Gender identity is a ‘third rail’ issue in public conversation. The third rail in a subway system is the one that’s electrified to power the trains—you touch it at your peril. The expert Cass Review into gender identity services for children and young people in England recently said the “toxicity” of this discussion is “exceptional,” health professionals are afraid to say what they think, and “name-calling echoes the worst bullying behaviour”.
That’s true here too where it’s been reported puberty blockers are being prescribed at ten times the rate as in England and Wales. With the stakes so high, why would any sane person want to venture into such difficult territory?
Ethos is doing it because we were asked for help. We’re a charity that offers support for people with questions about freedom of conscience and belief. Since we were established last year, we’ve heard from parents and school leaders wanting to know how they can best care for children experiencing gender questioning within the legal framework.
Schools currently receive multiple resources that promote an unquestioning “affirmative” approach, where children are thought to be the “expert of their own gender identity”. For example, one group, supported by the Ministry of Education, produced a guide for schools that says things like, “students need to be able to choose which toilets or changing facilities they want to use”. The Ministry’s own RSE Guidelines say that students should be able to use toilets that “align with their gender identification”, and that “all ākonga should be able to wear any of the uniform items available”.
Many schools, from primary to secondary, have been supplied with a policy that just says they will use a student’s preferred name and pronouns, without asking any questions about factors like the child’s age or whether their parents are aware and involved.
But those contacting us are often aware that research shows children questioning their gender are more likely to experience mental health difficulties such as anxiety or mood disorders, and want to better understand and support their holistic needs. They’re also aware of social contagion where students question their gender after being influenced by social media messages and by their peers and others.
In response, we’ve created a policy guide which we’ve made freely available to all schools. It considers how schools can respond when students raise questions about social transition, which is probably the most common scenario schools face. This might involve students thinking about things like changing their name or preferred pronouns, or wearing the uniform or using the bathrooms of the opposite sex.
As Dr Hilary Cass has said, social transition is not a neutral act but “an active intervention because it may have significant effects on the child or young person in terms of their psychological functioning and longer-term outcomes.” As a result, she says, “the importance of what happens in school cannot be underestimated.”
It’s not unusual for children and young people to question their gender at some point but typically this naturally desists on its own. However, social transition may be more likely to cement the persistence of gender questioning and increase the chance of progressing to medical interventions like puberty blockers, cross-sex hormones, and even surgical procedures like double mastectomy or genital surgery as an adult.
There’s mounting international concern and evidence against this approach. More countries are adopting a more thoughtful and “developmentally-informed” approach, which is now best practice in Sweden, Finland and England, and moving away from the ‘one-size-fits-all’ approach of immediate affirmation.
An alternative approach, watchful waiting, instead gives a child time and space to develop and explore who they are without seeking to affirm, change or suppress their gender identity. Watchful waiting means making sure you fully understand each child’s particular situation by considering factors like their age, whether their parents are aware of the questions they’re asking, whether peers or social media have influenced the child, whether medical practitioners are involved, whether there’s any formal diagnosis of things like gender dysphoria or incongruence, and whether the child has any co-existing issues, such as mental health challenges, that need support.
Crucially, our analysis has established that watchful waiting is a legitimate policy option for schools who want to care for their students and keep them safe, one that’s consistent with the relevant New Zealand law. Given the potential consequences of social transition, and the risk of social contagion, schools can reasonably conclude that the exploratory approach of watchful waiting is a better way to ensure student safety than immediate and uncritical affirmation.
We’ve received positive feedback from a number of legal, medical and educational experts, including Emeritus Professor Charlotte Paul, a public health specialist and medical epidemiologist, who says our guide “shows schools how they can follow a respectful and watchful waiting approach to children with gender related distress or gender incongruence. It also allows them to take a cautious approach to social transition, fitting with findings of the Cass Review.” Dr Melissa Derby, a senior lecturer in education, says this guidance “encourages schools to place children at the centre of their policies and practices, ensuring in the process that schools uphold their duty to protect the safety and wellbeing of all children.”
Children raising questions about their gender identity may be suffering real confusion and even distress. We owe it to them to rise above the polarisation and tribalism that have characterised this discussion, and to honestly and openly evaluate the best way to offer them the care and compassion they need.
