Testosterone & young females: What is known about lifelong effects?

by Kerry Smith, MD

Kerry Smith [a pseudonym], MD, is a board-certified internist in the US who has been practicing since 2004. She is the mother of several children, including a 12-year-old daughter who suddenly developed the notion that she is transgender after being exposed to the idea in her 6th grade classroom. It was this development that led Dr. Smith to research the protocol for medical transition of children. She believes that most physicians are blissfully unaware, as she recently was, of the current standards which aggressively promote unstudied and off-label irreversible medical interventions in children too young to drink, smoke, vote, drive, consent to sex, or even watch an R-rated movie.

Dr. Smith is available to interact in the comments section of her article.


What are the risks of giving testosterone to a female for a lifetime?

As the mother of a girl trying on a trans identity, and as a practicing physician, I need an answer to this question.

I’m not the only one. Every day more of us join this club, as the rate of girls questioning their “gender identity” continues to skyrocket, outstripping boys at a previously unimaginable pace. Surely, those who advocate for the medical interventions known as “transitioning” must have a risk-benefit analysis available for parents and patients, before committing young people to a lifetime of pharmaceutical (and potentially surgical) treatment for a poorly defined psychiatric condition?

As a physician who has sworn to do no harm, that’s what I would have assumed.

As it turns out, the WPATH-inspired standard of care, adopted by the US Endocrine Society, has pushed boldly ahead where no medical society has gone before, promoting radical, irreversible body modifications for adolescents using powerful, off-label hormone regimens in the absence of any longterm data about safety.

They are perfectly open about this choice, stating in the standards:

These recommendations place a high value on avoiding the increasing likelihood of an unsatisfactory physical change when secondary sexual characteristics have become manifest and irreversible, as well as a high value on offering the adolescent the experience of the desired gender. These recommendations place a lower value on avoiding potential harm from early hormone therapy.

I suppose it is considered “transphobic” of parents to persist in the nit-picky demand for actual data about what that “potential harm” might consist of, but so be it. Teenagers have always resisted parental concerns about their risky activities. Last time I checked, that didn’t keep us from trying to stop them from using dangerous drugs. Why should testosterone (a schedule III drug in the same category as Suboxone and ketamine) get a free pass?

Sex hormones have a long and checkered history in the US, having been widely celebrated as the fountain of youth before falling from grace after studies belatedly showed multiple adverse health outcomes. This was most striking when the evidence from huge studies WHI, HERS and HERS II demonstrated that, contrary to what earlier observational studies seemed to show, hormone replacement therapy for postmenopausal women actually increased rather than decreased the risk of heart attack, stroke and cancer.

Testosterone had its day in the sun as well, being prescribed not just for the medical condition of hypogonadism, but gleefully promoted as a panacea for the vitality and wellbeing of aging men, for the supposed diagnosis of “low T.” Recently the serious risks of this approach have been described, including increased heart attack and stroke; the FDA eventually placed a warning on testosterone products, and lawsuits are underway; however the shameless promotion to men continues unabated.

As a physician, my first stop for drug information is usually the evidence-based clinical resource UpToDate, which contains full prescribing information for medications available in the US and Canada including dosing, indications, risks, interactions, and other details. I reviewed the entry on testosterone and found that, to my surprise, there is no mention of any suggested dosing regimens for female to male transsexuals.

In the US, once a drug is FDA approved for one use, it is often used “off-label” for other conditions, which is a generally accepted practice. These common, accepted off-label uses will be listed in resources such as UpToDate along with relevant dosing information and warnings. For example, the entry for modafinil, a stimulant, has dosing information listed for the FDA approved indications of narcolepsy, obstructive sleep apnea, and shift-work sleep disorder, as well as for the off-label indications of ADHD, cancer related fatigue, major depressive disorder, and multiple sclerosis related fatigue.

In contrast, the UpToDate entry for testosterone makes no mention of any approved or off-label use for the treatment of transgenderism or gender dysphoria. The only indication for testosterone in females listed is for the adjuvant treatment of postmenopausal women with metastatic breast cancer.

I then checked the FDA prescribing information for Depo-Testosterone (injection) and Androgel (topical), and found a total lack of any reference to use in females for any purpose whatsoever.

testosterone

Testosterone:  Schedule-III controlled substance. The US FDA doesn’t acknowledge or mention its use, on- or off-label, for FTMs

This absence speaks volumes. While the WPATH Standards of Care would have us believe that “[f]eminizing/masculinizing hormone therapy – the administration of exogenous endocrine agents to induce feminizing or masculinizing changes – is a medically necessary intervention for many transsexual, transgender, and gender nonconforming individuals with gender dysphoria,” the reality is that this treatment is so far out of the mainstream of modern medical standards that it is not yet anywhere reflected in basic prescribing reference materials, even as an off-label use.

Because “transgender medicine” is a new field, there is as yet no meaningful body of data that can definitively answer the question of what risks my daughter might face if she embarks on decades of testosterone injections. Studies promoting this treatment as “safe and effective” are generally limited to a few dozen patients and a year or two of follow up. A review article in the Lancet published in April 2016 touted as providing “an evidence-based overview of the benefits, risks, and effects of testosterone therapy in transgender men” observed that “testosterone decreases HDL cholesterol, increases triglycerides, might increase systolic blood pressure, and might increase the incidence of [type 2] diabetes and metabolic syndrome” but was forced to ultimately conclude that the long term effects are largely unknown due to “a paucity of high-quality data” in this area, a disclaimer found in most articles regarding cross-sex hormone treatment.

The desired effects of testosterone for transgender-identified females are the development of male secondary sex characteristics: hair growth on the face and body, changes in bone structure, increased muscle mass, redistribution/decrease of body fat, deepening of the voice, cessation of menstruation, decreased fertility and clitoral growth are all expected. Of note, even these desired effects may not live up to the hype; clitoral growth can cause pain or numbness and, in some cases, appears to lead to difficulty attaining orgasm; voice changes may not reach the desired pitch, leading some patients to seek out voice deepening surgery; some reports suggest increased muscle mass on a female frame can lead to thoracic outlet syndrome.

Of these effects, the changes to body composition, menstruation and fertility may be reversible (if testosterone is started post-puberty; if administered immediately after puberty blockers, irreversible sterility is the norm). Though testosterone is a known teratogen, there is no shortage of glamorous stories celebrating transmen who manage to conceive and give birth after stopping testosterone. However, changes to voice, bone structure, hair distribution and genitals are usually permanent, even if the hormone is stopped.

Then there are the undesired effects. The most commonly reported one is acne, which is often severe enough to require treatment. Male pattern baldness is also unmasked in those who are genetically predisposed.

More important than cosmetic effects are the changes in markers for cardiovascular disease. Studies tend to show that exogenous testosterone increases LDL (bad cholesterol), lowers HDL (good cholesterol), increases erythrocytes (red blood cells) potentially leading to venous thromboembolism (blood clots) from polycythemia, and increases blood pressure. It has also been shown to increase fluid retention which can contribute to heart failure.

Studies suggest as well that in women (but not men), higher endogenous testosterone levels correlate with insulin resistance and the development of diabetes, and studies suggest that adding testosterone in the form of a drug may increase risk for diabetes.

Even in male patients, studies clearly indicate that testosterone therapy increases the risk of cardiovascular disease including heart attack. One review article notes dryly:

“The effects of testosterone on cardiovascular-related events varied with source of funding. Nevertheless, overall and particularly in trials not funded by the pharmaceutical industry, exogenous testosterone increased the risk of cardiovascular-related events, with corresponding implications for the use of testosterone therapy.” [emphasis added.]

In other words, all studies showed an increase in cardiovascular disease, but this effect was “less prominent” in Big Pharma funded studies. What a surprising coincidence!

Testosterone may cause mood changes. Small studies suggest testosterone treatment in transmen can increase anger, which makes sense, given that abuse of testosterone by bodybuilders is known to sometimes result in “roid rage,” a condition of unchecked anger and aggression. One article reports a case of late onset psychosis associated with testosterone use in a trans-identified female, in whom no other cause could be found.

Testosterone has also been associated with liver damage or tumors, though more often in oral formulations rather than the injectables favored by transgender medicine practitioners. It has been known to impair kidney function. It has been shown to impair mitochondrial function leading to oxidative stress. The list of recommended laboratory tests for monitoring is long.

The effects of testosterone on the ovaries and uterus are not well defined. Early research suggested testosterone administration causes enlarged and cystic ovaries similar to what is seen in polycystic ovary syndrome. While studies in postmenopausal women suggest that testosterone does not stimulate abnormal growth of the endometrium (uterine lining), small studies of young FTM patients suggest that in younger females, testosterone administration does induce proliferative changes in the endometrium, which could theoretically progress to cancer. Cases of ovarian cancer have been noted in females treated with testosterone. These changes to the ovaries and endometrium explain why removal of the uterus and ovaries are often suggested for FTM patients on long term testosterone treatment, though there is no medical consensus on this as there is minimal data.

There is some experience giving testosterone off-label to postmenopausal women for hypoactive sexual desire disorder (HSDD); indeed this treatment is still promoted online and prescribed by some physicians. However, despite promising results for women’s libidos, studies suggest that even low dose testosterone may increase risks for endometrial and breast cancer, and as of yet there is no FDA approval for any form of testosterone for this indication.

