Shrinking to survive: A former trans man reports on life inside queer youth culture

Max Robinson is a 20-year-old lesbian who recently detransitioned after 4 years of hormone replacement therapy. She underwent a double mastectomy at age 17, performed by plastic surgeon Curtis Crane in San Francisco. Max reports that her gender therapist wrote letters verifying the immediate medical necessity of these treatments.

Max currently works to provide direct support to developmentally disabled adults living in group homes; she detransitioned on the job in December 2015. Her novel Laika, which tells the story of the little stray dog who was sent outside Earth’s atmosphere in a Soviet satellite, is available digitally or in print here. In addition, Max and her partner collaborate on many graphic art and creative writing projects.

 Max, like many young lesbians of her generation, was led down the path to FTM “transition” as a teen, effectively short circuiting her chance to fully integrate her orientation as a same-sex attracted female.  As detailed in her account, the difficulties many young trans men face in queer communities are not widely known; and the less-than- rosy experiences of FTM teens are certainly not discussed in the many mainstream media stories which unquestioningly celebrate testosterone and surgery as welcome treatments for dysphoric girls—many of whom are same-sex attracted.

Max’s story will also appear in an upcoming anthology to be published within the year.

In the meantime, Max is available to respond to your questions and discussion in the comments section below this post.

All of us at 4thWaveNow are very grateful to Max for her courage in writing this post.


by Max Robinson

When I was 5, I led a girl rebellion. We put on capes and chased some boys in capes around. Whatever they said we couldn’t do, we did. It was mostly push-ups or holding bugs. I could hold any bug. My dad still has a picture in his office of me at a science fair, hands full of hissing cockroaches.

I hated to be told there was something I couldn’t do. In first grade, I’d go home from school all in a huff because the girls’ bathroom pass had pictures of bows on it, while the boys’ had soccer balls. My teacher wouldn’t let me choose which pass I wanted. I played soccer!

When I was in third grade, I drafted letters to the author of a children’s book series. I was bothered by the constant underlying sexism in her books about a family rescuing animals. The mom and the daughter were always secondary, sweeping or cooking in the background, while the father and son saw all the action. What troubled me most of all was that these books were written by a woman. I didn’t understand why she couldn’t create a single interesting female character.

Around the same time, my mom finally let me buy a pair of boys’ shoes. They were red and black, and I didn’t have to tie them. I wore them all the time, so often that the plastic frame of them tore through the fabric. It cut into my feet, but I didn’t tell my parents. I thought I wouldn’t get another pair. They didn’t find out until they saw the back of my ankles, torn and bleeding. When I told them why I hadn’t said anything, they got me another pair. This is my first memory of hurting myself on purpose so that I would feel better about my appearance. Later, there was tweezing, high heels, waxing, shaving, running, and trying to starve myself. In all of those, at one time or another, I was encouraged, but they really weren’t for me. I wanted to choose to hurt myself in my own way.

When I was 16, I talked my older sister into ordering me a binder, and I wore it as often I could. It hurt like hell. I insisted it didn’t. The pain made it easier to think less, which was nice, especially at school. Class was boring and I couldn’t focus, so I would always spend the whole day winding myself up with some thought obsession or another to keep busy. I would ask the teacher for bathroom breaks, and then used them to cut myself, just because I was under-stimulated and unhappy.

After school, I read Autostraddle articles and dozens of pages into the archive of FTM blogs. I was glad to see some women who looked kind of like me, saying that they had futures now. I wanted what they had, and I hated what I had. I think I was 15 or just barely 16 when I started checking this stuff out.

The longer I thought about it, the more sure I was that it was true. At first, I thought I might be genderqueer. Then, I wanted to go on testosterone for a while, but keep my breasts. Next I was sure that I wanted them gone. I would confess these changing thoughts anxiously to other trans-identifying friends online. They would reassure me that this happened to a lot of people, and that the dominant transgender narrative was oppressive.  Then I began reassuring others of this, too. We all agreed that being trans was very special and difficult.  Before, I had never felt special or that my pain mattered.

Some part of me knew I was talking myself into it. I ignored that part.

For the first time, I had a community that paid attention to me, at least online. We talked about our feelings and we listened to each other. This was my first real experience with Internet culture. I loved having friends. It wasn’t like school, where I was irritable and weird, floating between tables at lunch. People actually liked me on Tumblr. Almost all my friends were female and trans-identifying.

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I didn’t know anything. It was just so comforting to think that I was born wrong. If my body was the problem, it could be solved. Transition had clearly defined steps. Everybody chose from a set list, and when it was over, they were properly assembled.

When I renounced my connection to womanhood and what I shared with my sisters, I sealed away important parts of myself. I thought I was turning away from the hurt that came from being seen as a woman by men, but it was too late for that. That hurt has been inside my bones for years. After transition, I kept quieter than ever before. Always afraid, always afraid. Brought back into line.

Transition was supposed to fix things. That’s what I believed and that’s what doctors told my parents. I was 16 when I started hormone blockers, then testosterone. I was 17 when I had a double mastectomy.

If I didn’t look like a dyke and act like a crazy teenage girl, there would have been nothing to fix.

To fund my surgery, I started a blog where I posted print-to-order clothing and gifts, pandering to the interests of the people I saw on there. It worked pretty well. I got a bunch of money, but not quite enough. My parents used some of theirs, and my grandma helped, too. After all, this was a medically validated condition. I had been to appointments with professional after professional, all of whom agreed this was the way to go.

But it turned out to be cold comfort, removing hated body parts. Breasts marked me as a woman dressed funny. I wasn’t afraid to be anesthetized or cut open. The day of my surgery, after the doctor drew the lines of the incisions on my skin in Sharpie, I asked him where the tissue would go. He told me it would be incinerated as medical waste. I cackled. When they led me back to the operating room, I was confused. I thought there would be a silver table that I had to lie down on. I told my doctor this. He told me it wasn’t an autopsy, and laughed.

My first post-op memories don’t start until a day or two later. The pain wasn’t bad, and emptying my drains reminded me of using a menstrual cup, just with a lot more yellow stuff. It felt better than trying to live as a man with breasts. I couldn’t lift my arms to wash my own hair for a couple weeks, but seeing a flat chest was a breath of fresh air. It felt like it made sense after I had been watching my old face disappear, cheeks narrowing, beard coming in, because of testosterone. I didn’t want to be seen as a woman–as a lesbian–and I didn’t want to ask why.

Or maybe I just didn’t know who to ask. I did try. Before I started medical transition, I asked my gender therapist, a trans man, about internalized misogyny. The question was dismissed. I didn’t even really know what internalized misogyny was, but  I wanted to understand. Instead, I was assured that it probably wasn’t that. I got a letter for hormone replacement therapy, and later, for the top surgery. I was grateful.

It took years of testosterone for me to finally realize it was okay to live in my own body without it, that making this peace with myself was possible, and that I deserved that chance. I didn’t know it was okay to be a dysphoric lesbian, that I could survive this way. I was almost 20 when I stopped hormones. I had been 20 for a little while when I stopped understanding myself as a trans man.

Things changed. My mind changed.

There’s a species of rotifer (microscopic zooplankton) called Bdelloidea. A male bdelloid has never been observed. They’re all female, reproducing exclusively through parthenogenesis for millions of years. How did they survive quickly evolving parasites and rapidly changing environments without the adaptability afforded by sexual reproduction? Bdelloids shrivel up under stress. In anhydrobiosis, they’re easily carried away by the wind. For up to nine years, they’ll stay alive like this–barely living, but alive. Shrinking yourself to survive is a legitimate strategy, and sometimes it works.

After I detransitioned, I started a new job where I was known as a butch lesbian. At first, people treated me worse than when I was “passing” as male. Nobody trained me. They tried not to look at me at all. They didn’t relax until I started talking, talking like I had in high school. I made jokes and people laughed. I told them about my childhood when they told me about theirs. I did more than listen, finally. People actually liked me here, the same people who looked at me funny when I first started the job.

It had been so long since I had said anything outside my home without worrying about whether I “sounded male.” I hadn’t realized how much I had been holding back since I decided to transition. I hadn’t made new friends, except online, in years. In a couple weeks at this job, I got rides home and wedding invitations. I thought I was incapable of connecting to anyone in person, but I was just incapable of connecting to anyone as a man — because I’m not a man. I can’t pretend to be one without hiding an essential part of my nature.

I thought “woman” was wrong for me, because of how I dressed, how I related to my body, how I resented the expectations society had for me as a woman. I didn’t realize that my horror at my body could be caused by the horror of living in a world that wants to control all women.

If “being a woman” really was nothing but an identity, if I had been raised in a world where it really did just mean calling myself a woman, I never would have transitioned.  I would never have attempted to surgically and hormonally erase my femaleness. My drive to be anything but a woman was rooted in the material reality of being a woman, a material reality that cannot be identified out of. Trying to live in a fantasy where everything women have suffered for being female is null and void, even as misogyny continues to shape our lives, was valuable only in that I finally learned how incredibly valuable it was to name myself as a woman.

There is power in naming. It’s how we find each other, how we connect to our histories, how we connect to our futures. Driving us apart from each other is the easiest way to keep us from learning to recognize attempts to redefine our realities.

