Carey Callahan is a family therapist, writer, and organizer advocating for responsible healthcare for gender dysphoria. You can find her writing at medium.com/mariacatt42 (where this piece was first published), and she tweets at @catt_bear.
This piece is an intro to a series Carey will be writing in the coming weeks.
One of the sadder parts of being detransitioned and public about it is that the parents find you. They’ve been told by a doctor or a social worker that the only route forward that protects against suicidality is to affirm their kid’s trans identity. That they need to be open to the possibility their kid may need their pubertal process disrupted, may need to begin what could within a couple of years turn into a life time commitment to cross sex hormones, and could need surgeries to socially function. They’ve been told asking questions about the impact of their kid’s peer group, internet use, drug use, co-morbid diagnoses, internalization of sexism, or family dynamics is transphobia. They’ve been told, no matter what their authentic emotions are, to celebrate their child’s transition.
Pediatric transition has always been a troublesome topic for me. My efforts to advocate for resources and training for detransition mental healthcare have consistently put me in positions where I have to pick a side about pediatric transition. My choices have been: critique pediatric transition, be labeled a transphobe and be cut off from opportunities within the trans healthcare community to build an infrastructure for supporting detransitioners OR focus only on detransition care, and endorse pediatric transition.
Carey Callahan
At the end of the day, if I had a kid, they’d have to wait till they were 18 to get themselves on hormones and pursue surgeries, so I don’t feel right recommending parents do anything different. It’s not that I don’t believe I could have a kid who, in order to have a good life, truly did need to move through life in a gender role I didn’t expect. I know trans adults like that, and their medical transitions reduced their GD to such a level that they could function well, with loving partners and meaningful work. But my doubts about the ethics of pediatric transition are not based on assuming a trans kid’s identity isn’t going to be stable and long-lasting. (Although it’s worth remembering in 2009 hardly anyone had heard the word “nonbinary,” so I don’t think we can even can speculate about the gender schemas that will be popular in 2029.)
My insistence that any kid I raise be a legal adult before making these choices is based on knowing trans adults who have been surprised by the challenges of their long term healthcare. I am not going to create a situation where my kid is 25 and gets to blame their mom for pain when they orgasm, fusion of their uterus and cervix, reduced mitochondrial function, or straight up never having an orgasm. No way am I running the risk of allowing my kid to halt their puberty with Lupron shots and create a future spending big bucks at the dentist, rheumatologist, and endocrinologist. I didn’t have steady health insurance till my mid-thirties, so I don’t have faith that if my kid had chronic symptoms like the people in the Lupron Survivors Facebook group do that they’d be able to access specialists without sliding into inescapable medical debt.
Once I told a prominent psychiatrist and affirmative care researcher that there’s no way I would let a teen take testosterone because there’s a high likelihood they’d end up needing a hysterectomy in their twenties. After a hysterectomy you are dependent on HRT for your lifetime and need to prioritize having health insurance both for the HRT and the complications following the hysterectomy. It’s normal for Americans, especially in their twenties and thirties, to have long stretches of time where they can’t afford to see a doctor. The psychiatrist, appearing deeply perplexed, replied (this is a paraphrase), “But you can’t make decisions about your identity based on fears you won’t be able to access healthcare.”
The trans community is pretty clear you don’t need to take testosterone to identify as a trans man. Thus, testosterone isn’t actually a choice about your identity, it’s a choice about body modification, and yes you can absolutely choose to avoid body modifications that create risks to your health you fear you may not be able to manage. But if a Harvard educated psychiatrist can’t keep that distinction clear, can a teenager? Do the teenagers in your life know about co-pays, or how to get a referral to a specialist, or what COBRA is? I’ve had a fair amount of the letters of the LGBT alphabet soup confidently explained to me by teenagers, but I’ve never met a teen who knew how to apply for Medicaid benefits.
All this to say, if you are suspicious of the increased prevalence of youth GD referrals and the righteousness of activists who believe minors know what they’re getting into when they medically transition, I’m there with you. But if parenting teens were just about creating sane rules and explaining how the world works, teen boys could be trusted to shower regularly, teen girls could be trusted to use school bathrooms without putting fights on Snapchat, and Smirnoff Ice would have a significantly smaller market share.
The reality is that inmanystates on your teen’s 18th birthday they can walk into a Planned Parenthood and have the first of the two appointments it will take for them to get HRT. You have the power (although only if you and your coparent are on the same page) to keep your kid from initiating medical transition until that day. That day will roll around quicker than you think.
What this means is that cultivating a positive relationship in which you have credibility and influence with that person you made is paramount. From my work as a family therapist I can tell you being able to do that, when that person is in their teens and twenties, is a spiritual triumph. Young people’s psyches are built for separation, independence, and risk taking. But you, passionately loving parent, with the privilege of both your life experience, and fully formed pre-frontal cortex (boy howdy I’m hoping you can fully access all that emotion regulation) are gonna love that kid into some wise choices.
How do you do this?
The short answer is:
An unconditionally loving relationship demonstrated by you giving them feedback that is intentionally overwhelmingly positive
and lots of offering them your reflective listening skills;
bounded by clear and explicit, age appropriate boundaries
which are backed up by logical and consistent consequences.
Doesn’t strike you as that short of an answer, does it? But in actuality that answer above is the recipe for every successful relationship- kids, spouses, friends, coworkers. Having children hit puberty is a fantastic way to find out all your weird personal myths about how relationships should go and how exactly they do not work.
Here’s the basics of any human relationship: People love to be liked. People love to be understood and most people love to talk about themselves. People are most relaxed when rules, roles, and boundaries are clear, and people love to be relaxed. People absolutely don’t love logical consequences for their behavior. But the least painful way to learn about the process of considering logical consequences is from navigating logical and consistent consequences doled out by your parents.
Over the next two months I’ll dive into those 4 components of building a positive relationship with your kid, and how your kid’s gender dysphoria and trans identification interact with these components. I am NOT saying you can detrans your kid. I am absolutely saying that if you build a positive relationship with your kid, you can be both a valuable sounding board and a source of information for them. I know from my own experience the sources of information and the sounding boards (i.e. gender therapists and online community) available to gender dysphoric people who are discerning their medical choices tend to put forth a very rosy view of medical transition.
If you’re a parent, and you’re feeling desperate, the very best thing you can do before this series gets going is to get SERIOUS about your self-care. Having a child begin a clearly inappropriate medical transition is a specific level of hell, and I would never want to minimize how bad that situation sucks for parents. But in the midst of that hell you need to bring your parenting A game. You have to take up running, yoga, meditation, prayer, Xanax- whatever can chill out your emotional lizard brain so that you can access your logical, strategic, patient pre-frontal cortex. If you’re not giving an hour each day to chilling yourself out, you won’t be able to stay non-reactive when that baby you nursed tells you they’ve got a surgery date. An hour of self-care is the minimum, and I don’t want to get any emails from you if you wrote them before 2 hours.
Check back in about a week for Part 1, the deep dive into positive feedback for your endlessly confusing child.
Juliette van Steensel is a 19-year-old woman who identified as transgender for a brief period in her earlier teenage years. She wrote this piece particularly for parents who may be wondering how to best support and respond to their trans-identifying daughters, based on her positive experiences with her own parents during that time in her life. Juliette is originally from the Netherlands and now lives in the UK, where she is studying for a degree in linguistics. She is available to interact in the comment section of this post, and can also be reached on Twitter @jvsteensel.
Cases of young teenagers claiming to be transgender out of the blue seem to be on the rise. Though there are plenty of opinions and discussions on this to be found online, some voices are hard to hear: those of parents reluctant to give in to their children’s wishes to transition, and those of people who once identified with the transgender community and no longer do. I myself identified as transgender for a short time in my teens, but grew out of it. As I was looking for people with similar experiences, I came across 4thWaveNow. I recognise myself in many of the stories shared here, and I feel very sympathetic towards the parents sharing their struggles. I hope that sharing my experience with transgenderism and the ways in which my parents supported me in this will provide some insight to other people going through this.
When I was 16, I came out to my parents as genderqueer. This was following a coming-out as gay, which followed a coming-out as bisexual. At the time, I viewed this as a logical progression: I was breaking out of the heteronormative, cis-centric mold imposed on me by society. As a final step to complete this progression, I decided I would start hormone treatment when I turned 18, and start university ‘as a man’ — or at least, not as a gender-conforming woman. It never got that far, though: some six months later, I had started to grow out my hair, wear dresses and skirts again and didn’t think twice about ticking the ‘female’ box on my university application forms. Now, I have many other things to concern myself with outside of gender: I have recently finished an internship in linguistics in Singapore, and I look forward to earning my bachelor’s degree in linguistics at Cambridge University over the next three years. Rather than spending my free time obsessing over gender, I spend it on art, playing the violin, and going out with my friends.
Sometimes, though, I think back to when I identified as transgender. Mainly, I think about how it affected my parents, and my relationship with them. My parents never rejected me outright. However, when talking about this period later, I learnt how sceptical and worried they were. Now, I admire that they were able to keep most of this to themselves and trust me to figure myself out. Thankfully, I did manage to do just that, and I am now very glad I never made any permanent changes to my body. Looking back now, the reasons for my so-called gender dysphoria and wish to transition, followed by acceptance of my biological gender only about half a year later are painfully clear. They have little to do with gender beneath the surface.
As most teenagers do at some point or other, I started questioning my sexuality in high school. I was around 15 years old at this time and often turned towards the internet to share my thoughts and find like-minded people. The internet offers a wealth of stories and experiences from others on this topic and I spent a lot of time reading through these. In particular, I spent a lot of time on a blogging platform called Tumblr. On Tumblr, the LGBT community is particularly active. People share their personal experiences, as well as thoughts and opinions on sexuality as it relates to society, culture and politics. At the time I was discovering this content, I was young, impressionable and curious. Discussions about inequality, sexism and homophobia were a cause for me to be passionate about. Of course, in many places around the world people of non-traditional expression and sexual orientation aren’t considered equal, which ought to be discussed. However, rather than encouraging change and communication, many of the activist blogs I frequented on Tumblr encouraged a victim role. It was not unusual to see posts demonising people who identified as heterosexual or cisgender. In these communities on Tumblr, respect was earned not by showing strength, but rather by demonstrating the highest degree of victimhood. This means that the person with the most complex, unique and marginalised identity has the most authority — the unspoken rule was that someone who has not had the ‘lived experience’ could never understand, and could never have a useful word to say about an issue. Looking up to others in this community, I felt very tempted to immerse myself in these alternative identities. Besides, not identifying as heterosexual, I already felt like I fit in. It was a small effort to delve deeper.
As a teen, I struggled with identity and often found it hard to express myself. On Tumblr, the biggest discussions around self-expression usually centred around gender. This is how I became interested in dressing androgynously and rejecting traditional femininity. There were countless blogs of young people, mostly biological females, with boyish haircuts, wearing masculine clothes and asking to be addressed with gender neutral or masculine pronouns. Many spoke at length about their dislike of stereotypical femininity, their perception of heterosexual relationship and their discomfort with their female bodies. This struck a chord with me. As a young girl, at many points in my life, stereotypes and expectations felt forced upon me because of my being female: my family often asked me if I had a boyfriend yet, when I would finally grow out my hair beyond my shoulders, how many kids I wanted. These pressures made me insecure, partly because I didn’t want to fulfill some of these expectations, and partly because I was worried I wouldn’t be able to. I saw the experiences of non-binary, genderqueer and transgender-identified people on Tumblr as an escape from these pressures of traditional femininity.
However, none of this explains why I considered something so drastic as hormone treatment to change my feminine features. A much-used term on these gender-related blogs on Tumblr was gender dysphoria. Many people on the blogs I frequented described feeling trapped in their body and uncomfortable in their skin; they described being unhappy with their breasts and their hips, and feeling unattractive. On these blogs, these feelings were considered symptoms of gender dysphoria, and a sure sign that transitioning to the opposite sex with the help of hormone treatment and invasive surgery was the right course of action. At no point were negative side effects of these procedures discussed, nor was the possibility considered that these feelings might not be related to gender in the first place. At this age, there was much I disliked about my body, and combined with my need to reject traditional femininity, it seemed logical that gender dysphoria was the explanation for these feelings. I was convinced: I now had a way to experiment with self-expression and reject stereotypical femininity with masculine haircuts and clothing, and the term gender dysphoria to explain my bodily insecurities. After this, it wasn’t difficult for me to convince myself that transitioning was the key to happiness and security.
For me, the road to wanting to transition was a slow one. Initially, I simply enjoyed experimenting with more androgynous fashion and hairstyles. But over time, gender became an obsession. Relevant to my experience is the rest of my life at this time. My family had recently moved from the Netherlands to Scotland, where I started a new high school. At 15 years old, this was a very big shift for me and I struggled to make friends during my first year at school. On top of this, about a year after moving, my parents divorced. Perhaps as a cry for attention, an act of rebellion, or simply as a distraction, I became obsessed with all things gender identity. Everything around me reminded me of the biological and societal differences between the sexes. I became obsessed with hormone treatment and surgery, with disguising the feminine parts of my body and with ways to disassociate myself from femininity in all manners of expression. I was convinced that when I finally transitioned, and had the acceptance of my friends and family, I would be happy.
