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

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

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

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


Email from a trans-identified teen:

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

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

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

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


Lisa Marchiano’s response:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

 

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Detransitioned man blasts “transworld”

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

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

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


by Angus

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

by Worriedmom

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

fallon foxTake that, cry-baby.

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

lauren hubbard

lauren hubbard 2

No “fundamental difference.”

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

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

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

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

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

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

 

Letter to a gender clinic: A parent’s call to action

A version of the letter contained in this post was sent by the parents of a trans-identifying daughter to the gender clinic where she received transition services. PADad, who is the young woman’s father, would like this letter to serve as a template for other parents, and encourages readers to participate in the letter-writing campaign he describes below. PADad is available to interact in the comments section of this post.

Note to 4thWaveNow readers: The letter as written by PADad has undergone lawyer review. Please see the April 10, 2018 update posted beneath the letter.


 by PADad

Like many who congregate on 4thWaveNow, we are the parents of a young person (in our case, a 20-year-old daughter) who has recently and suddenly come out as transgender. And like most here, our daughter had never exhibited any gender dysphoria as a child.

We have been doing a lot of research and planning our steps carefully. We have decided that one thing we must do is to push back against the forces in our society that are encouraging young people to take potentially harmful medications and make irreversible changes to their bodies. We want to help ensure that, before they are given access to medical interventions, young people carefully explore why they believe these changes are needed and how the changes will affect their lives in the future.

The trans activists do not outnumber those of us who are concerned about this trend, and our inactivity is putting our children at risk. Right now, many clinicians prescribe hormones and surgeries for youth with little fear of repercussion. We can change the calculus for these clinicians. We must reveal to them how many parents have the same concerns, as well as our tenacity in calling them to account. We are not going away.

To that end, I have prepared a letter that I will be sending to all of the clinicians who are involved in my daughter’s care. Because she is on our health insurance plan, we have access to her actions and payments, so we know who these people are.

I have drafted a similar letter to send to our health insurance company, putting them on notice that they are complicit in this harmful trend and urging them to change their standards for the treatments and surgeries they will allow and cover. We are also pursuing legal representation to follow up on our letters.

If insurance companies see they may be exposing themselves to liability by covering interventions that may cause more harm than good, they can play an important role in limiting the number of young people who inappropriately undertake medical intervention.

This linked site contains a comprehensive list of gender clinics in the US., organized by state and easy to search. Please consider sending your own letters to no fewer than 10 clinicians on this list, if possible, by registered mail. You may choose to use/customize our letter (below) as a template. Choose the clinics who are closest to you and perhaps add in some at random. We need to get as many out there as we can.

If some of these clinicians and facilities change their ways, others will follow. The risk of lawsuits goes up for them if they allow themselves to be singled out. That can affect the cost of their malpractice insurance. If we act together, we can make a difference.


A Parent’s Letter to a Gender Clinic

You are receiving this letter because our child is a patient at your clinic or a clinic like yours. The purpose of the letter is to make you aware of a concern that many parents, including myself, and a large and growing number of medical professionals, share about the care you are providing for our children. Some of these young people are over the age of 18 and therefore do not have to include us in their health decisions. Regardless of their age, and regardless of whether or not we are involved in discussions between you and our children, you have an obligation to do what is best for their long-term health. We do not believe this is happening.

The increasing rate at which young people, aged 11-21, are coming out as transgender cannot be explained by the fact that the broader transgender movement in western societies is removing the social stigma around coming out. The evidence is very clear at this point, and becoming clearer by the day, that what is going on with at least some of these young people, particularly young women, has elements of a social contagion.

We are including links to multiple pieces of research at the end of this letter to support our statements and to elucidate our concerns. As medical professionals, you should be aware of this research, and you have an obligation to take it seriously. At a minimum, you should be raising the bar and making selection criteria considerably more stringent before prescribing “puberty blockers,” HRT and surgeries. Because these treatments have permanent effects on patients’ bodies and minds, you should be first requiring alternatives to these treatments which are more reversible. Unless social contagion and other underlying and preexisting factors (including other mental health issues) are ruled out, it is insufficient and negligent to place undue emphasis on self-reporting from the youths themselves.

We understand that you may be under the impression that existing law provides protection against future liability for prescribing these dangerous drugs and performing these surgical interventions. We disagree. Moreover, as human beings and responsible medical professionals, you can raise the bar for treatment, reduce future regret rates, and put pressure on your peers to be better informed and to act responsibly.

Be advised that through this letter, we are putting you on notice. So far as we know, the current course of medical transgender treatment for minors has never been tested in the context of medical malpractice liability, and we do not believe that these interventions will be found to meet the standard of care for the treatment of juvenile dysphoria.

If you do not act in the best interests of all of your patients, the day may well come that you will be held accountable. We are planning for that day. Clinics and doctors will be called out by name. We will call you out by name in legal proceedings, and in social and conventional media. You should assume that, particularly given the irreversible and (at least in some cases) unwanted changes that these young people will suffer, damages can reasonably be expected to be substantial.

In addition to the risk of legal action, you should think about your place in history and your reputation. This contagion will pass, as they all do. But due to its size and impact, you should expect this social contagion to be a topic for years to come. It is already large and catastrophic enough to garner significant interest and publication in medical, social and psychological journals. I urge you to think carefully about how your clinic and your name will be mentioned in the course of this crisis, and whether you protected or ultimately harmed young people; whether you acted out of concern for youth or for your profits. You can dismiss any single case or patient as justifiable, but history will be less kind when looking at the body of your work over time.