I didn’t know this then. I subscribed to an incredibly misogynistic set of beliefs for years. “DFAB privilege” was a common phrase in our community – “designated female at birth privilege.” It was accepted fact that being born female gave you a lifelong advantage over a male who transitioned. This included men who used transition only to mean using different pronouns on Tumblr and having an anime girl as their avatar. We believed that, as “dfabs,” we needed to shut up about our petty problems. We could never have it as hard as any “dmab women or non-binary people.” Everyone in the trans community agreed that it was our responsibility to uplift “dmab voices.” None of this seemed outrageous or strange to me; it felt pretty intuitive. Growing up under male domination is a grooming process that leaves many girls and women extremely vulnerable to manipulation.

The first experience that did make me start to feel suspicious of male transition was when I was 18 and a genderqueer-identifying man who had never pursued any kind of transition raped my best friend, a woman unacquainted with insular trans community politics. I had indirectly introduced her to this guy via mutual friends. After the rape, she told me what he did; I had been in the next room the whole night, awake, talking to someone I didn’t even like. I had no idea it was happening. When she let our mutual friends know, we both assumed they would have her back; after all, they referred to their apartment as a safe space for rape survivors. But instead, her rapist changed his pronouns on Tumblr, claimed to have schizophrenia, and then said that he couldn’t possibly have raped her, because of the power dynamics between a “cis” woman and a transwoman. He moved back to LA a few months later, without ever taking any steps towards transition. When he got there, he told his old friends he wasn’t schizophrenic or trans anymore.

Years before that, two different transwomen I knew had pressured me into sending nude photos of my breasts to them. I messaged them first, as a 16 year old, after seeing them repeatedly posting about being horny and suicidal, and how only nudes would make them feel any better. They didn’t even know who I was. To one of them, I submitted the nudes anonymously. I didn’t want to talk, I just wanted him to feel better. I thought it was my responsibility. It might still be posted somewhere, I have no idea.  Both of the transwomen who sexted with me identified as lesbians at the time and knew I was a transman. They didn’t care, as long as we were talking one-on-one.

I didn’t fully see the value in differentiating male from female until a traumatized and disabled lesbian I knew well, K, finally admitted to me that her transwoman partner M was beating her regularly.

For three years, she lived with steadily escalating physical & sexual violence, the details of which were originally included in this article but have now been removed for privacy reasons. Suffice it to say – it was an intimate portrait of what radical feminists understand as male violence.

It’s been two years since she moved in with me, away from him, and she’s still recovering from what he did to her. She had two decades of trauma before that, but nothing ever broke her like this did. Calling that relationship “lesbianism” left her stranded from the framework she desperately needed in order to contextualize her experiences as a survivor of captivity. It destroyed her ability to call herself a lesbian or a woman for a long time: if lesbians like to sleep with transwomen and were repulsed by the supposed maleness of transmen, how could she be a lesbian herself? If women are what her ex-partner M was, then she, K, must be something else entirely. The language of transition lends itself readily to abusive gaslighting that disguises and distorts women’s ability to name what is happening. What was done to her was extreme cruelty of a distinctly male variety, cruelty she was especially vulnerable to because of her lifelong history of trauma at men’s hands.

The more I started to understand that M could not have been female, the more I understood why I was. One’s actual sex matters. Running from its significance prevents you from doing anything but continuing its cycles of destruction. As soon as a transwoman said, “No, I’M not a man,” we instantly lost our ability to protect ourselves from him. Women who never transitioned in these trans circles believed their “cis privilege” rendered them man-like in their power. For those of us females (mainly lesbians) who did seek transition, we were often told that, as transmen, we were exactly as bad as any other men.

Loading the language was an incredibly powerful tool. I was a lesbian trying to save my friend from domestic violence at the hands of a man she had partnered with out of intense desperation, facing immediate homelessness as a severely mentally ill woman with limited mobility. Understanding this could have connected us to our foremothers who struggled through similar battles to protect each other from abusive men. Instead, we felt completely adrift. Other women dealing with abuse perpetrated by transwomen have described a similar sense of being in entirely uncharted territory, terrified to speak first, unable to find anyone else sharing experiences; they’re all too scared of being labeled an untouchable “trans-misogynist.”

In the 21st century, intelligent and capable adult women are having to relearn what “man” means, with fear at their backs every step of the way. We were among them, exploring radical and lesbian feminist ideology online and marveling at how decades-old works precisely described circumstances we had thought of as occurring only recently. Janice Raymond’s discussion of transexually-constructed lesbian feminists in The Transsexual Empire was startlingly relevant. She saw this coming. As lesbians, we have a rich history of theory that had been completely denied to women who came of age when K and I did. All either of us knew about Janice Raymond, until last year, was that she was evil to the core; a horrible transphobe. We believed this because we didn’t know any better.

Deprogramming took almost a year. Both of us were terrified just to read dissenting opinions. K, me, and another lesbian exited from the radical queer scene began moderating an online support group for anyone dysphoric and born female, including many who still identified as trans. When that group started, I was still one of the transmen. All of us were so incredibly relieved not to be alone. We disagreed on a lot of stuff, but we were all tired of what we saw happening to females.

When our remaining friends from the transgender community found out that we considered transwomen capable of male violence, and that we were concerned about transition’s effect on young adults, almost all of them deserted us immediately. Female trans-identifying friends who knew K’s history of homelessness and our currently rocky financial situation started talking publicly to each other about how we literally deserved to starve to death.

Losing these friends hurt enough on its own. Being cut off from them just when we had begun to see the severity of the situation within these groups was so much worse. I have a list of 20 intercommunity predators, mainly transwomen who prey on females — women or transmen. Eleven of them are one or two degrees of separation from us. So many women in our community had themselves been pressured to share nude photos, coerced into unwanted sex, or outright violently assaulted by males describing themselves as transwomen, but they still didn’t feel able to challenge the narrative they were being fed. These women, our friends, had been there with us. They saw transwoman predator after transwoman predator being named by their terrified female victims. The “call-outs” (a word used for anything from hurting someone’s feelings slightly to brutal rape) usually only happened once several victims of the same predator found each other and made sure they had friends on their side. When victims couldn’t be sure they would be supported, they didn’t come forward. The political climate made it doubly difficult to “call out” a transwoman. We were constantly being reminded that transwomen are harmed by the horrible stereotype that they’re all rapists or perverts, and we were taught that we needed to be constantly policing ourselves to avoid perpetuating this idea.

The silent victims of transwomen had good reason to keep quiet. We all saw transwomen using the language of “cissexism” and “transmisogyny” against anyone who named their behavior as harmful. Even transwomen dating other transwomen experienced abuse at their hands. In the resulting fallout, it was never clear who the true aggressor was; both of them would immediately begin using identity politics and “privilege dynamics” (i.e., someone poor can never hurt someone rich, under any circumstances, etc.) in a way that was very effective at obfuscating the truth. Our friends had been right beside us for all of this, and they still damned us for beginning to name what had enabled this wide-scale intercommunity violence.

Young lesbians in the “queer community” are known by many names: if you want to avoid scrutiny for not hooking up with transwomen, you’ve got to get creative. Some of us call ourselves queer, bisexual, or pansexual, because there’s no word for only being attracted to females, and you can’t be a lesbian if you date transmen or avoid dating transwomen. A lot of us, having been told that we can opt out of womanhood by choice, decided that we never want to be called “she” again. Young women who cling to the word “lesbian” find themselves increasingly pressured to sleep with transwomen, because—according to trans dogma–they are supposedly more vulnerable and oppressed than any “cis” lesbian.

Many transwomen seem to view dating a “cisbian” as a uniquely valuable source of gender validation. After all, lesbians only date women. There is no acknowledgement that, under some circumstances, some lesbians can be coerced into relationships that they are incapable of experiencing as anything except traumatic. I have never seen a transwoman from these circles ever express the possibility that this might be true. By all appearances, they have never considered it. Running from unpleasant truths is something that a lot of folks who transition (me included) tend to get very good at.

The insistence that lesbianism is not a strictly female experience runs so deep that transwomen, even those who only date other transwomen, often refer to themselves as “transdykes.” This includes those who are not transitioning–men who can literally only be differentiated from any other man when you ask his preferred pronouns. Many women believe that these “transdykes,” even those who have never been identifiable as anything but straight men to the outside world in any way, are more oppressed than any “cis” woman, specifically on the axis of gender. The level of gaslighting taking place here is difficult to overstate.

From the outside, now, I can finally see how ridiculous it is. Realizing this took months and months. It took us a year of exploring the feminist theory that had been forbidden to us before me or K could even call any transwoman a man without having a panic attack.

At first, when I started learning more about opposing viewpoints, I identified as a “gender-critical transman.” I knew that the transgender cause had been used in a lot of disgusting ways, but I still believed transition was the only way I could survive, and I was trying to reconcile seeing myself as transgender with believing that the vast majority of trans activism was harmful to women. During this time, I really looked up to gender-critical transwomen–transitioning males who were usually at least marginally more sympathetic and thoughtful than most men. I tried to reconcile our respective identities and our needs, as we understood them, with the needs of women as a class.

