Kenneth Zucker

Kenneth J. Zucker (born 1950) is an American-Canadian psychologist and sexologist. He was named Editor-in-Chief of Archives of Sexual Behavior in 2001. He was Psychologist-in-Chief at Toronto's Centre for Addiction and Mental Health^[1] and Head of the Gender Identity Service until December, 2015.^[2] Zucker is a professor in the Departments of Psychiatry and Psychology at the University of Toronto.

He collaborated with Susan Bradley, collecting clinical and research data over a period of twenty years and became an international authority on gender identity disorder in children (GIDC) and adolescents.^[3] In 2007, Zucker was chosen to be a member of the American Psychological Association Task Force on Gender Identity, Gender Variance, and Intersex Conditions, and in 2008 he was named chair of the American Psychiatric Association workgroup on "Sexual and Gender Identity Disorders" for the 2012 edition of the DSM-5. He previously served on workgroups for the DSM-IV and the DSM-IV-TR.^[4]

His views are controversial in the transgender community,^[5] which led to an external review of the clinic in 2015.^[6]

Life

Zucker was born in 1950 to Jewish parents and grew up in Skokie, Illinois.^[7] Zucker received his B.A. from Southern Illinois University, his M.A. from Roosevelt University, and his Ph.D. from University of Toronto in 1982. He holds a certification from College of Psychologists of Ontario.

Zucker became interested in gender identity after reading Richard Green's 1974 book Sexual Identity Conflict in Children and Adults.^[7] Zucker's graduate work in developmental psychology resulted in his master's thesis on normative gender identity development in children. While in graduate school, Zucker met his future collaborator, Susan J. Bradley, a child psychiatrist on staff at the Child and Adolescent Service of the Clarke Institute of Psychiatry (now the Child and Family Studies Centre of the Centre for Addiction and Mental Health), a public mental health centre and teaching hospital of the University of Toronto Faculty of Medicine.

Zucker was impressed with the Clarke Institute and met with then chief of psychology, Kingsley Ferguson, who told Zucker of Bradley's new working group assessing children and adolescents with gender identity problems. He joined Bradley's group.^[8]

Therapeutic intervention for gender variance

Since the mid-1970s, Zucker has treated about 500 preadolescent gender-variant children to make them accept the gender identity they are assigned at birth until they are at an age he believes they may determine their own gender identity.^[9] For children assigned as males at birth, Zucker asks parents to take away toys associated with females and instruct the child not to play with or draw pictures of girls.^[10] Psychologist Darryl Hill wrote that Zucker and Bradley believed that reparative treatments can reduce rejection by enabling gender non-conforming children to mix with children of the same sex, reducing the possibility of adult gender dysphoria.^[11]

Among Zucker's publications is the case history two patients who were male by birth but suffered a penectomy and were shortly thereafter reassigned as females. At age 26 both denied ever feeling the desire to be male. Both patients reported more masculine behaviors and bisexuality, about which Zucker suspects that gender role and sexual orientation develop mostly before birth while gender identity development begins shortly after birth.^[12] There is some support for the position that "prenatal sex differentiation can at least sometimes trump social influences."^[13]

Zucker says parents set the goals at his clinic. "We recommend that one goal be to help the child feel more secure about his or her actual gender, another to deal with the child's emotional difficulties, and a third to help with problems in the family. It's helpful to have parents set limits on things like cross-dressing, which many parents have not done before coming to us."^[14] Zucker's follow-up of 50 treated children found that "about 10 percent are still very unhappy about their gender, still cross-dressing, and thinking about having sex reassignment surgery" as young adults.^[14] Zucker has stated that "the therapist must rely on the 'clinical wisdom' that has accumulated and to utilize largely untested case formulation conceptual models to inform treatment approaches and decisions."^[15]

Zucker coauthored a statistical report with J. Michael Bailey that found gays and lesbians exhibited more cross-gender activity as children.^[16]

For adolescent clients expressing gender identity disorder, Zucker's treatment protocol resembles that for adult GID, consisting of hormone replacement therapy to aid the adolescent in a social transition. Since sex reassignment surgery is not generally performed on minors in North America, Zucker's clinic does not provide recommendations for it – instead, clients are encouraged to pursue reassignment through the adult Gender Identity Clinic at CAMH, which controls funding for the procedure in Ontario.

