“In the absence of solid evidence”: “Innovators” and “thought leaders” promote under-18 transition

by Overwhelmed

 

The University of San Francisco runs one of the most prestigious and well respected programs for “trans kids” in the United States.  Their publication, “Health considerations for gender non-conforming children and transgender adolescents,” written by Johanna Olson-Kennedy, MD, Stephen M. Rosenthal, MD, Jennifer Hastings, MD and Linda Wesp, MSN, consists of detailed guidelines on treatment for gender dysphoric youth. It appears to be written for providers, not laypeople, with specific recommendations for GnRH analogues and hormones—when to start, options for delivery (e.g. injection, patches, gel), dosages, needle gauge sizes, and lab tests for monitoring. Other areas are addressed too, including the induction of amenorrhea in natal females and the importance of discussing infertility. Towards the end of the protocol, there is a section about genital and chest surgeries.

The authors state that current standards of care recommend waiting until patients are 18 years old for genital surgeries. But regardless of this advice, they advocate for underage surgeries in certain cases:

Both the Endocrine Society Guidelines and the World Professional Association of Transgender Health (WPATH) Standards of Care version 7.0 recommend deferring genital surgery for both transmasculine and transfeminine youth until the age of 18 years. As youth are transitioning at increasingly younger ages, genital surgery is being performed on a case-by-case basis more frequently in minors.

One of the authors of the UCSF document, Dr. Johanna Olson, has frequently argued for relaxing the over-18 guidelines on genital surgery, including earlier this year on the WPATH Facebook page.

Here’s what the UCSF guidelines have to say about “chest” surgeries aka mastectomies:

 While increasing numbers of insurance companies are covering the cost of male chest reconstruction, there are often arbitrary barriers to surgery citing that youth need to be at least 18 years of age prior to undergoing this procedure. Providers should participate in appeal processes so that patients can undergo chest surgery. There are currently no available data that report the positive impact of male chest reconstruction in minors, although a study is underway now.

Gender doctors don’t have the data to back up the double mastectomies and chest contouring they are performing on minor children. But regardless, providers are instructed to recommend health insurance coverage for the procedure—including intervening in appeals processes.

Throughout the guidelines, there are a number of times it is admitted that the science of pediatric medical transition is lacking in data:

 “While sparse data exist regarding the impact of puberty suppression and gender-affirming hormones administered during adolescence, there have been promising results from the Netherlands indicating that this approach in adolescents results in improved quality of life and diminished gender dysphoria.”

 “While there still exists uncertainty as to which GNC children will continue into adolescence and adulthood with transgender identities and/or gender dysphoria and which will not, it is been noted in prior studies that increased intensity of gender dysphoria is a predictor of a future transgender identity.”

 “While data are sparse, preliminary results from the Netherlands indicate that behavioral problems and general psychological functioning improve while youth (age 12 and older) are undergoing puberty suppression.”

 “While clinically becoming increasingly common, the impact of GnRH analogues administered to transgender youth in early puberty and <12 years of age has not been published.”

 No consensus exists on the length of time GnRH analogues should continue after youth begin gender-affirming hormones.”

However, regardless of these caveats, the protocol comes across as very thorough. Eighteen different sources are cited for justification. The authors appear to be knowledgeable and capable.

But at the very end, there is this disclaimer:

ucsf-disclaimer

And there you have it. We are relying on the “expert opinions of innovators and thought leaders” in a field that is in its infancy. “In the absence of solid evidence,” children are being given earlier and earlier irreversible medical interventions based on best guesses about the future.

As the guidelines note, though, studies are indeed underway. Olson and other gender specialists have received a $5.7-million NIH grant to study children and teens who are currently undergoing medical transition. But importantly, these studies aren’t recruiting a control group of untreated trans-identified children, and they are only set to run for 5 years. While any information is better than none when it comes to this modern experiment on youth, the long-term medical and psychological outcomes for the people who were subjected to irreversible medical interventions in their youth will remain a mystery for decades to come.

112 thoughts on ““In the absence of solid evidence”: “Innovators” and “thought leaders” promote under-18 transition

  1. Reblogged this on A butterfly's diary and commented:
    This should really give any reasonable person pause for thought: we do not know what medical transition will do to children and teenagers in the long run, and whether it’s the right course of action, yet it is pushed as a silver bullet by people who raise the spectre of suicide if/when parents feel unsure. It’s unethical on so many levels.

    • Totally.

      Also, the chest surgery on minors – even taking at face value the justifications for hormone agonists and cross-sex hormones before puberty is complete to make for a more realistically “passing” trans adult, there is no reason to remove healthy breast tissue in underage females. Breasts will not influence height, hip/pelvis shape, face/body hair distribution.

  2. What in the hell is a “thought leader”?

    So, essentially, these people are saying, in the absence of actual scientific proof, to trust them. They say this is exactly what is happening to our children and teens and the treatment is a one-size-fits-all thing, even though if you bring in a kid with any other psychological issue, psychiatrists and therapists would acknowledge that even two kids with the SAME diagnosis will require individual treatment because they may have different actual reasons for their illness.

    But none of that with kids who identify as trans. Nope. If a kid, regardless of age or situation says the magic word, it’s hormones and surgery, full stop. Well, I’m not buying it. Sorry, “thought leaders.” I know you want to make a name for yourselves, but maybe some differential diagnosis is in order for these individual children and teens. Maybe, like with other mental health situations, you start with less-invasive interventions.

    Asking parents to inject their completely physically healthy children with hormones, postponing puberty which is not simply the maturing of the body, but of the mind, and perfuming surgery which is strictly cosmetic, but which is also extreme, due to the word of a “few” innovators?

    Hard pass.

  3. This movement is becoming increasingly fascist. Language is being policed, parents are being under mined, debate is silenced. Dissent is rewarded with abuse and sackings. My hope is give them enough rope….The manipulation of children is child abuse. Lawyers supporting today will be lining up to represent victims tomorrow.

  4. I so appreciate this blog. I have been dealing with my daughter for over a year who says she is a trans boy. She has been in mental health treatment since she is 9 for other issues with an esteemed psychiatrist in my area. I am shocked at what little info is out there for parents and that trans is taken at such face value. It is a very serious issue and yet there isn’t a knowledge base. I am not guving up on my daughter.

    • Professionals egos mean they are allowing the vacum of ignorance to be filled by the activists. By admitting they are clueless they would at least invite exploratory debate, healthier than acquiescence to a flawed ideology.

  5. According to a medical dictionary a ” thought leader” is a physician who is respected by his peers or is capable of influencing the way in which they practice medicine and—most importantly to the drug companies that coined the term—the proprietary drugs they prescribe.

