I've had my nose in a research prospectus for the last several days, writing up the literature on gender-questioning youth and pointing out how researchers' blindspots lead them away from critical questions. I've been researching this issue for years, and it still shocks me.
Research consistently finds that same-sex attracted youth are overrepresented among youth seeking transition. Take two Dutch studies, published in 2011 and 2013, which found that 95.7-100% of females whose gender dysphoria persisted from childhood into adolescence “reported feeling exclusively, and as long as they could remember, sexually attracted to individuals of the same natal sex, although none of the persisters considered themselves ‘homosexual’ or ‘lesbian,’ but (because of their cross-gender identity) ‘heterosexual.’” One research subject observed:
“I always fell in love with girls, I never felt attracted to boys. A number of children concluded that I had to be a lesbian, I thought about this but I never experienced it this way. I was aware of having a female body but in my feelings I was a boy, so I was not a lesbian but a heterosexual, just like the other boys.”
In fact, as recently as 2007, medical providers understood cross-sex identification in childhood and adolescence to be a normal stage of homosexual development, resolving in the majority of cases as the child moved through adolescence and became comfortable with his or her sexual development and sexual orientation. Long before the concept of gender identity took root in the LGBT community, the idea of being ‘born in the wrong body’ resonated with many young gays and lesbians—not to mention medical providers, who viewed homosexuals as ‘inverts’ in need of psychological or surgical ‘correction.’
The overrepresentation of same-sex attracted youth among youth seeking transition is often overlooked, downplayed, or denied by researchers and leading affirmative-care providers. Clinicians who rate the “gender presentation” of “transgender” preschool children on a scale from stereotypical girl (fitted, sparkly, frilly) to stereotypical boy (baggy, sporty) inevitably sweep up children whose rejection of gender stereotypes is rooted in their same-sex orientation. Take “Fanny,” one of those short-haired girls in boys’ clothing whose journey Diane Ehrensaft traces from her “assigned female gender and transition [italics mine] first to lesbian and then to transgender”:
“In the process of exploring their sexual identity, usually in adolescence or young adulthood, they discover, often through their romantic or sexual liaisons, that it is not actually their sexuality but their gender that is in question. We see this particularly in young females who have always been “masculine” in presentation and find a welcome reception in the lesbian community as “butch females” only to discover that they are actually butch males. As one teenager [Fanny] I worked with explained to me, ‘I really thought I was a girl who liked girls, but every time I was making out with my girlfriend I realized that in my head I was not a girl making out with her, but a boy. And then I realized that my head was sending me a message — I am a boy who likes girls.’ Five years later, this teen, now a young adult, has gone through a full transition from female to male, including hormones, and top and bottom surgery.”
Ehrensaft even coined a term for children and adolescents like Fanny, one that carefully overwrites the connection between homosexual development and gender dysphoria. “Prototransgender youth,” Ehrensaft writes, use same-sex “sexual identity as a stepping-stone toward their transgender true gender self.
And here’s where it becomes vitally important to tease out the L, G, B, and T, rather than lump these sexual identities together, as so many researchers do...