But every step I took — cutting my hair, wearing men’s clothes, adopting ‘masculine’ mannerisms — only made my insecurities worse. I felt like I didn’t fit in, I felt unattractive, and I felt like I would never be happy being in the body I was in, even more so than before I began presenting as male. I felt entirely dependent on outside validation that I came across as masculine —validation I didn’t often receive. For a while, I didn’t talk to my family about these feelings. But at some point, I felt so unhappy that I decided to talk to my mum about my wish to transition. I didn’t have to bring it up, but one day when I was in a particularly gloomy mood, my mum asked me directly if I wanted to be a boy. She’d noticed that I’d started wearing masculine clothes, cut my hair shorter and shorter, and had put the puzzle pieces together. That question allowed me to share the thoughts and feelings I had about gender and my body. During this conversation, my mum mostly allowed me to talk without interrupting, until I brought up the topic of transitioning.
I don’t believe I ever fully intended to transition; when I talked to my mum about hormone treatment, I had already decided I would start it only after finishing high school, so I would be able to start my ‘new life’ at university. I could tell my mum was hesitant: she expressed that she wasn’t convinced that hormone treatment was the right course, and she was very happy to hear that I wanted to wait a couple of years before starting treatment. Still, though, my mum was very understanding, and clearly wanted to fix my unhappiness as best she could. That reaction helped me step outside of my own head a little: it helped me realise the gravity of the decision I wanted to make. However, I was less receptive to my mum’s admission that it would be difficult for her to think of me as anything other than a daughter. I understand this now, and I am sure many parents here feel the same. At the time, though, this wasn’t something I wanted to hear: it made me feel pressured to fit an image my mum had of me.
We reached a compromise, though: my mum agreed to contact a gender therapist for me. We had one visit with this therapist — who didn’t push treatment, but simply wanted to look further into ways of self-expression without the constraint of labels — but when trying to book a follow-up appointment, we never heard back. My mum only received a response to her emails a few months later because of an issue with the therapist’s e-mail, and by this time I was no longer interested in transition. I wonder from time to time if I would have gone through with transition had I had more appointments with this gender therapist. It’s a scary thought, since I no longer have any desire to be male. However, I do feel like the appointment was helpful. It made me feel valid, but at the same time, it made the situation feel very real all of a sudden. It helped me to see how big of a change transitioning would be, and perhaps this was ultimately the first push for me to grow out of this phase.
Altogether, I identified as genderqueer and later as transgender for only about six months. I don’t remember exactly what led me to grow out of these feelings of gender dysphoria, but I think the most vital step was settling in at school. Making more friends and finding other ways to express myself, as well as feeling more at ease socially helped build my confidence. Around this time, I also started exercising, and this was a great way to relieve stress and learn to feel more at home in my body. By the time my fifth year of high school rolled around, I was too busy with friends, crushes and university applications to think much about gender.
Throughout all of this, my relationship with my parents was vital. My parents never rejected me — they expressed at times they didn’t agree with my self-diagnosis, but at no point did they make my insecurities feel invalid. My dad in particular was open to however I chose to express myself, and encouraged me to experiment. He complimented me on both my feminine and masculine clothes. He even took me to a male barber to get a haircut. I didn’t experience this affirmation as encouragement to transition; rather, it boosted my confidence and showed me my relationship with my dad wasn’t dependent on how I expressed myself. Both my parents made it clear that things like the way I dressed, the way I labeled myself, or who I loved would never make them reject me. Knowing I had their support and trust made it easier for me to return that trust, and kept me from feeling a need to rebel.
Now, I know how difficult the whole ordeal was for them, and I feel some guilt for worrying them as much as I did. The topic of gender doesn’t come up a lot in conversation: I feel too embarrassed to bring it up, even though I know my parents don’t think any less of me for it — though my family doesn’t shy back from making fun of my haircuts. At the time though, they took me seriously, for which I am very grateful. It allowed me to grow out of this phase of my life without need for intervention and before taking any drastic measures.
My view on these gender-related issues has changed gradually over the past few years. I see this sudden gender dysphoria that some teenagers express as symptomatic of other problems, rather than as a problem on its own. I interpreted my insecurity as gender dysphoria and my dislike of stereotypical femininity as a wish to be male. Frustrated with my situation — feeling alone at a new school, feeling insecure about my body, having to deal with my parents’ divorce — gender became an obsession. It functioned as an escape and as a problem to fix. I convinced myself that everything in my life would improve if I transitioned. I believe this might be the case for other young people claiming to experience gender dysphoria: obsession with gender serves as a way to avoid dealing with more complex, underlying issues with confidence, identity and security. These need to be dealt with first, before transition can even be considered. I also believe that the sudden increase in cases of gender-confused teens can be explained in part by the internet. I was introduced to these concepts of gender identity through the internet. It is also very easy to find people online that will affirm your feelings and encourage you to transition, even though these people are not nearly familiar enough with your real life to make these judgements. Validation is easily found online, which is why some teens might withdraw there to avoid confrontation instead of talking to family and friends in real life.
Despite my scepticism towards claims of gender dysphoria from teenagers, I would still urge parents of teens going through this to act with empathy before anything else. I don’t believe many teens would act this way on purpose, or to be manipulative: for me, it wasn’t in any way enjoyable to constantly deal with these obsessive thoughts and insecurities. For that reason, I would encourage parents not to view this as an act of rebellion from your child, but rather as a cry for help. What was by far the most helpful for me was knowing that my parents’ love for me was not lessened by how I chose to express myself, and that all their scepticism came from a place of concern. I also believe it is important not to reject your child outright, and to trust them to figure things out in their own time. Allow them to experiment with their fashion and hairstyle, and allow them to try out a different way to express their identity. Many children and young teens expressing gender dysphoria at some point in life later find they are gay, or that they simply feel more comfortable dressing like the opposite sex. If this turns out to be the case for your child, it is important that you support them — your acceptance will likely mean a lot to your child. Remember that for your child to share these thoughts and insecurities about their identity and body in the first place shows they trust you and are willing to talk, and this trust is something to be treasured.
In recent months, there has been a marked increase in the number of both trans-identified and detransitoned people speaking out on social media and YouTube about the harms they say they experienced from a variety of medical-transition procedures. It should be obvious that the testimonies of these regretters don’t somehow cancel out the positive transition experiences others report. In fact, many regretters who speak out do so not to deny others the right to access medical transition, but to provide information about possible unwanted side effects and/or sequelae of surgical and/or hormonal interventions.
Yet the typical response from trans activists can be summarized succinctly:
Regret and detransition are vanishingly rare. You’re an outlier, so don’t fearmonger.
As many detransitioners have pointed out, no one actually knows just how many regretters (some of whom continue to identify as transgender) and detransitioners there are. Regretters are not systematically tracked, and the few studies that have looked at regret rates typically report that many subjects have been lost to followup.
Most importantly, many regretters never return to their gender clinics once they’ve detransitioned (or discontinued further medical intervention). As Carey Callahan remarked in her recent interview with a detransitioner who did return to talk to her former gender doctor,
She’s exceptional for doing so- in my circle only a handful of detransitioners have gone back to inform their doctors about their detransition.
But regardless of how rare regret or detransition may ultimately be, why wouldn’t adult trans people and their supporters want others to learn everything possible about both the positive and negative impacts of medical transition–particularly when it comes to young people? Further, if a young person resolves their dysphoria and thus avoids the rigors of medical transition, how is that not a good outcome?
These questions (which we have posed many times in the past) inspired this recent tweet thread from the 4thWaveNow Twitter account.
In response to our most recent article about Dr. Curtis Crane, we have been contacted by one of Crane’s former patients, who asked us to share this video.
Be aware that the video contains graphic images and video footage pertaining to the phalloplasty surgery and complications experienced by this person.
We thank this former patient for reaching out to us, and for having the courage to speak out.
Third in a series. Part 1 is here. Part 2 is here. A YouTube video produced by a former Crane patient can be found here.
4thWaveNow contributor Worriedmom has practiced civil litigation for many years in federal and state courts.
Since our last coverage of medical malpractice litigation against renowned phalloplasty surgeon Curtis Crane, M.D., we’ve received frequent inquiries about the current status of the lawsuits and his practice. Research has revealed some interesting facts and circumstances about Dr. Crane.
First, as of this writing, there no longer appear to be any open civil cases against Dr. Crane in the state of California. All eight of the malpractice cases that had previously been pending in the San Francisco Superior Court have now been “dismissed with prejudice” (read on to understand the meaning of “with prejudice” in the settlement context, since this doesn’t mean what some folks may assume it does).
Specifically:
Doe v. Crane, CGC-16-550630 was dismissed April 5, 2017.
Carter v. Crane, CGC-16-554254 was dismissed December 10, 2018.
Raynor v. Crane, CGC-17-556713 was dismissed November 8, 2018.
Carson v. Crane, CGC-17-556743 was dismissed October 10, 2018.
Doe v. Crane, CGC-17-557327 was dismissed November 8, 2018.
Davis v. Crane, CGC-17-557363 was dismissed December 10, 2018.
Shepherd v. Crane, CGC-17-559294, dismissed October 3, 2018.
Doe v. Crane, CGC-17-560690 was dismissed March 15, 2019.[1]
A ninth malpractice case, Hansen v. Crane (CGC-18-571442), brought in November of last year, was also dismissed on January 14, 2019. As with the other actions listed above, this lawsuit also alleged malpractice in connection with genital surgery:
Interestingly, the plaintiff in that case alleged that at the time he consulted Dr. Crane, Dr. Crane told him that “none of his patients had ever had a serious complication from phalloplasty, that it was a safe procedure, and that only 5% of his patients have needed surgical repairs.”
As of the writing of this article, however, all of the malpractice litigation filed against Dr. Crane in San Francisco has now been dismissed. What does this mean? It’s impossible to know.
What we do know is that none of these dismissals appear to have been the result of a jury or other type of fact-finding proceeding that evaluated Dr. Crane’s conduct and made any findings about negligence or malpractice. In other words, it does not appear that an independent arbiter has reviewed the facts of these cases and ruled on whether the care provided either complied, or did not comply, with established “standards of care.” This is not surprising, since over 90% of all medical malpractice cases never go to trial.
One might reasonably conclude, then, that all of these actions have been settled out of court. For what amount of damages? We can’t know. It could be zero, it could be $10 million. The amount paid in settlement of such a claim is confidential virtually 100% of the time. The medical liability insurance carrier is, in most cases these days, the party that decides whether or not to settle a case, and this is a “business decision” on the carrier’s part.
From interrogatory answers filed in the Raynor case, cited above, we do know something about Dr. Crane’s professional liability and medical malpractice coverage in 2016, the date the malpractice alleged in that case was claimed to have occurred (see Motion for Relief from Waiver of Discovery Objections dated April 16, 2018, Declaration of Corban J. Porter and Exhibit D thereto):
Private settlement agreements also typically include “NDA” (or non-disclosure agreement) provisions, in which the parties agree to keep all terms of the settlement confidential, and further agree to the payment of damages in the event of a breach. These NDA provisions have, of course, come under public scrutiny as part of the “MeToo” movement and the Stormy Daniels affairs. Some commentators argue that keeping medical malpractice settlement amounts confidential hurts the public:
Secret nondisclosure agreements also affect patient safety by allowing bad doctors and other dangerous medical providers to continue to harm patients because their incompetency is hidden from their present and future patients and employers.
Finally, these litigations were also dismissed “with prejudice,” which means that the plaintiff cannot bring another lawsuit based on the same facts. This makes sense, because otherwise no defendant would ever pay money in settlement of a litigation if he or she knew that the plaintiff could simply re-file the same lawsuit another day. So, it’s important to understand: When dismissal “with prejudice” is entered as part of a settlement, it does not indicate that anyone has ruled on the merits of the case.
That’s it for our legal update, but for those of us who are interested in Dr. Crane and his business model, there have been some additional developments.
Most important, it appears that Dr. Crane may no longer be performing surgery in the state of California (although his medical license is still current in that state). His prior practice, Brownstein & Crane Surgical Services, seems to be out of business. Any internet searches for brownsteincrane.com result in a re-direct to “Crane Center for Transgender Surgery,” a practice operating in California and Texas.
In and of itself, this is not surprising. According to the Crane Center’s Facebook page, Dr. Brownstein retired in 2013, after having performed “thousands of FTM chest surgeries” and passing this extensive knowledge along to Dr. Crane.
What is notable is that, as of the time of our earlier article in 2018, Brownstein-Crane was a thriving California transgender medical practice. According to the Wayback Machine, which is the only source for information on the practice, back in March of 2018, Brownstein-Crane, in addition to Dr. Crane, employed:
Thomas Satterwhite, M.D. (plastic surgeon);
Heidi Wittenberg, M.D. (OB/GYN, surgeon);
Michael Safir, M.D. (uro-genital reconstructive surgeon);
Ashley DeLeon, M.D. (uro-genital surgeon);
Charles Lee, M.D. (micro-surgeon);
David Chang, M.D. (surgeon);
Gabriel Kind, M.D. (plastic surgeon); and
Michael Parrett, M.D. (plastic surgeon).
A photograph that appeared on Brownstein-Crane’s now-defunct website.
Of all those doctors, today only Drs. DeLeon and Safir remain affiliated with Dr. Crane. Dr. Crane now appears to practice in Austin, Texas, and has been joined there by Dr. Richard Santucci (together with Dr. DeLeon); Dr. Safir holds down the fort in San Francisco and has been joined by Dr. Angela Rodriguez. Dr. Crane’s website indicates that information about the Crane Center’s doctors is “coming soon.”