I failed. At the end of the day, I just don’t want anyone male in the bathroom with me. I don’t want them on a women’s volleyball team. I don’t want them at Curves. I don’t want them in a lesbian book club. The experience of being male is fundamentally different from the experience of being female — even if a man passes, even if a man has surgery to more closely resemble his idea of a woman. I don’t say this out of a hatred for transwomen. I say this out of love and respect for women. What we are cannot be conceived nor replicated in a man’s imagination, and it absolutely cannot be formed out of male tissue on an operating table.

The sympathy I feel for men harmed by gender, to the extent that it means I encourage male-to-female transsexualism, is in direct competition with the sympathy I feel for women harmed by gender. Everyone is entitled to make their own choices about their bodies. Everyone is also entitled to have opinions about the choices that others make about their bodies. I feel that transition is a treatment with far-reaching harmful side effects — not only for the individual receiving treatment, but for those around them.

Lesbians who see their sisters disappearing are more likely to try to erase themselves. Lesbians who are forced to welcome men into their spaces will never be able to see or understand the value of female-only space, having never actually experienced it. Transition does not cure the irreconcilability of our selves with our environments. Gendered identity crises are very real to the individuals experiencing them, myself included, but this energetic drive towards change is not best spent reforming ourselves into someone who can assimilate into the world men have built. We need to use this energy to work towards restoring balance to a sick world.

Many young lesbians (and some older lesbians caught up in a youth-oriented trans/queer culture) hold political views diametrically opposed to our collective interests. We genuinely believe some off-the-wall garbage, like that it’s wrong and evil not to be attracted to penises because of “internalized cissexism.” We have been successfully brainwashed to serve males at the expense of our own health and sanity.

I have so much empathy for other women who believed transition was their best choice. I lived that. The fact is, loving a woman does not automatically mean agreeing with her. I believe that all of us deserve better. We deserve to experience autonomous female space. We deserve the opportunity to experience our bodies as a part of nature worthy of celebration, not objects to be “reconstructed.” The energy we spend trying to run from our own bodies is better spent working to support each other.

Those of us who make it out of communities like the ones I was in often only manage to do so because of strong female (in my experience, lesbian) support networks that help us relearn how to think for ourselves without getting angry when we make mistakes in the process. I hear political opponents of the transgender movement calling it extremely cult-like and in the same breath damning the women, usually lesbians, who fall into the trap. This reinforces the learned hatred of anyone who disagrees without creating any opportunity for victims of this ideology to ask questions and explore viewpoints that—while the victims have not yet extricated themselves–genuinely feel like some kind of blasphemy to them. The pace of progress needs to be determined by the individual. Frustration with the behavior of young people in the transgender community is very understandable, but even the most righteous anger is unlikely to change minds when it’s directed at someone who has been manipulated into believing that dissenting women are literally equivalent to murderers.

The beliefs they have internalized are harmful to all women. No one is obligated to subject herself to being triggered or re-traumatized by the virulent misogyny that trans activists tend to espouse, even in the name of reaching out to a sister in crisis. Taking care of yourself has to come first. I try to stay available for conversations with questioning trans-identifying females, but I can’t always be there. I need rest, too.

As I move away from viewing myself and my body as an object to improve, I’m realizing more and more how much of my energy has been devoted to appeasing men in some way. By and large, that was a waste of time. I’m working on using my emotional energy for the benefit of myself first, and then for the benefit of other women.

While I was transitioning, I was terrified of eventually regretting it. I sure as hell didn’t let on much about my doubts, for fear of losing access to medical treatment, but I was consumed all the time with obsessive thoughts about it. I didn’t understand how I could go on living as a woman with no breasts. What man would want to fuck me? Never mind that I didn’t want to be fucked by any man; that didn’t feel like a good enough answer.

I am so incredibly grateful that I learned that there was more to being a woman. Transition was absolutely not the easiest way to learn this, but it was how I learned it. It was how I learned that I could survive without men viewing me as a piece of meat. I never shaved my legs or armpits again. I stopped tittering at their stupid jokes. I dress practically. I’m grateful that I learned it was okay to exist as I am.

For me, transition was a processing of distancing my true self from my body and my environment. Detransition has been the opposite: learning to participate earnestly in the world again. For me, this isn’t about undoing my transition. I’m not seeking any further changes like electrolysis or breast reconstruction. I am a woman, even if my body is recognizable as the body of a woman who once thought transition was the best choice available to me. My body has known tragedies, but my body is not a tragedy. When I catch myself slipping into deeply misogynistic internal tirades about the aspects of my appearance that changed during transition, I practice thought replacement. I am not a waste of a woman.

I’m so grateful for all of the incredible women I’ve connected with who are on the other side of transgender identities now. Some of them are women I met years ago, when both of us were still pursuing transition. Transition doesn’t have to be forever. If transition makes you sick inside, you don’t have to live and die with that sickness. There is community. There is processing. There is genuine healing. More and more of us are waking up, each with her own story. We question and disagree, with our enemies and with each other. We learn. Together, we are moving forward.

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In praise of gatekeepers: An interview with a former teen client of TransActive Gender Center

Cari is a 22-year-old woman who previously identified as a trans man. She pursued medical transition at 16, with the support of TransActive Gender Center in Portland, OR. She was on testosterone by the age of 17, and had “top surgery”(double mastectomy) a few years later. Cari says she has been moving towards detransition for over a year now, and started taking concrete steps towards it a couple of months ago, including stopping testosterone.

In this interview, Cari shares her thoughts on transition, parents of trans-identified kids, and her experience with TransActive Gender Center, with a particular emphasis on that organization’s exclusionary focus on medical transition. For gender-dysphoric young people, Cari advocates for greater mental health support, as well as the chance to explore alternatives to hormones and surgery as treatments for gender/sex dysphoria. You can read more of her thoughts on her Tumblr blog.

Cari brings up a number of interesting and controversial points; your comments and questions are encouraged, and Cari is available to respond to them in the comments section of this post.


How old were you when you first began working with TransActive? What brought you there?

I was 16, and I had come out as transgender about a year prior. I found them through a friend who had received therapy there. They were the only gender therapists I could find who offered a sliding scale, which was huge for me since I was paying for my own therapy.

What services did TransActive provide or recommend?

I was given therapy there primarily for the purpose of transition care—getting a referral to an endocrinologist for hormone therapy, and a letter to change the gender marker on my driver’s license. I had been hospitalized about a year prior to starting counseling there due to suicidal ideation and non-suicidal self-harming behavior, but this was not a focus of treatment, other than discussing ways that transition would help with my depression. I was not receiving any other form of counseling for my mental health at the time.

They also recommended their therapy groups and “FreeZone,” which is a social group for trans children, their parents, and TransActive staff, but I didn’t attend those. FreeZone struck me as kind of a weird thing, since it would entail seeing my therapist and probably her other clients in a social setting.

transactive counseling

Did any counselors there attempt to explore whether there might be other underlying issues which could contribute to you claiming a transgender identity? Was there ever a concern that other mental health problems could interfere with a “successful” transition?

My counselor did not explore this with me, other than what seems to be the standard, cursory question of “Would you be able to be happy being a butch lesbian?” or something along those lines. It seems like everyone asks this question, thinking it’s somehow going to help dissuade people who are transitioning for the wrong reasons, but with all the other positive things that are said about transition, it doesn’t really work. I didn’t know that I was a lesbian until after I had started to detransition (primarily due to dating trans men), so this question didn’t strike me as relevant at the time, and there wasn’t any discussion of alternative ways to deal with sex dysphoria. This may simply be because there isn’t much information about alternative treatments in general.

However, I also had an experience there which I believe to be directly negligent on the part of the therapist. During the course of my therapy, before I received a referral for hormones, I began to have trauma flashbacks, which I hadn’t previously remembered. I brought these up to my therapist, and her only response was to devote one or two sessions to it, and then continue with the transition therapy process. This process seemed to be primarily about validating pretty much whatever I said about my gender/planning and mapping out a timeline for my transition, and it was not brought up at any point that prior trauma might have anything to do with dysphoria. The implication that was always present, in therapy or in the other trans-related discussions I was part of, inside and outside of TransActive, was that if I was trans (and my therapist never gave me the impression that I might not be), my options were “transition now, transition later, or live your life unhappy/commit suicide.” To a teenager who is struggling with mental health issues, this is a very attractive proposal: “This is The Cure for all of the emotional pain you’re feeling”.

How did your parent(s) feel about your trans identity? Were they supportive? How do they feel about your decision to detransition?

My parents were supportive of (if a little confused by) my “social transition” (using my male name/pronouns, binding, etc) but thought that I should wait to transition physically until I was over 18.  The staff at TransActive told me I didn’t need their permission for hormones, however, and that they would refer me, so I think eventually my parents may have just gone along with it because they know how stubborn I am.

My parents are supportive of detransition, but told me they wanted me to make sure I was certain about it before “coming out” again. It’s kind of hard to explain that no, your son who used to be your daughter is now your daughter again.

This might be a good place to mention that I pretty recently came to the decision to detransition, so my experiences and opinions are influenced by the rather fluid and unsettled stage of life I’m in right now, and probably not representative of someone who has had more experience living as a detransitioned woman. I can speak as someone who feels that TransActive did not adequately prepare me for transition or present me with alternatives, but I don’t want to try to present my experience as an example of detransitioned women in general, only representative of me, one detransitioning woman.

