Cartoon: Which Kids Matter


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I wish the argument made by the second speaker in panel one was an argument I just made up for this cartoon. But it’s an argument I’ve seen, multiple times – the fear not merely that a young person will be mistaken about their gender, but that fanatical parents and profit-seeking doctors are forcing sex change upon unwilling kids.

Eight states have proposed laws banning puberty blockers from being prescribed to trans minors. Not asking for extra barriers or cautions, such as stricter regulations, or a mandatory second and third opinion (although those things would be bad enough): An absolute ban. Because conservative legislators know better than a ten year old’s parents or doctors, apparently.

Some of those bills are even more extreme:

Kentucky’s bill… would allow either parent to override consent for transition care, a right which the state cannot overrule; it would require all government agents to disclose to parents whether a child expresses gender dysphoria or gender-variant behavior; and it would protect the right of any government employee, including teachers, to express their views on gender identity, including misgendering or harassing transgender students. Additionally, any adult (or minor with parent or guardian permission) who had previously been given transition care would be allowed to sue doctors for damages for the next 20 years.

Because the bills don’t stop at banning puberty blockers, a second South Dakota bill introduced Tuesday would require any teacher, school psychologist, or social worker to out any students they suspect may be suffering from gender dysphoria to the student’s parents.

That’s quoting an article by Katelyn Burns. It’s not short, but if you’ve got a little time, it’s an excellent summary of the issue.

Of course, not 100% of trans kids will want puberty blockers. Like any large population, trans kids have a wide variety of needs. But for many, access to puberty blockers is not a trivial issue.

Transgender youth have a much greater risk of suicide, according to the US Centers for Disease Control and Prevention. However, if they have access to a puberty blocker, their chances of suicide and mental health problems in the immediate term and down the road decline significantly, a new study finds.

I’ve had arguments with folks who think access to puberty blockers should be more strictly limited, or just eliminated, for trans youth, and I come away every time amazed at their callousness about what happens to trans kids.


Another “two people arguing as they walk through a park” cartoon. I hope you don’t get tired of seeing these, because I do them a lot! It’s so much more fun to draw than cartoons where the characters are sitting in a cafe; they move, the backgrounds change, I can put the characters on different horizontal levels. (Notice how in panel 1, the hill putting the second character on a lower level gives me extra space for all the dialog she has in that panel?)

I tried to draw the characters talking while staying at least six feet apart. Strictly speaking, they should also have been wearing masks, but would be so hard for me to draw expressions without mouths! Let’s face it, huge mouths are kind of my “thing.” But drawing them six feet apart is my way of acknowledging that even when I do cartoons that aren’t about coronavirus, these still aren’t ordinary times.


I hope you’re all healthy and staying safe. Or if you can’t stay safe – if you’re an essential worker – then I hope you’re staying as safe as you can, and… Thank you.

And thanks to every one of you who supports my patreon. I thank you. My cat thanks you. (Patreon supporters saw this cartoon a couple of weeks ago.)


TRANSCRIPT OF CARTOON

This cartoon has four panels. Each panel shows the same thing: Two women walking through a hilly park as they argue. The two are staying at least six feet apart from each other as they talk.

The woman in front is wearing a jacket with rolled-up sleeves, black tights with holes in them, and a striped shirt. She has a pink streak in her black hair. The woman behind is wearing a skirt with a pattern of exclamation marks, a white collared shirt, and has wavy hair falling to a little below shoulder level. She’s wearing glasses.

PANEL 1

PINK is talking calmly while, behind her, GLASSES waves her arms and talks in an argumentative fashion.

PINK: So when an eleven year old trans kid is prescribed puberty delaying drugs, that could spare them decades of suffering!

GLASSES: But what if a boy likes dolls, so his parents decide he’s a girl and force him to change sex? That’s why we must outlaw puberty delaying drugs!

PANEL 2

Pink isn’t yelling but she’s speaking passionately, waving her hands as she talks. Behind her, Glasses has her hands in her pockets and is listening without much expression.

PINK: I’ve never seen a real case like that. That would be awful. But if a case like that happened, it’d be one in a million. On the other hand, there are definitely trans kids who need this treatment.

