Susan Coates and transgender people

Susan Winship Coates (born June 29, 1940) is an American psychologist who is a key figure in the pathologization of gender diversity. She is a notable supporter of the practice of “interventions” aimed at what she calls gender identity disorder in children (GIDC). She was involved in revising the 4th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) to reflect her views.

Background

Coates earned a Bachelor’s degree from Sarah Lawrence in 1962 and a Master’s degree from Vassar in 1968. She earned her Doctorate from New York University in 1976.

Coates served as Director of the Childhood Gender Identity Service at St. Luke’s-Roosevelt Hospital Center from 1980 to 1997. She served on the American Psychiatric Association DSM-IV Subcommittee on Gender Identity Disorders. She has served on the teaching faculty of the Columbia University Center for Psychoanalytic Training and Research. She has also served on the faculty of the Division of Sexuality and Gender in the Psychiatry Department of Columbia University. 

In addition to her work on childhood trauma, Coates has been an expert witness in a number of prominent trials, including the custody battle between Woody Allen and Mia Farrow. Coates had seen their child Satchel professionally.

Coates or someone associated with her has also heavily edited her Wikipedia biography to remove material she does not want reported.

Disease models of gender identity and expression

In 1989, a colleague summarized Coates’ presentation on the topic as follows:

Susan Coates spoke about “Conflict in Gender Identity of Boys.” She has studied boys with extreme boyhood femininity. All the boys in her study wished to be girls, preferred female activities, avoided rough-and-tumble play and liked cross-dressing. These boys all had other pervasive difficulties such as separation anxiety and depression. The mothers were often borderline narcissistic, depressed, dependent women who devalued men. Many of the mothers had been severely traumatized when their sons were two or three years of age. She postulated that maternal psychopathology impairs the child’s separation-individuation process. In order not to lose “Mommy” he merges with “Mommy.” Dr. Coates invoked a bio-psycho-social model but emphasized that the specific biological influences predisposing to childhood G.F.O. have yet been identified.

Leiter (1989)

In 1994, Coates spoke with the New York Times about her therapy for GIDC:

With therapy, younger kids usually come to accept their own gender and feel good about their temperament. When we go back to evaluate them three years or so after therapy, they don’t have compulsive cross-gender fantasies anymore, or often don’t remember them. But if you don’t treat it until 9 or 10, it’s much harder to turn around. And beyond age 12 or so, there’s a good chance they’re on course to become a transsexual as adults.

(Goleman 1994)

Coates reiterated that maternal trauma when the child was two or three was often a factor (Goleman 1994). She reported with Kenneth Zucker that five to thirty times as many boys are treated for GIDC (Coates 1992).

In 2008, she published on her “intervention” techniques for gender diverse children:

This paper reviews the origins of gender identity issues in preschool boys and presents an overview of treatment strategies for working with parents of boys and with the boy. The goals of treatment are to reestablish a secure attachment relationship with both of his parents, to develop a range of coping mechanisms for handling separation anxiety and aggression, to help the child to understand and enjoy his temperament, to help the child to be able to have same sex friendships, to develop gender flexibility and most importantly, restore his self esteem and his sense of authenticity. Specific treatment interventions are reviewed.

Coates (2008)

Selected publications by Coates

Listed by date of publication

  • Coates S, Lord M, Jakabovics E (1975). Field dependence-independence, social-non-social play and sex differences in pre-school children. Percept Mot Skills. Feb 1975 40:1, pp. 195-202 https://doi.org/10.2466/pms.1975.40.1.195
  • Coates SW (1985). Extreme boyhood femininity: Overview and new research findings. In Ruth Corn, Zira DeFries, Richard C. Friedman, eds. Sexuality: New perspectives. Greenwood Press ISBN 9780313242076
  • Coates SW, Person ES (1986). Extreme boyhood femininity: isolated behavior or pervasive disorder? J Am Acad Child Psychiatry. 1985 Nov;24(6):702-9. https://doi.org/10.1016/S0002-7138(10)60113-6
  • Coates SW (1990). Ontogenesis of boyhood gender identity disorder. J. Amer. Acad. Psychoanal., 18:414-438. https://doi.org/10.1521/jaap.1.1990.18.3.414
  • Bradley SJ, Blanchard R, Coates SW, Green R, Levine SB, Meyer-Bahlburg HFL, Pauly IB, Zucker KJ (1991). Interim report of the DSM-IV Subcommittee on Gender Identity Disorders. Archives of Sexual Behavior Volume 20, Number 4 / August, 1991 https://doi.org/10.1007/BF01542614
  • Coates SW, Friedman RC, Wolfe S (1991). The etiology of boyhood gender identity disorder: a model for integrating temperament, development, and psychodynamics. Psychoanal. Dial., 1:481-523. https://doi.org/10.1080/10481889109538916
  • Coates S, Zucker KJ (1992). Gender identity disorders in children. In Kestenbaum CJ, Williams DT (Eds.) Handbook of clinical assessment of children and adolescents NYU Press. ISBN 0814746284
  • Zucker KJ, Lozinski JA, Bradley SJ, Doering RW (1992). Sex-typed responses in the Rorschach protocols of children with gender identity disorder. Journal of Personality Assessment, Volume 58, Issue 2 April 1992 , pages 295 – 310. https://doi.org/10.1207/s15327752jpa5802_9
  • Zucker KJ, Green R, Coates S, Zuger B, Cohen-Kettenis PT, Zecca GM, Lertora V, Money J, Hahn-Burke S, Bradley SJ, Blanchard R. Sibling sex ratio of boys with gender identity disorder. J Child Psychol Psychiatry. 1997 Jul;38(5):543-51. https://doi.org/10.1111/j.1469-7610.1997.tb01541.x
  • Coates SW, Wolfe S. Gender identity disorder in boys: the interface of constitution and early experience. Psychoanalytic Inquiry, 1995, 51:6-38. https://doi.org/10.1080/07351699509534015
  • Coates SW (2008). Intervention with preschool boys with gender identity issues. Neuropsychiatrie de l’Enfance et de l’Adolescence 56/6 (2008), 386-91. https://doi.org/10.1016/j.neurenf.2008.06.004

References

Resources

Columbia University Center for Psychoanalytic Training and Research (psychoanalysis.columbia.edu)

Columbia University Department of Psychiatry (columbiapsychiatry.org)

Wikipedia (en.wikipedia.org)

The Association for Psychoanalytic Medicine (theapmnewyork.org)

  • Susan Coates
  • https://www.theapmnewyork.org/apm_member/susan-coates/
  • http://theapm.org/cont/roster.html [old site]