Lobotomy: The rise and fall of a miracle cure

Overwhelmed is the mother of a daughter who previously identified as transgender. Her daughter is now comfortable being female.  Overwhelmed can be found on Twitter: @LavenderVerse


by Overwhelmed

If you look back at history, some appalling medical treatments were once uncritically accepted.  Of course, hindsight is 20/20. It’s easy to critique from the future, now that we know better. But in the thick of it, members of the public don’t know better. They rely on medical professionals to guide them. And things can get out of hand when doctors promote bad science, the press sensationally markets it as a miracle cure, and the medical establishment stays silent.

Prefrontal lobotomies were performed in the 1930s to 70s, but were especially prevalent in the late 1940s to early 50s. The procedure was popular in many countries, racking up a significant number of patients:

 In the United States, approximately 40,000 people were lobotomized. In Great Britain, 17,000 lobotomies were performed, and the three Nordic countries of Finland, Norway, and Sweden had a combined figure of approximately 9,300 lobotomies.  …In Denmark, there were 4,500 known lobotomies, mainly young women, as well as children with learning difficulties. In Japan, the majority of lobotomies were performed on children with behavior problems. The Soviet Union banned the practice in 1950 on moral grounds, and Japan and Germany soon followed suit.

In the United States, the lobotomy pioneer and leading practitioner was Dr. Walter Freeman, a neurologist based in Washington, D.C. His story is featured in the hour-long 2008 PBS documentary, “The Lobotomist,” which I will quote from throughout this blog post. Here is the full transcript of the program.

freeman

Freeman believed that mental illnesses were caused by physical defects in the brain. In the spring of 1936 he came across a study conducted by Egas Moniz, a Portuguese neurologist, who took small corings from the brains of 20 patients with anxiety, depression and schizophrenia. Moniz claimed that the procedure eliminated symptoms in a third of them

Freeman built on the work of Moniz. He thought that disrupting the connections in the brain’s frontal lobes would bring patients relief from intense emotions and reset their personalities. Freeman didn’t have a license to perform surgery so he hired neurosurgeon James Watts. Later in 1936, Watts, under the direction of Freeman, performed their first lobotomy. He made incisions on the patient’s head, drilled holes through the skull, inserted a small spatula-like instrument into the brain and sliced through neural fibers connecting the frontal lobes to the thalamus.

Narrator: Four hours later, Alice Hammatt, the first patient to receive a lobotomy in the United States, opened her eyes. “Her face presented a placid expression,” Freeman noted, “By evening she was quite alert, manifested no anxiety or apprehension.” Excited by their results, Freeman and Watts began to do more lobotomies, acquiring patients from Freeman’s private practice.

After just a dozen operations, Freeman was ready to declare the lobotomy a success. He was confident in the procedure even if some patients relapsed (which prompted second, and sometimes third, operations). And even if there were some troubling side effects.

Edward Shorter, Medical Historian: Freeman’s definition of success is that the patients are no longer agitated. That doesn’t mean that you’re cured, that means they could be discharged from the asylum, but they were incapable of carrying on normal social life. They were usually demobilized and lacking in energy. And they were that on a permanent basis.

 Eventually Freeman sought an easier, quicker way to lobotomize patients. By 1946 he devised a new method to access the brain using simple tools—an ice pick and hammer. (The first ice pick was actually taken from Freeman’s kitchen drawer. But modifications were made over time. The tip on earlier versions occasionally broke during the procedure.)

lobotomy-instrumentAndrew Scull, Professor of Sociology: Freeman would peel back each eyelid, insert his ice pick and with a hammer tap through the brain, wiggle it about, sever the frontal lobes, withdraw it. And when the patient came to, he or she would be given dark glasses to hide the black eyes they’d been given.

 Freeman did the procedures himself, sometimes in his office. It took only a matter of minutes. He did not require an operating room and the equipment was portable, which made it convenient for travelling to mental asylums. (It was at this point that Freeman and Watts—who had grave concerns about the “ice pick” lobotomy being performed by those without formal surgical training—parted ways.)

lobotomy-eyeball

Initially Freeman’s procedure was heralded in the press as a miracle cure and correspondingly there was a rise in patients receiving lobotomies. But after the advent of antipsychotic medications and the poor outcomes noted in the first clinical trials, the procedure was recognized as barbaric and Freeman himself downgraded in the public eye to a charlatan. The history of medical fads (lobotomy being only one of them) tells us that pioneering doctors, and the medical establishment that embraces them, can fail in their duty to “Do No Harm.” That people, even those possessing medical degrees, are imperfect and can champion poor science.

Back in 1987, Dr. Valenstein (at the time a professor of psychology and neuroscience at the University of Michigan), reminded attendees at a science meeting that it was important to remember the history of the lobotomy. He warned that ”all the major factors that shaped its development are still with us today.”


valenstein

A few years ago, I believed that drastic treatments like the lobotomy could never again gain widespread acceptance. But I was wrong. It was quite a shock to realize how enthusiastic professionals were to medically transition young people like my daughter.

At initial glance, it may appear that lobotomies (which target assumed defects of the brain) and the medical transition of gender dysphoric children (which target assumed defects of the body) have little in common. But if you look past which body parts are “corrected,” you see that both are psychological conditions which were/are being treated by drastic, irreversible medical interventions. There are a number of parallels I’ll discuss in this post.

Desperate times call for desperate measures.

Both lobotomies and now the medical transitioning of young people were/are more easily accepted because of the environment in which they originated. A sense of hopelessness paired with yearning for a cure leads people to take chances they wouldn’t normally.

In the 1930s, anti-psychotic drugs weren’t yet invented. People suffering from severe mental illness were warehoused in overcrowded, underfunded mental asylums. The conditions were horrible. No one knew how to help these patients. Some were tied-up on benches. Others lay naked on the floor. Feces were sometimes smeared on the walls. And conditions became further strained with the return of shell-shocked World War II veterans. There was a huge impetus to find treatments to alleviate their symptoms and allow them to go home to their families. When lobotomies were introduced and touted as a cure, many chose to have loved ones undergo the procedure, rather than admit them to one of these terrible mental asylums– like the one exposed in this newspaper story:

pottstown

According to his son, Freeman felt justified in performing lobotomies because eliminating a patient’s intense suffering (and the associated high suicide rate) outweighed the loss of intellect and personality:

Walter Freeman III, son: …suffering the demons of mental illness. And he was trying to cure them of that, and the fact that they might turn into, let’s say, fat slobs afterwards was a small price to pay for the relief from this intense mental anguish. He pointed out repeatedly a very high rate of suicide of these individuals that they can’t stand this mental pain and he was helping them.

Currently, whenever a transgender-identifying child is discussed in the media, without fail a high suicide attempt rate is mentioned. It is implied by gender specialists that children will die unless fully “supported” in their chosen gender identities. We are told that proper pronouns, new clothes, a binder, puberty blockers, cross-sex hormones, mastectomies and genital surgeries may be necessary just to keep them alive.

This is just one of many examples found in today’s media coverage of trans-identifying children:

Neal found a therapist who told her and her husband to fully embrace Trinity’s female identity. She said that the therapist also gave strikingly blunt advice.

“She said, ‘Your daughter already knows who she is. Now you have to decide. Do you want a happy little girl or a dead little boy?'”

Gender specialists and trans activists continually scare parents with high suicide attempt statistics from a flawed survey study which did not ask whether suicide attempts occurred before or after transition; nor were co-occurring mental health problems controlled for in the study. Many highly publicized suicides of trans-identifying teens were young people who had been fully supported in their transitions by family, friends, and professionals (this phenomenon was discussed in this post, along with the risk of suicide contagion in vulnerable youth). One long-term study has shown that suicide rates, compared to those of the general population, are significantly higher in those who have medically transitioned.

If parents exclusively rely on distorted statistics or frank misinformation, it’s not surprising they would choose to medically transition their child. Nothing is worse than the prospect of losing a child to suicide.

 Someone other than the patient authorized/s treatment.

 During the lobotomy craze, many patients were not able to consent to the procedure themselves. Parents, spouses, and siblings were then called upon to make the decision. Many opted to have their loved ones lobotomized based upon a mental health professional’s recommendation. Some felt they were misled.

“I got the impression that it was no more serious than having a tooth extracted.”

There were family members who profoundly regretted their decision.

…her father opened up about the regret he felt about allowing the VA to lobotomize his brother. “The guilt came from the realization that it wasn’t as great as it was supposed to be and that he wasn’t able to be independent,” says Ms. Malzahn. “They thought it would make things all better, and it didn’t. In some ways, it made it worse.”

Currently, parents are responsible for approval of medical interventions for their under 18 year-old gender dysphoric children (although in Oregon it’s possible for 15 year-olds to get double mastectomies or other surgeries without parental consent). Based on media coverage, it appears quite a few children are undergoing gender-affirming treatment with parent approval.

A parent’s choice of what direction to take is highly influenced by the information sources they rely upon. Many gender specialists (and the media) paint a pretty rosy picture of what life can be like for gender dysphoric children if they are affirmed in their gender identity and given body-altering treatments so they can pass as the opposite sex. But this is an optimistic belief, based on opinion and anecdote, not solid evidence. Particularly since there is no media coverage of what life is like for those gender dysphoric children who are fully supported in being “gender nonconforming” but not endorsed in the idea that they are “really” the opposite sex.

Highly variable results.

Lobotomy outcomes were all over the map, which isn’t surprising if you consider the procedure itself was not exactly replicable. It was literally a “stab in the dark.” And Dr. Freeman’s patients—ranging from severely mentally ill adults to misbehaving children—had a wide variety of symptoms pre-treatment. Some suffered from a transient problem, which may have resolved by itself.

According to a Wall Street Journal article, lobotomy outcomes generally could be divided into three categories:

Drs. Freeman and Watts considered about one-third of their operations successes in which the patient was able to lead a “productive life,” Dr. Freeman’s son says. Another third were able to return home but not support themselves. The final third were “failures,” according to Dr. Watts.

Before and after lobotomy pictures (Case 121, 1942). Before: “Forever fighting…the meanest woman.” After: “She giggles a lot.”

lobotomy-before-and-after

 But the patients with successful outcomes still had concerning side effects. They often lost their ambition and weren’t able to make judgments or function well socially. Most were significantly changed, never to be the same person again.

A fellow 4thWaveNow parent, SunMum, shared this memory with me for this post:

It struck me a long time ago that my horror of surgical intervention for mental problems probably dates from my memory of seeing my mother’s best friend who had had a lobotomy. It was one of the tragedies of my mother’s life. She told me that her friend had been ‘brilliant and beautiful’. They were both unusual as female students at the London School of Economics in the 1930s. The friend had a breakdown after her husband left her for another woman. As her next of kin, it was the husband who gave permission for the lobotomy. The friend would come to London at Christmas and stay in a hotel. We would meet her for tea. She was capable of flat small talk but nothing else. She did not show any feeling.

