Insurance requirements are a “ridiculous” speed bump on children’s gender journeys

Yesterday, Johanna Olson-Kennedy, MD, one of the better known US pediatric gender doctors, railed against insurance companies who stand in her way. It seems they have the temerity to demand written evidence that her prepubescent clients are mentally prepared for the chemical blockade of their natural puberty.

The insurance companies also, inexplicably, want to see evidence that the children and their parents have actually agreed to this off-label (not FDA approved) and very expensive drug treatment.

johanna olson april 12 2017 eradicate gatekeepers

Olson-Kennedy wants WPATH, in its next Standards of Care (SOC 8), to “eradicate” the requirement that minors have some sort of psychological evaluation before embarking down the Lupron road (which leads in nearly every case to cross-sex hormones, as Olson-Kennedy well knows):

So, what a lot of people want to understand is, “If I give my child this blocker, can I take it away, if at the end of a certain amount of time they no longer have a trans-gender identity, or they don’t want to continue on to pursue a transition with cross-sex hormones.” The answer to that is, “Yes.” They are reversible. You can take them off without any problems or major medical problems. But it’s very rare that that happens. In my practice, I have never had anyone who was put on blockers, that did not want to pursue cross-sex hormone transition at a later point.

Olson-Kennedy is also no doubt aware of the growing controversy about Lupron and other puberty blockers, but that doesn’t seem to be a concern when it comes to insurance reimbursements.

This isn’t the first time Olson-Kennedy has publicly complained about the foot-dragging of insurance companies. Last September, she posted “unfounded” denial letters from insurance companies on the WPATH Facebook page–mostly having to do with the fact that puberty blockers have never been approved by the US FDA for use in chemically halting the puberty of healthy “trans” kids.

Johanna Olson complaining about blue shield sept 21 2016 cropped

Should insurance companies be in the business of paying for experimental treatments on children–some who (on Olson’s caseload) were actively suicidal? Take a look at these denial letters. Do gender doctors like Olson-Kennedy deserve this level of oversight?

Is my use of “experimental” warranted as an adjective–apart from the fact that, a full ten years after Norman Spack, MD first began to use GnRh agonists in his practice, these drugs are still not approved for this use by US regulatory agencies?

Take a look at these remarks by Rob Garafolo, MD, another top pediatric gender doctor, made in a PBS interview two years ago:

garafolo admits experimenting

Garafolo is referring here to the multimillion dollar NIH grant he, Olson-Kennedy, Spack, and others have received to study “trans kids.” He hopes to have more answers after, as Garafolo admits, the kids have been experimented upon for 5 years–and beyond. As he says, it’s an “imperfect field” and how these children will fare through a lifetime is “entirely unknown.”

 

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51 thoughts on “Insurance requirements are a “ridiculous” speed bump on children’s gender journeys

    • In most situations, a person going into the office of a doctor whom they’ve never met before and announcing a self-diagnosis to that doctor will not be met with immediate agreement, and if the person has self-diagnosed a rare condition, the doctor is going to be even less on board – they all learn in med school the saying “when you hear hoofbeats, think horses, not zebras”. The one category of “doctors” (and in this I include not just MDs, but naturopaths, homeopaths, etc) who immediately accept a self-diagnosis are quacks.

      Liked by 3 people

    • I am new to this wonderful site. I am so sorry to post here in the reply space, but I don’t know where/how to ask this question on the site. I only see a reply feature, not a place to pose a question.

      Can someone please, please help me? I have no idea where to find a good (even any) gender-critical therapist here in NYC of all places! All I can find are transgender affirming therapists. Does someone know someone I can speak to who is sane on this issue and will speak with my 12 year old daughter and I without trying to buy everything she is saying about her need to transition. The major institute in town wants to send her to a MTF clinician they have on staff to evaluate her. No way that’s happening for us. Please help! TY in advance. Again, apologies for posting here….

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      • In general, I have found Jungian therapists to be more questioning and open. You are right that you need to avoid anyone who claims that they deal with trans all the time or are specialists. Good luck.

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      • Thank you. Two things: Do you or anyone have someone to recommend in NYC? Also, is there a proper place to pose a question like this on the site. Not a response to a comment? Appreciate your thoughts. Best.

