 Welcome everyone to the Conversations webinar. I'm so thrilled to have you here. I'm Beth Daley. I'm the editor and general manager of the conversation. We do these webinars periodically so our readers can have greater insight into experts and ask them questions themselves they may have. For those who don't know about the conversation, we're a nonprofit news outlet that publishes 10 to 12 stories a day and all our reporters are actually the academics in the country. We tap into their expertise and have a team of about 20 editors that work with them to translate their work out of what can be sometimes rarely but sometimes jargon into plain journalism. Our content is read about 25 million times a month both on our site and also in about 1,000 news outlets throughout the country. So this webinar is quite personal for me. It came about as part of a series we did on transgender teams and it came about because I am a mother of a team and I had many questions about my daughter, had her approach to subject, had to talk about the subject in a supportive manner and what we do in the conversation is I brought it to my team and we talked about it and everyone said, yes, we're seeing more and more transgender teams that seem visible to us. What does the scholarly research say about it? And so we commissioned about, must be about eight stories on transgender teams from a variety of places and we published a series on it. Out of that series came this webinar which is really trying to help understand this phenomenon and everything in it. And we have two very esteemed guests who wrote for the conversation on the subject. We first have Jules Guild-Piersen and Associate Professor of History at Johns Hopkins University. She is the General Co-Ed Editor of Transgender Studies Quarterly and the author of Histories of the Transgender Child that was published in 2018. She's currently working on her second book, Gender Underground, A History of Trans DIY. And we also have Dr. Casey Kidd, I said it, I'm sorry, Dr. Kidd, the medical director of the Pediatric Gender and Sexual Development Clinic at WV Medicine Children's, which is at University of West Virginia. She's also an assistant professor of pediatrics in the Department of Pediatrics and Division of Adolescent Medicine at West Virginia University School of Medicine. So welcome both of you, we're so thrilled to have you here today. So just as a note to our participants, if you have a questions, please put them in the Q and A and we'll have a question and answer period for the end of the webinar. If you have any other thoughts, please always email us afterwards and please do submit your questions through the Q and A instead of raising your hand. All right, so let's jump in. This is really exciting. I wanna start with history a little bit, Jules, because you wrote for the conversation about history of transgender children. It was absolutely fascinating. And so the question I have for you is as we see more transgender and gender diverse youth become more visible than ever, how does transgender history inform us about where we're at and maybe where we're going? It's a fantastic question and I just wanted to say thanks for organizing today and for having Casey and I here, both excited to talk to one another as well and to spend some time with all of you who are joining us. Yeah, I think we really need historical perspectives today for a number of reasons. That kind of range from benign to kind of pressing and urgent. And the pressing and urgent one would be that the sort of hypervisibility or the visibility attached to certain kinds of trans people, trans women of color, trans youths and children is really part and parcel of a political strategy, of an anti-trans political strategy, of an authoritarian, ethno-nationalist kind of political strategy around the world. And so we're seeing trans young people kind of caught up in the political crosshairs of a number of much larger older political battles, but a lot of that rhetoric around kids frames them as totally new, right? Kind of takes that visibility kind of misrecognizes the fact that most people are getting to know that there are trans youth for the first time, kind of misreads that as meaning that there weren't trans kids before, that this actually is some sort of new generation or that there's something culturally going on in the world right now, other than perhaps somewhat greater acceptance of gender diversity that accounts for the existence of trans youth. So to my mind, history is really helpful first in just applying the brakes to those assumptions and saying, well, the visibility that we're dealing with today is pretty unprecedented, but that doesn't mean that the people themselves haven't existed before. And then I think more broadly, and in a last sort of pressing urgent or political way, it's important to have a connection to history in general. One of the challenges that anyone who's trans faces is how do you come to an understanding of yourself in a culture that fundamentally doesn't recognize that you exist? And certainly if we're talking about children, young people doesn't give you the tools you would ever need to know who you are. I mean, one of the most remarkable things about trans youth is that, you know, they're able to stand up in this world that we've created that gives them no reason to know who they are and say, hey, actually, I know something about myself that none of the adults in my life know. And so, you know, I think history can be a really powerful grounding force there to give young people a sense of lineage, you know, and an interesting complicated one. It's not like you look back in time and you see yourself reflected by any means, but I think it can be profoundly reassuring in a moment of not just political backlash, but the general isolation that trans people face in a cis-normative society to be able to think that, you know, you're not the first person to ever go through this, right? And so to my mind, that is just kind of a bit of a powerful message, one that I know I certainly subscribe to as an adult too, but I can imagine it's especially important for young people. Yeah, I think that that's so true. I mean, I think not being feeling alone and this idea sometimes, you know, we hear so much that social media is so bad for teens, but in some ways, and Casey, you wanna address this, or Jules, in some ways, social media may have allowed teens to sort of find others who are going through the same thing, just like they are learning that in history, there has been a long lineage of trans. I'm curious if either one of you wanna address that in the context of teens today and connecting with others? I can certainly say that the really amazing young people that I have the privilege of working with are often much more socially digitally connected than I. I find myself getting older by the day, the more I work with young people, but they help to inform me because young people create language. They are the driving factor that decide how we're gonna communicate in the future. And I think that the spread of social media and their access to knowledge has profoundly accelerated our evolution of language. And so I'm grateful for the knowledge that I gained from my patients in that regard most certainly. I'm muted, that was great. And you know, here's a question that I know I was talking to some friends before and then maybe jumping around a little bit, but I think a lot of people would like to know like how can we best support transgender and non-binary teens in school one at home and then beyond in larger society as parents, as community members, as, you know, our world? Jules, you wanna take a stab at that person then Casey? Sure, I mean, I think it's a super important question. And you know, I wanna recognize that people, I think there's a lot of fear and anxiety out there amongst adults, rightly so. And I think a lot of people's best motivation that brings them to this issue is often a fear, fear for their own kids, fear, you know, whether