PANEL 3

Pink turns back a bit to talk directly at Glasses as she asks Glasses a question. Glasses, hands still in pocket, replies calmly.

PINK: So how many trans kids would you sacrifice to prevent one hypothetical non-trans kid being forced into delayed puberty?

GLASSES: All of them.

PANEL 4

Pink has now turned all the way around, looking a bit horrified, and holding her palms up in a “let me just explain this” gesture. Glasses has stopped walking, has folded her arms, and has raised her voice, with an angry expression.

PINK: I don’t think you understand – we could be talking about a hundred thousand-

GLASSES: I said all of them!

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13 Responses to Cartoon: Which Kids Matter

  1. 1
    Polaris says:

    Thing is that puberty is a personality changing experience and kids whom were presumably trans or may even actually have been may turn out to be gay, lesbian, bi, tomboyish or effeminate.
    The same procedure to determine kids whom would undergo the procedure should be done in states/nations that don’t permit hormone blockers to establish a control group.
    Thus there would be objective proof about pros and cons.

  2. 2
    Ampersand says:

    “…may turn out to be gay, lesbian, bi, tomboyish or effeminate.”

    Don’t assume being trans is contrary to also being any of those things. Trans folks, like cis folks, come in all sorts of sexual preferences and gender presentations; there’s no rule that a trans woman can’t be tomboyish.

    Using a country where puberty blockers are illegal as a control group is a novel idea for getting around the ethical problems with doing a control group. However, it would be impossible to control all the variables that come from cultural differences. Control groups are usually chosen for their similarities to the treatment group; you can’t do that if the control group is from a different country, and one culturally different enough so that what’s legal here is illegal there.

  3. 3
    Grace Annam says:

    Polaris:

    Thing is that puberty is a personality changing experience and kids whom were presumably trans or may even actually have been may turn out to be gay, lesbian, bi, tomboyish or effeminate.

    I’m trans and a lesbian. The categories you’re presenting in opposition to being trans actually exist on somewhat orthogonal axes.

    The same procedure to determine kids whom would undergo the procedure should be done in states/nations that don’t permit hormone blockers to establish a control group.
    Thus there would be objective proof about pros and cons.

    There is already objective evidence about the pros and cons, but the results make many people uncomfortable. Those people, though they sometimes bill themselves as allies and sometimes have good intentions, share a worldview where cisgender is the normal and natural default, and transgender is exceptional and strange, requiring justification. But it’s a bit like vaccines; the evidence is overwhelming that they are directly beneficial to the overwhelming majority of the recipients, and secondarily beneficial to everyone else even if they don’t personally get vaccinated. And there is a dedicated minority of people who don’t understand the science, or who want to spare their particular children the minor immediate risks of vaccines while still benefitting from the fact that other people’s children assume those minor risks and get vaccinated. But they can’t say that, so they cherry-pick the evidence to showcase the dangers to justify their imposition of risk on other people, rather than confronting their own shortcomings.

    Ampersand already explained why your proposed control group would not be an actual control group; too many confounding variables.

    But, also, what you are suggesting is that we do a longitudinal study and await the results, results that would be thirty or forty years from now, if you want really good longitudinal data on lifetime happiness. In the meantime, there are decisions to be made today, the results of which can cause significant misery and death if they are made wrong. And you have a cohort of young trans adults who have actual memories of what it was like to be a trans child, and a trans teen, and those young trans adults are overwhelmingly saying that it would have been better if they could have avoided the wrong puberty.

    When there are high stakes, you don’t wait decades. You make the best decision you can on the evidence available, and at the same time do research toward better evidence so that you can improve tomorrow’s decision-making process. The problem here is that there are many people who, because they don’t have the life experience of being forced into the wrong gender, just don’t understand that the stakes are, in fact, high. They counsel caution, because they don’t really credit that the people who want action are in actual, pervasive pain, and that there is a treatment which will end some or all of that pain.

    Hormone blockers have been used for decades for other purposes. We already have data that, as medications, they are very safe. There are three stages of assessment of trans youth:

    (1) pre-pubertal, where there is no medical intervention, and the psych intervention is counseling and assessment.

    (2) puberty, where if it seems that a child might be trans they take hormone blockers until they’re 16-18.