I would encourage you to read the referenced research and clinical opinion, including the multiple links to additional published research in these articles, and familiarize yourself with it. There is sufficient information there to warrant serious soul-searching in any practitioner involved in the medical transition of minors and young adults.


Update: April 10, 2018. A few trans activists have claimed that the letter as written amounts to issuing (possibly unlawful) threats. For clarity, here are remarks by two lawyers in the 4thWaveNow community. (Caveat: This statement should not to be construed as legal advice for anyone reading this.)

Any communication, such as the letter referenced above, that states “if you engage in X behavior, Y consequences may result” could be termed, in some sense, a “threat.” The issue is not whether “threat” is the correct appellation, the issue is whether that “threat” is actionable (i.e. potentially gives rise to civil or criminal liability). Here, the answer is no.

Start with the understanding that in the United States, there is extremely wide latitude for speech. We enjoy robust First Amendment protections that give us the ability to express our opinions quite freely and widely without government interference, compared to other countries. There are allowable restrictions for such things as defamation or criminal conspiracy, as one would expect, but generally speaking, such restrictions on speech tend to be very narrowly interpreted and difficult to fall within. In the U.S., there simply is no such tort or crime as “hate speech;” our Supreme Court so ruled last summer. Moreover, “hate crimes,” or crimes motivated by animus against a particular group based on group characteristics, are a sentencing enhancement, or an additional penalty that is added on to a pre-existing crime. Other than in a few very select instances that don’t apply here, there is no such thing as a “hate crime” standing alone (an underlying crime such as assault, battery, etc. has to have been committed to give rise to the “hate crime” add-on).​

​On the “threat” point, first, as to criminal liability. A “threat” only gives rise to criminal liability when it communicates or contains, for instance, the intention to use bodily harm against the recipient, to harm the person’s property (e.g. “terroristic threats”), or to obtain financial advantage by unlawful means specified in an applicable law. An example of the latter would be extortion (“pay me X or I’ll tell your husband you are having an affair”). The “clinic letter” does none of these things, and 4thWaveNow unequivocally and strongly condemns any revision to the letter that would threaten such actions.

Second, as to civil liability. It is generally permissible to threaten to take legal action against someone in order to assert or protect one’s legal rights. Lawyers send “demand letters” (letters that outline why a party should do, or not do, some action, and the legal consequences for refusing to comply) all the time.

Moreover, it is not 4thwavenow that is making any demand in the letter; and the letter, in the form contained on the site, does not identify any recipient.

Summing it up, at the very most the “clinic letter” could be viewed as containing a non-actionable “threat” by the individual at issue (a) that legal remedies may be sought, to the extent such remedies are now, or in the future become, available and appropriate, and (b) to advocate the subject positions with, and exert public pressure upon, medical providers and insurers.


Suggested References

 “Evidence for Altered Sex Ratio in Clinic-Referred Adolescents with Gender Dysphoria,” Aitken et al, The Journal of Sexual Medicine, 2015

https://www.ncbi.nlm.nih.gov/pubmed/25612159

Analysis of article here:

https://transresearch.info/2015/09/10/evidence-for-an-altered-sex-ratio-in-clinic-referred-adolescents-with-gender-dysphoria-review/

The Canadian clinic saw nearly nearly three times as many female teens in the past 8 years as they had seen in the previous thirty. The Dutch clinic saw nearly twice as many female teens in the past 8 years as they had seen in the previous seventeen.

Rapid Onset of Gender Dysphoria in Adolescents and Young Adults: A Descriptive Study. Lisa L. Littman MPH., Journal of Adolescent Health, 2017.

http://www.jahonline.org/article/S1054-139X(16)30765-0/fulltext

Parents online are observed reporting their children experiencing a rapid onset of gender dysphoria appearing for the first time during or after puberty. They describe this development occurring in the context of being part of a peer group where one, multiple, or even all friends have developed gender dysphoria and come out as transgender during the same time frame and/or an increase in social media/internet use. The purpose of this study is to document this observation and describe the resulting presentation of gender dysphoria inconsistent with existing research.

“Medicine must do better on gender,” Margaret McCartney, British Medical Journal, 2018

https://www.bmj.com/content/360/bmj.k1312

A clear rise in referrals of children to specialist gender identity services has been seen in recent years, particularly in teens. Yet the role assigned to medicine can’t be separated from societal attitudes and abilities. The debate on gender occurs in an environment where boys are seen as being boys, and girls as girls, because of how they behave rather than their biological sex…

…Therapists are right to be concerned about overdiagnosis and overtreatment. But this concern can be perceived by parents as a barrier rather than a caring, evidence based response.

Many children with gender dysphoria will grow up without reassignment surgery but will be gay or bisexual. One concern is that gender reassignment makes homosexuality “disappear”: in Iran being gay is illegal, but the rate of gender reassignment surgery is the highest in the world.

“CBC Self-Censorship Part of Frightening Gender Identity Trend,” Susan Bradley, The Post Millennial, 2018.

https://www.thepostmillennial.com/cbc-self-censorship-part-frightening-gender-identity-trend/

In my own practice, I have seen a good many young women displaying the phenomenon known as “rapid onset gender dysphoria,” or ROGD, which overwhelmingly affects girls. Typically, the ROGD teenage girls I see have, wittingly or not, begun to experience homoerotic feelings about which they are conflicted. They tend to be socially isolated, and somewhere “on the spectrum.” They may have histories of eating or self-harm disorders.