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      • I am so sorry to hear you are going through this frustrating and difficult time .I think the scary part is the unknown and wondering where these children are going to be in 10 years down the road. My family is going through a similar experience for the last year and a half with my niece claiming to be a boy. She talked to therapist online who came recommended through my sisters employer. This therapist told my sister she was the 9th parent THAT DAY who called regarding their child’s so called transgenderism! This therapist told my sister to just go along with it for now because she (the therapist) was not completely convinced my niece was transgender. Nredless to say my niece didn’t want to talk to the therapist anymore….hmmmmm. So far at least my niece hasn’t expressed a desire in going on hormones or surgery, however does wear a binder. Anyways I would probably start with your family physician and get a referral to a child psychologist NOT a so called gender therapist. Because you are correct, they will push the child into transition.

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  1. At least in California, which is one of the largest states that covers transition-related health care under Medicaid, the standard for “medical necessity” is set by … you guessed it … WPATH: http://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2013/APL13-011.pdf

    As we know, WPATH is essentially a trade association and an advocacy group, not a disinterested arbiter of the best evidence in setting standards for medical care for adults and children. So, if Dr. Olsen and her peers can make the case for WPATH to adopt the “no psych eval for anybody including children” standard, this will automatically become the standard under Medicaid as well. It’s exactly like asking General Motors what the next generation of mileage standards for cars should be, or giving Abbott Labs the ability to establish drug safety protocols.

    Moreover, to the extent that private insurance companies adopt WPATH’s standards as their own in making reimbursement decisions, Dr. Olsen has a significant chance of eliminating all resistance by all parties (except for us irritating parents) to any gate-keeping for anyone, including children.

    One does begin to wonder what sort of future Dr. Olsen and her peers envision for young people. There is an aspect of the uncanny, or a certain darkness, that seems to attach to “transition for all, no matter how small.”

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  2. This is something we should be rallying against, not just on this site and in our minds. Many people have successfully changed corporate opinions using sites like change.org. We need a great writer to successfully compose a petition to all insurance companies and anyone else who will listen and take action. I think 90% of my friends support our view but have no venue to voice their support.

    Insurance companies don’t want to pay for hormones & srs (or anything else for that matter). But the activists are bullying them. Our evidence, support and voices MUST be stronger and MUST be heard in public!!

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    • I’ll admit, I did not read all of the denials. I truly believe no insurance company wants to pay for something so detrimental to your health. Actually, if given a choice, they would never pay a claim but that’s a different can or worms.

      As well, my choice of words should have been better. I don’t think we have to force insurance companies to change their policies but I do strongly feel we need to support them and to be proactive against this. Once the activists start filing lawsuits against the insurance companies and winning, like they’re winning against parents who defy them, who knows where this will end.

      The Norm Spacks and Olson-Kennedys of the world need to know the vast majority of people, whether they have kids caught up in this terror or not, are wholeheartedly against this. I feel many people will support our views and the facts, especially if they learn this all about gender clinics & surgeons making money hand-over-fist and about control.

      The activists have been given the power and the evil has completely consumed them. Time to take it back and send them slithering back to their caves.

      When you have cause – any cause – and have a large number of people sign your petition – that IS POWER!!!

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      • I don’t think we would be asking insurance companies to change policies, so much as asking them to apply existing policies, such as getting a second opinion, only paying for treatments that have a proven history demonstrated by peer review science, and following the law that treatments that can produce sterility in minors not be permitted without a judge reviewing the case. This law is being flouted!

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    • I’ve written a text for a change.org petition and have experience doing this, but I don’t know who to address the petition to. It has to go to a person or persons who are actually in a position to make a decision about this. Does anyone know who those people are?

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      • It might need to be addressed to each of the states’ Departments of Health Insurance.

        It might also be a good idea to address one to the AMA.

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  3. I am not au fait with the US health system, but I find it particularly odd that Olson is expressly objecting to having to provide “signed consents”. What is that about? It seems on the face of it extremely sinister.

    Secondly: I’m guessing that the insurance companies are not only trying to avoid paying out – they are trying to avoid getting embroiled in a medical malpractice suit.

