Saturday, January 24, 2015

Not Understanding vs Not Wanting to Understand - There is a Difference

This is my first time trying to submit to the asexuality blog carnival, and it looks like the topic is nonbinary gender identities. OK. Well, just because I'm a cis asexual shouldn't stop me from writing something about nonbinary people, right?

Problem is: I don't understand nonbinary gender identities.

Admitting that is kind of scary. I bet a lot of people are thinking right now that I'm denying that nonbinary identities exist, or that I'm saying they're wrong, or that nonbinary people should just pick a gender and deal with it. But I'm not saying anything of the sort.

All I'm saying is that I don't understand. I'm willing to try. I can't guarantee that I'll understand if you explain it to me, but I'll try. And even if I don't understand it, I'll take your word for it if you say you're nonbinary.

I remember, up until recently, I didn't understand binary transgender people, either. I have always felt that I'm female because I have female bits, not because of anything in my mind, so it didn't make sense to me that a person with male bits could call themselves female. I thought MtFs and FtMs were just effeminate boys and tomboyish girls who held such rigid gender stereotypes that they assumed having cross-gender interests meant they must be the opposite gender. Like an autistic woman believing so wholeheartedly in the Extreme Male Brain theory of autism, she decides she must be a man. I felt sorry for trans people, and I wouldn't have dreamed of treating them badly, but I didn't understand them one bit, because in my world view, there was physical sex and there were gender norms, but gender identity did not exist.

And then I met an FtM kid at a camp for disabled kids. And the biggest thing that struck me about him was that he wasn't some stereotypically male character. He came across as a boy (in fact, he successfully passed as male to me until a camp counselor outed him), but as a boy with a mix of typically male traits, typically female traits and traits that I didn't associate with gender stereotypes at all. In other words, just like most boys (and girls) I've met. I'd thought of trans people as MtF prom queens and so forth, presenting themselves as stereotypically as possible as their desired gender. Now I realized that real trans people weren't like that. With my theory blown out of the water, and with a kid I wanted to do my best by, I went out researching.

And I came across a theory that made a lot more sense. Phantom limb syndrome, in amputees, is well documented. Weirdly enough, though, even people with congenital limb abnormalities can have phantom limb sensations. It's less common than phantom limb in amputees, but it does happen. Conversely, there are people who have limbs that they feel don't belong to them. And I also noticed that many trans people described feeling sensations that sounded suspiciously similar to phantom limb syndrome or body integrity identity disorder - except the phantom sensations or feeling of not belonging were focused on gender-specific body parts, such as a penis.

Now, as a psych major, I know there's a mental map of our bodies, located along the sensory and motor strips on the border between the frontal lobes and the parietal lobes. And I know that phantom limb sensations come from having part of the sensory strip assigned to a limb that doesn't exist. Now, genitalia are represented on the sensory strip, just like any other body part. (In fact, since we need such acute sensation there, the sensory strip representation is disproportionately large.) So, just as embryos start out physically female and then undergo physical sex differentiation, chances are that the sensory strip of the brain starts out representing a female body, and then differentiates between male and female. And just like physical sex differentiation can go wrong, so can the differentiation of the sensory strip. It would explain why MtFs outnumber FtMs, because female is the default. (Among intersex people, XY girls outnumber XX guys.) It would also explain some nonbinary individuals - if the sensory strip started to differentiate but then didn't go all the way, you could end up in between, like the person I met on a forum who desperately wanted to be castrated but still have a penis. I also found a case report of some people who have alternating phantom genitalia - sometimes they feel physically female, other times they feel physically male - and while I have no clue how the sensory strip can suddenly alter its functioning so dramatically, it's no weirder than many other things the brain does, and I can readily imagine how that would feel.

But I know there's still a piece of the picture I'm missing. There are trans people, and especially nonbinary people, who don't report any issues with their sense of their body. Even the alternating-gender case study I linked to reported a few individuals feeling incongruity between their gender identity and their phantom genitalia at times (eg having a phantom penis while feeling female). So although phantom genitalia are part of the picture, they aren't the same as gender identity. And that leaves me, once again, not knowing what gender identity actually is.