They have found companions with the same attributes on Internet sites, which diminishes such adolescents’ sadness over their social isolation, but which can also lead to foreclosure of reflective thinking about their own feelings and situation. Some of these girls are depressed, afflicted with suicidal ideation. Because of the initial euphoria they experience in finally “belonging” to a well-defined kinship group, they tend to embrace the idea of transitioning wholeheartedly as the solution to their other problems.

“Transgenderism and the Social Construction of Diagnosis,” Lisa Marchiano, Quillette, 2018.

http://quillette.com/2018/03/01/transgenderism-social-construction-diagnosis/

Activists and certain clinicians who are sympathetic to the activist movement appear to feel threatened by the idea of rapid onset gender dysphoria because the suggestion that dysphoria might be influenced by social or cultural factors undermines the notions of innateness. If dysphoria isn’t innate, justifying medical intervention becomes more complicated.

“Early Medical Treatment of Children and Adolescents with Gender Dysphoria: An Empirical Ethical Study.” Lieke et al, Journal of Adolescent Health, 2015 

https://www.ncbi.nlm.nih.gov/pubmed/26119518 

Seven themes give rise to different, and even opposing, views on treatment: (1) the (non-)availability of an explanatory model for GD; (2) the nature of GD (normal variation, social construct or [mental] illness); (3) the role of physiological puberty in developing gender identity; (4) the role of comorbidity; (5) possible physical or psychological effects of (refraining from) early medical interventions; (6) child competence and decision making authority; and (7) the role of social context how GD is perceived. Strikingly, the guidelines are debated both for being too liberal and for being too limiting. Nevertheless, many treatment teams using the guidelines are exploring the possibility of lowering the current age limits […]As long as debate remains on these seven themes and only limited long-term data are available, there will be no consensus on treatment.

“The Influence of Peers During Adolescence: Does Homophobic Name Calling by Peers Change Gender Identity” Delay et al,  Journal of Youth and Adolescence, 2017

https://link.springer.com/article/10.1007/s10964-017-0749-6

Homophobic name calling emerged as a form of peer influence that changed early adolescent gender identity, such that adolescents in this study appear to have internalized the messages they received from peers and incorporated these messages into their personal views of their own gender identity.

“The Endocrinologist’s Office—Puberty Suppression: Saving Children from a Natural Disaster?” Sahar Sadjadi,  Journal of Medical Humanities, 2013

https://pdfs.semanticscholar.org/46da/ae7559f1b49d4516b0eee5266ab24a6e739a.pdf

Currently, the health consequences of the treatment are relatively unexplored. The treatment is being implemented, however, under the pressure of the emergency of saving the child from the devastation assumed to follow the onset of puberty. It must be remembered that puberty suppression as the first step to medical transition, if followed by cross-sex hormones, which has been the case for almost all reported cases, leads to infertility due to the permanent immaturity of the gonads and the reproductive tract. The absence of the discussion of sterilization of children as a major ethical challenge in this bioethics article, and many other clinical debates on puberty suppression, is striking. For any other group of children, such an intervention would be discussed extensively with ethics review boards.

The annual number of referrals to the gender dysphoria specialist team at the Astrid Lindgren Children’s Hospital in Stockholm. Referenced article in Swedish:

http://lakartidningen.se/Klinik-och-vetenskap/Klinisk-oversikt/2017/02/Kraftig-okning-av-konsdysfori-bland-barn-och-unga/

“A Different Stripe”, Renee Sullivan, Psychology Today, 2018

https://www.psychologytoday.com/articles/201803/different-stripe

It’s been four years since I reidentified as a woman. My gender dysphoria was real and often painful, but the way for me to resolve it wasn’t by becoming a man. It was by questioning and rejecting the stories society had told me about what it means to be a woman.

Some charts illustrating the steadily increasing number of natal females presenting to gender clinics, worldwide.

increase in girls Toronto amsterdam

Canada, Netherlands, UK, Finland

increase in girls sweden

Sweden

increase in girls tavistock

United Kingdom

New zealand increase in girls to gender clinic

New Zealand

increase in girls

Toronto and Amsterdam

 

 

 

Update: Top San Francisco phalloplasty surgeon now with 8 malpractice suits

by Worriedmom

Second in a series. Part 1 is here.

4thWaveNow contributor Worriedmom has practiced civil litigation for many years in federal and state courts.


San Francisco phalloplasty surgeon, Curtis Crane, M.D., continues his odyssey through the San Francisco court system. Since our initial post about Dr. Crane and his legal troubles, one of the lawsuits that was then pending against him has apparently been settled, and two more have been filed. This brings to a total of eight the number of times that Dr. Crane has now been sued for medical malpractice in San Francisco Superior Court.

This post updates the reader on the various lawsuits now pending against Dr. Crane, and also documents the peculiar silence with which these allegations have been greeted in the transgender community. It is indeed strange that, for all their fears about violence and mistreatment, transgender activists do not appear concerned in the slightest about a member of the medical profession who is alleged to have botched multiple surgeries, behaved insensitively (some would say cruelly), and caused medical havoc for many. (Of course, the allegations contained in the complaints detailed herein, until either admitted, or tested and proven in a court of law, remain just that – allegations).