So, the state of the art of transgender medicine for a young girl who believes she is a boy is to affirm this belief using hormones and possibly surgery. Current standards promoted by WPATH include puberty suppression using Lupron as young as age 10, followed by cross-sex hormone treatment with testosterone by age 16. It should be noted that in the United States, top gender doctors who see the greatest number of patients often begin cross-sex hormone treatment much earlier (as young as 12 in this recently published study).

We don’t know all the side effects this regimen may produce, but when started before puberty, one effect is certain: permanent sterility.

Aside from that pesky side effect, the expected effects of testosterone treatment include changes in body fat and muscle composition, changes in bone structure, facial/body hair growth and male pattern hair loss, clitoral growth, changes in sexual function, voice deepening, cessation of menstruation, and increased acne.

Likely side effects include adverse changes in cholesterol and blood pressure, leading to increased risk for heart attack and stroke; increased red blood cell mass which increases risks for blood clots; and changes in the ovaries and uterus potentially leading to increased risk of cancer, for which many experts recommend hysterectomy and bilateral salpingo-oophorectomy.

Possible side effects include increased risk of diabetes (another risk factor for heart disease and stroke), possible liver damage, possible kidney damage, risk of mitochondrial damage, and perhaps an increased risk for psychiatric disease.

How significant are these risks? Will they be worth it to a generation of “gender nonconforming” kids as they start their adult lives already committed to a lifetime as chronic medical patients? Will they face premature disability and death?

No one knows. Maybe it will all work out fine. Maybe testosterone really is the fountain of youth, providing strength, energy, vitality and virility to brave young gender outlaws, as they sacrifice their fertility to give birth to their authentic selves with the eager assistance of the medical and pharmaceutical industries.

Maybe.

But medical history is littered with miracle cures gone wrong. Future historians will judge whether the massive increase in girls and young women prescribed testosterone will go down as a triumph of medicine–or an ill-begotten disaster.

 

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Why I supported my autistic daughter’s social transition to a man

by FightingToGetHerBack

FightingToGetHerBack lives in the United States with her husband and 17-year old daughter Zoe. Four years ago, Zoe made the surprise announcement that she was transgender. 

FightingToGetHerBack shares her personal story to illustrate how even smart, educated parents can be emotionally blackmailed into supporting their children’s transition. She is available to interact in the comments section of this post, and can be found on Twitter @FightingToGetHerBack


 For almost a year, I actively supported my daughter’s social transition to appear as a man. I called Zoe by her preferred masculine name and pronouns, and introduced her to others as my son. I was by her side as she marched in a Trans Pride Parade, waving pink and blue flags and dancing to Lady Gaga’s “Born This Way.” I purchased the binder she wore to flatten her breasts.

Outwardly, I appeared as the supportive, loving mother of a transgender child. Inwardly, I was conflicted. Privately, I grieved. Alone, I cried.

As I look back on all I did to affirm Zoe’s mistaken identity as a man, I am mortified.

What caused me to ignore what seems like common sense: that my daughter could not possibly be my son?

Why did I dismiss my initial intuition: that Zoe was caught up in a false identity that was actively promoted at her school and online?

How did I fall for the unsupported scare tactics of “affirmative” gender specialists and the narrative widely promoted by lazy journalism: that Zoe’s mental well-being — and indeed, her life — hinged on my unquestioned support of her sudden self-proclaimed identity as a man?

Like my daughter, I became a victim of transgender ideology: a non-scientific, activist-driven dogma that inexplicably dictates protocol for medical practices, mental health counseling, school policies, media coverage, and an increasing number of laws in the U.S. and abroad.

Let me begin by telling you about Zoe. Throughout her childhood, she preferred feminine clothing and hairstyles, in marked contrast to my own low-maintenance appearance. As a pre-teen, she seemed to embrace the changes brought about by puberty, expressed excitement when her period began, and enjoyed shopping for bras and body-hugging clothes. When she started 7th grade, she begged for permission to shave her legs and wear make-up. Zoe had no stereotypical male interests and shied away from all sports, hating to get dirty or sweaty. There was nothing about her childhood that I would consider boyish, except for one: her difficulty in fitting in with other girls.

Zoe is autistic and highly gifted; socially challenged, yet intellectually precocious. When she was little, she talked to her peers as if they were adults and didn’t understand when they were bored by her academic monologues. Though we invited children to our house for playdates, the invitations were rarely reciprocated. At her annual birthday parties, the other kids ignored her and played mostly with each other. Fortunately, she was oblivious to their social rejection.

But as Zoe grew older, many girls became cliquish and exclusive. They judged each other on their appearances and their fashion choices. They were turned off by my daughter’s social immaturity and her low social status. My intellectual autistic girl had a hard time navigating their complex social cues. She was not aggressively bullied, but she was left out, and she began to realize that she was different.

Around 5th grade, she started to associate more with boys than girls; not because she shared their interests or participated in their rough-and-tumble play, but for their lack of drama. Thankfully, the boys were accepting of her quirky off-putting ways. Hanging out with them was much easier and preferable to being alone. And though the boys accepted her, she still felt disconnected from her peers. “Why doesn’t anyone like me?” she asked me more than once.

So when Zoe suddenly announced that she was transgender at the age of 13, this seemed to come out of nowhere. Zoe was confused, I thought, and had misinterpreted her difficulty in fitting in with the girls as a sign that she was a boy. My disbelief was not a reflexive reaction based on intolerance or prejudice (in fact, I have leaned toward the left side of the political spectrum, and have a career devoted to progressive causes), but based on a lifetime of observations as her attentive mother.

But I was concerned: How could such a smart girl believe she was a boy? What happened to make her believe this so strongly and so suddenly?

I asked Zoe to tell me when it was that she first started thinking she was transgender. She said she got the idea after attending a school presentation. I was appalled. I had no idea this was part of the school curriculum. Zoe also told me about other kids she knew who were transgender. I was stunned to learn that this was so common. Interestingly, all of the “trans” kids that Zoe knew were very similar: highly intelligent and with apparent autistic traits–and with a history of not fitting in.

I asked Zoe, “If you hadn’t known there were other kids who were trans, would you believe you were a boy?” Her answer was telling: “No, because I would not have known it was an option. But I don’t think I am a boy; I am a boy.” She patiently explained to me the differences between gender identity and sex assigned at birth. When I expressed confusion, she told me I wouldn’t understand because I am cis. I had never heard that word before. Clearly, she had been doing some online research.

I began to do some research of my own. But nothing I found confirmed my theory: that my child’s autistic thinking and history of not fitting in made her vulnerable to the false belief that she was transgender. To the contrary, all of my online searches told me that a child’s gender identity was not to be questioned, and that children, no matter their age, know who they are. Still, I held onto my belief that this was likely a phase that would pass.

I decided the best approach was to ignore the gender issue and help Zoe develop her identity based on her interests, not on her feelings. I signed her up for 4H and nature groups. I did everything I could to help her connect to who she really was, and help her find other kids who shared her passions.

isolated girl.jpgOver the course of a year, Zoe’s anger toward me grew. Our once strong, loving relationship deteriorated, and she threatened to leave home many times. She blamed her worsening depression on me and my lack of acceptance of her “true” self. It became clear that this was no simple phase that would fade away on its own, but I didn’t know what to do. Maybe she was really transgender, I wondered. My husband thought Zoe was just being a selfish, belligerent teen. But I decided that I needed someone to help me sort this out, a trained and experienced professional to answer some questions: Is my daughter really transgender? If she is, what should I do? And if she’s not, how do I convince her otherwise? I turned to gender specialists for help.

This was my first big mistake.

I went to the Psychology Today website and contacted ten local therapists who claimed a specialty with transgender issues. After explaining a bit about my daughter’s history, every single therapist responded in a similar manner: “A child would not choose this.” “A child would not make this up.” “Once teens reach puberty, there is no question that their gender identity is set.” They all ignored the fact of Zoe’s autism. “Even autistics know who they are.” They ignored the possibility of social contagion. “It’s becoming more common now because society is more accepting.” They did not see this as a temporary identity crisis, but as an absolute, undeniable truth that was dangerous to question.

Perhaps if I had found just one authoritative professional to confirm my misgivings, I would never have doubted myself.

Instead, I deferred to the apparently unanimous consensus of the experts and decided to work with Dr. Brown [not his real name], a therapist in private practice whose clinical specialties were transgender care and autism, and who was a member of WPATH, an organization that I ignorantly assumed was grounded in a scientifically-based, expert approach to transgender care.

My husband went along with my plan. We both met with Dr. Brown before he met Zoe. Surely, based upon his extensive experience, he could tell us if our daughter was really transgender. After hearing our story, he confirmed that she was. Since it had been over a year since Zoe came out to us, and because she had been “insistent, persistent, and consistent” in her identity, this meant that yes, this was real.

Dr. Brown comforted us by telling us what great parents we were for finding support for our son; that many parents refuse to believe their children are transgender and they become estranged from them. He told us that as a transgender teen, our son is at high risk of suicide and that research shows that the best way to prevent this is parental acceptance. Dr. Brown told us to start slowly by allowing him to transition at home using his preferred name and pronouns, but to wait several months until the summer to start coming out to friends and family, and to wait until the fall to come out at school.

I loved — and love — Zoe unconditionally, fiercely, and deeply. I would do anything to save her life and minimize her suffering. I have always sought the best care for her, no matter the cost. I was — and am — a vulnerable, confused, and scared mother. So I did what Dr. Brown told me I MUST do or my daughter would kill herself. I fell for the “live son” vs “dead daughter” scare tactic.