a kid is trans or not, you know, we have to think about what the consequences are of a cultural moment that's training this excessive kind of target, you know, on trans kids. One of the things that I've been speaking out about this year is the wave of over 100 pieces of legislation, you know, in over 30 states that were mostly targeting trans youth in school, you know, around sports or trying to ban gender-affirming care, you know, it's like whether or not these bills pass, whether or not they're defeated in court, you know, regardless of the specific legal outcome, they've succeeded in the sense that they've put, they've painted a target on the backs of young people in general. And you know, one of the things that we see so clearly in a lot of this legislation is you can't actually target trans kids without targeting all children on the basis of gender and sex. It just, that's the way these categories work. And so in order to punish trans kids, you're going to have to create a hostile environment at school. And so I really do worry about, you know, how difficult it is to go to school when the entire student body, but also staff, right, are now trained to look out for trans people, right? They have been given these kinds of tools by media and by anti-trans politicians and pundits, right? To train their eye and extend that kind of visibility into surveillance and policing and harassment, right? So I think, you know, one of the things I was talking about at a recent event I spoke at is trying to think tactically about school. I mean, you know, I don't think I have to tell anyone, we all see these videos of school board meetings around the country right now, certainly not like a place I wanna walk into, but trying to find allies in the sense of people who can show up and who have the clout and standing to kind of, you know, stand up in those meetings, stand up for trans kids, right? People who can go and protest policy, demand better policy, right? People who have the time, the resources, the literacy skills and, you know, because it's not a given, right? Like who has time to take off work and go to a meeting or get to know your, you know, superintendent or school board, et cetera, right? But I think, you know, really making it clear that this is everyone's issue is the number one kind of thing I'd like to see. I think one of the biggest sort of misleading frames around trans issues is that it's narrow, right? Because there aren't that many trans people, it's a wedge issue or it only affects a small minority. It's not true because we're talking about forms of gender oppression and gender discrimination. So they affect all of us. We're all obligated to have a gender, no more so than when we go to institutions like schools. And so, you know, of course there are all sorts of, you know, legal and policy avenues to try and adjudicate issues in schools, but more broadly, I think if adults start standing up and saying like, we care about this because we have hearts and we don't wanna see children subject to ostracization, harassment and policing, right? That to me would make a really big difference because they do worry that regardless of whether you live in a state or a local school board setting where there are pro or anti-trans policies, the environment has become very toxic. So that's one I think at home, you know, it's interesting. I will say, you know, as a historian, I think one of the only things that's really new about this moment we're living through is this presumption that trans children's best place to grow up is in their families. That's a really new idea. I mean, for a long time, no one would have ever said trans kids should be in their families. Families were well understood to be extremely dangerous, transphobic places. Most trans people, you know, told a common story of being kicked out or running away. That was not unusual at young ages. Some of the most famous trans people in history like Sylvia Rivera, whose name is often invoked during Pride, she ran away from home at 10, 11 years old, right? That was not unusual. So I think actually one of the things we might wanna admit is that we are woefully unprepared to think about how the family can be a safe setting for gender diversity because it's not the historical role of the family. It has been to reinforce gender roles, right? And so I think, you know, ultimately, and this maybe connects to the societal question, when it comes down to it, and I know this might sound ironic from someone who researches and writes about trans things for a living, I actually think there's very little in getting in our way here that's about gender or being trans. I really don't think there's a prevailing lack of ignorance. I really don't think people are suffering from a lack of good knowledge. I really don't think people need to become experts in gender identity or contemporary vocabularies of identity in order to do the basic thing that's really required here, which is to say that we take young people seriously, we respect their right to self-articulation and that we want to take care of them and love them. I mean, if you really want to do that, you can't end up becoming anti-trans, you know? And so like I think a lot of the issue here is about how we treat children in our culture, not really whether or not we think we understand gender. I mean, that's gonna continue to evolve, especially like, you know, trans people themselves have a million different ways to talk about gender identity. Young people have very different vocabularies than people my age do, right? So I think, you know, sometimes we see this as like, oh no, how am I gonna learn all of this information so I can, you know, be sensitive and thoughtful. And, you know, my reply to that is always very simple. You don't need to know all of that because you already know how to be thoughtful and respectful of other people. That's really kind of the core here. And I think if we start from that place, then all that learning can come as it need to be, right? As opposed to, oh no, it's the prerequisite. So I think there are places, you know, narrow places like school where we really do need to focus on policy, you know, organizing and, you know, really think concretely about what's going on. But more broadly, I think things have been overinflated in their difficulty in order to make it more inaccessible and more scary and more mysterious to most of the people out there. It's so, I have a follow-up question but I wanna get Casey's thoughts on this. Casey, yeah, just... I absolutely agree. I agree with all of that. And I would add that as an adolescent medicine specialist, I am very well aware of the importance of the family and family looks different for a whole lot of folks. Family are the people that matter to you, right? They're the people who care, the people you love and who love you. And if you have the support of those people, the chances of you thriving and reaching your full potential and becoming the incredible human you are meant to be is dramatically higher. And that's true of all young people and I don't think that that's shocking that I say that. I think we're all well aware of the value of the family, right? Whatever that looks like, especially people who are in the parent roles, right? And so that's the number one thing I talk to families about. Like, I know you love your kid, right? You're here seeing somebody like me. I know you love your kid. And it's kind of this other stuff that we can work through but that's what we need. And we can get you wherever you need to go from there. And I also agree with Jules that the place where there's a little bit more granularity in things that are just not helpful is in settings like school, right? And so a lot of the young people I work with are in really high tech schools, which is great, except that sometimes that involves having your legal name flashed upon the board every time you answer a question or when attendance is taken. And that means young people that I work with, they won't answer a