Transgender Kids: Who Knows Best?

Around the world, the transgender community is on the march.

You are the new world.

There is no normal any more. This is the new normal.

Not all boys have a penis and not all girls have a vagina.

Parents are facing an explosion in the number of children

saying they were born in the wrong body.

It was like a battle in a warzone.

She would literally scream, "A-A-A-A-Argh!

"I'm a boy, I'm a boy!"

I want to be a girl, I am a girl. I'm a girl.

I'm not comfortable in a boy body. I just want to be a girl.

We are now told to believe children and support them in changing gender.

There's this huge push to be, like, "OK, you know, he is a girl,

"you need to do everything you can

"to support that and make this kid a girl."

If they say they're transgender, chances are they are.

Sometimes, sir, the parent isn't part of the solution,

they are part of the problem.

The adult transsexual community tried to intervene

in the destinies of children who aren't even their own.

One top expert has now been fired for challenging the idea

that children know best.

A four-year-old might say that's he's a dog.

Do you go out and buy dog food?

Parents face terrifying choices and the stakes could not be higher.

That child will kill themselves if they're trans

because many trans children do.

Is that what parents really want?

My choices were absolutely the right thing. Totally.

I believe that in my whole being.

Nobody could tell me any differently.

An Ottawa area family is sharing their remarkable story tonight

about their little boy who knows in his heart he is a girl.

Around the age of two and a half, she told me one night,

"Mummy, I think God made a mistake, I'm really a little girl."

Warner is, um...transgender.

So she is, er...identifies as female.

Warner had preferences for pink, sparkles.

Even her physical mannerisms, with her hands, very flamboyant,

wanting to be a princess, and if you took her shopping,

she'd go right for dresses.

I never actually, like, fitted in with being a boy.

I don't like...

..the games, the hair styles, the clothes.

And I always thought from the beginning I was

a little bit feminine.

There's nothing wrong with being a boy,

it's just that I don't enjoy being a boy.

So Warner is nine years old.

She's just at an age now where sexuality is starting to develop.

So boy crushes and things like that are just starting to come in.

You can be a girl who wants to be a boy,

or a boy that wants to be a girl,

but for me, I'm a boy that wants to be a girl

and I'm not comfortable in a boy body.

I just want to be a girl.

Warner and Melissa live in Canada.

There's, like, tonnes of people here and there's lots of support here

and it just makes me feel really good about myself.

A country that has led the way in passing laws

to defend the rights of transgender people.

I'm proud to announce that tomorrow,

on the International Day Against Homophobia and Transphobia,

we will be tabling a bill in the House of Commons to ensure

the FULL protection of transgender people.

Look at you, you're so beautiful!

You are the new world.

We want to show them that we are every colour of the rainbow.

That there is no normal any more. That this is the new normal.

CHEERING AND APPLAUSE

In Toronto, politician and priest Cheri DiNovo leads the fight

for transgender rights.

I tabled, as one of my very first bills, Toby's Law,

which would extend human rights to trans people.

That's all it does, really.

So it means you can't fire somebody because they're trans,

you can't deny them medical care,

you can't fire them or you can't not hire them,

you can't not rent to them because they're trans,

like human rights for everyone else.

The next generation will grow up where they're not overtly bullied

and harassed as trans folk.

That might keep them alive. That's what we're aiming for.

When you're working with someone who's trans and they've begun

to access whatever kind of treatment is right for them,

you see these dramatic... Like, people just blossom.

It's gorgeous, it's lovely to watch.

Hershel Russell is a transgender psychotherapist

and activist in Toronto.

He's an advocate for the gender-affirmative approach.

The idea that parents should support and encourage children

who say their gender is out of sync with their body.

A mother of a gender-diverse kid asked her eight-year-old,

"So, how come you know that you're really a boy?"

And the child said, "I know way down deep, where the music plays."

And I think that's so precise.

It's non-rational, it's profound, it's beautiful, it's deep.

THAT'S how we know what gender we are

and very young children know that.

I am a teenage girl.

I'm also transgender, and I'm proud of that.

This gender-affirmative approach is now the mainstream in Canada

and much of the western world.

I'm a man! Like, physically, no, but look at this.

What do you see? Man!

Online media and TV shows are now full of young people

who are proud to talk about their transgender identity.

Actually, I don't WANT to be a girl, I AM a girl.

Parents like Melissa are encouraged to accept their child's new gender.

Once we attended the gender-identity clinic

and the doctors basically started telling us plain and simply

there is no fix for children like Warner,

um...that we needed to listen to her.

Well, we listened to Warner and we knew what we needed to do.