It’s not clear when Dr. Santucci joined Dr. Crane’s practice, but he does not appear to have been part of the earlier Brownstein-Crane incarnation:
The Crane Center has wasted no time in accessing potential new patients, sending attractive representatives to attend such conferences as Gender Odyssey in San Diego and the Philadelphia Trans Wellness Conference, and sponsoring art festivals and pride events.
For an added bonus, prospective patients may even be able to receive a free initial surgery consultation, right there at the conference!
What is the story behind Dr. Crane’s relocation to Texas?
It’s impossible to know. Perhaps some of his current or former patients will enlighten us.
[1] Interestingly, on March 7, 2019, Crane’s defense counsel in this case was ordered to pay a $1,800 sanction for “misuse of the discovery process.”
by William J. Malone, M.D., endocrinologist (Twitter: @will_malone).
with contributions from Colin M. Wright, Ph.D., (Twitter: @SwipeWright), biologist and Eberly Research Fellow at Penn State University; and Julia D. Robertson (Twitter: JuliaDRobertson), journalist, award-winning author and Senior Editor of The Velvet Chronicle.
Author’s note, 23 August 2019: This essay has been updated with a new graphical representation of sex-related differences in personality. The original essay had distribution curves showing an 85% overlap of personality traits between males and females. This comparison was based on earlier studies that have been criticized for having design limitations that underestimate sex-related personality differences (link). More recent studies show the overlap to be more in the 30% range. While the degree of overlap is an area of ongoing debate and study, the consequences for the gender-atypical individuals at the tail ends of the overlapping distributions remain the same. For further reading about sex-related differences and ways to measure them, see the following exchanges between experts in the field: (link) (link) (link).
Many health care professionals and mainstream medical organizations endorse the concept of an innate gender identity.[a] They define gender identity as the “internal, deeply held” sense of whether one is a man or a woman (boy or girl), both, or neither, and report that it can be reliably articulated by children as young as 3-5 years old.[b]
A growing number of scientists, philosophers, and health care professionals reject this concept or at least the above definition.[c] Developmental studies show that children have only a superficial understanding of sex and gender at best. For instance, up until age 7, children often believe that if a boy puts on a dress, he becomes a girl.[d] This gives us reason to doubt whether a coherent concept of gender identity exists at all in young children. Additionally, the concept relies on stereotypes that encourage the conflation of gender with sex.
However, starting at a young age, children do tend to exhibit preferences and behaviors that we associate with sex. For example, male children display more aggressive behavior than female children.[e] In addition, “cross-sex” behavior, or more accurately cross-sex stereotypical behavior, is often predictive of later same-sex attraction.[f] Can all of these findings be integrated?
To start, just as sex influences the development of bodies, it also influences brains. There are in-utero differences in hormone exposures (male testosterone surge at eight weeks gestation for example), and distinct developmental pathways are triggered based on the XX or XY chromosomal make-up of neurons.[g] The integration of these sex-related processes with environmental pressures gives rise to an individual’s personality and preferences.
It follows then that population-based studies have demonstrated sex-related differences in personality and preferences that are independent of social influences. When social influences are weakened (in more egalitarian societies), the sex-related differences in personality and preferences increase.[h][i] This suggests that as environmental pressures become relaxed, innate sex-specific preferences surface.
A closer look at personality traits shows that when analyzed together as a group, there is a roughly 30% overlap between sexes.[j][*] This is graphically represented below. The consequence of this overlap is that adolescent males who fall on the left end of the male pattern (blue, “masculine”) curve, and adolescent females who fall on the right end of the female pattern (pink “feminine”) curve, are going to have personality traits that are different than the majority of other members of their own sex. In fact, due to the significant overlap of personality traits between males and females, the personality traits of some females will be more “masculine” than those exhibited by some, or even most males, and vice versa.
Consequently, an adolescent female may find her behavior, personality traits, and preferences more “masculine” than most girls and most boys. This could lead her to incorrectly conclude that she is the opposite sex. That child’s parents could become confused as well, noticing how “different” their child’s behavior is from their own, or from that of their peers. That child simply exists at the end of a behavioral spectrum, and “sex-atypical” behavior is part of the natural variation exhibited both within and between the sexes. Personality and behavior do not define one’s sex.
There are approximately 40 million children in the United States between the ages of four and fourteen. The above distribution curves estimate that roughly four million of them have personality profiles that are “sex atypical”, but still part of the natural distribution of personalities within each sex. Our culture-at-large is incorrectly telling them that they may have been born in the wrong body. The propagation of this biological falsehood, in addition to other newly identified factors, is likely contributing to the growing number of transgender identifying high school students (now estimated to be 2%), and the rapid rise in adolescents presenting to gender clinics.[k]
There would be less confusion if the distributions wholly overlapped. It would be the norm that males and females display completely overlapping personality traits.
The broad, but normal distribution of personality traits also explains studies showing a 28% concordance of a transgender identity in twins.[l] Twins have identical chromosomes, and likely have similar sex-related behaviors as well as environmental influences on their behavior. Using twin adolescent males as an example: if their behaviors are at the “feminine” end of the male-typical distribution, they could both become confused as to what their behaviors and preferences mean about their sex. Whether they develop gender dysphoria as a consequence of that is another issue. If gender dysphoria does develop, 85% of the time it will resolve with uninterrupted puberty.[m]
What is being called “gender identity” is likely an individual’s perception of how their own sex-related and environmentally influenced personality compares to same and opposite sexed people. Put another way, it’s a self-assessment of one’s stereotypical degree of “masculinity” or “femininity,” and it’s wrongly being conflated with biological sex. This conflation stems from a cultural failure to understand the broad distribution of personalities and preferences within sexes and the overlap between sexes.
When a girl reports that she “feels like a boy” or “is a boy”, that sentiment may reflect her perception of how her personality and preferences compare to the rest of her peers. Also, if she has concrete thinking characteristic of an autism spectrum condition, she may not be “sex-atypical” in her behavior but could be falsely perceiving herself to be. These scenarios don’t apply to all cases of gender dysphoria, as many other triggers are described.[n] Counseling can help gender dysphoric adolescents resolve any trauma or thought processes that have caused them to desire an opposite sexed body.[o][p][q]
To summarize, there is a lack of understanding when it comes to the distribution of sex-related personality and behavioral differences. This lack of understanding has led to confusion. That confusion impacts children who fall at the extreme tail-ends of the distribution, who are statistically more likely to grow up to be gay, lesbian, or bisexual adults if allowed to experience uninterrupted puberty.n Additionally, telling a child that he or she was born in the wrong body pathologizes “gender non-conforming” behavior and makes gender dysphoria less likely to resolve.a
In conclusion, no child is born in the wrong body. Adults should expand their understanding of what normal male and female behavior and preferences look like. They should understand that being male and being female both come with a wide range of personalities, preferences, and possibilities.
[*]The first version of this essay used distribution curves showing an 85% overlap of personality traits between males and females. This comparison was based on earlier studies that have been criticized for having design limitations (looking at one trait at a time, not correcting for measurement error) that underestimate sex-related personality differences (link). More recent studies show the overlap to be more in the 30% range. While the degree of overlap is an area of ongoing debate and study, the consequences for the gender non-conforming individuals at the tail ends of the overlapping distributions remain the same. For further reading about sex-related differences and ways to measure them, see the following exchange between experts in the field: (link) (link) (link).
Helena is a 21-year-old woman who identified first as nonbinary, and later as a transgender man, from 2013 through 2018. In 2016, she began medical transition by taking testosterone, and detransitioned two years later. During her teen years, Helena was an avid member of several Tumblr “communities”: trans/gender identity, eating disorders, and self-harm.
This piece is the second in a series of articles that analyze aspects of Tumblr Helena has observed as detrimental to the massive numbers of youth who call the site their virtual home. The focus of this article is the self-harm and pro-anorexia Tumblr worlds. Part 1 is here.
Helena can be found on Twitter @lacroicsz and is a member of the Pique Resilience Project, a group of four detransitioned/desisted women creating multimedia content about their experiences.
In Part 1, I described a few elements of Tumblr’s design that compromise the perception and communication of its users. Now we will take a look at some of the ways Tumblr’s unique atmosphere has given life to dangerous subcultures that have engulfed the lives of countless young people, mostly girls, in the last decade.
Introverted, angst-ridden, struggling adolescents across the globe are now faced with the risk of becoming inundated with content from self-harm blogs, pro-anorexia blogs, social-justice blogs that encourage self-diagnosis of mental illness, the use of mental illness as social currency, and gender identity ideology that is even more logically flawed and emotionally driven than in the mainstream. In this piece, I will discuss the self-harm community, and the pro eating-disorder community, both of which I have had personal experience belonging to. The community surrounding gender identity and dysphoria, the one with which I am most familiar, will be discussed in depth in Part 3.
Self-Harm Tumblr
The community of bloggers that filmed and shared photos, gifs, and written glorifications of self-harm behavior, often called “self-harm Tumblr” or “self-harm blogs,” was nearly eradicated when Tumblr prohibited the practice in 2012, but the long-term impact of such a dark and abnormal presence on the character of the site–and the teenagers who use(d) it–are still very evident. During their heyday, these blogs permeated Tumblr with graphic, slow motion, black-and-white gifs of razors slicing through flesh or dramatic quotes about suicide that were available simply by typing “self-harm” or “suicide” into the search bar.
Here’s how it worked: Imagine you’re a sad teenage girl circa 2012. Maybe you hate your body, or you’re conflicted about your sexuality, or you don’t fit in with your peers, or your home life is disordered. You’ve started using Tumblr a lot; you love that you can search anything you’re thinking of in the moment and instantly be gratified with awesome fan art of your favorite characters or updates on your favorite TV shows. But on this day, it’s not your teen idol or some BBC show that’s on your mind. Instead, it’s painful thoughts of self-hatred or even suicide. Maybe it’s the crushing feeling that your parents don’t love you. Maybe they’re too busy fighting to reassure you they probably do. Whatever it is, it’s not good, and like with everything else, you don’t have many places to turn to with this kind of thing. Your parents won’t understand, you don’t want to bother your best friend with your complaining for the umpteenth time that day, and listening to emo songs isn’t hittin’ like usual. So you do what you always do when you’re lonely and stimulated: you go on Tumblr. You type “depression” in the search bar, and a thousand posts like this come up:
Feels good. Feels validating. All that energy vibrating in your chest is matched by the black-and-white moving picture on the screen in front of you. You scroll down, and what do you know, there’s more. An infinite supply, always updating, because thousands of people just like you are posting more and more of these depression-aesthetic memes every day.
Now let’s say that at some point you do begin to self harm. Maybe you saw it in a music video, or your best friend started doing it, or you even saw it in a Tumblr gif, but through whatever means, the thought of venting your feelings into your own skin with a razor blade finds its way into your head. Or maybe you want to self harm, the desire is burning within you, but you’re scared. Not to worry, go back to Tumblr and type in “self harm” or “cutting.” You’ll get another infinite supply of addictive, dopamine machine guns. But this time, they’re bloody. A lot of them are matched with captions that strike you as relatable. The gore is mesmerizing, you can’t look away. There’s something about watching blood pour or ooze (whether from your own self harm or from one of these gifs) that feels analgesic. Before you know it, you’ve been lying there in your bed for hours, body limp except for your thumb stroking your smartphone’s screen as you scroll through these countless images.
If you’ve never self harmed before, this might make you wanna try. Click here to view some examples of Tumblr self-harm posts, but be warned–they are graphic. These images, and the act of self harm, will make you feel better for a moment by flooding your body with endorphins as it resonates with and then tries to cope with the stinging pain, but the second another stressor, another hopeless thought comes your way, you have to go back again. It’s a deal with the devil, but there’s a reason so many kids have been seduced into shaking his hand.
No one is born with the desire to slice their flesh every time they feel upset, and previously, self-harming behavior was seen only in the most severe psychiatric cases. Ordinary teenage girls were not cutting themselves to the point of hospitalization a few generations ago, and the statistics reflect that. According to a study released in 2017 which evaluated ER visits for nonfatal injuries amongst adolescents from 2001 to 2015, rates of ER visits among youth “showed no statistically significant trend until 2008, increasing 5.7% annually thereafter and reaching 303.7 per 100 000 population in 2015. Age-adjusted trends for males overall and across age groups remained stable throughout 2001-2015. Overall age-adjusted rates for females demonstrated no statistically significant trend before 2009, yet increased 8.4% yearly from 2009 to 2015. After 2009, rates among females aged 10 to 14 years increased 18.8% per year—from 109.8 per 100, 000 in 2009 to 317.7 in 2015. Rates among females aged 15 to 19 years showed a 7.2% increase on average per year during 2008-2015.” (Mercado et. al.)
Note the statistic that the rates of female self-injury hospitalizations were stagnant until 2008, when they suddenly began increasing. Keep in mind that correlation does not equal causation, and cultural phenomena seldom have one clear explanation, but the fact that Tumblr was launched in 2007, and really picked up speed in 2008, should not go ignored in this discussion.