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    • Aren’t there just certain people where you really have to wonder what might be going on in their heads? I wonder what experiences O-K had with children that made her think that a tiny little baby or toddler could actually have any idea what gender IS, much less have its sense of gender fixed at that point. I’m assuming she’s had kids of her own – is there any parent, anywhere, who takes virtually anything a child of that age says, seriously? Much less something that would implicate lifetime, sterilizing medical procedures?

      I don’t mean at all to denigrate or demean little children and their thoughts and feelings. My goodness, they feel them sincerely when they feel them! All of us parents have experienced wistful fondness towards our sweet children’s pretend play… it’s one of the cutest things to watch, ever. But it’s cute precisely because it IS so naive, and credulous, and trusting, and completely detached from reality!

      What I just can’t understand is how someone of O-K’s professional stature willfully blinds herself to every (known and documented) stage of child development, particularly when the physical consequences are so harsh and permanent. For whatever reason, she must believe in her heart of hearts that she’s helping these children, I can’t accept that she’s intentionally and cruelly hurting them. It’s like the doctors who thought they were doing indigent or disabled women a favor by sterilizing them, you know? It is a pity but also a scandal that this misguided individual has achieved a position of such power and influence.

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      • Her spouse is a transman; I’m sure the feeling is that trans and “cis” are equally good paths. (All these docs seem prepared to weigh long-term physical risk as a less important issue than short-term psych benefit … aka suicide risk….)

        I agree that she comes off as very sincere; most of the zealot docs who do media interviews do. I believe they really believe their cause is just and that ALL of medicine, society, insurance industry will follow in time. (Well, Spack … he just seems fascinated by the ability to manipulate the human body, and the prospect of being a pioneer. Garofalo at Lurie Pediatric in Chicago is one of the few who openly seems conflicted about what he is doing. But still is doing it.)

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      • If you follow/read what the “affirmative” gender specialists say, they absolutely think medical transition is a positive outcome, not something to be avoided—even in young children. Not only do they believe they have perfect diagnostic skills (so they would never accidentally transition a child who wasn’t “truly trans”); they don’t see a real problem if they do, because it’s all part of the “gender journey.” Instead of an outcome to be avoided if possible (as more cautious clinicians believe), irreversible treatments, up to and including permanent sterilization, are worth it because the client is getting what they want in the moment. See below. It’s as if the clinicians themselves have reverted to adolescent thinking, where impulsivity, lack of foresight about future consequences, and all the rest have been completely jettisoned.
        WPATH Mar 20 2017

        WPATH Mar 10 gender fluidity

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      • If it is really just experimenting with gender (and drugs and surgery), then it should not be covered by insurance. This makes is clear that it is not a medical condition of any kind, but just a personal desire to explore the boundaries of gender.
        This zeal for altering children’s bodies and the complete denial that poor physical (or psychological) outcomes should even be considered frankly creeps me out. It is like H. G. Wells’ story “The Island of Dr. Moreau”. In the book, Dr. Moreau lives on an isolated island and operates on beasts to convert them into humans and the animals desperately try to convince themselves that they are indeed human. Among themselves they use the line (immortalized by Devo) “Are we not men?”. Here is a short quote from the book: “Each preserved the quality of its particular species: the human mark distorted but did not hide the leopard, the ox, or the sow, or other animal or animals, from which the creature had been moulded.”—Chap. 15, ¶8

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      • They want it both ways: The complete depathologizing of transgender, but full insurance payment for hormones and surgeries. That’s why they DON’T argue for complete removal of gender dysphoria from the DSM, because you have to have a code to bill insurance. Many are lobbying for the next DSM to change it to “gender incongruence” but still be billable. Homosexuality was removed as a disorder from the DSM years ago because being gay or lesbian doesn’t and shouldn’t require any “treatment.” Not sure how the gender docs are going to keep walking this line (no disorder/completely normal but want it coded as medically necessary, not elective).

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      • I think, regarding the quotes below from 4thwave, that’s it’s incredibly important to remind (or inform for people who have ended up here very recently and don’t know this) that one such “outcome” for a kid on a “gender journey” was death. And, we only know about that death because that kid was included in a study. How unethical is it that these “experts” are manipulating parents with “do you want a dead kid or a live kid” and they’re not being open that these interventions can and have led to deaths?