It seems that many gender specialists, and certainly many activists, are highly critical of attempts to “pathologize” people who identify as transgender. In fact, there is a movement afoot that says attempts to “gatekeep” trans-identified people with other mental illnesses is a form of “ableism.” and that even a person with Down Syndrome or on the autism spectrum should be allowed to medically transition, even as a minor. What are your thoughts on this?

I don’t think that people with comorbid mental illness should necessarily be barred from transition. What I do think is that there should be significant attempts to treat those conditions first, to rule out their involvement in dysphoria. I’m ultimately of the opinion that adults are allowed bodily autonomy, no exceptions, but that if we’re going to medicalize being transgender (which is the basis for having insurance cover it, having it be a protected identity, receiving any kind of special consideration under the law for anything, really), then there needs to be a standard of care that includes ruling out less invasive forms of treatment. It’s not considered best medical practice to jump to major surgery for any other condition, if there’s a reasonable possibility that medication or lifestyle changes could provide the same benefit.

I think that in my case, it’s entirely possible that I would not have been responsive to the idea that transition was not the only means of helping me. I know myself, and how stubborn I am, which I can’t blame TransActive or WPATH or ICATH or the APA or anyone else but myself for. But I do think that they need to be at least exploring these options. If I had been exposed to the idea that transition was not the be-all end-all of treating dysphoria, and that there were other viable options like treating my underlying mental health issues, I would be much more comfortable with their practices. But I wasn’t.

Trans activists vociferously deny that social media/trends could be a factor for some teens wanting to transition, yet it seems obvious to outside observers that the huge increase in girls identifying as trans is at least partly a result of immersion in Tumblr, YouTube, and other online forums. Did “social contagion” play a role in your own identification as trans?

I believe that it’s an oversimplification to blame social media for the increase in early transitioners. I think it has definitely played a role in younger people finding out that transition is a thing they can do, which to my mind isn’t an entirely negative thing—this is the same platform that allows LGBQ youth to connect with others who have similar experiences and find community. I think the increase is probably similar to the increase in teenagers going through a “bisexual phase”—it doesn’t invalidate the experiences of people who really are bisexual and discovered this in their teens, but it does mean that with the increased visibility of LGBQ people, that there is a higher incidence of teenagers questioning their sexuality. Now, with information about transition being readily available online, and a growing community of trans people to connect with, more young people are questioning their gender. The only difference being, questioning your orientation doesn’t make you want to pursue permanent medical interventions to your body, and it isn’t posited as a necessity for an LGBQ person.

To answer the question that you actually asked, though, online forums did play a significant part in my decision to come out as trans. I wasn’t so much into YouTube, though, and this was before Tumblr was a popular site. However, once I actually did come out, many, if not most of my formative interactions with the trans community (i.e., ones that influenced my decision to transition) were in-person ones, either through support groups or social events or LGBTQ youth spaces.

You no longer identify as transgender. What was your process of deciding this wasn’t right for you?

Actually, this is kind of funny, since your last question was about social media influencing people to transition. My decision to detransition was largely informed by social media, Tumblr in particular. Not that the detransition community, such as it is, convinced me to do so; my interactions with other detransitioned women have been limited since it wasn’t until recently that I stopped just reading and actually started interacting. But in the short time I have been communicating with other detransitioned women, I haven’t really ever felt any kind of pressure from them to do something particular about my transition, or to subscribe to any particular ideology. Rather, my experiences of reading the writings of detransitioned women were influential to me because they gave me what organizations like TransActive never did: images of women who had experienced the same things I had, who had struggled with dysphoria, and had found methods of making peace with their bodies in a way that I was starting to realize transition never would for me. Transition was very helpful for me in a lot of ways, and I wouldn’t say that I regret my decisions, but at some point it just ceased to be helpful to me. I think it helped me to be comfortable with my body and at some point I realized I was comfortable enough that I could stop, that I was ready to recognize myself as female again.

Do you believe some kids or teens are “truly trans”? Do you think gender identity is innate or “baked in” at birth? And if so, what differentiates true trans from people who thought they were trans, but eventually decide to detransition?

I think the scariest thing for me in my decision to detransition is that I haven’t really seen a whole lot to differentiate people who transition and are content, and people who transition and realize they made a mistake. I’ve seen people who checked all the “true trans” boxes, who were “transmedicalists” or believed themselves to be “just men with a medical condition,” who later detransitioned, or reidentified with their sex, or at the very least expressed serious doubts about their own motivations for transition, whether they pursued those doubts or not. I’ve also seen people who really didn’t seem to check those boxes, who had been transitioned for years and were still very happy with their decisions. I’d like to say that I know exactly how to tell the difference between the people who will end up happy with their transitions, and those who realize it isn’t the right choice for them, but the truth is I don’t. I think that all we can really do is to ensure that there are attempts being made to present all options, and to rule out other issues that might need to be treated first.

I also think that there are people for whom transition is the best choice, or at least the best choice they could have made under the circumstances. I’m coming to terms with the idea that I really just don’t have conclusive answers, that it doesn’t seem like anyone does, and that perhaps the best we can do in these situations is to try to make peace with our bodies as best we can. That perhaps there just aren’t any easy, unambiguous, black-and-white answers about why people are dysphoric or whether transition is the right choice for them. That’s what I wish organizations like TransActive would embrace–not “this is your only choice,” not “this is not a viable choice at all,” but instead, “we don’t have all the answers, but here’s what we know about your options.”

Partly due to lobbying by TransActive and its director, Jenn Burleton, the state of Oregon now permits trans-identified teens as young as 15 to obtain surgeries (including mastectomies and hysterectomies) without parental consent. TransActive is networking with activists and lawyers in other states to push for lowering the age of medical consent nationwide. Given your own experiences, do you think there should be a minimum age for medical intervention for trans-identified people? What age is appropriate to begin cross-sex hormones? To receive “top surgery?” To undergo bottom surgery and/or hysterectomy?

I think the idea of someone being able to get transitional surgery underage is concerning—in the state of Oregon, you can’t get a tattoo underage even with parental consent, but you can be permanently sterilized at 15 without any parental input. This is built off the law that minors 15 and older can consent to their own medical and dental diagnosis and treatment, up to and including surgery, but it seems to me that these kinds of surgeries are things that can wait until someone is at least 18. You can’t diagnose many mental disorders, such as personality disorders (which I have personally seen as a contributing factor in people incorrectly thinking they are trans) until the age of 18, and it seems reasonable to me that permanent surgical interventions for what is arguably a psychiatric issue be held off on until that age. I don’t know what I think about underage hormone treatment, but I lean towards the idea that it should be available, but that again, proper alternative treatment and safeguards need to be in place, that it needs to not be the sole focus of treatment or option presented.

What advice would you have for parents who are concerned about the seeming trend in kids identifying as trans? There is very little support for parents who don’t simply go along with their child’s announcement.

I think it can be a very delicate thing, as I’m sure you know. Children and teens who are questioning their gender are usually in a very vulnerable state. I think they often feel that the people around them can’t understand what they’re going through, and that leads to feeing very alone and isolated. I know I felt that way, and when I encountered resistance to my transition, it really made me feel that interacting with those people was unsafe or that they felt contempt or condescension for me and for what I was feeling. I did cut off or restrict contact with a lot of people due to them not supporting my transition.

So I think it is of the utmost importance that parents go about it with a lot of respect for their kids and validation that what they are going through is an incredibly difficult and painful state, without that necessarily meaning you’ll go along with their desires unquestioningly. I think it’s possible to have a child-centered process without it being all about transition. Brainstorm with them about what they might be able to do to help them cope with their dysphoria, support them in going to therapy, but suggest that they examine other modes of treatment in therapy before seeking transition, things like that. Try to make yourself a safe and supportive person for them to trust with their feelings—this not only allows you to make suggestions to them and discover their underlying feelings and motivations for transition, but also means that they might not be as scared to say, “hey, I think I might have made a mistake/I have these questions and the community isn’t answering them.” Knowing that my parents supported me making my own choices and weren’t about to say “I told you so” was a huge factor for me in feeling comfortable when I told them about my decision to detransition

That said, I think it’s entirely reasonable to set the boundary that you aren’t comfortable allowing them to medically transition while underage. As my parents explained it, once you’re 18, you can make whatever decisions you want, but this is something that you should take responsibility for as an adult person, rather than us signing off on it for you. Of course, this didn’t end up working for me, since I lived in Oregon, a state that allowed underage consent to transition. But regardless of that, I think it was a good thought for them to have and express.

Do you think parents should buy binders for their daughters who identify as trans men? Some parents feel it amounts to a “slippery slope” that may lead to their child seeking top surgery.