These attitudes have coincided with a steady increase

in young people attending gender clinics in Canada.

# On the hillside stands a lady

# Who she is I do not know... #

But not everyone agrees with this approach.

Modern ideas of gender diversity and gender fluidity can feel like

a long way from traditional childhood and parenting.

Can you lend me a few Pokemon cards?

-Why?

-Because. I want to battle you.

Some parents aren't comfortable with simply agreeing

to their child's demand to switch gender.

One Christmas, I guess it was his second birthday,

he really wanted a dress.

All he wanted for Christmas was a red dress.

So I...bought him a red dress.

And, er...he wore that dress all the time.

It's a really scary world as a parent of a child

who identifies differently gender-wise.

There's this huge push to be, like,

"OK, some days they feel like they're a girl.

"OK, he is a girl, you need to do everything you can

"to support that and make this kid a girl."

And that wasn't an approach we were comfortable with as a family,

to say, "OK, you like pink? OK, that means you're a girl.

"You're going to be a girl."

Um...and at the same time, we weren't comfortable saying,

"You're natally male, so you need to be a boy."

In our own family,

if I were to let my kids do everything they wanted to do

and affirm to everything, there would be Pokemon posters everywhere

and no-one would ever get dressed and we would eat only McDonald's.

Meredith took her son to see a psychologist

at a clinic in Toronto.

Dr Kenneth Zucker is one of the world's foremost child psychologists,

specialising in gender dysphoria,

a condition where a person is unhappy with their biological sex.

We received a referral and I spoke with Dr Zucker.

My child was diagnosed with gender dysphoria.

Euphoria means you're happy about something.

Dysphoria means you're unhappy.

Children as young as two or three,

up through the end of adolescence,

will come in because either the child himself or herself

is expressing an intense unhappiness about being a boy or a girl...

I feel like there wasn't this big push to just talk about gender,

gender, gender, it was more just, you know, "How was your week?

"What did you do this week? Oh, I see you're wearing blue shoes today.

"Do you want to talk, what made you choose the blue shoes over the pink shoes?"

For three decades, Zucker and his team treated more than

a thousand children at Toronto's child gender clinic

at the Centre for Addiction and Mental Health, CAMH.

He doesn't agree with the gender-affirmative approach

promoted by many transgender activists.

Identity is a process.

It's complicated, it takes a long period of time, in a sense,

to know who a child really is.

A four-year-old might say that he's a dog.

Um...do you go out and buy dog food?

Being lesbian, gay, bisexual, er...trans or queer is who one is.

To tell a child that who they are is wrong, we consider abusive.

Zucker became a target for transgender activists,

who have increasingly influenced policy in Canada.

It became clear to me that the therapist didn't think

that my trans identity was really real,

that it was an issue associated with my social life

and if that was fixed, then I would be fixed of my gender identity.

Zucker was accused of trying to cure transgender children.

The same way that psychologists used to try and cure gay people

of their homosexuality.

He was accused of practising conversion, or reparative therapy.

Drop the Barbie, that's the short version of it.

So we will work hard to actively discourage the child

from playing with certain kinds of toys,

wearing certain kinds of clothes, having certain kinds of friends.

So we will police the child's leisure activities

and force them in a particular gender direction.

That's straight up what we now call reparative therapy.

Although the people doing it don't use those words.

That's their problem.

I completely reject the allegation

that I've ever practised

conversion therapy.

I practise what I would call

developmentally-informed therapy.

In June 2015, supported by gender-affirmative doctors,

Cheri DiNovo pushed through a new law

banning conversion therapy in Ontario.

A review was launched into Zucker's clinic

and six months later, it was shut down.

Banning conversion therapy has had a huge impact.

In fact, the impact is still being felt.

One of our largest mental health institutions

changed their entire programming,

scrapped what they were doing, started again.

Dr Kenneth Zucker, one of the world's leading authorities

on gender dysphoria, was fired.

That was clearly on the cards from a very long time ago.

We were very supportive of that decision.

That's the way the professional studies and research is going.

It was time for CAMH to catch up with the rest of the world,

and we're glad they did.

But many of Zucker's patients were shocked.

When the news actually came out that the clinic was closed

and he was let go, I was very surprised and pretty angry.

Yeah, it was very shocking. I was very, very shocked at that.

I think for my husband and I, we were kind of, like,

"OK, so, now what?"

We've worked with these people for a year and a half,

my kid is comfortable coming here,

he's comfortable with his therapist, so, what's going to happen?

And there was a warning for parents too.

So-called conversion therapy could risk the life of their child.