question. They might not be able to be in that classroom. And so our technology sometimes limits our young people's ability to express themselves in ways that feel good to them. And that can be harmful. And so I get a lot of answers that, you know this is our policy, this is how our state does things, this is does that and the other. I think we need to be thoughtful about what sorts of systems we need to have and why we can't adapt those systems to make our students feel respected and seen in school spaces. And so that's my recommendation for folks that are working in schools. Try to think about ways that you can make sure your students are respected and seen. Yeah, those are such great, great answers. And I, you know, I have a question for both of you that just following on what you were saying was, we're saying Jules, like parents do get stuck in the, what I'm calling my nation now but based on what you said. And I think there's a fear of, you know people want to cheat sheet, you know what I mean? Like what is the right pronoun to use? When should I use it? Oh my gosh, I didn't use the right pronoun. And can you just address that a little bit more in depth? Maybe I'll start with Casey this time. It's, it sounds like you're saying like don't get so stressed about it. People know your intent if your intent is love and support. So don't worry about it. Acknowledge that you may say things wrong but get out that, you know, get out that support. So could you address that at all? And any examples or anecdotes you have obviously not to identify people but where you see that have come true. Absolutely. So you're gonna make mistakes, right? We all make mistakes. We are all human beings. Your kid will know that you love them, right? But absolutely when you make a mistake in any context apologize, correct yourself, move on and then do better the next time. Work on yourself to make sure that you're giving your best effort. And it's not an easy thing, especially if you have known and loved this human being since before they came into the world to change your idea mentally of what name you use and what pronouns you use. That's not easy. It's much easier for me as the medical person to say, hey, try this, right? It's not easy all the time for parents and it's okay to recognize that that's sometimes difficult. But that doesn't mean we should stop trying, right? Because it's so important for our young people to continuously see that we are working to support them and that we see them. And so it is important that our young people experience that affirmation but that doesn't by any means make it easy for families, especially parents. And that's something that we continue to work on. But when you do make mistakes, correct yourself, apologize, move on and do better. Wait, Jills? Yeah, and I think, again, I wanna draw attention to the sort of disproportionate burden that falls on trans people's shoulders, right? And a lot of the ways we've been told are the right ways to include trans people actually really are about containing the challenges we might pose to systems that hurt us, right? And so I think that part of that anxiety to get it right isn't actually, it comes from the fact that we're told there is a way to get all of this right. No, there isn't. Thunder is an inherently contradictory system that it's literally full of paradoxes and instabilities and things that don't add up, right? So there really is no mathematical solution, language is constantly changing. One of the things I often say, just the easiest way to understand that there really is no cheat sheet, there's no glossary is if there were, it would be incredibly ethnocentric, right? Oh, okay, well in the English language amongst college educated predominantly white Americans, there are ways that there are norms of conversation but even within those communities, there isn't consensus. So I think we've been misled to think there's some sort of secret consensus, but the reason that we have been misled is I think that serves to sort of contain trans people and try to assimilate them back into an idea of normality, right? And I understand that there's a lot of pressure on people to do that. And certainly people, I think what ends up happening though, and I've talked to many, many parents of trans kids about this or therapists and counselors who are working with youth and their families and I hear this all the time, right? There's some kind of blockage point. There's a breakdown in communication happening. Young person is experiencing a lot of anxiety or depression is withdrawing and the parent is just like locked down and is like, I can't do the things I'm being asked to do. And when you, and it looks on the surface like the issue is well, that parent doesn't understand what gender identity is or doesn't understand what transition is or has these legitimate questions about this medical procedure or just basic things like binding or clothes or whatever. And when you really sit down and talk with the parent it's not at all about that content. It's that they're so worried that something bad is gonna happen to their kid and then they are themselves are worried that they aren't getting it right, right? I talked to a therapist once who's working with a young person and their parent who's just really standing in the way of anything happening. And after sitting with the parent for a while the therapist was able to find out the reason that this parent was so kind of clammed up was that they had been to a meeting at their kid's school and at the school they were like, this is how trans works this is all the language and you need to get this right or like you're not being a good parent. And I was like, that's just terrible and not objectively misrepresents reality but in any case, that was the blockage. And so once they realized that it's like, okay, well, there's no issue there. If you can think that actually, yeah, trans people whatever our individual desires are part of what we're asking for is to question systems of gender classification and regulation, right? And so if that's really what your anxiety is about then to sort of outsource that onto the backs of trans people, that's the thing that's unethical, right? If it's just bringing something up for you and you're concerned, right? You're worried, you're anxious, okay, well, great that's a you problem, right? It's actually a collective problem, it's a social problem but I don't think we want to neutralize that, right? You know, to me, so many of the policy prescriptions around trans kids or trans people presume that we all want to be treated the same way or also that gender is this ineradicable stable thing and once it's figured out, you just say it out loud everyone says yes and we move on, right? And it's like, well, that's suspiciously reassuring for the adults in the room. It's like, can you really guarantee to me that your gender has never changed and never will change? What does that even mean, right? Your ineradicable sense of being a man or a woman or something else, sure. But like the minutiae of it, the language, the clothing the everyday culture, of course that's changing. Aging is, I like to say this too as a story to biology, like our sex changes normally as we age, right? You are not the same sex when you're 10 years old as when you're 30 years old as when you're 70 years old. I mean, that's just biology, right? And so it's like, you know, part of what I think is happening is that people have these kind of gut reactions, right? Because trans people are challenging, you know a kind of normative system that has been used to oppress us in the past and in the present. And a lot of our solutions try to kind of subtract, you know, that challenge because that would reinstate the norm. And so I think we need to be clear about what's really going on, right? When it's not really a personal conflict and it's actually more like a social or political conflict and not to put all that labor. Trans people's job is not to disrupt and then solve all gender