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  4. I took birth control for nearly 20 years, except for the time I went off of it to get pregnant (and through my pregnancy, of course). In addition to preventing pregnancy, I had a physical condition that made birth control necessary. Not once in those 20 years did I have insurance that covered birth control. Not once. Not through an employer, and not through private insurance. I guess now the insurance companies have to pay for it? (I don’t need it after a hysterectomy.)
    When I had my hysterectomy, my doctor had to provide proof that it was medically necessary in order for the insurance company to pay for it. An elective surgery would not have been covered, even though I suffered my entire adult life. Talk about suffering from a period–try wearing an overnight pad and a tampon and having to change it all every hour, and still having accidents at work that required a change of clothes. Try doing that for 10-14 days every month for years.
    I had 2 fibroid surgeries while I was in my 20s. I had to have Lupron shots each time for 3 months prior to the surgery to try to shrink the fibroids. Insurance did NOT pay for those shots. Each shot was $500. (I remember because I was shocked by the expense.)

    But, we as a society are now demanding that insurance companies pay to destroy the endocrine systems of physically healthy children, using off-label medications to do it.

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    • I totally sympathize. When young, otherwise healthy trans folk demand insurance pay for all sorts of cosmetic changes, it angers a lot of Americans who have dealt with the medical industry. When trans activist pursue this argument, it rightfully breeds a lot of resentment.

      When I was a teenager, I went to the doctor for chest pain. The doctor was fairly certain that the chest pain was caused by bruising on the chest wall, which would heal on it’s own, but because chest pain is often a symptom of something much worse, I had to get a differential diagnosis, which took a lot of time and involved some rather invasive test. It turned out it was just the bruising on the chest wall, but I do think it was safe and wise to do the differential diagnosis.

      Gender doctors don’t want the same logic applied to gender dysphoria. Even if we were to accept that some people are innately transgender, it would always be safer to do a differential diagnosis because missing a major mental illness is incredibly risky.

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      • Or trauma. Or autism. Or simply suggestibility.

        Really, there’s literally no excuse for pretending that just because a person diagnoses themselves that THAT is enough. In that case, why do we need doctors at all?

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      • It seems to me that when we are dealing with children it is important to also mentally evaluate the parents. Parents may be homophobic and prefer to use the narrative of having a child with a tragic medical condition to having the stigma of a gay child. Parents may be seeking media attention or have Manchausen by proxy. I think it is very important to look into motives or possible mental illness in parents as well as carefully evaluate the children.

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      • I just watched a video yesterday in which some trans You Tube posters were discussing their transiocity, but the key thing is that TWO of them, one being the “gender confusion” formerly known as Milo Stewart (currently calling herself “Quimby”) said that they decided to be trans because other people kept telling them they were trans!

        And for all this time, they’ve been saying that trans is an identity you know from within, nothing to do with characteristics other people can see about you, like whether you have broad shoulders & an adam’s apple or boobs and a little squeaky voice – it’s about “really feeling on the inside that I am X”.

        Here’s a link:https://www.youtube.com/watch?v=9yAxSuQ1C9M

        It’s at 1:33 that they start discussing being told by others that they were trans. I linked to the Drunken Uncle response video because I think Drunken Uncle is funny and I’d rather he get the views.

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  5. Has this woman lost her marbles??!! Why on earth would ANY insurance company agree to pay for gender transition, medical or surgical, WITHOUT a full psych evaluation??!! What needs to be looked at seriously is the reason why has the number of children and teens declaring they are transgender skyrocketed in just the last few years alone?? That should is what should be sounding alarm bells and raising red flags EVERYWHERE! These kids and teens should not be used as science experiments for these so called gender specialist. It must stop!

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  6. Trans activists cannot push for the dsm changes that make gender dysphoria a non-disorder AND demand health insurance coverage. Something has to give. “nothings wrong with you, you aren’t ill, in fact your being trans is perfect and beautiful, but I’ll pay out 30k in claims for drugs and surgery for your gender identity”. That’s what trans activists think it should be like. It’s never gonna be that way for more than a few minutes. Insurance companies run on math.

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    • If you aren’t sick or injured, you have no need for medical treatment. Trans people can’t have it both ways. If a woman doesn’t like her normal but small breasts, no insurance company pays for implants. If it man “feels” like a woman, paying for cosmetic surgery should be on him,.

