OPINION: Better understanding the issues around trans Alaskans

Over the past few weeks, the Alaska State House Judiciary Committee has heard three different bills that affect transgender youth in Alaska. To better understand what it means to be transgender in Alaska, I conducted a series of interviews. I spoke with trans youth, their parents, experts in the field of transgender health, and others. I released those conversations on my podcast, “The East Anchorage Book Club.” The goal was to better understand transgender people in general, and in Alaska in particular. Here are excerpts, lightly edited for clarity and brevity:

Trans youth are real and have always been here

Dr. Joshua Safer, Director of Mount Sinai Center for Transgender Medicine and Surgery in New York: “When I started in this field, the data we had at the time in 2004 was from the treatment of intersex people — people with differences in sexual differentiation and attempts to manipulate gender identity in them — that data was strong enough to make the point that even if we don’t know much else about it, gender identity is clearly a part of people’s brains and must therefore be coded. And the observations over time are simply that the people who come forward and ask for interventions, who get hormones and surgeries in customized ways, do the best.”

Earl Banning, an Air Force neuropsychologist and father of Charlie, a trans teen: “I went to Catholic school, and guess what you couldn’t do in Catholic school back in the day? You couldn’t write with your left hand. You had to write with your right hand. But by the time I went to school, you could write with your left hand. Guess what happened? Suddenly we had all these left-handed people. It’s like, where did they come from? Did we groom them? Did we make them left-handed? No, they were always left-handed. We just didn’t allow them to express it. It’s the same way with transgender people.”

Becca Bernard, an Anchorage lawyer, minister, and mom of a teen trans girl: “Nationwide, the percentage of the population that is trans is half a percent. If you take that and you figure a high school has several hundred or even a thousand students, you’re likely to have more than one trans student, even if they’re not out.”

Aaron Poe, Anchorage wildlife biologist and father of a trans teen daughter: “People need to understand that trans people have always been part of humanity. It’s not something new. It’s not something trendy. It’s just that, fortunately, this country feels safer for trans folks, so they can be more visible.”

Dr. Marci Bowers, pelvic surgeon in California and president of the World Professional Association of Transgender Health, or WPATH: “The proponents of the anti-transgender bills may not understand what transgender is. They may not believe it. But it’s been here since the beginning of time. You can find trans and gender diverse people back at the time of Jesus.”

David Leslie, Inupiaq Sipiniq (3rd gender): “If an Inupiaq boy was born and the last person who died was his grandma, that boy is his grandma, that’s his name. That’s his gender. That’s his identity. And around puberty, he would transition to his adult identity. So, we have always been gender fluid.”

Trans youth are not made trans by their parents, teachers, or peer pressure

Charlie Banning, an Anchorage nonbinary trans masculine teen: “Sure, your parents have an influence on who you end up being, but my parents didn’t make me trans. I was born like this. My parents helped me become that person, but not in a ‘they changed me’ kind of way. It was in a ‘they supported me with my decisions’ kind of way.”

Dr. Joshua Safer: “When you have multiple genes associated with certain parts of sexual reproduction, sometimes you don’t get all the genes that we think go with each other, including gender identity and sexual orientation genes. Anybody who deals with animals sees what we’ve believed was homosexual behavior among livestock or wild animals. We see that natural variation. Some of what we’re calling homosexual behavior is probably trans behavior, but we just can’t talk to the animals and ask them to explain.”

Earl Banning: “If you sat me down years ago and told me, ‘Hey, Charlie’s going to come out as transgender at some point,’ I would not have really bought into that. It was a surprise to us. So, it was definitely the opposite of grooming a child. Looking back and putting the pieces together where you see Charlie wanting to dress in certain ways — wearing bow ties and polo shirts — it’s not as much of a shock. But in the moment when they started to talk about it? Gosh, are they sure about this? Does this really make sense? Charlie was just persistent and consistent about their gender identity.”

Getting gender affirming care is a challenge and the care is purposely deliberative.