 A few patients were fortunate enough to have no noticeable side effects. For them, having a lobotomy appeared to bring great relief. But these patients were relatively rare.

A significant number of post-op patients were reduced to a persistent vegetative state. And for others, the operation was fatal.

Narrator: At Cherokee state hospital in Iowa, three of Freeman’s patients died on the operating table, one after Freeman’s ice pick slipped while he was taking a photograph. Without pausing, he packed up and left for his next demonstration.

Statistics from the Veterans Administration (which performed approximately 2,000 lobotomies), kept track of how many died as a result of the procedure:

The VA did try to determine whether the benefits outweighed the risks. And the risks were severe. Overall, 8% of lobotomized veterans died soon after the operation, according to a 1947 document. One hospital reported a 15% fatality rate.

There are a variety of outcomes to medical gender transition as well. Some people say that transitioning is life saving. Some react poorly to cross-sex hormones or have surgical complications. Some decide to de-transition and/or re-identify as their natal sex. And some even die due to medical transition itself (here is an analysis of a 2014 Dutch survey study in which one patient died from complications of surgery).

Treatment based on theories, not solid evidence.

 As the patient caseload of Freeman and Watts grew, they gained confidence in their technique and wanted to share it with colleagues. They presented their findings at a Baltimore medical conference.

Andrew Scull, Professor of Sociology: Freeman got up to announce that they had a new cure for mental illness. This was a very dramatic and highly charged occasion. There were angry interjections from the audience. There were questions. There were attempts to even shout him down.

 Jack El-Hai, Writer: Some of them were simply astonished that he would even try such a thing, and a few were outraged that he would try an untested procedure like this.

 Narrator: Freeman begged his audience for time. It would take months, even years, he argued, to properly evaluate the progress of lobotomy patients. Meanwhile, he promised, lobotomy would remain ‘an operation of last resort.’ But Freeman knew that ultimately it didn’t matter how much other doctors might oppose him; their disapproval would never reach the outside world. 

Elliot S. Valenstein, Professor of Neuroscience: At that time, it was considered unethical to publicly criticize another physician. So people didn’t write critical articles, they may have talked among themselves, they may even have raised critical questions at a meeting. But they did not write anything that would stop him from continuing his work.

Freeman was undeterred by their criticism and plowed ahead, convinced that lobotomies were the best option for treating mental illness. Fellow doctors remained silent. The lobotomy craze was largely unchecked until the mid-1950s.

But even after the medical establishment turned against him and his procedure, Freeman moved to the west coast where he continued performing lobotomies until 1967. And maybe he would have kept operating if his hospital privileges had not been revoked. The hospital took this action only after one of Freeman’s patients died from a brain hemorrhage. (It was her third lobotomy.)

As has been discussed many times on 4thWaveNow, there is a dearth of research that backs up the medical transition of children. The current protocol being used in the United States is based on best guesses, not solid evidence. However, this has not been a barrier for children being treated with puberty blockers and cross-sex hormones, nor has it stopped them from receiving mastectomies, hysterectomies and genital surgeries.

In the United States, the first pediatric gender clinic opened its doors in 2007, and since then many similar clinics have popped up across the country. But it wasn’t until May of 2016, almost a decade later, that an NIH-funded study was launched to record the effects of puberty blockers and cross-sex hormones on gender dysphoric youth. The results won’t be published for years; and since the study follows patients for only 5 years, longterm outcomes won’t be know for decades . In the meantime, concerned professionals, for the most part, remain silent and it appears that medical transition of youth is proceeding at an accelerated pace.

The power of the press.

Dr. Freeman used the media as a promotional tool. He often had newspaper journalists and photographers waiting for him at mental asylums.

Narrator: Aware of the power of public relations, Freeman aggressively courted the press. Soon he was receiving glowing reviews in major publications. The Washington Star called lobotomy “One of the greatest surgical innovations of this generation.” The New York Times called it “surgery of the soul,” and declared it “history making.”

 In 1941, the Saturday Evening Post, described how patients felt before and after lobotomies: “A world that once seemed the abode of misery, cruelty and hate is now radiant with sunshine and kindness to them.”

saturday evening post.jpg

Robert Whitaker, Writer: We think of science as having this sober sort of process, something is introduced, it goes to a medical journal, it’s peer-reviewed there. Freeman sort of bypassed that process because he in fact knew he was going to get a lot of resistance and he brings the press into it right from the beginning. And the press — they’re always eager for miracle surgery, it sells papers and so, next thing you know, you start having this story out there, not of damaging the brain, but of plucking madness from the brain, and it’s such a story of progress.

 A 1999 study analyzed popular press coverage of the lobotomy and its potential influence on how quickly acceptance of the procedure spread. The Abstract:

 This study analyzed the content of popular press articles on lobotomy between the years 1935 and 1960. Both a qualitative and quantitative analysis provided evidence that the press initially used uncritical and sensational reporting styles, with the content of articles on lobotomy becoming increasingly negative through time. The initial positive bias occurred despite opposing views in the medical community, which provided a basis for more balanced coverage. These findings support the theory that biased reporting in popular press articles may have been a factor influencing the quick and widespread adoption of lobotomy as a psychiatric treatment.

I don’t know if you caught that, but there were “opposing views in the medical community” that journalists often omitted. In 1941, the American Medical Association issued “a warning about several negative effects on personality including apathy, inappropriate social behavior, and lack of initiative (i.e., the frontal lobe syndrome).”

Also of interest in the study were these statements: “In addition to sensationalizing the positive effects of lobotomy, articles during this time period rarely discussed risks involved in the operation.” and “…in most cases mention of negative side effects was either absent or cursory.”

Currently there are nearly daily examples of trans kid media stories. They tend to be pretty formulaic. From an early age, the child realizes they feel different from their peers. A girl that throws a fit when mom puts her in a dress; a boy that wants to wear a dress. In general, preferences in clothes, toys and haircuts are used to validate that they are transgender. The child (or parent) finds out about transgender through the internet, on the radio or television and latches tightly onto that explanation. They either want to avoid the “wrong puberty” (which brings puberty blockers into the discussion) or have struggled through puberty and want to correct their bodies with cross-sex hormones and surgeries. Parents sometimes admit that they didn’t immediately believe their child was transgender. But when they learn of the suicide statistics, then they get on board. To drive the point home, the article quotes a gender doctor or therapist, a purported expert in the field, who states unproven theories as if they were settled science.

There are in fact opposing views in the medical community; views based on years of experience and research in gender identity clinics. But reporters who churn out the celebratory articles about “trans kids” rarely mention contrary views, nor do they ask any inconvenient questions of the parents who unquestioningly “affirm” their offspring. Recently, troubling new questions have been raised about Lupron, a GnRh agonist, but the reporter covering that controversy omitted the fact that Lupron is the drug used most commonly (off label) to block puberty in “trans” kids. With few exceptions, journalists focus on the feel-good aspect of the child being accepted as the opposite sex, a triumph over adversity. Not much time (if any) is spent discussing the significant risks associated with medical transition. Biased media coverage like this is likely contributing to the rapid increase in children presenting to gender clinics.

Embraced by the medical community.

 Initially many of Dr. Freeman’s fellow doctors were reluctant to embrace the lobotomy as an acceptable treatment, but that soon changed. Thanks to favorable newspaper articles, Freeman became somewhat of a celebrity. The public believed that he had found a miracle cure. His services were sought after.

Additionally, state-funded mental asylums were overcrowded and seriously underfunded, some so financially strapped that they were on the verge of closing. Freeman began travelling to these institutions, promoting lobotomies as a cost-cutting measure. The more patients that were discharged, the greater the savings. The procedure was seen as a godsend by many overworked asylum doctors and administrators.

Freeman aggressively championed his cause, even convincing the federal government via the Veterans Administration to perform lobotomies on veterans.

In 1948 Freeman was elected president of the American Board of Psychiatry and Neurology. In 1949 Egas Moniz, whose work inspired Freeman’s procedure, was awarded a Nobel Prize for psychosurgery. (He was nominated by Freeman.) The lobotomy gained further credibility.

Narrator: By decade’s end lobotomy had won the acceptance of mainstream medicine. Lobotomies were being performed at Johns Hopkins, Mass General Hospital, the Mayo Clinic, and other elite medical institutions.

Currently, there appears to be widespread acceptance of medical interventions for gender dysphoric youth. Clinics all across the country, many of which are part of elite Children’s Hospitals, are providing gender care for kids. It is becoming more common to obtain insurance coverage for puberty blockers, cross-sex hormones and surgeries. And laws  have been passed in some states that forbid therapists from trying to change children’s gender identities. Many mental health professionals seem to believe their duty is to simply affirm children’s gender identities, not to explore why there is a mind-body disconnect.

Lambda Legal has a handy list of organizations (last revised in 2012) that declare support for transgender people in health care. Here are AMA and APA statements:

 

Expanding the patient base.

Dr. Freeman barnstormed mental asylums, operating on many patients in each location. He was frequently gloveless, mask-less and sometimes sleeveless. Once he performed 25 transorbital lobotomies in a single day.

gloveless-freeman

(He appeared to enjoy surprising his audience. On some occasions, Freeman would start out operating using his right hand, and half way through switch to using his left hand. Other times he would an insert ice pick under each eyelid and simultaneously lobotomize through both eye sockets. Sometimes doctors in the audience would faint, or even vomit.)

While at the institutions, he would train others in his craft.

Andrew Scull, Professor of Sociology: He was convinced this was an operation which could be replicated very easily. As he put it, “Any damned fool, even a hospital psychiatrist could learn it within an afternoon.”

Freeman trained one psychiatrist in Rusk, Texas who performed 75 lobotomies in one day.

Narrator: Spurred on by Freeman, the number of lobotomies performed annually soared from 150 in 1945 to over 5,000 in 1949. Despite the known side effects, there seemed to be an endless supply of willing patients.

The momentum of lobotomy enthusiasm was greatly slowed in the mid-1950s by the advent of a pharmaceutical and results published in medical journals. An antipsychotic drug called Thorazine, promoted as a “chemical lobotomy,” became increasingly used. Also, the first long-term clinical studies of lobotomies were assessed by the medical community. Now that doctors had published proof of lobotomy’s negative side effects, and there was a suitable alternative, the medical establishment quickly turned against Dr. Freeman and his procedure. He no longer felt welcome in Washington, D.C. and moved across the country to California.

Freeman did not give up on performing lobotomies. On the contrary, he cultivated new categories of patients to treat. Disaffected housewives, people with chronic headaches, and misbehaved children were all fair game.

Andrew Scull, Professor of Sociology: If housewives found their early 1950s existence too depressing for words, why Freeman had a solution that would get them through their day happy as little clams. If children were misbehaving, conditions we might now see being called hyperactivity disorder, why they might need a lobotomy.

Nineteen of Freeman’s patients were children under the age of 18. One was only 4 years old.