In fairness to Dr. Crane, let’s start with some general observations about medical malpractice. Although it’s difficult to find comprehensive statistics, a recent (2017) survey conducted by Medscape found that 55% of all practicing U.S. physicians have been sued at least once. According to the survey, surgeons, such as Dr. Crane, are particularly likely to be sued (85% of them have faced a malpractice suit at some point in their careers). However, a large-scale study using data from the National Practitioner Data Bank also found that a tiny fraction of doctors (1%) accounts for almost one-third (32%) of paid medical claims.

Claim-proneness results from a number of factors, including type of specialty, age and sex; however:

“Compared to physicians with only one previous claim, a physician who has had three previous claims is three times as likely to have another one,” said lead author David Studdert, a professor of medicine and law at Stanford. “A physician who has had four is four times more likely and so on.”

Dr. Crane thus appears to be among the fraction of physicians who are extremely frequent targets for medical malpractice lawsuits.

Before getting into the details, we wondered whether perhaps lawsuits are a common occurrence in practice areas such as this one that involve relatively experimental or new procedures, and a patient base that might tend to have unreasonably high expectations. But a San Francisco Superior Court record search for Doctors Thomas Satterwhite, Michael Safir, Richard Santucci, Ashley DeLeon, and Charles Lee, all surgical partners in Dr. Crane’s practice, does not reveal any pending medical malpractice lawsuits for any of these doctors. Curious indeed.

As is common to all United States courts, records of lawsuits and the underlying documents can be found by going to the court website for the appropriate jurisdiction, in this case the San Francisco Superior Court. It is helpful to have the case number (also called an “index” or “docket” number), although a search can also be performed using the person’s name, so those are provided below.

A review of the lawsuits pending against Dr. Crane reveals the following detail:

Lewis Raynor and Haven Herrin v. Crane, CGC-17-556713. The plaintiff in this case alleges negligence in connection with Dr. Crane’s implantation of an inflated pump device in a second-stage phalloplasty, and the subsequent infection and loss of 40% of the plaintiff’s penis. Trial is set for December 17, 2018.

Crane Part 2 Raynor

Doe v. Crane, CGC-17-557327. The plaintiff alleges negligence in connection with three “transformative urological surgical procedures,” including a “procedure similar to a metoidioplasty,” replacement of testicular implants, and the placement of a new 3-piece inflatable implant. A metoidioplasty is a surgical procedure that uses clitoral tissue that has been enlarged through testosterone use to form a “neophallus.” Trial is set for February 19, 2019.

Carter v. Crane, CGC-16-554254. This case involves the truly unfortunate case of Cayden Carter, a young trans man who has endured over 20 surgeries in a thus far fruitless quest to obtain, and then ameliorate the effects of, a male-appearing genital structure. Carter maintains a Tumblr blog and has written extensively about the many surgeries and lasting problems resulting from the original phalloplasty, including an ileostomy and the continued need for a colostomy bag.

Crane Part 2 Carter

According to Carter’s complaint, the first surgery performed by Dr. Crane resulted in a perforated colon, which Dr. Crane first ignored and then failed to repair. There is no trial date set for this matter.

Taylor Carson v. Crane, CGC-17-556743. This case involves a plaintiff who was operated on twice by Dr. Crane, first to create a penis (which became infected) and second to attempt to repair holes in the urethra in the new penis (which failed). The entire penis was later removed, and the plaintiff was informed by another doctor that he never should have been considered for this surgery. The case has been set down for trial on March 4, 2019.

Crane Part 2 Carson

Doe v. Crane, CGC-17-560690. This case involves a plaintiff who had already undergone several transgender surgeries who wished to replace an earlier phalloplasty with a new graft that would also include lengthened urethra. The plaintiff had already undergone a “vaginectomy” (surgery to remove all or part of the vagina) and a “scrotoplasty” (a plastic surgery designed to transform part of the female genital area into a scrotum). According to the plaintiff, he specifically advised Dr. Crane’s practice in advance of surgery that he did not require a vaginectomy or a scrotoplasty; however, during the phalloplasty both of these surgeries were indeed performed. Interestingly, possibly due to potential statute of limitations restrictions, the plaintiff brought his complaint seeking damages for “medical battery” and “promissory fraud,” rather than medical malpractice. On January 4, 2018, the court denied Dr. Crane’s motion to dismiss the complaint. Trial is set for June 24, 2019.

Oliver Davis v. Crane, CGC-17-557363. This case involves Dr. Crane’s performance of a stage 1 phalloplasty that subsequently acquired a large blood clot, which the plaintiff claims that Dr. Crane ignored.

Crane Part 2 Davis

Most recently, Dr. Crane moved to have the complaint dismissed on various grounds and on February 14 of this year he lost that motion. The case does not appear to be set for trial.

Andrew Shepherd v. Crane, CGC-17-559294. In this case, the plaintiff sought to have a phalloplasty and the construction of a “large, realistic-looking scrotum.” However, the scrotum that the plaintiff was allegedly given by Dr. Crane was too small to contain even the smallest testicular implants. Since this surgery, the plaintiff has had two more surgeries, with other doctors, to obtain a larger scrotum, but they have both been unsuccessful. The case is set for trial on April 15, 2019.

In addition to the above seven cases, an eighth case, Doe v. Crane, CGC-16-550630, has now been settled (as of June 2017). This case also involved urology/surgical services provided as part of a female-to-male transition. According to the plaintiff,

Crane Part 2 Doe

The court documents do not disclose what, if anything, the plaintiff received in settlement of the case.