I don’t know that I think a parent “should” give their kid anything other than, you know, the things any parent should give that have nothing to do with gender identity–food, clothes, medicine, age-appropriate activities, an allowance if you can afford it, etc. I always bought my own binders, and paid for my testosterone prescriptions even when my parents were paying all my other medical expenses. I do think it’s invasive that a lot of parents will cut up their children’s binders or confiscate them. I think if a kid buys something for themselves that’s helping them cope and not making permanent unhealthy changes to their body, then it should be tolerated.  Doing something like taking a binder away is really only going to deepen the distrust the kid might have. Obviously if they’re binding with Ace bandages or tape or something, that should be discouraged, but I don’t see an issue with a teenager having a safe means to bind. As to whether it’s a “slippery slope,” I suppose it’s possible. I think I would say the same thing about letting your child bind as I would about anything transition-related: I don’t think it’s right to bar your kid from expressing themselves or exploring their identity, but that the more important factor is making sure they have proper information and resources, including the ways they could cope with their body without these interventions, and ideally, role models who have found a variety of ways of to cope with their gender nonconformity and/or dysphoria.

Suicide risk is often given as the main reason children and teens should be “affirmed” in their trans identity. What do you think about that?

I think it’s something to approach with caution. Suicide risk is a good reason to treat a lot of mental disorders and medical conditions, and I think the fact that gender dysphoria is one of those disorders is not necessarily cause for alarm. Someone being a suicide risk without psychiatric medications is a good reason to give them psychiatric medications, someone being a suicide risk because of neuropathic pain, which isn’t likely to physically kill you, is a good reason to give them pain medicine. Someone being a suicide risk due to feeling disconnected from their physical sex can, I believe, be a good reason to give them cross-sex hormones and surgeries, provided other courses of action have been examined in an objective way, and having really looked at those other options, medical transition still seems to be the best choice.

What I think is more concerning is the trans community’s tendency to present suicide as basically the only alternative to transition, and to martyr trans individuals who do commit suicide, as I think we saw pretty strikingly in the case of Leelah Alcorn.

Trans activists decry “gatekeeping,” with the current trend moving towards “informed consent,” trust in self identification, and earlier and earlier medical intervention, even for children. Do you agree with this trend? Why or why not?

I think this has been pretty well addressed with my answers to other questions, but to make it explicit, my opinion is that gatekeeping is absolutely necessary. Denying someone any kind of care for their issues is medical neglect. Forcibly trying to change someone’s mind about being trans is medical abuse. Showing someone all available options, following a standard of care that takes all of them into account, and ruling out a differential diagnosis that could be treated without permanent bodily alterations, is neither of those; it’s just part of providing good healthcare.

There has been some tension between gender critics—especially gender-critical feminists—and women who have detransitioned. I have read that some detransitioned women feel they are used by feminists to make a point that all transition is harmful. Quite a few detransitioned women write that self hatred and/or internalized misogyny or homophobia were factors leading them to transition in the first place, but when these same factors are pointed out by gender critical feminists, detransitioned women sometimes object. I wonder how much of the tension is down to a generation gap? Some Second Wave feminists who experienced gender dysphoria as children believe that if medical transition had been available at the time, they’d have jumped at the chance and likely been diagnosed as trans. On a political level, if detransitioned women and gender critics could unite, they could have the potential to make important changes in how children/teens are currently treated. How can this rift between gender critics and detransitioned people be healed?

I believe you included this question to address my stated uncertainty about doing this interview, due to my experiences being co-opted by radical feminists in the past. However, my experience of this happening was while I was still in transition, so I don’t have personal experience of what you’re describing.

From what I’ve seen, I think a lot of the backlash from detransitioned women has to do with the, honestly, very unkind and insensitive way that some radical feminists talk about transition—saying that trans people are “delusional,” that transitioned/detransitioned people are “mutilated,” etc. Whether or not transition is a good idea (for anyone), this kind of attitude really trivializes the emotional pain, the social struggle, and the complicated and messy ways in which people come to the decision to make these changes to their bodies. In my own case, I believe I made the best choice I could, given the options I was presented with. I don’t appreciate being called “mutilated” for doing what I felt I had to in order to survive.

I think it’s really great that radical feminism focuses on the social roots of these issues and doesn’t just go with whatever choices people feel like making without examining them critically. But I also think that sometimes can lead to a lack of compassion for the people who make those choices, and a lack of allowance for nuance and grey area around how people interact with and cope with their social realities regarding gender. I don’t have a concrete answer for you about how radical feminists can ally themselves with detransitioning women, but I think it has to start with a good hard look at the way these issues are talked about, to make sure that we’re having these discussions in a way that shows empathy for the people who are affected by this, whether they’re questioning or transitioning or transitioned or detransitioned

How are you doing now? Have you received any support from doctors or therapists/counselors for your detransition? Does TransActive provide any services for people who change their minds?

By the time I decided to detransition, I was not receiving gender identity-related therapy. However, my current therapist knows of my detransition, and is fully supportive of it. In fact, he told me he would not have signed off on my transition if he had been my therapist when I was transitioning, given what I’ve told him of my circumstances.

TransActive does not, to my knowledge, provide any services for transgender adults, so I wouldn’t expect them to provide anything for detransitioning adults. (I’ve recently contacted TransActive asking if they have any services/could refer a detransitioning person to services, and will update this response once they reply).

On being a liberal heretic, trans-activist thought policing, and the 1st Amendment

There’s a red-diaper baby named David Horowitz, who, after many years as a prominent activist, flipped from the far left all the way to the conservative far right. He’s the editor of a right-wing journal, and the tagline on his site is

Horowitz

I used to scoff at the utter absurdity of that notion. Everyone knows that to be on the left is to value free speech, human liberty, social justice, and equality—the complete opposite of authoritarian thinking.

But I now understand what he means, despite stringently disagreeing with nearly everything he stands for politically.

I’ve been a knee-jerk leftist my entire adult life. Like many of my ilk, until recently, I had pretty much endorsed every tenet of progressive-liberal dogma as received wisdom, not bothering to give any of it much thought when it came to the voting booth, or whose side I was on in any debate about politics or social issues.

The wakeup call resulting from my kid’s temporary identification as a trans man, and, in particular, her vociferous demands for the two Ts—testosterone and top surgery—roused me from my comfortable slumber. And the awakening was an entirely rude one.

My critical thinking thus stirred, I don’t think I could shut it down again, despite now perpetually sleeping on an intellectual bed of nails. Not that I’d want to be re-anesthetized at this point, as much as I might envy the still-smug certainty of most of my friends.

I see myself now as a classical liberal, no longer a progressive. Among other things, classical liberals historically believed in and defended the freedom of speech. “Progressives”—and that includes many journalists—now seem to see their role as uber-scolds: refusing to cover alternative viewpoints, muzzling skeptical voices, sinking so low as to delete even respectful, dissenting comments submitted to the many news articles which promote the medical transition of children. This self-censorship is the case even in the United States, where we are lucky enough to have a 1st Amendment to the Constitution which enshrines our right to freely speak our minds.

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The press, which ought to be the champion of open debate, has mostly abdicated that solemn role. This is all the more insidious in Western societies, where we are under the delusion that we actually still have a free press. In societies with overt censorship, such as China, citizens are only too aware that their access to actual facts is curtailed. In Western democracies, tacit editorial refusal to provide a platform to dissenters, thereby eschewing true investigative journalism, amounts to de facto censorship, which is all the more dangerous because the general public is not aware of it.

As a lifetime liberal, it pains me to have to turn to right-wing, conservative news sources to locate a modicum of the treasured right to free speech liberals so take for granted, while they are complicit in eroding it. But it is more and more the case that only the right-wing press—despite its massive failings (most notably, the homophobic labeling of transgender issues as part of the mythical “gay agenda”)–dares to raise thorny issues around transgenderism.

national review headline

Yesterday, writer Brendan O’Neill at the National Review wrote about the latest successful quashing of free speech—this time, forcing a retraction from the British writer Ian McEwan, who had the temerity to confess, “Call me old-fashioned, but I tend to think of people with penises as men.”

Can you guess what happened next? Yes, McEwan was subjected to a Twitch hunt, to that 21st-century bloodsport in which anyone who expresses an unpopular view or makes a less than PC utterance or simply misspeaks a little will be “called out” (shamed) by the bedroom-bound, Twitter-living, self-styled guardians of correct thinking. Twits went berserk over his apparently perverse linking of penises with maleness. They branded him a bigot, weird, a transphobe. Trans-rights activists put the boot in, too. Stonewall, the LGBT activist group, slammed McEwan for being “uninformed” and said his weird worldview doesn’t only “denigrate the trans experience, it denies its very existence.” Paris Lees, a trans woman and journalist, scolded McEwan, telling him his “ideas about penises are outdated.” He should apologize, the mob said.

O’Neill goes on to cite George Orwell’s 1984, which eerily predicted a future society utterly cowed by a thought-policing Big Brother. In the novel, Big Brother eventually manages to break the will of 1984’s protagonist, Winston Smith, who finally acknowledges that 2 + 2 does equal 5:

And now there’s punishment of people for saying there’s such a thing as reality, such a thing as tangible, measurable facts. This, too, is straight out of Nineteen Eighty-Four. In that novel, O’Brien, Big Brother’s torturer, ridicules our hero Winston Smith for believing in objective reality. He takes Winston to task for believing “reality is something objective, external, existing in its own right,” and that “the nature of reality is self-evident,” when in fact “whatever the Party holds to be the truth, is truth.”