These self-harm blogs were not simply the online diaries of depressed teenagers, but a thriving community in which mental illness became identity. The images, and the captions that accompany them, often reinforced depressive ruminations, such as: No one cares about the self harmer, the self harmer will be depressed forever, and suicide and self harm are justifiable ways of coping with negative emotions. It is this way of thinking, this immersion in depressive thought, and the resentment and alienation that results from suffocating yourself in this maladaptive coping mechanism on a constant basis, that paved the way for later subgroups surrounding mental illness.
Pro-Anorexia Tumblr
“Pro-Ana” culture existed years before Tumblr, with the first pro-Ana websites emerging in the 1990s, when the already existing real-life pro-Ana movement moved online. The issue was brought to public attention in 2001 when Oprah Winfrey discussed it on her television show, and the world was shocked to learn that not only was anorexia a prevalent threat to young girls, but that many of these girls seemed overjoyed to be suffering from it.
Since the pro-Ana movement has been so widespread for so long, there’s actually quite a bit of literature and research on the topic of social contagion and eating-disorder “symptom pooling,” that is, when sufferers of the same mental illness band together and form an echo chamber that exacerbates the symptoms of the illness. This article from the Social Issues Research Centre gives a good introduction to the inner workings of popular pro-ED websites, and much more information is available online. Pro-Ana culture is known for its users’ belief that they are not sick, but simply being themselves and making a lifestyle choice to be more “disciplined” than people who do not choose to be anorexic. The name “Ana,” as opposed to using the terms “anorexia” or “eating disorder,” personifies the illness almost as a goddess to be worshipped.
Pro-Ana ideology is one contradiction after the next, with users glorifying the illness, how it has empowered them, how in-control and serene they feel when they starve, how much better their life is since finding their pro-Ana friends, and how they “trigger” each other to victory–yet, in the next breath, advising that “if you don’t have an ED, turn away now. You don’t want to be like me.” It is a highly addictive formula of community, purpose, coping mechanisms, and a simultaneous god and victim complex.
While all of this is pretty standard for pro-Ana communities, the Tumblr pro-Ana community is unique. It doesn’t (and never did) have the same degree of vitriol, and has always been heavier on victimization. While some pro-Ana communities see themselves as a quasi-political class who have the right to starve themselves because that’s what they believe is right for them, the Tumblr pro-Ana community treats anorexia more like the mental illness it is. This doesn’t come close to solving the problem, though, since Tumblr has some twisted attitudes towards mental illness in the first place. Whereas other pro-Ana communities focus on the sheer act of starvation as fulfillment through self-mastery, the Tumblr pro-Ana community sets its sights on the end goals of the perpetual diet. Many of them view it less as a lifestyle choice for the rest of their lives, but more as a necessary evil to achieve a standard of living that is tolerable to them. They focus on what they will be able to do when they are thin, how they will look, and how much better life will be. Then, they can stop starving (or so they believe)– almost as if their anorexia is a transition to a different existence, a new body, a new life (the parallels with the trans/gender dysphoric Tumblr communities are quite obvious here).
There is a heartbreaking air of hopefulness in the anorexic community on Tumblr. They are not pro-Ana because they chose it to feel superior, they are pro-Ana because they feel they must be. They cannot survive another day seeing their reflections, and the fat they see on their bodies (even when there is none left) is more than aesthetically displeasing to them: it contains the very cause of all of their suffering. Every moment of pain since birth has been because they are too fat, they eat too much, they’re too out of control–as if losing a dangerous amount of weight would resolve the mental patterns that drove them to take such self-destructive measures in the first place.
Tumblr pro-Ana is a much more hopeful, naive pro-Ana culture than others online. It was born of the original culture in the 1990s, but influenced by the unique attitude Tumblr has developed towards self-harming behavior and mental illness. Users will repeat again and again, “no one chooses to be anorexic…” “if I could stop being this way I would…” and to a certain extent, this is true. No one can “snap out” of an eating disorder, but the Tumblr culture goes beyond acknowledging the difficulty of recovery. Anorexia is viewed not as a lifestyle choice, like in other pro-Ana communities, but as an inescapable battle bestowed upon these girls that they must fight, else they will never be happy. They were born to be redeemable failures, out-of-control gluttons, and every miserable moment traces back to the pounds that could be lost. Their only hope at survival is to beat their bodies into submission to rid themselves of the visible, tangible, evidence of their curse: fat. This is how anorexia ceases to be defined as a mental illness, ceases to be defined as a “lifestyle”, and begins its definition as an identity. It transcends the material and becomes spiritual. Some people are just born to suffer like this, and they have to learn to love it.
To an outsider, it seems convoluted. Unbelievable, even. It is so far removed from sanity that it is difficult for me to explain in a way that will convey even a fraction of the many ideological layers that have developed within Tumblr’s pro-Ana community. But to them, at least to the extent they are able to convince themselves, it’s not that crazy. It makes sense: you’re a fat ugly failure and you have to do something about it! Extreme normalization of this truly dangerous behavior has always existed in pro-Ana circles, where anorexics even go so far as to see their path as superior to a non-anorexic existence. On other pro-Ana sites, this looks like intense competition, purposefully “triggering” others by being heartlessly demeaning and catty, and exchanging tips on how to hide the severity of their illness from parents, friends, and doctors (including within inpatient psychiatric facilities).
On Tumblr, the approach is similar but less aggressive. “Meanspo” (meaning something to the tune of “mean thinspo,” a type of post in which the writer purposefully writes triggering, mean, messages but warns the reader beforehand) is distinguished from other posts, because as opposed to other communities’ competitive, vicious nature, the Tumblr pro-Ana community is soft and friendly. They understand themselves as a large congregation of friends, helpless in the face of the symptoms they share, and the only way to help each other is to be very sweet and lose as much weight as possible, to stave off the demons.
And if you’re not in the mood to be called a fat pig, don’t worry, there’s “sweetspo”: thinspo that is kind and loving, something these girls might not usually experience. Or if they do, they don’t feel worthy of accepting this love from anybody but Ana. But don’t get it twisted, Ana is only nice in the context of getting you back on track to lose weight. No “you don’t deserve to do this to yourself,” no “you don’t have to torture your body to avoid suffering.” There is no option presented by the pro-Ana community that does not fit within the confines of the ideology; rather, comforting sentiments are used to strengthen the sense of emotional isolation and dependency members of the community feel.
Something that has always been intriguing about the pro-Ana movement is its propensity for viewing itself almost as a minority group of sorts. On the original forum platforms for pro-Ana discussion, this manifested in members believing anorexia is a “lifestyle”, and that their choices deserve to be respected. A “good Ana doesn’t die”, and doctors or loved ones who attempt to intervene are violating the autonomy of the anorexic. With this came a militancy designed to keep girls in line and constantly living and spreading the lifestyle, because an easygoing, accepting atmosphere would not achieve results. This is why the pro-Ana social contagion reached the levels it did in the 1990s and early 2000s; it was a fierce battleground where the narrative proclaimed that only the strong survive, and the strongest will place first. But really it was the resulting group belligerence that emerged from this narrative, rather than the any truth to the narrative itself, that carried so many young women and girls through years of self destruction.
Other ideological groups on Tumblr are also popularly associated with a similar militancy, but the core dysfunctions of these groups, including the Tumblr pro-Ana community, are unique in the way they create psychological dependence. Other pro-Ana communities would create this dependence by fostering a competitive atmosphere in which it would be unacceptable to fall behind. Members were expected to display their starting weight, current weight, progress, and goal weights on every post and comment in the form of a signature. There would be daily threads requesting Anas to post their food intake diaries, and it would be an absolute disgrace to answer that you had Granny Smith apple slices, chicken breast, and 2.5 tootsie rolls when other girls only drank cucumber icewater all day. If you couldn’t run with the Alphas, the whole pack left you behind, it was that simple. In contrast, emotional dependency is created on Tumblr more through curating the pro-Ana community as a (conditionally!) loving and accepting oasis where everyone can feel “included” as an Ana, even if they aren’t underweight and even binge sometimes! Isn’t that nice?
Like pathological groups elsewhere on Tumblr, everyone is valid and included. You don’t need to lose any weight to be anorexic, it’s the thought that counts.
Now, don’t get me wrong, you can have a pretty severe eating disorder and not be stick-thin and struggle to lose weight as quickly as you would like, but it wouldn’t clinically be anorexia. Combinations of symptoms from anorexia, bulimia, avoidant/restrictive food intake disorder, and binge eating disorder are considered an Eating Disorder Not Otherwise Specified (or, EDNOS), and the concept used to be reasonably acceptable on other pro-Ana sites. Being hardcore anorexic (avoidant of food) or, to a lesser extent, bulimic (compensating for food not avoided by purging) was preferable (as long as it showed results), but the attitude that everyone must be included or else they won’t feel like they have a real eating disorder fundamentally contradicts the competitive nature of the ideology. On the non-Tumblr pro-Ana sites, girls who were overweight were encouraged to take up the lifestyle, but they were essentially second-class citizens compared to the veterans who had managed to maintain a low or underweight BMI, and they would not be considered sufficiently anorexic until they had proven their disorder. On Tumblr, young girls have managed to reconstruct mental disorder into a family just as complex, passionate, and loving as any real one can hope to be.
As of this writing, the self-harm and pro-ED cultures online have been forced to withstand quite a bit of censorship. Tumblr blogs that post gory content are deleted, and pro-Ana content is monitored, though to a lesser extent; explicit pro-Ana content can still be found. To evade Tumbler censorship, users employ special tags to find each other, like #not pro just using tags, or #anarexya. The culture has morphed to encompass “thinspo” that is less about skeletal, sickly bodies and more about conventionally attractive, slim Instagram models, and lots of memes (see the tag #proedmemes). Memes and aesthetically pleasing photos of pretty women (and in some cases, trans men) motivate this new generation of eating-disordered females, without showing off the glaring red flags of past generations, where the disordered behavior was purposefully exaggerated, rather than hidden away for preservation. When explicit visual content is impermissible, the disordered females must rely more heavily on emotionally based community interaction to motivate themselves to engage in painful, unnatural behavior like starving or purging; in way, it makes these communities even more inviting. For more examples, see the below gallery of current pro-Ana content.
I hope everyone is now sufficiently disturbed by the goings-on in the online communities comprised of teenage girls, and the disorders they have manifested in our society. The risk of being devoured and digested by these poisonous digital chambers and their respective ideologies extends to your daughters, sisters, granddaughters, and cousins. They lie open in waiting for any unsuspecting, naive young girl whose emotional terrain is still unknown and unfamiliar. The similarities between the self-harm, eating-disorder, and gender-identity ideological communities cannot be overstated, and we would be fools to ignore the role of Tumblr.com in the shocking and drastic increases in adolescent female gender dysphoria that have presented over the last five or so years.
In Part 3, I hope to do some measure of justice to the labyrinthine ideological shenanigans of this virtual community. Something in our culture has created the perfect storm for the explosion of gender-identity ideology, and as a detective would prioritize searching a suspected criminal’s bedroom, Tumblr may as well be the first place we look for clues.
Lisa Marchiano is a writer and therapist in private practice.She has been in contact with hundreds of parents of trans-identifying young people.You can find her on Twitter @LisaMarchiano. Lisa creates monthly audio content on Patreon for parents of gender-questioning youth.
by Lisa Marchiano
Say you’re a mom.
Maybe you’re also a lawyer. Or a doctor or nurse. A biochemical engineering professor at a research university. Or maybe you’re just a mom. You never wanted kids, or you always knew you wanted them, but when they got here, your life was turned upside down. They became the thing that mattered above all else. You had a baby girl. You chose her name carefully. Maybe something traditional, with a family connection. Maybe something unusual, to communicate how special you knew she would be. You adored her.
You nursed her on demand, carefully attending to her cues. For two years running, you didn’t sleep eight hours straight. She was colicky, or she wasn’t. Maybe she had inexplicable crying jags after you nursed. No one believed you that anything was wrong. Your pediatrician was dismissive, but somehow you knew. So you researched it. You read articles and asked questions of other moms. And you watched her. You paid close attention to what happened whenever she nursed, the way she pulled off the breast and arched her back and wailed. It turned out that she was allergic to the dairy in your breast milk. There was a test that proved it. So you gave up dairy, and things got better. For the next two years, you ate no milk, no yogurt, no ice cream. You made your own baby food. You bought only organic.
Maybe she had serious medical issues right from the beginning. Maybe she was a preemie, or had a rare disease. Or maybe it all went smoothly. She spoke her first words. She walked. You delighted in her smiles, talked to her, sang to her. You were diligent and attentive, reading research about infant-parent attachment. You wore her in a sling. You co-slept with her. Or you didn’t and she slept in a crib.
As she grew, you learned the intricacies of each cry. You struggled to understand what she needed, and to do your best to provide it. You knew she had a fever before the thermometer registered it. When she vomited for eight hours, you wondered if you should take her to the emergency room. Your husband said you were overreacting but something didn’t feel right. You insisted on taking her. She was admitted for dehydration.
You bought educational toys. You read to her extensively because you knew the research about language development and how important parental interaction is. When it came time to send her to pre-school, you chose carefully. You read the reviews, talked to other moms.
You didn’t care about your daughter being girly. You didn’t paint the nursery pink. You never pierced her ears or put a headband on her when she was a baby so everyone would know she was a girl. You were proud she liked dinosaurs. You made sure she knew that girls could do anything and be anything they wanted.
Maybe your husband was a great dad. She adored him and he adored her. Or maybe he wasn’t in the picture. There had been a divorce. Maybe he was angry, or even violent. Maybe he was just passive. Whatever the case, your top priority was your daughter. You wanted her to have a good relationship with her dad.