 For pediatric gender care, the actual patient numbers in the United States are difficult to determine. But based on the fast-paced expansion of gender clinics across the nation, the patient load has likely escalated similarly to what has been seen in the UK:

gender-clinic-stats

The first gender clinic in the US opened in 2007 in Boston. An October 2016 article states there are now more than 60. The demand is growing quickly, but there are still waiting lists for new patients. Based on this information, in conjunction with the growing number of 4thWaveNow parents (many who note the number of trans-identifying students in their local schools are multiplying), it appears that the cases of young people with gender dysphoria are skyrocketing.

Attempts to “cure” sexual orientation and gender non-conformity.

During the lobotomy’s reign, homosexuality was considered a mental disorder. Cruel “treatments” of this time period included chemical castration with cross-sex hormones, aversion therapy (using electrical shocks or vomit-inducing drugs) and masturbatory reconditioning. Lobotomies were also performed on patients like this gay man who was a patient at Pilgrim State Psychiatric Center in Long Island, New York.

CASE NO. 236 Man, 29, “had a psychotic attack [at age 19] and responded satisfactorily to 44 insulin comas.” Admitted to Pilgrim at age 20. “In the years which followed, this patient was consistently one of the most severe behavior problems, aggressively homosexual, out of contact, noisy, disturbed, overactive; he wet and soiled.” Lobotomy on Feb. 15, 1949. “Slow improvement. He was clean, pleasant, but mentally defective— a moron. He speech was clear but brief. On the insistence of his parents, he was released on June 15, 1949 but returned after a few weeks because of restlessness and poor judgment. There is no severe behavior problem, but he is hebephrenic— silly. He is now clean, quiet, passive, well-behaved, probably hallucinated, speech brief but rather scattered, but he is well-informed on current baseball scores, etc.”

At 4thWaveNow, we have repeatedly stressed that the majority of gender dysphoric children, if left alone, will grow out of their distress. Most mature into lesbian and gay adults. Sexology researcher Dr. James Cantor  posted a compilation of childhood gender dysphoria research going back many decades on his site Sexology Today:

In total, there have been three large scale follow-up studies and a handful of smaller ones. I have listed all of them below, together with their results. (In the table, “cis-” means non-transsexual.) Despite the differences in country, culture, decade, and follow-up length and method, all the studies have come to a remarkably similar conclusion: Only very few trans- kids still want to transition by the time they are adults. Instead, they generally turn out to be regular gay or lesbian folks. The exact number varies by study, but roughly 60–90% of trans- kids turn out no longer to be trans by adulthood.

When seen from this perspective, it is difficult to ignore the impacts on children who would likely grow up to be homosexual. “Trans kid” media stories are full of “gender nonconforming” behavior, which is often a sign a child or teen is or may eventually be gay or lesbian. Frequently, a preteen or teen even admits that he/she is attracted to the same sex. But parents in these celebratory articles conclude that their child is transgender and needs irreversible medical interventions. (Strangely,  journalists never question it.)

Since puberty is often the time that gender dysphoria resolves (and sexual orientation begins to be self-recognized), the use of puberty blockers (along with the reinforcement from gender therapists that the child is in the “wrong body”) likely prevents many young people from ever becoming comfortable in their unaltered bodies. Further, the vast majority (some clinics report 100%–see here and here) of children on puberty blockers proceed to cross-sex hormones, irreversible sterilization, and possibly later surgeries.

Earlier interventions to prevent potential problems.

 Initially Freeman claimed that the lobotomy would be an operation of last resort. He once said, “I won’t touch them unless they are faced with disability or suicide.” But as time went on he altered his views. He started advocating for lobotomy earlier, as a way to prevent progression of mental deterioration. In a 1952 Time article (“Mass Lobotomies”), he is quoted as saying, “it is safer to operate than to wait.”

The push for early intervention is also seen in medical transition of “trans” kids. Initially it was reserved for gender dysphoric adults, but now children are increasingly being treated. The justification: if gender dysphoria is caught while they are young, they can avoid the years of misery that many older trans people report. It is assumed that treating children with puberty blockers, cross-sex hormones and surgeries will help them appear more convincingly as the opposite sex. This, along with consistent affirmation of their gender identity, is assumed to help these children avoid suicidality, depression, unemployment, sexually transmitted diseases, drug abuse and homelessness commonly found in the current adult transgender population. Gender doctors state they are saving these children from potential future problems (without acknowledging the significant risks introduced by treatment).

“These kids have a very high risk of depression, substance abuse, suicidal thoughts, and suicide attempts,” said Stephen Rosenthal, MD, a pediatric endocrinologist and medical director of the Child and Adolescent Gender Center at UCSF Benioff Children’s Hospital San Francisco …. “Not treating is not a neutral option.”

Ambitious doctors.

Freeman came from a prominent medical family. His grandfather William Keen was a famous surgeon, the first to extract a brain tumor from a living patient. He enjoyed being a showman, performing operations which were viewed by large audiences. Freeman looked up to his grandfather and wanted to be as successful.

Early in his career Freeman became determined to alleviate the mental anguish of patients in the overcrowded, horrible conditions of mental institutions. Early on he spent a great deal of time examining the brains of dead mental patients, trying to find a defect which could be corrected. But he was never able to find any.

He was thrilled to come across Portuguese neurologist Egas Moniz’s work, which became the basis for Freeman’s lobotomy procedure.

Jack El-Hai, Writer: Freeman almost went wild with excitement. He thought, ‘This may be it.’ He saw a vision of the future unfold, not only a future in the treatment of the mentally ill, but his own personal future.

He latched tightly onto lobotomies as a way to bring patients a sense of peace, and never let it go. Freeman appeared to genuinely believe he was helping people by lobotomizing them, but seemed blind to the negative impacts of his procedures. It was as if he was looking through rose-colored glasses.

Andrew Scull, Professor of Sociology: One of the characteristics of an enthusiast, and Walter Freeman was certainly that, is that they are able to overlook everything that contradicts their enthusiasm. And they concentrate on all the things they see that show they’re on the right path. So over and over again, we can see Freeman managing to dismiss the casualties of his surgical interventions.

On the medical transition front, Dr. Norman Spack, a pediatric endocrinologist, in 2007 co-founded the first US gender clinic for youth in Boston.

In media articles, Dr. Spack appears to be a compassionate person who is concerned about gender dysphoric children. Over and over again, he talks about suicide rates  He implies that kids desperately need medical treatment because otherwise many of them will kill themselves, especially if they are unable to avoid their natal puberty.

World trans authority Dr. Norman Spack, a pediatric endocrinologist (or hormone doctor for children), warned the dangers of failure to treat trans teenagers. He said almost one in three trans individuals will attempt suicide if they do not receive treatment until after puberty….

…‘If your neighbor is bleeding, you should not stand idly by,’ Spack said, quoting Jewish philosopher Maimonides, and adding: ‘For trans people, the inevitable conclusion is that puberty is noxious.’

 He is a big proponent of using GnRH-agonists (commonly known as puberty blockers) to pause the puberty of gender distressed children. “Safe,” “reversible” and “life saving” are often words that gender specialists use to describe these pharmaceuticals. But there have been severe side effects reported, especially when administered to children.

This June 2015 article discusses what inspired Spack to incorporate puberty blockers into his treatment protocol:

Dr. Spack recalled being at a meeting in Europe about 15 years ago, when he learned that the Dutch were using puberty blockers in transgender early adolescents.

“I was salivating,” he recalled. “I said we had to do this.”

The puberty-blocking protocol gained legitimacy in 2009, when it was endorsed by the Endocrine Society, the leading association of hormone experts, on the recommendation of a task force including Dr. Spack.

 In August 2012, it was reported that Spack has trained many other gender professionals across the United States and in Canada.

Today, clinics for transgender kids in British Columbia, San Francisco, Los Angeles, Chicago, Denver, Minneapolis, New York, Hartford, Providence, and Washington, DC, have either been created or expanded. And in almost all of these places is a doctor that Spack has trained, mentored, or guided.

 And this October 2016 article states that Spack’s program has spread to over 60 pediatric gender clinics in the United States.

His program, copied in over 60 centers across the US, provides treatment including hormone blockers – ideally at the onset of puberty – and hormones for trans teens according to need and capacity to understand the implications of what was being done.

Spack says that treating gender dysphoric children is less complicated than it would seem:

spack.jpg

Many parents at 4thWaveNow are concerned that we may be in the midst of another disastrous medical fad. Our kids’ sudden change in gender identities has been easily accepted by their peers, schools, therapists and doctors. Puberty blockers, cross-sex hormones and surgeries are routinely encouraged as necessary next steps. The level of enthusiasm is stunning. There is an absence of caution. We don’t know how many young people will grow up to regret their permanently altered bodies. Which of them will wonder what their lives could have been like had they not taken this path? Some families in our community have witnessed their daughters or sons desisting from trans identity, and finding peace in their own skins—but in just the nick of time, and against the recommendations of enthusiastic gender therapists. These young people matter just as much as those who are being encouraged to believe they are the opposite sex and have begun medical transition. Who speaks for these desisters?

The no-holds-barred, uncritical championing of child transition now will eventually fizzle. Lessons will be learned. Science will evolve. And eventually books and documentaries may try to explain how things got so out of hand. How long that will take is anyone’s guess.

85 thoughts on “Lobotomy: The rise and fall of a miracle cure

  1. This is a great, well-researched, thoughtful article. Any thoughts about getting out there to a more mainstream audience? I know there would be a lot of blow back and maybe now is not the best time politically, but this article really says it all.

  2. “Dr. Spack recalled being at a meeting in Europe about 15 years ago, when he learned that the Dutch were using puberty blockers in transgender early adolescents.

    “I was salivating,” he recalled. “I said we had to do this.”””

    Dr. Spack was salivating. That really says it all…..

  3. This is an incredibly important article. Excellent research and the parallels with the transgender cause are staggering. I’d be interested to know whether anybody ever successfully sued for malpractice over a wrongful lobotomy.

    • PBS had a question and answer session with those featured in their documentary, “The Lobotomist.” (Highly recommend reading if you’re interested in more detail.)
      http://www.pbs.org/wgbh/americanexperience/features/general-article/lobotomist-online-forum/

      And this question was asked and answered (scroll down to the last question on the first page for the actual wording). No one did successfully sue Dr. Freeman for any lobotomies he performed. Nor was he ever reprimanded by any medical bodies. There is an anecdotal story of someone planning to sue, but Dr. Freeman died in 1972 and it did not proceed.

    • That was interesting about Twilight Sleep. I had never heard of it.

      Recently, I had found many pamphlets that my grandmother collected in the 1920’s in NYC from the Life Extension Institute (supported by medical experts such as William James Mayo – one of the founders of the Mayo Clinic). It had all kinds of advise as to how to live healthy and she had
      been tested and advised to do certain types of exercises and treatments. On one of the pamphlets I noticed that they were promoting Eugenics.

