An open letter to the medical profession

“I know better than most how precious a career in medicine is and I am willing to risk it for the sake of preventing harm. Why aren’t you?”


This fine article (reblogged below) launches a new website by a detransitioned Welsh medical student, “More Rote Than Meaning.”

In her first paragraph, MoreRote mentions the case of Helen Webberley, the UK GP under investigation by the UK General Medical Council for prescribing cross-sex hormones to 12-year-olds. In the US, gender doctors do the same with impunity–with no media or medical-board scrutiny in sight. We tweeted about the stark contrast between the two countries here:

Many thanks to MoreRote for telling her story, and for raising crucial ethical questions about medical transition of children and young adults.


 

More Rote Than Meaning

In recent years, the presence of transgender issues in the public consciousness has seen a seemingly exponential rise. There has been a concurrent rise in referrals to the Tavistock and Portman paediatric gender clinic, with almost two thirds of those referrals being for natal females (1). Though there is currently no NICE guidance governing the treatment of trans-identified children, said children are routinely treated with GnRH analogues (aka puberty blockers) from as young as the age of 12 and cross-sex hormones from the age of 16 (2, 3). This policy is next up for review in 2019, and a number of transgender charities are calling for the age limit for cross-sex hormones to be lowered, with some demanding hormones be freely available over the counter (4). A private GP, based in Wales, recently took matters into her own hands, prescribing cross-sex hormones to children as young as 12, despite an…

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It’s not conversion therapy to learn to love your body: A teen desister tells her story

Noor is the 14-year-old daughter of Brie Jontry, spokesperson for 4thwavenow (see here for more from Brie).

Noor believed she was male for 2.5 years, from age 11-13, but has changed her mind. In a Skype interview (transcribed below), we asked Noor to tell us about her journey towards a trans identity, and how she came back home to herself as female.

 Noor, along with her mom Brie, are available to interact in the comments section of this post, as their time allows.

All artwork in this post is by Noor.


For a couple of years, you thought you were transgender. How did it start? Why did you think that?

It started when I was 11. I thought I might be trans after spending time online where I saw people saying that if you feel dysphoric, you must be a different gender. So many people were saying it, that I came to believe it. At first, I identified as agender and then after thinking about it more, I realized I was a boy because I wanted to be “masculine.”

What did that mean, be “masculine?”

 For me, it meant wanting the physical characteristics of adult males: a beard, being taller and strong. And being masculine was about feeling safe.

Were you dysphoric?

I felt like I didn’t want to be in my body. I didn’t like it. It kinda felt like my body wasn’t mine and I wanted a different one.

What was going on that made you feel like that? What was it about your body that “wasn’t yours?”

A few different things. Mostly, it was previous trauma and being in the early stages of puberty. I don’t know anyone who isn’t uncomfortable during puberty, but at the time, I thought the way I was feeling was something extreme and different.

I used being trans to try and escape being scared about being small and weak. I thought that if I presented myself as a man I’d be safer.

What first got you thinking about being trans?

Things online. First, it was on DeviantArt. It’s an art-sharing website, but the DA communities I was in, which were made up of kids drawing animals and other original characters, went from sharing and commenting on each other’s art to being super dramatic and depressed. It also turned into a disrespectful “call-out” culture.

noor color cat

Some of the people I was watching, whose art I admired, came out as trans. Some people posted about how much they hated themselves and how badly they wanted to transition. Some started to transition and talked about how amazing they felt. Suddenly, a lot of the people I knew on DA were making transgender artwork.

Why do they call it “DeviantArt”?

There are some “deviant” areas of DA but the places I spent time in were for kids sharing art but I don’t think it is the main focus anymore. It was originally a great art site and I made a lot of friends there and everyone was very nice to me. I liked it. It was a friendly art community.

But now it’s mean. And it’s also a place for kids to post about all their self-diagnoses and identity issues. I know lots of kids who post about their self-diagnosed schizophrenia and other mental illnesses.

All these self-definitions, are they real?

I think the kids believe they’re real. But I don’t. If someone calls themselves “schizophrenic,” I believe they believe they have it! But it isn’t a disorder a teen can self-diagnose.

Were there other online places besides DeviantArt that influenced you?

I started to use Tumblr, also because of the art. Reading people’s bios, I learned more about being trans and that what I was feeling is called “dysphoria.” There are a lot of artists there expressing their dysphoria in comics and I identified with some of the things they were saying

From Tumblr, I found YouTube transition videos. When my dysphoria got worse, I started watching a bunch of FTM videos. All of the ones I watched were like, “I feel amazing!” and “I am finally my true self!” I thought it was weird that no one regretted anything but I wanted to believe medical transition would help me too. I started wanting hormones and maybe even surgery later.

I also talked to some of my friends. I was in a homeschool group and lots of the kids there were also trans.

“Lots” of the kids were trans? How can that be, when trans make up a miniscule proportion of the population?

 I wonder how accurate the data is that tells us only a “miniscule proportion of the population” is trans, because most teens I know identify as anything other than “cis.”

Hollow wolfIn my homeschool group, there were only two girls who didn’t have trans identities. Talking about gender identity and sexuality was very popular with my friends and also some of the parents. There was a parent who identified as pansexual and “demi gender” or something like that. She came and talked to all of us about using preferred pronouns and sexuality stuff. She was a facilitator there but not for my group. It was just a bad time even though I had a few really good friends there. There were some kids who were always talking about how oppressed they were and they weren’t. At all. They thought disability and mental illness were cool. They’re not. It was hard for me to hear them talk about all their self-diagnosed issues when I had to give myself insulin every day (I’m diabetic) and I hated my body. Also, my grandfather had just died. My mom started not wanting me to go there because I would get really anxious and have panic attacks and she would come pick me up early.

 Trans activists and some gender therapists insist that some people are “born in the wrong body” and that causes terrible dysphoria. They claim this is very different from not just conforming to gender stereotypes (even though many published accounts of dysphoric people also include stereotypes). Is dysphoria real?

It is definitely a real feeling! But being uncomfortable is part of being human. If you can’t cope with those feelings, then you need help learning better ways to cope. My psychologist understood I had dysphoria and we worked through the trauma that caused it.

Feelings are feelings. Feeling something doesn’t mean it is true or real. I didn’t understand that at first.

noor catAnd I thought that I would feel better as a boy. I wanted to stop my natal puberty because I didn’t want to be female. I thought taking testosterone would make me male. But now, I don’t think it’s healthy to be hurting yourself with hormones. Taking T is a very harmful thing to do to your body. There are YouTube channels where they’re talking about how great T is. But I wonder what they’re going to say in a few years? I wonder what’s going to happen to their bodies? If they say it’s totally safe, they’re wrong. I wanted to medically transition, so I looked up a lot about it. All I found was, “oh this is safe for you, you’re gonna feel better.” But then I found some other articles, that talked about heart disease; things like needing a complete hysterectomy in 5 years if you’re on testosterone because of what it does to your uterus and ovaries. My mom found other things for me to read. But you know what? At first, I didn’t want to believe that it was dangerous. I even thought I could block puberty forever and when my mom said that wasn’t true, I argued with her.

I talked to our friend who is a scientist and she told me more things about blockers and my brain development. I trusted her and I trusted my mom so I knew they were telling the truth but I didn’t want to believe them.

In my homeschool program, I tried to talk to my friends about this stuff but they said it was transphobic and I was wrong.

Do you think there are some young people for whom transition is a good choice ?

I know one person who’s on testosterone, and I believe transition is the only way for him to be happy. At the same time he’s very aware of how it’s going to hurt him.  I think he’s very young to transition, even though he’s 19, it’s very young. But he believes something bad will happen to him without testosterone.

Some people may need to transition but it should always be a last resort.

How is your dysphoria different? Why is medical transition not appropriate for you?

Extreme dysphoria might mean you can’t get out of bed in the morning or function at all.  But thinking about it in a more critical way, what teen doesn’t experience being uncomfortable about their bodies? Dysphoria is just an extreme version of that discomfort.

It was that bad for me for a while, and sometimes it can still be bad, but I’ve learned to move my body when I feel that way and do other things that don’t feed the feeling.

What kind of things do you do to work with your dysphoria?

I draw. I pet my animals and play with my Madagascar hissing cockroaches. I don’t lay in bed doing things that make me feel worse.

I used to watch FTM transition videos when I felt dysphoric. They made me feel even worse and also jealous and anxious that I might not transition soon enough and that I would never be masculine enough.

I know this sounds cliché but you have to find something to love about yourself instead. For someone like me, who thought I was FTM, think about the ways you’re already “masculine.”

Discomfort about your body and sometimes dysphoria are a normal part of being a teenager and having your body change.

I know some people who feel so wrong that they want to mutilate their bodies. That was me for a little while but it isn’t me now. Even when I was wearing a binder, I thought I looked physically better but I still hated my body.

So the image you presented to the world was “better” but it didn’t make you feel any better?

I remember being 11 and it was the beginning of summer. I was downtown with friends and their parents and one of the men made a joke about the way another little girl was dressed in short-shorts and a tank top. He said something like “I’ll never let you dress that way” to his daughter even though her brother was already dressed just like that! Then, a little bit later in the day, when a woman walked by he said “I love booby season.” That’s the kind of thing that made my dysphoria worse and made me sure that I would be happier as a boy.

noor muralIt made me think of myself a little better when I was wearing a binder but it wasn’t a good solution because it was physically hurting me. They’re not comfortable. I didn’t care then that it hurt to wear it and it didn’t really help wearing it, because I knew I still had boobs. My ribs still hurt and sometimes it is still hard to breathe even though I haven’t worn a binder in over a year.

The kids I know who are trans brag when they’re having a hard time breathing. They act like it is a cute little “trans-relatable” experience when they feel like passing out from wearing their binders for too long.

What made you change your mind?

 I realized that the only reason I was trans was because I wanted to feel big and safe and also, I didn’t conform to what I thought being female looked and felt like. But then I learned that being female isn’t a feeling. It’s a biological reality and I could feel however I feel without it meaning I was male.