By the time she was five, you knew she was a little different from other kids. She was more intense. She would read chapter books at lightning speed. Teachers loved her. They always gushed about how bright she was. Or, they disliked her. She could be difficult, moody. Maybe she had tantrums, or had difficulty reading social cues. She could be disruptive, with her passionate feelings about things.
You taught her to eat well. You wanted her to be healthy, and to take good care of her body. If she was a little heavy, you gently encouraged her to be more active without shaming her or drawing attention to her weight. You knew the dangers of eating disorders. You bought organic meat, or at least the kind raised without hormones. You limited refined carbohydrates and processed sugar. Sodas were not allowed in your house. You were careful about what she put into her body.
She obsessed over bugs. Or ballet. She was tall and lithe – a dancer’s body. She went on pointe a year early. Or she was always heavy. Kids teased her. She was happiest playing at the creek with the boys next door. She was a talented singer. When music played, she saw colors. Or she played ice hockey. You watched her grow and were proud. She was the most important thing.
She was a girly girl who always wanted to wear dresses and loved the “gown” she got to wear at her cousin’s wedding. Or she was a tomboy who wouldn’t wear a dress even at her kindergarten graduation. You didn’t mind at all. You admired her fierce, independent spirit.
When she seemed to struggle with reading in the third grade, you sensed something wasn’t quite right. You did hours of research on the internet. Why was your bright child struggling? Teachers said you were being ridiculous to suspect anything. They implied you were one of those moms. She was just lazy and needed to apply herself. Had you considered putting her on medication for ADHD? She’d always been a classroom management challenge. But you knew. You believed in yourself – that you knew your daughter better than anyone. You weren’t going to shame her or give her unnecessary drugs. You found the top specialists. You got the learning disability diagnosed. You paid thousands of dollars for specialized tutoring to remediate the difficulty, and the struggles ceased. You were relieved and proud of yourself that you listened to your gut.
Then puberty hit. She withdrew. You didn’t understand at first. She spent more time in her room. She was moody and distant. You listened outside her door. Was she okay in there? You knew she needed more independence. You gave her some space, but you were vigilant, watchful. You did what you could to know her friends. You talked to her teachers.
You gave her a smartphone for her 12th birthday. This was how kids communicated, how they stayed in touch. Not having one would make it difficult for her to have friends. She kept her computer in her room, and sometimes you discovered her on it in the middle of the night. You worried about how much time she was spending online, but this was what kids did. And she needed it – all of her homework was done online.
She went to public school. Or private school. A small, progressive school for the gifted. The teachers had face piercings and were called by their first names. Or maybe you homeschooled. You allowed her to follow her own lead, crafted a custom curriculum that reflected her unique gifts and challenges.
She became more withdrawn. She stopped talking to you. Maybe she gained weight. Or lost weight. Or started cutting. You saw the marks on her arm. You didn’t hesitate. You found a therapist. She had depression and anxiety. Maybe talking to someone would help.
Or maybe she just seemed insecure, more anxious. She had just started high school, and her friends were changing. The “alpha” in her friend group cut her hair off and came out as nonbinary. You saw that your daughter worried about not fitting in. Then three more friends came out as something, you found out later. One said she was a demi boy. Another announced she was pansexual. Another said she was really a boy. They all got the same haircut. They were fourteen.
She started spending time on DeviantArt when she was 11. She was always a talented artist. How great that she had a place online to share this interest. Or maybe she opened a Tumblr account. Or Instagram. Her other friends were on there too, and it seemed like such a female-friendly space. Maybe she watched a lot of YouTube videos. She liked ones about cooking and funny reaction videos. All of these platforms were somewhat unfamiliar to you and they seemed harmless enough.
Your daughter comes out to you.
Maybe she said she was gay. Maybe you weren’t surprised. You have kind of always known. You tell her you are glad she told you, and that you love and accept her no matter what.
But a few weeks or months later, she told you she got it wrong. She wasn’t actually a lesbian. She was pansexual. She was gender fluid. She was trans. She told you this one night while you were fighting over her slipping grades. This was the reason, she explained. She’d been depressed because she couldn’t be her authentic self.
You found out that the idea first occurred to her after a school assembly on transgender issues. Or after her guitar teacher came out as trans. Or after spending hours and hours online watching YouTube transition videos. She’d been going to the GSA meetings at school. You were relieved to know she was receiving support while coming to terms with her sexuality, but then you found out that all of the kids in the GSA identified as trans.
Or maybe she wrote you a letter. The style was unlike hers. You suspected she may have copied it from the internet. The letter announced her new male name and asked that you use male pronouns. It mentioned that she wanted to start testosterone right away.
You told her you love her, that her happiness mattered, that you didn’t want her to suffer. Then you started researching. Because that is what you do. It’s what you’ve always done. You paid careful attention to her. You’ve known her as well as one human being can know another. But you also researched.
You looked up the effects of testosterone on female-bodied people and learned that long-term risks are unknown, but that a hysterectomy is indicated after five years on “T” because of the increased risk of cancer. You discovered that there is a growing community of detransitioners who felt that they weren’t helped by transition. You read reports of other parents who also had smart, quirky teen daughters who suddenly decided they were a boy. Their stories were remarkably similar to yours. Some researchers spoke of social contagion.
You learned that there were few therapists who would help your child explore these questions in an open-ended way. You heard stories about children being greenlighted for hormones and even surgery after one, two, or three visits to a gender clinic.
Meanwhile, you could see that she was suffering from anxiety. Or an eating disorder. Maybe she was diagnosed a while ago with ADHD. Or autism spectrum disorder. It’s a complicated picture. The doctors at the gender clinic told you there was only one problem with only one answer, but you knew it wasn’t that simple.
Your child came out at school. She went to the principal and asked that her name and pronouns be changed, and the principal complied without consulting you. It was a small school, maybe 100 kids, but there were at least fifteen who identified as trans. Your daughter’s teachers were eager to support her. Her English teacher chose her essay to be read aloud at the school-wide literary salon. The essay was about being transgender.
You couldn’t speak about this to anyone. Your extended family reacted to her coming out post on Facebook with “likes” and encouragement. When you tried to talk to your cousin about your concerns, she said you were being old-fashioned, that things were different now and you just needed to support “him.” When you called a meeting with the guidance counselor and the principal, they were condescending. It was clear they thought you were a bigot.
You were living in a progressive neighborhood that featured Hillary lawn signs in the fall of 2016. There was a small independent bookstore and a food coop. At your Unitarian church, fellow parishioners who’ve known your daughter since she was a baby came up to you and squealed their congratulations. They were so excited your son had found his authentic self!
You couldn’t say what you were really thinking. You couldn’t let them know that this wasn’t your child’s authentic self, that your child was in fact doing this to fit in, to claim an identity. You couldn’t say this because no one would understand. They would think you were one of those parents, the ones who couldn’t accept their trans child. Your loneliness and isolation were crushing.
You had to bear this alone. If you were lucky, your husband saw things the same way you did. You and he were a team. If you were unlucky, he accused you of overreacting, of being hysterical. Maybe he even undermined you. Maybe your marriage ended.
You weren’t close with your daughter anymore. You knew that it was normal for teens to have conflict with parents, but this felt like something more. You walked on eggshells. She seemed unhappy and irritable all the time. Identifying as trans was supposed to be the answer, but she only became more depressed, more difficult to reach. She blamed you for not being supportive. She called you transphobic. If you really cared about her, you would help her transition, she said.
The activists characterized you as an anti-trans hater who didn’t care about her son. But you know your child. You’ve known her since she came out all tiny and perfect. You’ve been there every step of the way, encouraging her, striving to understand her unique challenges. You know that her belief that she was trans came about only after friends declared their trans identity, after hours of watching trans YouTubers. You know your child.
You tried to walk a line of supporting her as a person without supporting her belief that she was a boy, but family and teachers affirmed her, so your efforts to help her keep an open mind were undermined. She became deeply invested in the belief that she was trans. You found out that she had a transition pact with on online friend. They were planning on moving into together when they were 18 and starting “T.” You knew this wasn’t an idle threat, because your daughter would be able to access “T” as soon as she turned 18 without any therapy or assessment at an informed consent clinic.
So you wait. You wait for the mainstream media to start covering the story, so that people realize what is going on and you can speak about this without sounding crazy. You wait for the lawsuits to come, for reports to surface of the rising tide of detransitioners. You wait for therapists and doctors to realize that we are living through another mental health contagion such as we saw with multiple personality disorder in the 90s.
Say you’re a mom. A good mom. A mom who is fighting for her daughter.
Gender Health Query (GHQ) is a new organization started by Justine Kreher (@thehomoarchy on Twitter). Its focus will be research and political action from the perspective of gay, lesbian, bisexual, and trans-identified people who question the current LGBT zeitgeist around youth medical transition. GHQ is also on Twitter @genderhq.See the last section of this article for how to join and/or support this important new effort. Your support can be as simple as signing this statement.
Justine Kreher is a 50-year old bisexual woman who is happily married to the woman she has been with for the last 21 years. She believes, from personal experience, that one’s feelings about gender and sexuality can change drastically from the tweens to young adulthood. This reflects her own experience as someone who didn’t understand her own same-sex attraction until age 22, as well as the experiences of people in the LGBT population she has been around for years. Her personal philosophy is influenced by stoicism, Taoism, Enlightenment values, and most importantly, skepticism.
This 4thWaveNow interview with Justine was conducted via email.
Justine, why did you form Gender Health Query?
I started researching the subject of increasing numbers of children and teens being socially and medically transitioned for gender dysphoria, under the now popular affirmative model, about four years ago. I had noticed that gay men and lesbians were beginning to express worries and even outrage about this. Their worries were not surprising to me and shouldn’t be to anyone who has spent time among LGBT people. Gender dysphoria has always been a part of the gay and lesbian community and has existed without medical transition, even though medical transition has been an option for a few decades now.
Justine’s wife Tara in her girlhood (on left)
To take a very personal example, my spouse was very masculine-identified as a child, including using male nicknames, and having exclusive “male-typical” interests. As for myself, I was a tomboy. I don’t claim that I would have been diagnosed with DSM-5 gender dysphoria, but I had some gender dysphoria as a small child and again as a tween. At the time, it felt very depressing I wasn’t born a boy, but I grew out of what was really a female inferiority complex and now have no desire to be male. Understandably, some older lesbians/gay men are actually horrified by what is happening now because they feel that this would have risked their own journey to self-acceptance without being permanently medically altered.
GHQ will be a medical and censorship watchdog organization focused around the increase in minors being socially and medically transitioned for gender dysphoria. It’s also intended to be a platform for the increasing numbers of LGB, and even trans people, who feel there are serious risks involved with this. This is happening under the now popular affirmative model that states a child’s/teen’s expressed gender should simply be supported, and any attempt to help the youth avoid or delay hormones and surgery is considered unethical. This is also happening in the context of postmodern ideologies about gender being widely promoted in many areas of society. GHQ also critiques this relatively new gender ideology in the way it affects how LGBT youth–and society at large–view identity, sexual boundaries, and trans versus female rights.
Most of the existing research on gender dysphoric youth, as well as gender clinician observations, has found that children with even serious gender dysphoria may outgrow it and are more likely to grow up to be gay or lesbian. And now more stories are accumulating (partly thanks to 4thwavenow) about lesbian, as well as increasing numbers of bisexual and heterosexual youth, who are desisting from trans-identification. Some are also detransitioning after being medically altered.
There is an activist mantra that gender identity and sexual orientation are two different things. This is repeated by affirmative model MDs and PhDs. However, if you look at this closely, the line between gender-nonconforming same-sex-attracted people and trans in minors is blurry.
What is your opinion of the affirmative model, which validates trans-identification in children and teenagers, and defines encouraging coping skills and waiting as “conversion therapy”?
At this point people can’t deny there are going to be young people who will be medicalized unnecessarily with the rise of what I call the “child/teen medical transition movement.” This begins as young as nine or ten years old with hormone blockers or even cross-sex hormones. This also includes unnecessary sterilization, loss of sexual function, castration, and double mastectomies. It’s already happening and there is historical precedence for harm arising to young people even in environments with less lax gatekeeping than what we are currently seeing in the United States.
I initially thought that people’s worries were likely overblown. I assumed there would be a lot of concern and caretaking by the mental health and medical professions to ensure a proper screening process. I was wrong. In fact, I now believe this isn’t a priority among many of these professionals or even organizations like the APA or AAP. This may sound like hyperbole, but it is my opinion, as someone who has read most of the relevant research, attended gender conferences, listened to hours of presentations, and read all the articles by affirmative model advocates. In my view, it has simply already been decided that false positives are morally acceptable collateral damage when it comes to trans-positive social support and access to medical treatments.
I actually support the right of people to make this argument and I point to positive data (de Vries 2014), (Olson, 2016) around the affirmative model on the GHQ website to try to be fair. Decisions involving collateral damage are made all the time in society. There are trans youth who self-harm and seek hormones on the black market if not treated by doctors. I don’t think it’s helpful to deny the seriousness of this by saying things like “there is no such thing as gender” or this is all just the result of “social constructs,” easily abolished by cultural changes. Affirmative model advocates sincerely believe they are doing more good than harm by promoting early social and medical transition. I believe the hormone-blocker protocol is child abuse regardless of what the youth’s adult identity will be. I view any unnecessary alterations providing hormones and surgeries to cognitively immature minors as child abuse.