    According to Forbes a “thought leader” is an individual or firm that significantly profits from being recognized as such.

    Oh, the damage that is being done to our kids.

  6. This post says it all — trans is nothing but a big, social engineering experiment, and kids are the cannon fodder / sacrificial lambs. And this is all really about adults! These adults want to “make a name” for themselves; these adults wish for the name recognition of Mengele. Trans is iatrogenic.

  7. My daughter’s doctor said that her teen female patients ask her all the time to approve breast implants. She always tells them no, that they have to wait until they are 18. She also recommends to them that they wait until they are completely done growing, so they should wait until their 20s. She said she never approves major cosmetic surgery for a minor unless it is medically necessary because of the fact that they are still growing.

    If it’s good for the kids with gender dysphoria, it must be fine for the kids without it. So all of the 16-year-old girls who want breast implants so they can feel good about themselves should be able to get them. If the health risks and concerns don’t apply to kids with gender dysphoria, why should those risks and concerns apply to the mentally healthy kid? Oh, and with this logic, we should allow high school football players to take performance-enhancing drugs. As long as it is done legally and pharma makes money off of it. After all, if it’s perfectly fine for a teenage girl to take a bunch of testosterone, why isn’t it okay for a teenage boy to do the same?

      • How? You can’t assume that every teenager that claims to be transgender is genuinely suffering from dysphoria as opposed to something else treatable by different means(depression, social anxiety)- as that is the very question behind asking about the evidence and about social contagion. If one 16 year-old can “know”, without question, that they need surgery or hormones and they always will, what objective standard determines why another 16 year-old does not?

      • That’s why the psychiatrists are involved a lot to try to determine these things. I know as someone who’s trans if the things other possible trans people say “click” with me, by what they say and how they say it. They may use different language and phrasing than me, but it’s like there are some common elements that only someone that’s experienced them too can recognise.

      • Actually, the medical profession is moving away from involving psychologists and psychiatrists in this process. It’s considered unnecessary “gatekeeping”. Because it’s now politically incorrect to point out the fact that many people with gender dysphoria have co-occurring mental illness Many of the well informed people who contribute to this blog have up close and personal experience with some very incompetent mental health providers who are motivated more by virtue signaling and social justice concerns than actually assessing the mental health of our children and teenagers..

      • There has historically been a lot of gatekeeping, far too much, but you seem to be suggesting it’s going far too far in the opposite direction now. I know it’s a completely different treatment path in the USA than it is in the U.K.

      • Until you’ve experienced the system for yourself, you’ve no idea. It’s not as bad as it was (Google the bbc’s “a change of sex” for the old Dr type being all condescending). I’ll look at your link tomorrow as I’m really not in the best headspace right now to discuss things sensibly right now.

      • No, they are not. My kid’s doctor thinks it is medically unwise to do major COSMETIC surgery on someone who is still growing. Period. A physically healthy child should not be made physically unwell due to a psychological condition.

        If it is perfectly safe and wonderful for my daughter to take testosterone, why is it not okay for my son to also take testosterone? Maybe he’s not happy with his body, either.

        If it’s perfectly safe and wonderful for my daughter to have a double mastectomy at 16, why can’t my other daughter have breast implants at 16? Maybe she’s not happy with her body, either.

        Let’s be honest. If I took my healthy teen for a mastectomy because she diagnosed herself as trans, I would be celebrated for being a brave, supportive parent. If I took that SAME healthy teen for breast implants because she diagnosed herself with body dysmorphia, I would be seen as a f*cking monster who was furthering my daughter’s mental illness. There is NO WAY anyone can argue with that. Everyone reading this knows that’s what would happen.

        There is a double standard here. If someone who has diagnosed themselves as trans should be able to have major cosmetic surgeries as minors, why shouldn’t other minors who have not diagnosed themselves as trans also have major cosmetic surgeries? Why is it healthy for one kid to do it, but not for another?

      • They are different, and surgery in both cases shouldn’t happen before they’re legally of an age to consent themselves, but that’s why puberty blockers can be so important to some kids, I allows them time to decide which road to go down.

      • Also, there is no reason for people with other body dysmorphias to be denied the surgical treatments they desire if the only criteria is an inner feeling of who you really are which does not happen to match the body you now have. People in the transabled community, using the very same criteria used by the transgender community, want doctors to put out their eyes or amputate a leg or paralyze them as being blind, or having an amputated limb, or being paralyzed are the people they feel they truly are.

    • This is in reply to oopster74. I’m not sure if the comments will nest correctly. I know kids who are under 18 who started hormones a few months after diagnosing themselves as trans. One had a double mastectomy at 16. Where is the gatekeeping you speak of?
      Puberty blockers are not long-term solutions. The hormonal changes that happen with puberty affect more than the development of the sex organs. Should a kid be put on blockers at 11 or 12 and stay on them until 18? That’s a LONG time. What are the effects of taking blockers for that long?
      The “experts” in this field will admit that 100% of kids who go on blockers go on to cross-sex hormones. Here’s the problem as I see it: The adults around these children have made the children’s lives ALL about being trans. These kids are told for years that they were born in the wrong body. They don’t know any different. They don’t have a chance to find out whether or not they will like their natural adult bodies after puberty. They don’t have a chance to decide as adults about whether or not they want their own biological children one day. That decision has been taken away from them. I’m sorry, but asking a 12-year-old whether or not they want to have children when they’re 30 isn’t very reasonable or fair. Do we expect a 12-year-old to know where they want to go to college or what profession they will have? Even if they have an idea of what they want to do for a living, are we surprised when they change their minds 6 months later? Of course not. It’s normal for children to change their minds. It’s part of growing up.
      We as a society are stealing the childhoods from these kids for our little science experiments.

      Once again I ask: If a 16-year-old who has diagnosed themselves as trans can have a mastectomy, why can’t a 16-year-old who has not diagnosed themselves as trans have implants or a breast reduction?