Also, I have type 1 diabetes. On my five-year anniversary of going into the hospital to be diagnosed, a friend who was on testosterone injections texted me to complain about her monthly shot (she has detransitioned and uses female pronouns now). When I read her text, I felt anger, but I knew she wasn’t trying to hurt me or be mean. But I was so jealous. She didn’t have to get shots. Why would anyone want to be dependent on medication if not absolutely necessary for a serious medical condition? I saw everything clearly. I changed my mind at that moment. I would never transition medically.

At first, even though I knew there could be side effects with blockers and testosterone, I was okay with going ahead with that. Because if I hurt my body, I was in control of that. When I identified as trans, there was always a way I was hurting myself: wearing a binder, pinching myself, picking at my skin, cutting.

But why should I hurt my body to feel control over things around me that are messed up?

I remember driving to one of my homeschool programs and I was telling my mom that I wanted to transition because I would feel safer. And my mom said something about me turning my back on other women. I also realized that I was wrong thinking transitioning would make me safer. It wouldn’t. And I’d also always be afraid of not passing.

Your mom told us she took you to the Philly Trans Health Conference so you could learn more about trans issues—you even had a pizza party with Jazz Jennings. It sure sounds like your mom was open-minded about all of this.

My mom was always very open minded. She never pushed anything on me or tried to push any ideas away from me, unless it was something dangerous, like crossing the street without looking.

One of our friends posted my mom’s interview on Facebook and one of the comments was “this mom is pushing things on her kid.”  It was never like that at all. My mom wanted me to explore the thoughts I was having. She just didn’t want me to medically transition but even then she was being supportive. She never flat out said “no,” she just said that I needed to think about it and research it.

Do you think if she had been more resistant, if she’d said, “no way we’re going to that conference” or “no way you’re a boy” do you think that may have made you want to do it more?

I definitely think that. You know, as a “stubborn teenager” I would have wanted it more.

What was it like going to that trans conference? Did you feel connected to the other kids there?

All the kids were really friendly. But I did feel some pressure after talking to kids there to “look more masculine.” It was interesting. It wasn’t a bad experience.  But most of them were like Tumblr-SJW trans; I definitely got that vibe from them. When I was identifying as trans, I was what they call “truscum” or “trans-medicalist:” you have to have chronic dysphoria to be trans, and you definitely want to get some kind of help for that problem—not necessarily hormones, but maybe talk therapy if you just want to learn to cope with your dysphoria.

Philly trans health banner 2015

None of those kids were trans-medicalists like I was. I hate saying the word “snowflakes” because it seems rude, but…There was stuff like, “you can’t be a trans boy unless you get your head shaved and dyed.”  It’s like the trans-boy starter pack. They all had the same haircut. I don’t remember if anyone said exactly “you need to cut your hair and take hormones” but I felt that vibe from the other kids who were all talking about their anxiety over passing and being more “masculine.” I wasn’t wearing a binder yet but I was sure I was trans. I had long hair and I loved my hair so I didn’t cut it. Even then, I thought it was silly that all the transboys I knew had the same haircut, shaved on the side and dyed blue or green or some blue streaks, and that they thought boys had to have short hair.

That sort of made me question. I mean, all these kids were following the same exact trend. I never wanted to brag about being trans. Stuff like pronouns was the least of my concerns; I just wanted to deal with my dysphoria.  Because that’s a mental feeling, something people can legitimately feel.

In the banquet hall where they had a pizza party for trans kids and their parents, a few of the moms had their kids pull up their shirts to show off how great their binders worked to flatten their breasts. My mom remembers that a few transboys also showed off their bare chests and people talked about what a good job their surgeons had done. Some of them were like 14 or 15.

So did that event push you more or less in the direction of thinking you were trans?

It pushed me toward wanting to medically transition, but I saw what those kids were doing as trendy. Like, there was a whole line of penis packers there, in different colors and sizes. There was a neon pink one hanging up on the wall. It was horrifying. There were some for 6 year olds. Six year olds shouldn’t be worrying about what’s in their pants unless there’s a problem going on. I think it would make little kids sad to think about having to fake it.

Did you want one?

God, no. During that time I did want a penis, but not a fake one.

So you eventually wanted surgery?

No, I didn’t want bottom surgery. I just wanted to be a biological male.

So the gender therapists and activists might be saying right about now, ok. This kid figured out she wasn’t really trans. No harm done. Mom and dad, chill. Use their pronouns. Take them to a trans conference or a gender therapist. No harm done.

I think if I had gone to a gender therapist, I would still think I was trans now. If my mom had thought that hormones and blockers were the best solution for my anxiety and dysphoria, I would be taking T right now.

I’m glad she didn’t believe I was a boy trapped in a girl’s body. I’m glad she found a psychologist who saw how scared and angry and hurt I was and who wanted to help me with those things first instead of also helping me transition to be a boy.

But parents should be supportive and respectful of their kids. They should take them seriously and learn about side effects of transition and alternative opinions about gender together. Let them break stereotypes and talk about those stereotypes and where they come from and how they hurt people, not just girls, boys too. And kids need good therapists who will ask them questions they never thought of.

Until quite recently, believing oneself to be the opposite sex was considered a mental disorder and treated as such.

It is a mental disorder sometimes. People who feel mild dysphoria are like “I hate this thing about my body” which is different than “I hate this thing about myself and I am willing to hurt myself to relieve the feeling.” The second is a mental disorder. Somebody wanting to hurt themselves is a mental disorder. Dysphoria always has a deeper root.

“Trans” isn’t the right word. We’ve learned to know it as trans but really what I think some people feel is extreme, chronic dissociation, possibly from trauma and PTSD.

And for adults, it is different. Adults can do whatever they want, even if they don’t have dysphoria or other mental health issues. But kids need their parents and sometimes a psychologist to help them think about why they feel the way they do.

I don’t know any trans kids who have gender-critical therapists. And by the way, being gender critical wasn’t pushed on me either, but my mom and my therapist and other friends would gently suggest that I think about things beyond just “being trans.” They’d say I should think about why I felt that way, the reasons for feeling that way, and any other perspectives or reasons someone might feel that way. And that I should also think about my history and my experiences and relationships and why I might feel uncomfortable or not want to be a girl.

Parents who put their kids on hormones are trying to take care of their kids. I know they want to do the best thing. But what if they haven’t heard other ideas and they don’t understand about being gender critical, or about how to see their kids’ identity or presentation without stereotypes?

Most parents just want their kids to be happy, and their kids say “I need hormones to be happy.” Some kids even threaten to kill themselves if they don’t get the treatments they want. I’ve also seen kids say that after they started cutting, their parents took them seriously, and let them take hormones. There are places online that tell you, “This is how you come out to your parents to get hormone therapy.” I always hated those, because it was always … just threaten something to get what you want. That’s just putting so much pressure on your parent to make an impulsive decision and it’s such a terrible thing to say. I know people who’ve killed themselves and also people who have tried to kill themselves. People who are suicidal need help and love but using suicide as a threat is manipulative and cruel.

 Did you see a lot of that online?

 Oh, everywhere. Everywhere. Most ways to come out were like, “say this, you’ll be sure to get them to take you seriously.”

We see this in every news article—“Would you rather have a live daughter or a dead son?” It’s why most parents decide to agree to medical transition. It’s the worst thing that could happen to a parent. It sounds like people are being coached to say they’re suicidal, when they aren’t?

 I think being truly suicidal is rare. Like the true trans thing.  Some trans identified people I’ve known will threaten to cut or hurt or even kill themselves when they would never do any of those things. For the few that are serious, it ties into mental illness: If you are going to kill yourself because of gender roles, or stereotypes, or even dysphoria, that’s a mental illness. And it can’t just be fixed with a bunch of medication. Some of the accounts of boys trying to cut their penises off in the bathtub—that’s clearly a sign of mental illness.

You’re 14. Pretty young still. How do you know you’re not going to change your mind again or want to go on testosterone?

I’ve read a few comments on Facebook about my mom’s interview. One was really insulting because it said that I’m too young to know what I want and that my mom is manipulating me.

But if I had said I am trans, I’m sure that person would believe me and not worry that my mom influenced me. So, can’t I also know that I’m not trans?

How can any thirteen-year-old or their mom know that they’re “really trans” either? That’s why you shouldn’t make any permanent changes to your body at such a young age. I don’t know anyone my age who hasn’t felt uncomfortable about their bodies at some point. Everyone I know wishes there was something different about their bodies.

If it is on your mind 24/7 and you feed that idea, you give that idea power – and you start to feel like you need to do something to your body to feel better.

The idea of gender is harmful. It encourages dysphoria. It locks people into stereotypes.

Some people say that you shouldn’t help kids feel comfortable about their bodies or even feel okay with being a little uncomfortable. They say that’s “conversion therapy” to talk someone out of wanting to hurt themselves. It isn’t conversion therapy to learn to love yourself or at least, feel like you can live in your own body without hurting it on purpose.

That was Dr. Ken Zucker’s goal: to help younger children, especially prepubescent children, come to feel peace about themselves and in their own bodies. He says that in childhood, gender identity is subject to change, and if you can help a child not become a permanent medical patient, that’s a good thing.  It was controversial, but in at least some cases, he discouraged “gender nonconforming” behavior in young kids—things like toys, haircuts, and clothes more typical of the opposite sex. What’s your opinion on that?

 Toys and clothes don’t have genders. Kids should get to play with whatever they want and wear whatever they want. Kids should be allowed to explore the things that they find interesting. When I was little, I didn’t see clothing or toys as gendered. Parents need to keep gender ideas like that away from their kids. “Female” isn’t a way of dressing.

I was shopping with my mom when I was little, before I thought I was trans, and we were in the “boys” part of the store because I liked those clothes better. They’re more comfortable and have better pockets. And a salesperson came up to us and asked my mom, “What is your son looking for?”

I wasn’t offended. But it’s silly that she thought because we were looking at comfortable clothing we were shopping for a boy.