Only gender-affirmation could save them.

Parents who'd say, "It's my value system, it's my way or the highway,

"this is what I say, and what I say goes,"

are the parents who will lose their children.

And they will lose them either because that child will move away from home

and not have anything to do with them,

or that child will kill themselves if they're trans.

Because many trans children do.

Is that what parents really want of their children?

Because a child is who the child is.

Zucker's dismissal sent shock waves through the scientific community.

More than 500 clinicians and academics from around the world

signed a petition in protest at the politicisation of gender therapy.

People are now probably fairly terrified

of taking any stance that is out of step

with what trans activists are demanding.

They will certainly look and say,

if somebody as prominent as Ken Zucker could lose his job

for being reluctant to join the trans bandwagon,

what could happen to me if I expressed any reservations?

Sex and gender research has been political for decades.

Makes it more interesting, but also, er...

..more and more dangerous.

The issue of gender identity has always been controversial.

In the 1950s, former American GI Christine Jorgensen

caused a sensation by having an early form

of gender-reassignment surgery.

I don't have any plans at the moment and I thank you all for coming,

but I think it's too much.

Until recently, the ability to transition to the opposite sex

was mostly confined to adults.

But with changes in attitude

spreading through TV and social media,

the focus has now turned to children and young people.

I'm very fortunate to be on HRT already,

so, yeah, it's been six months,

I take two of these bad boys a day.

Modern medicine can now supply hormone-blockers

to stop children going through puberty.

Meaning that's a boy might never develop the attributes of a man.

I finally got my T blockers

that inhibit the production of testosterone, so it slows it down,

makes it weaker and it prepares my body, basically.

Depending on when they started puberty,

some 16-year-old genetic males

would have so many severe masculinising effects,

whether it's facial hair, facial bone structure,

vocal change, Adam's apple, you name it,

that to wait until 16 to then give them oestrogen

would be like just feminising a male figure.

And modern surgery can create realistic breasts,

penises and vaginas to order for young adults.

As soon as I could start forming an opinion about myself,

around two or three years old,

I could tell that I was not a typical boy.

At around four years old, I was taking a bath

and I remember saying, "I know I'm supposed to be happy with who I am,

"but I'm not happy with what I am."

Ella was born biologically male,

but is now a fully-transitioned 17-year-old transgender woman.

In the US, there are now 40 gender clinics

for children and adolescents.

Ella was helped to transition by Dr Norman Spack

from Boston Children's Hospital,

where he's set up America's first clinic

to medically treat transgender children.

I had the tools to do this.

It wasn't, as we say, rocket science,

it's just so rewarding to watch these kids give birth to themselves.

I just felt like a midwife, you know.

I was so young when this was all happening

that really I only had, like, what was going on in my head.

I didn't know what my parents thought about it.

All that I was met with was, you know,

"That's OK, we're here for you. We support you."

When we would go on vacation, they would let me present as a girl

and they would let me play dress-up in the house.

Ella was never a boy.

I mean, she might've had male genitalia,

but she was a girl from the moment she was born.

When she was ten,

Ella's parents took her to a transgender summer camp.

One of 20 that have sprung up across North America.

There's all of these kids,

transgender girls and transgender boys.

And I think it was really the first time that I felt like I belonged

in a social setting since I was really, really young.

Transgender camps help children like Ella

make a social transition to the opposite gender.

That was when I really learned, like, you can transition

and you can use female pronouns and change your name.

I don't have to go home after school and put on a dress,

I can wear a dress the whole day.

Look at the sky. It's so pretty!

I saw her run off to camp after she transitioned and I thought,

"Ah! That's just like a girl running."

Instead of, "Look at my son, he runs like a girl!"

-Right.

-It was finally the world was aligned.

She got to be who she was.

And it wasn't awkward.

-What was awkward was having her having to present as a boy.

-Right.

The risk of not being able to transition early enough, I think

that's where you start entering into a world of mental health issues.

A child does need a lot of support at that point.

And I just think it can break a kid, even if it's not suicide.

At the age of 12, Ella took puberty-blockers.

The next step was to take the hormone oestrogen

to give her adult female features.

Still a teenager, Ella then considered the final,

most irreversible step.

Ella had been looking at herself in the mirror.

She was 16 and she had been on oestrogen for over two years.

She was despondent.

In the one sense, she was feminising beautifully,

on the other hand, what was the value of putting off...

Actually, I don't like the term,

they call it SRS, sex-reassignment surgery,

but I call it affirmation surgery.

Because you're not changing someone's sex, really.

You're changing their body.