      • It interests me greatly that your argument (Two physically healthy children receiving surgeries that are unnecessary to continue living) is being considered inadequate by some. As someone who came across this page from searching up the phrase “free top surgery for minors” due to a personal desire of mine to have my chest removed so that I may closer “identify” with my fantasy of being a man, I can say that I quite fully agree with you:

        Any man, woman, or child who does not physically suffer from issues that would require drastic cosmetic surgeries- but still strongly desires them to the point of considering ending his or her own life if they are not received- is not mentally stable, nor a sound judge of what type of treatment he or she needs. While I have never been officially diagnosed with any sort of disorder or mental illness, I research these sorts of topics regularly and can confirm that long before I seriously entertained the idea of being a man, there were several indications that my thoughts and actions were influenced by some sort of uncontrollable condition. Even now, I do not wish to call myself “transgender”, for fear that I will completely give into this folly. Despite my desire to “transition”, I have always come back to the realisation that reality is set as it is: I am a young female, and no amount of silicone, erectile tissue, binding, or tissue removal will change that. Even if my reproductive organs were removed, I would still only be an infertile woman who looks and behaves as a man would. Even as I write, I feel a slight pang within myself as I try my hardest not to acknowledge my rather ample, sagging chest. I still think of myself, even as I admit that I am not, as a man or something between a woman and a man, though I am not intersex or male. I understand so much more than any of these children mentioned will ever know, for I am not only trapped in this state, but I also have an undesirable appearance for either gender: Flabby and out of shape, ugly and scarred, broad and disgraceful. All of these beautiful girls and handsome boys who believe that they ought to change themselves are sick. That is the reality of it. If even someone like myself- twisted and ugly and horrid- can confess that this is all a combined manifestation of my wild imaginations and the torment I suffer from within, then why can’t you all do the same and bravely face the reality that has been left to us? It is painful, but I would rather embrace the truth and burn brilliantly than cling to a lie and wither away silently.

    • Not to mention, a neovagina needs regular dilation to stay open, and a neophallus needs three separate surgeries before it’s considered complete. I didn’t know these things myself until hitting peak trans, so why should we expect any of these kids or teens know about it?

      • Whether they know the ins and outs of surgery (pardon the pun), it’s not always about genitals, but about how you feel about yourself, so then having the “correct” corresponding genitals becomes important.

      • Ok, so if as oopster says, it’s not always about the genitals, why does it have to be about transition? If a person with a vagina can lead a perfectly happy life with a buzz cut and a CDL license, why does society have to recognize that person as a male?

        It is the trans activists who are making the lines between boy toys and girl toys, between men’s clothing and women’s clothing more rigid than they have been for decades. And why do so many transition stories entail announcing “I always loved/hated pink”? When I was a little girl, I hated pink and I wanted to grow up to be an astronaut (never would have happened due to birth defects) – none of that made me think I was really really a boy.

      • I wanted to be an astronaut too! My class wrote to NASA, and I explained my desire. I got a bemused message back, explaining that women were unilaterally not accepted into the program. However, NASA did send some very nice commemorative photos, stickers, and patches. These days, woman ARE accepted into all kinds of professions that were completely closed to females in my day, but they feel they can not enter them as women, and must pretend to be “really” men, against all physical evidence. How sad. This does not advance equality at all.

        FtT might as well go back to the days of my youth, where Help Wanted Male and Help Wanted Female sections were the norm, and women were always paid less for doing the same exact job as men, and it wasn’t even controversial. Another fact for the young ones, women were not allowed to get personal or business credit, in their own names, and needed a male cosigner, usually a father or husband. This was true even if the woman worked and had her own income! Oh, and abortion was illegal too!

        Be proud to be female and a survivor! Do not betray your sisters!

    • We can’t even give a “transgender” kid, or adult, plastic surgery that will make it possible for them to reliably pass for the opposite sex, even with clothing on.

      Watching videos of people who have transitioned with hormones and surgery (not just bottom and top, but even facial restructuring), what strikes me is just how robust one’s birth sex actually is – being obvious in mannerisms, the ways of speaking, word choices, clothing choices (why does it seem like all MTTs dress like porn actresses and never like middle aged housewives – middle aged housewives are just as female as porn actresses, and I would think that if women born in women’s bodies have a large spectrum of interests, jobs, fashion sense, then women who are “really really women” but born accidentally in men’s bodies would not all have a single stereotypical presentation to the world)

      Another issue is that I’ve been noticing while watching many many videos on the subject is that a lot of people who claim to be transgender, especially younger ones, seem to view any sort of hormones or surgery to try to physically change the body to align with the desired sex as optional – they seem to want society to treat them as their declared sex based on nothing but declaring the sex they wish us to treat them as. Also – the number of such “genders” are multiplying.

      • This is something I’ve been wondering about. It’s not happening with my kid, but at this point I know a lot of transgender kids. What is the best thing to do when someone is transitioning to male but looks like a girl?

        The people around her will change their pronouns, but nobody is really going to perceive her as a man and outside her social circle she’s not even going to get the pronouns. Should someone give the kid a dose of reality?

        But on the other hand, at least they’re not doing anything harmful to their body. What if talking about this just increases their dysphoria and they decide they need hormones, etc.? Maybe if kids can believe they are the other gender without changing their bodies, they’ll have a little time to figure out that they like their bodies and want to be girls or boys.

        It’s all just so crazy.

      • Yes, give them a dose of reality. It is a kindness. Better to hear it from someone who really loves them. Not everything in life is a choice — and that is okay.

  8. I feel like a broken record, but I think we have to keep saying it. One of the kids who transitioned early in the Netherlands DIED. They got a serious infection after genital surgery.

    This is not a story of happy ever after endings for everyone. Talking about the results of the study in the Netherlands without talking about the kid who died is a kind of lie.

  9. The other thing that constantly irritates me in all this – none of these people are psychologists.

    They don’t have experience treating kids who outgrow their gender dysphoria or trying to figure out if the real problem is something else. They aren’t familiar with social contagion or fads in diagnosis.

    They should not have anything to say about whether or not kids get surgeries at a younger age.

    • Unfortunately, I don’t think many Psychologists are suspecting social contagion or fads on trans topic and they don’t seem to be trying to dig deep and figure out if the real problem is something else. It appears many have been sipping the Kool-aid also.

      The US doesn’t keep track of the number of transgender identified people. For something supposedly so rare I keep hearing about all these trans teens. All these kids in “wrong bodies”. Every HS in my area (Northeast) has a few trans kids. I keep hearing mostly natal girls transitioning and sadly my own.

      • The energy these girls are putting into rejecting the pink and pouty version of femaleness is a good thing. The pity is that it has been harnessed by men who want to dress as women.

      • I feel for you. I lost my own beloved daughter to the trans gender fad. She was over 18 so free to choose drug dependency, radical self mutilation, and a revision of her childhood narrative of a perfectly normal girl (don’t show photos!) over doing the work to mature and come to terms and accept herself for who she really is (which everyone has to do). I am heartbroken at the loss of my daughter and what had always been a close relationship. I am furious at her demands that I forget the actual history of her childhood and our relationship, in which she frequently requested “girl days” for instance when she would want to go out clothes shopping, getting our hair done, and other very typical girl things.

