More and more children and young people are rejecting their birth sex. The reason for this and how to deal with it is currently the subject of heated debate. Two experts on their daily experiences.
Psychologist Saskia Fahrenkrug notices at almost every consultation that something has fundamentally changed in dealing with the issue of gender identity. For twelve years she has headed the special outpatient clinic for gender dysphoria at the University Hospital Hamburg-Eppendorf, so children and young people who reject the gender they were born with come to her. Their parents, says Saskia Fahrenkrug, used to seem deeply shaken and sad, but today the change often can’t happen fast enough for them. “As if one had to eliminate everything female from biological girls immediately and at most.”
More and more determined young people
There are many opinions as to whether the topic of transgender people is just hype or is actually a life-changing issue for many people. But the trend is clear. Saskia Fahrenkrug experiences again and again that the determination with which young people question their gender and want to adapt quickly increases. “They often come here with a very clear idea, want this or that measure and think that everything would be better then,” she says.
She then offers them to pause: “It is immensely important to find out together whether the view of oneself can be expanded or differentiated beyond hormones and surgical interventions.” Sometimes this leads to a rethink and that is one of the reasons why, although more and more people come to the Hamburg outpatient clinic, only 20 percent receive these – sometimes irreversible – physical medicine measures. The proportion used to be twice as high.
A copycat effect?
The Munich child and adolescent psychiatrist Alexander Korte actually speaks of a “transhype” and blames the media for it. The topic is always present in both the social and the classic, an imitation effect is likely. But left-wing political currents also have an influence, according to Korte in the “Tagesspiegel”, because they regard biological sex as a question of attitude and decision. Alice Schwarzer, who, together with “Emma” journalist Chantal Louis, wrote the polemic “Transsexuality. What is a woman? What is a man?” even speaks of a mass phenomenon, a real fashion, as if young people would carelessly change their sex because they wanted a new look or because their girlfriend was doing the same thing.
Saskia Fahrenkrug finds this view flat:
Terms such as hype or fashion do not do justice to the phenomenon. Of course there is more visibility. It makes it more manageable and reduces fears, but it doesn’t explain the young people’s processes of identification.
The focus of the discussion is primarily on girls, because their proportion is higher – in Hamburg it is 60 percent. Presumably because the beginning of puberty is more problematic for them overall. “The uncertainty is great, the period triggers aversion in many,” says Fahrenkrug. But she also sees a shared responsibility in social media. “They increase the pressure. There are young women who don’t seem to even try to develop their own idea of femininity.”
Sabine Maur, child and adolescent psychotherapist in Mainz with a focus on gender dysphoria, gives another reason: “Trans girls, i.e. male gender, who feel like girls are tolerated much less. They experience significantly more rejection, especially from their peers, but also in families , if they are very conservative or patriarchal.”
New trans developments
What is new is that more and more young people are positioning themselves in the non-binary or queer area, for example only partially rejecting their biological gender and living as so-called demiboys. Another reason for the reduced proportion of those who receive hormones or subsequent surgeries.
The fact that there are no longer just the “classic trans developments” makes her work more complicated, says Saskia Fahrenkrug, “but they are all developments with a lot of suffering and over several years, even if it sometimes seems to those around them as if that’s coming Coming out from one day to the next.” This is another reason why a differentiated, cautious approach, especially when it comes to medical measures, is important. “Our job is to neither block nor encourage. I’m not sitting here with a magnifying glass trying to prove someone isn’t trans.”
Is there a way back
And what about young people who later realize that the adaptation wasn’t right after all and who are increasingly being read about in the media? The phenomenon is not currently apparent in Hamburg. Although Saskia Fahrenkrug assumes that there are unreported cases, only two so-called detransitions are known in a good 1550 cases so far: one concerned a young woman who stopped taking male hormones again, the other a biologically male teenager who was also taking hormone treatment Reaching the age of majority also had an operation, but now lives as a man again. Fahrenkrug, who of course would like to prevent something like this if possible, thinks it is realistic that there will be more changers in the future. Because not all young people agree to the differentiating, careful approach.
“You then get the hormones on the Internet,” says Sabine Maur. “Unfortunately, we can’t prevent that. It’s all the more important to improve health care so that waiting times for therapy are shorter and there are more counseling centers.”
Obstacles should be minimized
Until now, people have had to go through a grueling and lengthy expert procedure in order to change the official entry “woman” or “man”. The traffic light coalition would like to simplify this, but there is also criticism, especially when it comes to minors. “We’ve had personal status changes through self-declaration in ten European countries for a long time – and without any problems,” says Sabine Maur. She considers horrific scenarios that soon 15-year-olds will have surgery without their parents’ consent to be nonsense and a sham debate about what is planned self-determination law: “Even today, the family court offers the possibility of allowing treatment against the will of the parents. But in reality, in Germany, surgery is almost never performed before the age of majority. Before that there are many other steps that take years, and of course every therapist will work towards getting the parents on board.”
Society needs diversity
Both experts wish for more serenity in dealing with the topic. The fact that the parents are now exerting so much pressure sometimes seems to Saskia Fahrenkrug like an attempt to make amends, “because they blame themselves for having overlooked their child’s development for too long. Every week we have dramatic calls from parents whose child is three days old previously expressed the suspicion that he was trans and are pressuring that something should happen immediately next week.” She advises sitting down quietly and, by talking about it, “first letting a process develop. Of course, parents are still allowed to think for themselves or question things.”
But the public debate also needs more prudence. “Often it is not based on facts and is mixed up with ideological things,” says Sabine Maur. “It’s incredibly stressful for trans people and their families. In reality, we’ve come a long way: we have more support, for example in schools, there are more offers of help and there’s more acceptance overall.”
Binding box Brigitte Standard