      Now Eugenics is another medical “fad” of sterilizing the “unfit” individuals in society, just as “transgenderism” seems to be doing with would be homosexuals. One of the target populations of Eugenics were the homosexuals. History is always repeating itself. I wish people would wake up and stop this! Most of the world finally woke up about Eugenics once Hitler started employing its methods. Sweden didn’t end it until the 1970’s.

    • I had never heard of the Twilight Sleep movement. Thanks for the link.

      A lot of parallels here, including that it was wrapped up in a civil rights movement. Back then it was the Women’s Rights Movement and today it is the Transgender Rights Movement. Things can really get out of control when unproven medical procedures are seen as civil rights.

    • I’ve done a lot of reading about twilight sleep, and it always makes my hair stand on end. Ironically, women were the ones leading the push for it in the U.S. initially, while the doctors were against it. Then the tables turned and it became standard medical procedure. I had to bite my tongue when one of the women in one of my pro-science groups said if she’d ever had a baby, she would’ve wanted to go to sleep and wake up with a baby like women in the 1940s. It’s really sad how so many people in my pro-science groups reject anything having to do with natural childbirth and only support lots of drugs and interventions, even when there’s no evidence basis for them. I call myself a lower-case skeptic for that reason. So many upper-case Skeptics seem to be working from a checklist of things they’re supposed to support and oppose, even if science really says something else. Transgenderism is also one of those things many of the Skeptics I know are hugely in favor of. It’s odd how people otherwise governed by the principles of skeptical inquiry have such a blind spot when it comes to these issues.

    • My Mom had been an OR nurse around this time and she said that it was somewhat of a joke among medical staff that women taking Twilight Sleep had such a glowing review of the whole experience that it was effortless and pain free. Meanwhile, the women would be thrashing around, screaming and swearing, ripping their clothes and all sorts of crazy behavior all of which was counterproductive to the task of actually birthing a baby. Anytime the staff would hear a new mother talking about how she ‘just went to sleep and woke up with a baby’ they’d all be gritting their teeth. It wasn’t effortless for anyone involved, just that the mother had the bonus of forgetting about acting like a mental patient.

  4. Excellent article, Overwhelmed. Thank you for your time in researching this and writing this important piece. The analogy to what doctors are doing to self-identified transgender children is spot-on. This must be published where more can read it. How can we get the mainstream media to stop with all of the transgender puff-pieces and start doing their job? How can we get medical schools, associations, or any group of respected professionals to stop participating in political groupthink and start using common sense?

  5. I wonder if there are any known therapists who would genuinely encourage a wide range of gender non-conformity for children while discouraging medical transition. Zucker was certainly not that.

    • Zucker was more that than any current “gender therapists.” Zucker tried to treat each child as an individual and a member of a specific family system and believed that it would benefit MOST kids to live happily in a body which wasn’t hormonally and surgically altered.

      • From an article critical of his dismissal http://nymag.com/scienceofus/2016/02/fight-over-trans-kids-got-a-researcher-fired.html:

        “a GIC parent told me that when she explained to GIC clinicians that her little boy was obsessed with a Barbie book and insisted it be read to him at every bedtime, they suggested a new routine of reading him that book, and then reading him another book after.”

        “The GIC clinicians I spoke with questioned this idea [watchful waitlng] on a basic conceptual level, because to them it implies a false neutrality. If your child insists on dressing up as a girl every day, and you “watchfully wait” by allowing them to continue to do so, they believe you’re effectively reinforcing the behavior. ”

        Exactly how supporting Zucker can be compatible with anything meaningfully described as “gender critical” is beyond my understanding.

  6. Wow, this is very well written and researched. I wish this could get published where it would receive international attention.

  7. Counterpunch does publish trans critical articles as does thefifthcolumnnews.com. Also, Feminist Current might feature it on their page.

    • A “genderless” plastic mold… so how would anyone know it’s transgender, other than the way it’s marketed? In the context of a sexless doll, what does that word mean?

    • Yes, in some ways today’s enthusiasm to medically transition kids is worse. There are school programs that educate (and likely confuse) kids about queer theory. Pro-transition books, Youtube channels and TV shows–specifically geared towards children–regularly pop up. And now toys!

    • I really don’t see things ending well for “Jazz.” After all this media attention, and now even a doll based on him, it’s going to be so hard for him to back out and go back to living as his natal sex. It’s very telling how his mother once said, “She only knows transition is best because that’s what adults have told her.”

      • Almost nobody socially transed by his/her parents rejects medical transition. Jazz could be a happy effeminate gay boy, but his fate is already predetermined, sadly. Heartbreaking.

    • Another very important parallel to what’s happening to young people who would mostly likely grow up to be LG if left alone, instead of encouraged to persist in the notion they are in the “wrong body.” Do you have some links on the use of lobotomy on gay people?

      • I did a quick search and found several articles about severe treatments for homosexuals.

        http://www.davidmixner.com/2010/07/lgbt-history-the-decade-of-lobotomies-castration-and-institutions.html

        In reference to Dr. Freeman and lobotomies: “According to records, he treated over 4,000 patients this way around America and it is estimated that nearly 30% to 40% were homosexuals. He believed deeply this was the only way to cure homosexuality.”

        There is a slew of scholarly articles discussing the horrific “treatments” of homosexuals in medical history.

      • From Walter Freeman and James Watts, Psychosurgery in the Treatment of Mental Disorders and Intractable Pain, 2nd edition, 1950:

        ‘Latent homosexuality is very prevalent in schizophrenics, and has not been considered a deterrent to prefrontal lobotomy. We have been somewhat more reluctant to operate upon patients whose homosexual drive was openly expressed. In a recent case, however, (Case 465) we were presented with the choice of operating upon a man with the affliction or of having him kill himself. Two years after operation he reported that there had been no recurrence of the urge and that sex as a whole meant little to him.

        The eruption of homosexual behavior following prefrontal lobotomy is occasionally observed in both men and women, but it is rather unformed, juvenile, and tends to subside in a few days or weeks.’ (pp. 446f)

        I have seen nothing that substantiates David Mixner’s claim, quoted by HopeAfloat above, that ‘nearly 30% to 40% [of the people whom Freeman lobotomised] were homosexuals’. Mixner provides no source for this figure. I think it is very unlikely to be correct.

        Nonetheless, the above passage shows that Freeman himself did operate on some homosexual people: he evidently regarded it as acceptable if they were suicidal or showing signs of mental illness.

        During the 40s, 50s and 60s, many doctors besides Freeman carried out lobotomies and closely related forms of psychosurgery. The following is from a case history of a homosexual man who was lobotomised at Pilgrim State Hospital, New York, where about 2,000 patients were lobotomised by Henry Worthing and his team:

        ‘This patient was admitted to Manhattan State Hospital in 1931 at the age of 21 and was diagnosed as a case of dementia praecox, paranoid. … Before his hospital admission, he had been dating girls but his history revealed homosexual practices since he was 16 or 17. Apparently the patient consorted with men in Greenwich Village with whom he practised both active and passive fellatio. The patient admitted that he had become a “fairy” and had spent most of his time in the Village.

        He began to hear voices calling him a fairy and he had guilt feelings about his homosexual affairs; he became impotent and, subsequently, was more anxious about this problem. At Mannhattan State Hospital, the patient apparently adjusted fairly well, was not obviously involved in any sexual deviations and was released on convalescent status. During his convalescent care period, the patient took a job for about three months, then began to feel that people were looking at him because they knew that he was a “fairy.” He attempted to have sexual relations with a girl and became disturbed when he was impotent.

        In 1933, E. R. was admitted to Pilgrim State Hospital. Subsequently, it was noted that he participated in passive fellatio on the ward. … The patient slept poorly; ate poorly; roamed about the dormitory.

        In August 1951, he had a prefrontal lobotomy. Immediately following the operation, and for approximately two years afterward, the patient showed considerable improvement in behavior. … In the beginning of 1954, he again became disturbed in his behavior and for the next two years this patient masturbated excessively, and participated ia all types of homoerotic and autoerotic manifestations kissing, fondling other patients, engaging in active and passive fellatio. … He now has to be closely supervised; is actively hallucinating …’

        from ‘Autoerotic and Homoerotic Manifestations in Hospitalized Male Postlobomy Patients’, by Moses Zlotlow, M.D. and Albert E. Paganini, M.D., in Psychiatric Quarterly, vol. 33, issue 3, 1959.

        In other words, societal disapproval of his homosexuality turned this poor fellow paranoid (as well it might); finding himself impotent with a woman, he despaired of ‘straightening out’ and was incarcerated. He was not the easiest patient to manage and eventually the doctors wrecked his brain in the hope that it would make him more docile.

        Though Freeman cautioned against the use of lobotomy as a treatment for homosexuality per se, some surgeons did promote lobotomy for precisely this purpose:

        ‘Some opponents argue that psychosurgery in any form and for any mental or behavioral disturbance — regardless of its severity — should be outlawed. At the other extreme, some proponents argue that psychosurgical procedures should no longer be considered research but constitute routine and accepted treatment for a wide range of behavioral disorders ranging from childhood hyperkinesis — or overactivity — to homosexuality.’

        Dr Bertram S. Brown, Director, National Institute of Mental Health, giving evidence in 1973 to a committee of the US Congress. See Quality of Health Care — Human Experimentation, 1973 (p.341).

        (I always assumed that Robert C. O’Brien had invented NIMH. How interesting.)

      • In my previous comment I quoted evidence given by the Director of NIMH to the Subcommittee on Health of the Committee on Labor and Public Welfare of the United States Senate in 1973. The published record also contains some very interesting submissions by Peter R. Breggin, MD, a US psychiatrist who strongly opposed the practice of psychosurgery.

        Giving evidence in person, Breggin said to the committee, ‘Do not believe what you have been told today … about the demise of lobotomy. There is a great deal of lobotomy going on in this country right now. … most of the knowledgeable psychosurgeons admit that all of the newer procedures do the same thing: they are partial lobotomies.’ (p. 359)

        Breggin submitted in evidence several articles and papers he had written. These include references to brain surgeries performed on homosexual men:

        ‘… in West Germany, F. D. Boeder experimented with lesions in the hypothalamic region in an effort to cure “sexual deviation.” … This is what he accomplished : “Potency was weakened, but preserved . . . The aberrant sexuality of this patient was considerably suppressed, without serious side-effects. One important feature was the patient’s incapacity of indulging in erotic fancies and stimulating visions .” He boasts in addition that there was a disappearance of homosexual impulses and that psychiatric commitment could therefore be avoided. Psychiatric commitment avoided by obliterating a man’s fantasy life.’ (p. 458)

        Breggin mentions ‘an unsigned editorial comment in 1969 in the British Medical Journal calling for brain surgery for sexual disorders. The editorial comment praises German investigators for destroying a portion of the brain (hypothalamus, in this instance) of three male homosexuals, resulting in a “a distinct and sustained reduction in the level of sexual drive,” and all other drives of course, though they are unmentioned.