One allegation common to virtually all of the above cases is that Dr. Crane “over-promised” and “under-delivered” in terms of the likely success, appearance, and functionality of the constructed genitals. Moreover, several of the plaintiffs also allege that Dr. Crane’s response, when confronted with complications or distressing symptoms following surgery, was inadequate, unconcerned, and even unfeeling.

As a final note, other than coverage by 4thWaveNow, there appears to be nothing on the internet about Dr. Curtis Crane that is not completely laudatory and admiring of his surgical skills and acumen. YouTube videos sing his praises (see “Dr. Crane is AHmazing” and “Do I Regret Lower Surgery?” for two recent examples) . The Brownstein-Crane Facebook page contains 22 5-star reviews and only 2 negative reviews (neither of which mention the eight malpractice lawsuits). Susan’s Place, a major resource page for transgender people to connect and share resources, has a thread on Dr. Crane which contains only praise and, again, no mention of the extensive legal history cited above. Transgender Pulse, another major transgender resource and support forum, also has none of the above information about Dr. Crane. TSSurgery.com, a site providing information for transgender people about surgeons and others, that also contains reviews, has a large section on Dr. Crane, but again, no mention of his legal troubles.

Poignantly if not somewhat hypocritically, the “ftm” (female to male) Reddit references our earlier post about Dr. Crane as the source for information about his practice, and goes on to allege that his practice has been dropped from the Kaiser Permanente California health plan due to “the amount of lawsuits” against him:

Crane Part 2 ftm reddit

We were not able to confirm whether Dr. Crane is still a listed physician with Kaiser Permanente from that insurer’s site, but at least one additional source seems to confirm that he is not. (The insurance section of Dr. Crane’s practice’s website also does not indicate that it is “in-network” with Kaiser Permanente.)

The types of injuries detailed above are truly sad. One can only imagine what life will be like for these patients in the years ahead, as they try to cope with malformed, misshapen, and certainly non-functional genitals. Moreover, many of these plaintiffs will have difficulty in maintaining proper excretory function, a complication that can have serious ramifications for health. The embarrassment, pain, expense, and disappointment must be profound. We ask, why are these actual injuries, suffered by actual transgender people, so much less important to the transgender community than such nebulous insults as “mis-gendering,” the inability to access a desired dressing room, or hurtful Tweets? The fact that Dr. Crane has been sued for medical malpractice in connection with transgender surgery no fewer than eight times in the last two years is a highly pertinent and relevant thing for transgender people to know. Why doesn’t the community want people to know it?

Has the UK become a police state? (And has Twitter become its informant?)

Inga Berenson is the mom of a teen girl who previously identified as transgender but has now desisted. She lives with her family in the United States.


By Inga Berenson

Freedom of speech took another big hit in the United Kingdom last month. In response to a complaint filed by Susie Green, CEO of Mermaids, the Yorkshire police interrogated Kellie-Jay Keen-Minshull because of some tweets she posted in 2016 and 2017. Known on Twitter as ThePosieParker, Ms. Keen-Minshull is a stay-at-home wife and mother of four.

Mermaids is a nonprofit organization based in the UK. According to its website, Mermaids “supports children and young people up to 20 years old who are gender diverse, and their families, and professionals involved in their care.”

The offending words

According to Ms. Keen-Minshull’s account, Ms. Green objected to a tweet stating that “the CEO of Mermaids took her 16-year-old to Thailand and got him castrated.”

For this tweet and others criticizing Mermaids for promoting pediatric transition, Ms. Keen-Minshull was “interviewed under caution” for 40 minutes on February 23, 2018. She now awaits the Crown Prosecution Service’s decision on whether she will be charged. According to Ms. Keen-Minshull, the potential charges against her are “nuisance, public order, malicious communications compounded with a potential hate crime.”

On the crowd-funder site she has set up to raise funds for her legal defense, Ms. Keen-Minshull writes, “This fight is not whether you agree with my views on [the] transgender issue as much as it is that you agree that I have a right to air my views, a right to voice an opinion, a right to free speech.”

Without question, Ms. Keen-Minshull’s tweets were strongly worded, but were they untrue?

Unmasking euphemisms

It is not disputed that eight years ago Ms. Green took her 16-year-old child to Thailand to receive gender reassignment surgery, which was and still is illegal for minors in the UK and is now illegal in Thailand. (In fact, the legal age for SRS was raised to 18 not long after the Greens went there for the surgery.)

In a 2012 BBC 3 documentary, Ms. Green confirmed that her child underwent full GRS in Thailand. The narrator [4:15] states that Ms. Green’s child was “the youngest person in the world to change gender through surgery.”

It must indeed have been painful for Ms. Green to see a tweet in which someone says she had her child castrated, but the statement is not untrue. In fact, this type of surgery involves far more than castration, which refers only to the removal of the testicles in natal males. But Ms. Keen-Minshull used the word “castrated” to make an important point: GRS is a euphemism that conceals the drastic nature of this medical intervention.

And if it seems unfair that Ms. Keen-Minshull singles out Ms. Green, we must remember that she is not merely a mother who did what she believed to be right for her child. As CEO of Mermaids, she is an advocate for the use of these interventions in other people’s children. Mermaids has provided training and education to various UK government agencies, including schools and (interestingly) the UK police force. Mermaids representatives regularly attend Pride parades and other events to reach out to gender-nonconforming children and teens to inform them about transition. Ms. Green cannot reasonably expect that others won’t point out the full reality of these interventions if she is promoting them for other children.

