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Listening to Talk About Trans Youth and Early Gender Transition

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Listening to Talk About Trans Youth and Early Gender Transition THINKABLE FUTURES, PERMISSIBLE FORMS OF LIFE: LISTENING TO TALK ABOUT TRANS YOUTH AND EARLY GENDER TRANSITION THINKABLE FUTURES, PERMISSIBLE FORMS OF LIFE: LISTENING TO TALK ABOUT TRANS YOUTH AND EARLY GENDER TRANSITION By JAKE PYNE, M.S.W. Bachelor of Social Work (Ryerson University) Masters of Social Work (Ryerson University) A Thesis Submitted to the School of Graduate Studies in Partial Fulfilment of the Requirements for the Degree of Doctor of Philosophy McMaster University © Copyright by Jake Pyne, September 2018 McMaster University DOCTOR OF PHILOSOPHY (2018) Hamilton, Ontario (Social Work) TITLE: Thinkable Futures, Permissible Forms of Life: Listening to Talk about Trans Youth and Early Gender Transition AUTHOR: Jake Pyne, M.S.W. Bachelor of Social Work (Ryerson University) Masters of Social Work (Ryerson University) SUPERVISOR: Dr. Christina Sinding COMMITTEE MEMBERS: Dr. Ann Fudge Schormans Dr. Karl Bryant EXTERNAL EXAMINER: Dr. Susan Stryker NUMBER OF PAGES: 263 ii LAY ABSTRACT We are in a time of expanding futures for transgender youth who are able to “buy time” by blocking puberty and transitioning to a new gender while young. Clinical research and literature suggest this as a lifesaving option for trans youth, allowing them to avoid distress and harm. Yet there remain troubling disparities with this treatment. Many clinics report they are primarily serving white middle class trans youth and there are some indications that autistic trans youth may be stalled or delayed in the process. I report on a discourse analysis of 18 interviews with health and mental health clinicians across six countries, in addition to 10 interviews with community level experts. I draw on a range of theory and an “interpretive repertoire” analysis to theorize how these futures become thinkable and possible for trans youth, while considering the political implications and unforeseen consequences for those youth unable to benefit. iii ABSTRACT This is a time of expanding futures for transgender youth who are able to “buy time” by blocking puberty and transitioning young. Twenty years of clinical literature indicates that suppressing puberty can be lifesaving for trans youth, allowing them to avoid the distress and harm associated with transgender lives writ large. A growing number of “gender affirming” clinics now offer young trans people greater autonomy over their bodies, their futures, and their future bodies. Yet there remain troubling disparities, with indications that clinics are primarily serving white middle class trans youth and that autistic trans youth face delays. This thesis is a discourse analysis of 18 interviews with international health and mental health clinicians and 10 interviews with key stakeholders. Drawing from the literature of queer temporalities, sociological work on time and social power, queer and trans of colour critique, critical disability studies, critical autism studies, and transgender studies, I use an “interpretive repertoire” analysis to ask: How have puberty suppression and early gender transition become thinkable futures for trans youth? This thesis finds that the conditions of possibility that make early transition possible for some, are the same that foreclose it for others. The discourses of maturity and cognitive age, the expected “chrononormative” narrative, and the discourses of crisis and the “race against time”, each work to make outsiders of autistic and racialized trans youth in particular. While there is much to celebrate in the new futures available to trans youth, I argue that puberty blockers currently function as a “switchpoint” moving privileged trans youth onto a track toward even greater privilege, and widening the gap in life opportunities. This thesis introduces the concept of “the iv temporality of privilege” and calls for greater attention to the political implications augured by the contemporary scene of gender-affirming care for trans youth. v Table of Contents Lay Abstract……………………………………………………………………………..iii Abstract…………………………………………………………………………………..iv Table of Contents………………………………………………………………………..vi Acknowledgements………………………………..……………………………………..ix List of Abbreviations…………………………………………………………………….xi Chapter One: Introduction………………………………………………………………1 Background………………………………………………………..………………1 Review of Clinical Literature...……………………………………………………4 Theoretical Framing……………………………………………………………...13 Transgender Studies…..……...………………………………….……….14 Critical Disability Studies………………………………………………..14 Critical Autism Studies…………………………………….…………….15 Queer and Trans of Colour Critique……………………….……………..16 Queer and Trans Temporalities……………………….………………….17 A Note About Queer and Trans Future…………………………………..20 Research Problem and Questions…………..