So please, bear with me, people. I'm trying to understand, I really am.

And I think there's a lesson here beyond my specific failure to understand gender identity. Many people really struggle to accept the idea of someone not understanding a person's identity - either as the person who doesn't understand, or the person not being understood. A lot of people act like 'if I don't understand it, it doesn't exist'. And in response, a lot of people take not being understood as an act of hostility, claiming they don't exist.

But there's a difference between not understanding something and not believing it exists. If you're willing to let go of your confidence in knowing everything, you can approach something with an attitude of 'what is that? tell me more'. And that's where learning comes from.

Now, I just wish more people would take that attitude to me, when I tell them I'm asexual.

Monday, January 19, 2015

When an Ideal Upbringing Isn't in the Cards

As a society, we generally agree that children need to have the best possible upbringing. And it's possible to look through the scientific literature to get a pretty good idea of what an ideal upbringing is like. A consistent caregiver present throughout the child's life, who has enough support to effectively manage the stress of child-rearing, is sensitive and responsive to their child's emotional needs and comforts them when they need comforting, and disciplines by rewarding good behaviour, explaining rules clearly and having consistent, logical consequences, which they administer while remaining calm.

But what if that's not an option?

Research has found a critical period for attachment, that seems to start between 9-12 months of age, and ends somewhere around 3-5 years. Experiences during this age range have a critical, lasting effect on the child's attachment, emotional regulation, and the neural architecture of their brain. Both inadequate caregiving (eg abuse or neglect) and separation from caregivers have the potential to cause lasting harm, especially in this age range. On the other hand, children in this age range are better able to respond to a change for the better than an older child would be.

So, imagine an 15 month old child, already well within this critical period. His mother has a serious drug addiction, which is making it very difficult for her to provide sensitive and responsive care to her child. In reaction, her child has developed a disorganized attachment style, which puts him at higher risk for both internalizing and externalizing psychological problems.

But he is attached to his mom. And his attachment is better than it could be - he shows no sign of reactive attachment disorder (RAD), the most severe end of attachment disturbance. He still gets some comfort from his mother's presence, still prefers her to a stranger, and feels safe enough with her watching over him that he's willing to play and explore. His attachment style is not optimal - he often seems to be in a double bind, wanting mom's comfort but also being afraid of her - but there's still room for it to get worse.

And this puts us in a tough situation. If we remove this child, we could put him into a foster home, with a foster parent who will probably provide him with sensitive and responsive care. However, since this child is attached to his mom, losing her will be traumatic for him. He might recover from his trauma and attach to his foster carer, potentially forming a better attachment style in the process, or he might not, and start sliding towards RAD. And if he does attach to his foster carer, how long will that relationship last? Foster homes aren't intended as permanent homes. Although some children stay in one foster home for years, and some are even adopted by foster parents, many foster children end up being moved from home to home. And if this little boy, who's already showing a disorganized attachment, gets moved several times during the critical period for attachment, then we can virtually guarantee that he will develop RAD.

Alternatively, we could try to get his mom to stop using. If she does go clean, her parenting will improve, and her baby is still young enough to respond to that - especially if we give her attachment-focused parent training as well. But what if she relapses? Or even gets worse? Her child may need to be removed anyway, months later, having missed out on several more months of good care in the critical period for attachment. We could end up back at square one, except with a 28 month old instead of a 15 month old. And now that he's two, it's that much harder for him to transfer his attachment from mom to a foster carer, and that much harder for the foster carer's parenting to sink in and change his view of relationships.

There is no one option that will put this child on the best road to life. All we have are different bad options, each of which could be putting the child at further risk, but if not, we might be able to make things a bit better. And the best outcome will still fall short of where this kid could have been, if he'd gotten sensitive and responsive care from birth.