Though it was hard to hear those words — that my daughter was really transgender and that my actions were critical to preventing her possible suicide —  in a way, it was a relief. Finally, I could stop debating with myself and just work on accepting my daughter as my son. It was easier to put my faith in Dr. Brown and his expertise than to constantly question myself. I rationalized that I had been in denial for the past year, but now I needed to face reality and focus on Zoe’s mental health, our relationship, and keeping her alive.

I began supporting the first step in Zoe’s social transition that evening when I used masculine pronouns and called Zoe by his chosen name, Joe. I told Joe about Dr. Brown and his recommendations. I apologized to Joe for my lack of support over the past year. Joe was overjoyed. Later that night, I sobbed privately while I grieved the loss of my daughter.

Joe started seeing Dr. Brown right away. After each session, Joe did not seem happy or content. He seemed more fixated on transitioning. Despite the original plan to take this slowly, he immediately changed his name and pronouns at school. The school never notified me of this change, nor asked my permission. Since there were already several other “trans” kids at the school, this was seen as a normal request that did not need to involve parents.

Joe’s transition at school, as with the other “trans” students, was met with complete unquestioning acceptance by peers and teachers alike. Trans teens had become so common that no one acted like this was a big deal. And after years of not fitting in, Joe thought he had finally found his tribe.

Though I was upset with the school staff and concerned with how fast things were moving, I said nothing. I needed to support my son and maintain his mental health, so I kept my concerns to myself.

Now that Joe was “out,” I helped with his social transition by taking him to a barber followed by shopping for “boy” clothes. But that wasn’t enough. Joe begged me for a binder. I discussed this with Dr. Brown who told me it was now psychologically necessary for Joe’s social transition to be complete. Dr. Brown assured me that as long as I bought one from a reputable company, there were no dangers. He told me if I didn’t buy one, Joe would just use duct tape, which was very dangerous. Given the alternative, I felt like I had no choice. I complied.

Within one month of seeing Dr. Brown, Joe’s physical transformation was dramatic. His appearance disturbed me in a deep and visceral way. My once curvy 14-year old daughter now resembled a pudgy, unattractive 11-year old boy. I was ashamed of my feelings and felt guilty for caring about his physical appearance. I told myself it was his mental health I should be focused on, but I still found it painful to look at him.

Dr. Brown kept telling me what a good job I was doing, that Joe is so happy now, and that for the first time in his life, he feels like he belongs. Despite Dr. Brown’s assurances of Joe’s happiness, that was not my observation at home. Joe seemed more and more depressed. His periods, which had been non-events until he started seeing the gender therapist, now became a crisis. Joe refused to go to school on those days and became angrier and more depressed. After each step in Joe’s transition process, he became fixated on the next. So after binding his breasts, his new obsession was medically stopping his periods.

During the time that I supported Joe’s social transition, I purposely avoided any news articles on the topic. And when I heard critical voices — which at that time seemed to come only from ultra-conservative gay-bashers  — the unintended consequence of their hurtful words served only to harden my support for my son’s transition and bias my thinking.

As Joe continued to see Dr. Brown, I sensed that his “therapy” was mostly about validating Joe’s conviction that his was trans, while pushing the next step in transitioning. I eavesdropped on one session where I listened to Dr. Brown ask Joe about his week, how much he enjoyed being his authentic self, and about his next plans for transition. I did not hear Dr. Brown ask Joe about his increasing depression, or explore the basis for his growing discomfort with his body.

Despite this, we continued to see Dr. Brown and followed his expert advice. Although I never stopped having fears and doubts, I tried to convince myself that I was just a worried mom lacking objectivity. Meanwhile, my husband was mostly disengaged, refusing to talk with me about my worries, but willing to go along with whatever I decided.

Dr. Brown’s experienced, authoritative, and persuasive voice continued to convince me that my actions were the key to preventing Joe’s suicide. I deferred to his self-proclaimed authority, which was seemingly consistent with the overwhelming majority of the medical and psychological establishment. So when Dr. Brown recommended that I enroll Joe in a therapeutic support group for trans kids, I complied.

This was my second big mistake.

I selected a support group at a well-respected gender clinic, a collaborative practice that included clinicians who specialize in autism, clinical psychology, and adolescent gynecology. Their approach was described as research-based and conservative.

Before Joe started attending the support group, I met privately with the head of the clinic, Dr. Jones, to learn more. He told me that every meeting began with the kids announcing their preferred name, their pronouns, and the gender that they identified with on that particular day. He explained that the goal was to impress upon the kids that their current gender identity was not necessarily fixed. He told me that every child in the group had either been diagnosed with Autism Spectrum Disorder or had symptoms that suggested autism. I was reassured that Joe would fit in well with the other participants.

When I told Dr. Jones that over 5% of the students at Joe’s school thought they were trans, he denied the role of social contagion. He said the increasing numbers were a result of society and schools becoming more tolerant.

I asked Dr. Jones why kids with ASD were more likely to identify as transgender. He told me researchers do not know, but theorized that both transgenderism and ASD were caused by prenatal exposure to an excess of androgens. I asked if gender identity were innate, then why would it appear so suddenly with no signs throughout childhood? Dr. Jones explained that this was probably because ASD prevents children from thinking flexibly about gender until they are older. So although Joe’s gender identity was always that of a boy, Dr. Jones explained, Joe didn’t know his identity until recently because the ASD precluded the flexible thinking required to come to this realization when he was younger.

Privately, I thought all of his explanations seemed far-fetched, but as I had been doing with increasing frequency, I kept my doubts to myself, followed the “expert” advice, and agreed to allow Joe to participate in the program.

The kids in the group had many traits in common besides autism. Their trans identity came on suddenly when they were teens, they seemed really smart, and they were obvious social misfits. All had serious mental health issues. Compared to the other kids, my daughter appeared the most well-adjusted.

Although the clinicians acknowledged that these kids may change their minds, all of the parents were told to put their children on hormone blockers. When I questioned the possibility of side effects, my concerns were arrogantly dismissed. The head clinician told me that blockers were well-studied and perfectly safe, and encouraged me to set up an appointment with the clinic’s gynecologist. He recommended that Joe take blockers for one year, which he euphemistically described as “buying time.” At the end of his year on blockers, Joe would likely be ready to proceed to the next step: testosterone. Unconvinced, I refused to consent.

While Joe was in group, I got to know the other parents. We were all genuinely troubled by our children’s trans identity. We talked about how we lost friends and family members over this issue; how we had become more socially isolated; how our marriages had become strained; how surprised we were when our kids announced they were trans; how there had been no signs of this throughout their childhoods. Like me, these were caring, thoughtful parents who were determined to help their children in any way they could.

Unlike me, all of the other parents consented to medical treatment for their kids. Some were on blockers; others were already on cross-sex hormones. Apparently, I was the only one who had concerns about the medical protocol, and the only one who still harbored doubts about my child’s transgender identity. As the months passed, I felt more disconnected from the other parents. They began to question why I refused medical treatment for my son, told me I was endangering his mental health, and seemed personally offended by my non-compliance. I started to keep my opinions to myself and wondered if there was something wrong with me. Were my doubts and concerns well-founded? Or could I just not accept the reality of having a transgender child? I now believe that if I had met at least one other parent who shared my misgivings, I would have had the courage of my convictions to question the trans narrative much sooner than I did and would have escaped the power of groupthink.

So what finally woke me up? It was when the head of the program, Dr. Jones, the  well-respected “expert” threatened me: “Your choice is between a mental hospital or hormone blockers.” That’s when I finally realized the clinic’s true agenda: not to therapeutically help my child, but to push her on a dangerous path to medically transition under the pretense of it being a psychological necessity.

That night, I turned to the internet to figure out what to do next. That’s when I discovered 4thWaveNow, TransgenderTrend, GenderCriticalDad, and other reasonable gender-critical voices.

I could not stop reading for days. All of my original theories were shared by a group of intelligent, thoughtful, and eloquent parents and therapists.. For the first time since my daughter announced she was my son, I found evidence-based information to support my own ideas. My God, how could I have been so stupid to doubt myself? How did I fall for this? How could I have played along with her ridiculous belief that she is a boy? How did I not see that this sudden increase in trans-identifying teens at her school was part of a psychic epidemic? That these vulnerable children were being medicalized by unscrupulous professionals? That most journalists were singularly focused on portraying transgenderism as a human rights issue, rather than what was obviously a psychological and sociological phenomena?

It has now been over one year since I discovered the online support I needed to realize the truth. But my daughter remains a victim. It is as if she has been brainwashed. And increasingly, it seems as if society has been brainwashed.

Thanks to Zoe’s school, her gender therapists, professional health organizations, the media, and the internet, my daughter is still certain that she is really a boy. She refuses to discuss the topic with me, and refuses to listen to my concerns. She is also convinced that medical transition is necessary for her future happiness, a process she plans to begin when she turns 18 next year. And I will be powerless to stop her.

The only thing I can do is speak the truth and encourage others to do the same.

If you are a doctor or therapist, please don’t reflexively endorse a child’s belief that s/he is the opposite sex. Children need good therapy to explore underlying issues that are likely fueling their discontent.

If you are a member of a professional health organization, please demand that they base their professional guidelines for gender-confused children on science, not politics or ideology. Organizations like the American Academy of Pediatrics, the American Psychological Association, the American Psychiatric Association, and the Endocrine Society will continue to irresponsibly promote ideologically driven protocol as settled science until they are held accountable by their membership.