And agreeing with a girl that she is really a boy because she doesn’t like to wear dresses might lead to going to a trans support group or seeing a gender therapist and other things that result in a kid thinking they need hormone therapy. If medical transition wasn’t available,  I don’t think it would matter if a girl thinks she’s a boy for a while, because she wouldn’t be encouraged to do things that are harmful.

Parents should give their kids more choices about more things in life but not about things that will harm them.

What would you say to other girls who think they are boys? Any advice for them?

 There’s nothing wrong with your body. To be straightforward, you will never be male. You will never have a Y chromosome. You will never have a real penis. Stop hurting yourself. Not wanting to be female doesn’t mean you’re really male. Not wanting to be female makes sense when girls are sexualized before we’re ready to even feel sexual, and when people think we’re weak both intellectually and physically, when people don’t take us seriously, when people tell us to smile and be nice.

You weren’t born in the wrong body because that’s not possible.

You were born into a society where looks mean everything. But really our bodies are just what keep us alive. Why don’t we fight back against the idea that any person looks wrong as they are? Your “outside” doesn’t need to “match your inside.” The outside isn’t important enough to hurt yourself over.

Get angry at gender stereotypes. You can dress however you want but that’s called “fashion” or presentation. Your identity should be who you are and the things you do, not what you look like. I have resting grouch face. I don’t need to train my face to look kind or have surgery to make my face look kind, I just have to be a kind person.

You think, how can I act male? There’s no such thing as acting male. Male is a biological sex and you will never be that. Just act like you.

Go outside. Move your body. Make art, do something. Don’t spend time with other people’s stories about self-loathing and self-diagnosis. Stop feeling oppressed when you’re probably not oppressed. I know transitioning can make you feel like you get a lot of control but medically transitioning doesn’t give you power. It just makes someone else money.

Find people to talk to and ask for help if you need it. And find people who will ask you hard questions.

No glitter life: Don’t be swayed by middle-aged transitioners–including me

by Helen Johnson

As time permits, Helen will be available to interact in the comments section of this post. As always on 4thWaveNow, comments that challenge the author will have a better chance of publication if they are delivered respectfully.


My name is Helen Johnson and I am a trans woman.

That’s partly true. I am trans, but I’m not telling you my real name. After you have read my piece, I hope you’ll understand why. Transgender activists reserve a special kind of treatment for apostates who speak out against their dogma. I have no wish to deal with their threats and intimidation, but neither can I remain silent when those transgender activists are driving a contagion that is consuming our young people.

Much has been written about the explosion in the number of children who have come to believe that they were born in the wrong body. I’ve said nothing because — like other trans women who transitioned as adults — I’ve nothing to offer. I’ve no childhood experience of living as the opposite sex and my own kids are thankfully unscathed by this epidemic. I can therefore only sympathize with other parents whose children are struggling with their gender. Some have asked me directly, but I have always suggested that they seek support from other parents in the same position. Certainly not from me.

Unfortunately, other trans women think differently and some of them seem to think they know best. Entire pieces have been written about trans activists like Rachel McKinnon,  who told trans kids to dump their moms on Mother’s day and join the “glitter-queer” family of adult trans activists. Worryingly, Dr McKinnon is far from alone. The message is pervasive, and it is sinister: transition your kids or lose them. Sometimes it is subtle.  For example, Julia Serano, a leading figure in the trans community, suggested that children will grow distant unless parents affirm the transgender behavior. Others are more blatant. Caitlyn Jenner is one of many who throw suicide statistics around like confetti.

None of them are experts. All they have to offer is their own experience of growing up. But if they can do that so can I and, unlike deluded fantasists like Zinnia Jones who thinks they actually were an adolescent girl, I am in touch with reality.

Gender dysphoria was present in my earliest memories; it persisted throughout my childhood and stayed with me in adulthood. It made me socially uncomfortable and I struggled to make friends. My dreams of becoming a girl were never fulfilled and I reluctantly accepted that there was no alternative to becoming a man. I’ll say no more about that. The trans narrative is repetitive and it is tedious. But just like McKinnon, Serano, Jenner, and Jones, I survived childhood and everything it threw at me. Yes I had difficulties, but lots of children have difficulties. Growing up is hard.

Today’s youngsters are being fed dangerous and fallacious nonsense. Society has been infected by post-modern, post-facts, post-truth ideas that spread unchecked on social media. Opinions and feelings are on the ascendancy, while facts and evidence are cast aside. For socially awkward children struggling to understand themselves, McKinnon’s “glitter-queer” family may look superficially attractive; an easy escape from reality. But it comes at huge cost.

I am glad that I did not succumb as a child.  Male puberty was a mixed blessing for me. It changed my body in ways that I did not like, but it enabled me to have my own children. Today they are my pride and joy: fine kids who are now making their own way in the world.  They would not be here had I been transitioned in childhood.

It’s now becoming all too clear that the first generation of child transitioners may have thrown away more than the chance to be parents.  Sex reassignment surgeons need material to work with. Only after male puberty did I have sufficient tissue for my vaginoplasty. Children who never experience natural puberty, like Jazz Jennings for example, are finding that they have a serious problem. To be blunt, there is no way that a functional vagina can be created from a penis only two inches long and an inch and a half in circumference. Sadly, Jazz may never be able to enjoy the sex that adult male-to-female transitioners take for granted.

Even transitioning later is a mixed blessing. I am in remission from the gender dysphoria but that is only half the story. My life is harder in other ways. Whenever I am clocked as trans I am treated differently, and not better. Mostly I deal with this by living in stealth. In my day-to-day life I just don’t mention it. People can’t discriminate if they don’t know. But that brings troubles of its own: when I’m asked about my childhood, I obfuscate; when asked about my children, I fudge; when asked about my private life, I create back stories. I hope they are consistent. When acquaintances become friends, I anguish over whether to come out to them, then when to do it and finally how to do it. Lying about your past is not great, but admitting it is harder especially in the early stages of a new friendship. Securing a life partner is something else. Trans people are seen as exotic curiosities rather than possible suitors. Rarely are we seen as human beings, usually as trans human beings. Not quite the same and not quite suitable.

But, people say, at least I have found my true self. Maybe, but I’ve always been my true self. I transitioned to escape the pressures that I faced but I will never really be a woman, I merely live as one, and I am always one step away from being outed. It works but it’s an expedient tactic rather than a fulfilling solution.

But you must be sure, they say. How can I be sure? All I have are circular arguments: because I needed to transition I must be a woman, and I must be a woman because I needed to transition. But I can never know what it is to be a woman. All I can know is what it is to be me. My experience will always be different from the women around me. It isn’t a glitter life, it’s a hard life. It works because I make it work, but it’s not great.

To kids contemplating transition I have no answers, only questions. Do you really need to transition? Give up the chance to grow up and form relationships as a human being rather than a trans human being? Have your own children? Have sex like other adults have sex, and live free from lifelong medication? If gender expression is the issue then be yourself and embrace your gender, but don’t try and change your sex in the process. One day, society may free itself from the shackles of gender norms, and feminine men, masculine women and gender-neutral members of both sexes will be able to take their rightful place in it. Make it your generation that does that, not the ones that follow you.

To your parents I would say, give your children a hug. Love them and nurture them. Let them be free to explore their gender and help them make that break from the crushing weight of society’s restrictions and expectations. But steer them away from transitioning from one gender prison into another, certainly before they can experience what it means to be an adult. If their gender dysphoria persists, as mine did, they can always transition in adulthood. That option will always be there. If it desists, then they will have avoided making a truly catastrophic mistake.

But above all, parents, don’t be swayed by middle-aged transitioners. That includes me, but it also includes McKinnon and the others. You know your children, we don’t; you brought them into the world, we didn’t; you love them and care for them, we don’t even know them.

Have confidence in yourselves because, when it comes to your children, you will always know better than people like me. Never forget that.

Born in the right body: Introducing 4thWaveNow’s new spokesperson, mom of a teen desister

Brie Jontry is a part-time academic, and a politically liberal mom to an adventurous, wilderness-, insect-, and art-loving teen. She currently lives in the American southwest with her partner and daughter, a huge dog, three cats, and various insects who come and go.

Brie has been a member of the 4thWaveNow community for two years, since her daughter first temporarily identified as transgender. After exploring all kinds of ideas, thoughts, and feelings related to gender identity with her daughter, Brie has decided to speak publicly about her family’s experience.  In particular, Brie agreed to be our public spokesperson to counter the untruth that only religious, anti-LGB conservatives are skeptical about medical transition of gender-atypical young people.

Note: Anyone who has spent time on our site knows we are not a monolith, but a diverse group of parents with varying (though generally congruent) views.  Brie’s experiences and analysis are her own, but are on the whole in line with those of the other gender-skeptical parents in our community.

In a future article, Brie’s daughter, along with a few other teen desisters will discuss their own thoughts about identity, gender nonconformity, desistance, and more. Stay tuned.

As her time permits, Brie is available to interact in the comments section of this interview.


You are the parent of a teenage girl who temporarily believed she was trans, but changed her mind. Can you tell us something about her journey—and yours?

brie resized

Brie Jontry

A few months before my then 11-year-old said she might be transgender, she told me she didn’t want to grow up. She had just met her new pediatric endocrinologist (she has type 1 diabetes) and he told us she was in the early stages of puberty. In the car on the way home from the appointment, crying, my daughter asked me how much longer until she’d start bleeding, until her breasts would grow.

A few weeks after that appointment, Leelah Alcorn, a transgender teen in Ohio, committed suicide by walking onto a highway into the path of a tractor trailer. My daughter was gripped by Leelah’s story, by the horrific choice of death over a seemingly endless painful existence, and she agonized (for weeks) over the details in Leelah’s suicide letter. “What is transgender? Was Leelah a girl trapped in a boy’s body?” “How could her parents not see they were killing her?”

A few months later, my daughter told me she thought she might not be a girl. I asked if that meant she was really a boy and she said she thought so. I said something like, “this is a lot to think about” and asked her permission to speak to her grandfather, a psychologist, and another friend, a genetic biologist and a lesbian. She agreed and sheepishly let me know she’d already told her poppa.

