Sarah Wong is a photojournalist and one of the co-authors of Inside Out: Portraits of Cross-Gender Children, a culmination of a nine-year project involving the photographing and documentation of the lives of several transgender children in the Netherlands that were all undergoing a gender transition. All of the children involved were being treated at Vanderbilt University’s clinic for gender variant children under the ‘Berdache’ programme and were among the first to be treated with hormone blockers to delay the onset of puberty and avoid the damage that puberty often has on transgender adolescents.
I had the privilege of speaking to Sarah Wong about her work, the children she worked with and contemporary trans* issues. Confessing that when she started work on Inside Out she knew very little about transgender identities, she explained how the idea was conceived. While working on her book Sophia’s Children, an earlier project that saw her capturing photographs of children at Sophia Children’s Hospital, she was reached out to by the families of several transgender children who were keen to have photographs of their children expressing their gender the way they wanted to without the layer of sensationalism many photographers aim for.
“They reached out to me and said ‘We would like to have our children photographed like you did for the children in the hospital. We don’t have pictures of our children for media purposes because most photographers will take those pictures in a freaky way, making it sensational. We could see that your photographs of the children in the hospital were more like you were reaching out to the children, asking them, “How do you want to be in this picture?”’
Some of the doctors just ten years ago thought that these children were schizophrenic
“I said we also have to reach out to doctors and a medical journalist because it’s so difficult to explain to the audience. You can’t explain it in a fairy tale story or in a spiritual story, you have to reach out to media and society with a medical story. You can also explain that the children are not freak children, they do not have psychological problems, they are not schizophrenic. Some of the doctors just ten years ago thought that these children were schizophrenic.”
That medical journalist was Ellen de Visser, a writer for Dutch daily newspaper de Volkskrant, who co-authored Inside Out and wrote the original article in de Volkskrant in 2003. At that point there were seven children involved, though the number eventually grew to eleven. Sarah’s hopes for the project were always rooted in the interests of the children – the concept of being seen by the world the way the children always wanted to was ultimately about empowerment.
“You always have to reach out to them and say what do you want to share with the world? What do you want to share about yourself? I loved one of the children who said openly when she was only six, ‘If you don’t reach out to media, you can’t expect society to know how you feel.’” To ensure that the children and their families were protected from media reactions – the subject of treatment for transgender adults is controversial enough, and for children it is doubly so – she ensured that a safety net was in place.
“I always kept asking the parents – are you sure you want your pictures of your family and your children to be in the media?… We made a few agreements. They were not to talk to the media themselves, I was always in-between – because of the translation, and because those children were very young and vulnerable and did not understand the effect it could have on their lives.
“Sometimes the children would reach a certain point and then decide they did not want to be in the project anymore. And then two or three years later they would come back and feel they could come out again with a new name or new identity.”
As well as this basic level of protection, the families also met twice a year to “catch up” ,as Sarah described it, “because often the children and the family think, well, we are the only ones.” For transgender children and their families especially it is vitally important to have a support network, a community that understands the problems they face.
Transgender children are rarely able to access treatment like hormone blockers due to impenetrable medical pathways, critical parents and fear of coming out. Legal recognition of transgender children’s genders is not provided anywhere in the world, and so often coming out under the age of 18 makes transitioning difficult if not impossible, especially if their schools make no provisions for it. For many trans* people, childhood becomes a long wait before they can be who they are inside.
When I asked Sarah whether she believed the treatment the children received under the Berdache programme had helped them, her answer was unequivocal: “They always said, ‘We are so grateful we have this treatment, we are so grateful to have this, because if we did not have this we would be very unhappy.’ You also know that many of the transgender children who were not able to talk about it or have medical treatment or to have this freedom to experience themselves as another gender, they are very depressed. Lots of those children and people have committed suicide. I can only speak for [the children featured in Inside Out]; they are so happy with this, and it’s only possible because this hospital has worked on this treatment.
“All the children find it helpful, and the parents as well. They want to have a happy son, not an unhappy daughter.”
Of course, Inside Out was conceived in 2003 and concepts of gender within trans* communities has changed drastically. Recent years have seen the rise of non-binary gender identities and greater interest in androgynous, genderless self-expression. In the UK we have seen Selfridges ‘Agender’ store launch just earlier this year, and more recently H&M’s sister brand ‘& Other Stories’ launched an all-transgender clothing campaign. While the clothes sold at these stores are considerably more expensive than the average trans* person could afford, popular concepts of gender identity and expression are clearly rapidly shifting.
This is all coming at a time when Caitlyn Jenner dominates media headlines and has been featured on the cover of Vanity Fair. It’s important to keep reality in sight when discussing issues affecting the trans* community – Jenner received huge measures of support and vitriol, but ultimately she could never represent the trans* community as a whole. She will never have trouble finding work due to her gender identity, she will not face estrangement and homelessness as many trans* people do and she made her way through her transition and medical treatment rapidly, bypassing the years of waiting and interrogation by doctors that has become the standard for trans* healthcare. Her transition was as palatable as it could possibly have been for the mainstream audience, made easy by her wealth, whiteness, her binary identity, stereotypical femininity and non-radical politics.
Sarah Wong was quoted in a Buzzfeed article earlier this year as saying that the Netherlands “has probably the most progressive attitude toward gender variance in the world – transgender kids included.” It is undeniable that the country was a leader in trans* rights twenty to thirty years ago, and recently it has been making efforts to catch up with the current forerunners.
Childhood becomes a long wait before they can be who they are inside
It was only back in 2011 that the Human Rights Watch published their report, ‘The Netherlands: Transgender Law Violates Human Rights’, decrying the legal requirement for forced sterilisation of any transgender person seeking legal recognition of their gender identity, and while this was repealed in 2013 they are still behind the times – Ireland has recently become the latest country to adopt a law allowing for transgender people to self-define their legal gender, bypassing requirements for medical opinion and legal interference that the Netherlands (and the United Kingdom) still require.
Presently in the UK an inquiry is being held by the Women and Equalities Committee in Parliament into the status of transgender equality as a whole, with particular focus on possible amendments to the 2004 Gender Recognition Act, treatment for transgender people in the NHS, trans* people in education and the 2010 Equality Act and its effectiveness on tackling workplace trans*-related discrimination.
Inside Out is made real by its commitment to life and non-sensationalism, a world away from Caitlyn Jenner and expensive fashion, but it’s hard to call it radical now – stories of children transitioning have become commonplace. More often stories of transgender students battling their institutions for their right to transition and live as the gender they identify as are coming up in the news, while Louis Thereoux’s recent documentary Transgender Kids serves as a model for good coverage on the issue.
But what about less privileged trans* people? It’s far less common to hear about trans* people of colour, for instance, who are disproportionately affected by transphobia. As of August. 19 murders of transwomen have been reported in the US in 2015, 17 of which were transwomen of colour.
Also typically ignored are the stories of non-binary people, though when I asked Sarah if any of the children she had met identified as something other than male or female she had a lot to say: “I’m studying in the background as how to identify yourself, even as a normal person. I’m a female, a heterosexual female in a normal body. But some of the children are too young to say ‘I’m this’ and ‘this body doesn’t fit with me’, so sometimes you could say that they identify as genderfluid.”
“Some of these children and their families have come a long way to say to these doctors that ‘my child is definitely transgender’, and that is already a big step. Some parents and children say, ‘I’m definitely born in the wrong body’ and that means they identify themselves really with the other gender, but I think the next step is to identify not with the body but if you identify more with your personality and the gender between then you might end up with, like you and I are saying, because in the end the soul has no gender.
“And the language of the soul everyone understands.”