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Little Boxes
From the time she could talk, Maggie* has told her parents that she is a boy. She doesn’t say, “I want to be a boy.” She doesn’t say, “I feel like a boy.” She says, “I am a boy.” She tells her classmates, too. Lately—she’s in elementary school now—they’ve been having debates about it. “Maggie’s a boy,” one kid said recently, in a not-unfriendly, matter-of-fact sort of way.
“No, you idiot,” countered another. “She’s a girl. She’s wearing pink shoes.”
On a recent Tuesday morning, psychologist Kenneth Zucker tells this story at a weekly group supervision meeting, where he reviews cases with his dozen graduate students and postdocs. “As if, ‘duh’—it’s so obvious,” he says, and the room chuckles along with him.
Head of the child and adolescent gender-identity clinic at Toronto’s Centre for Addiction and Mental Health, Zucker is one of North America’s most widely published experts in the field of transgender and gender-variant^11. *Gender-variant*: stereotypical behavior associated with one’s gender. Because “variant” may connote deviance, the term is being replaced by “gender nonconfor (adj) acting in a manner that varies from the ming.” children. Since it was established in the mid-1970s, his clinic has assessed more than 600 kids with gender-variant behavior and gender dysphoria—the distress that results from feeling that one’s body does not match one’s sense of self. He has treated more than 100 of those children.
Given how early dysphoria can emerge in kids like Maggie and how deeply it cuts to the core of who they are, a growing number of therapists, doctors, and parents are advocating an early gender transition: If Maggie says she’s a boy, then it’s our duty to believe him and treat him as such. Given the very real risks to transgender people who remain in the closet—at one prominent clinic for transgender adolescents and young adults, 20 percent of patients have engaged in cutting or other self-mutilation, and almost 10 percent have attempted suicide—those in this camp say that to deny that Maggie is a boy is to set the child up for a lifetime of repression and pain.
Zucker, on the other hand, believes that girls who say they are boys are not expressing their true identity. Rather, they are confused. Their mismatched gender identity is likely the result of a childhood experience or trauma, or a manifestation of some underlying psychiatric or family problem. The situation will only be made worse, he argues, if parents and teachers encourage it. Zucker’s aim, if a family comes in with a kid like Maggie, is to make her more comfortable in her own body: to make her understand that she is a girl.
“We don’t know why Maggie mislabeled herself as a boy when she was younger,” Zucker says. “Was it because she was in some home day-care thing where she was around a lot of boys?”
One of Zucker’s doctoral students has been working with Maggie in play therapy. The student, Julia Vinik, pulls out a drawing that she and Maggie made together. Four stick figures represent a girl who likes to play sports, a girl who likes to play with dolls, a boy who likes to play sports, and a boy who likes to play with dolls. Vinik had asked Maggie which one she was. “She first went to circle the boy,” Vinik recounts at the supervision meeting. “And then stopped herself and said, ‘Wait a minute. Can you make another one here called tomboy?’
“I asked her, ‘What’s a tomboy?’
“‘It’s a girl who likes to do boy things.’
“I said, ‘Do you think there’s one already here like that?’”
Maggie pointed to the girl who likes sports. “She said, ‘Oh yeah, that’s a tomboy,’” Vinik tells her colleagues. “And she decided this one over here”—Vinik points to the boy who likes dolls—“would be called a tomgirl.” Everyone chuckles. Vinik recounts how Maggie then pointed again to the tomboy. “‘OK,’ she said, ‘This is me.’”
“That was very encouraging,” Vinik says. “She didn’t see herself as a boy anymore.”
This kind of therapy is precisely what worries Zucker’s critics. “That looks like psychodynamic free play, but it’s really coercive,” says Herb Schreier, a San Francisco Bay Area psychiatrist who has worked with children as young as kindergarteners to help facilitate gender transition. Schreier is part of a consortium of some 30 Bay Area psychiatrists, psychologists, and therapists who work with gender-variant children and their families. He’s one in a large and growing chorus of voices that accuse Zucker of relying on regressive gender stereotypes and practicing a thinly veiled version of 1950s-style reparative therapy^22. *Reparative therapy*: (noun) any clinical practice that aims to change a gay person’s sexual orientation to heterosexual. Also known as conversion therapy, it was widespread in the years homosexuality was considered a mental illness; it is now regarded as unethical since it is both ineffective—not a single peer-reviewed scientific study has demonstrated that orientation can be changed at will—and harmful, since it fosters shame and self-aversion. Still, according to the Southern Poverty Law Center, nearly 70 therapists in 20 states and D.C. currently advertise that they practice conversion therapy. Many are affiliated with fundamentalist Christian groups., which was used to “cure” homosexuality.
“The therapy session starts with an incredible assumption: that these kids have a problem. ‘We’re trying to figure out what problem you’re dealing with that gives you this particular way of being.’ It’s not a neutral therapy if it starts with that premise,” Schreier says. “Any therapy that starts with that assumption is bound to be problematic. In essence, he’s asking parents to deny who the kids say they are.”
Schreier characterizes Zucker’s approach as, “I think we should change them, and this would be for their betterment.” To Schreier and his colleagues, this sounds ominously paternalistic. “We would strongly raise the point: Isn’t there a downside to be had by denying a child’s identity?”
Zucker’s peers have written detailed, impassioned critiques of his work and his theories in professional journals—to which he writes detailed rebuttals—and his lectures and panels at professional meetings are often peppered with hostile questions and comments. A quick Google search turns up scathing, profanity-laced takedowns of Zucker and his clinic, including one calling Toronto the “global epicenter for oppression of sex and gender minorities.”
“The reason there is such dislike of and distrust for Dr. Zucker in the community is because he holds a position of immense power,” says Madeline Deutsch, a Bay Area emergency-room physician specializing in transgender health care. Since he publishes so widely, and edits an influential journal in the field, Zucker’s opinions matter. His opinions, she says, “fail to incorporate the very real empiric findings and experiences of other experts in the field, experienced clinicians, and activists … and instead remain focused on attempting to prove his own theories.”
Zucker does have a tone-deaf tendency to operate from the lofty perch of academia rather than engaging with communities on the ground. Despite a palpable empathy for his patients when he’s with them, in conversation with his colleagues he slots patients into scientific categories and describes their lives in psych-speak. Zucker doesn’t use the language or terminology that members of the trans community use to talk about themselves; instead, he refers to “homosexual persisters” and “homosexual desisters,” by which he means boys who grow up to be trans women and boys who grow up to be men. In meetings with his staff, he insists on referring to his patients—even those who have already begun to transition—by the pronouns of their birth sex. In an e-mail to me, he referred to a young patient by using that patient’s preferred gender pronouns in scare quotes: “… help us understand ‘his’ insistence/belief that ‘he’ ‘is’ a boy.”
The criticism of Zucker only became fiercer in 2008 when the American Psychiatric Association, which publishes the Diagnostic and Statistical Manual, or DSM—psychiatrists’ bible of mental disorders—announced that for the manual’s upcoming fifth edition, Zucker would chair the committee to revise the section on Sexual and Gender Identity Disorders. The National Gay and Lesbian Task Force issued a statement calling the appointment “extremely disappointing and disturbing.” In The Nation, Peter Rothberg called Zucker “retrograde” and encouraged readers to sign a petition opposing him. More than 9,000 people did. Circulated by the transgender community, the petition asked for Zucker’s resignation or removal, declaring that “in order to have any credibility in the field of gender identity, the DSM must not include discounted theories or junk science.”
The DSM is the primary tool by which psychiatrists and other mental-health professionals standardize, diagnose—and, crucially, bill insurance companies for—the mental-health problems their patients suffer. As the authoritative psychiatric guide for the National Institute of Mental Health, pharmaceutical companies, and other national and international organizations, the book’s practical and cultural significance is hard to overstate.
It’s also a historically loaded book for the LGBT community. Until 1973, homosexuality was listed as a mental disorder, and it was under the guise of treating it as an illness that many psychiatrists offered reparative therapy. (The diagnosis also meant that gay psychiatrists, psychologists, and psychoanalysts were forced to remain closeted in order to practice.) It wasn’t until a huge push by the gay community—and with fierce resistance by many association members—that the diagnosis was removed.
Transgender advocates and activists say that in a generation we will see the diagnosis of gender identity disorder as equally ridiculous. “Being differently gendered is not a psychiatric problem,” says Lisa Mottet, director of the Transgender Civil Rights Project at the National Gay and Lesbian Task Force. “It’s a human variation.” Or, as the University of California, San Francisco, child psychologist Diane Ehrensaft writes in a recent journal article, “As with left-handed children, who are also a small minority of the population, I believe these children who experience this discord [between their bodies and their sense of self] are not abnormal, they simply vary from the norm.” Ehrensaft and Zucker have sparred publicly on this issue. Gender identity disorder in children, or GIDC, is “a diagnosis and implied treatment that pathologizes perfectly healthy children who are simply expressing their authentic gender identity,” Ehrensaft writes. “The job of the clinician is not to ward off a transgender outcome, but to facilitate the child’s authentic gender journey.”
At the heart of the debate between Zucker and his critics lie fundamental questions: Are transgender people “born this way,” as people who support early gender transition argue? Or is gender a set of learned behaviors, a mix of “biological factors, psychosocial factors, social cognition,” and other mechanisms, as Zucker argues?
For Zucker, these questions are partly matters of scientific and intellectual curiosity. But for gender-variant kids, the stakes are much higher: If being transgender is part of one’s hard wiring, then to try to change kids like Maggie would be impossible at best, psychologically destructive at worst. Therapy that aims to change gay people’s sexual orientation is condemned as harmful and unethical by a slew of major professional organizations, including the American Psychiatric Association. Gay people subjected to conversion therapy as children have higher rates than their counterparts of depression, anxiety, and self-harm, including suicide.
Critics say that Zucker’s approach will have the same effect on trans kids: It will teach them from an early age that a fundamental part of their identity is wrong. What’s more, if these kids aren’t truly changed—if they simply learn to hide their identity until they are old enough to make autonomous decisions—then aside from the psychological harm caused by this hiding are issues of physical comfort and safety: Those who transition later in life have a harder time being perceived as the gender they identify with and require many more surgeries.
The argument about the origin of our gender identity has been simmering for decades, particularly among feminist theorists. On one side is the view called “social constructionism”: the idea that everything we know about what it means to be a man and a woman is something we learn, through subtle cues and explicit lessons, from our parents, TV, the world around us. The flip side is “essentialism,” a word radical feminists have used derisively, snubbing their noses at the idea that there might be something hardwired into women’s brains to make them more inclined to like lipstick and less inclined to fix a leaky faucet.
It’s not just the drag queens, social constructionists argue; we’re all in drag, performing our gender as surely as RuPaul does. Gender is “a kind of persistent impersonation that passes as the real,” writes social constructionist Judith Butler in her seminal 1990 work, Gender Trouble. Or, as Simone de Beauvoir famously said, “One is not born a woman, but, rather, becomes a woman.”
To embrace social constructionism means that there is no “born this way,” no born any way, except with a body around which the world begins spinning meaning and symbolism even before we are born. (See: blue nurseries, “it’s a girl” balloons, and, the latest, “gender reveal parties.”) So to hear the politically progressive, trans-positive community embrace essentialism, and then to hear Zucker, the man they accuse of being retrograde, embrace social constructionism is enough to make one’s head spin. Until you remember the gay gene.
When, in the early 1990s, geneticists discovered a relationship between homosexuality and certain genetic markers, many members of the gay community embraced these findings, using them as the basis of a new push for acceptance. If we were born this way, the argument went, then you can’t hold it against us; we can’t help it. Indeed, the work of these geneticists was read from the floors of many a senate chamber, and the “gay gene” was part of what turned the tide of public opinion in favor of compassion and nondiscrimination.
But this emphasis on biological determinism is discomfiting. First of all, even if gay folks weren’t born this way—even if they “learn” to be gay or develop the identity over time as a result of complex social processes—why would that make it any easier to change their identities? Second, there’s something apologetic about the whole premise that the world should accept gay people because they can’t help being gay. The unspoken part two of that argument is that if they could change, they surely would—or should.
It’s now widely accepted that no amount of therapy can change a person’s sexual orientation, and Zucker says he would not try to do so. But gender identity and sexual orientation are not the same thing. Sexual orientation is a matter of whom you are sexually attracted to. Gender identity is more elemental: It’s who you feel in your bones that you are. Zucker’s critics say that most transgender children know precisely who they are. “These kids come out very early and say, ‘Mommy, I’m in the wrong body,’” Schreier says.
Sure, Zucker says, but that doesn’t make it a fait accompli. Children’s gender identity is plastic and malleable, he says, shaped and formed by the world around them, by the feedback they receive, by the emotional resonance of the things they do, by their personal relationships, even by the clothes they wear. If this is true, then it should be possible for these kids to change.
Zucker is quick to point out that his clinic has referred more than 60 kids for the medical interventions required to begin their transitions; a paper he wrote on the subject was, in fact, the first such study published in North America. By age 11 or 12, he concedes, trans kids are typically “locked in” to their gender identity, and for them, “I very much support that pathway, because I think that is going to help them have a better quality of life.” But it’s different, he says, for younger kids. “If a child can grow up and feel comfortable in his or her own skin that matches their birth sex,” Zucker argues, “then you avoid the complexity of fairly serious surgical treatments. Penectomy and castration are not the same thing as having mild and minor cosmetic surgery. Lifelong hormonal therapy. It’s serious.”
It’s not just the medical interventions, he says. “One could argue, like many things, that there’s a strong value component to it. Holding everything else constant, at least at this point in time it’s relatively easier to grow up with a gender identity that matches your birth sex.”
That may be true. But for how much longer? Society is changing. The alphabet soup of LGB—lesbian, gay, bisexual—has, bit by bit, broadened, first to include “T” for transgender, and, more recently, to become the unwieldy LGBTQQIAA, which includes people who identify as queer, questioning, intersex^33. *Intersex*: (noun or adj) someone whose genitals, chromosomes, hormonal systems—or some combination of these—don’t fit the standard parameters for male or female. “Intersex” replaced the outdated and derogative term “hermaphrodite”; the more culturally neutral term is “disorder of sex development,” or DSD. As many as 1 in 100 people have a DSD like Turner Syndrome, androgen or estrogen insensitivity syndrome, and Klinefelter’s (or XXY) Syndrome.
4. *Genderqueer*: (adj) used to describe someone whose gender identity or gender expression blurs the line between masculine and feminine or rejects the binary of male and female altogether.
5. *Bi-gender*: (adj) identifying or presenting as female at some times and male at other times.
6. *Agender*: (adj) identifying as having no gender, which is known as “neutrois.” Agender people often prefer the pronoun “they” to the singular “he” or “she.”
7. *Two Spirit*: (noun) a traditional American Indian term for people who occupy a third gender category. Also known as berdaches, Two Spirits were typically genetic/physical men who did women’s work, cross-dressed, and formed relationships with non-berdache men; some tribes had additional gender categories for women who hunted and acted as warriors., asexual, and ally. “Transgender,” usually used broadly to encompass a range of gender-variant people (including transsexuals, the word traditionally used to describe people who make a full medical change to the “opposite” sex), is bursting at the seams as 21st-century gender identities proliferate. There are people who identify as genderqueer^4, bi-gender^5, agender^6, Two Spirit^7. There are trans people who choose surgery but no hormones, hormones but no surgery, or no medical interventions at all.
To the extent that Zucker builds upon this gender diversity by encouraging kids to widen their sense of what their gender can be—by helping kids feel comfortable as “tomboys” or “tomgirls,” or other gender inventions in between—he furthers the worthy cause of making the two traditional boxes bigger or helping to break them down, rather than stuffing kids inside them. At the same time, Zucker knows that the more society moves in this direction, the more his work becomes obsolete. “One could argue that with the emergence of gender-transition subculture, Western culture in some ways now has a third gender category,” Zucker says.
“Gender-transition subculture” is Zucker’s mildly dismissive go-to term for the approach of people like Schreier and Ehrensaft who advocate allowing gender transition for very young children in certain cases. “One could argue” is also a favorite formulation—it’s an easy way to distance himself from potentially controversial statements. He’s not necessarily arguing this, it seems to imply—just that one could. “It could be that in the next 10, 15 years, there will be more and more acceptance of extremely gender-variant kids, and the reaction will be, ‘Oh, he’s just a transgender.’ And we’ll see. If there is this greater acceptance, the argument that [not being transgender] is an easier pathway may be harder to make.”