problems for everyone else, right? And just to say that would let non-trans people up the hook, your genders aren't, you know quite as stable and natural as you might want them to be and that's okay, we are all stuck in this system that we're gonna have to figure out together, right? And so to me that's like, where I think of concepts like solidarity. So I like, you know, feminist approaches where, you know, trans people and non-trans people all of whom are women, right? Might have a lot in common or reproductive justice or other battles, right? Where we see it's just so clearly an alliance of interests but what gets in the way I think is that we're not used to thinking like that. That's really, that's so interesting that that aligns of interest. Like, yeah, it's really, okay I'm gonna switch gears a little bit because I know we have so many questions and I do wanna get to everyone's questions. So thanks everyone. But Casey, I just, I mean, you're a doctor that a lot of people probably don't understand what you do kind of day to day. And I thought I might be really useful for you to one describe what you do and the teens that you see and then give us sort of like a, if they put you on the spot kind of a how do you see trans teens that you're seeing? How are they doing? Like, are they, yeah, just, I'll just leave it like that an open-ended question. Yeah, so I have the best job in the world and no one will convince me otherwise. I have the outstanding privilege of getting to meet incredible young people and their families and help support them and watch them thrive. And that's what I get to do and I love it. And I also get to do research about that very thing also. And so I get to meet the individuals but also meet hundreds of folks and talk about bigger data. But the individuals that I get to meet are lovely and they're, I jokingly tell them, tortured by me for a long period of time, at least the first time they meet me. So most of what I do is talking and listening, hopefully in equal amounts. I try, I'm a talker as you can tell, but first visits with me are long and it's really my attempt to get to understand, get to know who a young person is. I believe them when they tell me who they are and I believe them when they tell me what they need in life. And I try to see if we can make that happen for them. And often that's just helping them to talk to their family because there is a lot of confusion, there is a lot of fear, there are a lot of questions. And so that's the vast majority of my job is having conversations. And so I love doing that. And after a young person in their family see me, we talk about resources, we talk about connection to community, we talk about how do you talk to other parents whose child maybe identifies in a way that your child does? How do you talk about this in your community? How do you become a bigger advocate for your child if that's your interest? And so that's the biggest thing that I do. And I love it, I love every minute of it. Sometimes we talk about other stuff. We talk about things like binders. We talk about things like medicine, but most often what I do is talk to people about who they are and how they see their future and how I can help support them. Yeah, that was one of the questions that came in. And I think the question came in to me this morning and said, is there a right age for gender affirming surgeries or binders? And I would just love for both of you to address that. And because a lot of people may not be familiar with those terms all the time, could you define them first? And again, in case I'll just start with you and then we'll get to the audience questions. Yeah, so a binder is a garment that constricts chest tissue and has a whole variety of uses. Elite athletes often use similar kinds of products and the same kinds of products, but it can help make someone feel more in line with who they are and can help them kind of navigate the world. And so it's something that we use if folks are interested in talking more about those and make sure that folks are using things like that safely. But the answer to your question is no, there isn't a perfect age, right? We don't like wake up one day, especially not the 18th birthday. I joke with my young people that I was like 30 when I figured out adulting maybe, right? That there is no magic age where you wake up and it's like, I'm an adult today and I'm ready to conquer the world and make every decision and I've got myself together. That just, that doesn't happen for like groans. I sometimes call us groans. And we just, we aren't always there and I'm not there every day myself. And so I think it's something that we try to impose. When you're 18, you have XYZ rights. When you're 21, you have XYZ rights. But in fact, there is no magic number, right? And these are long, thoughtful conversations and considerations and nothing that we kind of follow a standard you have to be so old for XYZ sort of protocol. No, that's great. Oops, Anisa, I think you're back on. I do want to remind people, please raise in your hand. We'll get your question answered. Although we see a lot of news and please answer your questions and be such great questions if we're going to get to you. Jules, do you want to quickly take a stab at that and then we'll- Yeah, you know, one of the things I'm always happy to say is that we have good reason to de-dramatize all of this, right? And remember the reason that so much of the language around transition, gender affirmation feels, you know, difficult to assimilate is because it was constructed to be mysterious, right? It has been withheld from everyone, right? But as a historian of medicine, one of the really interesting stories that I've told in my book, for example, it's like, okay, where did, you know, gender-affirming medicine come from long before it was gender-affirming, but the medicine, the medical techniques that, you know, we can use for transition. Well, they did come out of studying trans and intersex people and under really horrific, you know, actually just kind of barbaric, torturous conditions. But the goal of that research was actually not to help intersex and trans people. It was either one to force them to appear more normal, but it was actually to develop means to medically intervene into human sex and gender in general, right? And so one of the kind of, you know, interesting truths here is that there really isn't that much of a meaningful difference. The only difference sort of between trans medicine and non-trans medicine is who gets stigmatized for it, who has to go get a psychiatric letter of evaluation, who has trouble getting insurance compensation, right? But if we wanna talk about the kinds of things that compose sort of gender medicine, like gender-affirming medicine, hormones, right? Who takes the most of the hormones in this country? Cisgender women and cisgender men, right? They just don't have to ask for as much, right? Can you get, you know, other kinds of surgeries that are, you know, exactly the same as gender-affirming surgeries, but either have them covered or just paid for them out of pocket and call them cosmetic? Yes, right? Like the human body contains a kind of plasticity in which like changes in sex and gender are quite unremarkable and happen anyways. Hormones and things like this are bio-identical. There's literally no difference between them, right? And so it's like being trans is just, you know, it's very easy to make the argument that it's just as natural and biological as any other kind of embodiment. So really, you know, I often think that although I understand people's curiosity, if we hold in mind the context that the reason that these things are mystified are historical and political, not because they're actually complicated. We can remind ourselves that really, you know, everyone once again is subject to a regime of sex and gender and there are various kinds of medical, you know, supports that lots of people, you know, might want at different points in their life. And there are also lots