It’s one thing, of course, for adult trans activists and their media enablers to advocate on their own behalf. But as we know, they also want to shut down any whisper of dissent about their current program of identifying gender-defiant children as young as 2 or 3 years old as “transgender,” thus helping them down a medicalized path that will almost certainly consign them to a lifetime of hormones and surgeries.

A recent example of a whisper of dissent the activist-clinician lobby wants to hush up pertains to a post on this web site. Sexologist James Cantor committed the thought crime of tweeting a link to a recent interview with a therapist who has launched an organization of professionals concerned about the pediatric transition trend, published on 4thWaveNow.

For this transgression, the WPATH horde wants to ban Cantor (who is hardly a staunch ally to the 4thWaveNow community or gender-critical feminists) from their Facebook group and force a retraction.

What, specifically, was Cantor’s sin in tweeting this link? This: the interviewed therapist opined that it might be best to postpone medical transition until an age when the brain is more fully developed in its decision-making capabilities, generally recognized to be around 25. Mind you, that opinion was one sentence in a rather moderate interview, wherein the same therapist conceded there might be some kids for whom medical transition was the right answer.

Buried in a 5000-word interview are a few sentences that have earned this site the monikers “inflammatory,” “shameful,” “transphobic,” deserving to be listed as a “hate group” by the Southern Poverty Law Center.  As for Cantor, he was told that by tweeting a link he was [capital letters and all] KILLING CHILDREN.

The fact that Cantor disavowed any agreement with the 25+ suggestion, in another tweet the very next day makes no difference, because when it comes to trans activist thought policing, absolutely no critical thinking or dissent from the received wisdom around “transgender children” can be tolerated. None.

4thWaveNow is devoted in the main to intelligent discussion by parents of gender nonconforming and/or trans-identified kids about issues pertaining to pediatric transition. We have a stake in this discussion. We are hardly bystanders. These are our kids we are talking about. Yet the adult trans activists claim our kids as their own. They claim themselves as the experts on our kids, and argue for abridging our right to speak our minds about the physical and psychological well being of gender-defiant youth.

Let’s look a little closer at the particular heretical opinion that has earned such opprobrium. I’ll call it the Executive Function Heresy. Simply put, we Executive Function Heretics wonder whether, given the fact that kids and teens typically try on and discard multiple iterations of “identity;”  and given the fact that judgment, impulse control, and awareness of future consequences aren’t fully developed until the mid-20s, maybe it might make sense to wait until early adulthood to decide about making permanent body changes.

It’s not difficult to find real-life examples of why that might not be such a bad idea. A very recent case is a woman named Sasha, recently interviewed on the BBC Woman’s Hour (which actually allowed a whisper of dissent to be voiced on the show—highly unusual). Sasha had a double mastectomy at 19. Now 26, Sasha no longer identifies as a trans man, but considers herself “non binary” and, in retrospect,  wonders whether it might have made sense to look at less drastic options. As Transgender Trend points out in their post on the matter, Sasha is right around the age when the frontal lobes of the human brain are more or less fully developed. A key part of that development is the ability to reflect on decisions and experiences in a thoughtful way. A teenager, who by definition has very little prior experience to reflect upon, is highly unlikely to stop and think about how they’re going to feel ten years later.

The existence of even one young adult like Sasha ought to be enough to give pause to the pediatric transition industry (and it is an industry, supporting the careers of many thousands of activists, psychologists, doctors, and researchers around the world). But Sasha is far from alone, as we know from the detransitioned men and women who are starting to speak up about their experiences—for example, the bloggers Maria Catt and Third Way Trans.


So where does all this leave a dyed-in-the-wool lefty like me? Well, I’m still a liberal, in the classical sense. I still believe in universal health care. I support lesbian and gay people, as well as the right of transgender people to access jobs and housing without discrimination. I am a supporter of organized labor. I think corporations require strong government regulation. I recognize the reality of climate change and the disaster we’re courting, as we continue our global laissez faire capitalism, fueled by the unfettered burning of fossil fuels. And I still believe that being liberal means—or ought to mean—defending and using the right to free speech.

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Actually, conservative climate change denial is good analogy for the attitude of trans activists. Meddling and tinkering with nature has got us into quite a pickle, as the Arctic melts, extreme weather events multiply, species go extinct, and the seas around us rise. Most liberals have at least a modicum of respect for the natural world, frequently decrying the damaging effects of a human technology and industrial civilization gone rogue. Yet these same liberals never seem to reflect on their support for high-tech interventions perpetrated on the bodies of kids who are uncomfortable with their stereotyped gender roles, or who become alienated from their physical selves at the onset of puberty. They never seem to question the fact that so many formerly lesbian-identified young women suddenly decide they are straight men. Rather than treading softly and looking for more natural solutions, the liberal establishment—well funded by “progressive” think tanks, foundations, and billionaires like George Soros—is empowering the juggernaut which promotes invasive surgeries and science fiction procedures like uterus transplants for trans women.

Do progressives ever ponder what might happen when climate change eventually forces human societies to downscale? What will happen to all those people who were convinced as teenagers they were born in the “wrong” body, when high-tech surgeries and lifelong testosterone injections are no longer widely available? Do they think these people will all commit suicide? Or might they learn to live, love, and make peace with themselves, as generations of gender nonconforming people have always done in the pre-industrial age? Hey, environmentalists: How can nature get it so right when it comes to biological diversity and the exquisite balance that supports life on earth, but get it so wrong for these gender-defiant young people encouraged to despise their evolution-crafted bodies?

It occurs to me that the liberal-progressive-left is also like a teenager, with still underdeveloped frontal lobes, a passion for instant gratification, and a deficit in thinking through consequences of its actions when it comes to our gender-defiant youth.

I expect this sort of childish, primitive thinking from the conservative right. Recognizing it in my own liberal tribe has been a major disappointment, and that’s putting it mildly.

Do No Harm: An interview with the founder of Youth Trans Critical Professionals

A new organization has formed for therapists, social workers, medical doctors, educators, and other professionals concerned about the rise in transgender diagnoses among children, adolescents, and young adults. Youth Trans Critical Professionals was founded by a psychotherapist and a university professor just a few short weeks ago. The organization has a website (already publishing thought-provoking pieces from professionals), a Facebook page, a Twitter account, and many followers. If you are a professional skeptical of the transgender youth trend, please visit the website and consider contributing to the effort. Your anonymity will be protected at your request.

4thWaveNow recently interviewed one of the founders of Youth Trans Critical Professionals. She is available to respond to your questions and remarks in the comments section below this post.

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Why did you start this organization for professionals skeptical of the trans-kid trend? What is your personal interest in this matter?

I’m going to start by saying something that I will probably say several times. Our main concern is with medical intervention in children and young people that leaves their bodies permanently altered and/or sterilized. We don’t have a moral issue with people identifying as transgender, and believe that those who do should be protected from discrimination like any other minority. However, the medical treatments for children who identify as transgender are risky, not approved by the FDA, and permanent. With any other condition, we would be bending over backwards to find other ways to support these children without resorting to major medical intervention, and would turn to puberty blockers, cross-sex hormones, and surgery in only the rarest and most extreme cases. It is very disturbing to the originators of youthtranscriticalprofessionals.org that these treatments, whose long term effects are not well-studied, are being offered very casually for a condition which isn’t even clearly defined.

I have a private practice where I work mostly with adults, although from time to time, I do see adolescents. I first became aware of this issue because parents were coming in describing kids struggling with gender identity. I started to notice a pattern: an anxious, depressed, or socially awkward kid who spent a lot of time on social media would announce that he or she was “trans,” often requesting access to cross-sex hormones shortly after this announcement. Every one of the mothers in my practice who reported this behavior was incredibly supportive of her child. These moms may have shared feelings of confusion or concern with me, but their initial reaction toward their child was always acceptance.

The first time I heard this story, I didn’t make much of it. It sounded like normal teenage experimentation to me, and I admired the mom’s openness to accepting her child. However, as I saw more of these cases – and I saw the cases progress to the point where the child was demanding medical intervention – I became concerned and wanted to learn more.

What I found once I started looking was that more and more young people are identifying as trans, often after bingeing on social media. For some reason that I can’t quite fathom, there is a tremendous feeling of excitement around this issue among many adults. I found out that administrators at private schools were boasting about “several kids transitioning” at their school. I heard this from more than one school while I was researching this. They shared this as evidence, I think, of how truly progressive and accepting their school is. However, I find it really odd that no one blinks an eye when four kids are transitioning in a grade of sixty kids. Given how rare transsexualism is believed to be, doesn’t that alone ring a warning bell?

The more I learned, the more disturbed I became. Where were the critical voices? Where were the adults familiar with child development speaking out for young people who are in danger of being swept along on a current that may carry them towards sterility before they have even finished high school?

I was shocked to realize that many of my fellow therapists appear to have uncritically bought into the narrative about trans children that goes something like this: 1.) gender identity is a legitimate thing. You cannot question it without being bigoted. 2.) Children know their own gender identity. 3.) If you do not immediately and uncritically affirm a child’s professed gender identity, you will be doing that child grave harm, and may even induce suicidal behavior, 4.)  The best and only treatment for a child who professes to have gender dysphoria or claims to have a gender identity other than that associated with his or her sexed body is transition – social, medical, or both. It doesn’t matter whether that child has comorbid mental health issues such as anxiety, depression, trauma, autism, substance abuse or bipolar disorder. 5.) Once a child has professed his or her gender identity, the adults around that child should follow his or her lead, providing whatever treatment and accommodations are requested by that child.