I called my dad that night after she’d gone to bed. He reminded me that she’d always “been her own person” and that imagination and sensitivity could have been heightened by almost obsessively reading/thinking about Leelah Alcorn. He explained body and gender dysphoria, and drew a connection to eating disorders. “You wouldn’t help her starve herself if she thought she was too fat,” he said. “Help her just be her, in her own body, whatever that means.”

Next, I spoke to Audrey, our gay geneticist friend who reminded me of her own teen years and cautioned that she certainly would have considered transition had it been readily available. Together, we looked at the few studies we could find about hormonal suppression in adolescents and testosterone use in healthy female bodies. My friend was horrified by the lack of long-term data available for medical interventions being performed on healthy adolescent bodies. Audrey spoke to my daughter about the hormonal responses which occur in puberty, how besides development of secondary sex characteristics, pubertal hormones are needed for brain development, neural pathways, grey matter. If you “pause” that process, she told us, you’ll be stunting the very growth that will make you into the adult you. “You don’t know who you are yet,” Audrey said, “how can you know that’s not who you want to be?”

My daughter agreed to put medical transition, a process she’d been watching with envy in numerous transmasculine teen videos, on hold while we explored these ideas together.

What followed were two years of emotional upheaval and deep exploration. Family and friends agreed to stop using “girl” and worked hard to remember her requested “kid” in its place.

salt-in-the-soup.pngI pestered anyone who was willing, to talk to me about gender, adolescent development, and hormonal modulation. I talked to someone I knew in the midst of her own gender transition and to her partner. I talked to trans people, gay people, other parents of trans and GNC kids, endocrinologists, a Zohar scholar, educators, radical feminists, postmodern theorists, and child and teen psychologists, including those who designated themselves “gender specialists.” I joined large Facebook groups for parents of trans and gender non-conforming kids (and was subsequently thrown out for posting data about Lupron).

I asked my daughter to show me some of the things she was reading and watching online which led to her realization. Together, we explored all kinds of “you might be trans if…” quizzes and “Am I trans?” posts on Reddit’s “Ask a Transgender” subreddit, various Tumblr blogs, and elsewhere. We talked a lot about stereotypes and gender roles.

At my daughter’s request, we went to the Philadelphia Trans Health Conference, where we met Jazz Jennings and ate pizza with hundreds of transgender kids and their parents. Dinner conversations between parents were clearly divided between stories of natal boys who’d “always been this way,” who “always liked pink” or sparkly princess dresses; who liked to play with dolls and wanted to wear nail polish, and born-girls who, on the cusp of puberty, often friendless, suddenly came out as “trans.” My daughter made a lot of new friends that night, some of whom now, two years later, have been on testosterone for a number of years; some have had mastectomies. Of the teens she met that evening, I’m aware of one other who has also desisted.brie pull 2Ultimately, what brought her to the realization that she is not “in the wrong body” (about two years later), were endless, ongoing conversations about sex-based norms, gender roles and expectations, misogyny, and homophobia, between her and lots of other people, mostly women. NO ONE fits neatly into any stereotype associated with their “identity.” She came to understand that her suffering wasn’t because her body was wrong; she was suffering because growing up is hard! To her, “being trans” explained a lot of her discomfort and anxiety, but she came to realize that it wasn’t actually “being trans” that caused any of it.

She came to see medical transition as physician-assisted self-harm. In a twisted way, it helped that she is already dependent on synthetic hormones for her life. She has zero choice about injecting insulin every time she eats, or when her blood glucose is too high, up to ten times a day, for the rest of her life. When her friends who’d started HRT complained about needing injections, something snapped in her. She saw the stark difference between needing pharmaceutical treatment to live (no choice) and desiring it as treatment for a feeling. Her body IS, actually, wrong. It’s verifiably broken and without synthetic hormonal supplementation numerous times a day, every day, she will die. Quickly and painfully.

She realized that her friends had healthy bodies but that their therapists, their friends online and in real life, and sometimes even their parents, were supporting them in the belief it was their bodies that were wrong because they didn’t match their personalities, their preferences, who they were supposed to love. When she realized this, she got angry. She felt tricked into believing there was something wrong with her because she didn’t want to be ogled by teen boys, or wear dresses, or because one of her favorite things was to talk about the difference between aquatic and terrestrial isopods.

So it sounds like she experienced a “rapid onset” gender dysphoria in adolescence, a phenomenon which is now only starting to be recognized.

Yes. And…no. She told me that prior to Alcorn’s suicide, that she wasn’t aware that being transgender was possible, that it even existed. Once she came into contact with the idea, it captivated her and she quickly identified her “transness” as the reason she didn’t want to go through female puberty. She wasn’t alone. Numerous girls in her various peer groups would come out as trans in the coming year.

I think it is critical to this discussion, though, to talk about all the ways she’d been “gender non-conforming” up to identifying as trans.

As liberal, progressive, feminist parents, we never put energy into making sure our daughter adhered to gender norms. As a baby, she wore all the colors and never had a head-squeezing headband to denote “girl.” I never bothered correcting strangers who thought she was a boy. I insisted she wear a dress once, to a wedding, when she was eight. She cried.

When people asked her if she was a boy or a girl, she’d bark, or meow, or roar.

brie pull 4When she was younger, her favorite toys were stuffed animals, scraps of fabric, cardboard boxes, and small plastic insect, dinosaur, and dragon figures. Then, as she got older LEGO, but never the pink sets. She played lots of imaginative games with her stuffed animals and little figurines and dump trucks; she never wanted a doll and cried once when she was four and someone gifted her one. She couldn’t understand how someone who knew her might think a Mermaid Barbie would be a welcomed present.

Her favorite stuffed animal was a crab named “Crabby” who went almost everywhere with her. When people asked if Crabby was a boy or a girl, she’d answer: “she’s a boy” or “he’s a girl” and laugh. Outside, she liked to pee standing up, like her dad, and somehow figured out how to pee farther than her best friend, a boy.

She mostly preferred “boy’s” clothing: sweatpants and shirts with insects, dragons, monsters, and dinosaurs. We let her choose her own clothing as soon as she wanted to and had no problem with her heading over to the boy’s section of stores.

These are important details because once I turned to trans-affirming websites and books (which were all I could find until I learned the phrase “gender critical”), the gender nonconforming choices she made, her preferences, some of her behaviors, could easily be read as proof that she really was a boy, that she had a “boy brain,” and perhaps, that she was exposed to too much testosterone in utero as evidenced by her relative finger length.

The acute stress she felt over her body (dysphoria) was indeed rapid-onset. However, looking back, there were many incidents which could have been interpreted as signs of an “innate gender identity” that didn’t match her sex.

Trans activists have tried to convince the public that “desistance is a myth”. Yet your daughter did indeed desist. Why do you think activists want to deny the experiences of young people like your daughter?

Because desistance justifies cautious, rational, skepticism. Desistance proves that some people think of themselves as transgender and then come to think of themselves as not trans. Desistance creates doubt.

When I say “desisters,” I’m talking about those who once thought of themselves as trans but do not currently see themselves that way. Desisters like my daughter and the other young people we know, never took steps to medically transition although they considered themselves transgender and in most cases, looked forward to medical intervention of some kind.

Desistance stories are often criticized as being about kids who were never “really trans” to begin with. Brynn Tannehill, a board member of the Trans United Fund, argues that the 84% desistance rate is inflated because it caught up a lot of gender nonconforming kids in place of “true trans” kids–so of course they desisted; they were never trans!

Here’s the thing, neither was my kid. Chances are, most of the kids of parents reading here aren’t trans.

Let’s assume for the moment that there is such a thing as “true trans.” What does that mean? Let’s say there is at least minimal proof that gender identity is innate and biological (there isn’t). Let’s pretend that we have long-term data showing that medical intervention in adolescent development is beneficial to those who don’t fit easily into gendered expectations and norms and to those who suffer from dysphoria.

Now, let’s say that all the previous gender-atypical behavior my daughter exhibited growing up was resultant from a biological abnormality.

So what?

So what if she sits on the far end of the bell-curve’s tail of female behaviors and preferences? How does that make her “other?” Why does that mean she’s in need of medical intervention to “correct” something deeply amiss?

Why can’t she and all other outliers be supported as they are without needing to be fixed? Have we learned nothing from the historical horror show of medical interventions enacted on children with differences in sexual development (“intersex”)? Why does being an outlier mean that she’s “really a boy?” instead of simply, that she’s different than the female norm?

Desistance as a likely possibility gives rise to the “wait-and-see” approach, which according to some “affirmative” gender professionals, is just as dangerous to kids as insisting they’re not trans. This horrifies me, that cautious “wait and see” approaches are discouraged when there is zero evidence that socially and medically transitioning children and teens is beneficial, apart from (parent reported) immediate gratification and short-term validation.

The affirmation model used widely in the US is actually highly controversial. In the UK, a doctor is under investigation for providing cross-sex hormones to children as young as 12—a situation being normalized at pediatric gender clinics in the US.  Under-18 surgeries take place in the US, while they are prohibited in the UK—and even Thailand, once known as a go-to place for underage procedures.  US “affirmative” clinicians behave as if the debate on child transition is over, even though leading researchers at 17 worldwide locations cautioned in a 2015 journal article that “in actual practice, no consensus exists whether to use these early medical interventions.”

brie pull 3And still, WPATH argues in favor of lowering age limits for medical and hormonal treatment and easing access to transgender medicine. In the US, some pediatric gender practitioners and their advocates act as if this course of treatment is settled science. It isn’t. Even the gender specialists in the Netherlands who pioneered the use of puberty blockers in “trans kids”  caution against socially transitioning younger children, because kids who don’t socially transition seem to mostly work it all out by themselves, and some socially transitioned youth who changed their minds found it very difficult to desist later.