    (3) for a tiny minority who are persistent, consistent, and insistent, cross-hormone therapy starting at 16 or after.

    But people making anti-trans arguments routinely conflate 3 and 2, and very frequently even conflate 3 and 1. Which is pretty solid evidence that they are either ignorant of the basic facts of trans health care (and shouldn’t be trying to steer it) or purposely making a confusing argument, in bad faith.

    Grace

    (edited to fix tags)

  4. 4
    Adrian says:

    Polaris, you seem to be thinking of “puberty blocking” as a “procedure” that is done once, and thus prevents puberty from ever happening. That’s not how it works. We are actually talking about puberty DELAYING drugs. Kids can take them for a few years while they grow into more adult understanding of themselves. (They were originally invented to treat a disorder where little kids start going through puberty when they’re 6 or so. The drugs themselves are well-known to be safe.)

    Yes, the hormone storm of puberty changes people. Are you implying that makes them MORE able to make good decisions? The cognitive development between age 12 and 16 changes people even more, and is more likely to improve their decision-making abilities.

  5. 5
    J. Squid says:

    There is already objective evidence about the pros and cons, but the results make many people uncomfortable. Those people, though they sometimes bill themselves as allies and sometimes have good intentions, share a worldview where cisgender is the normal and natural default, and transgender is exceptional and strange, requiring justification.

    I was surprised during a conversation with a trans woman last winter to find that she vehemently opposes delaying puberty. I didn’t know her well enough to explore how she came to her justifications for her position.

    Other than her, I have yet to meet a trans person who doesn’t wish that treatment had been available to them. Given that it just delays puberty to later and is not actually an irreversible part of transition, it’s hard not to see something disturbing in that opposition. Very, very hard.

  6. 6
    Charles says:

    Thing is that puberty is a personality changing experience and kids whom [sic] were presumably trans or may even actually have been may turn out to be gay, lesbian, bi, tomboyish or effeminate.

    Is there any actual evidence for this, that a substantial portion of kids who persistently, consistently and insistently identify as trans pre-puberty stop identifying as trans as they go through puberty, and specifically as they go through puberty, so wouldn’t stop identifying as trans while going through non-puberty teenage years?

    Would it actually matter if there are kids who would identify as cis if they went through cis puberty, but who identify as trans if they are allowed to delay puberty and then go through a gender appropriate puberty? Isn’t this, in the end, exactly the argument in the cartoon? We know that going through default puberty while trans is often deadly and even more often profoundly harmful, but we should refuse to use the obvious safe method of preventing that while giving kids years to continue developing mentally and emotionally and to figure out which puberty they want, because there might be some kids who would have made a different decision at the end of those years if they’d never been given the option of making that decision? Even though it’s not really clear what harm a kid suffers if they delay puberty and then decide to transition hormonally, but they would have been okay with being cis if they’d not been allowed to delay puberty? How many trans kids are we supposed to sacrifice for this imaginary kid who is happy being trans but could have been happy being cis? All of them?

  7. 7
    bcb says:

    Thanks for this cartoon. I see someone is trying to make a bad-faith argument about how kids “don’t really know,” so I’m going to repost an argument I made elsewhere:

    Gatekeeping of gender-affirming health care is a lot like gatekeeping eye-glasses. Glasses and other optical treatments have several key things in common with gender-affirming health care, including:
    1)The need for eye-glasses is diagnosed based entirely on self report. When you tell an optometrist that you are having trouble seeing, they don’t say “no, I don’t believe you, you don’t fit the stereotype of a far-sighted person.” And they decide what prescription you need by putting different lenses in front of you and asking you which one makes things look the clearest.
    2)Giving glasses to someone who doesn’t need them has the same effect as not giving glasses to someone who does need them. If someone with 20/20 vision wore my glasses, it would make it harder for them to see.
    3)Wearing glasses at a young age can have a permanent effect on your vision for the rest of your life, in ways that can’t be reversed. If a kid wears glasses with the correct prescription, then those effects are positive. But, due to factor (2), if a kid wears glasses with the wrong prescription, it can damage their vision in ways that can’t be corrected later in life.