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    • The holy grail for these activists is to have transgenderism be a “disorder,” but a perfectly physical one, a birth defect of the body alone. That way they can have the “treatments” be “lifesaving medical care” akin to insulin for diabetics and therefore covered by insurance, while at the same time avoiding any whiff of mental illness.

      So the goal is indeed to get “Gender Identity Disorder” out of the DSM. As far as I know, it’s been removed and replaced with “gender dysphoria,” or the distress caused by the body sex not matching the internal “gender identity” or brain sex. So, halfway there, but still requiring a psychologist visit.

      In the perfect system, the kid knows their internal gender (or “brain sex,” etc) by age three or so, never to change, and only needs to announce it. This act of announcing changes everything, now the kid’s perfectly normal body and genitalia amount to a “birth defect,” and any pubertal changes are a looming deforming disaster waiting to happen. The kid’s natural hormones are now an “endocrine disorder” which any GP should be able to prescribe a fix for.

      Key point of this whole dance though is, the kid knows gender, and so the only thing you need to be officially trans is the kid’s word. And yet, since the kid now has this terrible “birth defect,” of course you need to correct it, don’t you? You wouldn’t deny correction of a cleft lip, after all.

      On the cutting edge, then, we have doctors (very much including Olson-Kennedy) coding the treatments as being for an “endocrine disorder.” It’s validating, that way, plus the idea is that the kid won’t ever have that “gender identity disorder” diagnosis or even a “gender dysphoria” diagnosis in the medical chart to possibly out them later on.

      Shaking my damn head.

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      • Since they now also bill for these “treatments” to be covered for their “non-binary” patients, one can only conclude that being gender fluid is also set in stone at birth. Which of course is a giant contradiction.

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      • The one giant problem with equating the toddler announcement of “I’m not a girl” (“I’m not a boy”) with a physical defect to get medical care is that, unlike diabetes, doing nothing to such a child will not result in death.

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    • This will be useful info when the lawsuits roll in. Insurance appeals are supposed to entail reviewing the medical records and available evidence. She doesnt do that. Her indiscriminant spamming of appeals offices paints a vivid picture of recklessness on her part. Steamrolling anyone who points out the experimental nature of puberty blocking drugs isn’t so smart, but it’s especially stupid to advertise that fact publicly. I would not be surprised if it violates contractual agreements between the insurance company and the clinic. Do these drs have difficulty thinking ahead ten years? Do any of them converse with attorneys about their activities? I’m just baffled at this point by the foolishness. I suppose there’s a reason so few physicians have this speciality.

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  7. I don’t know what the Lupron dosage difference is from this case in 2012, but:

    “Dr. Mark Geier, a Maryland geneticist, was featured in a 2009 Chicago Tribune investigation into dubious treatments for autism. Experts said Geier’s “Lupron protocol,” which involves injecting children with high doses of a drug sometimes used to chemically castrate sex offenders, was risky and based on junk science.”

    So using Lupron as a treatment for autism was deemed junk science by a number of state medical boards. Where are those medical boards now in evaluating the use of Lupron or other puberty blocker as a treatment for simply trying to make it through a particularly difficult puberty? There is no data to back up this practice, so how can it not also be deemed junk science?

    http://articles.chicagotribune.com/2012-11-05/news/ct-met-autism-doctor-20121106_1_autism-doctor-david-geier-mark-geier

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    • Just tell them the autistic kid you want to give Lupron to is also “gender fluid” and voila, Lupron Rx will be forthcoming!

      (sarcasm alert – I think this whole thing is awful!)

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  8. Sorry this is so long…

    I have been pondering hormone-blockers for puberty avoidance for a couple of days, after viewing some political trans videos on You Tube. Their argument in favor of puberty blockers centers on the fact – in their minds the *terrible* fact – that puberty is an irreversible process. (As if transition with hormone blockers, hormones or surgery is a game of Mr Potato Crotch that can be re-set at any time, or as if aging itself is not irreversible!)