        This editorial considers the “need to protect the public,” but also suggests that voluntary consent should be obtained. But voluntary consent is a myth when the individual involved is a social deviant subject to the alternative of prison or involuntary mental hospitalization.’ (p. 461)

        Breggin told the committee that he and others who opposed the use of psychosurgery were ‘fighting the medical establishment’. He said: ‘The pressure is on us because we present a view that is extremely unpopular and is rejected by the establishment and the mental health profession as well.’ (p. 361)

        Yet ultimately the battle to end lobotomy was won; I think we should take encouragement from this.

        Breggin summed up his opinion of lobotomy as follows: ‘I do not think it is a medical issue. I think it is nonmedical surgery on people who do not have disease in their brain, and it should be stopped.’ (p. 362)

        ‘Nonmedical surgery’ — yes. Like the surgeries practised on young people who do not conform to the patterns of behaviour socially prescribed for their sex.

        I find the following passage from one of Breggin’s articles distinctly interesting:

        ‘The political pacification implications of Freeman’s work has largely been ignored by Freeman and by critics, but they stand out in his summary of ideal surgical candidates in his textbook, Psychosurgery. He is obviously describing a leveling operation that controls oppressed and discarded elements of the society when he lists the following four top criteria for psychosurgical candidates: age: older; sex: female; race: black; and occupational role; the “simpler” ones.’ (p. 441)

        ‘Oppressed and discarded elements of the society’: yes; just such are the girly boys and the boyish girls, the potential, or actual, lesbian and gay teenagers, the empathetic men and the women who refuse to be dominated. I have said this before: the shocking things that being done to them by the medical establishment is being permitted because their fate is not felt to matter by the wider society. Behind all the smokescreen about saving them from suicide and the sentimental nonsense about helping them ‘become their authentic selves’, this is the bitter truth.

        Breggin notes more than once that the majority of victims of lobotomy and related treatments were women. He recognises that this is down to sexism:

        ‘Not only have the vast majority of patients been women, both in the past and in the current literature, but the two most in-depth pro-lobotomy studies have already told us that psychosurgery is much more effective on women than on men because women can more easily be returned home to function as partially crippled, brain damaged housewives, while there are no social or occupational roles for partially crippled, brain damaged men.’ (p. 445)

        ‘In recent years the old-fashioned modified prefrontal lobotomy has been used on a variety of non-schizophrenic patients by R. F. Hetherington, P. Haden and W. Craig, Departments of Surgery, Psychiatry and Psychology, Kingston Psychiatric Hospital and Queens University, Kingston, Ontario. Their report to the Second International Conference in 1970 admits that the hospital refused to allow them to operate on males because of the unfavorable publicity given to lobotomies in Canada after the negative follow-up studies of McKenzie. But they were allowed to operate on women, 17 in number.’ (p. 459)

        Whew.

        Dr Breggin is very much still with us; he has a website and a twitter account. I wonder what his views are on transing children.

      • Thank you very much for this research. “Curing” homosexuality has been with us for a long time. We know (from many replicated studies) that most of the children/teens currently being transitioned would grow up to by gay or lesbian, if not tampered with. Anti-gay eugenics has shifted from messing with the brain to messing with the body. It’s more sinister today, because the anti-gay aspect is denied. It’s likely that most practitioners don’t believe they are harming gay people, but the effect is the same. The sheer number of LG adults who talk about a gender dysphoric childhood (which resolved when they reached sexual maturity and had the opportunity to realize their orientation) should be more than enough to put a moratorium on the trifecta of child “treatment”: social transition, puberty blockers, and the inexorable next step to cross sex hormones, sterilization, and likely surgical intervention. The Dutch pioneers of pediatric transition tell us that 100% of the “persisters” (those girls who went on to transition) were same-sex attracted, while nearly all “desisters” were opposite-sex attracted. What more proof do we need that the current regimen is (even if inadvertent) gay eugenics tailored to the high-tech 21st century?

  8. This is an AMAZING article, and you have done the hard work and research to support exactly what I’ve been thinking – Even before getting on this rollercoaster ride 3 weeks ago, I had a very skeptical and critical view of the medical community. Part of my professional life includes walking with people at end of life, and the default here in the States is STILL to intervene with painful, expensive (in every sense of the word), invasive, and ultimately, pointless treatments. Of course, those doctors, just like the ones listed above, do not live with the heart-breaking consequences. They have nothing on the line, except the chance to be the hero. (I realize not ALL doctors, but I’m still seeing this way, way too much. Apparently the “First, do no harm” has been subsumed under our contemporary need for answers and treatments that carry any “hope” no matter how far fetched, NOW.)
    The medical community – they don’t have to pay at all. But as parents, and advocates, we do. I’m trying desperately to walk that line between realizing my 17.5 year old is trying to “launch,” and I’m still the kid’s best advocate. We do not allow people to self-diagnose, right? So why do these teens “drive the ship?” with their self-diagnosis?

    • Your last comments are the most pressing of all, mabelruthblanche!

      Why is it kids, or even obviously troubled young adults, get to self diagnose without question? I get looked at with disdain by my doctor if I come in with self diagnosed allergies! But by all means, let the kids call the shots.

      “First, do no harm” is apparently an antiquated suggestion only for some…too many…doctors today. Maybe only because they are not wanting to push back from the obvious consensus of supporting more money making treatments.

    • The “why” is because the whole current treatment paradigm is driven by the notion that the sense of gender is immutable and there is some biological mechanism for it. Yet to be identified, but the practitioners and advocates appear utterly convinced. Thus if you say you are trans, of course you ARE. It doesn’t matter how old you are. In this POV, transition is an effective treatment for a persistent biological condition that is causing unhappiness. (Of course, the fact that detransitioners, including adults who lived as the non-natal sex for many years, do exist — sort of gives the lie to that POV. If the sense of gender were immutable and biological, no one could/would ever walk it back or flip it around, just like you can’t cure a pathology such as cancer by merely saying “I no longer have cancer.”)

      Now, the newer notions of human potential seem to be drifting away from this “gender as biology” viewpoint. There are those who, as 4thwave has often pointed out, are more of a “hormones for all” mindset, as a human happiness option rather than a cure for a condition. Just like a boob job, nose job, whatever. Body modification as a consumer choice. I don’t see how they can make the “trans” label fit both ideas simultaneously but — in the case of the elective modification crowd different labels appear to be applied, especially labels of the “agender” variety. (There’s extra $ available in promulgating that view but of course getting insurance to pay for such a thing is going to be quite the stretch.)

      IMO postmodernist thinking in academia (which influences the psych treatment world, too) is helping drive the entire business. If language really only means “what I say it means,” if there is no objective truth/reality, then the world is merely a mishmosh of alternative facts, you know? Ergo, a 16-year-old girl saying “I am a boy” should be taken completely seriously and at face value. In this view, there is no truth but the self-defined variety. That’s her reality, who are we to judge? There ARE no objective facts. People who keep insisting on some correlation between penises and maleness or vaginas and femaleness are old-fashioned essentialists living on the wrong side of history.

      The logical continuation of this trend is free access to all modifications for all types of reasons. Elective amputations for body dysmorphic disorder, free use of extreme modifications for otherkin, modifications if you want to look like Barbie, Lord only knows what else. The only potential brakes are going to be massive lawsuits due to health consequences that hit practitioners in the wallet. Money still talks and still means something. (Apparently we haven’t quite yet reached the age of money as a construct that only “means what I say it means,” though we could get there in the end.)

  9. Wonderful, thought-provoking piece, Overwhelmed!!! Thank you for taking the time to research the paralells of these life altering “medical advances” that are clearly on the same path if destruction.

    It is actually terrifying how similar they are. I echo all the comments above – this needs to get to a wider, world audience.

  10. I also meant to add: The practice at the turn of the last century of pulling all (mostly women’s) teeth of those who were suffering from what I think we need to start calling instead of “mental health” “brain health” issues. (And again, natal females seem to take the brunt of all of this.) An episode of the HBO show “The Knick” showed this.

  11. Thank you so much for the hard work you have put into this excellent pice, Overwhelmed.
    I agree with other posters that this deserves publication in a mainstream forum. I will be sharing this far and wide. I am also going to send this to my MP who was less than willing to take on board the concerns I was trying to raise with him when I wrote to him prior to the debate in Parliament on the report from the Women and Equalities Committee enquiry on Trans Equality. It is so obvious to me that the adult Trans lobby NEED the validation of the theory that children can be “trans” in order to establish their claim of “born this way”. These children and young peple are the victims of adult agendas. It may be too late to turn the tidal wave of legislation and accommodations that are resulting in the erasure of sex based protections for women, amd the stripping of the language we need to express our experience, but surely to God the medicalisation of childhood identity formation is at least worthy critical thought?

  12. Overwhelmed, this is great work. We all appreciate the time it must’ve taken for you to research and create it, along with 4thwave’s time in getting it formatted in an appealing way with appropriate illustrations. Brava.

    Another parallel from more recent history — the ‘childhood bipolar’ movement of the late 1990s and early 2000s. Like lobotomy and like pediatric transition, this new diagnosis was driven by a few evangelistic medical “pioneers” and by parents’ desperation to help their kids and by clinicians’ desire to “do something” to help. It looked like an answer for these kids’ extreme behaviors (especially hair-trigger rage episodes), and heavy-duty antipsychotics were prescribed to many kids, even very young kids. The media were intrigued with this new solution for these exotic and alarming kids, and these psychiatrists were all over network TV and in major newspapers and magazines, touting their cures. The media coverage helped drive skyrocketing rates of diagnosis, as more and more parents brought in kids they suspected of having child bipolar.

    Eventually Congress started taking a look at the links between the docs and Big Pharma and the whole business was largely discredited. Especially since the treatments (drugs like risperdal and seroquel) were being used off-label (sound familiar?) and turned out to have some pretty bad and sometimes irreversible side effects, including tardive dyskinesia and gynecomastia and rapid weight gain and blood sugar effects leading to diabetes. The authors of the DSM-V declined to include the proposed ‘child bipolar’ diagnosis and instead stuck in a much vague ‘disruptive mood disregulation disorder’ label. The craze died down.

    HIstory just keeps repeating itself. Docs have egoes and want to be pioneers; pharma needs revenue streams; desperate parents do desperate things. The leader of the child bipolar movement, Joseph Biederman of Harvard/ Mass General, once compared himself to someone just one step below God during a hearing. I kid you not. It’s like Spack’s fascination with transforming tadpoles by jiggering the endocrine system. Tadpoles, then kids. These ppl just can’t seem to stop themselves. (Now, Olson and Olson and Garofolo and Ehrensaft et al seem to be more of the “compassionate justice warrior” mindset. They’re convinced they’re helping and that the risk-benefit ratio makes sense, and that there is no other way to help. For now.)

    Of course the pediatric trans situation also has the additional impetus of a few big-bucks transactivists funding clinics and (I am pretty sure) funding a sustained PR push to make sure the model they are advocating is widely publicized and thus normalized.