    When I was seven, my ophthalmologist at the time determined that if I didn’t get glasses, I would go blind in my left eye by the age of 10. He made this determination based only on my self-report of difficulties seeing things at various distances. Fortunately, my parents recognize the value of modern medicine, so I got glasses and my left eye still works.

    If a kid with 20/20 vision were to lie to a doctor and pretended to have my vision problems, they could be given prescription glasses that would cause them to go blind in their left eye. The entire system of ophthalmology only works because we expect patients to tell the truth to doctors about symptoms.

    One talking point that has been gaining popularity among conservative politicians is that there should be a ban on providing medical care to transgender minors, because “kids don’t know what they want.” If one were to believe this talking point, then you would expect there to be a lot of children with glasses that make their vision worse. The fact that a vast majority of optometry/ophthalmology patients get glasses or contact-lenses with accurate prescriptions is evidence that children can, in fact, report symptoms accurately.

  8. 8
    Michael says:

    @bcb#7- Not to comment on your larger point but according to these blogs, kids DO try to fake poor vision and optometrists have tricks to spot them:
    https://www.optometrystudents.com/spot-malingerer/
    https://www.coastalvisionva.com/2015/10/can-a-child-fake-their-way-into-glasses/

  9. 9
    Grace Annam says:

    bcb, that is a very useful analogy (Michael’s point acknowledged). Thank you! I’m going to adopt it.

    Grace

  10. 10
    Petar says:

    Eh. As if logic matters. This is not about protecting anyone, this is about fucking over people you do not like.

    When you can do nothing to improve your lot, screwing others feels almost as good. And in such a case, any excuse will do. A theoretical victim is a better excuse than some I’ve heard.

    “All of them!” is on the nose.

  11. 11
    Grace Annam says:

    Petar:

    Eh. As if logic matters. This is not about protecting anyone, this is about fucking over people you do not like.

    For certain values of “you” in that sentence, I agree. For other values, no. I interact regularly with people who are trying to get it, and for people like that, analogies sometimes work, or sometimes work to an extent. The pain analogy often works (though not always), because we have all experienced anguish. So, an analogy to a familiar and commonplace condition, the diagnosis and treatment of which relies mainly on self-reported symptoms, could be just what some people need to hear for the right frame to click into place.

    You’re right that there is no logical argument which will convince people who have an emotional investment in denying that trans people exist, or that we are who we say we are. For those people, there are only two things which work, and then only sometimes:

    1. Someone they actually care about and are predisposed to believe, usually a family member, coming out to them.

    2. Sufficient social censure for their beliefs, from cis people whose opinion they care about.

    Over time, #2 can move them past a place of reflexive rejection and disgust, usually to a place of, “You know, why do I care so much? Maybe there’s something to it.” And that puts them within talking distance of actual logical arguments.

    On those occasions when I do engage directly with bigots, I’m under no illusions that I’m going to convince them in the near term. But I am aware of the audience.

    Grace

  12. 12
    Petar says:

    I wish I agreed with you 100% but I do not.

    People who are emotionally invested to begin with cannot be turned unless their emotions are, and that happens, as you pointed it out, when someone they love or respect holds the opposite position.

    People who are not emotionally invested are seldom an issue in the first place. At least in my experience, most people default to laisser-faire/live-and-let-live, baring other motivations.

    The battle is won or lost in the minds of the next generation. Bigots, just like everyone else, die. The point, as you said, is about the bystanders. And that’s why I have such a wide range of opinions about Ampersand’s cartoons. They ones that expose the ‘enemy’ to scorn and ridicule, like this one, are fine. The ones who antagonize the neutral audience, or even worse, slightly-heretical supporters, are not.

    Of course, once it is decided that white cis-male scum is never neutral, the common ground shrinks significantly.

  13. 13
    Grace Annam says:

    Petar:

    I wish I agreed with you 100% but I do not.

    I can work with 99%. ;-)

    People who are not emotionally invested are seldom an issue in the first place. At least in my experience, most people default to laisser-faire/live-and-let-live, baring other motivations.

    This has been my experience around many issues.

    Sadly, “live and let live” has not been my experience around trans issues.

    I’ve sometimes said that we can divide gender dysphoria into two categories: physical and social.