Dr. Joshua Safer: “I think the key points are the current guidelines by the current establishment medical organizations like the Endocrine Society and WPATH (World Professional Association for Transgender Health) are very conservative, especially relating to youth for the reason that we depend on self-report, and we want to be very deliberative in our approach, and we do not advocate any medical treatment before puberty. We do not advocate any treatment at all without mental health people on board helping with the assessment as part of the conservative process of clarifying whether we really are trusting these kids to make this decision.”

Jessica Kalarchik, a retired Army First Sergeant who is a trans woman: “Finding a caregiver in Alaska is next to impossible. I contacted Identity (Anchorage’s gender affirming care clinic), and it took eight months to even get a return phone call. And once I talked to them and verified that I’d been getting treatment from a therapist, I then discussed a gender affirming plan with a caregiver. I think it took maybe four visits before I was able to understand what the process looked like.”

Charlie Banning: “I decided to start hormones after a lot of talking with my gender doctor, who is based in Seattle. And we ended up deciding that I didn’t really want to start just dive right in --that I wanted to ease myself into it and see how I felt. So, we started on a super low dose of testosterone for several months until I felt very positive that it was 100% what I wanted.”

Trans minors almost never receive gender affirming surgeries.

Dr. Joshua Safer: “Surgeries for minors are incredibly rare, and the surgeries that we do on minors are almost exclusively limited to some chest masculinizing surgeries for older trans boys.”

Becca Bernard: “Youth can get gender affirming care in Alaska, but not surgery. Nobody can get any kind of gender affirming surgery in Alaska. It’s just not available. The providers aren’t here. What happens in this country is that it is very rare for a minor to receive any kind of surgery. That’s generally an adult process.”

Dr. Marci Bowers: “When it comes to surgery, first of all, it’s not generally prescribed for adolescents. But this is the real problem: we have non-medical people — politicians, and lawyers — trying to make these very complicated decisions.”

Trans girls have a right to play sports on the girls team.

Dr. Marci Bowers: “Opponents see a man competing with a girl, and so let’s back up. First of all, it’s a very small percentage of the population. Transgender youth participate in high school and college athletics at a rate that’s substantially less than the general population. (Utah Gov. Spencer) Cox, when he vetoed a ban on trans girls in girls’ sports bill in Utah, it involved four girls out of 80,000 high school and college athletes. And he basically said, why are we spending so much time on such a divisive issue (that affects so few)? Secondly, there are already trans kids participating in high school and college athletics, and nobody’s that upset about it. They don’t know. When they transition early, boys and girls physically have the same muscle masses until about age eight or nine, and it’s just testosterone where things begin to diverge. But there are a lot of girls that run testosterone levels that are higher than some of the elite male athletes. This was true when the International Olympic Committee started trying to sort through this, and they still haven’t been able to figure out a real consensus about what to do.”

Aaron Poe: “If a person thinks that high school sports are to grow the next generation of NFL athletes (or) Olympians, then maybe that is a concern. But that’s not why I played high school sports … I played because it was a way to hang out with friends and to demonstrate that I could work as a team. It was a way to learn to be responsible, to take direction, to lead, like all those kinds of things. If it’s like for, the one in 300,000 person that is not going to get a bronze medal in the 2032 Olympics? I guess I don’t care about that as much as having kids that grow up in Alaska have opportunities to demonstrate their ability to be on teams and to gain friends.”

Lindsey Banning, psychologist and mom of Charlie and a 12-year-old cisgender girl: “What is the point of sports? … My daughter is a competitive swimmer, and she almost never wins anything. And she’s good, but she almost never wins. And it’s not trans girls who are beating her. And she still loves it, and she still considers it her favorite thing.”

Earl Banning: “Where are all these trans kids that are dominating sports in Alaska? Where are they? I haven’t seen them. And show me the advantages for prepubescent kids playing sports. Why would they be? There’s no hormone difference.”

Nonbinary is a legitimate identity.