      • The psychologists who have worked in this field a long time are the ones asking questions. I think they suspect social contagion or something like it.

        However, there are also plenty of psychologists who have drunk the KoolAid. They think they know what’s been proven because they go to conferences and are told this or that is true. They see a PowerPoint, not a study.

        This is one area where liberals have managed to become anti-science.

        You are spot on about the increase of teens with gender dysphoria. This used to be a 1 in 15,000 males and 1 in 30,000 females thing. You would expect to meet one transgender person in your lifetime. What we are seeing now is absolute insanity.

      • I think that not just in this area, psychology looks at the patient as an isolated phenomenon, taking the patient’s word for things that absolutely could be investigated by asking for info from people and records to get a bigger picture about what’s going on with the person (it is a known fact that an individual human can lie, and can misinterpret events).

        It’s like the profession as a whole learned nothing from the Satanic Panic/False Memories debacle of the late 20th century.

      • Freenampeyo- I feel so sad for your situation. My kid socially transitioned 6 months ago. We parents (grew up in the” Free to be you and me generation”) were shocked. Most everyone else not surprised, even siblings. Prior to her announcing this to me she was not aware of any other trans kids. She didn’t tell anyone else for many months but eventually felt she had to start transitioning. My kid was as non-girly as they get and uncomfortable in her social role and skin early on. Even voiced plans to have breasts removed years before they developed. I guess she would be considered a strong candidate for dysphoria persistence. Even though her dysphoria was not sudden onset it’s worsening and this is the most unsettling situation I have ever faced. She wants to erase her past also and eventually live stealth.

        Molly- My kids therapists is male 35+ years at practice and very ethical- took a long time getting to know my kid who other than a little anxiety is well adjusted. I believe that since
        transgender identity is not viewed as a mential disorder according to APA many therapists do not delve too deep. It’s not seen as something to correct or deter. I didn’t get the feeling he was aware of social contagian until I talked about with him and again he has been practicing 35+ years and with transgender clients.

      • Blindsided, what frustrates me is that therapists should spend the time to make sure it is the right diagnosis, even if they don’t think they can cure gender dysphoria. It sounds like your kid’s therapist took the time and you may be in a different situation from many parents here.

        I guess I believe that at this point, therapists can cure many cases of gender dsyphoria that come into therapists’ offices because they are a new kind of gender dysphoria.

        it’s difficult because you can’t say it’s not actually gender dysphoria since G.D. is just the belief that you are a different gender and want to change. On the other hand, there is a difference between someone who has been saying they were the opposite sex since they were three and someone who has recently come to believe that they are a different gender.

        But now I think there may be teens developing new cases of GD for other reasons like:

        they have other mental health issues or body issues
        they are gay or lesbian and facing homophobia and maybe bullying
        they are gender non-conforming and getting social pressure about it
        they are bullied and socially alienated
        they have discovered they like cross-dressing and are freaking out about it
        they are gay or lesbian and when they came out, people said, so are you trans?

    • The goal in an early transition is to keep people from changing their minds. A big thorn in the trans communities side is the 80% rate of kids that realize the body they were born with is fine.

      • the 88% desist rate requires that the kids aren’t affirmed in the other sex. How they feel about themselves is discusses but nobody ever says “yes you are the other sex than what you were born as”. I think the child as a person should be validated but not their dysphoria per se.

      • I’ve talked to some transgender adults who are genuinely convinced that desistence doesn’t exist. They are getting bad info.

    • I’m not sure it’d help anyway, most psychologists are the kind of people I wouldn’t trust to look after a pet rock let alone a vulnerable young patient. This isn’t to denigrate the rare good ones – they’ll know exactly what I mean, and this situation is just as impossible for them. The field not only hasn’t learnt since the satanic panic, as Trish says, it hasn’t learnt since Freud. It’s a field with a repeated history of abuses, and an arrogant refusal to acknowledge and address them, this is more the norm than the exception. I find it disturbing how often there’s been a sexual aspect to the abuses, too.

      I think it needs to be seen in that context, and in the context of how psychology often still (mis)treats people with other mental illnesses at present. People have too much faith that someone somewhere knows what they’re doing, when psychologists frequently don’t and have made horrendous mistakes (and ‘mistakes’ is at best) within recent history, and still do. I think that helps explain why someone can get away with being a ‘thought leader’ despite lack of evidence for their claims and how drastic they are. Even many of the actual psychologists do the same thing anyway. It is not a sufficiently scientific field, and the patients get treated almost as disposable. People with mental illness aren’t treated as thought they count as actual people.

      • Leo, I really think you are onto something. It is beginning to seem to me that every generation there are patients and families whose lives are destroyed by psych professionals who are at the cutting edge of the latest not-thought-out fad.

        The following is a general guide. I know there are some clinical psychologists who are informed by science – such as the psychologists who developed cognitive behavioral therapy.

        Psychology is divided into two areas: clinical and experimental. The experimental psychologists are the scientific ones, they do the experiments in how attention works, how people respond to authority, what populations are most vulnerable to social contagion, how people can be fooled/fool themselves, etc.

        Clinic psychologists, on the other hand, believe that everything they need to know is contained in the interactions they have with patients. (Freud would be their patron saint, ignoring the fact that he and one of his buddies, working on a theory of a connection between nasal tissue and sexual disfunction permanently mutilated a woman’s face).

        Not only is clinical psychology generally missing a connection to science, it is also missing any concept of the history of psychology, especially the tragic mistakes that are often made in the name of this “helping” profession”.

      • Yes, people in the “helping professions” should be slower to jump on bandwagons, given some of the more unfortunate incidents from history.

  10. As a body modification enthusiast, I’d never go anywhere near a piercer who pierced the nipples or genitals of anyone under eighteen. The law rightfully recognizes that’s a sexual, adult act, even if both parties are purely professional and very mature. We also don’t let people under eighteen get tattooed. People who tattoo minors or give them intimate piercings anyway are seriously sketchy, creepy, unprofessional people. Why then is it now considered cool for minors to get irreversible genital and breast surgeries? The brain isn’t finished developing until about age twenty-five!

    Looking back, I marvel at how very, very young I was when I became Jewish at age eighteen, after many years of longing for it. My parents insisted I wait until that age to make a decision about what religion I wanted to be. (They now regret not giving me and my little brother any religion so we could choose our own as adults, but what’s done is done.) But at least I was a legal adult and had had this desire long enough to know it wasn’t just some passing juvenile fancy. Likewise, I began wanting a nostril piercing at twelve, and didn’t get it done till twenty-three. All those years gave me a chance to make sure it was what I really wanted, and I was able to do lots of research. After thirteen years and counting, it’s become an integral part of my body which I couldn’t imagine not having. But when it comes to these so-called transkids rushing right into adult decisions like this, I see a huge coming wave of regret, disgust, and horror, after they realize they were sold a false bill of goods and inappropriately fast-tracked into something without any supporting evidence beyond warm, fuzzy feelings and propaganda about the risk of suicide.