The day that I had surgery, I finally felt at peace

because I could finally be able to look in the mirror

and see a girl looking back at me.

Not all boys have a penis

and not all girls have a vagina and not...

Yeah, that's just...

I don't know how else to say it, but, you know,

anyone who wants to be a boy can be a boy

and anyone who wants to be a girl can be a girl.

Around the world, gender clinics have been swamped

by young people like Ella, determined to transition.

And often supported by their parents.

In just five years, the UK's main child gender clinic

has seen in increase in referrals of more than 1,000%.

Many people are now convinced that a girl can simply be born

in a boy's body, and vice versa.

But is it really so simple?

When I work with families,

I try to understand a child...

on a case-by-case basis.

There are different pathways that can lead to gender dysphoria,

but it's an intellectual and clinical mistake

to think that there's one single "cause"

that explains all gender dysphoria.

# Sleep no more

# Sleep no more

# Sleep no more, Fair Rosa... #

Gender dysphoria can be a disturbing childhood condition.

I didn't think it was a phase because there was

a lot of things combined and he was so into, like, everything girlie.

It seemed like he didn't know that he's a boy.

Dalia's son, Kareem,

displayed the classic symptoms of gender dysphoria.

I started to get concerned when he was starting to draw

self-portraits, like, kids always draw their family.

And at the time, it was me and my mom and him,

and it would just always be three girls in the picture.

And he did that a lot, like, obsessively.

He did, like, hundreds of them.

And then it was that, combined with a lot of other things

that made me decide to ask my doctor, like, "Hey, is that normal?"

Dalia and Kareem were referred to Dr Zucker's Toronto clinic

before it was shut down.

His team didn't take what Kareem was saying at face value.

They would observe Kareem and I interacting.

The style of therapy was playing

and they would play with him

and interpret his issues and help guide him through them.

Play is a window into a child's internal world.

And it's through their play that they can tell you

what they're thinking and what they're feeling.

They didn't want to obsessively focus on the gender

and what toys he plays with.

What they did tell me was, like, say, for example,

don't fill a room with, like, Barbie's and, you know,

butterflies and put him in it and just only go in that direction,

and don't force him to only be with boy toys.

Just be, you know, neutral.

Just be whatever. Just have all toys.

The psychologists at Zucker's clinic

were looking for any hidden causes of Kareem's behaviour.

You're always trying to think about what these behaviours mean.

You're trying to...

..understand what is the relationship between

the surface behaviour and the underlying feelings?

Just because little kids say something doesn't necessarily

mean that you accept it, or that it's true.

Or that it's in the best interests of a child.

Zucker believes there may be many reasons

a child insists they should be the opposite sex.

At CAMH, Dr Zucker just explored, you know,

let's look at the full picture, let's look at the family.

It just didn't feel like the only focus was the gender

or one outcome, it was just helping us.

During therapy, Dalia shared more about her son's upbringing.

Dalia came from a very traditional family

and she was unmarried when she gave birth to Kareem.

I was really young when I had my son and, um...

my parents were really ashamed of me for that,

and weren't very proud of him either.

The gender piece with my son is possibly a symptom of other...

..things that are confusing him, things that are difficult for him.

Unable to cope, at one point, Dalia moved out,

leaving Kareem with her family.

Kareem has lost a lot of important people in his life

because his family relationships have been really rocky.

Like, he lost me for a period of time,

he lost my mom for a period of time.

He has been tossed around and he hasn't been able to hold on

to those important people.

It's possible that the reason Kareem is, you know,

gravitating towards these feminine, ultra-feminine tendencies,

um...is a way of being closer to me.

Because he has fear to lose me.

Zucker believes a whole range of psychological issues can manifest

themselves in a child's obsession with changing their gender.

Taking any behaviour in isolation

when thinking about gender dysphoria

is not the way that I think about it.

The mental health of children,

adolescents and adults is very important.

In one extreme case, Zucker treated a young girl

who had tragically witnessed her own mother being murdered.

Afterwards, the girl then became convinced she was a boy.

This youngster really struggled with having lost her mother

and she developed the belief that,

"If I had been a boy and not a girl, I would've been stronger

"and I would've been able to have saved my mom."

And by being a boy, she would be safe herself

and not be a target of male aggression.

There's also evidence of a link between gender dysphoria and autism.

One study found that children with gender dysphoria

are seven times more likely to be on the autistic spectrum

than children from the general population.

It's possible that kids who have a tendency to get obsessed

or fixated on something

may latch on to gender.

Dalia believes that her son's complex problems

may ultimately have a simple explanation.