Activists have compared Zucker's approaches with reparative therapy. The Gay and Lesbian Medical Association believes "'reparative' therapy that seeks to reverse sexual orientation or gender identification"^[17] is an "extreme example" of bias that "may lead to increased self hatred and mental health problems."^[18] Psychiatrist Simon Pickstone-Taylor has cited similarities between Zucker's therapeutic intervention and reparative therapy for homosexuals.^[19] Zucker responded that prevention of homosexuality was never a goal in their treatments and cite a lack of empirical evidence for the most effective approach.^[20] Journalist Marc Lostracco described Zucker's therapy as "well-meaning" but "problematic and harsh."^[21] Others, like author Phyllis Burke, object to any diagnosis of GID in children, considering it to be "child abuse."^[22] Zucker dismisses Burke's book as "simplistic" and "not particularly illuminating;" journalist Stephanie Wilkinson said Zucker characterized Burke's book as "the work of a journalist whose views shouldn't be put into the same camp as those of scientists like Richard Green or himself."^[23]

Archives of Sexual Behavior

As editor of Archives of Sexual Behavior, Zucker published a controversial study on reparative therapy by Robert Spitzer. According to The New York Times, after his presentation of the study caused controversy, Spitzer asked Zucker to publish it. "I knew Bob and the quality of his work, and I agreed to publish it," Zucker said in an interview. "But I told him I would do it only if I also published commentaries". Spitzer later recanted the study's conclusions.^[24]

DSM

LGBT activists protested Zucker's 2008 appointment to the DSM-5 working group.^[25][26] The National Gay and Lesbian Task Force issued a statement questioning the APA's decision to appoint Zucker and a second member of the work panel.^[27] According to a response released by American Psychiatric Association, Zucker does not advocate reparative therapy for transgender adults or for trans youth in all cases, and he opposes change therapy for gays under all circumstances.^[28]

Gender Identity Clinic for Children at CAMH

Zucker's treatment protocol came under scrutiny in March 2015 when Cheri DiNovo MPP tabled a private member's bill that banned on conversion therapies for gender identity or sexual orientation. Zucker's gender identity clinic stopped accepting new patients the same month, awaiting the result of an ongoing review of the practice. CAMH director Kwame McKenzie said that Zucker's treatments were against the centre's guidelines, but that there exist two groups of thinking on such therapy for children under 11 among professionals.^[6][29] The review was expected to take six months.^[30]

After that review, CAMH shut its Child Youth and Family Gender Identity Clinic in December 2015. The reviewers, Suzanne Zinck of Dalhousie University and Antonio Pignatiello of Toronto's Hospital for Sick Children noted numerous strengths of the clinic, but also described it as an insular entity with an approach dissimilar from other clinics. Zinck and Pignatiello invited stakeholders to comment on their experiences in the clinic. A former client, now an adult, claimed Zucker “asked him to remove his shirt in front of other clinicians present, laughed when he complied, and then referred to him as a ‘hairy little vermin.’”^[31] The accusation was subsequently retracted by the accuser.^[32] CAMH removed the report from its website and apologized.^[33]

Kwame McKenzie, medical director of CAMH's child, youth, and family services, said “We want to apologize for the fact that not all of the practices in our childhood gender identity clinic are in step with the latest thinking”^[34] and that Zucker is “no longer at CAMH.” CAMH announced a process of consultation with community leaders to examine how best to offer care.^[35]

Publications

According to the Web of Science, Zucker has published almost 100 articles in peer-reviewed journals. These articles have been cited over 2000 times, with an h-index of 20.^[36] He has published several books, including:

• Gender Identity Disorder and Psychosexual Problems in Children and Adolescents (1995)
• Attachment and Psychopathology (1997)
• Ex-Gay Research: Analyzing the Spitzer Study And Its Relation to Science, Religion, Politics, and Culture (2006)

References

External links

• Kenneth Zucker profile via Centre for Addiction and Mental Health
• Kenneth Zucker profile via American Psychiatric Association
• Kenneth Zucker at the Internet Movie Database
• Kenneth Zucker in The Atlantic