of issues of medical discrimination and neglect where again, trans people are your natural allies. Like we have dealt with some of the worst of it, you know, and I'm not the only one who can testify to that. But we are also then allies, you know, to talk about like how women are so mistreated in medicine, you know, disregarded, not included in clinical trials, how their pain is disregarded, how certain, you know, diagnoses are handed out disproportionately to women or withheld from them, right? These are natural points of alliance again where there really isn't a cis-trans distinction. That distinction is one that's been kind of imposed to try and keep our interests separate. So that's kind of one of my larger points is I don't think there's anything that remarkable about transition related medicine, other than the fact that it is so deeply withheld from people who want it. Right, right. That's so interesting. Okay, Jules, like five people have asked this question. Can you mention how our sex changes as we age more? Several people were questioning that and wanted some more explanation. Sure, sure, you know, real quick, I mean, I can't do it justice here, but you know, sort of one of the conclusions of my work as, you know, I've studied the history of the concept of sex and how it's been medicalized for, you know, the past 150, 200 years. And one of the things we don't remember, because why would we unless you're a huge nerd like me, is that really until the 1950s or 60s, the consensus in the biological sciences is that there were no males or females. Everyone was actually just kind of a mix of male and female characteristics. And this thesis sort of formed in the life sciences. This is the story that my book tells that human sex is naturally kind of fundamentally, it's defining characteristic is plasticity, ability to change over time. And the argument was purely developmental, right? It's like, okay, well, how does an embryo, how do we get from an embryo to a 30 year old, right? Like it's not, you know, unlike how we used to think maybe like 600 years ago, there isn't a tiny little 30 year old who just gets bigger and bigger, right? You undergo qualitative changes in the organism over time. Anyways, so if sex is really just sort of meant to be plastic, right? The thesis sort of emerged in the highly conservative, area of science and medicine that, it's like we are born sort of sexually undifferentiated and then human development is a process of differentiation. Now, this was like a really contested, deeply racialized kind of scientific conversation that fed into eugenics and all sorts of other things that I track. But on a basic conceptual level, if we follow where the science is gone today, I mean, science has no kind of claim that there's sort of some immutable sex, right? So when I talk about aging, it's like sex actually refers to two things, right? Refers to sexual reproduction and sexual differentiation and sexual differentiation is just like the form that your flesh takes, right? Your skin, your hair, right? Your metabolism, some of your, you know, reproductive or endocrine organs, but actually affects everything, right? Your brain development. And so, you know, I think it's really interesting to think about why do we call people taking hormones say for transition? Why do we call that hormone? Well, actually we don't. We call them both hormone replacement therapy. Me taking estrogen once a week and a menopausal cisgender woman taking estrogen or progesterone, we're both on HRT, right? So why don't we classify? I'm talking about human taxonomy here. Why do we not classify aging as a form of transition, right? Well, because we don't want to, but I think it would be a really great way to de-dramatize it and say like, yeah, you know what? We kind of all go through these weird experiences in life where sometimes we need to take hormones, sometimes we need surgeries, right? Sometimes our gender identities change, right? I mean, queer people are really good at this. Like there are lots of in-jokes and queer community about like how your gender changes as you get old, right? Like, you know, lesbians will cut their hair short and just become more masculine, right? Or, you know, if you've been butch your whole life you might grow your hair out and become a long-haired lesbian late in life. Like, you know, there are whole cultures that have sprung up around this, right? So I do think there's an interesting scientific argument to be made, but more importantly, there's one about human culture and shows where we place value, right? Who has to be the exception, right? And who sort of, you know, life course is just unremarkable enough to happen, right? That I think is ultimately like the real question I'm interested in. This is such a fascinating discussion I just have to say and getting lots of accolades on the Q and A. Okay, but there's a lot of questions and some of them are tough, but we're gonna go for it. So one person asked, I worry about my trans daughter having regrets in the future when going back won't be an option. What is the research on this? I don't know who wants to take that one, definitely. I mean, Casey, you might be able to speak better to the research. I mean, I've certainly read it. I will say I think the concept of regret is, I mean, I understand the anxiety, but I wanna make the case that it's a red herring that's been planted in our minds, the idea of regret. Cause actually, again, it assumes that, you know, being trans involves some kind of, you know, ineradicable, like opening a door and walking through it. Whereas like I was just saying, if we think that actually everyone's gender can change over time, then it's like, I think transition is one of the sort of like kind of unremarkable things that lots of animals are capable of, right? It's not just humans that, you know, transition, so to speak, we're just the only ones that have technologies to do it with. But, you know, I think the concept of regret, right? It's like, you know, is often tied to this idea of de-transitioning, the idea that you can transition and then untransition, right? Which is not a very good way of thinking about it, because, you know, if you ask the most trans people, it's like, no, no, no, you are trans. Transition is a thing that you can do, right? But it doesn't affect whether or not you are trans. You're trans if you haven't transitioned too, right? So I don't really understand the idea of de-transition. I don't think you can untransition, right? The same way that you can't turn clocks backwards, like time marches forward. You know, in reality, though, what we do know, both from research, and I can say from just like, widely encyclopedic knowledge of other trans people, is regret isn't really a thing. You know, much more likely when people do choose to de-transition, especially trans women, is due to overwhelming social pressure, discrimination, loss of social support. People de-transition when they lose their jobs, when their partners abandon them, when their families won't speak to them, when they're in financial dire financial straits, when they're experiencing street harassment and criminalization. That's what drives people, right? So when they don't have the material resources they need to live, right? And it's like, that's regretful. You wanna talk about like, that's what I worry about, right? And you know, it's tough, like I get it, but if we think about like that, you know, our children's genders aren't something that belong to us, right? And so our job is to support them in life and try to avoid those regrets, right? Try to avoid that. Or like the regret of going through puberty you didn't wanna go through or having to, you know, spend years pretending to be someone you aren't or having to work in a job suffering harassment instead of getting to be out. Like those I think are things we should feel regretful for as a society. Yeah, I don't know if that was your, I can't remember who did the study, but we ran a piece of the conversation