I think that my son may happily identify as gay one day.

I think that that is...

And I think he has definitely some confusion with his...gender,

but that may not be born inside of him,

that may be just because of what society expects,

that may be because of traumas he's been through.

There's lots of different ways.

So I don't think that it would be responsible

to just run with it if he said, "I want to be a girl."

CONGREGATION SING

But for campaigners like Cheri DiNovo, it is simply wrong

to link transgender children with mental illness.

She believes that transgender people

have always been a normal part of human society.

Philip reluctantly baptises a black African trans person

as the first Christian.

We've got the conversion of the Ethiopian eunuch

as the very first Christian.

That's pretty freaking queer, I think.

So this God, really, is trans from the beginning.

Going right back to our first nations

who had shamans who were both male and female,

there have always been trans people with us,

there have been always homosexual people with us,

there have always been bisexual people with us.

I believe that areas in gender identity and expression

are not psychiatric differences,

they are differences in the human condition.

Transgender activists are now campaigning to stop

gender-dysphorian children

being considered a medical or psychiatric problem.

It's not about mental health,

so why does it belong in a mental health institution?

This is one of the things we're hearing more and more emphatically

from families who have gender-diverse kids,

"We don't want mental health assistance.

"Yes, we do want to get together with other families like ours,

"but we don't want to see the psychologist or psychiatrist.

"Our kid's just fine, thank you."

If they say they're transgender, chances are they are,

so let's make a safe space for them to explore that.

The death of an Ohio teenager has sparked national outrage,

with reports the teen committed suicide

after being shunned for being transgender.

The suicide of 17-year-old Leelah Alcorn made headline news

around the world and changed the terms of the entire debate.

On social media, her parents were blamed

for trying to suppress her transgender identity.

#LeelahAlcorn's parents should be ashamed.

Charges should be brought.

Her death highlighted the shockingly-high rates of suicide

amongst transgender people.

According to a survey from 2010,

41% of 7,000 transgender people questioned

had attempted suicide.

Once again, the choice facing parents seemed stark.

You either support your child's transgender identity,

or you risk losing them.

I would argue to the parents who are frightened of trans children

and that their children might be trans, I would argue,

do you want your child to be safe? Do you want your child to grow up?

Do you want them free from suicidal ideation?

Do you want them free from, you know, excessive trauma?

And if they yes, then work with your child

to be what your child really is.

In Toronto, the gender clinic run by Dr Zucker was heavily criticised.

They were accused of preventing kids from transitioning,

stigmatising them and driving them towards suicide.

Charges they strongly deny.

If I don't transition my kid, I'm going to have a dead kid.

I think that's...clinically unsophisticated.

We know that a stigma does exist,

we know that discrimination does exist, unfortunately.

To say that everything is stigma and everything is discrimination

would be to oversimplify what's happening.

The clinical question is, why do they feel suicidal?

Zucker believes that stigma is not the only reason

why children with gender dysphoria might self-harm

or try to take their own lives.

The suicidality can be related to the fact that these kids

also have other mental health problems.

So it could simply be part of that.

It could also be related to family vulnerability

to mental health issues.

Rates of suicidal feelings amongst these children are high.

But Zucker's research suggests that they are

no higher than for other children with mental health conditions

like depression and anxiety, or ADHD.

For parents, the choices can be terrifying.

I'm just going to get some old films developed that I never got done.

I don't know how these pictures are going to make me feel, you know.

I really don't.

There were good times, but there were certainly much more

stressful times than there were good times.

It was like a battle, like, in a warzone.

Well, I got some disposable cameras here.

Some of these are pretty old...

In Toronto, Chris is getting some family photos developed.

Pictures he couldn't face looking at for several years.

Watching my daughter live her life,

it was very difficult to...to...to...

We were doing everything we could, we felt, to help her,

I felt I could do to help her to, er...

get the psychological help to deal with it

and what she was struggling with inside.

When Chris's daughter Alex was two-and-a-half years old,

she told him she was a boy.

But he chose to resist her demands to be treated differently.

I wouldn't give in and so she took a very negative opinion of me

and wanted nothing to do with me.

I mean, she even told me once,

"You'll never walk me down the aisle when I get married.

"You're not going to do that.

"You're not going to see my kids."

My choices were absolutely the right thing. Totally.

I believe that in my whole being.

Nobody can tell me any differently.

I know I made the right choice!

The hair was already starting to be cut.

Where we had it long and now she's starting to cut.

So this was the starting of the hair-cutting.

She would just say, "Get it shorter. Shorter."

She didn't say, "I want to get a haircut like a boy."

