The biggest problem with Zucker and his theories, I suspect, is that he's actually right part of the time. From the article, if I read it right, it seems like he has a pretty hard and fast rule of not trying to tinker with kids who are 13 years and older. He seems willing to accept evidence that on the face of it indicates the child is trans.

It's with the younger kids, especially the very young, where Zucker's theories (that of disbelieving that they could be truly trans and might be acting out some trauma or deficiency in their lives) probably do much more harm than good. But, his theoretical point might have some merit, that SOME children really aren't trans -- they're just going through a phase of some sort, or are gay.

One major problem with his gay theory, of course, is at that age (4 to 10) children are not normally sexualized unless they've been sexually molested, so their sexual preference would be entirely undeveloped at that age, even if it might in some sense be predictable. That is, they wouldn't be reacting against having sexual desire for the same sex and seeking to be the opposite sex to avoid being gay, simply because they're too young for sexual desire to have developed at all yet.

Another problem is that to a large extent, children ARE malleable. They will try to please their parents to seek love, even if it makes them miserable in the long run.

Yet, he does have a point. SOME children may just be going through a phase or working out some demons or lack in their family life. But, it's a point in search of a protocol. Unless some more definitive way is found of objectively identifying who is who, the bias of the therapist is treacherous. "Never ask a barber if you need a haircut," etc.

If you could tell in advance, which kid could benefit from encouragement to explore their birth gender, and which are truly rooted in the opposite one, it would be a slam-dunk to give the right kid the right treatment. So far, this seems like a field of study that's barely in its infancy. Zucker might some day get credit for inspiring it, but right now, today, he's just a barber who wants to give all these kids the same crewcut.

The clinicians who urge acceptance of the transgender nature of the children, and the clinics providing puberty-blocking drugs are, to some extent, doing the same thing, treating all their patients with the same assumption. One big plus in their favor, of course, is that their clients seem much happier, by and large, at least in their identities if not in their environments. But, there is always a danger that someone might enter such a program and not be one of the patients who really need it. Once in the program, though, their path is pretty well set. Puberty-blockers, followed by cross-gender hormones, along with a growing brain is likely to be a self-fulfilling prophecy.

This raises ethical questions. If the treatment itself is, so to speak, chemically reinforcing of the initial impression, then will the clinician have erred in not "salvaging" any borderline cases? The Dutch seem to have more intensive confirmation protocols in place than some of the other centers and individual practicioners cited.

Environment can not be discounted, either. If a transgender child is fated to be hounded and tormented by classmates and neighbors, the outcome can be devastating no matter what the clinical treatment is.

So, my depressing take on the situation is that while it is conceivably dangerous to take everything at face value all the time, so is it dangerous to make untestable assumptions that things are not as they seem. I don't know what the answer is.

I guess that's why I'm not rich and famous.