    A good summary of the bipolar phenom:
    http://www.huffingtonpost.com/allen-frances/children-bipolar-disorder_b_1213028.html

    Read it. Like Yogi Berra said: Deja vu all over again.

  13. Fantastic article! Huffington Post would be a good place to try and post this, given the amount of coverage they have given for trans trends and the number of eyeballs potentially seeing this article.

    As a medical professional, I see people getting hormones just on their say-so, without so much as an assessment from a psychiatrist. The current “standards of care” state that the wait lists for gender clinics are so long, it is recommended that prospective transitioners get hormones from their family physicians so that they don’t kill themselves while they wait. I can’t think of another medical condition that is treated entirely on the basis of a patient’s unverifiable claim. Whatever happened to evidence-based medicine?

    Far as I’m concerned, the treatment of gender non-conforming people is swamped by the same sort of pseudoscience that gives us vaccine skeptics and homeopathy.

    • there have been so so many great comparisons – Your post here just reminded me of another – Hormones in a totally different context – For women going through menopause – How it was assumed everyone HAD to go on them, then – Oops – we found out that wasn’t such a great way to go. Curious how many “hormones” and other of these “medical interventions” have been used throughout history on (natal) females more than males ….. After all, until recently, men were the ones calling the medical shots …..

    • First, trans activists use Kristina Olson’s “research” constantly (it’s all they have), as if it proves something about innate gender identity. Olson, along with other activists, runs a program, the TransYouth Project, predicated purely on the “affirmative” model of care for youth. She is hardly doing objective work, especially since all her research subjects come from support groups and gender clinics where all children identified as “trans” are socially transitioned and endorsed in the notion they are actually the opposite sex. There are no control groups of gender-defiant or gender nonconforming children who are loved and supported in that nonconformity but not transitioned. That said, it’s not exactly surprising that children who are allowed to wear what they like, play with what and whom they like, and otherwise allowed to do as they wish without being gender policed, are happy, is it? Olson doesn’t bother to study the mental health of children allowed to do just that, but not coddled in the belief they are in the wrong body; children encouraged to believe that, instead, they are unique and wonderful exemplars of their natal sex. One has to wonder at her lack of interest in comparing such children. A researcher with no bias would surely want to know whether it was necessary to socially transition all these kids (who almost always are then ushered onto the train of puberty blockers and then cross sex hormones–a process that used to be known as conditioning), when a more benign approach might work.

      Olson’s prior study, also constantly used as propaganda by trans activists, was critiqued in this piece, “Groundbreaking Study: Kids mean what they say” on 4thWaveNow last year. Olson’s entire premise–that kids who really, really, really prefer the lifestyle and appearance of the opposite sex MUST be trans is so tainted by confirmation bias it’s amazing it passed peer review. A critique of her second study is in draft and will be published here in the near future.

  14. Its clear none of you have ever met or spoken with someone who is transgender. Its not about doing something hip or trendy, its about feeling comfortable in ones own body, and ones own mind. Also, there are varying degrees that people go to modify their body, but ultimately, any lasting damage is only to the ego of people who dont understand or are scared of trans people.

    Respect the decisions of your neighbors. Don’t criticize and insult them just because you feel scandalized about them messing with your precious gender roles.

    Were good people if you take any time to learn about us. As a transwoman, i can tell you, ive never been more at home than i am today, and its not just a fad, people finally feel free to be who they are. Respect that strength. 🙂

    • It’s clear you have spent no time on this blog apart from your drive-by comment. If you had, you’d know the purpose of the site is critiquing the ever-accelerating trend to identify and medically “treat” children who don’t conform to gender norms. Most post authors are parents of such children. We aren’t “scared” of adult trans people, but we would suggest they focus on their own issues and leave our kids out of their activism.

    • “…its about feeling comfortable in ones own body, and ones own mind.”

      I think a lot of what drives the idea of transgender children is that adult transgender people know first hand the feelings of hopelessness and worthlessness that comes from being bullied. BI know what that’s like; I don’t ever want my kids to feel rejected or hated. No parent does.

      Everybody wants to be accepted. Everybody wants to feel safe to just be themselves without persecution so I get it. If the adult transgender community wants to help kids avoid the heartache they experienced those are good intentions, certainly.

      But what if I make a choice that I think will help my child but ends up hurting them in the long run? Those puberty blocker drugs scare the crap out of me. Adults and children who have taken them are now experiencing serious, life long side effects. How comfortable in one’s own body is someone going to be when they have full blown osteoporosis at 24 years old?

      And what if I’m wrong or my child is wrong? What if the therapist or doctor is wrong? Doctors misdiagnose people all the time. Children think they want something very badly and then change their minds all the time. What I mean is people do de-transition and the thing I hear from many in the trans community say is those people were never trans in the first place. Wouldn’t it be better to find out before getting surgeries and having side effects you can’t take back?

      The parents here are good people too. They aren’t judging their neighbors, they’re worried for their kids. They’re worried that drug companies and medical establishments are more interested in profit than safety.

  15. Overwhelmed, thank you so much for all your hard work and research. Ever since I got dragged down this rabbit hole, I’ve wanted to scream to the world that this whole trans mania is nothing more than Lobotomy 2.0. I can’t fathom why we can see it so clearly when medical professionals cannot. I am convinced that, someday, the rest of the world will wake up and see it. But I fear not before destroying far too many of our children.

  16. For less serious examples of “medical ideas that are set in stone” that turn out (ahem) not to be, consider two of them that occurred during our years of having and raising babies:

    When my first son was born, the absolute doctrine was, “babies have to sleep on their tummies or they will die of SIDS.” Well, wouldn’t you know, my son refused to sleep on his tummy, would flip over immediately onto his back, and I spent an entire year thinking I was a terrible mother for not forcing him to sleep on his tummy. In fact, believe it or not, we experimented with putting a baby blanket over him and weighting it down with bags of flour on either side, that’s how strong the fear was.

    Come to find out, what, 10 years later, that was absolutely the wrong thing to do! Now it’s “back to sleep” to avoid SIDS and I guess we would have been the perfect parents.

    Second example is the Dreaded Peanut. At the time most of us were having kids, we were instructed to avoid peanuts like the plague, not to introduce them, or any other possible allergen, until the child was at least two years old. That would help your child avoid a possible peanut allergy, of which there seem to be an awful lot these days.

    Now, research has shown that introducing peanuts early, like at four months, will help avoid peanut allergies in children and so that is the recommendation. The thinking seems to be, now, that strict avoidance of peanuts may actually have contributed to the rise in allergies!

    I’m not saying, at all, that doctors and scientists shouldn’t research these, or any other, issues. And, I for one appreciate it when recommendations change in response to science. That’s the way it’s supposed to work. But it really should give all of us pause, when what appear to be ironclad, firmly established, incontrovertible, health ideas turn out… not to be. The examples of back sleeping and peanuts are pretty benign, but putting a child or teen through the “trans” process, really isn’t. Why there is so much uncritical buy-in on this issue is a fascinating question indeed.

  17. Janice Raymond, in The Transsexual Empire (1979), on parallels between transsexualism and lobotomy:

    ‘Transsexualism, as a proclaimed form of therapeutic sur­gery for nonphysical disorders, is located on a historical continuum of similar medical ventures, all of which legiti­mate(d) bodily intervention for purposes of improving behavior. In the nineteenth century, clitoridectomy for girls and women, and to a lesser extent, circumcision for boys were accepted methods of treatment for masturbation and other so-called sexual disorders. In the 1930s, Egas Moniz, a Portuguese physician, received the Nobel Prize for his “ground-breaking work” on lobotomies. Moniz operated on state mental hospital inmates, using lobotomy for everything from depression to aggression. The new terminology for brain surgery of this nature today is psychosurgery, which its proponents have at­ tempted to disassociate from the cruder procedures of Moniz and others by pointing to its more “refined” sur­gical techniques. But call it lobotomy or psychosurgery, surgeons continue to intrude upon human brains on the basis of tenuous localization theories that supposedly pinpoint the area of the brain where the “undesirable” behavior can be found and excised. Finally, transsexual surgery is justified on the basis of adjusting a person’s body to his/her mind.

    What each of these surgical ventures has in common is that they derive their therapeutic legitimacy from a medi­cal model which locates behavioral problems within certain affected organs. Surgery then alters, intrudes, removes and, in the case of transsexualism, adds organs. In each venture, a surgical fetishizing takes place, reducing the social com­ponents of the problem to the most tangible and manage­able forms.

    Further, what each of these surgical ventures has in common is the modification and control of behavior. Clitoridectomies modify sexual behavior or fantasied sexual behavior; psychosurgery modifies the gamut of behavior from hyperactivity in preteen children to so-called manic depression in dissatisfied housewives; trans­sexual surgery modifies everything that comes under the heading of masculine and feminine in a patriarchal society—thus practically everything.

    In the case of transsexualism, behavior modification is both a prerequisite for and an effect of the surgery. … In this context, it can … be pointed out that sex-role conditioning itself is a form of behavior control (i. e., the control that a patriarchal society exer­cises over its members). Yet, with a good number of people, this form of social control has been unsuccessful. This has happened with the transsexual, who has not been adequately conditioned into the role/identity that accom­panies his or her body. Instead of seeing this unsuccessful conditioning and gender dissatisfaction as a “signal of tran­scendence,” however, the transsexual seeks out (with the help of the transsexual technicians) another mode of be­havior modification, which is transsexual treatment and surgery. This latter form of behavior modification and control then reinforces, for the transsexual, in several hormonal and surgical strokes, the behavior that it took years of sex-role conditioning to impose upon persons who belong to the sex that the transsexual desires.’ (p. 131f)

  18. Imagine the outcry if anxious parents took their depressed gender-non-conforming children to a doctor and were prescribed same sex hormones to make them more feminine (girls) or more masculine (boys). Or offered breast /penis enhancement.
    In fact – what’s the difference?

    • This — the hormone part, at least — used to happen in the eighties and even the nineties at residential treatment centers for “troubled and defiant youth.” There wasn’t much of an outcry until the late 90s, and it took a while to get those places shut down. Source: Gender Shock, Phyllis Burke (Doubleday, 1997). Now that this book’s 20 years old, it’s newly relevant — today’s practice of transing children seems like a through-the-looking-glass version of the de-gaying and gender-norm-enforcing pseudo-therapies of 30-40 years ago.

  19. Great article; I just read it for the second time. I find our society’s quickness to jump to medical interventions disturbing. I’ve studied psychology for years and am currently of the opinion that most of what we call “mental illness” is, in fact, dis-ease manifested in people due to societal sickness. Yet, we continue to tell the individual to change themselves instead of being critical of societal attitudes. I’m glad to see there are still critical conversations happening, especially in the interests of children–keep it up!