  11. Here is a question for Free, does your daughter want people to believe she was always a boy, full stop? In other words, is she intentionally disguising her birth and childhood from others who might find out the truth, that she was born female? How is living with that kind of secrecy not incredibly stressful and harmful to her mental health? It must be almost like being an undercover agent or a spy.

    • Yes, she seems to want to disguise her actual childhood. She wants me to agree that she is “really” transgender. The definition the trans community uses is that if you say you are transgender, then you are. I have freely agreed that she says this and so meets her own definition. This seems to make her mad. She actually wants me to agree that she has somehow always been a boy. That seems to me a bad long term strategy for mental health.

    • That is an excellent question for any person who is claiming to be trans.

      I have been suspicious of the trans activists for a long time because of the issue of changing the sex on people’s birth certificates. And adult who has transitions – even going all the way with facial reconstruction, all possible hormones, “bottom” surgery, lessons in how to walk, talk, dress as a woman, was never a little girl. Putting “female” on the birth certificate is falsifying history and falsifying a legal document.

      There is a procedure that would be far more appropriate, to create a paper trail connecting the new adult trans identity to the birth certificate, that is the procedure for a legal name change. The person goes to a judge, explains the reason for the name change (avoiding debts or legal sanctions is a no no), fills out paperwork and then receives official paperwork from the court that connects the birth certificate of Jane Name to the adult identity of Janis Doe, then uses that paperwork to get driver’s license, property deeds, medical records, etc., changed to reflect the new name.

      Another problem with changing the sex on a birth certificate is that even after doing all the procedures possible for a trans person to do, they are still on a chromosomal level the same XX female or XY male they were born as, and even with hormone agonists and cross-sex hormones, still vulnerable to sex-linked conditions (e.g., prostate cancer in MTTs)

      Finally, and this is very sad to consider, what if the person winds up victim of some awful killer and all the paperwork says a woman is missing, then a skeleton, or some part/s like the cranium or pelvis, is found with various measures that are definitely male and the crime is never solved and the family never knows what happened to the person?

      • As a genealogist, I can only imagine how finding one of those “updated” birth certificates would be very confusing for future generations researching their roots. Believing someone was born the opposite sex and had a different name from what they really were might lead the researcher off on a wild goose chase. It’s difficult enough to find records for women who are only identified as Mrs. Husband’s Full Name (or in Hungarian, with the suffix -né tacked onto the husband’s name). I understand changing something like a driver’s license after a name change, but not a legal document of historical record.

    • worriedmom, for some people it is necessary for their safety to be completely undercover about their transition. It is stressful, but they may have to do it to avoid being beat up or keep a job.

      That is different, though, from wanting your mother to say that you were always a boy. My kid hasn’t gone that far yet, but this idea is promoted out there. Janet Mock famously corrected a TV show for having said she was born a boy. Then there’s the revised birth announcement one family did that is shared as the ideal parent response instead of just nutty.

      I think it gets back to the theory that being trans is an intersex condition without any visible signs. But it’s mostly about an insecure gender identity.

      I don’t think it’s healthy and I see signs of unrealistic thinking in my kid that are probably not healthy for them either.

      Anyhow, freenamepeyo, it is extremely frustrating to deal with this kind of thing. Thoughts are free; we should be able to think what we want without our kids going off on us. We have a right to treasure photos of our kids. We and everyone get to believe what we want about gender and gender theory. It should be enough if we call someone by the pronouns and name they prefer.

      I’m not sure if I’m being unrealistic, but it seems to me that in the past, when people had gender dysphoria and transitioned, they were more realistic. They didn’t get mad if a parent got a pronoun wrong. They expected parents and other people to have trouble with the idea that they were the opposite sex.

      • Nothing exists in isolation. Children beleive they are superior to their parents gender action. They do not respect wisdom or life experience. Every day the news or tumblr or some meme reminds them we have messed up the world. The best line I hear is ‘ you have messed up the world for us’ ego centric victim hood.

  12. Without studies there can be no proof, but studies need volunteers to be studied. We don’t know the long term health issues of many medical treatments, but they still go ahead. What is needed is research, more research, and then a bit more research on top of that, but what do you tell the people of today suffering with gender dysphoria? Oh sorry we’ve not got the proof yet that you’re suffering. There are lots of conditions that could be said to “only in the mind”, but they don’t get neglected. The treatment for them changes and evolves over time with greater knowledge and treatment. I was a carer to a lady with Alzheimer’s slightly, and part of her care involved not getting her stressed or anxious, which means I often had to lie to her, which I felt bad about, but the alternative would have been worse for her. Evidence will come eventually for the best solutions, but we have to do the best with the solutions we have right now.

    • The problem is … the scarce research that IS available indicates that physical transition doesn’t actually fix dysphoria, depression, suicidality etc long-term. So we’re going forward with solutions that actually don’t seem to solve things, long-term, for a lot of people.

      Medical treatments are supposed to involve clinical trials — something I’ve yet to see implemented for use of testosterone on FTMs. It’s all off-label and I’m not confident there are going to be large studies any time soon. What there IS available for transition of FTMs is not at all encouraging, in terms of physical damage. Binders have documented risks/damage; testosterone has a HOST of documented risks, including some emerging ones (damage to mitochondria specifically in FTMs); and double mastectomies aren’t such a simple solution either. I’m not even going to talk about the well-known problems with phalloplasty/metoidioplasty, which are so bad that most FTMs don’t do it. Not to mention the not-so-hot track record of so-called “blockers.”

      I credit the detransitioned/questioning women in the group coordinated by redressalert, and the blogs/vlogs they are creating, with providing some actual aids for gender dysphoria in natal women that don’t involve hormones/surgery. These are suggestions that have worked and continue to work for people, and yet the med/psych/pharm community continues to pretend they don’t exist. That’s what I’d tell people who are suffering now: At least check out some low-risk alternatives. You owe that to yourself.

      I remain completely unconvinced that the “approved solutions” we have right now are good, especially for kids/adolescents/young adults. The risk/benefit ratio doesn’t work, and no matter how much I dig and read and research, I can’t make it work. We’re not doing the best with the solutions we have now if some of the potential solutions (perhaps not coincidentally, the ones that don’t enrich providers or make anyone famous) continue to be strenuously ignored by “thought leaders.”