    I notice that they are depicting puberty blocking drugs not as step one to transition but as a way to “buy time” as if these activists are actually in favor of waiting to finalize the transition! These are the same activists who have weaponized parental fears about their kids choosing suicide if demands about gender, identity and pronouns are not met with immediate, enthusiastic and unconditional support. These are activists that claim detransitioners were obviously not really trans to begin with while resisting the idea of even trying to figure out how to differentiate who will stick with transition and who will detransition. These activists demand that our government and our entire society accept “gender fluid” states such that not only must we treat any guy who puts on a dress as a woman in every social and legal way if he demands it (and call the same person a guy or a unicorn or a dragonkin the next day or week or hour), but calls it an act of *Violence* to “misgender” a person like that, even if the person in the dress has a full beard, or the “guy” is rocking pink hair and a miniskirt and this is the very first mention of a desire to “transition”.

    While trans activists demand that government and society dismiss the evidence of our own eyes that an individual is male or female, even on pain of up to a $250,000 fine or eviction in NYC, they want to give to children who aren’t even old enough to drive a car, or enter a contract, or legally have sex with other teens, the right to consume dangerous hormone blockers and cross-sex hormones to minimize the very secondary sex characteristics that they want to use legislation and demonization to make it illegal and wrongthink to say or think or visibly notice.

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  9. Damn, do I hate sympathizing with an insurance company’s point of view. As a retired social worker I have known too many women like TheMom commenting above who have had necessary medical interventions (not to mention psychiatric interventions) disapproved because of insurance company callous greed. What sways an insurance gatekeeper is the possibility that someone will die from lack of intervention. If they don’t think it will kill you not to have a procedure, good luck getting them to pay for it. I wonder if a family has sued them over a suicide of a pre-op trans person, or if they just think it might happen. They’re sure to get sued at the other end, though, if they don’t ask for documentation and signed consent. This is what we pay astronomical insurance premiums for, folks.

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  10. I love these fucking idiots and their first world problems are just finding problems for for-profit insurance now when it has been systemically ableist since the beginning. Disabled people that do everything right are still denied lifesustaining medical care but they will pay for drugs to put us down like dogs. I am really sick and disgusted that the trans movement make memes normalizing HRT use by co-opting medication acceptance affirmations from the chronically ill/spoony community.

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    • This is what horrifies me as a parent. Being trans is NOT the same as having cancer or diabetes. With cancer, serious drugs or surgeries are used to try and make an unwell body well again. With trans, serious drugs and surgeries are used to make a perfectly well body unwell.

      If my kid insisted that she had cancer and she really didn’t, I would not ask a doctor to prescribe her Lupron (or any other cancer drug) so she could feel like a cancer patient.

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      • You’re smart and I’m glad u r there for your daughter like that! It goes to show how deep rooted patriarchy is when we females often hate our bodies so much that we make our healthy, normal bodies unwell through self injury including the HRT which I see as a form of self harm tbh.

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  11. As messed up as health insurance can often be in the U.S., I’m glad some companies are refusing to immediately green light these drugs for minors. This isn’t a life-threatening medical condition like cancer. It’s like paying for unnecessary, vanity breast implants, penile lengthening, or height surgery.

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    • The author of the presentation serves on the board of TransActive Gender Center, a pro-youth-transition organization that relentlessly (and often recklessly) promotes transition for young people. TransActive Gender Center, and especially the activities of Jenn Burleton, its Director, have been extensively detailed on this board.

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  12. I’ve said it before but I’m a mid forties mom who is done having kids, hasn’t had a regular period for two years , have had pcos since puberty, currently have uterine fibroids, and my insurance won’t cover a hysterectomy. I want one because I’m in pain but they call it elective. It’s crazy.

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  13. I want to say that I am sympathetic to all of the parents struggling with what to do when their child tells them they are trans. Many of you seem to just what to do what is best for your child. Honestly, I do think that it is hard to know what to do with young people who may change their mind or not be certain about what path to take in terms of their gender and transition is not a road that should be taken lightly. I think a good therapist and a period of exploration is very important, as well as a willingness to explore socially transitioning as an experiment for some young people where it is OK to change your mind.

    Also, I agree that there is a limited amount of research on interventions for children and teens that identify as trans. I also feel for all of the people that have not had adequate coverage for medical problems from their insurance.