Ms. Keen-Minshull also came under fire for a tweet that said Mermaids “prey[s] on homosexual teens,” alluding to the organization’s efforts to reach out to gender nonconforming and gender dysphoric children, many of whom (many decades of research have shown) grow up to be gay or lesbian.

The 4thWaveNow website has previously featured articles about Mermaids and its influence on UK policymaking, as well as their efforts to circumvent parents and appeal directly to children and teens.

Although our website hosts authors from both North America and the UK,  4thWaveNow is based in the United States, which protects the freedom of speech via the 1st Amendment to the US Constitution. If that were not the case, we too might have been interrogated by the police, because Ms. Green’s complaint (which we have seen but are not at liberty to share at this time) also cited a tweet we issued in the summer of 2017:

mermaids candy and puppiesWe decided to raise this question in our tweet,  after seeing this one posted by Mermaids a few weeks earlier:

mermaids unsupportive parents

As parents of current or formerly trans-identified teens, we are concerned that Mermaids is trying to influence teens whose parents do not share the organization’s definition of “unsupportive.” (In fact, as parents who try to help our kids find ways to feel comfortable in their natural bodies – at least until they are adults, we are being supportive.) And the fact that Mermaids feels empowered to publicly state its intention to influence teens like ours is all the more troubling.

We and Ms. Keen-Minshull are far from alone in believing that Mermaids oversteps appropriate boundaries in advocating for transgender services for children. In October 2016, a court removed a seven-year-old child from his mother’s custody because she was found to have essentially groomed her child into a transgender identity. The mother had been receiving support from Mermaids. The court reportedly ordered the child should have no further contact with the charity. (See “The boy who ‘lived in stealth’: Judge challenges ‘emerging orthodoxy.’”)

Twitter’s role in the interrogation of Ms. Keen-Minshull

Although it’s troubling enough to think that a supposed democratic Western nation would interrogate someone for expressing her opinion, it’s even more troubling to hear that a US-based company revealed the person’s identity to the government. According to Ms. Keen-Minshull, the police informed her that they had obtained her contact information from Twitter.

This is not the first time that Twitter has shown its bias in the battle between adherents of gender ideology and those who see dangers in it. Gender-critical individuals have had their Twitter accounts suspended for merely stating that “transwomen are men” while adherents of gender ideology regularly direct misogynistic language like “cunt” or “Kill All TERFs” at people who disagree with them.

It turns out that individuals associated with Mermaids are also guilty of mud-slinging on Twitter. “Helen” (@Mimmymum), who has frequently stated she is a member of Mermaids, regularly brandishes the word “bigot” at those who don’t share her opinions. In a tweet referring to Dr. Ray Blanchard, an American-Canadian sexologist, best known for his research studies on transsexualism and sexual orientation, she writes:

mimmymum blanchardBoth sides of this debate are exercising their democratic right to express their opinions and their concerns about public policy, but it appears that both the UK police and Twitter have chosen to respect the rights of the one while disregarding the rights of the other.

Uncomfortable truths

Ms. Green and her organization suggest that those who oppose the transitioning of minors are motivated by bigotry and hate. They refuse to acknowledge that this opposition could stem from genuine concern for the welfare of children and outrage that organizations like hers promote transition so eagerly and misrepresent the realities of it.

In a segment on BBC Newsnight in November 2016, Stephanie Davies-Arai, founder of the organization Transgender Trend, said that “the treatment pathway [for treating trans-identified children is] … cross-sex hormones…. It leads to children being sterilized and on medication for life.” When the interviewer asked Ms. Green if this were correct, she answered, “Well, no,” then changed the subject. (See “Should Mermaids be permitted to influence UK public policy on ‘trans kids’?”)

Yet this statement is correct, and it’s acknowledged to be so by clinicians who promote and administer these treatments. While the word “castration” may be jarring, Ms. Keen-Minshull used it because it exposed the reality that activists like Ms. Green would evidently rather conceal.

Ms. Keen-Minshull believes strongly, as do we at 4thWaveNow, that drastic interventions like these deserve public scrutiny. To be able to express our concerns about these interventions, we must be able to name them. If people no longer have the right to speak uncomfortable truths because others may find them offensive, a democratic society is no longer possible.

An RN & mum of a trans-identified young adult on perils of off-label cross-hormones as first-line treatment for gender dysphoria

Mumtears is a registered nurse, a wife, and mum of two daughters, currently aged 23 and 20 years old. She lives with her husband of 27 years, the father of her two daughters. She says: “Because of my currently unpopular thoughts, and because of not wanting to cause harm to my family, I feel I need to remain anonymous. I also started a blog a while ago, but- frankly- I haven’t kept it up. I am not very technologically sophisticated. If you want to read what there is in my blog, you can find it at myheartandhope.wordpress.com.” She can be found on Twitter @Mumtears1 and is available to interact in the comments section of this post.


by Mumtears

I have been a registered nurse for 30 years. From childhood, I always wanted to be a nurse. I really feel like being in the nursing profession was a “calling” for me.

While going through my post-secondary studies, studying for my Bachelor of Nursing degree, I recall being taught that, in all conditions, medical and nursing treatments should always begin with the least invasive way to treat that condition. I was taught that this was best practice care for the human body.

I have had many years’ experience working in Acute Care Pediatrics at our local children’s hospital. It was there that I learned that children are not simply “little adults”. Pediatric patients require specific attention and care, due to their rapidly developing minds and bodies. Their bodies and minds function very differently from adults. Medications and treatments are all prescribed based on the child’s body weight. They also cross different developmental stages at different rates on their way to becoming adults.