She would just get it shorter and get it shorter.

There, she's starting to look more like a boy.

And again, the hair is still long,

but some people might look at this and say,

"Well, she doesn't really look like a boy there,"

but that's only because we just didn't give into it.

We would refer to her as a her.

She would start screaming and freaking out and yelling

just because we used that gender reference towards her.

She would literally scream, "A-A-A-A-A-A-A-A-Argh!

"I'm a boy, I'm a boy!"

Around that age, between, I would say, like, seven, eight,

was when I really started to, like, hate myself.

I was mad at, just, like, I guess, my life situation,

which was that I was a girl and I was in a girl's body,

but I didn't want to be a girl.

Or at least I thought I didn't. I wanted to be a boy.

In my mind, I...thought that maybe

I wanted to be a boy because

of what I was interested in, or how I pictured myself.

I looked at her and I said, "Alex, you're a girl."

And as soon as I did that, her face started to twist and grimace

and she visually got very angry and then she stood in front of me

with her fists clenched and then she started to...

proceeded to punch herself in her, er...her genitals, her vagina,

and started yelling, "I'm a boy, I'm a boy, I'm a boy!"

And it just floored me.

I just knew at that moment that this was not tomboy,

there's something else going on here.

In my heart, I knew that she was born a girl, she's a girl.

That's the way I looked at it.

I guess to people that don't know me, I look like a boy,

so I must be a boy, or I should be a boy.

I was never happy with the fact that I was a girl,

but I wasn't happy with the fact that I was a girl

who wanted to be a boy.

Chris took Alex to Dr Zucker's clinic.

When I went to CAMH, I always looked forward to it

because it seemed like a happy time

and I'd just chew gum and say, "I don't know," to all their questions!

So, yeah.

And that went on for about, I would say, like, two years,

until I kind of opened up more.

Let's see if there's any chance that this child

could feel comfortable with their biological sex.

Let's see if we can teach this girl

that there are a lot of ways to be a girl.

Some girls like Barbie's and some do not.

Some girls like dresses and some do not.

Both are equally acceptable.

I don't have to play Barbie dolls to be a girl, um...

I can play hockey or soccer

with other girls who like hockey or soccer.

CHEERING

I think that when I joined the baseball team,

I saw these other girls who maybe were more tomboy.

They liked to do sporty things

and I never really had come across that before.

It was then, for me, a moment where I started to accept myself

for who I was, which was being a girl that also had boy interests.

I realised it's not as big a deal as I was making it in my head.

And I think that helped along the road with my, um...self-acceptance.

At 12 years old, she, of her own volition, accepted who she was.

She came to her mother and said, "I want to grow my hair long

"and I want to go shopping for girls' clothes."

It just was earth-shattering, um...

and a huge weight came off my shoulders

that maybe we had turned the corner

after this, in my opinion, long battle.

I mean, it lasted six years.

A lot of kids that struggle with gender identity or transgenderism,

they also tend to have, you know, other issues,

whether it's anxiety that they deal with, or depression.

I also had OCD.

So it was kind of like a collective of therapy in terms of that.

I didn't believe that a child of that age, four, five, six,

seven, eight years old could really understand the complexity

of the gender issue.

What does a three-year-old really know about gender at that age?

Cases like Alex, where children do not transition, are common.

Many overcome their gender dysphoria.

But what this means is another source of controversy

in the transgender debate.

Studies from Europe and North America

suggest around 80% of children with gender dysphoria

eventually accept their biological sex.

The 80% desistance rate is so wearisome.

It has been taken apart so many times.

Some of those research studies took place in the 1980s.

Things have changed around how gender is expressed.

We don't know. We don't know how a child is going to grow up.

In a recent study, Zucker's colleague, Devita Singh,

looked at the outcomes of more than 100 boys who attended the clinic.

88% of them eventually desisted.

Some of the boys who desisted were just as severe

in their gender dysphoria, in their cross-gender behaviour,

as some of the boys who persisted.

So if we went back in time and looked at two boys,

one who desisted and one who persisted,

they could look equally severe.

But over time, they had two very different outcomes.

What I think is very important for parents to know,

little kids can present with extreme gender dysphoria,

but that doesn't mean they're all going to grow up

to continue to have gender dysphoria.

Some will, but a lot won't.

And there is now evidence that childhood gender dysphoria

could be linked to homosexuality in later life.

Studies have shown that between 60% and 80% of boys who desist

turn out to be gay or bisexual adults.

The great majority of children who show significant cross-gender

behaviour in childhood end up as ordinary gay men

and not as transsexuals.

