Might Trauma Affect Gender Identity? | Opinion

Another month, another social milestone. On June 27, Kataluna Enriquez became the first transgender woman in history to be crowned Miss Nevada USA, thereby qualifying to compete in November's national Miss USA contest. But like other recent "firsts," Enriquez's story tacitly excavates a question that some want to leave buried: might there be a relationship between trauma and gender self-reassignment?

As Enriquez was the first to note, the new Miss Nevada has a troubled past. Both parents left the future beauty pageant winner behind in the Philippines with friends as they emigrated elsewhere to find work. In one interview, Enriquez "disclosed that she is a survivor of physical and sexual abuse."

Physical abuse, sexual abuse, absent and/or divorced parents—these details riddle stories now emerging from beyond the binary. Consider a recent piece in USA Today: "Stars like Demi Lovato, Elliot Page, Sam Smith identify as nonbinary. What does that mean?" Every celebrity named in it shares two biographical commonalities: absent parents (almost always because of divorce) and a self-reported history of childhood and/or adolescent abuse (in almost all cases, sexual).

Demi Lovato is a child of divorce. Lovato has also reported having been raped as a minor, as one of Disney's kiddie stars; and again years later, by a drug dealer from whom the singer bought opioids.

Elliott Page—born female, and known before transition as Ellen Page—first identified as a lesbian, and was married to a woman (they have since divorced). Page now identifies as both transgender and non-binary, using pronouns "he/him" and "they/them." Page, too, is a child of divorce, and reported having been serially abused and harassed as a minor in Hollywood, including sexually.

Musician Sam Smith is another celebrity newly adopting the "non-binary" label. Born male, Smith is also a child of divorce, and further reports experiencing "violent homophobic abuse" throughout childhood and adolescence, as well as "homophobia and bullying in the gay community."

One might also consider Queer Eye's Jonathan Van Ness, a child of divorce who reported having been sexually abused as a teenager by an older boy in his family's church. Another trans pioneer cited often is Leyna Bloom—the first transgender model to appear in Sports Illustrated's swimsuit series, and the first transgender actor of color with a leading role in a film screened at the Cannes Film Festival. Raised motherless, Bloom too divulges having been raped as a child, as well as having engaged in the potentially traumatic transactions known as "sex work."

San Diego pride flag
General view of San Diego's Pride Flag at She Fest on July 10, 2021 in San Diego, California. She Fest is the flagship event that opens San Diego's LGBTQ+ Pride week. Daniel Knighton/Getty Images

The suggestion that gender migration might owe anything at all to outside influences is vehemently denied by today's establishment. Consider the uproar that greeted journalist Jesse Singal two years ago, following an essay he wrote for the Atlantic called "When Children Say They're Trans." Despite its earnestness and observance of au courant language, the piece nonetheless became a lightning rod—in part because it suggested that environmental factors might be overlooked en route to transition. One therapist told Singal, "I take a full, complete review of systems, and I always take a trauma history. And the vast majority of my patients have trauma histories [emphasis added]."

Evidence also suggests that histories of abuse and trauma are not unique to transgender and non-binary celebrities. As one 2017 article in the journal LGBT Health put it, "Transgender women have consistently reported elevated rates of lifetime physical and sexual abuse." It concluded, "Given these associations as well as the high prevalence of physical and/or sexual abuse among transgender women, mental health professionals and social service providers working with this population should be sensitive to the abuse history and mental health needs of the transgender women with whom they work."

A 2021 article in Pediatrics by a team of researchers found that "violence and victimization is not only widespread among a national sample of transgender and gender diverse (TGD) individuals but that it is often first encountered early in life as childhood abuse." The article also singled out "the growing body of research in which researchers emphasize that TGD adolescents' experiences often include childhood trauma."

As more and more transgender individuals share their personal stories, such statistics take on unexpected new life. Last month, The New York Times ran an essay called "What I Saw in My First 10 Years on Testosterone" by one more path-breaker, Thomas Page McBee. The first transgender man to box in Madison Square Garden, McBee celebrated the new trans confessional-ism. "The tide has turned," McBee wrote. "Our insistence that we be the architects of our own stories has only grown."

McBee's memoir Man Alive: A True Story of Violence, Forgiveness, and Becoming a Man, tells a terrifying story. It recounts years of sexual assault at the hands of the author's own father, beginning when McBee was four. The author writes: "It is still hard to capture the salty terror of the worst of it, the freeze, the split: how I lost a body, or how I conflated the two ways my body was lost to me."

These are searing, terrible words. And they suggest a clear logical leap from hating what is done to one's body, to rejecting that body.

What, if anything, might help the individuals scarred by such sufferings? Trauma deniers dismiss past abuses as inconvenient impediments to hormone shots and surgery. Such indifference ignores research documenting the multiple heavy crosses borne by abuse survivors. As a meta-analysis of studies concluded in a paper for Mayo Clinic Proceedings,"A history of sexual abuse is associated with an increased risk of a lifetime diagnosis of multiple psychiatric disorders." The fact that abuse so often entails other serious problems should alone demand higher scrutiny of any patients with such a history, transgender or otherwise. Given today's transition-first absolutism, a more nuanced approach would be a step forward in itself.

Second, the question of childhood trauma suggests that medical professionals take caution over protocols that put hormones and scalpels first. Their current status as cure-alls surely incentivizes quick-buck diagnosis. It also disincentivizes extended therapy and non-hormonal medications that might deliver authentic, long-term relief.

Trauma deniers insist that transition-forward medical professionals know best. But as history has lately shown, well-meaning doctors buffeted between suffering patients and aggressive medical marketing can make catastrophic mistakes—especially when substantial industry profits are on the line. Last time around, just such a toxic triad produced the greatest self-inflicted public-health catastrophe in American history: the opioid crisis. As we learned then, or should have, the fact that desperate patients will beg doctors for specific products should not trump the Hippocratic Oath.

No one is suggesting a unified field theory about anything as complicated as transgenderism. But at a minimum, the troubling autobiographical details offered up by some transgender and non-binary individuals themselves suggest new grounds for questioning the current consensus.

Mary Eberstadt holds the Panula Chair in Christian Culture at the Catholic Information Center, and is a senior research fellow with the Faith and Reason Institute.

The views expressed in this article are the writer's own.