Alex exemplifies the growing acceptance of gender diversity. Born with a girl’s body six years ago, Alex is “just a cool little kid, really,” says his mom, Andie. At school, he is a boy: boy clothes, boy hair, boy pronouns. “And at home, we respectfully—somewhat faking it, because I’m not 100 percent there—we treat Alex as a boy.”
Andie knew from the time Alex was a toddler that something was different. “I noticed that Alex gravitated towards playing with the boys,” Andie recalls. “She* preferred to do the boy things.” At three, Alex refused to put on a girl’s bathing suit. She refused to wear dresses, then she refused to wear skirts, and then “it got down to, if there was a little pleat that you wouldn’t even notice on the shoulder,” Alex would refuse to put it on. Still, Andie was herself a tomboy as a kid, so she mostly let Alex dress how she wanted and didn’t think much of it.
About halfway through Alex’s kindergarten year, Andie’s usually easygoing, happy kid seemed anxious and irritable. She discovered that Alex was polling kids at school: “Do you think I’m a boy or a girl?”
“And I go,” Andie says, “‘Why are you doing that? You’re obviously a tomboy.’
“‘Well, I want to be a boy.’
“I’m like, ‘Well, you’re not a boy.’ I had no idea, really, about issues like that.”
She went to talk to Alex’s teacher, who had noticed a similar change in Alex’s behavior. “It’s almost like she doesn’t know who to play with or what to do,” the teacher said. “Have you heard of gender dysphoria?”
Andie took a few weeks to think it over, do some research, and talk to her family. Then she called the principal. “Listen,” she said. “Alex thinks she’s a boy. So we need to somehow make Alex comfortable at school.” The principal said, “OK. I’ll make some calls.”
It was that easy. But it won’t necessarily stay easy.
In five or six years, as boys his age find their voices deepening and their upper lips darkening, Alex will begin to develop breasts and hips. He will get his period. Unless, that is, he begins the long journey of medical interventions that will allow him to stay a boy.
First there are hormone blockers, medications that are used to suppress puberty in one’s birth sex. These are fully reversible—an adolescent who stops taking them will begin puberty in their birth sex—and are meant to buy the child some time to mature enough before he or she makes irreversible choices.
For adolescents who continue their transition, hormone blockers also help to prevent later surgeries; a boy like Alex who never grows breasts in the first place need not have them removed. By around age 16, Alex could start on cross-sex hormones, which would deepen his voice, cause hair to grow on his face and his chest, and prompt the other hormonal changes of a typical teenage boy. Genital surgery—a much less common choice in transgender men since the surgical techniques are less advanced than they are for transgender women—can happen as early as age 18.
Andie admits that she would prefer Alex not go down this path. Not because she has a problem with him being transgender but because she hates giving her kids medication. “I don’t care what drug it is,” she says. “I don’t like the thought of kids putting drugs in their body. But I also want a kid that’s alive,” rather than at high risk for suicide. “My other little guy has epilepsy. So he has to take high levels of meds to keep his body safe. I’m going to try to look at this the same way. If that’s what Alex needs to feel secure, that’s what Alex will have.”
Andie brought Alex to Zucker’s clinic after Alex had already made his gender transition at school. She Googled Zucker only once her family had gotten to know him and was shocked by the criticism she read; she says he has been supportive of her approach and has never encouraged her to treat Alex like a girl.
“One starts, more or less, with where a family is at,” Zucker says. “I offered for us to see Alex in individual therapy to get a further and more in-depth understanding of Alex’s internal, subjective world. I think that both Andie and I are watching to see if Alex will develop any alternative ways of how Alex currently experiences ‘his’ gender.” Zucker stops short of saying that fostering these alternative ways is his aim. “It would have to be their aim,” he says of Alex’s family. “It’s not my job to impose it.”
With encouragement from Zucker, Andie reminds Alex that he could grow up to be anything—a girl, a boy, or anything in between—and tries to encourage him in any case to love his body. “My goal is for Alex,” she says, “to feel good about herself, and to have the tools she needs to be able to say, ‘Hey, this is who I am.’ I have no right to tell somebody that they’re something that they’re not.”
Alex plays on a local boys’ hockey team; his dad volunteered to coach so Alex would feel more comfortable playing. He goes snowboarding and dirt biking with his mom. In advance of Thanksgiving, Andie called her own mom—who is slowly coming around—to lay out the ground rules for their family dinner: “‘Refer to Alex as he, or I’m not OK with it.’” Andie’s family complied.
Andie doesn’t want Alex to talk to reporters, so I didn’t get to meet him. But as Andie was gathering him to leave after his therapy session, I couldn’t help but see his little snowboarder jacket and his mop of dark hair out of the corner of my eye. Zucker was bending down, hands on his knees, to look at the newly loose tooth Alex was excited to show off. “Now what,” Zucker said, with grandfatherly excitement, “do we have here?”
The industrial sign marking the bathroom in Zucker’s clinic is all-inclusive, with a hybrid male-female symbol indicating a myriad of gender possibilities. Zucker’s office door is papered with colorful marker drawings of smiling cartoon figures, trees, flowers, and houses. “Thank you!” several of them read, in rainbow letters. “I enjoyed being with you!” reads one. “Thanks for helping me,” reads another.
While countless individual therapists work with transgender kids on an individual basis, there are only about a dozen clinics for transgender kids and adolescents at major medical centers in the Western world. Most clinics take a “watchful waiting” approach. They advise against an early gender transition, instead counseling parents to find “a sensible middle-of-the-road approach,” as one clinic describes it—neither encouraging nor actively discouraging. A few, like Herb Schreier’s Bay Area group, will—in extreme cases—help children make an early gender transition. But none attempt to actively prevent transsexuality as Zucker does.
With short silver hair and beard, mismatched belt and shoes, and a perpetual pen stain on his shirt pocket, Zucker looks, and has the demeanor of, the workaholic grandfather that he is. The first thing you notice, talking to him, is his voice: Its deep basso timbre rumbles in a blend of Canadian and Midwestern accents. He has a dry sense of humor and a penchant for deadpan teasing that at times catches even friends off guard. “One of the things I told everybody that they really needed to think about today,” Zucker said at the opening of his Tuesday-morning clinic-supervision meeting, “was what to wear.” He never even broke a smile, but he was (mostly) joking that everyone should try to impress the visiting journalist. “I wore my best shirt and got here early and then”—he pointed to that day’s pen stain—“put my blue pen in upside down.”
Zucker grew up in suburban Skokie, Illinois, the older of two kids (his sister Barbara, he points out with an ironic smile, is nicknamed Barbie). His “intellectual, left--winger” Jewish parents were victims of McCarthy-era witch hunting—his dad lost several jobs, Zucker says, because he refused to “rat on his Commie friends.” In Zucker’s telling, they ultimately decided that “for the sake of their children, they needed to become conformist,” and they moved to the suburbs to “disappear from the scene—trapped in middle-class consumer subculture for the good of the cause.”
Born in 1950, Zucker came of age at the dawn of a different kind of scene. During our time together, Zucker happened to mention, in passing, a cow that stuck its head into his VW van at Woodstock and a summer he spent in Cambridge, Massachusetts, driving “the People’s Bus,” but when I pressed for more details, he would say only, “We’ll leave it at that.” What he will say is that he emerged from those times with a distaste for dogmatism and a sense that “maybe hiding in science is safer than fighting political, dogmatic battles.”
He regards his detractors as dogmatists. “I would say one thing that does bug me about some of the debates in this area is people’s supreme confidence that gender is a complete social construction, or that gender is completely biologically determined, or that this can all be explained by specific psychodynamic mechanisms.” Zucker calls himself a “gender agnostic.” He thinks that gender emerges as a mix of these elements, but he feels that the mechanisms are still far from clear.
His fascination with gender identities began while Zucker was a psychology graduate student and he read a book by UCLA psychiatrist Richard Green, whose pioneering work in the emerging field of sexology laid the groundwork for Zucker’s practice today. Green’s 1974 book Sexual Identity Conflict in Children and Adults was the first longitudinal, scientific description of a cohort of “feminine boys” and included transcripts of Green’s sessions with these boys and their families. Zucker was intrigued. “Identity is such a core part of what it means to be human,” he says, “and gender identity is such a core aspect of the self that it’s inherently interesting.”
When Green began his “Feminine Boy Project,” the research study on which his book (and The Sissy Boy Syndrome, a subsequent book) is based, his aim was to describe the “natural history” of transsexuals. He thought that by studying these boys early in life, he could watch their cross-gender identities unfold, like caterpillars in chrysalises. That’s not what happened. Green’s most striking finding was that only one of his 44 “sissy boys” turned out to be transsexual. Most of them—75 percent—grew up to be gay men. Subsequent studies led to similar findings: Gender-bending kids who grow up to be transsexual adults are the exception, not the rule.
This may be changing. Given increasing visibility and acceptance (think Chaz Bono, Transamerica, RuPaul), more and more people who challenge traditional gender stereotypes (from butch women to “sissy boys” to those whose gender identity is more fluid) feel empowered to take on the mantle of genderqueer or transgender—and, in some cases, to seek medical attention. Recent studies indicate that the number of people seeking treatment at gender clinics in the United Kingdom and Canada has risen sharply in the last five years.
Does this mean that Green’s numbers are an under-estimate—that with greater parental and societal acceptance more of his “sissy boys” would have grown up to be transgender? New data might help to answer this question. During the time I was in Toronto, Zucker talked a lot about a scholarly paper currently under review by a group of well-respected Dutch clinicians and researchers. In their group, kids like Alex who underwent an early gender transition were more likely than other gender-variant kids to be “persisters”—that is, to continue to identify as the opposite sex into adolescence and early adulthood.
Because the Dutch data seem to support Zucker’s theory—that the way parents respond to a child’s early gender dysphoria has an impact on whether it persists—the paper feels, to him, like something of a vindication. Herb Schreier sees the same data and reaches the opposite conclusion: The kids who transition early, he says, are the ones who identified themselves vocally and from an early age—the ones who were clearly going to persist anyway.
In the vast majority of these kids, however, gender dysphoria resolves on its own. In light of that, I asked Zucker, how do you know your interventions are working? He was honest: “I don’t think we know.”
As a child, Karl Bryant, now a sociologist at the State University of New York, New Paltz, “desperately wanted to be a girl, and I expressed it often,” he recalls. But this was the early 1960s—there was no early gender transition subculture—and Bryant was growing up in a small farming town about an hour from Los Angeles. So he became one of the earliest subjects of Richard Green’s Feminine Boy Project. He was enrolled in the “treatment” arm and had sessions with Green every other week.
Bryant liked Green and remembers trying hard to please him. “I knew at a certain point what the expectation was,” he recalls. Bryant wrote his Ph.D. dissertation on the politics of gender identity disorder, and he recounts the story in the introduction. “I remember occasionally trying to muster the kinds of masculine behaviors that I knew I was supposed to naturally express,” he writes. “Ultimately I learned to hide as best I could my feminine behaviors and identifications.”
Bryant grew up to be a happy, successful gay man, and he refuses to speculate how, or whether, things would have been different if his parents had allowed him to follow his fervent childhood wish to be a girl. But his “happy outcome,” he says, is despite, not because of, Green’s interventions. The study, he says, gave him the lasting impression that “the people closest to me, and that I trusted the most, disapproved of me in some profound way.” He says it’s hard to overstate the harm that such knowledge can inflict: “The study and the therapy that I received made me feel that I was wrong, that something about me at my core was bad, and instilled in me a sense of shame that stayed with me for a long time afterward.”
Zucker acknowledges “more similarities than differences” between his treatment and Green’s. “The UCLA group, Richard’s group, certainly had a big impact on me,” Zucker says. That said, developmental and cognitive psychology are much more sophisticated now than they were then, and Zucker says that the theoretical underpinnings of his work rely on much of this new research. For example, he bases his approach in part on the concept of “gender identity self-labeling.” Zucker explains: “You somehow, by the age of two or three, have recognized that gender is a social category. The world consists of males and females: mommies, daddies, men, women, boys.” Children figure out how to label themselves as a boy or a girl (how they do this is the big question, and one that has not been satisfactorily answered) and then “search out information in their environment: If I’m a girl, how is a girl supposed to behave? You look to the social environment.”
Take something as seemingly arbitrary as color preferences. In general, girls like pink and boys like blue. This is not just anecdotal, Zucker says; studies have confirmed “sex-dimorphic^88.*Sex-dimorphic*: (adj) used to describe a trait or characteristic that varies along gender lines—height, for instance, or the presence of facial hair. color preferences.” This isn’t because girls are “born” to like pink, Zucker says, but rather because they say to themselves, “‘I’m a girl. OK, so what do girls do?’ You have your own self-label and then you actively try to behave in a way that matches the label.” Zucker’s aim, then, is to broaden the kids’ sense of what someone of their birth sex can be. “Let’s say a little boy with a strong desire to be a girl, in part, has come to this because temperamentally he has a lot of trouble with rough-and-tumble play,” Zucker says. “And so recognizing that some kids might think in binary terms—‘I’m not like that, therefore, the only alternative is to be a girl.’ But if one can help kids realize there are different ways one can be a boy, maybe that lessens the wish to be a girl. Because one realizes, ‘Oh, I don’t have to be running around on a soccer field as the only way one can be a boy. I can do something else.’”
Zucker also relies on more traditional behavior--modification therapy, in which you reinforce or reward certain behaviors and ignore or discourage others. He encourages “limit setting,” like allowing your boy to wear a dress at home but not out of the house, for example, or only for a certain number of hours a day. But he stresses that each child’s treatment plan is individualized: For a kid like Alex, encouraging him to be flexible in the way he thinks about gender is as far as he’ll push. For a kid like Olivia, he felt comfortable going further. This is largely because Olivia’s parents felt comfortable going further.
Olivia is nine now. But from the time she was two, “She wouldn’t wear things if there were a pleat or a bow or a sparkle,” her mom, Erin, says. Olivia wouldn’t drink from a pink cup or eat off a pink plate. She refused to go to school on her birthday, because the teacher gave girls a princess crown to wear on that day. “And if there was a special day where I would tell her that a dress was required, there would quickly be juice dumped down the front of it.” Erin laughs recalling it. “Smart kid.”
Erin also noticed that Olivia couldn’t tolerate social situations. She got teased a lot at school, and at home, if Erin’s friends came over with their kids, Olivia would either go up to her room and shut the door or sit and rock in the corner—“almost like she was autistic,” Erin says.
By the time Olivia was four or five, they would argue about her gender constantly. “I would clarify—not understanding what the heck,” Erin recalls. “I would say, ‘Olivia, you’re a girl. You’re a bit of a tomboy. You’re a girl that likes boys’ things.’ Then it started into the whole dialogue of, ‘When am I going to become one?’ That’s when I realized that she needed help.”
Erin was referred to Zucker by a therapist she was seeing, but having read some of the criticisms of him online, she was wary. “My values are that you take people for who they are, and people can be whoever they want to be in life,” Erin says. “So if my daughter chooses to be a boy or chooses to be gay or whatever, so be it, and I’ll love them and support them and do whatever I can to make them happy in their world.”
But then Zucker asked her a question that stuck with her: “If your daughter said to you that she wanted to stay up until two in the morning, would you let her?” No, Erin told him. “Well,” Zucker continued, “she’s telling you that she’s a boy and is going to change into one. And she’s young enough that we think in this clinic that she’s confused, and you can clarify that for her. What do you think about that?”
Erin thought, “OK, let’s try this.”
The first thing Zucker encouraged them to do was to go shopping for clothes. “You’ll have to try to make her clothes gender-neutral,” Erin recalls Zucker saying to her. “We’re not telling you she’ll ever wear a dress. But you need to try to get her to grow her hair, get it so she’s not looking so much like a boy.” He also told her to be clear with Olivia why they were coming to the center for ongoing therapy sessions and why they were going shopping. Erin was nervous about it, because she knew it would upset her daughter, but she recalls, “I said, ‘You’re not going to be able to wear boys’ clothes anymore. So we’re going to go to the store, and you’re going to wear girls’ clothes because you’re a girl.’”
Zucker is mindful that clothes and hair length—not to mention toys and games, indeed, just about every outward sign of gender that he targets—are superficial. “Yet, if you look at normative studies of gender development, kids often use cues pertaining to hairstyle and clothing style to not only mark their own gender but to mark the gender of other kids,” Zucker says. “So those cues, or markers, are surface representations of a child’s underlying gender identity. And I think, in young childhood, there can be a feedback effect.”