Trans activists don't like the high rate of desistance talked about

because if you know that 80% of gender-dysphoric children

are going to end up as ordinary gay men,

I'm going to encourage all of them

to try and adapt to their anatomic sex,

and the handful that are destined to be transsexuals

no matter what will sort themselves out later.

I've heard some parents say after their child transitioned,

"Well, at least they're not gay."

Because the child has transitioned to the other gender

and therefore, in terms of their sexual attraction,

it'll be heterosexual.

So an interesting issue as to what extent religious

or cultural factors that are anti-gay are part of the mix.

But Zucker's critics believe policy shouldn't focus

on the children who desist,

but on the minority who go on to be transgender adults.

It's interesting when you look at the debate between how do we manage

gender dysphoria in children knowing that 60-80% will not continue.

The experts will use the same studies and they'll say,

"Well, listen, um...20-40% will continue.

"And, so, what about them?"

At the heart of the debate about transgender children

is the idea that your brain can be at war with your body.

The easiest way to think about the difference between gender and sex

is to think that gender's between your ears

and sex is between your legs.

For example, when I was born, the midwife saw me, said,

"It's a girl," and they were wrong.

In its most simple form, some might call it a caricature,

transgender people have been described as having

a pink, female brain inside a blue, male body,

or vice versa.

The idea that you might have a blue body and a pink brain,

for me, means you completely misunderstand what makes a brain.

Gina Rippon is a professor of neuroimaging

and the author of a major study into gender and the human brain.

There aren't any parts of the brain which you can really call

uniquely male or female.

If you picked up any brain, looked at it in detail,

you would not be able to tell the difference.

You'd not be able to tell whether

that brain had come from a man or a woman.

So, could someone be born with a brain that is somehow

a different gender from their biological sex?

Well, if you look at the brains of newborn babies, you could not

tell that the child that contained that brain was male or female.

So we don't have a brain that is born either male or female.

The only way you can really understand the brain

is to know about the world it's grown up in,

not just the sex of its owner.

Boys often display gender dysphoria by growing their hair,

wearing dresses and playing with dolls,

thinking this makes them a girl.

But are these stereotypical behaviours innately female?

I think the transgender movement is reinforcing gender stereotypes

because one of the things that transitioning people say

is they feel they've been born in the wrong box

and therefore they need to change from one to the other.

But nobody seems to challenge the concept that actually,

there's something wrong with having boxes.

There are all sorts of other factors that you should be thinking about

before you jump to the conclusion,

which is rather an 18th-century conclusion,

that men and women have different brains.

What the science tells us is that it's our relationship with

the world around us that largely forms our ideas of gender.

We live in a gendered world

and that gendered world will change our brains.

So we're not born with a male brain or a female brain,

we're born with a brain that gets immersed in a gendered world

and a gendered world produces a gendered brain.

Anybody who wants to use the narrative,

"I have a girl's brain in a boy's body,"

it just so oversimplifies the data that, er...

You have to understand that narrative more, er...

as a political or a psychological argument

than a reflection of science.

Here's one of the things that's lovely about being transgender,

we mess with everyone's theories about gender.

There's the biological theory of gender,

if you were born a woman, you are a woman

and you have deep nurturing feelings and you're this, that and the other.

Oh, we messed with that one!

Then there's this social construction theory of gender.

You are the gender you are because your mummy told you to be

and your school told you to be and the media told you to be,

the social construction of gender. We messed with that one!

We messed with everyone's ideas about gender

and that's fine with me.

Despite the lack of agreement about what is happening to children

with gender dysphoria,

the gender-affirmative approach has now become almost universal.

In Canada, this change has coincided with

a rise in sex-reassignment surgery

of nearly 400% since 2010.

No-one, no-one, least of all me, no-one is suggesting children

should have surgical alterations to their bodies. Please don't.

Um...but children, especially younger children,

mostly think about gender as being connected to how you behave,

what you wear, what your hair's like, what toys you play with.

So for them, as long as they can socially transition,

they usually just feel a whole lot happier.

By taking that position,

I think that the activists are basically saying

that there's only one way to work with little kids,

and that's to kind of nurse them along

until they're ready to transition

and need biomedical treatment.

There is evidence that the younger a child is socially transitioned,

the more likely they are to persist in their feelings

of being the opposite gender.

Many believe this will result in more children

receiving hormone therapy and later surgery.

You don't want to, for example,

recommend surgery for anybody...

..where you are worried that they're going to regret it.

Because surgery is irreversible.

The assumption from the outset was that

if I said I was transgender, then I must be.

Nobody, at any point, questioned my motives.