Others believe standing by and not helping a distressed youth who may be sure they want to transition is child abuse.
This view is being reinforced by inducing suicide terror in parents and the public, by avoiding mentioning desistance altogether in articles about trans youth, and by removing links, (something done even by research universities), to information that reveals data that looks disturbing. And by extremist activist behavior that prevents people from questioning the affirmative model.This is why Gender Health Query is necessary. If LGB people want someone to be invested in caring about the negative impacts of this on immature LGB youth, they will have to take responsibility for caring themselves. There is already harm happening from the affirmative model. It’s only a matter of what the extent of it will be. And I believe there will be a concerted effort to ignore it, or even suppress it, in liberal media, by LGBT organizations, by universities, and by people in the mental health and medical professions in the United States. I expect increasing numbers of desisters and detransitioners to be treated horribly within the “queer community,” where gender and sexual fluidity are now esteemed, and you’d better not interfere with anybody’s easy access to hormones and surgery or else. They already are.
Our site also addresses risks to heterosexual youth (with more seeking transition now) who may be on the autism spectrum, have BDD or BPD, or be victims of trauma.
So, GHQ will mainly be tracking harm arising from the increase in minors transitioning and the ramifications to youth who are harmed. What about the young people who will medically transition, no matter what?
I can’t object to people arguing that good things are coming of the affirmative model or that making a young person wait to transition may be very distressing to them. I try to make data-based arguments and there is data to support these positions.
But “false positives” (for lack a better word) are an inevitability of the affirmative model or “child/teen medical transition movement.” Transition is starting in childhood now, at age nine or ten, not even the tweens. Studies on regret rates are generally of poor quality, with many lost to follow-ups, and mental health issues persists. While reported regret rates are very low in research on adult cohorts who transitioned under a gatekeeping model, they still are not zero. But adult regretters are adults with agency.
Young people cannot truly consent to the serious consequences of these actions until around age twenty-five. This means that affirmative model advocates, LGBT organizations, and now society as a whole, are making a conscious decision to perpetrate a major human rights violation on at least some children and teens, by drastically subverting their maturation process. This could be considered an atrocity if a youth has been sterilized and/or has their sexuality permanently destroyed. It’s just as bad as what has been done to intersex babies and those who’ve undergone surgical genital mutilation. The level of harm to over-medicalized minors could possibly dwarf what was done to intersex babies via surgical “correction,” in terms of sheer numbers, as thousands of children are being put on hormone blockers (and other medical interventions) in the western world.
As more and more people who transitioned as minors start to express regrets under this new approach, as things are going, society will put the responsibility for that on the child or teenager (now an adult), as the affirmative model necessitates a “let the child lead” narrative. This creates another ethos: It absolves adults of moral responsibility. We are seeing affirmative-model advocates make statements to the public that detransition is “no big deal” or just part of their “gender journey.” In my opinion, this is being done to acclimate the public to this coming new reality of sterilized youth, with destroyed sexual function and pointless double mastectomies; to make it morally acceptable. Detransition is not a harmless ordeal based on the multiple accounts I have read from people who transitioned as minors or young adults.
Justine (left) with wife Tara.
There is also a risk this protocol may be used to “correct” effeminate pre-gay boys and masculine pre-lesbian girls in homophobic countries like Iran, China, and Russia, once the child medical transition movement is fully normalized in the West. Dismissing this worry as paranoia is very naive. Much worse has been done to LGB people. Iran already prefers transgenderism and forces homosexuals to transition. And accusations of homophobic parents fueling a child’s transition have already been made in relatively gay-friendly England.
Affirmative model advocates should be upfront about all this, in my opinion, rather than make lengthy red herring arguments about how methodology has inflated desistance statistics. It’s possible that they may have been inflated. But these arguments do nothing to prove the numbers are so small they are irrelevant.
Johanna Olson-Kennedy has argued that regretters shouldn’t stop all youth from transitioning. If a confused, likely same-sex attracted young person, who transitioned as a teen has regrets, she can “just go and get” fake breast implants later.
But our grief over watching detransitioned, medicalized young people, who haven’t even reached full-cognitive development, matters. We are no less justified than the trans activists whose angry protests against Dr. Ken Zucker caused USPATH to cancel his lectures. Those of us who are concerned should not apologize and anyone who tries to intimidate us out of it is acting oppressively. We aren’t trying to shut anyone else down. But until affirmative model advocates prove early social transitions and early medical treatments only rarely prevent desistance, this is as much a homosexual/bisexual human rights issue as it is a trans rights issue.
If they are going to argue that perpetrating a human rights violation (sterilizing and creating other permanent changes) on other vulnerable minorities (as children and teens) such as LGB youth, autistic youth, and traumatized girls,they are morally obligated to justify these acts with much better data than they have now, because in all other cases, these medical interventions would be considered highly unethical.
GHQ will demand data that justifies this and a right to know what the costs are specifically. “Apples. oranges, and fruit salad,” Diane Ehrensaft’s diagnostic explanation, is not acceptable proof in my opinion. Control groups are considered unethical but there are probably back-end ways to determine social influence. For example, a researcher could study a population of trans-identified children and teens in a country where giving youth hormone blockers isn’t occurring. Or how about recruiting some of the desisters (and perhaps their parents) who have begun to speak up on social media and personal websites? But at the same time, I reject the idea that any type of control group not employing enthusiastic transition is unethical, which affirmative model advocates argue. Parents could lovingly raise their dysphoric children to view themselves as an outlier “third gender” type of male or female, rather than lying to them that they are literally biologically the opposite sex. There are already parents who treat transition as something that will be safer if done when older. Children have no understanding of the ramifications of transition at that age, and there are ethical questions around promoting harsh medical treatments as a panacea to their struggles.
There currently appears to be a culture of apathy throughout the affirmative-model mental health and medical professions about the impact of their approach on grey-area nonconforming children and teens. This is despite the fact that there is a lot of information that demonstrates gender dysphoria is influenced by the environment and culture. These influences include homophobic bullying, family stability, trauma, and what appears to be social contagion. Environment and culture now are extremely pro-medical transition.
This apathy permeates much of liberal society, media, and all other LGBT organizations, despite the fact the data to support all of this is minimal. In fact, I would say there is open hostility towards LGB youth and other teens with issues who may be harmed. There is an explosion of trans-identified females. Many are promoting the idea this is due to positive increasing acceptance. They are refusing to acknowledge some of it looks very disturbing and similar to other body dysmorphia contagions. Brown pulling down the link to Lisa Littman’s ROGD study is just one example.
The abuse the journalist Jesse Singal has received, enabled by actual liberal media outlets, is another example. His articles are perfectly reasonable and well-balanced, and there is much evidence on the GHQ site to support the validity of the issues raised in them. There are leftists who are criticizing all of this (I am center-left). But many liberals appear hostile towards the concept of caring about youth who may be hurt because they are used to “hurt the trans community,” something Johanna Olson-Kennedy said at a 2017 Gender Odyssey conference I attended. It’s why I believe my argument that affirmative-model advocates view LGB youth simply as morally acceptable collateral damage to trans-positive healthcare is a very fair opinion to have of them.
You have mentioned that the site will also critique postmodern influenced gender ideology, a subset of “queer theory.” So, the site is more than just a medical watchdog site?
I originally wanted it to be a dispassionate analysis of desistance statistics but realized all of this is happening in a larger cultural context of society beginning to believe biological sex is irrelevant; even to the point that school teachers and scientists are repeating these ideas.
The GHQ site actually includes data that supports biological explanations as to why trans people, as well as gays and lesbians, have some characteristics that align with cross-sex controls. So, in this regard a “gender spectrum” argument is not totally unreasonable (but only for a very small percent of the population).
Unfortunately, the current way this ideology is playing out in this time and place is actually doing some harm. And I believe this harm is tragic and totally unnecessary, but currently very real. LGBT people have been completely turned against each other over it. Women have been turned against each other over it. And people on the left have been turned against each other over it. I believe support for the “LGBT community” is going down significantly because of it, as recent polls show a decline.
LGBT youth culture has become very obsessed with pronouns, labels, body dysmorphia, and identities to the point of being unhealthy. There are many people who agree with me, particularly GenX LGBT people, like myself, who believe current “queer youth” culture seems angrier, more sexually confused, and more gender confused than ever. Some young people cannot tolerate people deviating from their views on gender even slightly. They have difficulty functioning without the validation of the outside world, which is now increasingly bowing to demands for pronoun verifications before all social interactions. Research by people like Jonathan Haidt points to harms coming to young people from identity-politics-obsessed environments. Yet affirmative-model advocates, and I mean psychologists and doctors here, actually are encouraging these problems.
Also on the GHQ site, there is anecdotal evidence that queer/gender identity politics doesn’t promote positive mental health. There are some studies that show people with non-binary identities have poorer mental health than binary trans as well. There isn’t even really proof all of these non-binary-identified youth, mostly females, really have gender dysphoria and not some other mental health issue or body dysmorphia.
And disturbingly, some people are acting as if others owe them emotional and sexual access to validate their gender identity. LGBT organizations and mental health professionals, in some ways, enable this by uncritically pushing the idea that your sex is merely what you declare it to be and that multiple genders are real. I would expect these people to be more critical and assess possible externalities or even negative impacts on these individuals. And I would expect them to prepare young people for the real world of genital-preference-centered sexuality, and to teach them respect for others’ sexual orientations, which these professionals increasingly don’t respect themselves.
I cannot stress enough the harm this has done within the LGBT community and particularly between lesbians and trans people. I don’t think large numbers of lesbians, who previously embraced the rainbow, will ever trust any concept of an “LGBT movement” ever again. Starting in 2015, I tried to warn lesbians in LGBT media how destructive this would be. And I am a latecomer compared to other women who were smart enough to anticipate these problems years before I even knew they existed. I disparaged some of them and now have to apologize and give them credit.
Your organization is trans inclusive. Why did you choose to make it an LGBT organization, since trans people are front and center everywhere else?
At this point all LGBT people need to have some stand-alone organizations. The issues are all actually different in many ways. Gay men need HIV prevention outreach programs. Bisexual women(and LGBT organizations expend almost no energy on bisexuals), have higher abuse rates than gay men or lesbians. Sometimes specific groups have a better understanding of their particular issues and more motivation to address them. Trans activism may be hurting aspects of the homosexual rights movement that has nothing to do with surgeries on minors or pushing girls out of winning sports positions. Lesbians definitely need their own activism as that tiny population is getting overtaken by trans and “queer” activism that values gender and sexual fluidity.
But I have tried to raise concerns about the overmedicalization of gender nonconforming young people and some of the negative fall-out from gender ideology with hundreds of LGB people in academia, in LGBT orgs, and in LGBT media. And I have watched other gay men, lesbians, and bisexuals attack, and viciously at times, other LGB people for raising perfectly reasonable concerns. I’m not going to blame everyone in the trans community for the toxic discourse around this whole issue any more than I am going to excuse some lesbians who I have seen abandon their own youth in ways I think are really appalling and profound.
Trans people are not a monolith and GHQ is ideologically-based, not identity-based. Youth medical skeptics, postmodern gender ideology skeptics, and other acknowledgers of biological sex are welcome. The current extremism in trans activism may have unintended consequences for trans people too. Some trans people don’t believe that early transition, without emphasizing patience and coping skills, is ultimately the healthiest outcome for all youth who will go on to transition. You can find serious consequences to that here. People may be feeding into an obsession addressed with quick fixes and “passing” at the expense of desistance, proper brain development, fertility, bone health, and cardiovascular health. Many trans people have children or say they want them or never even get bottom surgery. The ethical questions of medically transitioning youth who will have a trans-identification no matter what are just as relevant as the effects of all of this on desisters.
Certain trans people–some dub them as “truscum”–are not supportive of concepts of multiple genders and resent being lumped in with people who don’t medically transition. They receive a lot of abuse and get censored by the most powerful social media companies in the world like Twitter and Facebook. They are reasonable people and we all share in common some harm from this. I hope that we can all find a way forward.
There is so much censorship around these issues on the left. Some people opposing aspects of gender activism are turning to right-wing venues and right-wing activists. Do you plan to do that?
From what I have seen, I don’t blame people who feel so desperate that they are aligning with the right-wing around fall-out from gender activism. Sometimes dialogue can actually increase tolerance if people avoid existing in these increasingly cult-like ideological states. So I don’t condemn that.
But I make it clear on the website that this is a place that supports inclusion of LGBT people in family and public life. I’m not interested in enabling people who want to enforce bible or conservative ideology-based gender or sexuality norms on people. In fact, they are part of the problem at times, in my opinion. I sometimes tell them that when I engage with them superficially. I reserve the right to be quoted or write something for a conservative newspaper, since there is a liberal media blackout on these issues. But I don’t want GHQ to ever coordinate activism with the right-wing in any official capacity. I’m too concerned it endorses some of their motivations that I oppose. And beyond that, alliances with the Right upsets people I care about and want to be a part of the discussions around the safety of all of this.
There is 4thwavenow and Transgender Trend and other child/teen transition skeptic orgs. How is GHQ different?