If a young boy feels he is a girl, Zucker argues, then playing with Barbies is not as simple or as neutral as playing with blocks or puzzles. Part of the thrill of the Barbies for that boy is that they make him feel like a girl. Because he feels like a girl, he will continue to want to play with Barbies. And so on. “There is a back-and-forth between gender identity and surface behavior,” Zucker argues. “I’ve been trying little questions out lately, like: ‘If you like to eat leaves off tall trees, would that make you a giraffe?’ Some little kids fit that kind of thinking. Kids conflate identity with appearance.”
This was certainly true for Olivia. Finding gender--neutral girls’ clothes was a challenge, but she and her mom finally agreed on some collared shirts and cargo pants cut in a girl’s style. “What happened over time was, she stopped getting bullied at school because she stopped looking like a boy,” Erin says. “It would get her confidence going.”
On days that Olivia came home from school and complained that “so-and-so called me a boy,” Erin would steel herself and reply, “Well, you kinda look like one today, Liv. Your choice. I don’t know what you’re expecting.” Ultimately, Olivia “got to a point where she would get upset when people would get confused, calling her a boy. Even though originally that was what she wanted.”
The final recommendation her parents followed was to help Olivia make more female friends. She’d always had more boy friends than girl friends, but her parents enrolled her in girls’ soccer and hockey and were amazed at the difference it made. “The girls are like her,” Erin says. “They’re still more girly than her, but they’re rough, and when they go to a tournament, they’re just tearing around playing Hunger Games. They relate to her.”
Social interactions still don’t come easily for Olivia, but Erin feels the changes they made have helped give Olivia the confidence she needs to move through the world more peacefully. “I think that if I hadn’t gotten the help, I would have allowed her to continue to dress the way she was, and life would have been really tough,” says Erin. “I think she would have been very withdrawn and disturbed and had difficulty making friends, and been bullied.” Erin knows the future is still uncertain: “Who knows what she’s going to decide? Is she going to be gay? Is she going to be transgender? I don’t know. But I do know that she’s going to be a confident person and be her own person and feel like she can make her own choices, and recognize how to fit in and how society works. I think this place has saved her.”
There’s a chance, of course, that Olivia might feel otherwise later in life. “If your parents have brought you to Dr. Zucker to figure out your gender, and they are already perhaps less than supportive or [at] least nervous and confused, and then you sit in a play space with an authoritative doctor suggesting you play with a truck, what do you think the child would do?” asks emergency-room physician Madeline Deutsch, who is transgender. “I suspect that we will see a large number of Dr. Zucker’s former patients in their thirties, forties, or fifties seeking gender reassignment, only to regret having not been able to do so decades earlier.”
Traditional epidemiologic studies have assumed the prevalence of transgender people to be rare: somewhere in the neighborhood of 1 in 10,000. But recent studies show the numbers are much higher than previously thought (or are higher now than they used to be): 1 in 200, or even, in one recent sample of middle schoolers, 1 in 100. This means that only a tiny sliver of what may be a relatively large population of transgender people are showing up at clinics to make a medical transition. It speaks to the fact that in between living fully in one’s birth gender or undergoing all of the cross-gender interventions that Western medicine has to offer is a whole range of options that Zucker’s approach doesn’t account for.
“The proliferation of gender categories that represent people’s desires and experiences and identifications, those are fairly new,” Bryant says. So “to look at kids today who are gender-nonconforming and try to make some prediction about what they’re going to be when they grow up is really fraught. The things that they are going to be when they grow up don’t exist right now.”
Because of this proliferation, critics like Bryant say, Zucker is basing his work on an outdated conception of gender, suggesting parents radically change the way their children live—not let them play with the toys they choose, or wear the clothes that make them most comfortable, or play with the friends they most connect with—on the basis of a dubious guess that some tiny percentage of them will one day want to have sex-reassignment surgery. Or, worse, on the basis of societal prejudice: because the world will not accept them for who they are. This seems as unsettling as Zucker’s parents moving to the suburbs and conforming for the good of the cause. It’s fair to ask: Whose cause, exactly?
Although the DSM is strictly a diagnostic manual—it does not make treatment recommendations—implicit in the very existence of a diagnosis is the suggestion that it warrants treatment. This is largely the concern that transgender activists and mental-health professionals had when they heard that Zucker would be chairing the DSM’s Sexual and Gender Identity Disorders work group.
Zucker’s approach “has this default assumption that not identifying with the sex you were assigned at birth is in some way psychopathology,” says Karl Bryant. “It treats the gender of the child [as] a problem that merits some kind of correction.”
But transgender advocates concede that the new diagnostic criteria represent an improvement over the old. In the previous DSM, for instance, the bar seemed lower for diagnosing boys than girls: To meet the criteria, boys need only have a “preference for” wearing girls’ clothes, whereas girls had to “insist on” wearing boys’ clothes. In the new DSM, the language is more analogous. The new DSM, which will be published in May, also recognizes the limitations of the gender binary, noting that a child could express either “a strong desire to be of the other gender” or “some alternative gender different from one’s assigned gender.”
Still, whether the diagnosis should be in the DSM at all remains a contentious issue. Because hormone--replacement and sex-reassignment therapy cost tens of thousands of dollars, transgender people are in a bind: They need a diagnosis to get health-insurance coverage for their transition-related medical care. Zucker and his colleagues tried to address some of the community’s concerns by renaming the diagnosis “gender dysphoria.” This means that it’s not the identity that is a disorder but rather the distress that may result from that identity. A gender-variant kid—a boy who likes to wear dresses, for instance—wouldn’t automatically meet the criteria, unless the behavior caused him “clinically significant distress or impairment.” In other words, unless he were suffering.
The name change alone was a big deal, says psychiatrist Dan Karasic of the University of California, San Francisco, because it implies that “the distress of gender dysphoria is the pathology as opposed to gender identity.”
Zucker likes to say that the DSM is “agnostic” with regard to the origins of one’s suffering, but the question of where the distress originates is not a small one. Many kids in Zucker’s clinic come in with psychiatric and psychosocial issues. A quarter of them have been involved with child protective services and a quarter have attempted suicide. Zucker concedes that “experiences of ostracism, social rejection in the peer group, et cetera, does account for some” of the distress. But, he says, “I personally think that it’s too simplistic to say that it’s the peer ostracism or the stigma that explains it all. We see a lot of adolescents whose families are pretty supportive,” he continues. “They’re not being rejected. Their friends are chill. But they’re still very unhappy and very distressed and miserable. So even with external acceptance, the incongruence between somatic sex^99.*Somatic sex*: (noun) the sex implied by one’s physical body. People with gender dysphoria suffer a disconnect between their somatic sex—their physical sexual characteristics—and their gender identity. and felt gender is still very painful.”
For the most part, following his interpretation of the standards of care, Zucker will not recommend puberty suppressors or cross-gender hormone therapy for anyone whose psychiatric issues aren’t addressed first. His critics say this misses the point: Transitioning is addressing their psychiatric issues. By offering hormone therapy and other medical interventions, “you treat not only the medical hormonal deficiency and help them attain the body that they wish, but you are very likely to erase a whole bunch of psychopathology that’s all secondary,” says Norman Spack, an endocrinologist who runs the Gender Management Service at Boston Children’s Hospital. Spack says he has seen major depression, anxiety—even mild Asperger’s—resolve after kids are able to transition.
While I was in Toronto, a teenage patient of one of the other psychologists in the clinic came in for a follow-up visit. This person had the body of a female but covered his breasts in layers of binders and was so afraid to be read as a female that he wouldn’t leave the house, even for school—he attended high school online and ventured out only for his appointments and, once a week, to the in-person component of his curriculum. He told his psychologist, one of Zucker’s colleagues, that if she wouldn’t refer him for hormone therapy, he would kill himself. The colleague stopped by Zucker’s office to ask him what to do.
The standards of care say someone is ready for hormone therapy when he has lived successfully as his preferred gender for a period of time. Did this person qualify, if he never left the house? Is his extreme distress the result of his gender dysphoria? Or is the depression clouding the psychologists’ ability to get an accurate read on his gender identity? All these questions were theoretical, though. In the next room was a real patient who was suffering, and Zucker did what he thought was best: He referred him to the endocrinologist to begin hormone therapy.
*The names of Zucker’s patients and their family members have been changed to protect their privacy. Reported by The American Prospect 1 day ago.
“No, you idiot,” countered another. “She’s a girl. She’s wearing pink shoes.”
On a recent Tuesday morning, psychologist Kenneth Zucker tells this story at a weekly group supervision meeting, where he reviews cases with his dozen graduate students and postdocs. “As if, ‘duh’—it’s so obvious,” he says, and the room chuckles along with him.
Head of the child and adolescent gender-identity clinic at Toronto’s Centre for Addiction and Mental Health, Zucker is one of North America’s most widely published experts in the field of transgender and gender-variant^11. *Gender-variant*: stereotypical behavior associated with one’s gender. Because “variant” may connote deviance, the term is being replaced by “gender nonconfor (adj) acting in a manner that varies from the ming.” children. Since it was established in the mid-1970s, his clinic has assessed more than 600 kids with gender-variant behavior and gender dysphoria—the distress that results from feeling that one’s body does not match one’s sense of self. He has treated more than 100 of those children.
Given how early dysphoria can emerge in kids like Maggie and how deeply it cuts to the core of who they are, a growing number of therapists, doctors, and parents are advocating an early gender transition: If Maggie says she’s a boy, then it’s our duty to believe him and treat him as such. Given the very real risks to transgender people who remain in the closet—at one prominent clinic for transgender adolescents and young adults, 20 percent of patients have engaged in cutting or other self-mutilation, and almost 10 percent have attempted suicide—those in this camp say that to deny that Maggie is a boy is to set the child up for a lifetime of repression and pain.
Zucker, on the other hand, believes that girls who say they are boys are not expressing their true identity. Rather, they are confused. Their mismatched gender identity is likely the result of a childhood experience or trauma, or a manifestation of some underlying psychiatric or family problem. The situation will only be made worse, he argues, if parents and teachers encourage it. Zucker’s aim, if a family comes in with a kid like Maggie, is to make her more comfortable in her own body: to make her understand that she is a girl.
“We don’t know why Maggie mislabeled herself as a boy when she was younger,” Zucker says. “Was it because she was in some home day-care thing where she was around a lot of boys?”
One of Zucker’s doctoral students has been working with Maggie in play therapy. The student, Julia Vinik, pulls out a drawing that she and Maggie made together. Four stick figures represent a girl who likes to play sports, a girl who likes to play with dolls, a boy who likes to play sports, and a boy who likes to play with dolls. Vinik had asked Maggie which one she was. “She first went to circle the boy,” Vinik recounts at the supervision meeting. “And then stopped herself and said, ‘Wait a minute. Can you make another one here called tomboy?’
“I asked her, ‘What’s a tomboy?’
“‘It’s a girl who likes to do boy things.’
“I said, ‘Do you think there’s one already here like that?’”
Maggie pointed to the girl who likes sports. “She said, ‘Oh yeah, that’s a tomboy,’” Vinik tells her colleagues. “And she decided this one over here”—Vinik points to the boy who likes dolls—“would be called a tomgirl.” Everyone chuckles. Vinik recounts how Maggie then pointed again to the tomboy. “‘OK,’ she said, ‘This is me.’”
“That was very encouraging,” Vinik says. “She didn’t see herself as a boy anymore.”
This kind of therapy is precisely what worries Zucker’s critics. “That looks like psychodynamic free play, but it’s really coercive,” says Herb Schreier, a San Francisco Bay Area psychiatrist who has worked with children as young as kindergarteners to help facilitate gender transition. Schreier is part of a consortium of some 30 Bay Area psychiatrists, psychologists, and therapists who work with gender-variant children and their families. He’s one in a large and growing chorus of voices that accuse Zucker of relying on regressive gender stereotypes and practicing a thinly veiled version of 1950s-style reparative therapy^22. *Reparative therapy*: (noun) any clinical practice that aims to change a gay person’s sexual orientation to heterosexual. Also known as conversion therapy, it was widespread in the years homosexuality was considered a mental illness; it is now regarded as unethical since it is both ineffective—not a single peer-reviewed scientific study has demonstrated that orientation can be changed at will—and harmful, since it fosters shame and self-aversion. Still, according to the Southern Poverty Law Center, nearly 70 therapists in 20 states and D.C. currently advertise that they practice conversion therapy. Many are affiliated with fundamentalist Christian groups., which was used to “cure” homosexuality.
“The therapy session starts with an incredible assumption: that these kids have a problem. ‘We’re trying to figure out what problem you’re dealing with that gives you this particular way of being.’ It’s not a neutral therapy if it starts with that premise,” Schreier says. “Any therapy that starts with that assumption is bound to be problematic. In essence, he’s asking parents to deny who the kids say they are.”
Schreier characterizes Zucker’s approach as, “I think we should change them, and this would be for their betterment.” To Schreier and his colleagues, this sounds ominously paternalistic. “We would strongly raise the point: Isn’t there a downside to be had by denying a child’s identity?”
Zucker’s peers have written detailed, impassioned critiques of his work and his theories in professional journals—to which he writes detailed rebuttals—and his lectures and panels at professional meetings are often peppered with hostile questions and comments. A quick Google search turns up scathing, profanity-laced takedowns of Zucker and his clinic, including one calling Toronto the “global epicenter for oppression of sex and gender minorities.”
“The reason there is such dislike of and distrust for Dr. Zucker in the community is because he holds a position of immense power,” says Madeline Deutsch, a Bay Area emergency-room physician specializing in transgender health care. Since he publishes so widely, and edits an influential journal in the field, Zucker’s opinions matter. His opinions, she says, “fail to incorporate the very real empiric findings and experiences of other experts in the field, experienced clinicians, and activists … and instead remain focused on attempting to prove his own theories.”
Zucker does have a tone-deaf tendency to operate from the lofty perch of academia rather than engaging with communities on the ground. Despite a palpable empathy for his patients when he’s with them, in conversation with his colleagues he slots patients into scientific categories and describes their lives in psych-speak. Zucker doesn’t use the language or terminology that members of the trans community use to talk about themselves; instead, he refers to “homosexual persisters” and “homosexual desisters,” by which he means boys who grow up to be trans women and boys who grow up to be men. In meetings with his staff, he insists on referring to his patients—even those who have already begun to transition—by the pronouns of their birth sex. In an e-mail to me, he referred to a young patient by using that patient’s preferred gender pronouns in scare quotes: “… help us understand ‘his’ insistence/belief that ‘he’ ‘is’ a boy.”
The criticism of Zucker only became fiercer in 2008 when the American Psychiatric Association, which publishes the Diagnostic and Statistical Manual, or DSM—psychiatrists’ bible of mental disorders—announced that for the manual’s upcoming fifth edition, Zucker would chair the committee to revise the section on Sexual and Gender Identity Disorders. The National Gay and Lesbian Task Force issued a statement calling the appointment “extremely disappointing and disturbing.” In The Nation, Peter Rothberg called Zucker “retrograde” and encouraged readers to sign a petition opposing him. More than 9,000 people did. Circulated by the transgender community, the petition asked for Zucker’s resignation or removal, declaring that “in order to have any credibility in the field of gender identity, the DSM must not include discounted theories or junk science.”
The DSM is the primary tool by which psychiatrists and other mental-health professionals standardize, diagnose—and, crucially, bill insurance companies for—the mental-health problems their patients suffer. As the authoritative psychiatric guide for the National Institute of Mental Health, pharmaceutical companies, and other national and international organizations, the book’s practical and cultural significance is hard to overstate.
It’s also a historically loaded book for the LGBT community. Until 1973, homosexuality was listed as a mental disorder, and it was under the guise of treating it as an illness that many psychiatrists offered reparative therapy. (The diagnosis also meant that gay psychiatrists, psychologists, and psychoanalysts were forced to remain closeted in order to practice.) It wasn’t until a huge push by the gay community—and with fierce resistance by many association members—that the diagnosis was removed.