    I do want to provide a counter-narrative to the idea that all of these young trans kids are just being swept up by social media and by a trend for people to identify as transgender. Maybe a few are. Who am I to say? I think we need more research to see what is going on with it, but some of these children and teens, perhaps most, may simply be now identifying as trans to you the parents and to others because they recognize something true about themselves in “transgender” whereas they did not have the words to express it before. This is what happened with me. i did not know that there were transgender men before about the age of thirty when I finally met a transman. There was something incredibly affirming and fascinating about meeting him, but I still struggled with whether transitioning was right for me for many years afterward. As a child I was a tomboy, but was not incredibly masculine. I felt more like a boy than a girl but never told anyone this. I know it would be seen as weird and it did not fit with what society and my parents kept telling me to be if I wanted approval and love. While wrestling with my gender as an adult and wanting to be “normal” but also feeling very uncomfortable with my body and the living as a woman I came to understand that for me personally, medically transitioning was necessary. I am lucky to have the support of my mother now who saw over many years the depression, anxiety, and pain I went through. I was afraid she would not accept me, but she has and on my last birthday sent a card to her son. My insurance company did not pay for my “top” surgery. I did. It has made me feel much better about my body. Finally my insurance just started covering surgery and other interventions for transgender people this year so I can get adequate medical care.

    Perhaps if I was a teenager today I would not have to be so miserable and confused, although to be honest, I am not sure. For all the talk on this website of a trend or fad of people being transgender I am not seeing that most places. I think more people may be understanding themselves that way because now they have the language for it. It is still a difficult road with a lot of stigma. Maybe there is less stigma, but it is still there. That is a big part of the struggle.

    I feel sad that so many people feel that they have to take strong sides on this issue and do not listen to the other side. So I am reading what is said on this website. Surely, unlike most of the country lately reasonable minds can find some common ground and can try to see what the other side has to say and can agree that the other side may occasionally have a point.

    From my perspective, I have a medical condition that needs treatment. Most trans people cannot afford this treatment without insurance coverage. I believe reasonable checks within the system make sense, especially for children. Good therapists who are trained to be curious, non-judgmental, and accepting while being open to many possible paths a person may take are needed. The idea that not everyone who feels an incongruence in their experience of gender will need hormone or surgery or anything else should be presented and explored. However, for some people these steps are needed and the research so far does indicate that for most people who do transition it does help (but not totally eliminate) problems of gender dysphoria. This has been my experience. It has helped enormously that my colleagues, peers, students, friends, and family have been supportive and it helps enormously that there are these treatments available. I am more lucky than many other transgender people I know because of this and also because treatment allows me to me viewed by most people as unquestionably a man. Perhaps if I had known about this, if the world had been accepting, and I could have accessed treatment when I was young I would not have spent many years deeply unhappy and unable to really engage with myself or the world as the person I am.

    Liked by 1 person

  14. Thanks for the comment Sam. Your perspective is helpful. And you make an excellent point:

    “Good therapists who are trained to be curious, non-judgmental, and accepting while being open to many possible paths a person may take are needed.”

    Once the decision was made in just this past decade to only affirm anyone who announced “I’m transgender” and then proceed with immediate transition treatments, the “many possible paths” has been blocked off. Where are the “good therapists”? Their lips have been zipped closed.

    The “many possible paths” were never presented to my daughter by any professional. She self-diagnosed after binging online (like so many of the teens with parents who frequent this site), was affirmed by a couple of therapists after short visits (one only over the phone), and then proceeded to an informed consent clinic with an easy prescription for testosterone after a one-day appointment after living 6 months “as a man” on a college campus (not exactly a real life experience). Most everyone will agree that is simply too fast.

    I don’t think those who have been transgender for a while realize the speed with which youth can now access body and mind morphing hormones. Anyone over 18. This is a recent development, post-2013 thanks to DSM 5. THAT is the reason for this blog. If someone truly had therapy with a “good therapist” who explored the many possible causes for feelings and the “many possible paths” and still came to the only & best solution being medical transition, blessings on all. But that is simply not happening these days.

    The “old” days were the “gatekeeper” days that the trans advocates pushed to have changed. However in doing so, a Pandora’s Box was opened. Many young men and women may feel that transgender speaks to them, but only a single path is being offered…quick medical transition….like snake oil salesmen with a potion that cures all no matter the motivations and underlying reasons.

    Liked by 1 person

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