Desistance stories also add weight to recommendations for cautious approaches that focus on first treating underlying mental health issues. That’s problematic in a climate where trans activists want to completely depathologize transgenderism. I know a lot of families whose children currently think they’re trans. In almost every instance, there are prior mental health diagnoses or family experiences of trauma.

Parents like you—many of whom are contributors on 4thWaveNow—are castigated as “transphobes” or (at best) “unsupportive.” What do you say to these charges?

Supporting children in desiring and procuring plastic surgery, synthetic hormonal suppression and supplementation is not healthy, supportive, enlightened, or progressive.

Authentic selves do not require surgical and hormonal treatment unless there is underlying pathology, like for my daughter’s autoimmune condition which requires daily hormonal supplementation.  Medical transition should be a last resort for those whose suffering cannot be ameliorated otherwise.

Becoming a life-long medical patient is not liberating; it is enslaving. Being critical and cautious is not hatred, it’s being a good parent.

Gender dysphoria is real and it causes real suffering. My daughter was in deep, profound, pain.

After initial hesitation, I knew my child was not “born into the wrong body” and that as her parent, I would be doing more long-term good (and also less long-term harm) by offering her the time and tools she needed to see herself as whole, capable, and “authentic” as she was instead of affirming that there was something wrong with her.

I think that the most supportive thing we can offer our children is to take apart all our preconceived ideas about gender and identity alongside them. I was told by parents of trans kids and gender therapists that the only expert on my child’s gender identity was my child and that asking “why?” “what does that mean?” “How did you arrive at that conclusion?” “Who are your sources?” and a thousand other questions which would lead down a thousand other rabbit holes, was transphobic, unsupportive, and harmful to her well being.

They weren’t. Those are exactly the questions that helped her make sense of herself, helped her feel whole instead of in need of corrective treatment, helped her be resilient in the face of disappointment and learn to manage both real and perceived limitations.

The stories we’ve been telling aren’t enough. They don’t go far enough. Deep enough. They’re too easy. The answer isn’t a pill or plastic surgery. How many children were prescribed Ritalin simply because their bodies couldn’t stay still? I mean, come on. An entire industry has risen up around trans kids. Careers are being made, not just in the medical field but in education, policy, fashion, the media, all because normal, developmentally appropriate childhood behaviors have been repackaged as (often homophobic) pathologies. We’ve seen this before.

Being “trans” is too easy. It’s an identity picked off a shelf and inside the packaging, there’s a list of other necessary components one must procure before reaching authentic selfhood. “Being trans” to girls like my daughter is like a quest in a video game with each “affirming’ “medical procedure acquired is an “epic win” bringing you one step closer to having all your problems solved. Except no video game exists that suppresses development or leads to the removal of healthy body parts. Being trans isn’t a video game, it’s real life. Real, painful, confusing, life and being trans was the defining aspect not only of identity but also the root of all her suffering.

I supported my child in her journey. What I didn’t do was accept the first and easiest answer. I helped my daughter know that disagreement or unacceptance of any gendered norm was more than okay. I fully supported what my generation quaintly called ‘gender bending” in all ways, but I didn’t agree to let her subject herself to significant bodily harm in an attempt to treat her dysphoria. From the very first announcement, I let her know that she could cut her hair however she wanted, wear whatever clothing she wanted, and use whatever name she chose.

I supported her in her discomfort, to the best of my ability, and I also let her know that discomfort and confusion are legitimate aspects of a meaningful, deeply explored life.

 There are two rationales given for the urgent need to medically transition young people: the risk of suicide, and “passing” better as the opposite sex if puberty is blocked. Do you think these reasons are valid, and if not, why?

Major life moves made from a place of fear and lack of choice are rarely successful. Kids don’t kill themselves because they’re trans. Suicidality needs to be treated as a dysfunctional response to unhappiness, not as a symptom of being trans. Anxiety needs to be treated as anxiety and not as a symptom of being trans. Depression needs to be treated as depression and not as a symptom of being trans. And suicide should not be used as a strategy to manipulate vulnerable parents desperate for “expert” advice or to prime kids to take their own lives. Stop already. That stuff’s contagious.

Most of the parents who’ve agreed to support medical transition for their children and the various gender “experts” I’ve talked to over the past few years argue that children who transition young will pass easier. That’s a problem, because prioritizing “passing,” like much of the surrounding ideology, actually reinforces binary perceptions of gender by suggesting there is only one way to be/to look like a man or a woman. I know gorgeous women with broad shoulders. I know handsome men who can’t grow a beard. So what? The effects of testosterone on a natal female are rapid, and some, like the growth of facial hair, male pattern balding, and changes to one’s voice are irreversible. Besides, it’s recommended that natal females taking testosterone for more than a few years have a full hysterectomy to minimize increased risks of some cancers. Therefore, early transition does not limit later medicalization. Sometimes, it even increases the need for more intensive and painful procedures later.  I think it would be far healthier for those who are gender-atypical and for society to get rid of the idea of “passing” completely.

Until recently, the only critics of pediatric transition seemed to be people primarily from the conservative right.  They tend to conflate transgenderism with gay rights, and are opposed to both. What is your own political affiliation and viewpoint?

Oh, I’m left-of-left. Another reason I want to speak out is because most opposition to trans advocacy comes from the conservative right and IS deeply entrenched in sexist and homophobic beliefs.

Most on the left are too afraid to speak out for fear they’ll be labeled as transphobes, bigots, TERFs, bio essentialists, and just plain old shitty, hateful, shallow-minded people.

Sigh.

Look, if an adult decides after careful and hopefully well researched, in-depth exploration into why they want to undertake surgery and/or HRT, and they fully understand–to the extent it is possible to understand given the lack of long-term data—what their medical choices could mean 5, 10, 40 years down the line, I believe they should be free to make whatever medical choices they and their support team believe to be best. I think insurance policies or better yet, a national health insurance policy (I can dream), should pay for all services related to transgender care.

I believe trans people should be protected against discrimination in education, healthcare, employment, and housing. I want trans people to feel safe walking down the street. I want them to be safe walking down the street.

What do you hope to achieve as public spokesperson for parents of trans-identified young people?

I want to make the conversation larger; I want it to go deeper; I want the medical community to keep their ‘corrective treatments’ away from our children’s bodies. It’s not okay to offer them life-long patienthood without first giving them tools and support to explore the “why?” the “what next?” and a myriad of other possibilities and conclusions.

Currently, the only voices in the discussion are those involved with the industry that’s risen up surrounding transgender medicine. I want to take the discussion beyond the self-declared “experts” who are making entire careers off of the notion that it’s possible to be born into the wrong body.

Many advocates of medical transition for youth claim that there are “true trans” kids who are very different from merely “gender nonconforming” youth. Do you agree?

No. I think almost every human on earth is gender non-conforming in some ways. I was listening to Georgia Warnke recently. She’s largely responsible for getting the medical community to stop performing surgeries on young intersex children, and she helped people learn to be more comfortable with ambiguity in sex and gender presentation. She cautions that we don’t want identities to “go imperial,” a phrase she borrows from Kwame Anthony Appiah who writes that some identities “risk becoming the obsessive focus, the be-all and end-all, of the lives of those who identify with them,” and they “lead people to forget that their individual identities are complex and multifarious.” I’m concerned that’s what’s happening with many of our youth.

Their lives are boring, they’re isolated, the earth is dying, the economy is dying, their families are disintegrating, they’re carrying so much. I can’t imagine a more difficult age to come into ‘ideological’ adulthood than this one. I think a great many young people identifying as trans are doing so because it’s the only life-shaking, meaning-bringing area of their lives they have any control over. Being trans is an answer, a solution, and a meaningful marginal identity during a time in history when being a member of an “oppressed class” also begets greater social currency in some circles.

We’ve given them surfaces. Reflections of reflections of copies. The Mirror Stage mirrored and misidentified. A rose wet with Photoshop dew on a handheld screen that’s the first thing they touch when they wake up and the last thing they touch before they go to sleep. We parents didn’t realize what was happening. We couldn’t predict how digital lives would bleed into reality, that we’d need to clarify what we mean when we say the word “cloud.” Another mom going through this says, “online worlds seep into life like too much salt in a soup.” Curated personas, best friends you’ve never smelled or touched, avatars brought to life.  The Junior Oxford Dictionary removed the words “acorn, ash, buttercup, dandelion, fern, ivy, nectar, pasture and willow” to make room for: “blog, broadband, celebrity, chat-room, mp3 player and voicemail.”

Huge, meaningful and exciting swaths of our kids’ lives have played out in digital worlds while their material worlds have become smaller, more isolated, and disconnected. In many cases, our kids were already disassociated from their bodies, even before they became aware of trans identities. Running, jumping, dancing, wrestling, all these things happen primarily in controlled spaces now. The only remaining place for many young people to gather away from adult-controlled, contrived, and protected spaces, are digital worlds. It follows, in this climate, that “authentic selves” might also be technologically-mediated products to consume. My god, talk about planned obsolescence. This is planned obsolescence of the body from the moment of its birth and our kids are early test subjects in transhumanism. For real. No tinfoil hat needed. Google “postgender.”

No. I don’t believe that there’s such a thing as “true trans.” I believe we’re all mosaics of hormonal, skeletal, emotional, personal, etc. traits and that identity is being commodified in dangerous ways.

Your daughter is only 14. The “affirmative” clinicians will say, see? She just wasn’t really trans. No one can be “made” to be trans, so your daughter just figured out she wasn’t. No harm done.

The only reason my daughter figured out she isn’t trans is because I gave her space, time, and access to diverse people to talk to. I did not, as was advised, immediately affirm her new trans identity. Had I done so, had I said, “oh, yeah, that makes sense” she would most likely, she says, be taking testosterone now. She thanks me regularly for not believing she was a boy trapped in a girl’s body.

Related to the previous question, how do you know your daughter won’t change her mind again and realize she actually is trans? Again, the activists/affirmative clinicians will say maybe she’s just staying “in the closet” about being trans to please you.