There is nothing about the narrative outlined above that is beyond controversy and shouldn’t be open to questioning. The construct of gender identity is poorly defined and lacks coherence. It surely shouldn’t be the basis for subjecting our kids to irrevocable body changes and sterilization. Assuming that children have some mysterious knowing about their gender identity seems like poor practice. Children are often very sure of things at one moment in time and believe something completely different a week, a month, or a year later. Child development is a fluid process. Refraining from immediately affirming a child’s gender identity brings with it no documented harm. The oft-quoted figure about suicide among transgender youth is a misuse of statistics. Many children (and adults, for that matter) feel significant distress about an aspect of their body or identity. Usually, therapists explore many ways to support a person facing this kind of discomfort. Sometimes medication can bring relief. Sometimes, exploration brings a new understanding. Sometimes, discomfort must be borne as we come to terms with a difficult or disappointing reality. Why the rush to change the body? Permanently?! Of course we as adults should be putting the brakes on a process that is leading toward permanent sterilization. Of course we should. Where were the other professionals who also believed this?

There is such a dearth of professional voices calling for restraint and caution in turning to medical intervention. Pediatricians, social workers, psychologists – most professional groups state that we must affirm a child’s gender identity. While we appreciate the intention here to be supportive of gender non-conforming kids, it seems the greater value ought to be protecting children from unnecessary medical procedures that often result in sterility; a central aim of youthtranscriticalprofessionals.org is to raise awareness of this.

Yes. Where are the child and developmental psychologists on all of this?  Much of what transgender activists promote seems to fly in the face of what we know about child and adolescent developmental psychology. It has been understood for decades that young children confuse fantasy with reality; that adolescents try on and shed different identities;  that children are conditioned by what they experience; that a child or adolescent’s sense of self is anything but rigid. Have you heard from any skeptical child psychs, and what will it take for some of them to start speaking out?

So far, I haven’t heard from any, but I imagine we will. You are right, and you phrase the issues very clearly. Kids do try on different identities. And we as adults don’t do them any service by privileging gender identity as some special, separate category. There is nothing innate or special or sacred about gender.

And kids have very strong feelings about what they want, and they often confuse things they want with things they need. It is so incredibly difficult to watch out child be in psychic pain. It can send us flying into action as we try to make their suffering stop. But part of our job as a parent is to use our discernment as the adult who knows them best to learn when to listen to the manifest story they are telling us about themselves, and when to listen to a deeper story underneath that.

I was talking recently with a friend who has a daughter in college. She was telling me about the awful, awful time she went through when he daughter was 13. The girl was obsessed with getting an iPhone. She cried nightly about how terrible it was for her not to have one, how it was damaging her social life and making her isolated and depressed. She was visibly distraught over this issue being any reasoning. She begged for it literally as if her life depended on it.

Thinking of this issue with trans kids, I said to her, “At least you knew that she wasn’t going to come to any grave harm if you didn’t give her an iPhone.”

My friend surprised me by saying that at the time, she felt confused about whether she was doing great harm to her daughter by not giving her a phone. “Between the peer pressure and the advertising, I was almost convinced that I was doing her grave psychological damage.” Imagine how hard it would be to stand up to a teen’s desperate demands for hormones if you had mental health professionals telling you that you were damaging your child by withholding them!

I suppose the point is that just because our kids want something very, very badly doesn’t mean that we have to capitulate or surrender our adult judgment. Teenagers don’t have a fully developed prefrontal cortex. We can’t abdicate our responsibility as their parent to say no when what they fervently desire may be harmful for them, or at least may have consequences they aren’t capable of fully appreciating.

Do you believe there are truly transgender children? Are they different from the teens who claim to be trans because of social contagion?

What a complicated question! Let me break it into a couple of parts.

First of all, there is no question that there has been a huge increase in kids identifying as trans. Much of this increase is certainly due to social contagion. Kids are getting exposed to this on social media, where they are taught that “if they are asking whether they are trans, they probably are.” Look, most teenagers go through a period of feeling intensely uncomfortable in their own bodies. I think that for many of these kids, this is an expression of that discomfort. Forty years ago, maybe more kids developed eating disorders. Twenty years ago, they were cutting. This is the current way to express that nearly universal adolescent discomfort. We all need to feel that we fit in, and that we stand out. Identifying as trans hits both of those criteria big time. You go to school and announce you are now Joe instead of Jo, and let people know you want to be referred to by a different pronoun, and in many schools, you are met with excited acclimation from peers. You are different in an exciting, trendy way. At the same time, you can feel a part of the other kids who are also embracing different gender identities. It must be very heady.

So I do believe that there is a huge social contagion piece, and this is one of the things that I don’t hear other people talking about much. This matters a great deal, because it has probably happened that some anxious, socially awkward kid has come out as trans as a way of gaining acceptance and belonging, and has gotten so much support and affirmation that she has continued down the road to take hormones. In short order, she had permanently altered her body – a deepened voice, facial hair, baldness, increased risk for certain diseases – and maybe this wasn’t for her, really? Or not for her forever? But now this person has to live with those consequences forever. Testosterone and other cross-sex hormones are not tattoos that carry trivial risks, or can at least be hidden easily. This ought not to be a life-style or fashion decision, and for some kids at least, I am convinced it is. I realize this is an incredibly unpopular stance, but this is what I am seeing from my little perch.

Of course, there are those who identified significant distress with the sex of their body before transgenderism became a cause celebre. I have read the stories about two-year-olds who ask why God made a mistake. Some of these stories are pretty compelling. I am not an expert in this area, and when I read these stories, my strongest reaction is that I am grateful I have never had to be the person responsible for making a decision about such a case. I’m not at all sure what the right thing to do is, but I will say that I could imagine that transitioning might be right in some cases.

There is an Atlantic article about this from 2008 that I found very interesting. It profiled several of these kids who are “persistent, insistent, and consistent” starting at an early age. Some of the Canadian kids were treated by Dr. Kenneth Zucker. The article describes some of the things involved in the treatment such as “taking all the girl toys away.” I admit that made me cringe. Really?! Who would want to do that to their child? However, at the time the article was written, Chris, the child in question, had grown up to be a gay, effeminate man who had a healthy, intervention-free body.

My understanding is that when Zucker’s team assessed a gender dysphoric child, they closely examined the family system, considering carefully different dynamics that were in play, and then crafting an individualized treatment plan that might involve several different kinds of interventions. I believe that enforcing gendered toys was something that was done in some cases, but was accompanied by other therapeutic interventions that took into account the whole family dynamic. The ultimate aim was to help the child feel comfortable identifying with his or her natal sex.

The article also followed an American child who had been affirmed early, and had begun to live as a girl. And it made reference to the social media star Jazz Jennings, who was profiled by Barbara Walters. I found the reaction of the Canadian parents to this practice of early affirmation very compelling, so let me quote from that part of the article. (The bolding is my own.)

The week before I arrived in Toronto, the Barbara Walters special about Jazz had been re-aired, and both sets of parents had seen it. “I was aghast,” said John’s mother. “It really affected us to see this poor little peanut, and her parents just going to the teacher and saying ‘He is a “she” now.’ Why would you assume a 4-year-old would understand the ramifications of that?”

“We were shocked,” Chris’s father said. “They gave up on their kid too early. Regardless of our beliefs and our values, you look at Chris, and you look at these kids, and they have to go through a sex-change operation and they’ll never look right and they’ll never have a normal life. Look at Chris’s chance for a happy, decent life, and look at theirs. Seeing those kids, it just broke our hearts.”

So I think, if I had a little boy who insisted he were a girl, and I could do this terrible thing of enforcing gendered play, or I could do this terrible thing of altering his body and destroying his ability to have his own children, which would I pick? If I knew I would have a healthy, happy, whole gay man at the end of it, if I had a reasonably good guarantee that would be the outcome, I would much rather pack away the Barbies. The personal and social difficulties of back-tracking on a childhood or adolescence spent transitioning will inevitably be immense. If a child has been transitioned from a young age how will they know, or be able to begin to articulate, that a mistake has been made? At a recent at Cambridge University seminar entitled ‘Gender Non-Conforming Children: Treatment Dilemmas In Puberty Suppression‘ it was stated that 100% of children on puberty blockers go on to transition; it’s clear there is absolutely no going back on medical intervention.

In any case, those of us who started youthtranscriticalprofessionals.org would argue that transition is always an option into adulthood. I am familiar with the view that when someone transitions as a child, they have a better chance of “passing” in adulthood, but given the very real risk of later regret, I think we might decide that medical transition is a choice to be made by full-fledged adults only.

How do you answer charges that you are promoting harmful reparative therapy on trans youth? How is this different from trying to turn gay kids straight?