If you are a college professor, administrator, or counselor: Please speak up about a phenomenon that is becoming increasingly common across college campuses. Although most college students are legal adults, their brains are still developing and they are just as prone to social contagion as young teens. Those with underlying mental issues, often exacerbated by the stress of college life, are especially vulnerable. Many students begin their medical transition services as part of their college health plan — with little or no mental health counseling to explore other underlying factors.

If you are a journalist, please re-think the currently popular mainstream narrative and investigate this issue more deeply. Why are there suddenly so many kids who think they are trapped in the wrong body? Does science really support “an innate gender identity?” Why have the number of gender clinics treating children skyrocketed in the past ten years? What is the source of the millions of dollars that is funding this movement?  Does it really make sense to treat children medically on the basis of a belief which is likely to change over time?

Whoever you are, please speak up. Please help prevent more children’s minds from being poisoned by lies, bodies from being irreversibly altered, and families like mine from being destroyed.

“Intellectual no-platforming”: Ken Zucker pushes back on the latest attempt to discredit desistance-persistence research

by Marie Verite and Brie Jontry

Dr. Kenneth Zucker, recognized as one of the world’s top experts in childhood gender dysphoria, penned the following paper (released today).

Zucker, K. J. (2018). The myth of persistence: Response to “A Critical Commentary on Follow-Up Studies and “Desistance” Theories about Transgender and Gender Non-Conforming Children” by Temple Newhook et al. (2018). International Journal of Transgenderism. https://doi.org/10.1080/15532739.2018.1468293

Dr. Zucker has offered to provide a PDF of the full-text article if readers contact him via email.


Multiple trans-activist journalists and “affirmative” gender clinicians have (rather successfully) propagated the meme that desistance from a trans identity is a “myth”; that Zucker (former director of the Toronto clinic), Thomas Steensma, Peggy Cohen-Kettenis (of the Amsterdam team which pioneered the use of puberty blockers for gender-dysphoric children), and others have wrongly conflated merely gender nonconforming children with “true trans” kids. Therefore, their entire body of research is essentially worthless. These critics have gone further, accusing some clinicians (like Zucker) of forcing harmful reparative therapy on “trans kids.”

Dr. Zucker’s detailed rebuttal to the Temple-Newhook et al article is well worth reading in its entirety.  Be forewarned: The paper is densely argued and referenced, such that understanding it requires a decent working knowledge of the clinical literature on childhood gender dysphoria, the nuances/changes in the DSM diagnostic classifications (e.g., DSM-IV “gender identity disorder” vs. DSM-V “gender dysphoria”), as well as the trans-activist reactions to all of the above.

In a series of tweets today, Dr. Zucker emphasized one of the key points in his paper.

 “…that pre-pubertal gender social transition is itself a psychosocial treatment, which Temple-Newhook et al ignore.”

The context for this tweet can be found on page 7 of Dr. Zucker’s article:

Thus, I would hypothesize that when more follow-up data of children who socially transition prior to puberty become available, the persistence rate will be extremely high. This is not a value judgment – it is simply an empirical prediction. Just like Temple Newhook et al. (2018) argue that some of the children in the four follow-up studies included those who may have received treatment “to lower the odds” of persistence, I would argue that parents who support, implement, or encourage a gender social transition (and clinicians who recommend one) are implementing a psychosocial treatment that will increase the odds of long-term persistence.

And later, on page 10:

Temple Newhook et al. (2018) go on to state that “It is important to acknowledge that discouraging social transition [with reference to the Dutch team’s putative therapeutic approach] is itself an intervention with the potential to impact research findings…” Fair enough. But Temple Newhook et al. (2018) curiously suppress the inverse: encouraging social transition is itself an intervention with the potential to impact findings. I find this omission astonishing.

An astonishing omission, indeed.

As regular readers of this website will know, most parents in the 4thWaveNow community are particularly concerned about the recent increase in teens (particularly females) presenting to gender clinics, with a sudden onset of gender dysphoria around the age of puberty.

Although the characteristics and clinical course of early-onset gender dysphoria (the primary population discussed in Zucker’s paper) are different from that of adolescent-onset, an underlying question pertains to both: Does “affirmative” treatment increase the likelihood that a cross-sex identification will persist?

We must point out here that trans activists consider it “transphobic” for anyone to believe that a child’s desistance from trans-identification would be preferable to persistence. (In fact, this accusation is leveled by Temple Newhook et al in their paper, in so many words. This helps to explain why so many trans activists object to the very idea of studying persistence vs. desistance in the first place.)  Yet, we find it mystifying that a preference for desistance is even controversial.  Surely, if a child can find peace in his or her unaltered body–and happily avoid becoming a sterilized medical patient dependent for life on drugs and surgeries–that is a positive outcome. To leverage an analogy popular with trans activists, many say that “gender affirming” medical treatment is analogous to treatment for children with life-threatening cancers. Yet who would not feel happy for the cancer patient who goes into remission, thus avoiding the ravages of chemo and radiation?

Furthermore, is it not possible to support young people in their gender atypicality,  while at the same time encouraging bodily acceptance?

Central to this discussion is the trans-activist conflation of psychotherapeutic methods with conversion therapy.  Zucker addresses this problem head-on on page 9:

Now, of course, it would not come as a surprise if Temple Newhook et al. (2018) took umbrage at the mere idea of a treatment arm designed to reduce a child’s gender dysphoria via psychotherapeutic methods. They might, for example, offer up the following from the seventh edition of the Standards of Care:

Treatment aimed at trying to change a person’s gender identity…to become more congruent with sex assigned at birth has been attempted in the past without success (Gelder & Marks, 1969; Greenson, 1964)….Such treatment is no longer considered ethical.” (Coleman et al., 2011, p. 175)

Yet, on the very same page of the Standards, one finds the following: “Psychotherapy should focus on reducing a child’s…distress related to the gender dysphoria…” (p. 175) or “Mental health professionals…. should give ample room for clients to explore different options for gender expression” (p. 175). The lack of internal consistency between the first statement and the second and third statements is rather astonishing.

“Reducing a child’s…distress related to the gender dysphoria” should be the primary goal of all treatment methods. Quite a few 4thWaveNow parents have observed that upon social transition, their children’s dysphoria actually increased. This is another aspect related to the different populations (early-onset vs. adolescent rapid-onset) that needs to be clarified but still remains unknown. Dr. Zucker explains that he “prefers the following summary statements about therapeutics with regard to children with gender dysphoria”:

Different clinical approaches have been advocated for childhood gender discordance….There have been no randomized controlled trials of any treatment….the proposed benefits of treatment to eliminate gender discordance…must be carefully weighed against… possible deleterious effects. (American Academy of Child and Adolescent Psychiatry, 2012, pp. 968–969)

Very few studies have systematically researched any given mode of intervention with respect to an outcome variable in GID and no studies have systematically com- pared results of different interventions….In light of the limited empirical evidence and disagreements…among experts in the field…recommendations supported by the available literature are largely limited to the areas [reviewed] and would be in the form of general suggestions and cautions… (Byne et al., 2012, p. 772)

…because no approach to working with [transgender and gender nonconforming] children has been adequately, empirically validated, consensus does not exist regarding best practice with pre-pubertal children. Lack of consensus about the preferred approach to treatment may be due, in part, to divergent ideas regarding what constitutes optimal treatment outcomes… (American Psychological Association, 2015, p. 842)

Here at 4thWaveNow, we have repeatedly stated that we seek to support—not “eliminate”–our children’s “gender discordance” although we resist the idea that gender atypicality is a sign of bodily incongruence. More than anything, 4thWaveNow parents seek to help our children minimize the discomfort that accompanies their nonconformity to gender norms. Since many of our children only experienced dysphoria upon reaching puberty, we call for (much) more evidence that social and medical transition are better at alleviating dysphoria than psychotherapeutic methods.

And as Dr. Zucker has made clear via his life’s work (and in this paper), the jury is still very much out on that question–despite the many attempts by trans activists to deplatform those who study the matter of persistence and desistance.

zucker intellectual no platforming

 

The Open Society Foundations & the transgender movement

by Michael Biggs

Michael Biggs is Associate Professor of Sociology at the University of Oxford and Fellow of St Cross College. He researches social movements and collective protest.


The transgender movement has transformed cultural norms and social institutions at breathtaking speed. Most of us, becoming acquainted with the trans issue for the first time, are astonished to discover the extent of the gender revolution. The movement has accomplished in a few years what the movements for women’s and for gay and lesbian rights took many decades to achieve.

Part of the explanation is the amount of money behind transgenderism. The Gender Industrial Complex, as we may call it, has many components. Lucrative sponsorship comes from pharmaceutical companies and medical providers. Charities originally established to fight for homosexual rights (like Human Rights Campaign in the United States and Stonewall in Britain) wield large budgets. Last but not least, three American billionaires have bankrolled the transgender movement on a global scale: Jennifer Pritzker, whose activities were detailed in another blogpost, Jon Stryker, and George Soros.

This blogpost focuses on the Open Society Foundations (OSF), funded by Soros. This is not easy to discuss because he is vilified by right-wingers, whose criticism sometimes degenerates into anti-semitism (Williamson 2018). Therefore those of us who are liberal or progressive tend to react instinctively by dismissing any scrutiny of Soros out of hand. This is unjustified, as I will show by providing some facts about how OSF has funded the transgender movement.