      • You’re right on a lot of things, but wrong on some too. I’m trans, my ex is too. A lot of the depression we’ve suffered as a group (from the trans people I know personally), is down to not being able to open up or seek treatment, but a lot of that goes away when they start the process of transition. There’s still a lot of problems left over to deal with, and not everyone deals with that in the best possible way, but that could be said of anyone regardless.

      • Oopster, how does starting the transition process do anything about your admitted inability to open up emotionally to others?

      • I really don’t understand the question you’re asking me? Where have I said I can’t open up emotionally to others? I know I said I wasn’t in the best headspace the other day, so if that’s what you mean then I was just having a bad day that day, nothing else.

      • Hi Oopster, to directly quote your own post, “A lot of the depression we’ve suffered as a group (from the trans people I know personally), is down to not being able to open up or seek treatment, but a lot of that goes away when they start the process of transition.” My question, “Oopster, how does starting the transition process do anything about your admitted inability to open up emotionally to others?” was directly in response to that. If you were simply having a bad day, I hope today is a better one, but your post made it sound like not being to open up was an ongoing problem leading to depression.

      • oopster74, the question isn’t do some individual people find relief from hormone therapy, but do we have studies showing that hormone therapy works for most people? and do we have studies of the harms and side effects for some people?

        lovetruthcourage, I don’t think attacking oopster74 personally is helpful.

      • MollyW, I do not think accusing me of attacking Oopster personally is helpful. I do NOT intend to attack Oopster, but I do fully intend to attack her flawed logic and delusions.

    • I want to pose a question which I have been thinking About. I am a feminine woman but when I was raising my daughter I was uncomfortable with the bombardment and messages of the disney princess movies ,books, and toys and then barbie movies and toys and lastly american girl. Birthday parties were fashion shows or mani pedi parties. I wonder if the dysphoria is a backlash to all of that?

      Sent from my iPhone

      >

      • I don’t know. It used to be okay for little girls to be “tomboys.” But then it started to dawn on people that tomboys often become lesbians, so now you can have your daughter “transition” and be a straight man.

      • I honestly don’t know sorry, but the messages for young kids about blue and pink and princesses and superheroes are far too much for young kids especially.

      • For many FtT, there does seem to be a backlash against stereotypical norms of femininity. Yes, as Oopster correctly pointed out, it is all a bit much. However, the answer isn’t transition, but forging a more authentic path. There are as many ways to be a woman, as there are women. The world can be a painful place for women who are not conventionally attractive, thin, sexed up, and compliant with stereotypes. This is a reason to lose the stereotypes, not a reason to transition to a different set of stereotypes for men. It is truly ironic, that at this point in history, women have more freedom than ever before, yet so many of them are wasting it, by cowering, and choosing the illusion of transition. In prior decades, there were more real threats to women who broke new ground. Now women are accepted in more jobs and social roles than ever before, and have more freedom, but there is a subset of (mostly) young women who are not taking advantage of that. If only they had the courage that their great-grandmas had!

      • Bonnie- I believe dysphoria is caused by many things. My daughter, who has a very high IQ, was born shunning femininity. I believe she was aware at an early age of being different than most girls. Most girls didn’t mind the girly stuff, the girly party themes. My kid says she felt she was a boy when she was younger. I interpret this as she was aware her interests “should” be different than her brothers and boy friends and she “should” like the girly things but had interests that more aligned with the boys. We parents treated her no different than her brothers, never forced her to be feminine. Just wanted her to be her.

      • I disagree that kids are molded by toys, movies, books and movies – I think the manufacturers/sellers of these things are molded by what their target customers (the kids) prefer. There will always be kids who are less intrigued by the toys that most of their peers like. I loved my Barbie dolls, but converted my Barbie Dream House into a starship, so we could play Star Trek. I loved mini skirts and hated pink. I also loved my electronic experiment kit from Radio Shack.

        The first Montessori school was very anti-dolls. The girls were not supposed to have them, which did not make the girls not want dolls. In fact, one of the girls at the first Montessori school made a doll for herself out of a lightbulb and some fabric.

    • Oopster, here is an example of something that was given to women who were undeniably suffering from severe morning sickness during early pregnancy. In an effort to ease these women’s illness, they were given a drug that they were assured was safe both for them and for the developing baby. Even though there hadn’t been sufficient research, doctors decided that women should receive the drug anyway. You can read more about it right here: http://www.thalidomide.ca/the-canadian-tragedy/

      • I’ve heard about thalidomide. I know the effects it had on the children of mother who were taking it. That’s one reason why the medical profession are a hell of a lot more cautious about things now.

        You know the most commonly used drug for mtf transwomen is? The pill, the birth control pill. We’ve had lots of studies on that. Countless natal women use it. If something bad were to occur with it, we’d know soon enough.

      • There’s nothing “cautious” about the off-label use of cross-sex hormones on prepubescent children–who are, as fully admirted by the prescribers–part of a grand, unprecedented medical experiment, the results of which won’t be known for decades.

      • They’re not just handed out like sweets you know. It’s rare that pre-pubescent kids are given cross-sex hormones anyway, puberty blockers maybe after a considerable time of counselling and only with the permission of the parent(s) or guardian(s).

      • No, it’s not rare at all. Jazz Jennings is the tip of the iceberg of an increasing number of kids who are prescribed blockers and cross sex hormones, frequently at the same time. Jazz has been on cross sex hormones since at least age 13. Just watch the spectacle of the endocrinologists trying to get the hormone cocktail just right and deal with Jazz’s suicidal depression, all chronicled on the “I am Jazz” reality show. There is a push on by top providers to do this earlier and earlier. Apparently, you haven’t read much of this blog, because several posts have direct quotes from gender doctors who are very eager to speed up this process. And you ignored the main point of my comment: it’s an experiment. The post you are commenting on has multiple caveats issued by these providers in their own guidelines. They are all very careful to state that no one knows the ultimate outcome for these medically transitioned kids. No one.

      • oopster, this is really important. Tran women used to get strokes from estrogen therapy. The people in the field think they’ve figured out how to reduce that risk by changing the dose. I think the original problem was in fact birth control pills. They are not safe. If you have any trans women friends, they should not self-medicate with birth control pills.

        In addition, if a trans woman smokes and takes estrogen, she might get lung cancer, just like any woman on birth control pills.

        And yes, we know that bad things can happen for natal women who take birth control pills. We know that because we have had large studies over many years plus clinical experience with millions of women. That allows us to screen women and look for the side effects.

