Transgender Bathroom Policy: What the Government Can’t Tell You, But a Pediatrician Can

It’s been almost a year since I wrote about the issue of transgender students and bathrooms in schools, and it is time to revisit the subject.

One week ago, the Trump administration rescinded federal policies put in place by the Obama administration that allowed transgender students in public schools to use bathrooms and facilities that correspond with their declared gender identity. It is now an issue that will be dealt with on a state-by-state basis.

Writing as a pediatrician, not political spokesperson, who has treated thousands of children over the past 30 years, it is imperative that we consider the emotional and physical health of every child when we make decisions that affect all of those children.

This is more than a state v. federal issue; this is an issue about the well being of all of our children. When bathroom use at school is up for grabs, so too, are the psyches of many immature children.

When bathroom use at school is up for grabs, so too, are the psyches of many immature children.

Now, young children who may or may not be questioning their gender identity are asked which gender they prefer—today, that is. Because next week, the child may change his/her mind. This is not a criticism of the child, but a comment on the struggle of gender dysphoria. Then, according to the gender with which the child identifies that day, he/she should have the option of choosing which gender bathroom to use. This means that an eight-year-old girl who identifies herself as an eight-year-old boy should have the opportunity to use a urinal. Or go into the stall of the boy’s bathroom and sit on the toilet.

Likewise, a genetic 11-year-old boy who self-identifies as a girl should have the option of using the girl’s bathroom along with the other 11-year-old girls. Until he changes his perception, which may well happen after he goes through puberty because many children change their position about gender identification after puberty.

Sound confusing? It is—especially for young children, whether they have gender identity issues or not. All children are confused by the bathroom controversy and here’s why.

We know that statistically, true gender dysphoria in kids is very rare. It is reasonable to assume that more than 99 percent of boys and girls in the U.S do not suffer gender dysphoria. These children, because of cognitive limitations of childhood, see much of the world in concrete, black and white terms. What they see determines their reality. A cat is a cat and a teacher is a grown up.

We know that statistically, true gender dysphoria in kids is very rare.

Now they have issued a decision: Is the boy in his class a girl or a boy? And then, those children may begin questioning their own gender identity.

If a child hears a boy say that he is a girl, he not only becomes confused, he seriously questions his ability to make an accurate assessment. That boy or girl is declaring that what he sees is wrong. And being a child, rather than rationalizing that something confusing and complicated is occurring, he determines that he is the one who cannot see things correctly. Then, he wonders, if what he sees is inaccurate, is he seeing anything right? A child thus learns to question his abilities to accurately assess anything around him.

Now consider that a boy who says that he is a girl uses the girl’s bathroom. Once inside, he accidentally lets a few girls in the bathroom see his penis. They are all embarrassed. They don’t know if he is wrong or they are wrong. And, the girls feel so uncomfortable that they do what most uncomfortable kids do: chide the boy.

Let’s consider this dilemma from the gender-dysphoric child’s perspective.

A nine-year-old in great turmoil tells the class that she is a boy, and the teacher tells her to use the boy’s bathroom to make her feel more comfortable. The teacher, after all, is simply attempting to convey acceptance of the child. She goes to the stall to pee and someone hears her. The other boys, being nine and confused, begin to laugh because she can’t use a urinal. Then how does the boy/girl feel? Pained and humiliated, that’s how.

The lifelong work of Dr. Paul McHugh, former head of psychiatry at John’s Hopkins, teaches that transgender issues in adults are very complicated. He does not advocate gender reassignment because, he says, those who have had reassignment have 20 times the risk of suicide from the general population.

To impose rules on all children that support the beliefs of some children is misguided.

Whether one agrees or disagrees with Dr. McHugh, his work cannot be ignored. The bottom line is that there is a lot we don’t know about gender identity issues, and thus to impose rules on all children that support beliefs that gender reassignment (even if verbally) is helpful, is misguided.As a pediatrician and advocate for all children, giving biologically male children the right to share bathrooms with girls and vice versa is not only wrong; it is harmful to children with and without gender identity issues.

Our children are not social experiments.

They are young people with hearts, minds and souls. Every child deserves protection from trauma and humiliation. And every child can learn to be accepting and kind to those who are different. But to force “acceptance” on children when it means causing them to see very private genitalia of the opposite sex, questioning their own ability to believe what they see, and causing more suffering to already troubled children is fair to no one—except, perhaps, the adults who want to see their own agenda promoted. And to that I say, shame on them.