  20. I completely agree that the medical world is moving too fast to promote intervention to children, I even wonder if it’s because there’s an emerging market that physicians can make a capital gain off of. I also understand the parallel you’re making between medical fads, however I feel as though labotomies are a very extreme example. I’ve personally thought of medical transitions in more of a plastic surgery fad sense (if that makes sense). I’ve also been to Dr. Sparks clinic, he was (I believe he is now retired and GEMS is run by Dr. Robert at Boston children’s) hasty but meant well. I believe Dr. Roberts is much more understanding and cautious.

    I have to ask though, what are the opinions of readers at the 4thwavenow about just using mild hormones blockers (for example: birth control to prevent menstruation) and allowing children to wear binders without other medical intervention s until they are of age? Do you believe that all trans people are just a fad or is it a mix of truly trans and teens taking on false identity? And why do you believe the majority of trans youth would be gay/lesbian if untampered with?

    Excuse any spelling mistakes, I’m on my phone and editing is a bit difficult.

    • There is a ton of information about lobotomies. Media articles, books, and documentaries are chock full of knowledge about this time in history. There was even a study done that analyzed if newspapers and magazine coverage had an impact on how widespread the procedure became. I wrote the article because of the plethora of information available and the many parallels between the rise in lobotomies and pediatric medical transition.

      Parents are appropriately concerned about their kids who out of the blue announce they are trans. This doesn’t mean that we believe that all trans people are a fad. Just that we are worried at the break neck speed which our own children, many who were influenced by social contagion, are being shuttled down the medical transition path.

      I personally haven’t looked into the potential effects of “mild puberty blockers” although I would expect some side effects from tinkering with hormone levels at this age. And binders have their own set of risks. Here is a link to an article discussing some serious negative consequences of binding: https://broadly.vice.com/en_us/article/chest-binding-health-project-inside-landmark-overdue-transgender-study?utm_source=broadlytwitterus

      It is pretty common for homosexual adults to admit they were gender dysphoric when they were young. I’ve read this many times, but here is one example: https://www.theguardian.com/film/2016/jun/19/rupert-everett-dangers-of-child-sex-change-operations-gender

    • I will say for myself that I have allowed my 14 year old to wear a binder that seemed least likely to cause lasting spinal damage, and when she has complained about her period I have indicated that I would be willing to let her take bc pills to stop it (as I personally do) because those are hormones that her body already produces, and the impacts of taking them have much more of an evidence base behind them. I think that my child is more likely a lesbian than a transboy simply from my experience of her over her lifetime and the fact that virtually all of her close friends are female (she has one close male friend who is gay and has been rejected by his straight friends because of his “feminine” traits). I could imagine my view on more significant interventions changing if (1) there was a biological test to show that gender identity is an inherent trait that can be different from sex and my child tested as having a gender identity distinct from her sex or (2) my child significantly matured, recovered from her depression and anxiety, express love for herself and thus seemed developed enough to be able to make irreversible medical decisions. Absent one of those I think it is pretty reasonable for me to stop at social transitioning and let those decisions be made by my child in adulthood.

    • I don’t think most of us here would call trans “just a fad” OR a “false identity.” I think a lot of us would call it adaptive behavior developed in response to a variety of stimuli, which seem to vary a good bit depending on the natal sex and on individuals’ life histories. It’s a self-label that’s doing something for the people who adopt it, but that “something” isn’t the same for everyone.

      Whatever causes it — and I find the “brain sex” theory utterly unconvincing based on a lot of research — this sense of disconnect between the natal body and the proposed gender identity can’t, to me, be anything but a variety of mental illness. So there’s a place where I differ with the DSM-V and those who continually push to remove any mental health diagnosis related to trans identification (but still get insurance to pay somehow!). Any self-identification that would make a person ignore the many health risks of blockers, opposite-sex hormones, and surgeries to remove and/or radically alter healthy body parts is the result of disordered thinking, in my point of view. People who are willing to shorten their lives, or subject themselves to long-term medical oversight and the considerable risk of chronic health issues over the long term, isn’t thinking totally straight. IMO. That’s not intended as an insult, that’s just — my point of view, based on all the info I’ve been able to get my hands on, including exposure to opinions of trans, non-trans, and detransitoned people.

      In the case of my daughter, and the kids of a lot of others who post here — there’s a history of mental health issues long predating the trans identity. For them to be met with unquestioning professional “affirmation” with zero exploration of co-morbid mental issues that may be contributing to the sense of being trans is not doing them any favors. Research proves that transition does not get rid of these mental health issues for many people. Once the inspiring goal of transition is met, the issues come back for not a few. The suicide rates remain high.

      I think most of us here are willing to accept that there are people for whom dysphoria is so persistent, or issues such as autogynephilia so intractable, that there’s little other choice but transition. I still don’t accept that they’re “true trans” in a biological sense, but — grownups get to make those choices.

      Re your other question — binders are dangerous but my kid’s been wearing one off and on for the past 2 years. When I point out the dangers, she’s very fingers-in-the-ears, “la la la can’t year you.” Like I said, the “male” presentation is doing something FOR her that seems stronger than the risk of what the binders could do TO her. I don’t think they’re a great solution and I regret the day I let her order them, but it was in the midst of demands to be taken to a clinic RIGHT NOW and — the binders were kind of a compromise, at the time. A bad one, maybe a gateway drug, you know? But, yeah. I don’t think the people who sell and promote these things are at all up front about the potential damage.

      As for period-stopping birth control — not a big fan. But if it’s choice between that and going to T, I’d rather have the kid use the birth control. We’ve discussed it. If periods are such a dysphoria-making thing, like I said, better than T from a risk standpoint, and a long-term-irreversible-effects standpoint. I would, of course, rather have the kid able to get DECENT counseling to help her unpack all this stuff, instead of a band-aid like this. In the state where I live, the law has now made this nearly impossible, even if she was willing to do therapy. Right now she just thinks T is the solution to all life’s problems and is totally uninterested in talking.

      For what it’s worth. Thanks for the polite tone of your questions. Wishing you peace.

      • I don’t think most of us here would call trans “just a fad” OR a “false identity.” I think a lot of us would call it adaptive behavior developed in response to a variety of stimuli, which seem to vary a good bit depending on the natal sex and on individuals’ life histories. It’s a self-label that’s doing something for the people who adopt it, but that “something” isn’t the same for everyone.

        Thanks for this, Puzzled — this is a beautifully clear and precise way of putting it.

      • I agree with this, but also want to add that there are kids who don’t, technically, have dysphoria. My girl is one such person. She claimed it early on, because that was the narrative, but she actually dropped it within the first year and it’s important to note that we’re seeing some kids who don’t seem to be reacting to issues with trauma and/or their natal bodies. I don’t say this to discredit what you’ve written, but because I think there ARE some kids who are drawn to the trendy thing which is getting a lot of press.

        As best we’ve determined in the last couple of months with a therapist who was willing to tell my kid that the trans identity wasn’t the most important thing and she wanted to explore some other stuff, my kid has pervasive anxiety, intense emotions and emotional dysregulation, and very impaired soothing and coping skills. No body dysphoria. No trauma. It seems she misdiagnosed herself because she met a trans-identified kid who she befriended and she kind of adopted that kid’s “stuff.” (Which, you know, we KNEW and told professionals, but we’re just stupid. Natch.)

        Anyway, this therapist, who specializes in LGBT youth and who thinks some kids DO have “gender identities” which differ from their natal sex, thinks that trans has become a trend. She says 5-10 years ago, the “trendy” identity/self-diagnosis for teens was bisexual. Now they see kids presenting as trans at a high rate. Like you said, puzzled, for some kids with trauma history and dysphoria, it’s an understandable RESPONSE. But, there is also a social contagion/trend thing which seems to be happening, as well.

    • The other posters have done a lot to answer your question, which I will assume was asked in good faith.

      The only thing I have to add is that a “soft transition,” of the kind you suggest, will likely have the same end result as the full-on approach. The more our children focus on their gender, the more this becomes central to their lives, the more they view their gender identity as defining them … the more likely they will be, I think, to go for the more radical option (attempting, insofar as it is possible, to transform into the opposite sex) as they grow older.

      And, the radical option is not, in itself, benign. As between doing it and not doing it – clearly from a health perspective it is better not to. Fewer drugs are better than more drugs. No drugs are best of all. Less surgery is better than more surgery and so forth.

      You know, if we were 50 or 100 years down the road here, and there were multiple generations of people who received Lupron as teens, and cross-sex hormones, and surgeries to hugely alter their reproductive systems, and it had all been carefully studied and the results were that there were no negative health impacts – we’d be in a totally different ball park than we are now. The fact is, we have virtually none of that data. We have no idea what these kids’ and teens’ health futures will look like, except that the small amount of data we do have (on early Lupron use, for instance) points in a bad, bad direction.

      Since, at best, the theory of brain sex and the scientific basis for the transgender assertion are debatable, we prefer not to expose our children to unknown health consequences in service thereto. And anything that pushes them along that continuum is, in my view, potentially dangerous.

      • Thanks for the response’s everyone, you all come from a very fair standpoint with a lot to back up your points (which I really appreciate).

        I did some research and realized there really can be some adverse side affects from hormone blockers, so I stand corrected on that point. I still question whether hormonal treatment is actually bad for the body, from just a physical perspective.

        However, I think the reason’s people seek these medical interventions can be extremely detrimental to their own health. I believe that, not just the trans community, but the majority of the LGBT community is unhealthy, especially amongst younger generations. But, I don’t think it’s just the LGBT community that has this issue. I think this community is just an amplification of something that is very prevelant amongst all youth today, which is a heightened sensitivity to mental health.

        This is just a personal theory, but I think a lot of youth today are romanticizing mental health, whether it be depression, self-mutilation, or the woes of being LGBT. With the way people communicate today, it’s very hard not to get sucked into these communities where there’s a cycle of unhealthy thinking.

        It seems like every teen at school, home, and on social media (especially tumblr) has some sort of issue around self-deprication, esteem, depression, etc. I don’t know if you’ve ever heard the theory: we act like the people we’re around the most,but I think it’s true. And if kids are constantly around these these types of communities, then they too will start to feel this way.

        I don’t think there’s anything inherently wrong or inaccurate about being transgender, gay, etc. or having a strong indetity, however, I think there’s something wrong with the perception that people make about what it means to be these things. A lot of kids think that if you’re transgender, then you must feel like crap about yourself and you have to get a quick fix (i.e. surgery) to make it all better. But, it doesn’t work that way.

        I believe a lot of transgender people are unhappy before and after medical transition because they suffer from a cycle of negative thought and perception; no matter how much their body changes, they never work on improving their mindset and creating a healthy relationship with themselves.

        The first thing a parent of a transgender child should do, is start talking about: positive thinking, ways to recognize unhealthy relationships with one’s self, how even after medical transition people still aren’t happy, and ways to recgonize and separate from unhealthy communities.

        After that, likd the author says, you just have to trust yourself as a parent.

