Kenneth J. Zucker is a Jewish American-Canadian psychologist and sexologist, and head of the child and adolescent gender identity clinic at Toronto's Centre for Addiction and Mental Health.[1] Based on his collaboration with Susan Bradley, Zucker is considered an international authority in the field of gender identity disorder in children (GIDC) and in adolescents.[2] His clinic has probably diagnosed more GIDC than any other facility in the world.[3]
Zucker is also a Professor with the Departments of Psychiatry and Psychology at the University of Toronto. He was named editor-in-chief of Archives of Sexual Behavior in 2001. In 2007 Zucker was chosen to be a member of the American Psychological Association Task Force on Gender Identity, Gender Variance, and Intersex Conditions, and in 2008 was named chair of the American Psychiatric Association workgroup on "Sexual and Gender Identity Disorders" for the 2012 edition of the DSM-5. He previously served on workgroups for the DSM-IV and the DSM-IV-TR.[4]
Contents |
Zucker was born in New York.[5] Zucker received his B.A. from Southern Illinois University, his M.A. from Roosevelt University, and his Ph.D. from University of Toronto in 1982. He holds a C. Psych. certification.
Zucker's graduate work in developmental psychology resulted in his master's thesis on normative gender identity development in children. While in graduate school, Zucker met his future collaborator Susan J. Bradley, a child psychiatrist on staff at the Child and Adolescent Service (now the Child and Family Studies Centre) at the Centre for Addiction and Mental Health (then, the Clarke Institute of Psychiatry), a public mental health centre and a teaching hospital of the University of Toronto Faculty of Medicine.
According to his biography, "Zucker's awe of the imposing Clarke Institute edifice inspired him to meet with the then chief of psychology, Dr. Kingsley Ferguson", who told Zucker of Bradley's new working group to assess children and adolescents with gender identity problems.[6] Zucker had read Richard Green's 1974 book Sexual Identity Conflict in Children and Adults and was convinced to join Bradley's group.
Since the mid-1970s Zucker has treated about 500 preadolescent gender-variant children to "help these kids be more content in their biological gender" until they are older and can determine their sexual identity.[7] For children assigned as males at birth, Zucker orders parents to take away their child's "feminine" toys and instruct the child not to play with or draw pictures of girls.[8] Psychologist Darryl Hill describes Zucker's approach to gender-variant children:
Zucker and Bradley believe that reparative treatments (encouraging the child to accept their natal sex and associated gender) can be therapeutic for several reasons. They believe that treatment can reduce social ostracism by helping gender non-conforming children mix more readily with same sex peers and prevent long-term psychopathological development (i.e., it is easier to change a child than a society intolerant of gender diversity). Reparative therapy is believed to reduce the chances of adult GID (i.e., transsexualism) which Zucker and Bradley characterize as undesirable.[9]
Zucker is at odds with gay and transsexual groups, but distances himself from organizations that share this distinction. Zucker believes that failing to control a child's gender expression at a young age and seek early counseling for transgendered behavior is neglectful. He claims some parents have been swayed by an activist transsexual agenda to "cement...in more and more" behaviors that may not result from transsexualism. Instead Zucker advises such children work through their hatred of their bodies before being accepted as transsexuals. His work shows an 80-90% success rate in swaying children from later transsgender identification.[10]
Following in the footsteps of Dr. John Money, Zucker supports the early intervention of children with ambiguous genitalia to be assigned and reared as female, or more generally as "the gender that carries the best prognosis for good reproductive function, good sexual function, normal-looking external genitalia and physical appearance, and a stable gender identity." He published results of two patients, one of Money's and one of his own. Male by birth, both suffered ablatio penis and were shortly thereafter reassigned as females. At age 26 both denied ever feeling the desire to be male. Both patients reported more masculine behaviors and bisexuality, about which Zucker suspects that gender role and sexual orientation develop mostly before birth while gender identity development begins shortly after birth.[11]
Zucker says parents set the goals at his clinic. "We recommend that one goal be to help the child feel more secure about his or her actual gender, another to deal with the child's emotional difficulties, and a third to help with problems in the family. It's helpful to have parents set limits on things like cross-dressing, which many parents have not done before coming to us."[12] Zucker's follow-up of 50 treated children found that "about 10 percent are still very unhappy about their gender, still cross-dressing, and thinking about having sex reassignment surgery" as young adults.[12] Zucker has stated that "the therapist must rely on the 'clinical wisdom' that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions."[13]
Zucker coauthored a statistical report with J. Michael Bailey that found gays and lesbians exhibited more cross-gender activity as children.[14] Bailey claims Zucker considers transsexualism a "bad outcome" for these children, specifically citing the risks and hassle of sex change operations.[15]
For adolescent clients expressing gender identity disorder, Zucker's treatment protocol resembles that for adult GID, consisting of hormone replacement therapy to aid the adolescent in a social transition. Since sex reassignment surgery is not generally performed on minors in North America, Zucker's clinic does not provide recommendations for it – instead, clients are encouraged to pursue reassignment through the adult Gender Identity Clinic at CAMH, which controls funding for the procedure in Ontario.
Critics cite "'reparative' therapy that seeks to reverse sexual orientation or gender identification"[16] as an "extreme example" of bias that may hamper effectiveness of care, an approach that "may lead to increased self hatred and mental health problems." [17] Clinicians have called Zucker's therapeutic intervention "something disturbingly close to reparative therapy for homosexuals." [18] Journalist Marc Lostracco described Zucker's therapy as "problematic and harsh.",[19] and author Phyllis Burke wrote, "The diagnosis of GID in children, as supported by Zucker and Bradley, is simply child abuse." [20] Zucker dismisses Burke's book as "simplistic" and "not particularly illuminating;" journalist Stephanie Wilkinson said Zucker characterized Burke's book as "the work of a journalist whose views shouldn't be put into the same camp as those of scientists like Richard Green or himself."[5]
LGBT activists protested Zucker's 2008 appointment to the DSM-5 working group.[21][22] The National Gay and Lesbian Task Force issued a statement questioning the APA's decision to appoint Zucker and a second member of the work panel, Ray Blanchard, who argues that certain manifestations of transgender behavior should be classified as a paraphilia or transvestic fetishism, terms to which transgender advocates object. According to a response released by American Psychiatric Association, Zucker does not advocate reparative therapy for transgender adults or for trans youth in all cases, and he opposes change therapy for gays under all circumstances.[21]
According to the Web of Science, Zucker has published almost 100 articles in peer-reviewed journals. These articles have been cited over 2000 times, with an h-index of 20.[23]