OSF fully supports the objectives of transgender activists. Self-identification is “an essential legal right for trans people” (OSF 2014a). In other words, biological sex must be superseded by subjective gender identity, to include options “outside the binary categories of male and female” (OSF 2014b). Identity should not be “governed by age restrictions” (OSF 2014b). Therefore OSF funds “trans-led or LGBT organizations that promote progressive, rights-based processes for legal gender recognition” (OSF 2014a). It also advocates access to “hormonal therapy, counseling, and gender-affirming surgeries” on demand (OSF 2014a). This includes puberty blockers for youth (OSF 2013).

How much has OSF spent to promote the transgender movement? In 2011–13, it spent $3.19 million, which made it the top funder, followed by Stryker’s Arcus Foundation and Pritzker’s Tawani Foundation (Funders for LBTQ Issues 2015). OSF’s current database includes grants worth $3.07 million for 2016–17 (searching for keywords “trans” and “transgender”). The largest recipients in this current tranche are the International Lesbian, Gay, Bisexual, Trans and Intersex Association ($642,000), Global Action for Trans Equality ($500,000), and Transgender Europe ($500,000).

open society reception areaThree million dollars on trans issues is a tiny fraction of OSF’s total expenditure, merely 0.3% (OSF 2017). Crucially, however, this funding greatly exceeds the resources given to alternative voices. This website, for example, receives no funding. To illustrate the difference that money can make, consider the commemoration of the victims of violence.

As we saw, OSF gave $500,000 to Transgender Europe in the past two years. Transgender Europe also received $1,072,000 from the Arcus Foundation from 2010 to 2017 (Arcus Foundation 2018). The organization’s projects include the Transgender Day of Remembrance, which is underpinned by a comprehensive database of victims throughout the world, Trans Murder Monitoring. This database counted 325 trans victims of violence in year from October 2016 to September 2017 (TMM 2017). The great majority of these occurred in Central and South America. There were only three in Western Europe, and thankfully none in the United Kingdom. Surprisingly, perhaps, the Transgender Day of Remembrance was widely observed in Britain in November 2017. In many universities, for example, candles were lit for each of the victims, the transgender flag was raised, speakers were invited, and services held. Searching university websites (the domain .ac.uk), we find over 2,800 webpages containing the phrase “Transgender Day of Remembrance”.

While no transgender person was murdered in the United Kingdom in 2017, 138 women were killed by men, including murders where a man was the principal suspect (Smith 2018). These data were compiled by Karen Ingala Smith, who receives no funding for this work. She started recording such deaths in 2009, under the rubric of Counting Dead Women. This was developed into the Femicide Census—in partnership with Women’s Aid—with minimal funding and pro-bono support by two legal firms (Femicide Census 2016).

Despite the diligent research over many years, this has left barely a trace in British universities. The equivalent search on their websites yields fewer than a hundred webpages containing the phrases “Femicide Census” or “Counting Dead Women”.

To sum up, more than a hundred women are murdered each year in the United Kingdom at the hands of males, but no day has been set aside to commemorate their deaths. Transgender murders are exceedingly rare—eight in the past decade (Trans Crime UK 2017; Evening Standard 2018)—and yet they have an institutionalized day of remembrance. Even if we consider the homicide rate rather than the number of homicides, Nicola Williams demonstrates that transgender people are no more likely to become victims than are women (Fairplay for Women 2017).

The prominence of transgender victims, compared to the virtual invisibility of female victims, is partly explained by the amount of resources devoted to compiling evidence and promoting commemoration. Thus funding from large American charities like OSF—along with the Arcus and Tawani Foundations—shapes the political climate in Britain and around the world.


References

All but one (indicated by *) have been archived on the Internet Archive.

Arcus Foundation. Grantees in Europe, Focusing on Social Justice, Beginning with T. https://www.arcusfoundation.org/grantees/?_paged=&focus=Social+Justice+Grants&amount=default&_year=default&location=Europe&post_title_start_with=T#scroll-anchor-1

Evening Standard. 2018. ‘Hounslow stabbing’, 22 March 2018. https://www.standard.co.uk/news/crime/tributes-paid-to-victim-found-stabbed-to-death-in-hotel-near-heathrow-a3796261.html *

Fairplay for Women. 2017. How Often Are Transgender People Murdered? https://fairplayforwomen.com/trans-murder-rates/

Femicide Census. 2016. Profiles of Women Killed by Men: Redefining an Isolated Incident. https://1q7dqy2unor827bqjls0c4rn-wpengine.netdna-ssl.com/wp-content/uploads/2017/01/The-Femicide-Census-Jan-2017.pdf

Funders for LBTQ Issues. 2015. TRANSformational Impact: U.S. Foundation Funding for Trans Communities. http://www.lgbtfunders.org/wp-content/uploads/2016/05/TRANSformational_Impact.pdf *

OSF. 2013. Transforming Health: International Rights-Based Advocacy for Trans Health. https://www.opensocietyfoundations.org/sites/default/files/transforming-health-20130213.pdf

OSF 2014a. Explainers: An Essential Legal Right for Trans People. https://www.opensocietyfoundations.org/explainers/essential-legal-right-trans-people

OSF. 2014b. License to Be Yourself: laws and Advocacy for Legal Recognition for Trans People. https://www.opensocietyfoundations.org/sites/default/files/license-to-be-yourself-20140501.pdf

OSF. 2017. Open Society Foundations 2017 Budget Overview. https://www.opensocietyfoundations.org/sites/default/files/open-society-foundations-2017-budget-overview-20170202.pdf

Smith, Karen Ingala. 2018. 2017. https://kareningalasmith.com/2017/02/12/2017/

Trans Crime UK. 2017. Trans Homicides in the UK: A Closer Look at the Numbers. http://transcrimeuk.com/2017/11/16/trans-homicides-in-the-uk-a-closer-look-at-the-numbers/

Trans Murder Monitoring. 2017. TDoR 2017 Update. http://transrespect.org/wp-content/uploads/2017/11/TvT_TMM_TDoR2017_SimpleTable_EN.pdf

Williamson, Kevin D. 2018. “An Epidemic of Dishonesty on the Right.” National Review, Feb. 22. https://www.nationalreview.com/2018/02/parkland-shooting-hoax-latest-right-dishonesty-epidemic/

The project of a lifetime: A therapist’s letter to a trans-identified teen

Therapist and Jungian analyst Lisa Marchiano received the following email recently. She and the writer of the email agreed that Lisa would address the author’s questions in a public forum, and the author kindly agreed to allow the email to accompany Lisa’s response.

Lisa can be found on Twitter at @LisaMarchiano. She blogs at theJungSoul.com

Please note that this post is intended for educational purposes only and is not meant to replace professional advice.


Email from a trans-identified teen:

Hello. I’m almost 16 years old and recently I have been reading some of your writing on “Rapid Onset Gender Dysphoria.” Currently I identify as transgender and have for almost 2 years, but as a chronic over-thinker, I like to expose myself to viewpoints and ideas that are different from my own. If my parents knew what ROGD was, they would probably argue that I am in that category. I came out to them about a year ago and I hadn’t shown any gender dysphoria in early childhood. To them, it probably seemed a little “out of the blue,” though I had known for a year before that, had begun to transition (cutting my hair and buying from the men’s section), and had been questioning since puberty. I don’t have any mental or physical health problems, and I have a wide social circle of friends, none of whom are transgender or homosexual (though one of my friends is asexual, and my girlfriend is bisexual). I’m almost positive that I’m transgender, but your writing got me thinking and I have a few questions for you.

If what I am experiencing is ROGD, and simply a coping mechanism for something else, what signs could I look for in myself to figure that out? You talked a lot about the parent’s side of the equation, but what can I, as a trans teen do to ensure that I’m not “tricking” myself into believing this?

When do you believe a trans identity is valid? I certainly don’t disagree with you that there are many teenagers in my generation that are “becoming” trans because it is trendy, having no symptoms of gender dysphoria (I know a person like this). But do you think that trans people need to meet certain criteria to be considered trans and be considered for medical transition? If so, what criteria? Do you believe that gender dysphoria can present itself at puberty?

Thank you for reading and hopefully replying. I really appreciate your time.


Lisa Marchiano’s response:

Thank you for writing me such a thoughtful email, and for your willingness to take the answer here in this public forum. First of all, it goes without saying that this letter can’t take the place of therapy. I can’t diagnose from afar. I am, after all, just a stranger on the internet, and this is just my opinion. I believe it is an informed opinion, but it can’t take the place of discussing important issues face to face with someone who knows you well. Looking at these issues with a qualified therapist who can help you ponder your feelings in an open-ended way without prematurely foreclosing exploration can be very helpful. In addition, I hope you might feel comfortable someday discussing this with your parents. There may be a lot they don’t understand, but it is likely that there is no one on the planet who is more steadfastly on your team than they.

As a Jungian, I see psychological health in terms of a movement toward wholeness. Over the course of our lives, we hopefully integrate more and more aspects of ourselves, including parts that may be “feminine,” and parts that may be “masculine.” This life-long growth process means that we become larger and more complex as we become conscious of more aspects of ourselves. I do not believe that it makes sense to think in terms of identity, as this implies a single, fixed “truth” about ourselves – an endpoint that can be decisively known. Rather, I believe we continue to grow and change throughout our lives.