Well, I’m not sure I believe that we should try to “talk kids out” of believing that they are trans, first of all. If a fourteen year old kid came into my office and said, “I’m pretty sure I’m gay,” or “I am gay,” I would say, “Tell me about that! What is that like for you? How long have you known? What lead you to first wonder about your sexual orientation? What is hard for you about knowing this? What kind of support do you need?”

If a fourteen year old kid came into my office and said, “I think I am trans,” or “I am trans,” I would ask similar questions: “Tell me more about that? What does that mean to you? Help me understand your internal experience that leads you to know yourself as trans? What kind of support would be helpful in addressing this? When did you first start to wonder?”

The purpose is both cases would be to do the thing that therapy is meant to do – to explore our experience so that we can understand it more deeply.

There are a couple of differences. First, while I would be interested in hearing from the gay child about his particular way of experiencing his gayness, we all have a pretty clear idea of what that means. A gay boy experiences sexual attraction to other boys, and not so much with girls.

The notion of gender identity, however, is much less clear. If a boy of fourteen were to tell me he is really a girl, I would want to know about that experience. What does that mean? In what way do you experience this inner sense of femaleness? How does this experience manifest for you? What are the different ways of understanding this experience? Is it a consistent experience, or is it subject to variation? How does this experience influence your understanding of yourself?

Sexual orientation and gender identity are actually quite different and these differences justify different approaches. Sexual orientation has shown itself to be quite stable. Most gays and lesbians knew from very early on that something was different. These feelings aren’t dysphoric, although they may cause distress because of homophobia. It isn’t dysphoria, it is just an awareness of who you are. It isn’t a sense of being wrong, or in the wrong body. And it doesn’t tend to change. These feelings are generally stable throughout the life span.

This isn’t the case for gender dysphoric kids. We know that a majority of them will naturally desist. Unlike sexual orientation, gender identification does tend to change for the large majority of dysphoric kids.

The other major difference – and this is the heart of the artichoke – is intervention. Gays and lesbians are not seeking intervention. They just want to love whom they love. My hypothetical gay boy client and I would be free to discuss and explore his experience of being gay and his coming out process without any high stakes medical decisions hanging over our heads. If I knew that my hypothetical trans patient would not have access to medical intervention until she was, say, 25 years old, she and I could spend our therapeutic hours exploring her experience as a trans woman, and I could offer support for the difficulties involved in being different in this way.

My goal for therapy with a trans kid would be to provide a warm, judgment free space in which they could explore their gender identity and what it means for them without a rush to medical intervention. I wouldn’t aim to convert. No. But I wouldn’t want to close in on this being the final answer, since I know that so many gender dysphoric kids will desist of their own accord.

I would hope that no one would ever be shamed or persecuted or made to feel unworthy or respect and love because of these feelings. I would argue that there is another approach in between rejection and affirmation, and possibly the word for that would be acceptance. I accept you as you are. I support you. I am curious about what you are going through. I want to hear more about your experience. And I accept that your sense of your own identity might change, and I will accept you then as well. But in any case, I would hope to delay medical intervention until the person was at least 25 years old.

Maybe the last thing to say about this is the most controversial. It isn’t really clear what exactly “gender identity” even means. It appears to refer to a subjective inner state, but when pressed, those who identify as trans will often resort to gender stereotypes in describing their discomfort. Forgive me, but I am not going to want to send any person down a conveyor belt toward permanent mutilation and sterilization over a self-diagnosis of an inner state.

Gender is a social construct. If gender is the problem, why on earth change the body? Is seems obvious that the right thing to do is to change or even abolish the construct altogether. Changing the body to fit the social constructs we have around gender only serves to further entrench the constructs we are trying to escape – and these are socially, not biologically constructed; there is no evidence that gender identity is innate.

What is your vision for Youth Trans Critical Professionals? What do you ultimately hope to achieve?

Initially, we are hoping to solicit posts from 100 professionals writing on the trans child trend from how they see it. By doing this we aim to assemble the first collection of voices of Youth Trans Critical Professionals to evidence our mutual concern. There is a meeting being planned, and we are also discussing the possibility of co-authoring a book. Ideally, we would like to help move the needle on this conversation, hopefully resulting in clearer standards of care that protect gender dysphoric and nonconforming young people from unnecessary medical intervention and permanent sterilization.

How can a group of anonymous professionals make a difference? Without a public face and voice, who will believe you are who you say you are?

Anonymity certainly limits our credibility at this point. Many of us are contending with constraints of professional institutions which broker no dissenting views. It is our hope to speak out publicly once there are more of us. In the meantime, I hope that we will be judged by how we write and think. I believe that people that read the site will know that we are striving to do this in order to protect children from unnecessary medical procedures and permanent sterilization, not out of hatred or bigotry. In addition, some professionals working with us are also friends and relations of children and young people identifying as trans and need to remain anonymous to protect their loved one’s privacy.

In the few weeks the site has been live, have you heard from other professionals who want to be on-board?

The site has been up for less than two weeks, and it has already been viewed over 2,000 times. The overwhelming majority of the comments have been positive. (I have not deleted any comments, if that tells you anything. One person wrote a critical comment, which I approved.) And yes, professionals are reaching out and asking how they can be involved not just from professions allied to medicine, but teachers, youth workers, practitioners of law, artists and writers and so on.

How can parents find therapists and other medical providers who will resist the current trend to diagnose kids as trans? There are no public directories, while there are tons of  published resource lists of “gender specialists.”

What a good idea! Perhaps we could gather the names of such providers and maintain a directory. This would be a great resource because families are telling us they reluctant to access services because they do not trust service providers to tread a sensitive line between gender confusion and medical intervention.

As a therapist, how would you suggest a parent deal with a child insisting they are trans? The current trend seems to be “affirming” the child’s identity, no matter how old the child is.

Well, this is another complicated question. Obviously, we always want to communicate love and acceptance of our children. We can accept and affirm our child and respect their struggles and personhood without necessarily affirming a professed identity.

Part of what makes this a thorny problem is that there is no neutral stance. If we affirm the kid’s gender identity, we likely tip the scales in favor of a trans identity. If we look for other ways to express our support and empathy for our child, we likely tip the scales the other way. Given that even doing nothing is not a neutral intervention, we have to ask a difficult question. Is desistance a better outcome? If we had to choose which way to tip things, what is the right way? For me, it is clear that, all things being equal, desistance is a better outcome because it avoids invasive medical procedures and sterilization. Whenever a young person is engaged in keeping the conversation about their trans identity open, they may feel comfortable deferring medical intervention which will have the side effects of irreversible sterilization – at least this puts growing maturity on their side.

There is also the very critical issue of social contagion. I believe that many kids identifying as trans for the first time as teens – and perhaps many younger kids as well – have “picked this up” from social media. Parents are not infallible, but we are likely the best judges of whether our kid is truly suffering from deep-seated gender dysphoria, of whether the gender issue is a way to express other issues.

If a parent has a teen who comes out as trans, I would be interested in knowing the following:

  • Has the child been anxious, depressed, or struggling socially?
  • Does the child have other mental health issues, such as PTSD, substance use, or bipolar disorder?
  • Has the child been spending a lot of time on social media? What sites? How much time?
  • Are the child’s peers (or desired peers) coming out as trans as well?
  • Did the announcement come “out of the blue,” without prior indication that the young person has ever struggled with their gender or identity before?

If the answers to these questions are pretty much “yes,” I would actually suggest that the parent state firmly and clearly that they do not support their child’s transition. I realize this is heresy. I would, as David Schwartz suggests, stop talking about gender. Anxious and depressed teenagers may learn that they can get a rise and a reaction out of adults when they mention gender. Addressing only the gender dysphoria instead of the underlying issues does these kids a huge disservice.

We know that social media sites like Tumblr and Reddit are fertile ground for social contagion and that many children start talking trans following immersion in these worlds. We know it’s easier said than done, but disconnecting them from the internet, especially social media, does give space for developing more self-reliant thinking. For some families it may be possible to remove a young person from their environment completely. Three months spent in nature away from screens, or overseas, or volunteering in a challenging environment may serve as a “hard reset,” allowing them to focus on something other than themselves. (After all, gender dysphoria is in essence very solipsistic.) Of course not all families have the networks or necessary resources to broker new horizons for their child in these ways. Parents are telling us it is extremely difficult to work out the best ways to support their child. But we are gaining increased confidence that saying ‘no’ to your child’s trans aspirations can inspire your child’s confidence for reflection. All parents try to keep their children away from dangerous trends sweeping youth culture and the trans trend requires the same vigilance.

I do believe that parents can have an impact. Letting a kid know that you don’t buy the gender identity drama, stating plainly that you love them as they are, but you don’t want to see them destroy their health and sterility can have an impact. They might roll their eyes, but I believe they hear you. At least if they ever look back in regret and despair they will know that you tried to protect them.

How can we support you?

If you know a lawyer, doctor, therapist, academic, nurse, teacher, guidance counselor or other professional who deals with young people and questions this trend and is thoughtful, please send them to our website! We are hoping to solicit 100 professionals to post on the site over the next few months. They can reach us from the site, and can send us material to post – anonymously if they wish.

Send parents, trans youth and their allies to the site too. Our aim is to cohere strength amongst and between us to bring serious, committed and critical attention to the dangers of trans orthodoxy.