Transgender advocates and activists say that in a generation we will see the diagnosis of gender identity disorder as equally ridiculous. “Being differently gendered is not a psychiatric problem,” says Lisa Mottet, director of the Transgender Civil Rights Project at the National Gay and Lesbian Task Force. “It’s a human variation.” Or, as the University of California, San Francisco, child psychologist Diane Ehrensaft writes in a recent journal article, “As with left-handed children, who are also a small minority of the population, I believe these children who experience this discord [between their bodies and their sense of self] are not abnormal, they simply vary from the norm.” Ehrensaft and Zucker have sparred publicly on this issue. Gender identity disorder in children, or GIDC, is “a diagnosis and implied treatment that pathologizes perfectly healthy children who are simply expressing their authentic gender identity,” Ehrensaft writes. “The job of the clinician is not to ward off a transgender outcome, but to facilitate the child’s authentic gender journey.”
At the heart of the debate between Zucker and his critics lie fundamental questions: Are transgender people “born this way,” as people who support early gender transition argue? Or is gender a set of learned behaviors, a mix of “biological factors, psychosocial factors, social cognition,” and other mechanisms, as Zucker argues?
For Zucker, these questions are partly matters of scientific and intellectual curiosity. But for gender-variant kids, the stakes are much higher: If being transgender is part of one’s hard wiring, then to try to change kids like Maggie would be impossible at best, psychologically destructive at worst. Therapy that aims to change gay people’s sexual orientation is condemned as harmful and unethical by a slew of major professional organizations, including the American Psychiatric Association. Gay people subjected to conversion therapy as children have higher rates than their counterparts of depression, anxiety, and self-harm, including suicide.
Critics say that Zucker’s approach will have the same effect on trans kids: It will teach them from an early age that a fundamental part of their identity is wrong. What’s more, if these kids aren’t truly changed—if they simply learn to hide their identity until they are old enough to make autonomous decisions—then aside from the psychological harm caused by this hiding are issues of physical comfort and safety: Those who transition later in life have a harder time being perceived as the gender they identify with and require many more surgeries.
The argument about the origin of our gender identity has been simmering for decades, particularly among feminist theorists. On one side is the view called “social constructionism”: the idea that everything we know about what it means to be a man and a woman is something we learn, through subtle cues and explicit lessons, from our parents, TV, the world around us. The flip side is “essentialism,” a word radical feminists have used derisively, snubbing their noses at the idea that there might be something hardwired into women’s brains to make them more inclined to like lipstick and less inclined to fix a leaky faucet.
It’s not just the drag queens, social constructionists argue; we’re all in drag, performing our gender as surely as RuPaul does. Gender is “a kind of persistent impersonation that passes as the real,” writes social constructionist Judith Butler in her seminal 1990 work, Gender Trouble. Or, as Simone de Beauvoir famously said, “One is not born a woman, but, rather, becomes a woman.”
To embrace social constructionism means that there is no “born this way,” no born any way, except with a body around which the world begins spinning meaning and symbolism even before we are born. (See: blue nurseries, “it’s a girl” balloons, and, the latest, “gender reveal parties.”) So to hear the politically progressive, trans-positive community embrace essentialism, and then to hear Zucker, the man they accuse of being retrograde, embrace social constructionism is enough to make one’s head spin. Until you remember the gay gene.
When, in the early 1990s, geneticists discovered a relationship between homosexuality and certain genetic markers, many members of the gay community embraced these findings, using them as the basis of a new push for acceptance. If we were born this way, the argument went, then you can’t hold it against us; we can’t help it. Indeed, the work of these geneticists was read from the floors of many a senate chamber, and the “gay gene” was part of what turned the tide of public opinion in favor of compassion and nondiscrimination.
But this emphasis on biological determinism is discomfiting. First of all, even if gay folks weren’t born this way—even if they “learn” to be gay or develop the identity over time as a result of complex social processes—why would that make it any easier to change their identities? Second, there’s something apologetic about the whole premise that the world should accept gay people because they can’t help being gay. The unspoken part two of that argument is that if they could change, they surely would—or should.
It’s now widely accepted that no amount of therapy can change a person’s sexual orientation, and Zucker says he would not try to do so. But gender identity and sexual orientation are not the same thing. Sexual orientation is a matter of whom you are sexually attracted to. Gender identity is more elemental: It’s who you feel in your bones that you are. Zucker’s critics say that most transgender children know precisely who they are. “These kids come out very early and say, ‘Mommy, I’m in the wrong body,’” Schreier says.
Sure, Zucker says, but that doesn’t make it a fait accompli. Children’s gender identity is plastic and malleable, he says, shaped and formed by the world around them, by the feedback they receive, by the emotional resonance of the things they do, by their personal relationships, even by the clothes they wear. If this is true, then it should be possible for these kids to change.
Zucker is quick to point out that his clinic has referred more than 60 kids for the medical interventions required to begin their transitions; a paper he wrote on the subject was, in fact, the first such study published in North America. By age 11 or 12, he concedes, trans kids are typically “locked in” to their gender identity, and for them, “I very much support that pathway, because I think that is going to help them have a better quality of life.” But it’s different, he says, for younger kids. “If a child can grow up and feel comfortable in his or her own skin that matches their birth sex,” Zucker argues, “then you avoid the complexity of fairly serious surgical treatments. Penectomy and castration are not the same thing as having mild and minor cosmetic surgery. Lifelong hormonal therapy. It’s serious.”
It’s not just the medical interventions, he says. “One could argue, like many things, that there’s a strong value component to it. Holding everything else constant, at least at this point in time it’s relatively easier to grow up with a gender identity that matches your birth sex.”
That may be true. But for how much longer? Society is changing. The alphabet soup of LGB—lesbian, gay, bisexual—has, bit by bit, broadened, first to include “T” for transgender, and, more recently, to become the unwieldy LGBTQQIAA, which includes people who identify as queer, questioning, intersex^33. *Intersex*: (noun or adj) someone whose genitals, chromosomes, hormonal systems—or some combination of these—don’t fit the standard parameters for male or female. “Intersex” replaced the outdated and derogative term “hermaphrodite”; the more culturally neutral term is “disorder of sex development,” or DSD. As many as 1 in 100 people have a DSD like Turner Syndrome, androgen or estrogen insensitivity syndrome, and Klinefelter’s (or XXY) Syndrome.
4. *Genderqueer*: (adj) used to describe someone whose gender identity or gender expression blurs the line between masculine and feminine or rejects the binary of male and female altogether.
5. *Bi-gender*: (adj) identifying or presenting as female at some times and male at other times.
6. *Agender*: (adj) identifying as having no gender, which is known as “neutrois.” Agender people often prefer the pronoun “they” to the singular “he” or “she.”
7. *Two Spirit*: (noun) a traditional American Indian term for people who occupy a third gender category. Also known as berdaches, Two Spirits were typically genetic/physical men who did women’s work, cross-dressed, and formed relationships with non-berdache men; some tribes had additional gender categories for women who hunted and acted as warriors., asexual, and ally. “Transgender,” usually used broadly to encompass a range of gender-variant people (including transsexuals, the word traditionally used to describe people who make a full medical change to the “opposite” sex), is bursting at the seams as 21st-century gender identities proliferate. There are people who identify as genderqueer^4, bi-gender^5, agender^6, Two Spirit^7. There are trans people who choose surgery but no hormones, hormones but no surgery, or no medical interventions at all.
To the extent that Zucker builds upon this gender diversity by encouraging kids to widen their sense of what their gender can be—by helping kids feel comfortable as “tomboys” or “tomgirls,” or other gender inventions in between—he furthers the worthy cause of making the two traditional boxes bigger or helping to break them down, rather than stuffing kids inside them. At the same time, Zucker knows that the more society moves in this direction, the more his work becomes obsolete. “One could argue that with the emergence of gender-transition subculture, Western culture in some ways now has a third gender category,” Zucker says.
“Gender-transition subculture” is Zucker’s mildly dismissive go-to term for the approach of people like Schreier and Ehrensaft who advocate allowing gender transition for very young children in certain cases. “One could argue” is also a favorite formulation—it’s an easy way to distance himself from potentially controversial statements. He’s not necessarily arguing this, it seems to imply—just that one could. “It could be that in the next 10, 15 years, there will be more and more acceptance of extremely gender-variant kids, and the reaction will be, ‘Oh, he’s just a transgender.’ And we’ll see. If there is this greater acceptance, the argument that [not being transgender] is an easier pathway may be harder to make.”
Alex exemplifies the growing acceptance of gender diversity. Born with a girl’s body six years ago, Alex is “just a cool little kid, really,” says his mom, Andie. At school, he is a boy: boy clothes, boy hair, boy pronouns. “And at home, we respectfully—somewhat faking it, because I’m not 100 percent there—we treat Alex as a boy.”
Andie knew from the time Alex was a toddler that something was different. “I noticed that Alex gravitated towards playing with the boys,” Andie recalls. “She* preferred to do the boy things.” At three, Alex refused to put on a girl’s bathing suit. She refused to wear dresses, then she refused to wear skirts, and then “it got down to, if there was a little pleat that you wouldn’t even notice on the shoulder,” Alex would refuse to put it on. Still, Andie was herself a tomboy as a kid, so she mostly let Alex dress how she wanted and didn’t think much of it.
About halfway through Alex’s kindergarten year, Andie’s usually easygoing, happy kid seemed anxious and irritable. She discovered that Alex was polling kids at school: “Do you think I’m a boy or a girl?”
“And I go,” Andie says, “‘Why are you doing that? You’re obviously a tomboy.’
“‘Well, I want to be a boy.’
“I’m like, ‘Well, you’re not a boy.’ I had no idea, really, about issues like that.”
She went to talk to Alex’s teacher, who had noticed a similar change in Alex’s behavior. “It’s almost like she doesn’t know who to play with or what to do,” the teacher said. “Have you heard of gender dysphoria?”
Andie took a few weeks to think it over, do some research, and talk to her family. Then she called the principal. “Listen,” she said. “Alex thinks she’s a boy. So we need to somehow make Alex comfortable at school.” The principal said, “OK. I’ll make some calls.”
It was that easy. But it won’t necessarily stay easy.
In five or six years, as boys his age find their voices deepening and their upper lips darkening, Alex will begin to develop breasts and hips. He will get his period. Unless, that is, he begins the long journey of medical interventions that will allow him to stay a boy.
First there are hormone blockers, medications that are used to suppress puberty in one’s birth sex. These are fully reversible—an adolescent who stops taking them will begin puberty in their birth sex—and are meant to buy the child some time to mature enough before he or she makes irreversible choices.
For adolescents who continue their transition, hormone blockers also help to prevent later surgeries; a boy like Alex who never grows breasts in the first place need not have them removed. By around age 16, Alex could start on cross-sex hormones, which would deepen his voice, cause hair to grow on his face and his chest, and prompt the other hormonal changes of a typical teenage boy. Genital surgery—a much less common choice in transgender men since the surgical techniques are less advanced than they are for transgender women—can happen as early as age 18.
Andie admits that she would prefer Alex not go down this path. Not because she has a problem with him being transgender but because she hates giving her kids medication. “I don’t care what drug it is,” she says. “I don’t like the thought of kids putting drugs in their body. But I also want a kid that’s alive,” rather than at high risk for suicide. “My other little guy has epilepsy. So he has to take high levels of meds to keep his body safe. I’m going to try to look at this the same way. If that’s what Alex needs to feel secure, that’s what Alex will have.”
Andie brought Alex to Zucker’s clinic after Alex had already made his gender transition at school. She Googled Zucker only once her family had gotten to know him and was shocked by the criticism she read; she says he has been supportive of her approach and has never encouraged her to treat Alex like a girl.
“One starts, more or less, with where a family is at,” Zucker says. “I offered for us to see Alex in individual therapy to get a further and more in-depth understanding of Alex’s internal, subjective world. I think that both Andie and I are watching to see if Alex will develop any alternative ways of how Alex currently experiences ‘his’ gender.” Zucker stops short of saying that fostering these alternative ways is his aim. “It would have to be their aim,” he says of Alex’s family. “It’s not my job to impose it.”
With encouragement from Zucker, Andie reminds Alex that he could grow up to be anything—a girl, a boy, or anything in between—and tries to encourage him in any case to love his body. “My goal is for Alex,” she says, “to feel good about herself, and to have the tools she needs to be able to say, ‘Hey, this is who I am.’ I have no right to tell somebody that they’re something that they’re not.”
Alex plays on a local boys’ hockey team; his dad volunteered to coach so Alex would feel more comfortable playing. He goes snowboarding and dirt biking with his mom. In advance of Thanksgiving, Andie called her own mom—who is slowly coming around—to lay out the ground rules for their family dinner: “‘Refer to Alex as he, or I’m not OK with it.’” Andie’s family complied.
Andie doesn’t want Alex to talk to reporters, so I didn’t get to meet him. But as Andie was gathering him to leave after his therapy session, I couldn’t help but see his little snowboarder jacket and his mop of dark hair out of the corner of my eye. Zucker was bending down, hands on his knees, to look at the newly loose tooth Alex was excited to show off. “Now what,” Zucker said, with grandfatherly excitement, “do we have here?”
The industrial sign marking the bathroom in Zucker’s clinic is all-inclusive, with a hybrid male-female symbol indicating a myriad of gender possibilities. Zucker’s office door is papered with colorful marker drawings of smiling cartoon figures, trees, flowers, and houses. “Thank you!” several of them read, in rainbow letters. “I enjoyed being with you!” reads one. “Thanks for helping me,” reads another.
While countless individual therapists work with transgender kids on an individual basis, there are only about a dozen clinics for transgender kids and adolescents at major medical centers in the Western world. Most clinics take a “watchful waiting” approach. They advise against an early gender transition, instead counseling parents to find “a sensible middle-of-the-road approach,” as one clinic describes it—neither encouraging nor actively discouraging. A few, like Herb Schreier’s Bay Area group, will—in extreme cases—help children make an early gender transition. But none attempt to actively prevent transsexuality as Zucker does.
With short silver hair and beard, mismatched belt and shoes, and a perpetual pen stain on his shirt pocket, Zucker looks, and has the demeanor of, the workaholic grandfather that he is. The first thing you notice, talking to him, is his voice: Its deep basso timbre rumbles in a blend of Canadian and Midwestern accents. He has a dry sense of humor and a penchant for deadpan teasing that at times catches even friends off guard. “One of the things I told everybody that they really needed to think about today,” Zucker said at the opening of his Tuesday-morning clinic-supervision meeting, “was what to wear.” He never even broke a smile, but he was (mostly) joking that everyone should try to impress the visiting journalist. “I wore my best shirt and got here early and then”—he pointed to that day’s pen stain—“put my blue pen in upside down.”
Zucker grew up in suburban Skokie, Illinois, the older of two kids (his sister Barbara, he points out with an ironic smile, is nicknamed Barbie). His “intellectual, left--winger” Jewish parents were victims of McCarthy-era witch hunting—his dad lost several jobs, Zucker says, because he refused to “rat on his Commie friends.” In Zucker’s telling, they ultimately decided that “for the sake of their children, they needed to become conformist,” and they moved to the suburbs to “disappear from the scene—trapped in middle-class consumer subculture for the good of the cause.”
Born in 1950, Zucker came of age at the dawn of a different kind of scene. During our time together, Zucker happened to mention, in passing, a cow that stuck its head into his VW van at Woodstock and a summer he spent in Cambridge, Massachusetts, driving “the People’s Bus,” but when I pressed for more details, he would say only, “We’ll leave it at that.” What he will say is that he emerged from those times with a distaste for dogmatism and a sense that “maybe hiding in science is safer than fighting political, dogmatic battles.”
He regards his detractors as dogmatists. “I would say one thing that does bug me about some of the debates in this area is people’s supreme confidence that gender is a complete social construction, or that gender is completely biologically determined, or that this can all be explained by specific psychodynamic mechanisms.” Zucker calls himself a “gender agnostic.” He thinks that gender emerges as a mix of these elements, but he feels that the mechanisms are still far from clear.
His fascination with gender identities began while Zucker was a psychology graduate student and he read a book by UCLA psychiatrist Richard Green, whose pioneering work in the emerging field of sexology laid the groundwork for Zucker’s practice today. Green’s 1974 book Sexual Identity Conflict in Children and Adults was the first longitudinal, scientific description of a cohort of “feminine boys” and included transcripts of Green’s sessions with these boys and their families. Zucker was intrigued. “Identity is such a core part of what it means to be human,” he says, “and gender identity is such a core aspect of the self that it’s inherently interesting.”