…………………………………….25 Methodology and Methods: Studying Text, Listening to Talk, Thinking with Theory……………………………………………………………………………27 Studying Text…………………………………………………….………28 Listening to Talk………………………………….……………………...29 “Thinking With Theory”…………………………………………………33 Next Steps……………………….…….……..…………………………...34 Methods and Reflections……………………………..…………………..35 Overview of Chapter Abstracts……………………………..……………………38 2. Arresting Ashley X: Trans Youth, Puberty Blockers and the Question of Whether Time is On Your Side…………………………………….…….39 3. Narrative Malady, Normative Temporality: Doing Time with Autistic Trans Youth in the Gender Clinic………………………….……….……40 4. The Temporality of Privilege: Trans Youth of Colour and the Trouble With Triage…………………………………….…….….….…...40 Organization of Sandwich Thesis….….….….….….….….….….….….….……..41 vi Chapter Two………………………………………………………………………….....42 Arresting Ashley X: Trans Youth, Puberty Blockers and the Question of Whether Time is on Your Side Introduction……………………………………..…………….………………….44 Arrested Development, Queer Time, Trans Time…………….………………….45 Arresting Ashley...………………………………………………………………..49 Trans Youth and the Demand of Time……………….……………….………….53 Asynchrony and the Alignment of the Mismatched Body/Mind………………...58 Cognitive Age: The Infant Versus the Mature Minor...………………………….63 Discussion and Conclusion...…………...…………...…………...………………67 Chapter Three…………………………………………………………………………...85 Narrative Malady, Normative Temporality: Doing Time with Autistic Trans Youth in the Gender Clinic Introduction…………….………………………………………………………...86 Autism and Transgender: Together At Last……………………………………...89 Narrative Malady, Normative Temporality: Storying Autistic and Trans…….....96 Transtextual Narrative: Trans Narratives Over Time……………...……..97 Autie-Narrative: Autistic Story and the Story of Autism………………...97 Methods……...……………………………………………………………..…...112 Results..………………………………………………………………………....115 “It’s So Natural, It Doesn’t Stand Out As a Story”: The Authentic Trans Youth Story……………………………………………………………..120 “How Do I Get My Head Around This?”: The Questionable Autistic Gender Story……………………………………………………………127 Discussion: Narration, Time, Story……………………………………………..144 Conclusion………………………………………………………………………155 Chapter Four…………………………………………………………………………..170 The Temporality of Privilege: Trans Youth of Colour and the Trouble With Triage Introduction…….……………………………………………………………….171 Puberty Interrupted…….………………………………………………………..173 Trans Youth of Colour: If Not Now, When?………………………………..…..177 The Racialized Politics of Time……………………………………………...…183 The Event, The Situation, The Temporality of Privilege……………………….186 vii Methods……...……………………………………………………………….…188 Results..……...………………………………………………………….………191 “Urgent and Emergent”: The Event…………………………………….196 “That’s Something For Someone Else”: The Ongoing Situation ……...199 The Temporality of Privilege and the Trouble With Triage ……………………207 Conclusion: A Problem We Should Not Live With…………………….………216 Chapter 5: Conclusion..…………………………………………………………...…..229 What Makes it Thinkable and Possible?………………...........................231 “Others” in the Gender Clinic…………………………………………...234 Contributions of Thesis …………………………………………………237 Questions Left Open….…………………………………………………243 Final Thoughts…….…………………………………………………….247 References……………………………………...……………………………………....248 viii ACKNOWLEDGEMENTS Thank you to my supervisor Chris Sinding who, in addition to her sharp eye, her generosity, and at least the appearance of endless patience, is also the most organized person I know. At various points when I was mired in theoretical or methodological questions, Chris always knew where I needed to go. I couldn’t ask for a more supportive supervisor. I hope someday to live up to her model as an academic. Thank you to my Committee Members Ann Fudge Schormans and Karl Bryant for the pleasure of their thinking company throughout these years and for their patience with my mad dash to the finish. Thank you to my External Examiner Susan Stryker whose brave intellect was a companion first through her writing and then as the examiner at my defence. Thank you to Katrina Roen for guidance during initial phases and to Nadine Attewell for generosity and expert dialogue in previous studies. Thank you to former professors who inspired my learning: Ken Moffatt; Akua Benjamin; Iara Lessa; Jana Vinsky; Gordon Pon; Kristin Smith; Samantha Wehbi; Henry Parada; Dawn Onishenko; Melanie Gough, Stephanie Baker, Ann Fudge Schormans, Chris Sinding. Thank you to the clinicians and community experts who generously gave their time to discuss their work with me. Thank you to the Trudeau Foundation (in particular Josée St. Martin) and the Vanier Canada Graduate Scholarships Program for funding and support of my doctoral studies. Thank you also to Stephanie Baker Collins for her assistance with
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