There is no robust evidence for innate gender identity. Our sense of gender appears to be an emergent property that arises out of a complex interplay between our bodies, our minds, and the social world. Though there is almost certainly a biological component to gender dysphoria, it is also likely shaped by our life history. The way we experience ourselves in terms of gender – that is as more or less male or female or both – is shaped by our family, our wider social network including friends and teachers, and the culture, including advertising, YouTube and other social media. Traumatic experiences, such as the loss of someone close, parental divorce, or emotional, physical or sexual abuse can also affect our experience of our gender.

Can gender dysphoria present for the first time at puberty? Clearly, many young people feel dysphoric at adolescence. Nearly all natal females feel discomfort with their bodies at puberty. I wonder if the question you are asking is whether dysphoria at adolescence but not before means that one shouldn’t identify as trans as a result. I think the answer to that is complicated, and I can’t really answer that for you. Again, this would be something to explore with a therapist who could really get to know your unique situation. Let me just say that based upon my reading of the medical literature, dysphoria presenting for the first time at puberty used to be unusual (but not unheard of) until recently.

Rapid onset gender dysphoria appears to be a relatively new phenomenon, and we don’t understand much about it yet. It appears as though the typical presentation of an ROGD teen involves considerable social influence, either online or by peers, as well as psychiatric comorbidities and/or vulnerabilities. Based on anecdotal reports, many ROGD teens first decide they are trans after reading on the internet. There is very little research on this, but the little there is seems to point to a different outcome for those with ROGD traits (no dysphoria in childhood, higher rates of psychiatric comorbidity, social influence) vs those with the more typical presentation of GD. And outcomes matter, because at the end of the day, we want all people to do as well as possible.

People often come to therapy to explore difficult decisions. I’m going to share a little bit about how I help someone explore their options. If you were to find a therapist to have this discussion with, here are some of the things the two of you might consider together.

There is a difference between what we feel, and what we choose to do about those feelings. I have a passionate conviction that all feelings are valid and important. We should be encouraged to feel them, to take them seriously, to honor them, and to be curious about them. We can take our feelings seriously and acknowledge them as valid without that acknowledgement meaning that we need to take a particular course of action as a result of them. For example – if we are very angry at someone, our feelings of anger are valid and deserve to be felt. What we do about that anger – whether we lash out at the person, for example – is another question entirely. When considering what to do about feelings, I am always interested in whether a given course of action is adaptive or maladaptive.

Let me explain more of what I mean by that. When someone comes to me with a question or a problem, I find it very helpful to examine the issue through the lens of pragmatism. I am interested in identifying what works for this particular person. This means that I ask us to set aside – at least for a moment – judgments based on values, morals, or ideology, and just explore whether a given response works.

What do I mean by “works?” In some sense, we all get to define that for ourselves, and one person’s definition might vary greatly from someone else’s. But we need some firm ground to stand on, so I do have a general answer – something works if it helps you to “do your life.” Freud famously said that the cornerstones of a mentally healthy life are the ability to love and to work, and I think that’s a great place to start. To have a life that is fulfilling, we generally need work that we find meaningful, as well as abiding relationships, at least some of which are truly intimate. I would add a third category to these two: . we can consider that a life strategy works if it is protective of our physical health – or at least not inimical to it. In sum, something works and is adaptive if it doesn’t interfere with our ability to work, to love, and to maintain our health.

Whether identifying as transgender for any individual is adaptive of maladaptive will depend on the person’s particular situation. If we are a natal female who has an inner experience of maleness (and I, in fact, believe that all females have masculine traits, and that our experience of the male side of ourselves can be very important psychologically), then identifying as male could be very liberating, exciting, and growth promoting. It could very well enable someone to engage productively in work and relationships. In this case, a transgender identity would be adaptive.

There could also be cases when identifying as transgender may not be adaptive. Whether it is or not will likely depend in part on how we understand what it means to identify as trans. For example, if part of identifying as transgender means that we need to be perceived as male when we are female bodied, we are putting ourselves in a vulnerable position, as we are giving others power over our sense of ourselves. We can’t control how others see us. Positioning ourselves so that we only feel okay when others perceive and validate us as we want to be perceived, rather than focusing on developing self-acceptance and resilience in the face of slights or rejections, is a decision that may promote worse mental health. This in turn could make it more difficult for us to concentrate at work or school. It might cause us to withdraw from friendships or other important relationships. If this were the case, we might say that our trans identification was proving to be maladaptive.

Furthermore, if identifying as transgender means that we understand ourselves to be literally male when our bodies are female, we may experience cognitive dissonance. Cognitive dissonance refers to the inner tension that we feel when important beliefs are contradicted by evidence. It can be quite uncomfortable. Psychologists have studied those whose strong beliefs are challenged by material evidence. (The theory of cognitive dissonance was developed by a psychologist studying a doomsday cult, and what happened to cult members’ beliefs when the world did not in fact end as their leader had predicted.) They note that we have a tendency to “double down” on our false beliefs in order to resolve the internal tension. Our beliefs become more extreme, and we work even harder internally to justify or reconcile with the challenged belief. (This isn’t just true of cult members. It’s true of every one of us.)

Those who identify as transgender can suffer from pangs of cognitive dissonance. This can often make the dysphoria worse. I have heard many stories from desisters and detransitioners that identifying as transgender made them feel worse, because they then had to deal with a constant tension around the fact that their body looked and acted differently than how they thought it should. This can invite obsessive, perseverative thinking, which can be draining and cause increased distress and anxiety. Adopting a belief that contradicts material reality can be a recipe for unhappiness, as we will likely feel the need to strive to become the thing we are not. This is part of the reason many wisdom traditions and psychotherapy schools direct us to cultivate acceptance of those things we cannot change.

The blogger ladyantitheist articulates the above sentiment eloquently in her post about her trans identification and desistance from it:

One of the biggest problems I think with being transgender is it comes out of an unhappiness, and that the impossibility of the accepted solution amplifies the unhappiness. Having short hair doesn’t give you an Adam’s apple, testosterone injections won’t change your bone structure, a phalloplasty won’t let you produce sperm. The closer you get to the real thing, the further the gap between you and being a real male grows. Freeing yourself from the task of climbing a mountain whose peak can never be summited is your only chance of ever actually being happy. I eventually stopped looking for validation as something I would never be, and started the process of loving myself.

If identifying as transgender amplifies our unhappiness with our bodies, if it causes us to perseverate on features of our bodies which we don’t like, then I would say that doing so is probably not adaptive.

There’s one other major conversation to have when considering whether identifying as transgender works, and that is the matter of maintaining our physical health. If identifying as transgender means that we feel compelled to engage in activities that could cause long-term harm to our body, then it may be maladaptive. Binding can result in collapsed lungs, compressed ribs, and back problems, and some report that they continue to suffer ill effects even after they are no longer binding. Mastectomies remove healthy tissue and can result in painful scarring. Testosterone will result in vaginal atrophy and may damage fertility. It can negatively affect one’s lipid profile, bone density, and liver function. It may increase one’s risk of heart attack and diabetes. There are currently 6,000 cases pending in litigation against drug manufacturers having to do with male bodied people who took testosterone, and experienced blood clots, heart attacks, stroke, and sudden death. Phalloplasty is known to have a high complication rate, and these can be serious and debilitating in some circumstances. If a basic measure of whether something “works” is if it helps us to protect and maintain physical well-being, it would appear that medical transition may not do so in many cases.

Could medical transition ever be adaptive? Yes, I think so. There are trans adults who feel that their capacity to love and work has been enhanced by transition. I suspect that those who benefit from transition have had a good process in which they explored their gender; addressed any underlying issues; and had realistic expectations for the outcomes of transition. Since transition compromises physical health, it is important to carefully consider such a step, and be certain that the benefits will outweigh the considerable known and unknown risks.

I would like to offer another rule of thumb when considering whether a particular life strategy is adaptive or maladaptive. All things being equal, it is better to preserve options and maintain flexibility. This is especially true when we are in the first half of life. When in doubt, leave options open. One of my concerns about medical transition for young people is that it shuts down future options. Having a mastectomy will permanently remove the option of nursing. Taking testosterone may render us infertile. Even if we think we never want to become a parent, there is still a value in protecting the future possibility of doing so. And fertility is not the only option to protect. If a person has taken on a significant transition to another gender expression and then has serious questions about it, they may be faced with even more serious challenges than they had before. Freedom of expression may be seriously, and in some cases, profoundly restricted or limited. Transition does have the potential to seriously limit additional life choices.

We really are all works in progress. Our sense of ourselves will continue to change and shift throughout our lives. It may be tempting to strive for certainty in tumultuous times, but I’d be wary of any urgency. You do actually have time on your side. By staying curious – as you clearly are – and trying out different things, you will gather more and better information in order to help you decide what works for you. One of the helpful things about a pragmatic framework for evaluating life strategies is that it leaves room for things to change. Most strategies don’t work forever. For any decision we make, we can ask ourselves, is this working? And then a few months later, is this still working? If the strategy is benefiting us in living our fullest life more than it is hampering us, we know to continue pursuing it. And if the day comes where we realize the balance of the equation has tipped so that the strategy is more costly than beneficial, then we can abandon it. We need not limit ourselves according to rigid beliefs about what is right or wrong.

elephant-blindmenWhile I was working on this letter, I was reading a novel called The Nix by Nathan Hill. The novel is in part the story of a woman named Faye, and it follows her throughout her life as she tries to discover who she truly is. Toward the end of the book, the author makes some comments about how we understand ourselves that I thought were very wise. I’ll let him have the last word.