        In addition, for many years, menopausal women were given estrogen and nobody thought there were side effects. Eventually a large, long-term study showed that estrogen therapy could increase the risk of death, mostly due to heart problems. We don’t know if those effects apply to trans women, but it wouldn’t be crazy if they do.

      • Strokes are the main issue with taking birth control pills and smoking. What study shows that lung cancer risk goes up when combined with taking bc pills? Obviously, smoking is enough to cause lung cancer, and some people who have never smoked get lung cancer.

      • 4thwavenow, Jazz is suicidal? I didn’t know that. And what’s going on with her hormones?

        How old is Jazz now? I thought maybe she’d had surgery?

      • Oopster, your comment about the pill just struck me now.

        It’s certainly true that natal women have been taking the pill for quite a while. And, that in general the impact of the pill on natal women has been studied pretty carefully, and in a very, very large sample. As you are no doubt aware, the “pill” itself has been re-formulated and “tweaked” countless times as different side effects have emerged, and research has shown various outcomes.

        The fact that the impact of birth control pills on women has been studied is, however, almost entirely irrelevant to the impact of birth control pills on natal men! It would be one thing if it were some kind of a cancer drug or medication for another condition, and even then, it’s really important to study drugs as they interact with both men and women.

        But to say that birth control pills, which affect the entire endocrine and hormone system, are “safe” for men because they are (comparatively) “safe” for women borders on the facetious.

      • Great comment, worriedmom, and you are 100% correct that the risks of birth control pills on women (who naturally have more estrogen and progesterone than men) tells us nothing about the effects of birth control pills on men. You make a really important point. The converse is also true. Knowing how testosterone treatments effect men (who have relatively more testosterone naturally) tells us nothing about the safety of doping women with testosterone (who have relatively less testosterone than men.) We have some info, but the data is limited. One should not assume that this is safe, just because the practice is becoming more common.

      • The pill can have bad side effects even for natal women, and even though women’s bodies produce some testosterone, women taking testosterone also has negative side effects that natal males taking testosterone are far less likely to suffer.

      • lovetruthcourage, you are correct, lung cancer is not a concern. Strokes, however, are.

    • There are some HUGE fallacies in your post.

      For one thing, the surgeries and drugs for trans-identified people are elective and NOT medically necessary, unlike experimental drugs sometimes given for potentially fatal diseases and conditions. Even in the situation of a terminal illness, it is extremely difficult to get experimental drugs. All drugs require rigorous, multi-phase, clinical trials, and FDA approval.

      Yes, we treat some mental disorders with drugs, and trans is clearly a mental disorder, but it does not follow, that therefore, trans should be treated with drugs. Why not? Because there is ZERO clinical evidence that hormones and surgeries are any kind of cure for gender dysphoria. In fact, playing into the trans delusion, has been shown to actually exacerbate the delusion. “First, do no harm.” Even with grave, potentially terminal illnesses, experimental drugs are stopped when shown to be counterproductive. Further, there is evidence that trans-identified people are at least as likely to commit suicide AFTER they are catered to, with surgeries, drugs, and ridiculous social demands. Trans people deserve better than this! Don’t you think so?

      We don’t prescribe starvation diets, diet pills, and lipo to anorexics, and similarly, we should not enable trans-identified individuals to harm themselves. Don’t you agree, that no professional recommends affirming the identity of someone who rants and raves, and thinks that they are a long dead historical figure? Those mentally disordered people deserve better than that! Painful truths are better than well-intended lies. The truth shall set you free! We tell them that they are not that person, and that they should seek psych care. Sometimes, we even commit them to mental institutions against their will. Similarly, believing against all evidence and science, that one is somehow “born in the wrong body” is a grave delusion. It would be criminally irresponsible, and downright cruel, to affirm that identity! Can we agree on that?

      The best treatment for trans that we know of, is talk therapy. It is essential to get to the root of the problem, which is rejection of self and reality. No drugs / hormones / surgery can cancel reality. Can we agree on that? Magical thinking is the hallmark of trans-identified people, but reality does not bend to delusion. A man can not become a woman. A woman can not become a man. Sorry! Time to grow up, abandon childish things (like magical thinking), and accept reality. Raging against reality is futile. Can we agree? Of course, the reality that talk therapy— not surgery, drugs / hormones, or ridiculous social demands— is the best available treatment for people suffering from transgender delusions, is quite clearly NOT the evidence the trans community wants to accept, but science is reality-based, not want-based.

      • I actually don’t think talk therapy works that great for some ppl. At least among natal females, what people who choose to ‘reidentify’ as women often say has been helpful in dealing with dysphoria is immersion/identification in radical feminism and/or women’s communities, and/or getting reidentified with the body by regular working out or other types of physical activity, and/or broadening social ties beyond a small circle of trans-identified people, and/or immersion in activities/work that provide a sense of identity and satisfaction without being related in any way to gender identification.

      • Of course, no treatment works for ALL people. That goes without saying, which is why I didn’t say it. My point was that talk therapy works BETTER than drugs and surgeries for gender dysphoria for MOST people. Your other suggestions are good ones, but outside of the scope of the helping professions. I agree that reconnecting with one’s body via exercise, is excellent and effective, and so is understanding radical feminism, but that is something that people can pursue on their own.

      • I said I’d reply properly later but it’s been a long day and I’m tired. Might have to wait till the weekend to properly reply to your comment sorry.

      • Unfortunately, I don’t think we have any evidence that talk therapy works well for people with gender dysphoria. Most people in this field say it doesn’t work.

        Talk therapy works for all kinds of other problems that someone might have though. Transition isn’t going to fix mental illnesses and nobody should expect that it will do that.

        Transition does help some people with gender dysphoria not have gender dysphoria. The issue I have is that we are seeing a huge increase in the number of people who say they have gender dysphoria – why is that? Could some of it be related to the way we talk about gender?

        And the other big problem is that we are seeing teens with problems quickly pushed along to taking hormones without making sure the issue really is gender dysphoria and not just depression and anxiety or reactions to trauma.

        I suppose one last issue is that researchers should be looking for solutions other than hormones and surgery because hormones and surgery don’t work all that well.

      • I think the usefulness of talk therapy depends largely on the type, and content, of the talk therapy and the skill of the provider. Just nodding one’s head and affirming everything a transgender-identified person thinks is NOT helpful. Perhaps that is what you were thinking. If so, we agree. However, a really deep dive into the root causes is known to be helpful. This would involve looking in depth at preexisting psych issues, issues around puberty, and traumatic events that may have triggered the dysphoria, among other things. And of course, there are effective providers, and bad ones, just like any profession. However, I think that just because there are a certain number of unhelpful counselors / psychologists / therapists etc, it is not helpful or honest to label the entire scope of talk therapy, and all people providing it, as useless for gender dysphoria. As always, the devil is in the details.