Information from these sites have been instrumental in increasing my understanding of some of the downsides to what is happening with more young people transitioning. I think the GHQ site spends more time highlighting pro-transition arguments for context than some other youth medicalization skeptics sites and discourse. In addition, it is specifically geared towards the LGBT perspective on the issues. That said, although I spent a lot of time launching GHQ, I consider my efforts a community project as my knowledge, analysis, and viewpoints have been helped immensely by the whole community of LGBT people, parents, desisters, detransitioners, therapists, social scientists, and doctors who are discussing this and how safe it is.
The GHQ site is also organized systematically for easy access to multiple areas of interest. There are 17 topics with multiple subtopics. So if parents, or journalists, or LGB people, or whoever, wants to access information such as medical consequences, gender clinician quotes, science article quotes, and the references that go with them, they can read things based on subject matter listed in a long outline you can find here. The information in these sections is pretty extensive and should contain most of the important information that has come out over the last few years. As more news comes out, it will be tagged at the end of each of these topics. That way people can access information accumulated from a few years of data collection, as well as any new information that comes out, and this will be updated regularly.
For example, this blog post on a recent Swedish documentary that features transition regret was tagged to the GHQ “regret” topic, as well as the topic of increasing numbers of female teens coming out as trans. Opinions will also occasionally be featured if they can be supported by evidence, real-world observations, or personal experience.
Comments won’t be open on blog posts. It’s a better use of our time as activists, at least for GHQ, to spend energy in raising awareness among LGBT organizations and media, than moderating comments for trolling, brigading, or hateful comments. We are on Facebook and Twitter so plenty of commentary will happen there. But anyone can contact us with comments, questions, or blog post ideas anytime. In fact, I would like to encourage that now.
Can you summarize your activist agenda?
This is a huge issue with so many unintended consequences that need to be addressed. Initial main goals will be as follows:
1) To be a database of extensive information, including peer-reviewed research and real-world observations, to support rationally defensible reasons for concern, coming from the perspective of LGBT people. The site will also cover the increasing numbers of heterosexual youth who are dysphoric. And to show LGBT support for educators, mental health professionals, and doctors, who are frankly terrified for their jobs to express any skepticism about the affirmative model.
2) To spread this information, particularly to LGBT organizations, mental health entities, and educators. There is a real lack of awareness that first and foremost needs to be addressed through outreach and face to face interactions whenever possible. This will be done via mail campaigns, press releases, requests that these entities meet with concerned individuals, communications via organized speaking panels, and if the current refusal to address harms here continues, organizing protests.
3) To try to create dialogue with other LGBT organizations, such as the Trevor Project, about downsides to youth medical transitions, and the harmful effects of blurring the lines between sex and gender that all of these organizations participate in. They need to reiterate respect for sexual boundaries with young people, who are increasingly feeling entitled to sexual access to others (as well as being targeted themselves, sometimes by older people).
4) To create an activist push, as many trans activists have done to achieve their goals, to remind the mental health and medical professions that the onus is on them to prove they are not harming grey-area, dysphoric youth. And to address the damage when they do harm. The first priority should be to find ways to collect data that prove early social transition and use of hormone blockers don’t increase persistence. If it does, as some gender clinicians fear, the affirmative model has a side effect, unfortunately, of also being an unintentional gay and lesbian eugenics movement. In teens, the picture is more complicated. There is little evidence these entities in the United States will care that much unless they are made to care through activist pressure (our area) and ultimately lawsuits (not our area).
5) LGBT organizations such as GLSEN and entities such as the LGBT centered Division 44 of the APA need to include people who handle and study detransition. There will be more detransitioners. These entities enthusiastically encourage youth transition. We are going to demand they help when it goes wrong.
How can people join your organization? Are you looking for other LGBT people to help you in your efforts?
There is a statement on the site for people to sign if they agree with our mission. This isn’t a petition and will be ongoing. It helps demonstrate support for raising these issues from people who are not generally against basic LGBT social inclusion and rights. The statement can be found here. There will be a mass email statement sent out to many LGBT organizations, medical organizations, mental health organizations, and media soon. So, adding your name will be helpful.
Please contact us if you have a blog post idea you would like to contribute if the information can be supported by science research, an informed opinion, real-world observations, or personal experiences.
Also, please contact us if you would like to get more directly involved in public outreach, research, or anything else that is relevant or have any ideas to contribute.
I can travel to speaking events and can present this issue with arguments that can be morally and rationally justified. The same can be said for appearing on a podcast or YouTube channel. There is a plethora of issues not delved into in this interview that are very interesting and currently relevant. I can discuss this issue from most angles; the medical consequences, issues regarding affirmative model health professionals, desistance statistics, gender activist extremism, and the conflicts around identity politics within the LGBT community.
Carol F. is a 39-year old woman (adult human female) from a conservative area in California. She was raised in a religious environment. From ages 35 to 38, she identified as a transgender male and lived her life being perceived as such. The disconnect between her lived experience as female and how she was treated while being seen as male caused her to begin to question the trans narrative. A few months ago, Carol began to detransition, after being on testosterone for almost 4 years and undergoing a bilateral mastectomy.
Carol has spent her time since starting detransition being vocal about how the push for transition harms women and girls, particularly those who do not perform femininity in the “traditional” way. In this essay, she talks about her own transition-detransition process, as well as the often negative impact of the transgender movement on the lesbian community, spouses, and family members.
My decision to detransition began when I started taking antidepressants for depression and anxiety. A month into treatment I felt like my whole world had come alive. I could feel true joy for the first time in years and I could take pleasure in everyday things. I had struggled with being very angry and agitated and often had enraged outbursts over nothing, but it had begun to be less overwhelming and I found I could manage and control my emotions.
I suddenly–and with some horror–realized that I had never needed to transition. My life didn’t feel overwhelming anymore. I could feel my emotions more clearly and sort through what had seemed before to be a complete disaster of thoughts and feelings. I started to question my motives, my perceptions, and my feelings, not only around transition but around all the life decisions I had made. I began asking myself what it would be like to live as a woman again, but I had gone so far with transitioning. How could I admit just a month into taking anti-depressants that I was wrong, how could I turn back? No, I told myself, it couldn’t have been that simple.
We are told that being transgender is this deep-rooted thing, that it is part of our being, our core. It’s who we are, it’s our truth or truest self. I believed this when I started transition, how could this have been so flawed? How could my feelings have been so wrong? I kept these thoughts and feelings to myself and decided I would just continue living as a man, that it was too late to change this. I made my bed now I will lie in it.
I continued living my life as I had. I graduated college that spring and began working in the mental health field. I got a job working at a youth psychiatric hospital. This is when the second realization happened that made me question further being trans and trans ideology. At this hospital I saw so many young gender nonconforming girls come in claiming they were trans men. They wanted to go by male pronouns and male names. They were 13 years old, they were 15, they were 17. They all looked like little butch lesbians to me, and I felt a pang of shame and sadness. I saw myself in them. I saw their pain and fear and the abuse some had experienced. I saw the mental health issues they struggled with and how these issues left them longing for escape. They harmed themselves, they tried to end their lives, and they hurt. I wanted to reach out to them; I wanted to tell them it’s ok to be a lesbian woman. I wanted to show them a strong functioning butch woman. But how could I, when all they could see when they looked at me was a bearded man? How could I tell them what I couldn’t tell myself?
It was at this facility that I also began to work closely with men, something I had never really done before in my life. I had steered clear of being close to men in any way, although I had not realized I had done this; it was all unconscious at the time. Being considered “one of the guys” and having to play that role as much as I could left me with a deep sadness and longing for connection with women again. I knew I didn’t fit in. I hadn’t had a boyhood or been socialized as a male. I had had abuse and discrimination thrown at me just for being born a female, something they could never understand. Socialization makes up much of who we are, dictating the kind of path we are set on at birth. It has expectations and demands; it molds us and forms us in ways we are rarely aware of until you cross over to the other side in a kind of covert way. I often felt like an interloper in the male world–an alien observing private behavior and culture rarely seen by the outside world. This experience of being an intruder or imposter in the male world more than anything informed me that, yes, I was in fact a woman. There was no changing that. In a strange way this experience let me see how much of a woman I am. I had always labored under the impression that I was more male than female because of my mannerisms, likes, and way of dress. However, being on the other side with men solidified the truth that I was female and a woman through and through. My mannerisms, the way I dressed, and all the rest were just window dressing. It didn’t make me woman or a man, it was just me.
Then there were the London lesbians. There was the protest at London Pride where a handful of radical feminist lesbians stepped in front of thousands and made their voices heard. I had been following a well-known transman on social media and he had posted a story from Pink News. The headline went something like “transphobic lesbians storm the parade” or some kind of nonsense like that. I read the story but was a little annoyed because it didn’t say what they were protesting. Just that they were transphobic. I posted on social media asking others why the women had been protesting and what their message was. The response I got was basically “who knows, they are just transphobic and being hateful.” Well, I thought, maybe so but it’s always better to know the full story before making a decision to write people off. I began my internet search, and wouldn’t you know it, that led me to radical feminism. And that was the hammer that broke my illusion right open. The next several months was me and radical feminism and I heard the phrase I wish I had heard years ago, “The only thing that makes you a woman is that you are female.” A simple, to the point, and really quite obvious observation. How could I have thought otherwise? I agreed with it, but had still not taken the final step to detransition. But the push to do so began to be ever-present and its whispers grew louder every day.
My stubbornness is both a hindrance to me and my great strength. Sometimes it takes getting to the tender and protected parts of me to push me into a kind of submission, letting go of the thing I have been gripping so tightly for so long. It was the lesbian stand-up comic Hannah Gadsby who broke that grip. I saw her Netflix special, Nannette, and it hit parts of me I didn’t know were there. Her raw anger slapped me right in the face and told me something I hadn’t wanted to ever admit: Being a butch lesbian woman was fucking hard, it could be sad, it could be vicious, and it could break a woman.
When you walk through the world as a living example of everything that the world tells you is ugly and disgusting it can break you. And it had broken me. I knew, as I sat there in my room sobbing, that I had some real truths to face about myself. About my motivations for transition and the deep pain I carried with me. My internalized homophobia was something I always denied but it was damn strong and I had used it as another tool to hurt myself with. But the time had come to stop hurting myself, I knew this.
I contacted my doctor the next day and told her I wanting to quit my testosterone shots. It’s now been 4 ½ months since I last injected testosterone. I feel good and healthy. I’m on the mend and it’s wonderful.
The factors
ADHD is a very misunderstood disorder by most people. It affects almost every aspect of your life. I was not diagnosed with ADHD until I was 36, but after receiving the diagnosis it made a lot of the way my brain works finally make sense to me. I now see that ADHD played a large role in my fixation and desire to transition. People with ADHD often get hyper-focused on a particular thing. That thing becomes an obsession and we think about it nonstop for days, months, or even years. I got it in my head at 22 that I was trans and there it stayed for 15 years until medical transition had become almost completely unregulated. When I was 34, I found myself in a very mentally vulnerable place. Often when people with ADHD become mentally overwhelmed, we go back to a fixation we might have had or one we have kept with us but maybe have ignored for a while. We go to these fixations for comfort and organization, to feel better and safe again. I went back to my ideas about being a trans man and transitioning.
Looking back now, I think this was probably one of the most devastating times in my life. I had recently become a parent, which although a happy life change, is also a very stressful one. Around the same time, I lost my grandmother (who was more of a mother to me). I cut ties with my mother because I could not in good conscience allow her around my child and for this my brother and sister refused to have anything to do with me. I lost my good friend and brother-in-law to suicide. My wife literally lost her mind with grief and I felt like I was drowning. I became very depressed and wanted out of my life. I isolated myself, watching transition videos nonstop for months. I wanted to kill myself but knew what a shit move that would be to my family, so I latched onto transition as a way to feel at peace again. ADHD also affects one’s ability to reason though things thoroughly. Even though we may think about a subject nonstop we are not actually doing any kind of real analysis. It’s more like a movie that just keeps playing our favorite scene. The scene I played was one in which I was a strong man who lived a happy life.
When you are told from the age of 8 that the way you walk, talk, and act is like a boy by your mother, your schoolmates and other adults, it’s so easy to buy into the idea that you really are a man and that makes you completely normal after all.
I was raised in a very religious household where we were taught that women were put on this earth to serve men. I was not allowed to cut my hair or wear anything but long dresses, as my body was deemed immodest by default. My father had died when I was 2 in an accident and my mother had remarried into this religious atmosphere. My stepfather and mother abused me extensively from the age of 4 to 9. I learned to cope with the abuse by detaching myself from my body. I took back my power by never allowing my abusers to make me cry, I withstood the pain upon my body by disassociating. I believe this early abuse and dissociation from my body gave rise to the feelings that my body was wrong, not my own, and some kind of foreign entity—the same things people describe when talking about gender dysphoria. The sense of “wrongness” that one feels with their body.
When I was 9 my stepfather and mother divorced. I had a little more freedom to be myself and I began to express my likes and dislikes, as is normal for children to do. I wanted to play football, I liked boys’ clothing and style and I loved the idea of having short hair. My mother, although not as religiously fervent as she had been with my stepfather, was still a staunch fire-and-brimstone Christian, and very homophobic. She would become angry at me for wanting these “boy” things and punish me if I behaved “like a boy.” She ridiculed the way I walked and my mannerisms, telling me that I needed to walk and act like a girl. I had one bright spot in my childhood, and that was my paternal grandparents. They allowed me to wear boys’ clothes when I stayed with them and do my hair any way I wanted. Of course, I had to be very careful that my mother never found out, and we all knew it.