about regret from trans and it was remarkably low. And I hope that, you know, whether that gives people comfort or not, comfort or not is interesting, but it's a really interesting study. I gotta find it and I'll share it with people when we go. So can you comment on outing? And I'll pose this to Casey. Can you comment on outing your trans child, young adult to your peers, coworkers? Should that only be totally up to the trans person and how do you handle that? Yeah, so that's a really good question. And this has been a really great conversation. And so I just wanna go back to one of the prior points. Puberty is my specialty and that is one of the life transitions that, you know, if we are lucky to have puberty in our lives, it means that we are advancing, right? As an individual. And so puberty is a critically important part in our lives and it's one of those gender transitions that we all experience. So I wanted to add that too because puberty is my favorite life transition. I think young people get a whole lot of negative attention, right? There's a whole lot of stigma about teenagers and impulsivity and all of these sorts of things. That is how our brains develop. Teenagers are incredible humans and I think we give them a hard time, unnecessarily sometimes. And so I'm here for all of my young people, but to kind of get back to your question and I'm sorry, can you tell me your question again to make sure that I get it fully? I got off track with puberty. I just forgot it, I was just looking at so many questions. Oh yeah, it says, what do you... Oh, yes, yes, sorry. Yeah, so I think this one is you need to talk to your young person, right? This is their truth, right? And you are certainly a critically important part of their circle and their world and their life and you know this important information. And I always express gratitude when people share important information like this with me, right? But it's not your information to share. How it impacts you can be, but to out your young person without having that conversation with them about how they want that to happen can be really problematic and harmful. So I would recommend talking with the young person. Yeah, that's really good. I just wanna give some thank yous to both of you. You know, as someone's writing, as a parent of a trans preteen, how grateful I am for the de-dromatization of transness in this conversation. I've often been struck by the creation of a crisis in trans medical care, even from practitioners who are technically, at least technically affirming. So I think that's, I'm getting a lot of those. And then this is just like a really basic question, but where does the term CIS, C-I-S, gender come from? That's from someone in Ken. I can take that one. Yeah, CIS is a really interesting term that has just seen this like rapid take, like real fast. And I think it's probably because it's been fit into a sort of corporate kind of diversity machine kind of algorithm. It's like when big corporations decide something sounds good, suddenly we see it everywhere, but CIS is actually a term from chemistry. So it's a prefix that you can put in front of words. So is trans, right? And trans as a prefix means across as it's the spatial metaphor, moving across something. CIS means on the same side of. And so it comes from originally from chemistry, but at some point on the trans internet, let's say, and maybe the late thoughts, right around the kind of high tide of the Tumblr moment, people started using that word. They were looking for a word to distinguish between people who are trans and people who are not. And so they picked up on this idea of, oh, you could be CIS gender, which what's the same side here? It means that your gender identity matches what was assigned at birth. That being said, it's not a totally kind of innocent or uncomplicated term. It's become very in vogue, I think, to think of CIS gender as something that people need to own up to. It's like in a pronoun circle or in a meeting, you have to be like, okay, I'm CIS gender. And it's like to me, I'm not sure how helpful that is. It's a difficult system. I think we're trained through sort of sexuality politics where for a long time it was like, oh, people are straight or gay, right? We think there is this sort of binary, right? But there really was kind of a serious obligation over the past 150 years to be somewhere that binary was sort of a crisis created by Western culture for itself. But there isn't really a binary like that around sister trans even right now, right? Is one of the points I wanna make. And I think often the pressure for people to like name themselves as CIS doesn't make any sense either. It's like, well, what makes you CIS gender? Did you really go through that long process of deciding if your gender matched what's on your birth certificate? Like trans people have to deal with that because we're forced into that situation. So, you know, I tend to use the words CIS in my work to describe large historical structures that organize and create that very obligation in the first place. We live in a culture that has an obligation that who you present yourself as in the world. And this can show up on your driver's license in HR, right? Airport security that it match people's imagination of what is on your birth certificates. We don't have our birth certificates all the time, thankfully yet, right? But, you know, so there is a sort of cis gendered system that we live under, I would say. And that seems true, you know, but whether or not this term kind of hangs around, you know, I'm not so sure. But it has such a kind of a funny funky history coming from the internet, but also being a chemistry metaphor. So as a, not a metaphor, but being borrowed. So as a science nerd, you know, I do appreciate that part. But yeah, it's Latin, so, you know. Any case you had to add or you got? No, to build off of that, we as a people have a tendency to like to put people in boxes, right? And I'm sure that many of us have had the experience of not neatly fitting into a box that society ascribe to us. And I think that that's something that we all can connect to and relate to. And understand that our job of putting people in boxes is not helpful, right? And there is no binary for most things, right? If not all things. And I think our realization of that helps to understand this kind of broader de-dramatization that we're talking about today. Yeah, I do want to acknowledge we're getting lots of comments and thoughts. And some of them take, I'm rigid the fact that they're, that people don't have regrets after transitioning. I just want to acknowledge that it's not really a question, but I do think that's a fair thing to note because that's coming through. So this comes from a minister and I've just lost the question. But as a minister who is in a church that has been very harsh treating of trans, how do I individually, saying this right, how would individually help in some way? And I think that's perhaps a hard question, but I'll throw it out there. I mean, I think it is a tough question. And one of the things I can offer, right? Is that, you know, it might be a relatively, it might be a surprisingly recent historical phenomenon, the idea that religion and transness are opposed, right? One of the things I sometimes find myself mentioning, you know, in 1966, Johns Hopkins University was sort of the first American university clinic to open a gender clinic very famously. And, you know, when they were opening the clinic, they literally had a panel of local faith leaders that showed up to be like, we love this for lack of a better phrase. There's a whole newspaper article and everything, right? And I often tell that story because people are shocked. They're like, well, weren't they opposed? And I was like, no, there wasn't really seemed to be any particular conflict at the time. You know, now they're, you know, obviously, you know, there's no shortage of examples, whether it's, you know, Catholic church dictates, you know, framing so-called gender