Ezzy, 12-year-old cisgender girl and sister to Charlie Banning: “Since Charlie’s nonbinary when I’m talking to people, I’ll say, ‘I have a sibling. They’re 15.’ And people are, like, ‘Oh, you have a brother?’ And I’m like, ‘no, they’re not my brother.’ And then people are like, ‘Oh, are they your sister?’ And I’m like, ‘no, they’re nonbinary.’ And then people are like,’Ew, what’s that?’ And I’m like, ‘oh, that just means that they don’t really identify with being a girl or a boy,’ and they’re like, ‘okay, that’s weird.’ And I’m like, ‘Why is it weird? It’s just my sibling.’ And that’s a way that I make friends: if a person doesn’t have that one reaction that it’s weird, then they’re someone I could be friends with because we would have more of the same views on life.”

Dr. Marci Bowers: “If ever there was a failing of the medical and surgical community in treating trans persons, (it) was not recognizing that there’s diversity even amongst transgender persons. It’s never one size fits all … And this is especially true of this generation where people just want to be themselves. They recognize they may not be fully male, but they feel more masculine than they do feminine. And they are using medicine in the way they see fit … and so they’re demanding things that may be short of full transition. They may not even desire surgery. They may just want to be recognized. They maybe just want hormones. They may just want pronouns. And I see that as a good thing. I see society finding a happier place.”

Dr. Joshua Safer: “Questions for non-binary patients: To what degree is your gender identity not aligned with some of the rest of your biology? What interventions might we consider and how do you want to label yourself? Even in the past when people were labeling themselves in very binary ways, we definitely had people looking for lower dose regimens, partial regimens: some hormones, but not surgery … things like that. We always customize our approach to the patient. Now, I have more kids come to me and say they’re non-binary and using ‘they’ pronouns. I’m an endocrinologist. And so they’re usually coming to me for hormones, so I ask, ‘What is it that you want to achieve?’ The majority of the kids telling me that they’re non-binary are still looking for binary hormones. So, I don’t know that there’s really a practical difference if we’re customizing to the patient anyway.”

The Legislature should not be making these decisions.

Dr. Joshua Safer: “Things that the Legislature should know: Medical treatment before puberty does not happen. Puberty blockers? They’re reversible, but I think we need to be cautious because most of the kids who get those puberty blockers go on to other hormones. So, we want to consider fertility and sexual function as we move forward. And I think those are probably not decisions that should be made in the Legislature, but those absolutely should be conversations among the medical folks, the teens and their parents.”

David Leslie: “To push legislation that would affect such a small handful of trans kids, but while harming so many people, not just trans people, is unconscionable. Cisgender people will get labeled as trans, and that could be an excuse for violence. We’re seeing hatred ramp up in the massive amounts of misinformation being spread with people focusing on genital mutilation, which is not happening. But people are testifying at these hearings as if it were. Someone is deliberately feeding them bad information, and they’re doing it for political power. It’s insane.”

Jessica Kalarchik: “These bills are being brought forward because trans kids are an easy target with very soft representation. There are just so few of them. Every single time a trans person commits a misdemeanor, it gets blown up into a big media circus because it’s an easy low-hanging fruit with little defense that can generate a lot of fear. A vocal minority is trying to legislate trans people out of existence for their own gain. They vote for these ridiculous draconian legislative maneuvers to satisfy the extreme right.”

Earl Banning: “My big thing is the absolute horror at being a professional, being married to a professional, doing the right thing for our kids based on research, serving our country, and people wanting to prosecute us. Are we going to stay in Alaska? You don’t want a neuropsychologist in Alaska to provide care? You want him to leave because his kid has a different pronoun? Is that good for the state? And how does this fit with freedom and autonomy? You want the state to decide this very intimate issue for my child? Really? Don’t you want a doctor to do that? Don’t you want a parent to have that right? Why are you taking away parental rights? Because that’s what you’re doing.”

Transgender people can be happy, well-adjusted people

Lindsey Banning: “Charlie being trans means that I’ve been forced kicking and screaming to see them as who they are and not who I wanted them to be. And that has been so liberating and beautiful. Charlie has benefited from us doing the work to separate ourselves and to center who they are as opposed to who we thought that they were. We finally realized that this is their story to tell. I went from having a shell of a kid who I couldn’t figure out to having the coolest person in my life.”

Rep. Andrew Gray, D-Anchorage, represents the U-Med district and hosts the East Anchorage Book Club Podcast.

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