I don’t know that my daughter won’t change her mind. How could I? What I know is that she spent the past two years interrogating her dysphoria: where it came from, what purpose it served/didn’t serve in her life; what triggered/increased/decreased its intensity. For the most part, she faced her dysphoria, anxiety, and past trauma head-on and learned ways to live in her body more comfortably.

Is she just waiting until she leaves home to come out again? Best to ask her [Note to readers: We will!] but I don’t think so. She’s angry that she wasted two years of her childhood worrying about her gender identity. She sees her non-conformity with gender roles and her non-compliance with “femininity” as aspects of her individual personality, not as pathology in need of corrective medical care. To her, and she can explain this better than I can, being “trans” means accepting that males/females can only be one way, that some aspects of identity/personality/self-essence beyond biological functions belong to only males or females. She doesn’t believe that’s true.

Do you oppose medical transition for all youth? Why or why not?

No. I believe that for some youth, pharmaceutical treatment might bring the most relief. I do not believe that surgery to remove healthy body parts should ever happen on children or adolescents.

Physically altering (and sterilizing) bodies as a “corrective measure” is nothing new. The history of medicine overflows with horrors enacted on dark skinned and disabled bodies, the bodies of women, and of homosexuals. Doctors in the Netherlands, where homosexual males used to be surgically castrated, were the first to suppress natal puberty in trans identifying children. I think that history, of medically-supported and induced harm on noncompliant bodies, is important to keep in mind when thinking about transgender medical treatment. I mentioned Ritalin earlier. But let’s remember lobotomies, cures for hysterical women, female genital mutilation. Let’s remember that puberty suppressants followed by cross-sex hormones will sterilize a body for life. Gender specialists are sterilizing and greatly increasing the risks of cancer and other debilitating medical conditions in children, many of whom would simply have grown up to be gay in earlier times.

Caution. We have to be more cautious, not open the gates wider. Puberty suppressants, cross-sex hormones, and surgery, all have life-long consequences. Shouldn’t the focus be on helping people learn to accept themselves, in all their messy, unmatched, contradicting, and possibly limiting, glory? We contain multitudes, right? Let’s contain them in the healthiest of possible bodies, with the least amount of dependency on chemical and specialized medicine.

We all want to thank you for stepping forward as public spokesperson for 4thWaveNow. As you are well aware, many parents feel they cannot go public because of the current political climate.

I want those of us who live with and care for young people investigating their gender identities to think more critically and carefully about the idea that humans can be born into “wrong bodies,” and that “authentic selves” are dependent on medical consumption. I want to push the conversation beyond “because I am trans” answers. That’s not good enough. There’s more here and we owe it to our kids and future societies to ask harder questions and to wait, patiently, for more meaningful answers.

I want to speak out because I know others can’t. The risk to one’s livelihood and to the peace of their families and communities is immense. Nothing I am saying is hateful or bigoted but questioning the dominant narratives of innate gender identity and affirmative models of treatment are dangerous moves when even philosophical questions are considered “epistemic violence” against trans people.

This is unacceptable. We cannot think rationally or make well-informed choices if half the conversation is muted. The voices of desisters are important contributions to any discussion focused on dysmorphic adolescents and kids who don’t easily conform to gender norms. I want parents to know that it’s okay to say, “hang on, lets think all this through together.”

You know, if “being trans” simply meant I am who I am who I am and it didn’t often come with a side of medical necessity, I wouldn’t be here insisting we need to talk about this stuff more thoughtfully, more thoroughly.

If sex is socially constructed, like trans advocates argue, why does anyone need to alter their sexed bodies to match their gender identities? It doesn’t make sense. Transgender medicine is being marketed to our young people under the guise that their gender-atypical behavior and/or their developmentally normal bodily discomfort is a sign of incongruity, of imbalance. Normal, healthy teen angst, the challenges of independent identity formation in adolescence, these processes have been pathologized. Instead of helping kids be resilient, many aspects that fall under “gender identity exploration” enable self-perceived and socially-inflicted oppression, hardship, isolation, and malaise.

But, too, in many ways, what’s happening with awareness about gender identities is meaningful and I’m thankful to young people for pushing the rest of us to think about what being “masculine” and “feminine” means in this day and age. Thanks to young people, many are noticing how toys are more gendered now than they were thirty years ago and lots of parents are questioning why boys can’t wear sparkles and why we tell girls to smile. This is all good stuff! But all the good stuff is coming at the cost of our children’s long-term physical and emotional health.

I’m adding our story to the mix because it offers an alternative trajectory to the one that currently dominates the press. In addition to the “courageous trans kid” who lets everyone know that she is a he, I want to highlight young people who’ve come to terms with their sexed bodies and courageously move forward in life without feeling there is something wrong with them, that they’re disabled in some way, that their bodies or other’s perceptions of them are in need of correction.

Both my daughter and I want other parents and young people to know it is possible to work through some/most/all aspects of dysphoria without removing healthy body parts or injecting off-label cancer drugs and cross-sex hormones.

I want parents to know it’s okay to ask questions, to dig deep, to be skeptical. To push your children and those who oversee their care to go beyond “just because” answers like “because that’s how I feel” or, “that’s who I am,” to deeper levels. Push through to “why?” and “what does that mean?” to “where does that feeling come from?” and bravely explore what’s uncovered. What does it mean to “feel” like a woman or a man? Why do those feelings mean healthy bodies are in need of medical intervention? I mean, really, how can it be that so many have suddenly been born “wrong?”

Should Mermaids be permitted to influence UK public policy on ‘trans kids’?

by Artemisia

Mermaids is a UK charity. Its aims are ‘to relieve the mental and emotional stress of all persons aged 19 years and under who are in any manner affected by gender identity issues, and their families, and to advance public education in the same’.

The organisation began a number of years ago as a support group for parents, and it still maintains an online forum. It also undertakes casework, training, advocacy and political campaigning.

In interviews with the press, its Chief Executive Officer, Susie Green, has described her experiences as the perplexed mother of a small boy who was drawn to ‘girly dresses and dolls’ rather than ‘’trucks and football’. When Jackie was nine, permission was obtained for him to wear girls’ clothes to school.

At twelve, his mother took him to the United States for a consultation with Dr Norman Spack, an endocrinologist at Boston Children’s Hospital. Dr Spack prescribed a puberty-blocking hormone, a treatment that at that time was banned in Britain for any child younger than sixteen.

Later, when Jackie was thirteen, Spack put him on estrogen: again, a highly controversial approach. Current policy in the NHS prohibits the prescription of cross-sex hormones to children younger than about 16.

In recent years, under Susie Green’s leadership, Mermaids has pressed insistently, disregarding the concerns of clinicians, for cross-sex hormones to be prescribed to younger children.

For Jackie’s sixteenth birthday, he was flown to Thailand where he underwent a seven-hour operation to fashion a pseudo-vagina. This would not be legal nowadays; soon after Jackie’s operation new regulations were imposed by the Thai Medical Council, restricting ‘sex change operations’ to patients over the age of eighteen. Furthermore, since 2009, young adults aged 18-20 must now obtain parental permission to undergo sex change procedures in Thailand. As can also be seen in this excerpt from a 2009 Telegraph article discussing tightened restrictions, a Thai gay rights activist drew attention to the phenomenon of post-SRS regret experienced by some patients.

In England under the NHS, irreversible gender-related surgery is only available to patients eighteen and older. This is in accordance with international standards of care.

Mrs Green has promoted Mermaids energetically. As CEO, and before that, Chair, she has been regularly quoted and interviewed in the media. In recent years she has been an invited speaker at various forums and conferences. Convenors have included the Westminster Social Policy Forum and the Royal College of Paediatrics and Child Health.

In 2015, Mrs Green was selected to give evidence in person to the inquiry into Transgender Equality conducted by the Women and Equalities Committee of the House of Commons. Mermaids also submitted a written statement. Later in this post I shall have more to say about that.

In a previous post I discussed an episode in which local authority social workers handed over to Mermaids the effective management of a child welfare case. This did not end well. Ultimately the High Court ordered that the child be removed from his mother. The charity was excluded from further contact.

Mermaids also offers training to professionals:

With this in view, it is reasonable to enquire into Mrs Green’s qualifications for the kinds of activity she and her organisation undertake. Under ‘Education’ on her LinkedIn page there is only one institution listed: ‘prince2 academy’.

PRINCE2 is an acronym for PRojects IN Controlled Environment and as its name suggests, it is a project management system. The PRINCE2 Academy appears to be a set of courses delivering online training in the PRINCE2 method. It is not clear if Mrs Green is a registered PRINCE2 practitioner or whether she has simply taken the foundation course. But that is not particularly important.

Project delivery is about process. Training, advocacy, an advisory role with respect to public policy: these are primarily about content. Delivery of accurate information is key, accompanied with well-informed insight, perceptive analysis.

Let’s look at how Mermaids measures up.

Mermaids submitted erroneous evidence to the Women and Equalities Committee

 The following passage is taken from the written evidence submitted by Mermaids to the Transgender Equality Inquiry conducted by the Women and Equalities Committee in 2015.

Mermaids frequently quote the Equality Act, primarily to schools unwilling to accommodate trans children. Antithetically, a young person of 16 wanted their name changing at school but their parents did not consent to this. Although the Equality and Human Rights Committee found the schools refusal to comply was discriminatory, they could not proceed with action against the school as the young person was under 18.

[Recommendation]: Lower or remove the age the Commission could pursue a young person’s complaint without parental consent.

This passage was quoted in the Committee’s report, which duly recommended:

The Equality and Human Rights Commission must be able to investigate complaints of discrimination raised by children and adolescents without the requirement to have their parents’ consent. [See pp. 27, 74, 81]

Following which the Government Equalities Office looked into the matter. Here is the Government response:

No such restriction exists on the Equality and Human Rights Commission’s (EHRC’s) power to investigate complaints of discrimination, and we are not aware of any legal basis for the statement in Mermaids’ written evidence to the Committee that “a young person of 16 wanted their name changing at school but their parents did not consent to this. Although the Equality and Human Rights Committee [sic] found the schools [sic] refusal to comply was discriminatory, they could not proceed with action against the school as the young person was under 18.” The Committee may wish to note that, in order to comply with the Data Protection Act 1998, the Equality Advisory and Support Service may pass an individual’s details to the EHRC only with the explicit consent of the individual. The case referred to in Mermaids’ written evidence was not referred to the EHRC. EHRC staff have met with Mermaids recently to clarify how the referrals process operates. [p. 13]

Rather snarky, it seems to me, but civil servants don’t like having their time wasted.