ideology or evangelical political organizing, you know, but it's like most of these things trade in moral panics. You know, there's really nothing behind them. And I think on an individual level, right? I mean, I certainly wouldn't claim to tell a minister how to do their job, but, you know, to sort of think about that individual relationship as one where you can both acknowledge and listen, I think so often. And this might hold true in general for trans young people, you know, it's like if you're an adult in someone's life who acknowledges a reality when they are basically being gaslit by all the people in their life or all the institutions in their life who tell them they're not real or that they're sick or they're wrong, if you can be that one person in someone's life who's like, I hear you, I see you, I've taken you seriously. And also maybe acknowledge that context. Say, you know, this church doesn't have a good track record on this issue. And I'm acknowledging that, but I want you to know that that's not my, you know, personal approach and I would like to be accountable. And then, you know, like with most things, I think when it comes to support, it's so interesting, like how much our culture puts so much pressure on us to always know what to do in every situation. I don't know if this is just like something the pandemic has made worse or whatever, right? We like always talking about self-care. And then like as if we're all supposed to walk around the world knowing how to care for everyone else. And it's like, no, that's too hard. I think you can just ask, right? Ask people because, you know, I think if someone is still a member of a religious organization that, you know, might structurally be antagonistic towards them and is willing and, you know, confident enough to reach out, then they're the expert in what they need, right? I mean, it's so, you know, it's such a simple thing, but I think it's kind of profound just to ask someone, how can I support you? Not to assume that you know in advance, yeah. That's great. I'm just, I'm going to go to Casey for a second because I did want to ask you something that I had forgotten about, but it'll be so many more questions. And I do, many people keep asking how to share this afterwards. And if it is being recorded, it'll be on YouTube. We'll send everyone a link, like everything at the conversations. It's always free to read and republish. And we're likely going to be doing a story out of this as well. So there'll be like, we'll answer hopefully if Jules and Casey are kind enough to answer maybe a few more questions on email or something, we could put those in if that would be okay, because I do want to be respectful of the time, but also so many questions. Casey, so you just had a recent article in Pediatrics. I just want you to describe that and talk a little bit about it because I think it'd be really informative for people. Absolutely. So there's a really important article that came out before mine that talked about how many young people identify as transgender. And the survey was pretty broad. It covered quite a few states, quite a few urban areas as well, in addition to those states. And identified a higher number than had been published prior to that. That was about 2%. And the CDC had really important infographics and talked about that number. The question that was asked in that study that was by Michelle Johns at all was do you identify as transgender? Yes, no, not sure, a version of that. And the issue that I saw with that question is that a whole lot of the young people I work with don't necessarily connect directly with that word, right? We've talked about language and how it's very fluid. It evolves and the word transgender isn't a fit for every young person that we might consider to have a gender diverse identity. And so I took the kind of broader look at asking a two-step question, which many scholars have been talking about for quite a while. I certainly didn't invent that. But the two-step question is where you ask someone what their gender identity is and you give options, right? And folks in the best kind of scenario can actually like write for themselves and give their own answer. Unfortunately, we were unable to do that bit of it, but we gave a long list. And then the second step is to ask the sex they were assigned, right? And we took the route of considering anyone gender diverse if those two things didn't fully align. And so we anticipated that we would have a larger number than 2%. And we only studied one school district. And so that's an important consideration. This study needs to be done on a much larger scale, hopefully on a national scale soon, but of the thousands of school children in high school. So these are 14 to 18 year olds, roughly. And we found that almost 10% of them had some incongruence between their gender identity and the sex they were assigned at birth. And that doesn't mean that the vast majority of them would identify as transgender or non-binary or some of these other words that we use, but that there was that incongruence. And I think that speaks to Jules and her incredible book that this is not a new phenomenon, right? Diversity and identity is not new, it is not rare. And I think we need to kind of be more mindful of that. And I think it's a helpful way of looking at it kind of more broadly. That's really, that's so interesting. And it speaks to, well, Casey, did this speak to both, I guess you don't have a look back, but I wonder if that question was asked, I don't know, 30 years ago, what percentages we would find. I would throw that to Jules first. Yeah, I would, right. My guess is we maybe find something very similar. I'm so sorry, I was looking at the Q&A for a second but you can find repeating it. We were saying, I was saying, Casey did her study 30 years ago. I'm curious, what would the percentages be? And then we don't know. Yeah, I think that's an interesting question, right? And it's like, the way I tend to think about data is that it often reflects something structural in the society. So it's so interesting, right? We've seen this kind of manufacture of moral panic around the idea that transness is somehow exploding right now, right? Which presumes that something is going, there's sort of lazy, easily debunkable social contagion theory, which is like the oldest way to libel children, right? I mean, it literally used to be in the 1890s it was like they're reading dying novels and they're all gonna become rabid ruffians and then it was radio and then it was rock and roll and now it's the internet, right? And you literally see these like ridiculous pundits who never the less have huge platforms being like, I think watching anime makes kids trans and it's like, oh, really do you? But I think what we might say, right? Is that like these numbers are actually indicative of how free of a society you live in. And so if we lived in a freer society I expect that number to go up, right? And so if we were to look in the past, I mean, it's like the number would be lower but that doesn't mean there were less trans kids. I think one of the interesting implications of the historical research I've done, right? Is that most of the children I was able to find only exist in the archival record because of an encounter with some sort of disciplinary power a psychiatrist, a foster care worker, a surgeon, a police officer, a parole officer and they're mostly records of terrible transactions of violence that were used to try and punish and normalize those kids, right? Which means that the many, many, many more trans youth that didn't come into those situations, right? That weren't disciplined for who they were kind of get the last laugh historically speaking because they didn't get captured by the archive. That means I can't know their story. There are only a couple I ever encountered indirectly that way but that doesn't mean they didn't exist. It's a limitation of our imagination that we would think that they don't. So I am interested in these numbers