The only cure for this would be hormones and surgery.

Lou - not her real name - was born a girl.

As a child she experienced gender dysphoria,

which intensified with the onset of puberty.

I became very self-conscious of my body.

I was developing breasts

and periods, which,

for me, felt like there was...

..an alien crawling out of the inside of my body.

I...

became very depressed.

I thought the only explanation

for my gender dysphoria

must be that I was actually a man.

I was struggling with self-harm and had attempted suicide

on a number of occasions,

and was very much told

by the community that if you don't transition,

you will self-harm and you will kill yourself.

I became convinced that my options were

transition or die.

I didn't understand

that the degree of disconnect from and hatred of my body

could be considered a mental health problem.

In the UK, the medical approach is similar to Canada.

A child can begin hormone blockers at 9,

they can receive sex hormones at 16

and have surgery at 18.

At 20, Lou had her breasts removed

in a double mastectomy,

a decision that now haunts her.

The darkest moment was when I realised

that I had actually

looked normal for a girl,

that I had actually been slim and pretty,

that my body hadn't been grotesque,

the way I thought it was.

Now, as a result of having transitioned,

I will always have a female body that is freakish.

I will always have a flat chest and a beard.

And there's nothing I can do about that.

Are there people who sometimes go ahead with transition,

a physical transition, and regret it? Yes, there are.

There are not very many of them.

It's well under 4%, it's probably closer to 2%,

but somehow this group of people are being given

a huge amount of attention, which...

in comparison to the people for whom it's gone absolutely great,

who are feeling terrific about it.

Lou only agreed to do this interview anonymously.

She has received extreme abuse when discussing her story online.

I've received death threats.

People are terrified of being accused of being transphobic.

Nobody wants to question the received knowledge

that transition is the only option,

because nobody wants to be the one person

that puts their head up and says,

"Hang on, I don't think this is all right."

They want to get rid of boys' and girls' sports teams,

and many people aren't aware of that.

To get rid of those boundaries - and that's not OK.

Canada is at the forefront of defending the rights

of gay, lesbian and transgender people.

But the debate over how to deal with gender dysphoria in children

is polarising opinion.

And sometimes, sir, the parent isn't part of the solution.

They are part of the problem.

New legislation in the province of Alberta

states that parents have no right to be told if their children

want to adopt another gender at school.

The whole attitude around trans children in our educational system

we're working towards should be, and is becoming,

that it's the safety of the child that is first and foremost,

their paramount concern.

Not the safety of the parents or the parents' prejudices or thoughts.

It's my child. So, whose child is it anyway?

I guess that's what we're talking about. Whose child is it?

Is it my child? Is it the government's child?

Is it society's child?

And how much of a say do I have for their life?

I think the parent, you know,

should have the right to bring up the child the way they see fit,

that's why they're the parent.

It's their responsibility, it's their child.

I am very protective of and concerned for

children of my own community,

the children who are going to grow up to be people like me.

I think that's a fundamental adult responsibility.

What we're talking about here is not the adult trans community

taking control of its own destiny,

but the adult transsexual community trying to intervene

in the destinies of children who aren't even their own.

If I was talking to

a gender dysphoric girl

who hated her body the way I hated mine,

I would tell her to get out into the mud,

to climb trees,

to find ways of inhabiting her body on her terms.

Expressing doubt about the gender-affirmative approach

to children is now risky.

Accusations of transphobia are common.

In Canada, one of the world's leading authorities

on gender dysphoria was fired.

A lot of people who are professionals,

and would be perfectly willing in private

to say that they're appalled by Ken Zucker's firing,

would be terrified to say that in public

for fear of their own jobs,

or being treated as pariahs by their co-workers.

We're in an era, now,

where you're either a good guy or a bad guy.

I'm hoping there'll be less venom

and more rapprochement among

some of the different philosophical approaches.

Like families across the world,

Warner and her mum face some tough decisions.

I'm pretty sure I'm going to have to get surgeries, and all that,

to become...erm...

to become a...boy.

Wait, a girl. Um...

Em... It might be rough, cos everybody has a rough life...

It's going to be rough.

At this point we have to start considering, um...

puberty blockers. Things like that.

So, we've been researching that like crazy and speaking to doctors

and different things to try to make those decisions for her,

because she's too young to make them.

Cos it's a really big decision.

Like, I've already made the decision I want to be...

a girl, but I haven't made the decision

if I want to do the surgeries.

It's, like... I don't feel perfect.

I'm not the full puzzle.

I feel like there's a couple of pieces missing.

I feel like my journey is to find all those pieces.