Adults care about gender politics way more than kids, doctor says. So why is it such a big deal?

When you were born, someone likely told you that you're a boy or that you're a girl. And while your reproductive organs, yes, revealed the sex you were born as, your gender identity was far from predetermined, says child and adolescent psychiatrist Dr. Jack Turban.

Turban is the founding director of the Gender Psychiatry Program at the University of California, San Francisco, who regularly speaks out about gender-affirming care in media. His new book, "Free to Be," is out Tuesday.

"A big hope for the book is that it'll expand the nuance through which people think about gender," Turban says over a recent Zoom call. "Younger generations think about gender with much more nuance than older generations, and they think about all these different dimensions of it and complexity, in a way that's been really beautiful to see as a psychiatrist."

The interview below has been edited and condensed for clarity.

It seems like people love to cherry-pick data points that fit their viewpoint (either for or against gender-affirming care). Is that where you see most of the misinformation stem from?

Also just misrepresenting data. One of the worst misrepresentations is the idea that 80% of trans kids are going to change their mind and grow out of it, so we should just ignore their gender diversity, which is certainly not true. And we talk about that research. Also, we see a lot of just making things up out of thin air.

The bathroom debate is the perfect example that unfortunately, people with really big platforms, including J.K. Rowling, for example, are out there saying that trans-inclusive spaces are going to increase sexual assault risk, providing no data, sometimes providing anecdotes, when we do have these research studies that show that, those trans-inclusive spaces actually improve safety for trans people, and don't make it any worse for cis people.

If trans people are using the bathroom that is not corresponding to their gender identity, (they're) actually more at risk for something going wrong, right?

Exactly. And the other thing that I was really hoping people would take from the book is hearing actual stories of trans people and trans kids, because I think too often these debates become totally intellectualized and removed from reality. And it's really easy to get off into a space that is not correct when you do that. Again, bathrooms are a good example. Because if you knew a teenage transgender girl, if you had to actually watch that girl be forced to go use a boy's bathroom, it would create that understanding. This is not safe for that child. This is embarrassing to this child. It's cruel. But often trans people aren't part of the conversation. Kids definitely don't have the voices. And so I was hoping to highlight some of their voices a little bit more.

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Something that gets missed a lot in talking about this is that some kids are going to go on puberty blockers. Some aren't. Some will eventually want surgery, some won't. How do you think that nuance gets to be more mainstream?

I have a lot of faith. Not everyone shares this faith. But from my vantage point, I do see a lot of that nuance being erased in older generations and in political debates and among people who have lot of power in society. If you're on Twitter or reading the news, it can feel like those are the predominant ideas in society. But the reality is I sit with young people all day, and they don't think about it that way. They love their trans friends. They're really open, accepting of gender diversity.

It's inevitable that as time passes, things are going to get better.

What I gather is that kids are talking about trans issues, but not in the same way that adults are talking about it. Do you think that's fair to say?

I think that's fair. The different generations are thinking about it intensely in different ways. Adults are thinking about it in this very politicized, binary way. And then interestingly, kids are largely not thinking about those things. Like they don't care when their friend uses the bathroom.

Transphobia appears to be something that we learn, not that we're born with.

When did gender-affirming care become such a political issue?

(Gender-affirming care has) been around for decades. Doctors were practicing, they were doing this, families were benefiting, we were having these same involved nuanced conversations. But then it was really the past five years or so that it became really politicized and made everything more difficult.

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You talked about optimism for the future. Can you expand on that?

Part of that is where we are with gender. I'm not a political scientist, by any means. But living in the world, it does feel like we are at a difficult political time, broadly, not just limited to this, where there are a lot of things happening in politics that I didn't see coming. And it seems like it's harder and harder to predict. If you had told me this would be the situation in the world five years ago, I would have never believed you. And so I'm hesitant to, to necessarily predict what things are going to be like in five years.

But I do really, truly think that trans people are becoming more visible. Younger people are thinking about this with more nuance, younger people don't have as much stigma around it. It's not being hidden, more closeted as often. So I think we're making progress. There's all this anti-trans rhetoric and legislation right now that probably is forcing a lot of people back into the closet and making people more afraid to talk. But I do think that probably is going to be a blip and things will continue to improve.