The Lacey Spears Case, Gender Dysphoria, And Munchausen By Proxy

Last night, my wife and I watched a true crime show on the Lacey Spears case, in which Spears, a single mother desperate for attention, wildly overshared on social media about her son Garnett's health struggles. Garnett passed away at the age of 5 from high levels of sodium leading to swelling in his brain. On March 2, 2015, a jury found Spears guilty of murdering her son by poisoning him with table salt, which she had administered to him from infancy through his feeding tube.

The case has become a well-known example of Munchausen by proxy:

Munchausen syndrome by proxy is a mental illness and a form of child abuse. The caretaker of a child, most often a mother, either makes up fake symptoms or causes real symptoms to make it look like the child is sick.

Most discussions attribute its motivation to attention-seeking by the mother, but in another case, the Dee Dee Blancard murder, the mother exploited her daughter's putative handicaps and disabilities to live entirely on charitable donations and public assisstance. She was able to represent her daughter, Gypsy Rose Blanchard, as much younger than her actual age due to "medical" treatments that disfigured her and stunted her growth.

Many people who met Gypsy were charmed by her. Her 5-foot (150 cm) height, nearly-toothless mouth, large glasses and high, childlike voice reinforced the perception that she had all the problems her mother claimed she did. Gypsy often wore wigs or hats to cover her baldness; her mother regularly shaved Gypsy's head to mimic the hairless appearance of a chemotherapy patient, allegedly telling Gypsy that since her medication would eventually cause her hair to fall out, it was best to shave it in advance. When they left the house, Dee Dee often took an oxygen tank and feeding tube with them; Gypsy was fed the children's liquid nutrition supplement PediaSure well into her 20s.

. . . Dee Dee seems to have at least once forged a copy of her daughter's birth certificate, moving her birth date to 1995 to bolster claims that she was still a teenager; Gypsy said in a later interview that for 15 years she was not sure of her real age. She sometimes also claimed that the original had been destroyed during the post-Katrina flooding. Dee Dee did keep another copy with Gypsy's actual birth date. Her daughter recalls seeing it during one of their hospital visits and becoming confused; Dee Dee told her it was a misprint.

The Dee Dee Blanchard case ended when Gypsy Rose met a man online and prevailed on him to murder her mother. A remark in the TV program on the Lacey Spears case mentioned that Munchausen-by-proxy mothers must normally kill their victims in childhood before they can figure out what's being done to them; Garnett Lacey is an example of the norm, while Gypsy Rose Blanchard illustrates the danger of not doing this. Her mother Dee Dee probably delayed killing her daughter because continuing the game brought her significant financial benefits, while we must assume Lacey Spears exploited her son's condition primarily for attention and could dispose of him more easily.

The big thing I noticed in the Garnett Spears program happened because I wasn't paying full attention: There were lots of video clips of the child as a toddler, since the mother was a social media oversharer. Somehow I missed references early in the program to Garnett's gender, and throughout the first part of the show, I thought Garnett was a girl. This is clear in the photo at the top of this post, Garnett clearly has a girl's hairstyle, and in most of the videos, he's wearing only a diaper, so there was no gender-specific clothing.

There was a time, of course, when boys didn't have their hair cut or begin to wear trousers until they were roughly Garnett's age when he died. In this case, his mother seems to have wanted to keep him in a more innocuous female state, although she always identified him as her son, until he reached the age when she'd need to dispose of him in any case.

This brings me to the question of early childhood gender dysphoria, where certain children are encouraged to believe well before puberty that they're the wrong gender, and puberty blockers and pre-surgical therapies are prescribed. According to Wikipedia,

Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent (gender dysphoria) due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.

The problem I have with this whole idea is that a child with gender dysphoria can never be anything but a proxy for some adult, either a parent or a school official acting in place of a parent and approving and supervising the child's medical treatment. There is no assurance that the parent isn't effectively running a Munchausen con for attention, and there's also no assurance that school officials promoting such treatment aren't simply making a good living from the game.

An individual who undergoes hormone or surgical treatment for gender dysphoria effectively becomes a permanent medical patient, bad for the individual, good for unethical doctors and school officials, good as well for attention-seeking parents. For some parents, the idea of delaying puberty or transforming a potentially disruptive boy into a more agreeable girl would also bring benefits, no matter how damaging to the child.

And at this point, we've had little experience with what happens to children who've been through this therapy. I've got to think there are more Gypsy Rose Blanchards waiting to emerge in these cases.