For the past 7 years, I have been working at a very busy family practice, caring for all types of patients with all types of concerns, from birth to the very elderly. I work with a family physician who also specializes in transgender care and sexual health. I have seen, assessed and cared for countless adult transgender patients. They comprise a combination of male-to-transgender and female-to-transgender patients.

Almost 5 years ago, my youngest (then 16) daughter expressed to her dad and me that she “thought she should be a boy”. That was the day our family life changed in ways we never anticipated. Throughout childhood, our daughter never presented as stereotypically “masculine”. She never outwardly expressed to us any kind of discomfort. She appeared to be mostly happy. A bright spark. She loved to play outside: doodle with chalk on sidewalks, sandbox play, climb trees, ride bikes. She smiled often. She loved building with Lego, playing Polly Pockets and with tiny toy horses. She enjoyed making tiny crafts, including models of people and animals made of Sculpey clay.

She was also very academically smart, reading beginner short novels before entering Grade 1. She taught herself how to tie her shoes and how to ride a bike. With the help of her father, when she was about 8 years old, she built one amazing bicycle from two used bikes purchased at a garage sale. In Grade 4 she challenged a Math unit about fractions and passed the final exam with flying colours, even before the unit began. She was musically advanced, playing beautiful piano tunes at age six, wonderful tenor saxophone solos in junior high. We had her tested for giftedness by a school psychologist. He told us that she was “just below” the gifted category.

We parents did begin to notice some general, social discomfort in late junior high, but we assumed that this was normal teen awkwardness, which can happen during puberty, so we were not concerned about it. We were absolutely blindsided by her proclamation that she thought she would be a boy.

My older daughter never had a temper tantrum when she was a toddler. I thought it was down to good parenting. How wrong I was. When our younger daughter was born, she behaved quite differently from her sister. Different personalities, which was not surprising to us because my husband and I are also very different from each other. Our youngest daughter started having temper tantrums at 18 months of age, which lasted 4 long years. Then, it was like a light switch turned on. Suddenly she realized she could settle her emotions down by reading quietly, alone on her bed. After just over 4 years of a frequently chaotic time, our house and family seemed to be at peace again. It was lovely.

Thinking back to this time in early childhood, I thought my daughter’s gender discomfort might be a similar phase for her. I still think it might be. I pray that, with time and life experience, she will develop an acceptance and comfort about her female body, and a knowledge that being the female sex does not have to place limits on her happiness and what she can accomplish in life.

drawing-testosterone-injectionBefore daughter told us she thought she should be a boy, I had already seen and assessed countless adult transgender patients. They comprised a combination of male-to-transgender and female-to-transgender patients who ranged in age from late 20s to early 50s. I admit that I when I first started working in family practice, I was very naïve about what “transgender” means. I noticed that all of the adult transgender patients I met also had comorbid mental health issues, which had not been fully resolved and, in some cases were severe/debilitating. My professional duty was (and still is) to provide excellent, compassionate nursing care to these patients. My personality is compassionate, empathetic and caring. I learned some of the transgender lingo; for example, “top” and “bottom” surgery. I’ve administered countless testosterone injections. I’ve changed the dressing on the donor arm of a young 20-something female-to-transgender patient who had recently undergone phalloplasty surgery. And now, after I administer these injections, I’ve found myself in the staff washroom, trying to compose myself for my next patient. Watching female erasure (in particular) causes me much sadness, partly due to what is going on with my own daughter. But mostly due to the fact that I am an adult female-born woman.

As I already said—but it’s worth saying again–I was taught that, in all conditions, medical and nursing treatments should always begin with the least invasive way to treat that condition. I was also clearly taught that pediatric patients have smaller, ever changing and rapidly developing bodies and minds, and need to be treated differently from adult patients. I was taught that physical, mental, and emotional development in children is ongoing, well into the early to mid 20s. Because of my knowledge about child development, both body and mind, I don’t understand why the medication Lupron is being given to healthy-bodied children. This medication is approved for use to treat adults with advanced prostate cancer and endometriosis. In children it’s used to slow down precocious (early-onset) puberty. It’s only in the past few years that it’s being prescribed for children who have gender dysphoria. This is an off-label use for this drug and it’s being given to healthy-bodied children even though there has been no research done to determine its safety or efficacy regarding gender dysphoria.

And we know that puberty blockers lead in most cases to cross-sex hormones. Why is the current first-line treatment for gender dysphoria in young, healthy bodies off-label, unstudied cross-hormone prescriptions? Young adult females can go into a family doctor’s office, state “I’m transgender”, and be handed a Rx for Androgel. This is what happened with my daughter, over a year ago. She never filled that particular prescription. However, last week she notified her father and me that she plans to start taking testosterone. She’s in a lengthy queue to be seen by our city’s gender specialist/psychiatrist and is impatient. She gave us no concrete reasons for wanting to start taking testosterone. She demonstrates little outward discomfort when she is in our home or when interacting with extended family.

She had one visit with the same family doctor who gave her the previous Androgel Rx. She told us that he told her what side effects could occur (while reading from a computer screen). She told us that he did not discuss reproductive planning with her, and that he gave her no written information about any of the side effects. She told us that he gave her the prescription and some bloodwork requisitions. This family doctor did not take a multidisciplinary team approach; he acted on his own. He did not refer her to an endocrinologist to check her hormone levels. He did not send her to any mental health professional, who could have assessed her for the source of her discomfort and possibly provided her with other less-invasive treatment options, such as cognitive behavioural therapy. How is the way in which this family doctor gave my daughter this off-label cross-hormone prescription medically ethical? In my province, family physicians can be the primary prescriber of cross-hormones. While using a multidisciplinary approach might be a good practice, it is not mandated. I’m currently trying to find answers via our provincial and national medical associations. The answers I’m looking for aren’t forthcoming.