    • Sadly, double-blind placebo-controlled studies of transitioning via hormones, hormone agonists and/or surgery, especially for minors, are not an option.

      But the link between smoking and lung cancer was found without using that particular scientific protocol. There are other ways – like Sweden, which has long collected a large variety of data from their national health system collating the data on people who chose to transition using Sweden’s medical services, which has given the world a lot of info on the effects of transitioning on those who have transitioned.

      The best option, absent double-blind, placebo-controlled protocol, would be a Framingham type of longitudinal study where, from this day out, certain categories of data would be collected from people seeking transition, age/birth sex/race/region matched with non-transitioning controls. Considering the known risks of the hormone agonists, cross sex hormones and surgeries, and the changes being requested of our society (bathrooms, pronouns, ignoring centuries of biological science) allowing the collection of such data is a reasonable request.

      • I think I get what you mean. Double-blind placebo tests feel a little unethical and possibly cruel to me where someone’s mental and emotional wellbeing is concerned though. It’s s tricky one regardless.

    • “There are lots of conditions that could be said to “only in the mind”, but they don’t get neglected.”

      Yes they do, and it’s realer neglect (not allowing a teen to permanently alter and damage their healthy body is not neglect). Speaking as someone with multiple mental illnesses (they’re not ‘all in the mind’ I don’t think, there’s evidence for physical causal factors. That’s something that often gets neglected, too), our suffering gets taken less seriously than that of transgender people seems to be. We’re expected to take a potential suicide risk for transgender people with grave seriousness even when it’s a hypothetical, but a parent can desperately call for support for their child with depression who is actually suicidal and in crisis right that minute, and be told too bad, no beds. They can watch their anorexic daughter get thinner and thinner, knowing she’s killing herself and still not be able to get access to treatment. These are real cases, multiple ones, I’m talking about. Even with actual evidence, even when the treatment or steps to take are relatively straightforward and don’t involve permanently altering and damaging a healthy body when it’s unclear it’ll even help (and if it does it is for reasons that are ‘in the mind’), patients very often do not receive it, or it’s insufficient and improperly given. Trans suffering is a fashionable cause to liberals, ours isn’t, though I’m not sorry for that since we wouldn’t benefit from it being either.

      I know it’s difficult to maintain perspective in such situations, especially for young people, and that their suffering is very real, but more perspective might help, and this is something adults could be helping them with. There’s nothing wrong with their bodies. Other people with mental illness who are in great distress often get expected to just deal with it, even when they can’t, and having to deal with it, to be with the distress in the moment, live with it, face it head on, wait it out, is often part of the treatment, and a necessary one. So are people who are in great distress because there is something actually wrong with their bodies often expected to deal with it, even if they’re in terrible pain and it’s impacting their mental health (people with nerve pain have killed themselves because they couldn’t bear it any more and were getting no help. Nerve damage is also a possible SRS surgery complication. As someone with it after medically necessary spinal surgery, which has made a huge mess of my life, I find it odd for it to be risked unnecessarily, along with other risks. One young person died following SRS surgery). Other people have to wait and hope. They don’t get told they can’t possibly do so. Sometimes they are asked to suffer. Maybe that even helps sometimes? Suffering is part of life in any case and cannot always be avoided.

      I would tell them to try to learn to live in their bodies, and suggest meditation and exercise as starting points and encourage reading the blogs of detransitioners. People with dysphoria have managed it before, and we have accounts of dysphoria improving and dissipating. I would not tell them they HAD to alter and damage healthy bodies, right now ASAP as a teenager, any more than I’d tell someone with anorexia they had to starve themselves, because it would not be truly kind even if it reassured them in the present moment. More constructive reassurance however can be offered that although it hurts terribly right now it’s possible to overcome, because it is.

  13. It appears to be written for providers, not laypeople, with specific recommendations for GnRH analogues and hormones—when to start, options for delivery (e.g. injection, patches, gel), dosages, needle gauge sizes, and lab tests for monitoring. Other areas are addressed too, including the induction of amenorrhea in natal females and the importance of discussing infertility. Towards the end of the protocol, there is a section about genital and chest surgeries.

    Dr. Mengele would be proud.

      • I have read accounts of people who are transitioning and those who are looking back on their experience. By far the most common sentiments expressed are “fun” and “exciting”. This sounds more like sentiments surrounding extreme sports than finally getting relief from a devastating illness. We should be suitably skeptical.

      • freenampeyo

        Having had some brushes with serious illness, and some pretty serious surgeries, I would not describe these experiences as “fun” or “exciting”, at best I would say that looking back on these experiences my emotion is “relief”.

      • Yes, that is the difference between medically necessary surgeries and transgender explorations.

  14. Trish, I think what Nampeyo is trying to say, if I may paraphrase, is that while a person is in the process of attempting to change his/her sex, there is a certain exhilaration that comes from physical changes and getting closer to “goal.” I have heard many transitioners talk with excitement and pleasure about different “achievements” that they make towards their desired outcome. This is also heightened by taking hormones which may change one’s mental state.

    Two points on this, first, it is easy, I think, to mistake progress towards being the other sex for progress in life. I am thinking, now, of several early 20’s transitioners that I know. While they are going for more surgery, more drugs, more procedures, it’s easy to forget that they’re not making any progress towards an adult life. Second, at some point, transition has to be declared over. No matter what, there will come a day when either you have no money left, or your body can’t take, one more mod (or there are no more mods left to try, although enterprising doctors seem to have a nearly infinite supply of those)!

    • I agree, and it is an important point, that there is a difference between exhilaration towards achieving a goal, versus achieving in life. So much time and energy is invested in trans identity. This time and energy is better spent on achieving at school and work, and better spent on developing great relationships with loved ones. Living authentically is vital! A person pretending to be the opposite sex is not living authentically, despite the illusion that they are living MORE authentically as the opposite sex. Detransitioners can teach us so much!

    • worried mom, I got that. I was just contrasting what facing actual life-threatening illness and major surgery is like, compared to trans procedures.

      And I think you are absolutely right about this whole thing ending up with these young people putting actually maturing on hold. When I look at FTTs, it seems to me a lot of them want to become boys, not men. I think there’s a stall-adulthood-at-all-costs element.

    • “Second, at some point, transition has to be declared over.”

      Declared over, in the teeth of the cold fact that (as you know), “transition” can never be completed in reality, because human beings cannot actually change sex…

      It will always be incomplete.It cannot be otherwise.

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