particularly because as they go up I would tend to think that that's a positive reflection of something perhaps that this younger generation is more invested in the idea of autonomy and gendered freedom for everyone, right? Because I think that again, the thing that's ingenious about that question, right? Is it's not that it's saying, oh, everyone identifies as trans, right? But it's that gender incongruence is actually clearly a very widespread experience in our society. So if we are allowing space for that it'll be great for trans folks but it'll be great for so many other people too if we are relaxing the kind of policing that we do around gender every day. This is, wow, this is such a great conversation. I'm gonna, I wanna ask this question because it came up a few times and I'm gonna save the questions because some school districts are asking for your help which I'm sure you might be interested in in some way. So I'll just, this is one and there was an earlier question too. So it said not a new, this is maybe not a new film but what about the explosion among young women? Is it an explosion among young women of trans? And can someone address that? Yeah, no, it's disinformation. I mean, one of the things I've written about this summer is the actually symbiotic networks between these kinds of respectable sort of often self-styled gender critical pundits who are often freelance journalists and we'll write books or kind of have a kind of speaking circuit thing where they actually really end up laundering extremist kind of disinformation concepts that widely circulate now in places like QAnon and amongst white supremacists, the Proud Boys and organizations like that. They've really fixated on a very old kind of moral panic that girls are in danger. It's like the oldest play in the book, right? And actually, I think it's really key to look at, what bothers me about it is it's an incredibly misogynist argument, right? It's basically that no one likes being a girl. Being a girl is a horrible experience already and so that's why girls do drastic things, right? Like they, and they make all these kinds of weird analogies that have no logical coherence and for which there are no evidence that, being trans is like an eating disorder. It's like cutting or something like that, right? And basically it sort of suggests that well, no one really wants to be a girl and so our job socially is to police girls to stay as girls. And so transmasculine people aren't really, they're not real and they're just actually girls that need to be saved. It's like, it's really a kind of narrative that has its roots in the 19th century, especially in the United States and the United Kingdom, the imperiled white girl. I mean, this is like old stuff, but it reinvents itself so frequently, right? And I don't mean to suggest that the person asks the question or people who are seeing this that there's something like bad about you for not recognizing that it's my job as a historian, but no, there's just no actual phenomenon in the world that we need to be worried about and just sort of additionally, like, so what if there was a lot of people identifying as trans, like so what? If you really believe that trans people should be allowed to exist, you shouldn't really have a problem with that. It's just sort of a red herring to me, but there is a lot of active disinformation around it that's picked up by the media and it comes through sort of lazy both sideism, sometimes sort of like corporate media in the United Kingdom is sort of entirely run by people kind of funding anti-trans propaganda. Like there is a massive campaign underway to suggest that somehow young girls are in danger, right? But it's like 20 years ago, the danger was whatever like drugs or sacks or and then further back it was rock and roll and like racial integration. I mean, we just see this over and over again in our culture, unfortunately. This is such a fascinating conversation and we're going a little bit over, but only a minute or so I just want to get final thoughts and I'm saving all the questions, but Casey you're up and any final thoughts you want to share with people or? I want to build off of what Jules just shared and that my paper and pediatrics actually addressed this too. And so we asked all the high school students and there was an even number of folks who were assigned male and female who had a gender diverse identity by that definition. And so I think that gives further evidence to when you ask everybody, it's very different than who might present at a clinic for example, who has access to medical care, who has the ability to negotiate with parents or guardians to get to medical care and who's facing stigma discrimination and bias in our society. And I think that plays a big role in this whole argument. And Jules final thoughts. Yeah, I'll say something that I'm always happy to say it's the conclusion of my book too. We live in a society where the sort of scope of institutions whose programmatic interest is in eradicating or reducing the number of trans people is ubiquitous, right? Literally every institution in our world works over time to prevent the development of trans people out of childhood and to try and stop there from being trans people, right? And so in that context to me really, our job as adults is really simple but difficult. It is to turn to those institutions and turn to that world and say not just that we accept that there are trans children, that they're real, that they exist, that we might tolerate them, but to say that we actively want them in the world, that we celebrate that they are trans, that being a trans child is a good thing, not something that if we take off all these boxes and go to all these appointments and do all our research, we might reluctantly come around to and sign off on. Now we need to learn to actively want the trans children in the world and not just to accept them belatedly and subject them to a kind of scrutiny that we as adults would never tolerate being trained upon us. And I think to me that's something that I think is really hard. It involves unlearning what you've been taught. Trans people have to unlearn it themselves too, to learn to love themselves in one another and it's a beautiful transformative experience. The thing I often say to a parent when a young person comes out is congratulations. You have been given a really rare gift because not only do you get to love someone who's going to have a really rich and expansive experience, but you are by virtue of caring for and loving them and being in relation to them going to be gifted the opportunity to think reflexively about gender and your place in the world in a way that most people could only dream of. And to me that is a rich and beautiful added value for which we should all be really grateful. And speaking of gratitude, I'm just so grateful to the conversation and to you Beth and to you Casey for the work that you do and for giving us some space and time to talk in ways that I think were just really enjoyable but also so helpful and so interesting. And my door is open certainly as a professional and a historian and someone that does work with lots of different institutions. I'm sure there are so many more questions that people have and I'm sure we're all sort of of that same conviction that we want to be of as much use as we can. Yeah, I suppose I think you both so much for such a spirited and in-depth conversation. We can't cover it all, but Casey and Jules it's been fantastic. And I just want to say thank you to our guests for being so engaged and the gratitude you expressed on the messaging board for Jules and Casey. We are a nonprofit news outlet. If you like these webinars, if you like doing reading the stories and I urge you all to sign up for our series about trans teens. Please support us. It means a lot to us. It helps us keep the light on and editors working. So goodbye everyone. Thank you both, Casey and Jules. Hopefully we'll see you again very soon. Bye everyone. Take care. Bye bye.