When Green began his “Feminine Boy Project,” the research study on which his book (and The Sissy Boy Syndrome, a subsequent book) is based, his aim was to describe the “natural history” of transsexuals. He thought that by studying these boys early in life, he could watch their cross-gender identities unfold, like caterpillars in chrysalises. That’s not what happened. Green’s most striking finding was that only one of his 44 “sissy boys” turned out to be transsexual. Most of them—75 percent—grew up to be gay men. Subsequent studies led to similar findings: Gender-bending kids who grow up to be transsexual adults are the exception, not the rule.
This may be changing. Given increasing visibility and acceptance (think Chaz Bono, Transamerica, RuPaul), more and more people who challenge traditional gender stereotypes (from butch women to “sissy boys” to those whose gender identity is more fluid) feel empowered to take on the mantle of genderqueer or transgender—and, in some cases, to seek medical attention. Recent studies indicate that the number of people seeking treatment at gender clinics in the United Kingdom and Canada has risen sharply in the last five years.
Does this mean that Green’s numbers are an under-estimate—that with greater parental and societal acceptance more of his “sissy boys” would have grown up to be transgender? New data might help to answer this question. During the time I was in Toronto, Zucker talked a lot about a scholarly paper currently under review by a group of well-respected Dutch clinicians and researchers. In their group, kids like Alex who underwent an early gender transition were more likely than other gender-variant kids to be “persisters”—that is, to continue to identify as the opposite sex into adolescence and early adulthood.
Because the Dutch data seem to support Zucker’s theory—that the way parents respond to a child’s early gender dysphoria has an impact on whether it persists—the paper feels, to him, like something of a vindication. Herb Schreier sees the same data and reaches the opposite conclusion: The kids who transition early, he says, are the ones who identified themselves vocally and from an early age—the ones who were clearly going to persist anyway.
In the vast majority of these kids, however, gender dysphoria resolves on its own. In light of that, I asked Zucker, how do you know your interventions are working? He was honest: “I don’t think we know.”
As a child, Karl Bryant, now a sociologist at the State University of New York, New Paltz, “desperately wanted to be a girl, and I expressed it often,” he recalls. But this was the early 1960s—there was no early gender transition subculture—and Bryant was growing up in a small farming town about an hour from Los Angeles. So he became one of the earliest subjects of Richard Green’s Feminine Boy Project. He was enrolled in the “treatment” arm and had sessions with Green every other week.
Bryant liked Green and remembers trying hard to please him. “I knew at a certain point what the expectation was,” he recalls. Bryant wrote his Ph.D. dissertation on the politics of gender identity disorder, and he recounts the story in the introduction. “I remember occasionally trying to muster the kinds of masculine behaviors that I knew I was supposed to naturally express,” he writes. “Ultimately I learned to hide as best I could my feminine behaviors and identifications.”
Bryant grew up to be a happy, successful gay man, and he refuses to speculate how, or whether, things would have been different if his parents had allowed him to follow his fervent childhood wish to be a girl. But his “happy outcome,” he says, is despite, not because of, Green’s interventions. The study, he says, gave him the lasting impression that “the people closest to me, and that I trusted the most, disapproved of me in some profound way.” He says it’s hard to overstate the harm that such knowledge can inflict: “The study and the therapy that I received made me feel that I was wrong, that something about me at my core was bad, and instilled in me a sense of shame that stayed with me for a long time afterward.”
Zucker acknowledges “more similarities than differences” between his treatment and Green’s. “The UCLA group, Richard’s group, certainly had a big impact on me,” Zucker says. That said, developmental and cognitive psychology are much more sophisticated now than they were then, and Zucker says that the theoretical underpinnings of his work rely on much of this new research. For example, he bases his approach in part on the concept of “gender identity self-labeling.” Zucker explains: “You somehow, by the age of two or three, have recognized that gender is a social category. The world consists of males and females: mommies, daddies, men, women, boys.” Children figure out how to label themselves as a boy or a girl (how they do this is the big question, and one that has not been satisfactorily answered) and then “search out information in their environment: If I’m a girl, how is a girl supposed to behave? You look to the social environment.”
Take something as seemingly arbitrary as color preferences. In general, girls like pink and boys like blue. This is not just anecdotal, Zucker says; studies have confirmed “sex-dimorphic^88.*Sex-dimorphic*: (adj) used to describe a trait or characteristic that varies along gender lines—height, for instance, or the presence of facial hair. color preferences.” This isn’t because girls are “born” to like pink, Zucker says, but rather because they say to themselves, “‘I’m a girl. OK, so what do girls do?’ You have your own self-label and then you actively try to behave in a way that matches the label.” Zucker’s aim, then, is to broaden the kids’ sense of what someone of their birth sex can be. “Let’s say a little boy with a strong desire to be a girl, in part, has come to this because temperamentally he has a lot of trouble with rough-and-tumble play,” Zucker says. “And so recognizing that some kids might think in binary terms—‘I’m not like that, therefore, the only alternative is to be a girl.’ But if one can help kids realize there are different ways one can be a boy, maybe that lessens the wish to be a girl. Because one realizes, ‘Oh, I don’t have to be running around on a soccer field as the only way one can be a boy. I can do something else.’”
Zucker also relies on more traditional behavior--modification therapy, in which you reinforce or reward certain behaviors and ignore or discourage others. He encourages “limit setting,” like allowing your boy to wear a dress at home but not out of the house, for example, or only for a certain number of hours a day. But he stresses that each child’s treatment plan is individualized: For a kid like Alex, encouraging him to be flexible in the way he thinks about gender is as far as he’ll push. For a kid like Olivia, he felt comfortable going further. This is largely because Olivia’s parents felt comfortable going further.
Olivia is nine now. But from the time she was two, “She wouldn’t wear things if there were a pleat or a bow or a sparkle,” her mom, Erin, says. Olivia wouldn’t drink from a pink cup or eat off a pink plate. She refused to go to school on her birthday, because the teacher gave girls a princess crown to wear on that day. “And if there was a special day where I would tell her that a dress was required, there would quickly be juice dumped down the front of it.” Erin laughs recalling it. “Smart kid.”
Erin also noticed that Olivia couldn’t tolerate social situations. She got teased a lot at school, and at home, if Erin’s friends came over with their kids, Olivia would either go up to her room and shut the door or sit and rock in the corner—“almost like she was autistic,” Erin says.
By the time Olivia was four or five, they would argue about her gender constantly. “I would clarify—not understanding what the heck,” Erin recalls. “I would say, ‘Olivia, you’re a girl. You’re a bit of a tomboy. You’re a girl that likes boys’ things.’ Then it started into the whole dialogue of, ‘When am I going to become one?’ That’s when I realized that she needed help.”
Erin was referred to Zucker by a therapist she was seeing, but having read some of the criticisms of him online, she was wary. “My values are that you take people for who they are, and people can be whoever they want to be in life,” Erin says. “So if my daughter chooses to be a boy or chooses to be gay or whatever, so be it, and I’ll love them and support them and do whatever I can to make them happy in their world.”
But then Zucker asked her a question that stuck with her: “If your daughter said to you that she wanted to stay up until two in the morning, would you let her?” No, Erin told him. “Well,” Zucker continued, “she’s telling you that she’s a boy and is going to change into one. And she’s young enough that we think in this clinic that she’s confused, and you can clarify that for her. What do you think about that?”
Erin thought, “OK, let’s try this.”
The first thing Zucker encouraged them to do was to go shopping for clothes. “You’ll have to try to make her clothes gender-neutral,” Erin recalls Zucker saying to her. “We’re not telling you she’ll ever wear a dress. But you need to try to get her to grow her hair, get it so she’s not looking so much like a boy.” He also told her to be clear with Olivia why they were coming to the center for ongoing therapy sessions and why they were going shopping. Erin was nervous about it, because she knew it would upset her daughter, but she recalls, “I said, ‘You’re not going to be able to wear boys’ clothes anymore. So we’re going to go to the store, and you’re going to wear girls’ clothes because you’re a girl.’”
Zucker is mindful that clothes and hair length—not to mention toys and games, indeed, just about every outward sign of gender that he targets—are superficial. “Yet, if you look at normative studies of gender development, kids often use cues pertaining to hairstyle and clothing style to not only mark their own gender but to mark the gender of other kids,” Zucker says. “So those cues, or markers, are surface representations of a child’s underlying gender identity. And I think, in young childhood, there can be a feedback effect.”
If a young boy feels he is a girl, Zucker argues, then playing with Barbies is not as simple or as neutral as playing with blocks or puzzles. Part of the thrill of the Barbies for that boy is that they make him feel like a girl. Because he feels like a girl, he will continue to want to play with Barbies. And so on. “There is a back-and-forth between gender identity and surface behavior,” Zucker argues. “I’ve been trying little questions out lately, like: ‘If you like to eat leaves off tall trees, would that make you a giraffe?’ Some little kids fit that kind of thinking. Kids conflate identity with appearance.”
This was certainly true for Olivia. Finding gender--neutral girls’ clothes was a challenge, but she and her mom finally agreed on some collared shirts and cargo pants cut in a girl’s style. “What happened over time was, she stopped getting bullied at school because she stopped looking like a boy,” Erin says. “It would get her confidence going.”
On days that Olivia came home from school and complained that “so-and-so called me a boy,” Erin would steel herself and reply, “Well, you kinda look like one today, Liv. Your choice. I don’t know what you’re expecting.” Ultimately, Olivia “got to a point where she would get upset when people would get confused, calling her a boy. Even though originally that was what she wanted.”
The final recommendation her parents followed was to help Olivia make more female friends. She’d always had more boy friends than girl friends, but her parents enrolled her in girls’ soccer and hockey and were amazed at the difference it made. “The girls are like her,” Erin says. “They’re still more girly than her, but they’re rough, and when they go to a tournament, they’re just tearing around playing Hunger Games. They relate to her.”
Social interactions still don’t come easily for Olivia, but Erin feels the changes they made have helped give Olivia the confidence she needs to move through the world more peacefully. “I think that if I hadn’t gotten the help, I would have allowed her to continue to dress the way she was, and life would have been really tough,” says Erin. “I think she would have been very withdrawn and disturbed and had difficulty making friends, and been bullied.” Erin knows the future is still uncertain: “Who knows what she’s going to decide? Is she going to be gay? Is she going to be transgender? I don’t know. But I do know that she’s going to be a confident person and be her own person and feel like she can make her own choices, and recognize how to fit in and how society works. I think this place has saved her.”
There’s a chance, of course, that Olivia might feel otherwise later in life. “If your parents have brought you to Dr. Zucker to figure out your gender, and they are already perhaps less than supportive or [at] least nervous and confused, and then you sit in a play space with an authoritative doctor suggesting you play with a truck, what do you think the child would do?” asks emergency-room physician Madeline Deutsch, who is transgender. “I suspect that we will see a large number of Dr. Zucker’s former patients in their thirties, forties, or fifties seeking gender reassignment, only to regret having not been able to do so decades earlier.”
Traditional epidemiologic studies have assumed the prevalence of transgender people to be rare: somewhere in the neighborhood of 1 in 10,000. But recent studies show the numbers are much higher than previously thought (or are higher now than they used to be): 1 in 200, or even, in one recent sample of middle schoolers, 1 in 100. This means that only a tiny sliver of what may be a relatively large population of transgender people are showing up at clinics to make a medical transition. It speaks to the fact that in between living fully in one’s birth gender or undergoing all of the cross-gender interventions that Western medicine has to offer is a whole range of options that Zucker’s approach doesn’t account for.
“The proliferation of gender categories that represent people’s desires and experiences and identifications, those are fairly new,” Bryant says. So “to look at kids today who are gender-nonconforming and try to make some prediction about what they’re going to be when they grow up is really fraught. The things that they are going to be when they grow up don’t exist right now.”
Because of this proliferation, critics like Bryant say, Zucker is basing his work on an outdated conception of gender, suggesting parents radically change the way their children live—not let them play with the toys they choose, or wear the clothes that make them most comfortable, or play with the friends they most connect with—on the basis of a dubious guess that some tiny percentage of them will one day want to have sex-reassignment surgery. Or, worse, on the basis of societal prejudice: because the world will not accept them for who they are. This seems as unsettling as Zucker’s parents moving to the suburbs and conforming for the good of the cause. It’s fair to ask: Whose cause, exactly?
Although the DSM is strictly a diagnostic manual—it does not make treatment recommendations—implicit in the very existence of a diagnosis is the suggestion that it warrants treatment. This is largely the concern that transgender activists and mental-health professionals had when they heard that Zucker would be chairing the DSM’s Sexual and Gender Identity Disorders work group.
Zucker’s approach “has this default assumption that not identifying with the sex you were assigned at birth is in some way psychopathology,” says Karl Bryant. “It treats the gender of the child [as] a problem that merits some kind of correction.”
But transgender advocates concede that the new diagnostic criteria represent an improvement over the old. In the previous DSM, for instance, the bar seemed lower for diagnosing boys than girls: To meet the criteria, boys need only have a “preference for” wearing girls’ clothes, whereas girls had to “insist on” wearing boys’ clothes. In the new DSM, the language is more analogous. The new DSM, which will be published in May, also recognizes the limitations of the gender binary, noting that a child could express either “a strong desire to be of the other gender” or “some alternative gender different from one’s assigned gender.”
Still, whether the diagnosis should be in the DSM at all remains a contentious issue. Because hormone--replacement and sex-reassignment therapy cost tens of thousands of dollars, transgender people are in a bind: They need a diagnosis to get health-insurance coverage for their transition-related medical care. Zucker and his colleagues tried to address some of the community’s concerns by renaming the diagnosis “gender dysphoria.” This means that it’s not the identity that is a disorder but rather the distress that may result from that identity. A gender-variant kid—a boy who likes to wear dresses, for instance—wouldn’t automatically meet the criteria, unless the behavior caused him “clinically significant distress or impairment.” In other words, unless he were suffering.
The name change alone was a big deal, says psychiatrist Dan Karasic of the University of California, San Francisco, because it implies that “the distress of gender dysphoria is the pathology as opposed to gender identity.”
Zucker likes to say that the DSM is “agnostic” with regard to the origins of one’s suffering, but the question of where the distress originates is not a small one. Many kids in Zucker’s clinic come in with psychiatric and psychosocial issues. A quarter of them have been involved with child protective services and a quarter have attempted suicide. Zucker concedes that “experiences of ostracism, social rejection in the peer group, et cetera, does account for some” of the distress. But, he says, “I personally think that it’s too simplistic to say that it’s the peer ostracism or the stigma that explains it all. We see a lot of adolescents whose families are pretty supportive,” he continues. “They’re not being rejected. Their friends are chill. But they’re still very unhappy and very distressed and miserable. So even with external acceptance, the incongruence between somatic sex^99.*Somatic sex*: (noun) the sex implied by one’s physical body. People with gender dysphoria suffer a disconnect between their somatic sex—their physical sexual characteristics—and their gender identity. and felt gender is still very painful.”
For the most part, following his interpretation of the standards of care, Zucker will not recommend puberty suppressors or cross-gender hormone therapy for anyone whose psychiatric issues aren’t addressed first. His critics say this misses the point: Transitioning is addressing their psychiatric issues. By offering hormone therapy and other medical interventions, “you treat not only the medical hormonal deficiency and help them attain the body that they wish, but you are very likely to erase a whole bunch of psychopathology that’s all secondary,” says Norman Spack, an endocrinologist who runs the Gender Management Service at Boston Children’s Hospital. Spack says he has seen major depression, anxiety—even mild Asperger’s—resolve after kids are able to transition.
While I was in Toronto, a teenage patient of one of the other psychologists in the clinic came in for a follow-up visit. This person had the body of a female but covered his breasts in layers of binders and was so afraid to be read as a female that he wouldn’t leave the house, even for school—he attended high school online and ventured out only for his appointments and, once a week, to the in-person component of his curriculum. He told his psychologist, one of Zucker’s colleagues, that if she wouldn’t refer him for hormone therapy, he would kill himself. The colleague stopped by Zucker’s office to ask him what to do.
The standards of care say someone is ready for hormone therapy when he has lived successfully as his preferred gender for a period of time. Did this person qualify, if he never left the house? Is his extreme distress the result of his gender dysphoria? Or is the depression clouding the psychologists’ ability to get an accurate read on his gender identity? All these questions were theoretical, though. In the next room was a real patient who was suffering, and Zucker did what he thought was best: He referred him to the endocrinologist to begin hormone therapy.
*The names of Zucker’s patients and their family members have been changed to protect their privacy. Reported by The American Prospect 1 day ago.
