Developmental and clinical psychologist Diane Ehrensaft is an associate professor of pediatrics at UC San Francisco and director of mental health at the UCSF Child and Adolescent Gender Center, which provides comprehensive services to gender-nonconforming and transgender youth and their families. She is the author of several books, most recently “The Gender Creative Child: Pathways for Nurturing and Supporting Children Who Live Outside Gender Boxes.” Ehrensaft, 72, is a mother of two, grandmother of one, and daughter of a 99-year-old mother; her father recently passed away at 101. She lives in Oakland with her husband, Jim Hawley, “a nice Jewish boy,” she says.

J.: How did a straight, cisgender woman become one of the leading advocates for nonbinary and transgender people?

Diane Ehrensaft: This goes back to the mid- and late-1960s. When I arrived at the University of Michigan as an undergraduate in 1964, Ann Arbor was a sleepy college town. But by 1968, things had changed. There was a cultural revolution going on then. I stayed on at the university for my doctorate. My dissertation, “Sex Role Socialization in a Preschool Setting,” looked at whether preschool teachers treated boys and girls differently. No surprise — they did. So that’s how it began. As a second-wave feminist, I was interested in these issues.

J.: In the last several decades our society has shown great strides in understanding the lives of non-cisgender individuals, but progress has come with some setbacks. How do you view the current situation?

DE: Transgender people and their parents are very anxious right now, but I don’t think [efforts to roll back transgender rights] will be effective. We now have a different cultural understanding. From a clinical perspective, social gender dysphoria is understood as the culture having the pathology, because it fails to see beyond two boxes [boy and girl]. It is no longer the individual who has the pathology.

Recently I heard a new term, “gender modalities.” Instead of cisgender and transgender, everyone has a different gender construction. I can see this play out most in little kids. They will increasingly say, “I’m a little girl, but please take me to the boy’s department for clothes.” These examples are taking place not just in New York and San Francisco, but throughout the United States.

J.: You donate your time and expertise as a witness on behalf of transgender youth in court cases challenging their right to use bathrooms matching their gender identities. Can you describe the pushback, and how it makes you feel?

DE: These are some of the messages I receive: “You are a charlatan.” “You should have your license taken away.” “You have lost your way from your Christian God.” I always chuckle at this one, because as a Jew, I never went looking for it. “You are a rubber stamper with a trans agenda, trying to make kids trans.” I also chuckle at this one, because you try making a cisgender kid transgender. Sometimes they also send me a list of references so that I can “enlighten” myself and see the way.

It never feels good, and my reactive self wants to respond immediately, but my wiser, older self tells me to just keep on doing the work I’m doing as a testimonial to the right way to do things. I also incorporate some of their quotes into my slides for public presentations. My political activist background certainly helps contribute to this fortitude, but I do sometimes lament the tenor of parts of country — that people can actually act like this and take the time to harass others with their fake news. Occasionally, a group of us get together and craft a community response or a commentary in a journal when such accusations begin to show up in print.

J.: And the good news, of course, is that your arguments often prevail. Can you tell us about a recent case?

DE: I provided expert testimony for a transgender boy in northern Florida who was living as a boy since middle school and wanted to use the boys’ bathroom in his high school. The judge ruled in our favor even though he initially said that he didn’t know much about the issue. But by the time he made his ruling, he said that he had learned a lot.

J.: That’s all in the public sphere, of course. You also work a lot with parents on accepting their children’s gender identities.

DE: Just as all people are on a gender spectrum, parents are on the spectrum [of acceptance]. Like their children, they are on a journey. I remind parents that it’s about their children’s dreams, not theirs. I also tell parents that youth who do not get acceptance from their parents are at greater risk for anxiety, depression, poor school performance, self-harm, drug abuse, sexual acting out and suicidal ideation.

J.: You reference your Jewish Midwestern background as key to your own success.

DE: I grew up in a very left-liberal Jewish household in Chicago. We understood what it was to be part of a minority, and we were very focused on social justice. I was part of very progressive Jewish youth groups, and I went to a progressive Jewish camp. My father, in particular, always said to me, “Girls can do anything. You can do anything your brothers do.”

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