In the story of the blind men and the elephant, what’s usually ignored is the fact that each man’s description was correct. What Faye won’t understand and may never understand is that there is not one true self hidden by many false ones. Rather, there is one true self hidden by many true ones. Yes, she is the meek and shy and industrious student. Yes, she is the panicky and frightened child. Yes, she is the bold and impulsive seductress. Yes, she is the wife, the mother. And many other things as well. Her belief that only one of these is true obscures the larger truth, which was ultimately the problem with the blind men and the elephant. It wasn’t that they were blind – it’s that they stopped too quickly, and so never knew there was a larger truth to grasp…. Seeing ourselves clearly is the project of a lifetime.

 

Detransitioned man blasts “transworld”

Angus is the pseudonym of a mostly-retired clinical epidemiologist on the faculty of a major health sciences university. We asked Angus to provide a short bio, and this is what he wrote:

“Angus is in his late 50s now, but back in his 40th year of life, his arrogance and folly led him to think it was fine to transgress, wear the dress, and pretend to be a “woman.” He did this for 13 long years, taking the synthetic estrogen drug every day, self-absorbed and entirely content. He was so convinced that he would carry on as a fake “lady” until the day he died, he decided to have some surgery. Not the more drastic option, it’s true, but most men would do anything to avoid the one he got. Quite unexpectedly one morning Angus snapped out of his transfugue trance state and felt compelled to examine his life. He rapidly ceased his masquerading and mimicry and re-engaged with material reality. He has the blog at autogynephiliatruth.wordpress.com but hasn’t put anything up there for a while. Angus can sometimes be observed causing trouble on Twitter @iforgetalready.”

As with all articles submitted by our contributors, the opinions expressed by the author are his own. He is interacting in the comments section of his post under the moniker “Awesome Cat.”


by Angus

The trans industry must concede that rapid onset gender dysphoria is a social contagion and they must cease recruiting efforts among young people.

Girls and young women increasingly make the claim in recent years to have “gender dysphoria,” an inversion of the male-dominant pattern that has been observed over many decades. More than just flipping the chart, this represents a major surge in the rate at which women are inducted into the illusory realm of TransWorld. The trans industry’s nonsensical position is that practically all “cis” people are potentially “trans,” but it’s impossible to know for sure whether anyone is a man, a woman, or some innovation unless they tell you. Even then, you may need to ask again tomorrow.

Clinicians have struggled to explain why there has been such an appalling growth in adolescent “gender dysphoria,” especially in girls and women.  One possible explanation, recognized as far back as 2010 and 2012, is the impact of social expectations, including the Internet, on the development of a transgender identity.

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And even further back, in 1999, WPATH (formerly called the Harry Benjamin International Gender Dysphoria Association) advised clinicians to proceed with caution when treating adolescents because of the changeability of “gender identity.”

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Then, in 2016, a physician named Lisa Littman conducted a study which, in part, investigated whether social contagion could be a contributing cause; in other words, perhaps some kids caught up in this mix do not really have a long-standing discomfort with their sex. It’s possible for many that the trap door could open below their feet, and within a short time, they’d be injecting testosterone. That’s truly how they roll with “affirmative transcare.”

Trans activists raged over the anticipatory invalidation they already felt with this story, as it dramatically undermined their alibi of “born this way” innocence. They seek transrecruits among children and youth, and at least in the USA, have an alarming interest in giving kids hormone drugs and surgeries at the earliest possible ages. Along with academic and clinician running dogs and other personnel getting paid in the trans industry’s multifarious dimensions, they worried that the mainstream public might see through transvested interests of its pseudoscience. They tried to kill this story with fire. Their efforts only made the story better known.***

Let me just say that I don’t believe that anyone on Earth is “transgender,” “transsexual,” trans-anything except perhaps transvestite, because that term is specific to clothes (Latin vestīre). In English the word just means crossdresser, which is accurate in a simplistic way. Nor is anyone “cis.” Evolution would not allow development of a heritable trait cluster or quasi-sub-species in which a woman or man in good physical health would have an insatiable obsessed yearning to mimic the sociocultural sex stereotypes (i.e. “gender”) for appearance and mannerisms of the opposite sex. There is no way that little Johnny likes to play with dolls or that little Jenny likes to play with trucks because as “trans kids,” they are on the spear point of an ancient evolutionary process that manifests at a certain prevalence in a given population. Had there been such genetic innovation back when we roamed the savannahs, folks with those characteristics would have all died out pretty quickly due to the lack of skilled plastic surgeons and endocrinologists. After all, along with voice coaches, such professionals are the only ones who can deliver “the basic health care they need to survive.” Our illustrious forebears in the painted caves would not have been pleased with the maladaptive meltdown and tantrum behaviour that would have emerged in proto-trans people in response to rampant “misgendering,” and excess mortality due to other people declining to play along would have been high. In real life, simpler explanations are more likely to be true, and there are far more compelling approaches to exploring the question of why women and men with healthy bodies might get it into their minds that they are really the opposite sex.

It should be pretty obvious that the “transition” one hears too much about is also a bogus mind-game. No-one “transitions” to anything except a likely-shortened lifestyle with lots more trips to the doctor, massive surgeries, aftercare; complications (some quite filthy), surgical revisions, risk of cardiovascular trouble; and lifelong drugs. Men may look forward to practicing fake voices & mincing walks, incessant “dilation” of the pseudo-“vagina” seeping void space created through flaying & inverting their genitals, heightened risk of multiple sclerosis and still being 100% male. Women may anticipate the potential for luxuriant back hair growth and being rather shocked that after mastectomies and having the organs of their reproductive systems ripped out, they are still as female as the day is long. Also, a greater risk of kidney failure, even if they are vegans.

Men and women who bought into the transprop and believe its lies have paid with their bodily integrity, and many times with their health. They are victims of it themselves, and I wish healing and wholeness for them. In the moment, however, many contribute to transgenderism’s harms.

For nearly 100 years, since doctors began misleading confused men and women to believe that this might be an option, vastly more males than females have desperately demanded to go under the knife and “change sex.” Such “change” is only illusion, but many men and women have fixated on that fraudulent goal in the vain hope to escape the miseries and melodrama of their own real lives. It is thus a matter of tremendous public health concern, indeed it’s a public health emergency, that over the course of a few years the rate of young women and girls who newly claim to be trans has gone through the roof. Doctors in Amsterdam and Toronto reported in 2015 that in their clinics there were now more females than males getting transbees in their bonnets. These women and girls had never previously shown profound dissatisfaction with being female; their “gender dysphoria” seemed to be new. Investigators used their Discussion to propose that among other reasons why women now greatly outpaced men, perhaps more secretly trans heterosexual women were now hopping on board the transwagon. Alternatively, maybe this decade’s grossly overblown propagandizing of all things trans has resulted in an Exodus of silently-suffering transfolk, women and men both, from “cisnormative” agony; women lead the way, enjoying their female privilege, as many already owned a few pairs of blue jeans or had short hair.

Newcomers to the trans industry, Helsinki then piped up to say that in their first two years running a child transing center they were stunned to find that 41 of 46 (87%) of adolescents were girls. Inconveniently for trans industry bigwigs, the Finns continued. It seems that 35/47 (75%) of these youth were already in treatment for serious psychiatric comorbidity unrelated to “gender”; and 12/47 (26%) were on the autism spectrum. The ratio of females to males, autism prevalence and levels of comorbid psychopathology were far higher than had ever previously been reported. Investigators were flummoxed by all of this, pointing out the ways that it contradicted the lying official translore, and could propose no solid explanations; least of all for the massive overrepresentation of girls.

Reports from the United Kingdom of huge spikes in the rate of child referrals to transing centers also show far more girls than ever before. The most recent of these papers from the UK suggests that from 2009-2016, the average year-on-year increase in referrals for children under age 12 was “only” 48.6% for boys, while it was 92.7% for girls; in adolescents the corresponding rates were 54.9% and 88.6%.

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Naturally, the new transcenario posed a problem for TransHQ. Most industry clinicians maintained the party line, more or less saying “gee, we didn’t know there were so many transkids.” When two of the more notorious pediatric trans industry doctors were asked about the startlingly high proportions of girls, Johanna Olson-Kennedy seemed taken aback but then acknowledged that it was true, before uttering a few more incoherent half-thoughts. Joshua Safer seemed evasive and glassy-eyed as he answered in terms of both sexes.

None of the researchers reporting this outbreak of “girlpower denied” was apparently able to imagine a possibility that would require coloring outside the lines of the trans cult’s hijacked rainbow; an answer that was much more likely to be true than their mouthfuls of bloated transjargon.

In 2016, however, Dr. Lisa Littman (now at Brown University in Rhode Island, USA) published a summary description of her survey undertaken with parents of youth purporting to have “gender dysphoria.” Results of her survey suggested something pretty obvious: This new type of rapid-onset gender dysphoria (ROGD) is a whole different animal than the usual kind observed in adolescents. It was really sort of a youth craze, exacerbated via social contagion through the influence of peer groups and shady characters who promote trans ideology and recruit adolescents aboard the transwagon. Psychotherapist Lisa Marchiano also wrote eloquently on ROGD in several articles, including this piece from the perspective of Jungian psychology.