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Recreate Olivia Wilde's Makeup From 'The Incredible Burt Wonderstone' Premiere
*Olivia Wilde* looked STUNNING at the Los Angeles premiere of her new film, The Incredible Burt Wonderstone! Celebrity Makeup Artist Melanie Inglessis created a smoldering, smoky eye to complement Olivia's black Gucci gown and now she's sharing her tips for recreating it at home!News: Olivia Wilde Shares Tweets from Angry Beliebers
1. To start I applied a primer over the lids so the shadow will adhere better and last longer. Then I created the shape of the smoky eye by tracing both top and bottom rims with a thick black line. It doesn't have to be perfect as it will be blended. The darker around the rim of the eyes, the sexier the eyes will look.
2. Next, I applied a dark cream shadow to fill the entire lid and create a base to which the powder eye shadow will stick. I also used this color on the bottom lash line to start creating the smoky eye. I applied a dark burgundy powder shadow to lid and under the eye on top of the cream to create a bit more depth. The trick to a good smoky eye is blending! Blend all of the colors with a medium and small size shadow brush according to the eye shape that you want. I like to blend a smoky eye with a strong but light shimmer eye shadow on the outside of the eye. I also used this color on the inner corner of the eyes for brightness.
3. To finish the eyes, I curled the lashes, applied one coat of mascara to top and bottom lashes, waited for it to dry and repeated a second time.I topped the look off with a really pretty baby pink on the lips and applied it with my finger, building the color for a natural and polished look.
Photos: Olivia Wilde's 29 Hottest Beauty Looks!
Inglessis used the following products for Olivia’s red carpet look:
Face
Revlon ColorStay Aqua Mineral Make Up
Revlon ColorStay Undereye Concealer
Revlon PhotoReady Cream Blush in Pinched
Eyes
Revlon PhotoReady Eye Primer + Brightener
Revlon ColorStay Eyeliner in Black
Revlon ColorStay Smoky Shadow Stick in Torch (darker shade)
Revlon ColorStay 16H Eyeshadow Quad in Precocious (burgundy shade)
Revlon Luxurious Color Diamond Lust Eyeshadow in Starry Pink
Revlon PhotoReady 3D Volume Mascara in Black
Lips
Revlon ColorStay Ultimate Suede Lipstick in Front Row
*What do you think of Olivia's makeup look? Would you rock it? Tell us below or @OKMagazine!*
Photo credit:
Getty Reported by OK! Magazine 18 hours ago.
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Olivia Wilde Reads Mean Tweets from Justin Bieber Fans – Video
Other people would probably be very upset (at the very least) for becoming the target of Justin Bieber’s fans’ hatred, but Olivia Wilde is taking their nasty messages in stride. Check out the video above to see what she has to say about them. As she explains to Jay Leno, she became Beliebers’ number one enemy when she dared suggest on Twitter that he put a shirt on when out and about. Since then, she’s been receiving thousands of hateful mess...
Reported by Softpedia 19 hours ago.
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Jason Sudeikis -- 'Cheating' WITH His Fiancée Olivia Wilde
Jason Sudeikis was totally busted leaving a restaurant with Olivia Wilde -- who IS his fiancée, but apparently not everyone's heard the news. Which is why we now present ... "Educating Max!"Check out TMZ on TV -- click here to see your local…
Reported by TMZ.com 11 hours ago.
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'Thoroughly Modern Millie Jr.' Opening This Weekend with Local Talent
Patch La Jolla, CA --Christian Youth Theater San Diego opens Thoroughly Modern Millie Jr. Friday night at Pacific Beach Middle School. The cast, including Muirlands Middle School student Asher Smith, are all 8 to 18 years old. Smith plays the role of Ching Ho and will sing in Chinese.
The musical takes place in New York City in 1922 and tells the story of young Millie Dillmount, who has just moved to the city in search of a new life.
There are six performances through Saturday, March 23.
Tickets are $12 online or $15 at the door.
*Shows:*
· Friday, March 15 – 7 p.m.
· Saturday, March 16 – 7 p.m.
· Sunday, March 17 – 2 p.m.
· Friday, March 22 – 7 p.m.
· Saturday, March 23 – 2 p.m. , 7 p.m.
*Song:*
· Not for the Life of Me
· Thoroughly Modern Mille
· The Speed Test
· What Do I Need With Love
· Jimmy
· Forget About the Boy
· Ah! Sweet Mystery of Life
· I Turned the Corner
· Gimme Gimme
· Finale
*Director* - Lauren King
*Assistant Director* - Bethany Slomka
*Musical Director *- Michael Sanchez
*Choreographer* - April Henry
*Cast:*
· Millie – Heather Banks
· Jimmy – Tyler Tafolla
· Dorothy – Marisa Gomez
· Mrs. Meers – Brittany Wolfe
· Trevor Graydon the Third – Ryan Tafolla
· Miss Flannery – Kiani Nelson
· Ruth – Ekaterina Belous
· Gloria – Rachel Banks
· Rita – Olivia Tafolla
· Alice – Courtney Wolfe
· Ethel Peas – Giovanna Zavala
· Ching Ho – Asher Smith
· Bun Foo – David Gillcrist
· Stenographers – Abby DePuy, Courtney Wolfe, Ekaterina Belous, Giovanna Zavala, Katie Walsh, Lauren Burdine, Lydia Sandy, Madeline Lynch, Mikaela Partaine, Olivia Tafolla, Rachel Banks and Tierra Gonzalez
· New Moderns - Chloe Pryor, Ella Godinez, Ella Ryan, Ellie Stauderman, Eloise Lubsen, Gracie Roche, Isabella Farrell, Jane Lubsen, Jessica Ellis, Kallie Kay, Katie Church, Kylie Shults, Olivia Havluciyan and Sophia Havluciyan
· Policeman – Robert Collins
· Gangsters – Alex Wolfe, Asher Smith, Conner Ellis, David Gillcrist and Nikita Belous
· Newsies – Charlotte Egan, Claire Scheper, Delanie Tasto, Eleni Havluciyan, Jamie McCoy, Maddie Wozniak, Mimi Weisenberg and Natalya Belous
· “Now that I’m Here with You” Soloist – Kiani Nelson
· Dance Captain – Rachel Banks Reported by Patch 7 hours ago.
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Little Hari's personality shines through so brightly
This is South Wales --HARI Kieft is living proof that with a little bit of help from your friends dreams CAN come true.
A year ago, March 6, 2012, three-year-old Hari, who has spastic diplegic cerebral palsy, underwent life-changing surgery in America called selective dorsal rhizotomy to enable him to walk.
The surgery was performed by world-class neurosurgeon Dr Tae Park after a six-month fundraising mission by family and friends to hit the £45,000 needed for the surgery as it is not funded on the NHS in Wales.
"This time last year, Hari faced a future of uncertainty as his condition impacted greatly on his mobility but never on his spirit or determination," said his mother Cerianne.
"At just two and a half, however hard Hari tried he could not walk unaided and was desperate to run alongside his sister Olivia.
"Hari had never kicked a ball, never splashed in a puddle, never had a pair of trainers, and above all had never fulfilled his wish to walk."
How things have changed since the surgery.
When I went to meet the family at their lovely home in Neath, it was Hari who answered the door with the biggest, cheekiest grin I have ever seen.
Not only is Hari walking unaided, he had just arrived home from his gymnastics class and was keen to show me how he could do a roly-poly, just like his lovely four-year-old sister Olivia.
"Since surgery, Hari has achieved so many firsts which as parents we feared he'd never manage," said Cerianne.
"Hari has walked out as mascot with his hero Ashley Williams at the Swans v Liverpool game, he has walked in snow, and most recently he has walked hand in hand with his sister Olivia on his first day at Alltwen Primary School.
"Hari's cheeky disposition means he is very much part of a community that have helped us as a family to provide the best future we can for our son — we are a very lucky family," added Cerianne.
Hari and I have a lot in common, more than I realised.
Firstly, we were both born with cerebral palsy, we both weighed just 4lb at birth, both wore glasses as toddlers and we both have an older sister to nag and look out for us!
It also turns out that Hari has the same fantastic physiotherepist that I had as a child. Her name is Julie Harvey.
Oh, and it seems we both love a bit of banter.
"Are you my friend now, Stuart?" asks Hari with a beaming smile.
"Of course I am," I replied.
"We can go to the pub for a beer and a meal if you want," suggested Hari as if it's the most natural thing in the world for a three-year-old to ask.
Sounded like a good plan to me, but he decided rubbing sticky Playdoh all over my jeans, on my shoes and up my nose was far more fun, before flushing the evidence down the toilet, much to the amusement of his sister.
Hari, is full of fun, and when his mother asked recently who he wanted to come for tea as his sister was having a school friend over, he said: "I think I will have a belly dancer over for tea, Mammy." I like his thinking!
Personality counts for so much in life, and even at three years old Hari has one of the biggest and most endearing personalities I have ever encountered.
When posing for a photo while sitting on my lap, Hari announced: "Stuart, I may do a wee wee on your lap."
I replied: "I won't be your friend if you do that, mate."
He responded through a massive smile: "So what!"
I am happy to report we are still firm friends.
"Hari still strives hard every day to improve his mobility as he is learning to use his legs in a completely new way," said Cerianne.
"He receives regular physiotherapy to improve his core stability and balance and has recently joined a gymnastic class! Hari always exceeds targets set for him as his cheeky determination has no limits.
"Olivia has been beside him throughout and helps Hari with his daily stretches and physio. She has never once moaned at the attention Hari receives and we are inspired by both our children, despite their young ages," she added.
"We'd like to thank everyone who has followed Hari's story. This really is just the beginning for Hari," said his father Richard.
"We are no longer scared to look into Hari's future and are excited to see what he will achieve next.
"As a family we worked tirelessly to raise the funds needed as well as juggling work and Hari's huge medical commitments.
"We managed to reach our target in less than six months. Our fundraising efforts were boosted when Swansea City and Wales captain Ashley Williams and Charitable Group AG Swansea heard about Hari's wish to walk and together arranged the most emotional event that raised the bulk of the money needed in just one night," he said.
Added Cerianne: "For the first time, as parents we allowed ourselves to believe that Hari may get his wish.
"Since the surgery in America it does really seem like a miracle to see how far Hari has come.
"From a little boy who couldn't stand pre-op to a little boy who is dying to run like his sister and tries so hard at his gymnastics and horse riding," she added.
Little Olivia handed me a lovely picture she had drawn of herself and her family. It was noticeable that her brother was standing up in this picture and not on the floor, as she used to draw before his surgery.
"Did you help your sister draw this for me, Hari?" I asked.
"No, I couldn't be bothered," he answered frankly through a smile. That told me!
He then took the picture off me and posted it through the front door on to the front step. It seems Hari will do anything to get a laugh.
Before meeting Hari, his mother had told me in an email: "I always say to Hari, 'Don't be afraid to be amazing!' and when you meet him, Stuart, I really believe he'll amaze you!"
I can safely say that Hari Kieft is one amazing little boy, not just because he has achieved his dream of being able to walk, but because at three years old he was totally on my wavelength. I'm not so sure what it says about me — I'm 36. I'm looking forward to that pint, Hari. Reported by This is 12 hours ago.
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Olivia Newton-John brings UK tour to Birmingham NIA
Olivia Newton-John fans were hopelessly devoted to the singer when she brought her first UK tour in 35 years to the West Midlands.
Reported by Express and Star 8 hours ago.
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March Movie Madness: Releases This Weekend at the Box Office
Patch Kingstowne-Rose Hill, VA --I'm sitting outside the Verizon Center, once again fighting for parking this week with the sports fans next door to my screening movie theatre. It reminds me, even when it matters, sometimes the winning team is a fluke, sometimes it's well deserved…
As Cinema Siren is meant to "guide you through a sea of celluloid," I'd like to direct you toward the more deserving teams of filmmakers releasing something this busy week at the multiplex. With spring break upon us, this early March weekend offers an odd mix of genres, with each vying for the top spot at the box office. Best of luck to them, they'd be replacing or be added to a top 10 where only two have even 50 percent positive reviews, and some of which are so bad they should be benched like the tasteless or very badly behaved player they are.
This week, we have four new movies of note, and I'll briefly give my thoughts and recommendations, so you know what you're getting into before you hand over your hard-earned cash and sit in expectation for upwards of two hours….
*The Call: Don't Answer*
This movie stars Halle Berry as 911 operator Jordan in a race against time to save a teenage abductee Casey (Abigail Breslin). For a story which centers on the potential torture, rape and death of a young girl, it starts off well enough. We learn why Berry's character is highly invested in keeping alive the girl at the center of the action.
She's been there before, and it didn't go well. This means not only will you, dear audience, be watching extended scenes of a terrified teen screaming and crying in the trunk of a car while the serial killer trundles along with her toward his torture lair and kill zone, you will also see the pre-show, where we learn how truly awful the villain is.
Jordan in the 911 "hive," talking Casey through ways of getting out alive, is tense and compelling. I would argue, however, that from the very first scenes, this movie is extremely unpleasant to watch, and qualifies as anything but a good time at the theatre.
But let's say you like high-octane suspense flicks where a lot is at stake, and teenage girls being chloroformed and punched is an acceptable plot point. Perhaps you, like Cinema Siren, would like to support a black lead actress carrying a film. In that case, she'd better be driven by making sound decisions.
Unfortunately, The Call quickly veers off-road to four-wheel in the Land of Stupid Choices, that place in horror usually littered with the bodies of promiscuous co-eds. The movie gets weaker and weaker and more far-fetched, as it becomes more and more a revenge fantasy. At one point, Jordan goes alone into a hidden underground hiding place.
I'm tempted to scream, but lean over to a fellow critic and say, "Alone?" to which he replies sarcastically, "Oh, she's got this!"
Suffice to say by the end of The Call I hated this movie so much, it made me sorry I couldn't have walked out a full half-hour before. There is no joy, no cohesion, bad choices and a truly gruesome premise. Good acting all around made my distaste all the more unfortunate. When your local theatre gets The Call, don't answer.
*The Incredible Burt Wonderstone: Tragic Magic*
What happens when you mix great character actors Steve Buschemi and Alan Arkin, and funny men A-listers Jim Carrey and Steve Carell? It should be magic, right? If this was the movie equivalent of the magic trick where a woman gets sawed in half, there'd be blood all over the stage.
No question its heart is in the right place. Carell and Buscemi play lifelong pals who perform together as Burt Wonderstone and Anton Marvelton, making big bucks in Vegas with assistant Jane (Olivia Wilde) in an increasingly stale magic act. The two stars have grown to hate each other. When guerrilla street magician Steve Gray (Jim Carrey) steals what is left of their audience with his new over-the-top stunts, they lose their jobs and break up. Will Wonderstone get his magic mojo back when he discovers his childhood magic idol Rance Holloway (Alan Arkin)?
For a comedy, this movie has few funny moments. It does, however, have its fair share of mean-spirited elements, along with an "ick" factor that overall can only be described as bad taste. The actors do a perfectly fine job. Alan Arkin builds a particularly interesting and well-developed character, like magic, out of a script made of thin air….Olivia Wilde plays Jane with a straightforward sweetness and optimism that flies in the face of the movie as a whole.
It is the writing, both the dialogue and the script, that can't seem to decide what it wants to be, or where it wants to go. It is wildly uneven, as is our commitment to any of the lead characters. If they had stuck with Alan Arkin as the movie's central figure, they would have had something…Added to the weakness in the dialogue is an ending, after intermittent attempts to make the story somewhat believable, that stretches credulity to say the least.
As the end credits roll, our hopes go poof. Let this one disappear from theaters; watch at home if you must. Honestly, you'd be better off buying a magic kit and spending the time learning a real trick or two. * *
*Stoker: All in the Family — Hitchcock Style*
Director Park Chan-wook makes his first English-language film with this Gothic creepfest, building suspense slowly with equal amounts of nerve and perve. The visual style is eye-strokingly gorgeous, with set decoration, production design, and editing that together make up for the holes in pacing and storyline.
Hitchcock is beyond an obvious influence, but clearly the film's inspiration, with several direct odes and parallels to Shadow of a Doubt, starting with the name of the introduction of "Uncle Charlie," which was also the name of the villain played by Joseph Cotton in the 1943 classic.
The story is of Evelyn Stoker (Nicole Kidman) and her daughter India (Mia Wasikowska). They have just lost Evelyn's husband Richard to a fatal car crash, when Richard's preppily handsome and fresh-faced brother Charlie (Matthew Goode) unexpectedly shows up to stay a while. In a country manor where time seems to have stood still, their already seemingly off-kilter world begins to completely unravel and heat up.
