A tragic story
A week ago Radio NZ ran a tragic story about a teenager who starved to death alone despite the involvement of multiple agencies in their life. They developed anorexia at age 12 (and were sexually abused at age 5) and ended up hospitalised ten times. They died age 17 weighing 30 kgs. The heart break of the parents is wrenching, and their years of battling to try and prevent this end leaves you with despair.
One aspect of the story is that some years after being diagnosed with anorexia and autism, their daughter said she was non-binary and then later she identified as a male. Her parents were not supportive of her proclaimed gender identity on the advice of her long-term psychiatrist:
“The psychiatrist advised us that Vanessa was using the transgender identity as a mask for her continuing anorexia – that Vanessa was saying the reason she didn’t want a curvy, female body was not because she was suffering from anorexia, but because she was really a boy.
“The psychiatrist recommended not affirming Vanessa’s transgender identity.”
The non recognition of Vanessa’s gender identity led to estrangement from her parents, and various government agencies shunned them, and seemingly focused on everything except her anorexia which killed her.
Ani O’Brien and Liam Hehir have both written about the failings of the state in this issue.
Some have been outraged that Radio NZ dared to run a story from the parent’s point of view. They seem more upset by misgendering the dead 17 year old, than the fact they are, well, dead.
To my mind the gender identity part of the story is not the most important. It is the fact a 17 year old under the care of multiple state agencies was allowed to starve to death, and the removal of the compulsory treatment orders that had been in place.
No one can know for sure whether the teenager did truly have gender dysphoria, or whether it was linked to the anorexia. The fact the parents were acting on the advice of the actual psychiatrist who had been involved with their child for half a decade seemed a reasonable thing to do.
Liam Hehir has a second article and makes the point:
It is a position found in standard clinical literature, including journal articles in Transgender Health and the Journal of Eating Disorders. It is true some clinicians and guidelines recommend early affirmation as a form of harm reduction in some complex cases. But there’s just no reason to assume that this wasn’t considered and carefully rejected by the treating professional.
To reduce this kind of judgment to conversion therapy or bigotry is to misunderstand what psychiatry is for. The job of a psychiatrist is not to affirm whatever a patient believes about themselves. It is to assess those beliefs carefully, especially when they may be part of a harmful pattern. This is not cruelty. It is care.
None of the people now attacking the parents or the journalist treated this young person clinically. They weren’t there across the five years of hospitalisations. They weren’t involved in the long-term psychiatric management of the case. Yet many feel entitled to accuse the family of emotional abuse and the reporter of transphobic malpractice.
The parents have also put out a statement:
We acknowledge that there was tension and conflict between Vanessa* and us. We discussed this in detail with Ruth Hill from Radio New Zealand. The challenges in our relationships were painful and it is appalling that the details of the most devastating aspects of our family life is being used by activists to paint us as bad parents.
Children often become very angry with their parents when we have to assert our authority and make decisions we consider to be best for them. We made Vanessa* eat when she did not want to, we took away her access to the internet when she was using it to take part in pro-anorexia forums, we took her to doctors and psychiatrists when she wanted to be left alone with her eating disorder, and yes, we had her hospitalised when she was dangerously ill due to that disorder. She was very angry with us. Doing the right thing by our child was often the very hardest thing.
We object to the portrayal of Vanessa’s* struggles with anorexia, autism, and gender as though they were simply the result of our lack of understanding or ignorance. To be clear, Vanessa* was not “lost” due to her ‘gender identity’. Her anorexia, a long-standing and deeply painful struggle, was the cause of her death. She was 30 kilograms when she died. That is what killed her.
Parenting is never easy, but when your child is autistic, has anorexia, and is a survivor of childhood sexual abuse, the challenges can feel overwhelming. As parents, we have always done our best, but the complexity of Vanessa’s* needs and the trauma she carried meant we often had to be the ‘bad guys’ advocating for her best interests when her mental illness was telling her to harm herself.
I can’t even imagine what life must have been like for these parents. I hope those attacking the parents, and Radio NZ for giving them a voice, desist.