    Physical dysphoria is discomfort with the primary and secondary sexual characteristics of your body not being consonant with your brain’s map (and there is preliminary evidence to suggest that this may, at least sometimes, be a result of the conformation of structures in your brain, or patterns of structures, which are as gendered as external genitalia are, but which don’t match your external genitalia). You fix physical dysphoria by changing the body to better match the brain’s map, so far as that is possible (some things are possible with everyone – like facial hair removal (for people who want that) or voice dropping (for people who want that) – and some things are impossible with everyone – like a change in height in an adult – and some things vary with genes – like breast size or the final pitch of a dropping voice. All well and good; within the limits of medical technology, you can shape your body as you like, and it’s nobody else’s business.

    Social dysphoria is discomfort with the gender role which other people assign you to, which has a direct and pervasive impact on how you function in society. Here, the problem is that in order to be treated appropriately, you have to meet someone else’s idea of what it is to be male or female (or, in the case of nonbinary people, you need other people to understand that they can go beyond male and female). And some people hold the belief that if you were assigned male at birth, for instance, that you are forever and irrevocably meaningfully male for social purposes. This belief is typically deeply socialized rather than actually thought-out, and it can be very resistant to being re-thought-out, even by people who want to. (I know people who show every sign of wanting to be able to welcome trans people… except the sign of actually being able to do it, functionally.)

    And those people, even if they have an emotional investment in wanting you to be happy, or even if they like having you around, treat you differently than they treat other women (if you’re a woman who was assigned male at birth), or other men (if you’re a man who was assigned female at birth).

    The people who just don’t even want to think about it? Forget about it; every interaction with them is a scrape, and pretty soon you’re raw.

    Unless they don’t know you’re trans. If you can manage to pass as cisgender in your actual gender role, then all of these problems go away and people treat you in accordance with the correct gender role. And then you can work, and get the groceries, and socialize at the beach, pretty much without issue.

    In other words, it’s live-and-let-live as long as other people don’t know you’re trans.

    If they do, then it’s not live-and-let-live at all.

    And that’s the unsolvable conundrum. In order for me to be safe, you have to do a thing. I can get you to do the thing, if I’m able, by seeming cis so that your habits work for you, and me. But that’s the only lever of control I have. You, on the other hand, can decide to dig into your worldview, re-examine, and re-work. But that’s a lot of work (I know, because I had to do it it before I could transition), and not high on most people’s priority lists. So, here we are.

    So, yeah. Sadly, for trans people, indifferent people are very often an issue.

    (In this general exposition, Petar, I hope it’s clear that I’m using the rhetorical “you”, not addressing you directly or accusing you in particular of anything.)

    I suppose, in a way, it’s a bit like masks. N95 masks protect pretty well against incoming viral particles. But they have to be fitted correctly and worn correctly, and they’re not comfortable for routine wear (the Man in Black’s flippant comment notwithstanding). However, as I learned recently, N95 masks are required because of particles which have dried out and aerosolized. Particles which are still in a little globule of moisture get caught in much less stringently-woven fabric. And when you’re breathing, or coughing, or singing, or shouting, you’re putting out moisture packets. They haven’t dried out and aerosolized, yet. Which means that if you’re infectious but don’t know it, you can protect everyone else substantially by wearing a simple mask of cotton or stretch fabric, like a bandana.

    I can’t put that bandana on you. You have to decide to put it on. But if you do put it on, I’m substantially safer, and I don’t even have to wear an N95 mask, to be reasonably protected myself. (Though, like you, I still have to wear a lesser mask if I want to help protect others…)

    Now, it doesn’t matter, to me, why you wear the mask. If you wear it because you feel a social responsibility to do so, or if you wear it because your friends and family shamed you into it, either way, everyone else is much better protected against any infection you might have.

    And all of this is why I get really irritated at people who shout “My freedom!” as they refuse to wear a mask. Because it’s directly analogous to people asserting their freedom to squat and leave a crap on the sidewalk. We all have to deal with the results of that.

    This rant brought to you by the global pandemic, and the letter “Y”.

    Of course, once it is decided that white cis-male scum is never neutral, the common ground shrinks significantly.

    I don’t think I follow you, there.

    Grace

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