      • Response to tethomas121:

        I believe that, not just the trans community, but the majority of the LGBT community is unhealthy…

        Please clarify your remark that “the LGBT community is unhealthy”, specifically with reference to lesbians and gay men.

        I am a lesbian, British, over sixty. I came out more than 40 years ago.

        I think that the ‘LGBT community’ is at most a (crumbling) political alliance; otherwise no more than a sentimental fantasy. There is no unified community; never was. There are communities of lesbians, communities of gay men. There are bisexual people who have social/relational involvements with a community or communities of lesbians or gay men: in all the respects that matter, they are part of those communities.

        I know many more lesbians than gay men (this is normal) but years ago, when I was very actively involved in campaigning for LGB rights I also mixed with many gay men.

        We didn’t and don’t ‘[romanticize] … the woes of being [LGB]’, to quote from your comment. We put ourselves on the line, risked our jobs, relationships with our families, friendships with heterosexual friends, and worked damned hard i) to change social attitudes and ii) to support each other and our communities. We were, and are, sane, clear-sighted and very tough.

        And it is not a generational thing. I salute those same qualities in the detransitioned women organising to support each other and carrying out the research that the medical profession is neglecting to conduct. Most of these women are lesbians, most are still in their twenties. I salute them in the vlogger Magdalen Berns, scourge of bullshitters; in Nat Trimm, a gay man who detransitioned, who blogs and vlogs, very perceptively, as MiriamAfloat. I have no doubt that there are many others.

      • Tethomas121,

        In your comment:
        “I believe that, not just the trans community, but the majority of the LGBT community is unhealthy, especially amongst younger generations. But, I don’t think it’s just the LGBT community that has this issue. I think this community is just an amplification of something that is very prevelant amongst all youth today, which is a heightened sensitivity to mental health.”

        -you make a good point in relation to the youth of today. I don’t think the majority of the LGBT community is unhealthy, though a few really outspoken members of the community with various mental or emotional issues may wrongly claim to speak for the majority.

        I do think that today’s young generation up to early 20s seems to glamorize mental health issues or at least use them as a badge of some sort. The amount and range of labels my daughter and friends use to describe themselves and each other is staggering and ridiculous. So, one question is whether there is a true mental health problem in our youth or whether there is a general desire or craving in a cult like fashion for these kids to grab many identities and labels for attention, status, whatever? It is probably both and that is one reason professionals have trouble with treating patients with GID and related issues.

  21. Dr Kenneth Zucker (no friend of trans people) disagrees with James Cantor, Ray Blanchard and Michael Bailey.

    Zucker’s own words
    2015 GIC Review. Interview with Dr Zucker.
    GIC-Review-26Nov2015b.pdf

    Page 12: “at age 3 , children begin to self label and form their gender identity. ” .
    Page 12 again: ” At age 15 in adolescence the most likely outcome is persistence of the GD. 70%-80% would continue to have GD. The treatment would be social transition and biomedical treatment.”

    Even he prescribed puberty blockers and later HRT for trans adolescents.

    So who is right, Cantor a paedophilia expert with no history of transgender research, or Zucker with over 200 papers on trans people, mostly children and adolescents?

    Zucker only argued that sexuality and gender were ‘malleable’ up until puberty, hence his gay/trans conversion (they were the same thing) therapy only concentrated on young kids by eliminating gender non conforming behaviour. At puberty it all becomes fixed.

  22. I’m not sure where to post this, but it’s sort of fitting with the article. After six months of doctors, psychiatrists, and counseling for my daughters depression and gender identity problems, I finally ordered and paid for labs out of pocket. She’s 13, had told me she was transgender but hasn’t been persistent about it for a while. I’ve been more worried about her mental state, she’s been extremely depressed and not herself. She’s been to many doctors, even was hospitalized, but nobody did a full lab test on her until I demanded one. They only focused on psychological problems. Turns out she has severe hypothyroid and low progesterone. Each can cause problems, lack of development, etc. I think it’s why she felt less female than her peers also, she is a tomboy, but she’s not necessarily transgender. I don’t understand why they were so eager to call it a mental illness without checking her physical health. I guess I’m saying this to make sure doctors rule out every physical disorder before considering a permanent label, even transgender. I’m going to get her hormones to normal and see if she still feels transgender. I’ve always been accepting of it in adults but I don’t think she’s actually transgender. Even she thinks it’s a good idea to wait.

    • This is a great point.

      I have to be honest — for the past several years, I did not take my daughter who was trans-identifying to the medical doctor because I was fearful the doctor would push us to transition her medically. Considering what happened with mental health professionals and educators, I think it was well-founded. (Also, in our state, doctors can work with kids 13 and up without involving parents. So, in theory, our teenage daughter could get a prescription from our doctor without our knowledge. I didn’t want to risk that.)

      And, I only say all of this because I think it’s important to know how paranoid this makes parents. I shouldn’t be afraid to take my kid to the doctor or be opposed and ignored by the school.

      • I’m admittedly paranoid about going to the endocrinologist. But I plan on not bringing up the transgender issue with them, and I don’t think my daughter will either. She is more worried about feeling bad and the fatigue at the moment. That’s going to be what we discuss. I don’t think she’s caught on to the fact that endocrinologists treat transgender also, but she’s still too young to get a prescription in our state thankfully.

  23. A cursory search on google shows many articles from women’s health advocates, alarmed and armed, fighting back on Lupron and the lawyering up over what it had done to women’s health and lives. Ten or so years later, again all on a quick google search, it’s all good. Lupron is now a wonder drug. For transing children, mention of side effects and previous ruined lives a generation or so before, nil to short shrift.

    Also there on google search, OBOS, who dedicated a huge hunk of their last publications to serving the health issues of trans “women”. Our Bodies Ourselves. Fait accomplis. I wish someone could tell us how this happened, a total 180 from the brilliance of the 2nd movement to…vapid.

    • Women — actual, real, biological women — don’t matter. Simple as that. Even as adult, functioning humans, we’re discounted AS MOTHERS when we know that this trans trend is wrong and our daughters require help. Dismissed. By whom?

      Oh, yeah — mostly adult men in dresses who claim they make better women and mothers THAN US.

  24. While both interventions are indefensible , there is at least one very big difference between the selling of lobotomies and of pediatric transsex (toddler “wrong body “) interventions . At least initially , lobotomies were aimed at desperate cases where there was no other form of treatment. Pediatric transsex is a preemptive intervention , which is applied without there being distress. The “Gender Dysphoria ” model required only an anticipation by others of future social /professional impairment , while the affirmative model pushed by Ehrensaft and K Olson requires nothing but a behavioural preference

    . ALL the kids in the often miss-cited K Olson trans youth “well-being ” parent survey were without any diagnosis , a total non-clinical sample , while Ehrensaft and the gender spectrum folk actively seek “gender messages ” from happy healthy kids. So it is an intervention as brutal and untested as lobotomy , but offered more like a choice of hobbies than as a response to suffering .

    The later uses of lobotomy of course have more in common with pediatric transsex, as it was not uncommonly applied in response to merely socially disapproved behaviour.

    The appalling thing though, is that the evidence base for pediatric transsexual is even worse than for that of lobotomies. While they are both interventions that obliterate rights, autonomy and social futures , pediatric transsex is unique in not ever having been demonstrated to do any of the things claimed for it . Unless we count the one 2014 Dutch study (which we obviously shouldn’t * ) , there isn’t a single shred of evidence to support any of its claims. *
    ———

    * We need to talk about this .

    Great article by the way. Really well researched .

  25. I liked that article, most here, too.

    The analogy between the lobotomy craze and this is very good. I studied the former, a great tragedy.

    I cannot believe what is being done to children in Western countries.

    In Japan, too, at least a couple of transformers I met clearly had early intervention, mid-teens, but not as infants!

    4th wave now? Of what is it the fourth wave?

    I can see that this site is mainly for mothers and FtM accounts, so my own account of recoil (because I am womanly enough to pass, by looks and motion) probably has no place here.

    I would recommend Walt Heyer’s Transgender Regret, too.

    Most attempted and successful suicides are post-surgery and much after surgery.

    De-transition is as much a myth as transition in a way, but it is a choice to return to the natal sex. If the organs are gone,

    As the final point I want to make on this now, the huge portion of FtMs, or if you like FTTs who don’t go through surgical mutiltation down below, are exactly the same as butch lesbians in the past.

    I used to like a rad-les band, the bassist had a bum-fluff-beard. She may have been on testosterone, sure looked like it,

    Of course never raised in conversation.

  26. Very very good article. I think the comparison is so good. With one exception. Lobotomy has never been recognized as a human right like gender identity. Once gender identity is protected by the law, how will we be able to undo that?

    • Thanks, Diane. Yes, I think the pediatric medical transition trend will be more difficult to stop. The transgender rights movement has given it significant momentum. There have been state laws enacted that restrict how therapists can conduct sessions with trans-identifying minors. Organizations like Gender Spectrum are in schools training students and staff about transgender ideology. Judges, hospital staff, police officers, churches, etc. are also being “educated” by activists. Guidelines in some school districts require teachers/staff to treat students as the opposite sex and hide it from their parents. Many Democrats (USA) are well-meaning, but will tow the party line and assume anyone with skepticism about this topic is a “transphobe.” And, there are some trans activists who will go to great links to discredit people who publicly speak out against trans dogma–promoting lies, attempting (sometimes successfully) to get people fired from their jobs.

      Unlike lobotomies, there is not a promising new drug (or other treatment) on the horizon that will impede the momentum of child transition.

      Also in the time of lobotomies there was no internet, which now amplifies social contagion. Online pro-trans communities like Tumblr are heavily influencing many young people.

      I agree that it would have been a good idea to include this information in the original post. I actually had planned to add a section discussing how lobotomies and pediatric medical transition differ, but the post had already gotten quite lengthy and unwieldy so I decided against it.

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  28. Pingback: Is the widespread acceptance of “gender transition” similar to the past acceptance for lobotomies? | The Prime Directive

  29. Pingback: ‘Bridging hormones’: Increasing number of UK GPs leery of prescribing treatment | 4thWaveNow

  30. Quite horrific ! Right up to the early 1960’s,routine lobotomies were still routinely given to homosexuals,(mostly male),often without their consent ! The crude procedure often left the victims severely brain-damaged.They were deemed a “cure” and success when the person was reduced to a perpetual vegetative state. Their homosexual desires were erased,….along with everything else !These procedures destroyed countless lives.The lives of good,decent,intelligent and productive young men…and the only thing they were guilty of was being human and not being heterosexual ! Thankfully,some 60 odd years later,we realize how ignorant,paranoid and brainless society was way back then and bow these tragic souls were victimized for something they did not choose,and certainly could not change !

  31. Don’t forget that it was also used as a treatment on mentally ill people and it does work sometimes if someone has a bad mental illness they have to get a lobotomy

  32. Pingback: Cruel and unusual: history’s most disturbing medical treatments – LULZ

  33. Pingback: Cruel and unusual: history's most disturbing medical treatments - IQfy

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