So: for whatever reason, Mermaids included a claim without foundation in its submission to the Transgender Equality Inquiry. The Committee trusted the organisation to know what it was talking about — and found itself with egg on its face.

Does Mermaids understand how much this matters?

It matters because public policy should be founded on sound evidence — on facts. No one who peddles made-up claims should be advising government committees.  Nor should they be involved in training professional people with direct responsibility for children, sick people or families in crisis.

Susie Green refused to acknowledge on the BBC that cross-sex hormones cause sterility

susie green bbc newsnight

Susie Green

 The evidence is there on YouTube for everyone to see. On 1 November 2016 there was a short debate on BBC Newsnight between Susie Green of Mermaids and Stephanie Davies-Arai of Transgender Trend.

Here is a transcript of the key exchange, which begins at around 4:20. Important passages bolded:

 Stephanie Davies-Arai: The treatment pathway is the same as transsexual, it’s cross-sex hormones (not cross-gender hormones). It leads to children being sterilised and on medication for life in order to be ‘their authentic selves’.

Evan Davis (interviewer) to Susie Green: Is that correct or …

Susie Green: Well no. I think that in terms of the way that these young people are assessed, they go through very careful assessments before any medical intervention is offered, that’s never before puberty has at least begun and got through to a certain stage …

Susie Green’s denial—’Well no’—and avoidance of the key issues raised by Ms Davies-Arai–are remarkable. Note the following points:

  1. ‘The treatment pathway is … cross-sex hormones’

At the Tavistock and Portman Gender Identity Development Service (GIDS) the treatment pathway is cross-sex hormones from the age of 16.

Less than four months before she appeared on Newsnight Susie Green gave a statement to the Guardian in which she called for the age limit for prescribing cross-sex hormones to be lowered.

  1. ‘It leads to children being sterilised’

This is a well-recognised effect of administering cross-sex hormones. Here is a concise and comprehensive statement from a medical authority, which also covers the effects of so-called ‘puberty blockers’ and gonadectomy:

Medical treatments—effects on fertility

Pubertal suppression with gonadotropin releasing agonists (GnRH-a) not only prevents development of potentially distressing secondary sex characteristics but also suspends germ cell maturation. Puberty appears to progress normally after discontinuation. However, many transgender individuals initiate gender-affirming hormone therapy concurrently with pubertal suppression, and thus, germ cells never fully mature. …

Gender-affirming hormones produce impairments in gonadal histology that can cause infertility. Estrogen use by transgender women results in impaired spermatogenesis and an absence of Leydig cells in the testis. Testosterone use by transgender men causes ovarian stromal hyperplasia and follicular atresia.

Gonadal effects of gender-affirming hormones are thought to be at least partially reversible. For example, pregnancy has been reported in transgender men who have previously used testosterone. Thresholds have not been established for the amount and duration of exogenous testosterone or estrogen exposure necessary to have a permanent negative effect on fertility.

For patients who elect surgical transition, gonadectomy will render them permanently sterile.

Source: Johnson EK, Finlayson C (2016) ‘Preservation of fertility potential for gender and sex diverse individuals’, Transgender Health 1:1, 41–44

  1. ‘It leads to children being … on medication for life’

Here are a couple of relevant statements by medical authorities:

  1. a) ‘Cross-sex hormone treatment has an important role in acquiring the secondary sex characteristics of the desired sex. Transsexuals often start taking sex hormones at young to middle age and in higher than recommended dosages. Fearing loss of secondary characteristics of the reassigned sex, transsexual subjects usually continue hormones lifelong.’

Source: Asscheman, Henk, Giltay, Erik J et al, ‘A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones’, Eur J Endocrinol April 1, 2011 164, 635-642

  1. b) ‘After reassignment surgery, which includes gonadectomy, hormone therapy must be continued.’

Source: Gooren, Louis J., Giltay, Erik J, Bunck, Mathijs C. ‘Long-Term Treatment of Transsexuals with Cross-Sex Hormones: Extensive Personal Experience’ The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 1, 1 January 2008, Pages 19–25


Considering her position as the CEO of an organisation that claims to speak with authority on the transition of children and young people, it is shocking that Susie Green should go on television and mislead the public on these crucial matters.

To say the very least: this is not professional behaviour.

Immediately after saying ‘Well no’, Mrs Green changed the subject with very noticeable promptness. Let’s look at what she said next: ‘in terms of the way that these young people are assessed, they go through very careful assessments before any medical intervention is offered’.

We might find this just a little bit glib, coming as it does from a woman who ignored the settled opinion of experienced clinicians and arranged for her son to have a gonadectomy when he had barely turned sixteen–in a country (Thailand) which now bans such surgeries to people under the age of 18.

Mermaids has falsely stated the survey population when purporting to cite statistics for suicidality among ‘trans youth’

In presentations aimed at concerned professionals, Mermaids has exhibited a PowerPoint slide with the heading ‘Statistics’. It displays a set of figures designed to chill. But let me quickly say: these are not what they seem. They have been fiddled to support an agenda. They are, in fact, completely worthless.

Mermaids-suicide-stats-compressor

Here are the phony statistics in question:

  • ‘59% trans youth considered suicide
  • 48% attempted suicide
  • 57% actively self-harm’

A subheading claims that the figures come from a survey of ‘more than 2000 trans people in the UK’. The survey, cited at the foot, was conducted by academics from three universities in collaboration with PACE, a now-defunct LGBT+ mental health charity. The report was published in 2014.

There is no mention of the report’s title: LGB&T Mental Health — Risk and Resilience Explored. The foreword records that ‘Over 2000 people completed our survey…’

Spot the obvious mistake. The trans participants in the survey were only a subset of the total number of people who took part. The statement that ‘more than 2000 trans people’ were surveyed is not true.

And this matters enormously, because unless the survey population is of adequate size, the results of the survey have very little meaning. It is not possible to use those results to make useful generalisations about the target population, the group about which the survey is intended to provide information.

In the case of the survey into ‘LGBT&T Mental Health’, the overwhelming majority of respondents were lesbian, gay or bisexual. Only a minority, just over 17%, identified themselves as trans.

And here’s the clincher: Only 27 of the trans respondents were under 26. This is the total size of the survey population on which the claim is based that 48% of ‘trans youth’ have attempted suicide.

There is absolutely no way that the results of such a tiny survey can be mapped onto the whole population of trans-identifying young people in the UK.

That twelve of the 27 reported such an attempt is very sad for them and their families. However, it tells us nothing about the prevalence of suicide attempts among ‘trans youth’ in general. This micro-survey is of no value whatsoever as a basis for determining social policy.

This is not an abstruse matter: it should be obvious to anyone with common sense.

Mermaids has used the supposedly high risk of suicide attempts by trans-identified young people to support its campaign to lower the age at which the NHS prescribes cross-sex hormones to children. It claims that medical transition reduces the likelihood that a gender dysphoric child will commit suicide. In reality, there is no persuasive evidence that this is true.

When Susie Green gave oral evidence to the Transgender Equality Inquiry she argued that the treatment protocols followed by the Gender Identity Development Service are too restrictive and should be relaxed. She claimed that children waiting to be put on cross-sex hormones become ‘self-harming and suicidal’ and referred to ‘a 48% suicide attempt risk’.

This claim was picked up and repeated in the report from the Committee: ‘Mermaids said there was a significant risk of self-harm or suicide where hormone treatment is not yet being given; they drew attention to evidence that the attempted suicide rate among young trans people is 48 per cent.’ [p. 52]

For the 48% figure a footnote refers to an article in the Guardian published in November 2014. The Guardian in turn cites ‘findings released by Pace’. Evidently the journalist had had an advance view of a press release from PACE dated 20 November. This press release predated the publication of the full report of the survey.

The press release gives an overall figure of 485 for ‘survey participants under the age of 26’. Rather strangely, however, it omits to give an overall number for the ‘young trans* participants’ while stating that ‘48.1% … have attempted suicide’. The use of percentages at this point conceals the very small number of respondents. The other figures in the Guardian post also come from PACE: the Guardian has simply rounded them down, so that 48.1% becomes a snappier 48% and the figure of ‘59.3%’ for suicidal thoughts becomes 59%.

It is, perhaps, not coincidental that these misleading and alarmist figures were initially presented by a charity that was forced to shut its doors for lack of funding just over one year later.

Meanwhile, the Guardian confused matters further by implying that all of the ‘more than 2,000 people’ surveyed were ‘trans’. Presumably this was due to a careless misreading of the statement from PACE.

Given that the Mermaids PowerPoint slide refers to a ‘survey of more than 2000 trans people’ it seems likely that the figures on the slide came by way of the Guardian report. Even assuming that this is the case, it does not let Mermaids off the hook.

It is simply not professional to quote statistics from a newspaper report without attempting to check them at source. In this case the survey report is easily found on the web. Although PACE has closed down, the report has been archived on several sites by interested parties.

Regardless of what it was intending to do, Mermaids deceived the audiences to whom it presented that PowerPoint slide. Even more important and worrying, it gave misleading information to the Women and Equalities Committee.

There is more. The problems with the figures on the PowerPoint slide have been pointed out in detail in at least two important blog posts:

So far as I am aware Mermaids has never acknowledged either of these critiques, nor has it qualified Susie Green’s statement to the Women and Equalities Committee.

The organisation does not seem to have cited the 48% figure recently. But last month Mrs Green was back beating the same old drum, this time in an article on Huffington Post UK. This time she kept things vague, asserting that there are ‘shockingly high statistics for suicide attempts by transgender young people’ without citing any source at all.