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The discussion of ROGD came upon trans activists unawares, but as the story continued to gain traction, the transmachine hotly blew up its transmissions, spewing towering tizzies of refutation, torrid pseudoscientific tirades, aggrieved attacks on academic integrity. Many trans industry academics and clinicians who have desperately tried for years to show that “gender identity” is innate now faced the possibility that the public would begin to catch on: “Innate gender identity” was complete garbage. Ice cold embarrassment and waves of sweaty invalidation flew from the ridgetops of their enormous brows. Social media was also transflamed with outrage, scorn, popcorn and flipped wigs.

But what can these trans cult & industry personnel and enablers really say in their dizzy diatribes? They raged against ROGD, called it a “hoax diagnosis,” scoffed at the study design and impugned Dr. Littman’s academic integrity. Yet they knew full well that the entirety of the “affirmative model of care” for people confused about what sex they are has much flimsier underpinnings, in addition to cherry-picking, confirmation bias, same-team replication & review, in-house “bioethicists” and financial or other conflicts of interest. What can they say, when reports from around the world confirm not only an explosion in the rate of children and adolescents getting hooked into TransWorld, but a reversal of the old familiar sex ratio? What can they say when there is in real life no “trans”?

Young people are systematically gaslighted in their indoctrination about all things trans. Like many adults, adolescents are usually overstimulated, sleep-deprived and eating suboptimal food; often somewhat traumatized and fragmented far away from knowing their own wholeness. Trans ideology is now presented to kids in USA schools as truth, “settled science” that helps people to “become their authentic selves,” masquerading through life as the opposite sex. But based on both my personal experience as a former “transwoman” and my ongoing research,  trans itself actually doesn’t exist, at least not in material reality. It exists only through mind-games; reversals, inversions & perversions of meaning; language-policing; and bureaucratic paperwork.

All human beings are “valid,” but transgenderism is a cultish ideology that leads to serious harms. Rich countries of the world have fallen grotesquely into error and if there is any justice, the people who promote and take advantage of the transcraze in young people someday will be held accountable.

“Surly Shirley” and the assault on women’s sport–then and now

by Worriedmom

The year is 1976, and the place is the Montreal Olympics. And it’s clear that something is wrong.

The East German women’s swim team is unstoppable. Inhuman, almost. Smashing every record, every competitor, sweeping every race – then jumping out of the pool like it wasn’t even challenging. Race after race, the American women – before this, favored to medal, if not win, most swimming events – are outclassed, demoralized, destroyed.

What could possibly be happening? Who are these women? Where did they come from and how are they dominating this Olympics so thoroughly? Today, of course, we know that the East German and other former USSR-bloc women athletes were part of massive, intensive, state-sponsored doping programs, that “processed” thousands of female athletes, pumping them full of anabolic steroids, human growth hormone, and other performance enhancing drugs to turn them into athletic machines.

Kornelia EnderAfter the fall of the Berlin Wall and subsequent disclosure of state-sponsored doping programs, the story of the East German women’s drug scandal today is well-known. Sadly, many of these athletes, such as Kornelia Ender (pictured left) did not even know until much later that they were the victims of a doping machine. As Ines Geipel, an East German sprinter, stated, “We were a large experiment, a big chemical field test.” (Have we heard this somewhere before?)

Virtually all of the “doped” women went on to suffer serious health consequences stemming from steroid use, including chronic pain, kidney disease, heart attacks, infertility, and skeletal problems. Germany has now compensated some for their life-long health problems, and there have even been a few criminal convictions of “doping doctors.”

The drug program was not limited to swimming, nor East Germany, and several commentators have suggested that track and field records set during this period should be invalidated since it is unlikely they will ever be equaled.

Jarmila KIn 1983, Jarmila Kratochvilova, a “previously mediocre” 32-year-old Czech middle distance runner, set a world record in the 800-meter run in 1:53.28 seconds. That record has never been beaten in the 35 years since.

What is not as well-known today is that at the time, one particular woman, who was cheated out of as many as five gold medals – and who knew she was being cheated – was harshly criticized, ridiculed, and silenced when she dared to speak up about the unfairness she saw all around her.

Shirley Babashoff of the United States, then known as the “Queen of U.S. swimming” and  favored to exceed her stellar performance in the 1972 Olympics, arrived in Montreal in 1976. Her first clue that something was wrong was when she and the other U.S. women were changing in the locker room and heard men’s voices. Assuming the locker room was co-ed, they dressed quickly and looked around the corner, only to find the East German women’s swimming team.

Getting on the bus to return to the Village, Babashoff was asked by reporters for her opinion of the East German team. She replied, “Well, except for their deep voices and mustaches, I think they’ll probably do fine.”

The comment was the spark that lit the flame. (Source.)

As the 1976 Olympics went on, things got worse for the American women – and particularly for Shirley Babashoff. Beaten by East German women in all of the individual events in which she was entered (the 100, 200, 400 and 800-meter freestyle events), Babashoff won gold in only one event, the women’s 400-meter medley relay. Overall, the East German women won 32 out of a possible 38 Olympic women’s swimming gold medals.  Dubbed “Surly Shirley” by an unforgiving press, for continuing to speak out against the obvious cheating, Babashoff returned home from Montreal to find herself labeled a “loser” by none other than Sports Illustrated.

According to Mark Schubert, her coach at the time, “She was the only one that had the guts to speak out back then. If anybody had the right to speak out, it was her because she was the one that was cheated out of Olympic gold medals.” (Source.)

surly shirley olympics ceremonyDismissed as “shrill,” and “angry,” pictured is Shirley Babashoff, at left, during the Olympic medal award ceremony for the 400-meter freestyle, which she lost to Petra Thumer of East Germany. Thumer later admitted to using performance-enhancing drugs.

The 1976 Olympics marked the end of Babashoff’s swimming career. No fame and fortune like that enjoyed by Mark Spitz in the same era, no valuable endorsements, no cereal boxes, just finger-pointing, blame and ultimately, anonymity. Babashoff went on to a career as a postal carrier and life as a single mother to her son. It’s only recently that anyone has become interested in what Babashoff has to say, and in her recent book, Making Waves: My Journey to Winning Olympic Gold and Defeating the East German Doping Program, Babashoff expresses hope that the International Olympic Committee will consider re-awarding the gold and other medals from the 1976 Games to their rightful recipients. As of press time, she’s still waiting.

The other women athletes around Shirley Babashoff learned her lesson well. Speak out and get thumped in the press. Be labeled a “bad sport” or a “sore loser.” Get told you’re imagining things, or that you’re not seeing what’s right in front of your own eyes. Most important of all, don’t take yourself or your performance seriously. Give up your athletic dreams if they say you should, and do it with a smile on your face, like a good girl.

Could the parallel be any closer to what is happening to the female athletes of today, who are expected to compete with natal males in sports as varied as track and field, marathon running, weight-lifting, mixed martial arts, women’s football, American football, dodgeball,cricket, volleyball, golf, basketball, cycling, softball, even roller derby? After all, as Vice News puts it,

fallon foxTake that, cry-baby.

Most articles discussing the entry of transgender women athletes into women’s sports do not feature the voices of the women affected. A classic example is “Transgender Weightlifter Might Have ‘Unfair Advantage’ – Expert”, published on the New Zealand news site News Hub.  Quoted in the article are a skeptical professor, a defensive New Zealand sporting official, an annoyed Australian official, and of course Hubbard, who was given a platform to say the following:

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No “fundamental difference.”

Typical of the coverage afforded transgender athletes, however, we rarely if ever hear from the women beaten by Hubbard, who competed as a male in weightlifting for many years, and has now broken several women’s Masters weight-lifting records.  In fact, anybody with an objection to Hubbard’s stunning performances is dismissed as “prejudiced” and “jealous.”   Shades of Shirley Babashoff, who was ridiculed for losing to the East Germans when she was favored to win, and critiqued for not somehow prevailing anyway in an entirely unbalanced and unfair competition.

sore loser awardsIn many ways the failure of women athletes to object to transgendered men in their sports is not surprising.  There is a strong taboo in athletics against appearing to refuse to take personal responsibility for one’s sporting losses. No matter the circumstances, athletes are expected to take all of the blame when their performance does not measure up to standards.  Even in circumstances that are objectively unfair and unequal, a female athlete – faced with the pressure to be socially correct, the requirement that females be “nice” at all times, and worries about being judged as a griper and a sore loser – will hold her fire and not point out the obvious.

Women athletes are in an impossible bind: speak out and suffer Shirley’s fate, or continue to lose in lopsided and unfair competitions. Nothing will change until the athletes themselves, and not their surrogates, begin to protest, speak out, and refuse to participate in patently unfair competition. Until then, women’s sports will continue to be vulnerable to domination by transgender males.  How long will it be until potential women competitors decide it simply isn’t worth it? Why compete at all, if not on a level playing field?

Even the youngest competitors seem to sense that protesting will lead only to being punished, not heard. In Connecticut in 2017, Andraya Yearwood, a male teenager, who had undergone no medical treatment whatsoever, entered, and won, high school girls sprint races (on both the state and regional level).

andrea yearwoodAccording to Sarah Hall, the female athlete shown being beaten by Andraya Yearwood in this picture, “I can’t really say what I want to say, but there’s not much I can do about it” (Source). “It’s frustrating,” said Hall, who finished third in the 200. “But that’s just the way it is now.” (Source.)

That’s just the way it is now.  Shirley Babashoff could have told her that.