It is a sinister slow burn with a very European pace, reminiscent of Polanski's Repulsion. Psychosexual disfunction permeates the story. Chan-wook seems to excel at juxtaposing disturbing imagery like spiders crawling between India's legs with family scenes in the innocuously pea green parlor or at the family piano.
Mia's India sculls about dressed like she's in an Edward Gorey illustration, demonstrating a curiosity and intensity that leads the audience to question what's going on behind that deadpan stare of hers. Charlie is clearly more than he seems, and for better or worse we discover just how much more through the course of the movie. Evelyn is an ever-oppressive manipulative presence like a New England Blanche Dubois, but she may turn out to be the least concerning of the lot.
Though the last few minutes of the movie leave you scratching your head about motivation or deeper meaning (perhaps there is none), scenes in which the camera languidly captures what can only be described as an utterly demented family going about their demented doings will stay with you way after the end credits roll. A particularly memorable one recalling The Bad Seed had some audience members wide-eyed and clucking with dread, "No!"…If dark and Gothic is your thing, Stoker will give you the creeps you so richly desire.
*Upside Down: See Gravity-Crossed Lovers in So Pretty Sci-fi*
The creative idea to put young lovers Adam and Eden (Jim Sturgess and Kirsten Dunst) in two worlds that share opposing gravity and watch them try to find a way to be together is reason enough for curiosity about Upside Down. Alas, the script skips story continuity and any consistent explanation relating to the proceedings, so what could have been a great movie all around will have to survive on breathtaking dreamlike visuals and magnetic leads.
These two worlds are not allowed to fraternize, and are a metaphoric brick in the head about haves and have-nots. Down Below recalls a WW2 post-bomb blitz London. Up Above looks like Coruscant from Star Wars. Where the two meet, frolic, and fall in love as teens is like the most beautiful mountain landscape you've ever seen, only times two.
Nevermind the silly and sillier plot points, it's about the romance and the visuals, which are more than worthy to be seen on the big screen. Director/writer Juan Solanas uses photography and his experience training with famed cinematographer Felix Monti to create a strong personal artistic perspective with a surprisingly small budget.
Twilight shmilight, teens could do far worse than obsessing about this movie. You've never seen a couple so bathed in light and aglow with love and its accompanying optimism. Love may conquer all in the end, or leave them alone and dejected, but either way you'll be in for a dazzling cinematographic ride.
My vote, after going through these four movies, is for Upside Down and Stoker, both of which are in limited release, which might mean a bit of a road trip for some of you. They are both indie films, which means they were created on a much smaller budget, and allowed more freedom to those involved. How lovely that we might actually feel compelled to support what's good instead of what's big!
*Check out movie times and ticket prices for Kingstowne 16.* Reported by Patch 3 hours ago.
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Olivia Wilde's magic boot camp for Wonderstone
Olivia Wilde took part in a magic ''boot camp'' to prepare for her role in 'The Incredible Burt Wonderstone'.The actress - who stars alongside Steve...
Reported by ContactMusic 2 hours ago.
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'Thoroughly Modern Millie Jr.' Opening This Weekend with Local Talent
Patch La Jolla, CA --Christian Youth Theater San Diego opens Thoroughly Modern Millie Jr. Friday night at Pacific Beach Middle School. The cast, including Muirlands Middle School student Asher Smith, are all 8 to 18 years old. Smith plays the role of Ching Ho and will sing in Chinese.
The musical takes place in New York City in 1922 and tells the story of young Millie Dillmount, who has just moved to the city in search of a new life.
There are six performances through Saturday, March 23.
Tickets are $12 online or $15 at the door.
*Shows:*
· Friday, March 15 – 7 p.m.
· Saturday, March 16 – 7 p.m.
· Sunday, March 17 – 2 p.m.
· Friday, March 22 – 7 p.m.
· Saturday, March 23 – 2 p.m. , 7 p.m.
*Song:*
· Not for the Life of Me
· Thoroughly Modern Mille
· The Speed Test
· What Do I Need With Love
· Jimmy
· Forget About the Boy
· Ah! Sweet Mystery of Life
· I Turned the Corner
· Gimme Gimme
· Finale
*Director* - Lauren King
*Assistant Director* - Bethany Slomka
*Musical Director *- Michael Sanchez
*Choreographer* - April Henry
*Cast:*
· Millie – Heather Banks
· Jimmy – Tyler Tafolla
· Dorothy – Marisa Gomez
· Mrs. Meers – Brittany Wolfe
· Trevor Graydon the Third – Ryan Tafolla
· Miss Flannery – Kiani Nelson
· Ruth – Ekaterina Belous
· Gloria – Rachel Banks
· Rita – Olivia Tafolla
· Alice – Courtney Wolfe
· Ethel Peas – Giovanna Zavala
· Ching Ho – Asher Smith
· Bun Foo – David Gillcrist
· Stenographers – Abby DePuy, Courtney Wolfe, Ekaterina Belous, Giovanna Zavala, Katie Walsh, Lauren Burdine, Lydia Sandy, Madeline Lynch, Mikaela Partaine, Olivia Tafolla, Rachel Banks and Tierra Gonzalez
· New Moderns - Chloe Pryor, Ella Godinez, Ella Ryan, Ellie Stauderman, Eloise Lubsen, Gracie Roche, Isabella Farrell, Jane Lubsen, Jessica Ellis, Kallie Kay, Katie Church, Kylie Shults, Olivia Havluciyan and Sophia Havluciyan
· Policeman – Robert Collins
· Gangsters – Alex Wolfe, Asher Smith, Conner Ellis, David Gillcrist and Nikita Belous
· Newsies – Charlotte Egan, Claire Scheper, Delanie Tasto, Eleni Havluciyan, Jamie McCoy, Maddie Wozniak, Mimi Weisenberg and Natalya Belous
· “Now that I’m Here with You” Soloist – Kiani Nelson
· Dance Captain – Rachel Banks Reported by Patch 3 days ago.
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Mid Somerset Festival 2013 - Results
This is Bath -- 12 March C1 Choirs (14 & under): Dame Alice Owens School Junior Chamber Choir C2 Free Choice (16 & under): Cantate Youth Choir C3 Sacred and Secular (16 & under): Calthorpe Park Choir C4 Unaccompanied Madrigal Group (19 & under): Dame Alice Owens close harmony group C5 Sacred Music (19 & under): Prior Park Senior Chapel Choir C6 Female Voices (19 & under): Hayesfield School Senior Choir C7 Popular or Show Song (19 & under): Wyedean School C8 Free Choice (19 & under): Dame Alice Owens School Senior School Choir C9 Gospel Music (19 & under): Wyedean Gospel Choir 13 March JC1 LEA Choirs: Christ Church Primary School Choir JC2 Class/School Music Presentation: Christ Church Primary School JC3 Roundabout: Christ Church Primary School Choir JC4 Sacred and Secular Music: Widcombe Junior Girls' Choir Class 7 Primary Group Mime: Oldfield Park Junior School 8 Primary Group Acting: Oldfield Park Junior School 9 Verse Speaking (6-6½): Miranda Webb 10 Verse Speaking (6½-7): Lauren Briggs 11 Verse Speaking (7-7½): Lucy Jones 14 Verse Speaking (8½-9): Benjamin Bathurst 15A Verse Speaking (9-9½): Olivia Stockinger 15B Verse Speaking (9-9½): Beatrice Watts 18A Verse Speaking (10½-11): Poppy Hedley 18B Verse Speaking (10½-11): William Loosley 19A Verse Speaking (11-11½): Olivia Heath 19B Verse Speaking (11-11½): Ava Spencer Jones 25 Verse Speaking (14): Jennifer McGlynn 26 Verse Speaking (15 & 16): Elliot Shirnia 27 Verse Speaking (17 & over): Lara Lawman 32 Bible Reading (15 & over): Elliot Shirnia 37 Reading Aloud (10 & 11): Liberty Shirnia 38 Reading Aloud (12 & 13): Jack Bather 46 Memorised Prose - Dickens (12-14): Florence Shirnia 47 Memorised Prose - Dickens (15 & over): Elliot Shirnia 56 Devised Group Performance (under 16): Stagecoach 2 62 Duo Mime (under 14): Jack Bather & Freddie Robb 63 Duo Mime (under 19): Isobel Lee Barber & Fleur Harrison 64 Solo Mime (10 & 11): Liberty Shirnia 65 Solo Mime (12-14): Jennifer McGlynn 66 Solo Mime (15-18): Charles Beaven 67 Group Acting (12 & under): Leweston Trio 68 Group Acting (16 & under): Next Stage Youth 70A Duo Acting (under 10): Scarlett England & Jasmine Harvey 70B Duo Acting (under 10): Ellie Green & Georgina Edney 75 Duo Acting (under 15): Anna Green & Ella Thompson 81 Solo Acting (8 & under): Scarlett England 82 Solo Acting (9): Elodie Commissaris 84 Solo Acting (11): Julian Shirnia 86 Solo Acting (13): Freddy Downham 92 Solo Shakespeare (13 & 14): Isabel Elliott 101 Public Speaking (9-11): Julian Shirnia 102 Public Speaking (12-14): Florence Shirnia 103 Public Speaking (15-18): Eilidh Hide 77 Duo Acting (under 21): Eleanor Mules & Lila Chillingworth 79 Duo Shakespeare (under 18): Antonia Redpath & Olivia Macintosh 90 Solo Acting (17 & 18): Lara Lawman 91 Solo Acting (19 & over): Miranda Shirnia 94 Solo Shakespeare (17 & 18): Lara Lawson 95 Solo Shakespeare (19 & over): Miranda Shirnia 97 Repertoire: Florence Shirnia MARCH 14 Class 1 Primary Verse Speaking (6): Jon Forbes 2A Primary Verse Speaking (7): Isabella Cuthbert 2B Primary Verse Speaking (7): Ruby Walters 3A Primary Verse Speaking (8): Mattie Forbes 3B Primary Verse Speaking (8): Nina Stevenson 4A Primary Verse Speaking (9): Jasmine Stevenson 4B Primary Verse Speaking (9): Joe Bruton 5 Primary Verse Speaking (10): Naomi Poole 6 Primary Verse Speaking (11): Arthur Williams 12 Verse Speaking (71/2-8): Ben Humphries 13 Verse Speaking (8-81/2): Olivia Laughton 20 Verse Speaking (111/2-12): Isabel Watson 21 Verse Speaking (12-121/2): Cecilia Toke Nichols 28 Sonnet (14 & over): Lara Lawman 31 Bible Reading (11-14): Julian Shirnia 33 Reading Aloud (6): Miranda Webb 34 Reading Aloud (7): Daisy Atkinson 41 Memorised Prose (7 & 8): Maya Persad 43 Memorised Prose (11 & 12): Finlay Yates 44 Memorised Prose (13-15): Elliot Shirnia 45 Memorised Prose (16 & over): Miranda Shirnia 49 Group Speaking (12 & under): King Edwards Junior School 51 Theme (12 & under): Grittleton House School 53 Dance Drama (open): Warminster School 58 Group Mime (under 12): Monkton Prep School 71A Duo Acting (under 11): Niamh Harding & Elizabeth Narbett 71B Duo Acting (under 11): Rosie Wakelin & Jessie Nicol 73A Duo Acting (under 13): Jack Bather & Freddie Robb 73B Duo Acting (under 13): Meg Scott & Hannah Lowrie 74A Duo Acting (under 14): Cameron Fraser & Oliver Bell 74B Duo Acting (under 14): Georgina McSherry & Caitlin Mazza 78 Duo Shakespeare (13 & 14): Grittleton House School 83 Solo Acting (10): Felicity Ingledew 85A Solo Acting (12): Inca Bayley 85B Solo Acting (12): Phoebe Bolton 98 TV Newsreading (10 & 11): Edward Bazley 99 TV Newsreading (12 & 13): Louise Smallbone 100 TV Newsreading (14-18): Lara Lawman 105 Youth Debating: Oldfield School
Reported by This is 2 days ago.
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Olivia Wilde whisked off Jason Sudeikis for raunchy strip club date after engagement
Olivia Wilde took her new fiance Jason Sudeikis on a raunchy date to a New York strip club, where they booked a private room with two pole dancers.
Reported by IndiaVision 22 hours ago.
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Movie Reviews: 'Dead Man Down,' 'Jack the Giant Slayer,' 'Safe Haven' and More
Patch Cedar Falls, IA --Movie information aggregated from MovieFone.com
*The Call*
· *Run Time*: N/A
· *Starring*: Halle Berry , Abigail Breslin , Morris Chestnut , Michael Eklund , Michael Imperioli
· *Director*: Brad Anderson
· *Trailer*
"The Call for the most part is a tense, extreme-jeopardy thriller that delivers the intended goods." Todd McCarthy, The Hollywood Reporter.
"Rare is the thriller that goes as completely and utterly wrong as The Call does at almost precisely the one hour mark. Which is a crying shame, because for an hour, this is a riveting, by the book kidnapping." Roger Moore, Movie Nation.
*Do you plan on seeing this movie? Leave a review of the film with a comment below after you do.*
* -*
*The Incredible Burt Wonderstone*
· *Run Time*: 100mins.
· *Starring*: Steve Carell , Jim Carrey , Steve Buscemi , Olivia Wilde , James Gandolfini
· *Director*: Don Scardino
· *Trailer*
"The Incredible Burt Wonderstone draws a lot of goodwill from the basic likability of its star performers." Marjorie Baumgarten, Austin Chronicle. Full Review
"The inconsistencies in tone - is it an Anchorman-style farce or something more serious? - distract from likeable turns from the leads." Helen O'Hara, Empire. Full Review
*Do you plan on seeing this movie? Leave a review of the film with a comment below after you do.*
* - *
*Dead Man Down*
· *Run Time*: 110mins.
· *Starring*: Colin Farrell , Noomi Rapace , Terrence Howard
· *Director*: Niels Arden Oplev
· *Trailer*
"The tone and pacing of Dead Man Down have a distinctly European flavor, which may explain why American viewers, used to having background and exposition pared down and cleanly delivered, may feel adrift at the outset." James Berardinelli, ReelViews. Full Review
"The action merely meanders when it should be hurtling forward, running in circles when one expects it to head toward a conclusion or some sense of resolution." Calum Marsh, Slant Magazine. Full Review
*Have you seen this movie? Help your neighbors out. Leave a review of the film with a comment below.*
* -*
*Oz the Great and Powerful*
· *Run Time*: 130mins.
· *Starring*: James Franco , Mila Kunis , Rachel Weisz , Michelle Williams , Joey King
· *Director*: Sam Raimi
· *Trailer*
"Raimi manages to keep things engaging, which is a very real act of wizardry in and of itself." Jordan Hoffman, Film.com. Full Review
"This trip isn’t so notable. It’s not bad. Some bits are enjoyable. But ultimately, other than some genuinely impressive visuals, it never makes a compelling-enough case to justify its existence." Bill Goodykoontz, Arizona Republic. Full Review
*Have you seen this movie? Help your neighbors out. Leave a review of the film with a comment below.*
* -*
*21 and Over*
· *Run Time:* 93mins.
· *Starring*: Miles Teller , Skylar Astin , Justin Chon , Sarah Wright ,François Chau
· *Director*: Jon Lucas, Scott Moore
· *Trailer*
"Writer-directors Jon Lucas and Scott Moore find a nice balance between the over-the-top high jinks and an emotional core, which unexpectedly crystallizes relatively late in the movie." Peter Hartlaub, San Francisco Chronicle.
"Yes, surely for them, the lucky few and probable many, 21 and Over will be the Best Movie Ever. For the rest of us, though, it’s something of a chore." William Goss, Film.com.
*Have you seen this movie? Help your neighbors out. Leave a review of the film with a comment below.*
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*Jack The Giant Slayer*
· *Run Time*: 114mins.
· *Starring*: Nicholas Hoult , Stanley Tucci , John Kassir , Ian McShane ,Ewan McGregor
· *Director*:Bryan Singer
· *Trailer*
"Ultimately, it’s hard and a bit pointless to nitpick Jack The Giant Slayer because it never sets out to be or presents itself as anything more than a slightly beefed up fairy tale." Kevin Jagernauth, The Playlist. Full Review
"This epic waste of $190 million plunders the grab bag of overused plotlines, failing to put its own stamp on much of anything." R. Kurt Osenlund, Slant Magazine. Full Review
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*Snitch*
· *Run Time*: 112mins.