My mother’s behavior introduced an internal hate inside myself as a gender non-conforming girl. This would later be compounded by the homophobia I faced when I came out as a lesbian. I had never given the trauma I had to go though as a young lesbian the kind of gravity it deserves. When I was 17 my mother was growing very worried because I was showing no interest in boys or men. She decided to set me up on a blind date with one of her friends’ 22-year-old son. I was sheltered and ignorant and scared of my mother, so I went out with him. She had never met the guy and had not actually seen her friend in years; they only occasionally talked on the phone. I knew within the first 5 minutes of being in the car with him that he was very dangerous and unpredictable. I could feel with everything that I was that he was fully capable of killing me. I knew I couldn’t set him off, he would use any excuse to become angry. I spent the next 30 minutes of the car ride being as polite and submissive as possible, all the while strategizing on how I could get out of this. When we got to a town I lied and told him my mother wanted me to call her and let her know we arrived and I faked exasperation with my mother’s request. I went to a payphone and called my mother. I told her I wasn’t feeling well and was coming home. I then told him that she had told me I needed to return home because her employer had called her into work due to an emergency and I had to watch my sister and brother. He was displeased, and I made every effort to ensure him of how upset I was that our night had been ruined and assured him that we would go out next week. The drive home was the longest drive I’ve ever taken. I made it home safe and for the first time ever I yelled at my mother for her stupidity in putting me in a dangerous situation. This showed me how expendable I was as a woman if I could not adhere to the roles expected of me. I was better off dead than a dyke.
When I finally did come out as a lesbian at 19 years old, I was put through hell by most of the people most important to me in my life at the time. I lost friends, I was told I was never allowed at family gatherings because I was sick and would cause harm to the little kids. I was ridiculed and called every nasty name in the book. I was propositioned by men who were sure they could make me straight if I allowed them to have sex with me. I was told I was too pretty to be a lesbian, I was trying to be a man, I had been turned by a child molesting dyke, and the list goes on. I faced harassment in public life, mostly by men who would yell out “dyke” to me as I walked down the street or became confrontational with me if I looked at their girlfriend or god forbid smiled and said hi. I was not even safe at my job. There were men who would make jokes about raping a woman who got out of line, men who called me “spike” and “sir” to my face and refused to work with me. Men who talked openly about beating up fags or killing their sons if they were gay. It was enough to make anyone want to escape. I just wanted to live my life, I wanted to be unnoticed, but I couldn’t be. I hated this, I hated myself, and I felt like I must be the most disgusting creature in the world—that I must be wrong.
Trans explains why I’m wrong
The first time I heard the word transgender applied to women was in 2002 when I was 22 years old. It seemed as if overnight the young lesbian community had started to embrace this trans idea. Most of the butch lesbians I knew refused the label “butch” and instead said they were trans men. My wife and I were friends with several lesbian couples at the time and every butch woman in that couple now claimed to be trans. The first time I was corrected by a young butch named Lacy, she said “Oh I’m not butch, I’m really a trans man.” I had no idea what she was talking about so I asked. As I remember, she gave the simple answer, she was a man trapped in a female body. I was disgusted by this and repulsed even, but it never left my mind. I then began to ponder what it meant to be a trans man. A man who had a female body seemed to tick a lot of boxes for me. After all, I was always told I behaved like a boy. I walked like one, I acted like one, I was attracted to women. I liked men’s clothes and short hair. It started to make sense. It explained everything that was wrong with me. All the ridicule, all the abuse I had suffered through wasn’t my fault, or even the fault of the people who did it. What I suspected must be true, these people saw something in me that was wrong and broken. I latched onto the trans label very quickly and began telling friends and family that I was trans and that I wanted to transition.
However, this was 2002 and standards of care were still relatively strict compared to today. I had to see a gender specialist, live as my desired sex for at least six months, and undergo at least 6 months of therapy before being allowed to receive cross-sex hormones. I managed to find a gender specialist in my hometown and began working with her. She demanded that if I wanted hormones I needed to start living as a man, going by a male name and pronouns and being in male-only spaces. This was impossible for me. I had large breasts that could not be hidden and a curvy, obviously female body. I was also stricken with fear at the idea of going into male-only spaces. This seemed incredibly dangerous to me. I refused and decided to let go of transitioning. However, I always kept it in my mind as the explanation for why I was the way I was. I didn’t demand people recognize me as a trans man but I saw myself as such, and it brought me comfort that I was normal.
Transition wasn’t what I thought it would be
I made the decision to start medical transition in spring 2015 at the age of 35. Older than most transitioning woman to be sure, but not unheard of. Although many teens and younger women are transitioning, there is also a large population of adult women, mostly butch lesbians, who have also transitioned in the last 5 years or so. These mostly go unnoted because we are adults and already living on the outskirts of society. A simple look at a butch-lesbian dedicated subreddit or Facebook group will show many conversations about butches transitioning. The loss is very real and is leaving devastation in its wake in the lesbian community. I’m just one of the many. Only four months after I started testosterone injections, I had top surgery, or more precisely a double mastectomy. I hit the ground running with regards to transitioning. I couldn’t seem to do it quick enough.
Detransitioners know about the honeymoon period of transition. It lasts anywhere from 6 month to 3 years, depending on the person. Two years seems to be about average. Transitioning, although it ends up not helping in the long run, does help for a while. This is what makes it so hard to explain to those who are either still trans or those who have never been in this situation, because transition did help, for a while. I felt better when I started taking testosterone. I had more energy, I was less depressed, and my mood seemed more stable. I thought this meant I had made the right choice, and even my therapist and doctors saw this as proof that hormones were good for me.
I have done a little research into testosterone use in females, and although there isn’t much out there, what I have found seems to indicate that elevated mood and energy are some of the positive effects of testosterone use. Even males who use testosterone experience this. But what made me feel good was not some spiritual lining up of my brain with the right hormones (yes, a therapist did say this to me) but a simple side effect of a drug. No different than drinking alcohol or using any other substance to ease emotional pain. Another reason transition helped was that being seen as male enabled me to walk through the world like just another person. I didn’t draw attention and I got treated better than I ever had, by my co-workers and strangers alike. I have since heard of some trans-identified females who make the decision to continue living as men, not because they actually believe they are men but because they know it’s safer and easier for them than if they were to detransition and live as woman again. I honestly can’t blame them. It was wonderful to experience the freedom and safety of moving through the world being thought of as a man, if only for 3 years.
After about 2 years on testosterone I noticed that my anxiety had started to become much worse. I discussed this with doctors and psychiatrists, but they didn’t think the testosterone could cause this effect. As time went on my anxiety became worse, to the point where I was taking an anti-anxiety medication daily. It reached a breaking point when I could no longer leave my bedroom without having a panic attack. I couldn’t drive because that triggered a panic attack as well. I really couldn’t do anything but keep myself sedated on benzos and stay in bed. This is when I hit bottom. I went to a psychiatrist and got an antidepressant called Viibryd that is also used for panic disorders. Starting antidepressants is both mentally and physically hard. Those first 2 weeks on the medication were like hell. My brain felt like it was ripping apart and I had panic attacks that were so bad that I really did want to die so I would not have to feel them anymore. But by week 4 the side effects dissipated, and I began to feel joy, a sense of peace, calm and clearer headed.
On top of the anxiety and depression, transitioning had ended up making my dysphoria worse. Why? Because now I was worried that men would discover I didn’t have a penis when I used the male bathroom. Because I was smaller than most males. Because my voice wasn’t as deep. Because my hands & feet were smaller. Because my body shape was more feminine then male. Because the way I talked and gestured was seen as feminine. Because my chest had scars across it. Because I was soft spoken and not aggressive. Because I was raised as a girl and was never part of the boy’s club, so I didn’t know how to interact in male culture. Because every day, I stepped outside my house and was consumed with not being found out for what and who I really was: a woman. It seemed like I had switched one set of problems for another.
There were also the health side effects I was experiencing. My skin seemed to always have something wrong with it. The first year I had terrible acne, which is expected, but after that subsided, I always seemed to have some kind of rash or irritation that I hadn’t had before. My vagina was showing signs of atrophy and was painful all the time. To alleviate this, I would have needed to start taking a topical estrogen cream that you insert into your vagina. For someone with dysphoria around their genitalia, this is really the last thing you want to have to deal with. I was always aware of my female genitals because they hurt and were unhealthy. Again, not helpful if you have dysphoria around this area. I was also seeing my cholesterol climb every time I had a blood panel done, which was every six months. I knew it was a matter of time before I would need to be on medication for this. I was also starting to creep into the range of concern for diabetes. Additionally, I was quickly losing my hair and, in another year or two would likely be bald. All this happened in a span of 4 years on testosterone. I was completely healthy with thick beautiful hair before starting testosterone.
As of this writing, I have been a little over four months off testosterone. My cholesterol levels have dropped, risk for diabetes has gone down, and my hair is starting to fill in a little. The atrophy to my genitals and uterus has reversed and I am in good health. I feel happy and content. There are some things I will never get back, though. I had a double mastectomy only 4 months into transition, so my breasts are gone. I mourn this, I mourn that I will never get the chance to make peace with them like I have started doing with my sex and body. We all carry scars from life, and these are mine.
The family suffers too
I believe it’s very important to recognize the pain transition and trans ideology can cause to the family members of the trans-identified person. The families are the forgotten victims in all this, and this is unacceptable. The trans community takes little care in the impact transition has on not only the trans person themselves, but also their family. These are some common things I heard when I began my transition.
“You are the same person you have always been”
“You will be a better person/spouse/parent because now you will be living your true self”
“Your journey is important”
If the family is upset, sad, angry or generally just confused about the transition of their family member, here are the things said to the spouse/parents/child/family member.
“This isn’t about you, it’s their journey”
“You aren’t being supportive”
“You are being transphobic”
“They have always been this person, you just didn’t know”
This is so problematic because trans ideology is, at its core, extremely self-centered sometimes even in the narcissistic range. The trans person is encouraged to view the family’s emotional state as hateful or transphobic towards them if they experience normal human emotions of sadness, loss, confusion, or anger. Trans people are not encouraged by the community to see transition as the major life-changing event that it is. Instead, it’s downplayed and given the emotional weight of a new haircut or a change of clothes. The family members are expected to say nothing but positive things and show no “negative” emotions. They are shamed into silence. Mandated to keep their feelings to themselves lest they be labeled the most horrible thing one could be called in our society right now: transphobic.
When I began transition my wife who I had been with for 15 years was devastated, and rightfully so. In the beginning she believed as I did in most of what trans ideology had to say. She really did think I was trans and she was supportive. However, her life was also being turned upside down emotionally. She had lost her brother to suicide only a year earlier, she was a new mother, and now her wife was trying to become a man. She was scared, sad and feeling loss. She naively turned to the trans community for support during this time, trying to find other spouses of transitioning people to talk to. She thought these “support groups” would be a place for support. A place one could talk openly about the emotions they had as they went through transition with their family member. What she got instead was everyone saying how happy they were for their spouse and how exciting this all was. No negative emotions. When she started expressing her confusion, fear and anger over my transition it wasn’t long before she got the “TERF” word thrown at her. She had never heard the word before and after multiple people labeled her a TERF and eventually ran her out of the support group, she went online searching for “TERF” (as we all would if we didn’t know what something meant). She found gender critical and radical feminist information, chats and web sites. It was there she found support. I find it quite funny that it was the trans community itself that drove someone to turn into a “TERF”.
What I’m trying to show here is the very unhealthy & damaging effect trans ideology has not only on the trans-identified person but also their families. I really do believe this is cult-like, even religious behavior. It is divorced from reality, basing everything on a belief supported by feelings and very little science. It is faith-based and you must believe. It is all or nothing, good versus evil with no room for nuance or critical analysis. I’ve seen this before, as I wrote about in the beginning of this article, because I was raised in religious extremism. Trans ideology mimics this very closely. It can capture people on the fringes of society, people with mental health issues and people in pain from trauma. It promises relief from symptoms, an answer for which people are searching.
The community positions itself as the most oppressed demographic in society, while holding the people on the outside hostage with threats of suicide and blame for murders committed against the trans community. It showers acceptance and validation on its members as long as they adhere to trans dogma. The trans people who do not adhere to the ideology are called truscum, traitors or TERFs. People such as myself who detransition are told we no longer have a right to say anything about the trans experience because we are no longer trans or never were trans to begin with. Many of us are shunned from the community — like a dirty secret. This shunning of former members is a great deterrent to detransitioning for some. For those who do detransition, we usually slink away and are never heard from again. For those who do speak out we are labeled TERFs (a label that has come to mean nothing but a person who doesn’t completely agree with trans ideology), or ridiculed for not knowing we weren’t trans. We are told that we took valuable resources away from “real” trans people and that we should be quiet and go away.
I began as a true believer, I thought I had found my answers, I thought it all made sense. I had euphoric feelings of relief and happiness when I began transition. Four and a half years later, and I am rebuilding my life from the ashes. I burned myself and my family up into a million pieces and now we have to make sense out of the disaster. I am very lucky and grateful that I have a wonderful wife who has stuck with me more than she ever should have and a son who is immensely forgiving of his mother’s flaws. I find that every day is better than the last, if only by a half step. The resilience of the human spirit is amazing to me. Never give up.