These serious misstatements of fact are not acceptable

Mermaids presents itself as a repository of wisdom on the subject of transgender children and youth and in many quarters it is accepted as such. The inaccurate statements detailed above are not minor matters. The UK, as a society, cannot afford such lapses in an organisation that trains professionals and advises on public policy.

Moreover, none of this is helpful to children who show symptoms of gender dysphoria or gender identity disorder (as currently defined), or their anxious and more or less bewildered parents. They deserve a more professional service than Mermaids is currently providing.

Meanwhile, it should, unfortunately, be recognised that it is never safe to take on trust any statement that comes from Mermaids.

 

‘Bridging hormones’: Increasing number of UK GPs leery of prescribing treatment

by SunMum

SunMum is a UK parent with kids who have been affected by gender ideology. She can be found on Twitter @Mum3Sun


 If you are a medical care provider and you have concerns about the safety and appropriateness of prescribing hormones and surgery to young people who are uncomfortable with their bodies, you are not alone. Trans activists frequently cite the non-existent ‘consensus of the medical community’ to argue that the only effective way of treating gender dysphoria is social and medical transition. However, in this carefully researched piece, SunMum reveals that a growing number of general practitioners (GPs) in the UK appear to feel uncomfortable providing transgender health services.

 Special note to UK readers: If you are concerned about proposed changes regarding transgender health services in this country, please complete the NHS survey by October 16. A helpful guide can be found here.


The recent sudden increase in young people identifying as trans presents a quandary for the UK’s National Health Service. Trans activists demand access to ‘life saving’ health care but there are simply not enough gender specialists to deal with all the new patients. Currently NHS England is holding a twelveweek public consultation on specialised gender identity services for adults who, worryingly, they define as ‘17 and above’. But it seems that not all GPs are happy with the role they are being asked to play. The current arrangement is that the patient’s own GP is responsible for ‘prescribing, on the recommendation of the specialist team’. But according to the Guide to Consultation ‘a small but significant and increasing proportion of GPs do not feel able to accept responsibility for prescribing’.

Why are GPs increasingly unhappy to prescribe gender medicine? Surely the profile of transgender has never been higher as trans charities work to ‘Embrace. Empower. Educate’?

Zara Aziz, a GP partner in Bristol writing in the Guardian newspaper in August 2017 in response to the consultation, is concerned about the demands placed on GPs by what she describes as ‘a niche field’ of medicine. GPs are asked to monitor gender treatment through blood and hormone levels. And since 2016, new British Medical Association guidelines ask them in some circumstances – where patients are self-medicating with hormones or where there is self-harm or risk of suicide – to provide “bridging prescriptions” for emergency hormones. This new demand has met with resistance from the General Practitioners Committee which states that GPs ‘should not be obliged to prescribe “bridging prescriptions’’’. So the BMA and the GPs own organisation are in conflict. According to the GPC, the British Medical Association’s report ‘fails to address the resulting significant medicolegal implications for GPs, and neglects the non-pharmacological needs of [gender dysphoric] patients.’ It almost sounds as if GPs would prefer psychotherapy to medication for these patients. As Dr Aziz put it, GPs are worried about ‘the risk of complaints and litigation against family doctors’.

GPs have clearly noticed the sudden increase in demand for gender medicine. Zara Aziz reports that ‘this year I have seen three gender dysphoria patients (although I have not prescribed any treatment for them yet), but before that it was that many in nine years.’ Like many of us, these reluctant GPs seem to be waking up to the realisation that something strange is going on. Just 10 years ago the number of adolescents who wanted to transition to the opposite gender was vanishingly small; today they seem to be in every school.

If a GP does go ahead and offer a ‘bridging prescription’ for hormones, she will be doing so off-label; these drugs are tested and licensed for other uses. As the NHS consultation document points out: ‘This arrangement differs from prescribing practice in many other secondary and tertiary care services, particularly when prescribing for ‘off label’ indications.’

Gender medicine asks GPs to behave in ways for which they have not been trained.  Perhaps the protocols of gender specialists are increasingly diverging from those of other medical specialties, and this gives the doctors pause?

2015 miller enquiry sunmum

From left: Susie Green, CEO Mermaids, and Anna Lee, first “queer trans disabled lesbian woman” to run for women’s officer at the National Union of Students, listen to Bernadette Wren (on right), consultant clinical psychologist at Tavistock clinic.

Or perhaps these GPs are concerned about the influence that activist groups like Mermaids and Action for Trans Health are having on transgender health care. After all, these groups are pushing for earlier and swifter intervention. In evidence to the UK Parliament Transgender Equality Inquiry in 2015, Susie Green of Mermaids spoke of the frustration of parents with NHS treatment pathways and explained that her organisation helped them to access early intervention abroad:

 ‘We have current conversations going on; I have at least six families who have children who are pubertal who are looking at that option now and are actively contacting the Hamburg centres and America to access that treatment, because they know that they are not going to get it here within the NHS.’ (Q58)

Many activist groups believe the role of the clinician is only to supply the drugs and medication requested by the transgender  patient. Perhaps GPs are concerned that activists are driving treatment decisions that rightfully belong in the hands of medical professionals.

In 2009, one of the leading British gender specialists, Dr Stuart Lorimer, a psychiatric consultant at Charing Cross Gender Identity Clinic and founder of GenderCare, a London private gender clinic, was asked what he saw as his biggest impediment in the development of gender identity services. The answer was ‘medical colleagues, GPs, other psychiatrists’. Lorimer mentioned a survey of 1,000 doctors of which 84 percent felt that gender services are ‘not legitimate, not deserved, should not be in the NHS’.

It is clear that a consensus on the protocols of transgender medicine does not exist outside the small group of specialists. A much-cited Swedish study from 2011 describes the standard treatment for gender dysphoria as ‘a unique intervention not only in psychiatry but in all of medicine’. Searching for parallels, one contributor to 4thwavenow had to go as far back as lobotomy. No other contemporary psychiatric therapy, after all, includes ‘the surgical removal of [healthy] body parts.’

Transgender medicine is not just a specialized field but something of a club. A 2003 Dutch study asked 382 Dutch psychiatrists about their experience of ‘diagnosing and treating patients with gender identity disorder’ and found that ‘[a] small number of psychiatrists’ were responsible for a large proportion of the referrals to ‘specialized sex reassignment therapy centres’. The study concludes that ‘the therapy options proposed to patients with gender identity disorder depend heavily on the personal preferences of psychiatrists’. (Am J Psychiatry 2003; 160:1332–1336) Personal preference is not a reassuring basis for medical treatment.

In the UK it seems that nothing much has changed in the 14 years since the Dutch study. Transgender medicine continues to be in the hands of a small group of clinicians and the NHS consultation guide cited above notes that ‘there is limited collaboration and sharing of best practice across the current providers’. A small number of treatment centres operate on the basis of limited evidence about outcomes.

It’s both welcome – and worrying – that the NHS is only now bidding for research into gender medicine. The commissioning brief acknowledges ‘the lack of a UK evidence base for the NHS to inform decisions about gender identity health services’. And the research bid notes that ‘the long-term iatrogenic impacts of hormonal treatments and surgeries on young people and adults are largely unknown, but some studies show some treatments increase risks of several long-term conditions including cardiovascular and renal diseases, and fracture risk, while research on user satisfaction and psychological outcomes in the UK is of small scale and duration.’ These treatment protocols, in other words, could be causing long term damage – we don’t know enough to rule this out.

When evidence is lacking, we might expect doctors to be cautious. But instead of trying to understand the reluctance of so many GPs, trans activists demand swifter interventions and ascribe medical caution to bigotry. Zara Aziz explains that ‘any reticence on our part to prescribe can be challenged and can sometimes be misinterpreted for prejudice.’ Specialists and activists work to bypass the caution of mainstream doctors. Lorimer’s private GenderCare clinic is designed specifically to get round the reservations of GPs. He explains that:

 In my GenderCare clinic, I saw those people who’d yet to reach a GIC, whose GPs had stalled, dismissed or, in one memorable case, informed them that no such service had ever existed in the UK.

Guidance for NHS clinicians who also offer private treatment issued in May 2009 recommended that ‘specialists should as a general rule make it clear to members of the public that they usually do not accept patients without a referral from a GP or other practitioner.’lorimer summer reading

GPs may not subscribe to the conventions of gender clinicians, but they do tend to know their patients and their family situations. And that, more than anything else, may explain the increasing reluctance of many GPs to provide transgender health services. Just as parents know their children, GPs know their patients. Perhaps more and more of them are seeing young patients who never expressed discomfort with their bodies as children suddenly demanding transgender health services. That would certainly be enough to make a good GP think hard before writing a prescription for cross-sex hormones.

Transgender Children PREDATOR ALERT: Riley Byerly

Warning: This is a highly disturbing, important piece of investigative journalism by GenderTrender. All parents of trans-identified youth need to read it.

Many parents turn to adult trans activists for advice on how to parent their kids. While no one would suggest every such “advisor” is a dangerous predator, is it really a wise idea to seek counsel from such individuals? Particularly since some better-known trans activists, and organizations run by such activists, encourage young people to abandon parents if they won’t endorse their transgender identity–and seek solace in “glitter families” of strangers on the Internet.

GenderTrender

Brynner Rennecke / Riley Byerly

WARNING for all parents of transgender children, all transgender teens and tweens, and all parents of children who interact with adults on the internet.

Riley Byerly is a transwoman who authors the website ‘My Transgender Life: Sharing My Life One Moment At A Time’.

He also goes by the name Riley Lilian Grace Byerly. He is 27. His legal name is Brynner Phoenix Rennecke. He currently resides in Minot, North Dakota, but has also lived in Tucson, Arizona within the last year.

From his bog: Arizona resident

Before his arrest at the age of 15, this transwoman had raped or sexually assaulted at least five children. From ages 18 to 26 he was confined under civil commitment in the state hospital in Jamestown, North Dakota as a sexual offender at high risk to re-offend. He was released last year.

Released from Civil Commitment…

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