· *Starring*: Dwayne Johnson , Barry Pepper , Susan Sarandon
· *Director*: Ric Roman Waugh
· *Trailer*
"Snitch is grittily streetwise, and until its last 20 minutes fairly credible compared to other movies "inspired by" true stories." Steve Persall, Tampa Bay Times.
"Although Johnson performs admirably in the drama-heavy role — far better than many of his action-hero colleagues would manage — John Matthews is a character as boring as his name." Barbara VanDenburgh, Arizona Republic.
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*Safe Haven*
· *Run Time:* 118mins.
· *Starring:* Josh Duhamel , Julianne Hough
· *Director:* Lasse Hallström
· *Trailer*
"A sentimental romantic thriller. But it’s a well-made sentimental romantic thriller, and that makes all the difference." Connie Ogle, Miami Herald.
"It’s hard to argue with the title here – Safe Haven, indeed. This is all about safety in the Hollywood workplace. Why make a movie when making a Hallmark-card-with-dialogue is so much less risky?" Rick Groen, The Globe and Mail.
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*Identity Thief*
· *Run Time: *N/A*
*
· *Starring: *Melissa McCarthy , Jason Bateman , John Cho , Clark Duke ,Amanda Peet
· *Director:* Seth Gordon
· *Trailer*
"Melissa McCarthy is riveting in simply-penned moments of remorse and confession, adding tearful depth to her ace timing and formidable physical comedy." R. Kurt Osenlund, Slant Magazine
"Identity Thief is a road movie with its creative lanes clogged, and a Mack truck comedian barreling through, anyway." Steve Persall, Tampa Bay Times
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* -*
Any of these spark your interest? College Square in Cedar Falls will be showing all these flicks. Showtimes and ticket cost can be found on the theater's website. Reported by Patch 14 hours ago.
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Move over Brangelina
James McAvoy and Anne-Marie Duff are Britain's new golden acting couple, tackling everything from classical theatres to action movies. But they are reluctant stars who are happy to live out of the limelight
Standards have been set when it comes to golden couples of stage and screen. Half a century ago, when Elizabeth Taylor and Richard Burton met on the set of Cleopatra, then the most expensive movie ever made, the powerful personal chemistry was immediately clear. In consequence, the love of the two British-born stars is now almost as fabled as the story of Antony and Cleopatra itself.
Since the 1960s there have been occasional challenges, one from Kenneth Branagh and Emma Thompson, perhaps, for the title of Britain's premiere theatrical partners. But quietly, even reluctantly, since they do not desire it, a talented new pairing has staked a claim: Anne-Marie Duff and her husband James McAvoy.
Their screen union did not involve burnished Egyptian barges and a cast of thousands. Instead it took place in a kitchen on the fictional Chatsworth council estate where, as the unlikely lovers Fiona and Steve in Channel 4's Shameless, they made passionate love for the television cameras against a Formica worktop.
This weekend that impromptu coupling seems in the distant past, as McAvoy stars as Macbeth on the London stage, while one of his three new films opens in cinemas across Britain, and Duff prepares to return to the West End in Alan Hollinghurst's adaptation of Racine's Berenice.
Duff still maintains the kitchen scene was no fun to shoot, even though she liked McAvoy. "It is like sumo wrestling in knickers in front of a group of strangers," she has claimed.
For Emma Burge, who brought the two together as producer of the first series of Shameless, the memory of watching them work in the early days is a fond one. "There was a very sweet kind of spark and a rather nice, but slightly charged feeling about the place," she recalled this weekend.
Duff is to return to Chatsworth to say goodbye in the final episode of Shameless this May. It is something she always said she would do for a show that made her name and earned her a Bafta nomination by casting her, aged 33, as a 20-year-old forced into caring for her young siblings. "We thought it was a dark drama and didn't get the comedy at all. For some strange reason none of us sniffed that out. I thought it was brilliant and clever, but we were all like pioneers. We didn't really know what we were doing as there had been nothing akin to it," she has said of screenwriter Paul Abbott's creation.
Duff had already appeared on stage opposite Helen Mirren in Collected Stories, picking up an Olivier nomination. Burge said: "I had seen her in a play with Mirren and I remembered this very young-looking person. Her agent then told me that Anne-Marie was a little older than she looked. And since we wanted our Fiona to have an age on her because of the responsibility of bringing up a family, we wanted to see her. We all utterly fell in love with the idea of having her as our family's surrogate mum."
Since she and McAvoy left the acclaimed show in 2005 their careers have gained incredible weight, substance and variety. McAvoy's physically rigorous Macbeth at the Trafalgar Studios has been much-admired this spring and last Friday his new thriller, Welcome to the Punch, co-starring Mark Strong, was released. Next up is Filth, based on the Irvine Welsh novel, then comes Danny Boyle's Trance. And on Saturday he starred alongside Benedict Cumberbatch in Radio 4's production of Neil Gaiman's Neverwhere, originally filmed as a BBC TV series starring Gary Bakewell in 1996.
"I am really thrilled by what has happened for them," said Burge, "but not remotely surprised because they have incredible capacity. They both have a core energy and very quick minds and they are effortlessly able to sum up the human condition."
Despite their success, the couple continue to live in a north London flat with their son, Brendan, who was born in 2010 and named after Duff's father. Neither grew up in the area. McAvoy, 33, is Glaswegian and 42-year-old Duff, who is of Irish descent, grew up in Hayes, Middlesex, the daughter of a painter and decorator and a mother, Mary, who worked in a shoe shop. Friends say they like the area and will not live in Hollywood full time.
Duff has concentrated on theatre work since Shameless, with triumphs as St Joan at the National Theatre and in Rattigan's Cause Célèbre, but she came back to television drama last year to give an unsettling cameo performance in the BBC's Parade's End and was one half of a superb pair of performances alongside Olivia Colman in Jimmy McGovern's Accused.
Both McAvoy and Duff have faces that suggest youthful innocence, something which makes the subtlety and range of the parts they play all the more unexpected. Although McAvoy quickly distinguished himself on screen in Atonement and The Last King of Scotland, he is now also a Hollywood action hero, starring in Wanted and as a young Charles Xavier in X-Men: First Class. His friend James Corden has noted approvingly the way McAvoy balances his work between mass entertainment and independent cinema. "You can see in his career there is a sense of 'one for me, then one for them', one project to keep the bigger picture happy, Wanted, or X-Men, and then one to feed the soul," he has said.
Yet McAvoy is also happy to try on a cosier persona too: voicing the animation Arthur Christmas, playing the faun Mr Tumnus in The Lion, the Witch and the Wardrobe, bearing the Olympic torch through Glasgow or doing a bit of Red Nose posing.
Burge wants to speak up for the big screen blockbuster parts too. "To really pull off an action movie is an incredible skill and I don't think people realise that," she said. If a slight figure can make action, or violence, credible on screen, it is due to his vitality, she suspects. "When he came on to the Shameless set for the first time he had this amazing physical presence, I remember."
The couple have vowed not to speak about each other publicly, but McAvoy makes it evident that he thinks his wife has the real gift for theatre – an ability to commit totally. Director Howard Davies spotted the same abandoned quality, once saying: "She throws herself at parts as if bruising herself on them."
In spite of his film-star status, McAvoy suggests it is stage performance he prefers. Film, he has argued, always means that "the world will have changed by the time the audience sees it". He loves the immediacy of theatre and the fact "you tell a story from beginning to end and never stop".
His Macbeth for director Jamie Lloyd has been praised for its fully fledged assault on the expectations of the audience. "James's instinct is such that he'll throw himself into it 100% each time we do it. There's no skirting around the edges," Lloyd said recently.
McAvoy puts it more plainly. "I am a very shouty Macbeth. You know you've got the audience there and can do anything to make them feel uncomfortable. We do it on purpose."
His whole-hearted portrayal of the ambitious Scottish king has been reflected in the number of injuries sustained in the run. "We got cuts and bruises all over and we are down at the physio a couple of times a week," he has revealed, admitting it will be a struggle to get through to the end of April when the show closes.
He grew up in Drumchapel, Glasgow, in the care of his maternal grandparents and with his sister, the actor Joy McAvoy. His parents divorced when he was seven and his mother, Elizabeth, a nurse, judged that the children would have a more stable childhood there. He left drama school in Scotland in 2000 and by the time he appeared in Shameless he had already starred in the 2003 TV series of State of Play and was lined up to play the nerdy lead opposite Rebecca Hall in a film comedy about a quiz team.
"When we made Starter for 10 James was near the start of his film career, yet already he was a natural on screen," said the film's producer Pippa Harris. "One of his great strengths is his versatility – for us he played a charming, gauche university student, but he's just as believable wielding a gun in Welcome to the Punch."
McAvoy is now Hollywood-bound once more, making The Disappearance of Eleanor Rigby, a film drama in two parts, with Jessica Chastain.
Arguably, given their surnames and McAvoy's recent appearance in Macbeth, if we must have Brangelina, perhaps we can now adopt MacDuff as a composite name for the couple. And, since the Shakespearean phrase is actually misquoted and then corrected in the BBC's production of Gaiman's Neverwhere this weekend, we do perhaps have licence, just this once, to cry out: "Lay on, MacDuff!" Reported by guardian.co.uk 9 hours ago.
Standards have been set when it comes to golden couples of stage and screen. Half a century ago, when Elizabeth Taylor and Richard Burton met on the set of Cleopatra, then the most expensive movie ever made, the powerful personal chemistry was immediately clear. In consequence, the love of the two British-born stars is now almost as fabled as the story of Antony and Cleopatra itself.
Since the 1960s there have been occasional challenges, one from Kenneth Branagh and Emma Thompson, perhaps, for the title of Britain's premiere theatrical partners. But quietly, even reluctantly, since they do not desire it, a talented new pairing has staked a claim: Anne-Marie Duff and her husband James McAvoy.
Their screen union did not involve burnished Egyptian barges and a cast of thousands. Instead it took place in a kitchen on the fictional Chatsworth council estate where, as the unlikely lovers Fiona and Steve in Channel 4's Shameless, they made passionate love for the television cameras against a Formica worktop.
This weekend that impromptu coupling seems in the distant past, as McAvoy stars as Macbeth on the London stage, while one of his three new films opens in cinemas across Britain, and Duff prepares to return to the West End in Alan Hollinghurst's adaptation of Racine's Berenice.
Duff still maintains the kitchen scene was no fun to shoot, even though she liked McAvoy. "It is like sumo wrestling in knickers in front of a group of strangers," she has claimed.
For Emma Burge, who brought the two together as producer of the first series of Shameless, the memory of watching them work in the early days is a fond one. "There was a very sweet kind of spark and a rather nice, but slightly charged feeling about the place," she recalled this weekend.
Duff is to return to Chatsworth to say goodbye in the final episode of Shameless this May. It is something she always said she would do for a show that made her name and earned her a Bafta nomination by casting her, aged 33, as a 20-year-old forced into caring for her young siblings. "We thought it was a dark drama and didn't get the comedy at all. For some strange reason none of us sniffed that out. I thought it was brilliant and clever, but we were all like pioneers. We didn't really know what we were doing as there had been nothing akin to it," she has said of screenwriter Paul Abbott's creation.
Duff had already appeared on stage opposite Helen Mirren in Collected Stories, picking up an Olivier nomination. Burge said: "I had seen her in a play with Mirren and I remembered this very young-looking person. Her agent then told me that Anne-Marie was a little older than she looked. And since we wanted our Fiona to have an age on her because of the responsibility of bringing up a family, we wanted to see her. We all utterly fell in love with the idea of having her as our family's surrogate mum."
Since she and McAvoy left the acclaimed show in 2005 their careers have gained incredible weight, substance and variety. McAvoy's physically rigorous Macbeth at the Trafalgar Studios has been much-admired this spring and last Friday his new thriller, Welcome to the Punch, co-starring Mark Strong, was released. Next up is Filth, based on the Irvine Welsh novel, then comes Danny Boyle's Trance. And on Saturday he starred alongside Benedict Cumberbatch in Radio 4's production of Neil Gaiman's Neverwhere, originally filmed as a BBC TV series starring Gary Bakewell in 1996.
"I am really thrilled by what has happened for them," said Burge, "but not remotely surprised because they have incredible capacity. They both have a core energy and very quick minds and they are effortlessly able to sum up the human condition."
Despite their success, the couple continue to live in a north London flat with their son, Brendan, who was born in 2010 and named after Duff's father. Neither grew up in the area. McAvoy, 33, is Glaswegian and 42-year-old Duff, who is of Irish descent, grew up in Hayes, Middlesex, the daughter of a painter and decorator and a mother, Mary, who worked in a shoe shop. Friends say they like the area and will not live in Hollywood full time.
Duff has concentrated on theatre work since Shameless, with triumphs as St Joan at the National Theatre and in Rattigan's Cause Célèbre, but she came back to television drama last year to give an unsettling cameo performance in the BBC's Parade's End and was one half of a superb pair of performances alongside Olivia Colman in Jimmy McGovern's Accused.
Both McAvoy and Duff have faces that suggest youthful innocence, something which makes the subtlety and range of the parts they play all the more unexpected. Although McAvoy quickly distinguished himself on screen in Atonement and The Last King of Scotland, he is now also a Hollywood action hero, starring in Wanted and as a young Charles Xavier in X-Men: First Class. His friend James Corden has noted approvingly the way McAvoy balances his work between mass entertainment and independent cinema. "You can see in his career there is a sense of 'one for me, then one for them', one project to keep the bigger picture happy, Wanted, or X-Men, and then one to feed the soul," he has said.
Yet McAvoy is also happy to try on a cosier persona too: voicing the animation Arthur Christmas, playing the faun Mr Tumnus in The Lion, the Witch and the Wardrobe, bearing the Olympic torch through Glasgow or doing a bit of Red Nose posing.
Burge wants to speak up for the big screen blockbuster parts too. "To really pull off an action movie is an incredible skill and I don't think people realise that," she said. If a slight figure can make action, or violence, credible on screen, it is due to his vitality, she suspects. "When he came on to the Shameless set for the first time he had this amazing physical presence, I remember."
The couple have vowed not to speak about each other publicly, but McAvoy makes it evident that he thinks his wife has the real gift for theatre – an ability to commit totally. Director Howard Davies spotted the same abandoned quality, once saying: "She throws herself at parts as if bruising herself on them."
In spite of his film-star status, McAvoy suggests it is stage performance he prefers. Film, he has argued, always means that "the world will have changed by the time the audience sees it". He loves the immediacy of theatre and the fact "you tell a story from beginning to end and never stop".
His Macbeth for director Jamie Lloyd has been praised for its fully fledged assault on the expectations of the audience. "James's instinct is such that he'll throw himself into it 100% each time we do it. There's no skirting around the edges," Lloyd said recently.
McAvoy puts it more plainly. "I am a very shouty Macbeth. You know you've got the audience there and can do anything to make them feel uncomfortable. We do it on purpose."
His whole-hearted portrayal of the ambitious Scottish king has been reflected in the number of injuries sustained in the run. "We got cuts and bruises all over and we are down at the physio a couple of times a week," he has revealed, admitting it will be a struggle to get through to the end of April when the show closes.
He grew up in Drumchapel, Glasgow, in the care of his maternal grandparents and with his sister, the actor Joy McAvoy. His parents divorced when he was seven and his mother, Elizabeth, a nurse, judged that the children would have a more stable childhood there. He left drama school in Scotland in 2000 and by the time he appeared in Shameless he had already starred in the 2003 TV series of State of Play and was lined up to play the nerdy lead opposite Rebecca Hall in a film comedy about a quiz team.
"When we made Starter for 10 James was near the start of his film career, yet already he was a natural on screen," said the film's producer Pippa Harris. "One of his great strengths is his versatility – for us he played a charming, gauche university student, but he's just as believable wielding a gun in Welcome to the Punch."
McAvoy is now Hollywood-bound once more, making The Disappearance of Eleanor Rigby, a film drama in two parts, with Jessica Chastain.
Arguably, given their surnames and McAvoy's recent appearance in Macbeth, if we must have Brangelina, perhaps we can now adopt MacDuff as a composite name for the couple. And, since the Shakespearean phrase is actually misquoted and then corrected in the BBC's production of Gaiman's Neverwhere this weekend, we do perhaps have licence, just this once, to cry out: "Lay on, MacDuff!" Reported by guardian.co.uk 9 hours ago.
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