly willing in private
0:56:29 > 0:56:32to say that they're appalled by Ken Zucker's firing,
0:56:32 > 0:56:35would be terrified to say that in public
0:56:35 > 0:56:37for fear of their own jobs,
0:56:37 > 0:56:41or being treated as pariahs by their co-workers.
0:56:41 > 0:56:44We're in an era, now,
0:56:44 > 0:56:47where you're either a good guy or a bad guy.
0:56:49 > 0:56:51I'm hoping there'll be less venom
0:56:51 > 0:56:56and more rapprochement among
0:56:56 > 0:56:59some of the different philosophical approaches.
0:57:08 > 0:57:10Like families across the world,
0:57:10 > 0:57:13Warner and her mum face some tough decisions.
0:57:14 > 0:57:18I'm pretty sure I'm going to have to get surgeries, and all that,
0:57:18 > 0:57:20to become...erm...
0:57:20 > 0:57:23to become a...boy.
0:57:23 > 0:57:25Wait, a girl. Um...
0:57:29 > 0:57:33Em... It might be rough, cos everybody has a rough life...
0:57:33 > 0:57:34It's going to be rough.
0:57:34 > 0:57:38At this point we have to start considering, um...
0:57:38 > 0:57:41puberty blockers. Things like that.
0:57:41 > 0:57:45So, we've been researching that like crazy and speaking to doctors
0:57:45 > 0:57:48and different things to try to make those decisions for her,
0:57:48 > 0:57:51because she's too young to make them.
0:57:51 > 0:57:52Cos it's a really big decision.
0:57:52 > 0:57:56Like, I've already made the decision I want to be...
0:57:56 > 0:57:59a girl, but I haven't made the decision
0:57:59 > 0:58:02if I want to do the surgeries.
0:58:05 > 0:58:08It's, like... I don't feel perfect.
0:58:08 > 0:58:10I'm not the full puzzle.
0:58:10 > 0:58:13I feel like there's a couple of pieces missing.
0:58:15 > 0:58:19I feel like my journey is to find all those pieces.