I know that in no other medical or other health-related case would something like this happen, with regard to the prescription of off-label medications. I’d like to give you another home-based, common-sense example: Young adult child says to parent: “I have a really bad headache.” Think about this. Would it make any sense for the parent’s first response to be, “Your dad has some leftover oxycodone from his recent surgery, which he no longer needs to take- here, have some!”? Of course not. What would make medical/practical sense would be to first check that the young adult isn’t dehydrated. It is known that dehydration can cause headaches. “Try drinking some water and see if you feel better”. That would be the least invasive thing to try at first. If drinking water didn’t help the headache and if the young adult child had no know allergies or health conditions, it would be appropriate to next offer them acetaminophen, dosed per the package instructions. It is known that acetaminophen is a very effective analgesic, with a low incidence of side effects. If the headache persisted, perhaps it would be appropriate to then try a non-steroidal anti-inflammatory, such as Advil. There might be some inflammation in the neck or jaw muscles, causing the headache, which, if reduced, could relieve the headache. It is known that Advil is a mostly safe anti-inflammatory medication, with low potential side effects.

Recently I attended a Medical Education Session, which was held at a recent clinic retreat. The session was about low testosterone levels in adult males and testosterone replacement therapy. What I learned is, that for male bodied patients, the recommendation is that if the testosterone bloodwork result is low, it is important to clearly understand the patients’ symptoms concerns and general health. If the patient’s symptoms are low and the patient is not concerned, then giving the patient a prescription for testosterone is not advised. This is because there are also many side effects that can happen from taking testosterone, which can cause negative symptoms/concerns for the patient–especially if these male-bodied patients also have other health concerns. I learned that this is appropriate safe medical care for male-bodied patients.

I’ve done my own learning about testosterone. The pharmacy companies’ printed drug information about testosterone products states that this medication should not be given to women. It has never been studied in female bodies. Also, there are no long-term studies which indicate safety or a positive result for females who take this medication. Physicians are prescribing it “off label”.

I have been trying to learn as much as I can about gender dysphoria and its treatment. I have read many studies, documents, medical association websites, etc., and continue to do so.

When I learned about the newly recognized “rapid onset gender dysphoria”, I realized that much of its description matched what we were/are witnessing in our youngest daughter. Currently there is little known regarding care or treatments for young people presenting with rapid onset gender dysphoria. And few physicians are even aware of this phenomenon. There has been a dramatic increase, over a short period of time, in the number of teens and young adults who are seeking care for being transgender. And the demographic for which sex is declaring transgender has also changed. There are now more natal females than males with this concern.

With all that I have learned about rapid onset gender dysphoria and current treatments for it, I have more questions: Why are these off-label testosterone prescriptions being given to young healthy-bodied female patients as a first-line treatment for gender dysphoria? Especially since it is known that testosterone causes permanent body changes in female bodies, making it an invasive and irreversible treatment. Why are physicians prescribing these off-label cross-hormones without doing further assessments to ensure that this is the best treatment for their patients? I believe these are reasonable questions to ask. I believe these are prudent questions to consider. It is not transphobic to ask these questions. Many parents are asking questions like these. If you’re a parent wanting to learn more and connect with other parents, you can check out: https://gendercriticalresources.com/Support/index.php


Afterword:

I have recently learned that my daughter has likely started her testosterone prescription already. I found the receipt for it in her room at home, for low dose Androgel, from a pharmacy our family never uses, so I know that she has purchased it. She is currently living away for university, in a city which is a 2-hour drive from our home, studying in an arts program there. She has never told any of our close extended family anything about her gender dysphoria. We all live in the same city and see each other fairly frequently. Our older daughter (a graduate with a degree in Cultural Anthropology) knows and supports her sister’s claims, but that is all.

androgelOur younger daughter had the opportunity over Christmas (two Christmas dinners actually), to tell anyone in her extended family about her plan to start testosterone. She hasn’t said anything to any of them. Nothing about her gender dysphoria. I’m sure that it will be upsetting to many of them. My daughter and I text back and forth. We text about her activities (theatre, parkour). About her classes (she studies hard and gets excellent grades). About her saxophone practice (she recently was accepted into the university’s wind orchestra). I am proud of the person she is. I see so much potential for her to become an amazing woman and I am sad that she wishes to erase her female body. Frankly, I believe that “gender” is a crap concept, which is why I don’t discuss this with her. Ever since she first told us her thoughts, we have been clear in telling her our concerns. It’s up to her to think about what we have told her. We hope that she will undergo some work to understand the source of her discomfort, but we know that the decision will be hers to make. She tells us that she loves us. We have clearly told her that we love her and always will. We financially help support her post-secondary education. We want her to have many good job opportunities. We want her to have a good life and be happy and healthy. I dread her voice changing. I dread seeing her beautiful face change. And I find myself wondering if she actually needs to go through all of this, in order for her to “find herself” and come out the other side. The birth name we gave our youngest daughter means “strong”. I thought this would serve her well. We continue to use her birth name because we have not given up hope. As parents, we were never prepared for any of this. And as a registered nurse, I am very disturbed by all of it.