New support forum for parents of gender-dysphoric kids & young adults

Note to all: We at 4thWaveNow are very happy to see the launch of this new forum for parents. But please also keep participating in the comments sections of posts on 4thWaveNow. We want to continue to be an open forum for all (parents and others) who question the contemporary rush to transition kids, teens, and young adults. Also, your continued participation here is vital for the many near-drowning parents who shipwreck by accident upon 4thWaveNow–one of the few places on the open Internet that openly questions the wisdom of turning gender-questioning kids into lifelong medical patients.


by Niniane, Kellogmom, Gender Critical Dad, Marge Bouvier Simpson, Mary, & Cat

There is a new forum for parents of gender dysphoric kids, teens, and young adults. We’re here to provide peer support for parents who would like a thoughtful and cautious approach to intervention for their gender-dysphoric daughter or son.

https://gendercriticalresources.com/Support/

Please note: Anyone may register for the forum, but you will be unable to contribute or see posts until approved by a moderator.

Most of the parents on the forum have teens or tweens who appear to be presenting with rapid-onset adolescent gender dysphoria, which some experts believe may be significantly influenced by such social factors as peer pressure, social media, and the Internet. Social contagion is a real thing for young people. Parents with rapid-onset teens desperately need support for a cautious approach, since the prevailing “affirmative” treatment model has been influenced more by ideology than evidence. Indeed, many parents joining the forum have had difficulty finding professionals who would support them in following a more careful route when addressing their child’s dysphoria.People help join solve bridge puzzle

In general, the parents who find their way to this forum value tolerance — tolerance of diverse viewpoints, political affiliations, and sexual orientations. We are not interested in pushing forward any ideology. We simply care about our children and want to support each other in discovering what is best for them.

If you have a child who has desisted from a trans identification, your presence is especially welcome on the forum, and we hope you will join us. You can help other parents learn how to help their child resolve his or her distress without resorting to life-long medical intervention.

We hope all parents who need support will join the forum. There is strength in numbers. If parents find each other, we can offer each other support and know we are not alone. We can have a louder voice when speaking to schools, professionals, and policy makers. Please come find us. We look forward to seeing you there.

A note of caution: Please understand that the moderators have no way of verifying anyone’s identity. Therefore, we cannot guarantee that everyone on the board will be there in good faith. It is probably wise to operate under the assumption that the forum is being watched by those who would not wish us well. So, when you join, choose an anonymous user name, don’t reveal identifying details about yourself, and use appropriate caution when interacting with others on the forum.

https://gendercriticalresources.com/Support/

 

Advertisements

Suicide or transition: The only options for gender dysphoric kids?

by J. Michael Bailey, Ph.D  and Ray Blanchard, Ph.D

This is the first in a series of articles authored by Drs. Bailey and Blanchard. As their time permits, they will be available to interact in the comments section of this post. Please note: As always on 4thWaveNow, if you disagree with the content of this article, your comments will be more likely to be published if they are delivered respectfully. Hateful or trollish comments will be deleted.


Michael Bailey is Professor of Psychology at Northwestern University. His book The Man Who Would Be Queen provides a readable scientific account of two kinds of gender dysphoria among natal males, and is available as a free download here.

Ray Blanchard received his A.B. in psychology from the University of Pennsylvania in 1967 and his Ph.D. from the University of Illinois in 1973. He was the psychologist in the Adult Gender Identity Clinic of Toronto’s Centre for Addiction and Mental Health (CAMH) from 1980–1995 and the Head of CAMH’s Clinical Sexology Services from 1995–2010.


It is increasingly common for gender dysphoric adolescents and mental health professionals to claim that transition is necessary to prevent suicide. The tragic case of Leelah Alcorn is often cited as the rallying cry: “transition or else!” Leelah (originally Joshua) was a gender dysphoric natal male who committed suicide at age 17, blaming her parents for failing to support her gender transition and forcing her into Christian reparative therapy. Subsequently, various “Leelah’s Laws” banning “conversion therapy” for gender dysphoria (among other things) have been passed or are being considered across the United States.

The suicide of one’s child is every parent’s nightmare. Given the choice for our child between gender transition and suicide, we would certainly choose transition. But the best scientific evidence suggests that gender transition is not necessary to prevent suicide.

We provide a more detailed essay below, but here’s the bottom line:

  1. Children (most commonly, adolescents) who threaten to commit suicide rarely do so, although they are more likely to kill themselves than children who do not threaten suicide.
  2. Mental health problems, including suicide, are associated with some forms of gender dysphoria. But suicide is rare even among gender dysphoric persons.
  3. There is no persuasive evidence that gender transition reduces gender dysphoric children’s likelihood of killing themselves.
  4. The idea that mental health problems–including suicidality–are caused by gender dysphoria rather than the other way around (i.e., mental health and personality issues cause a vulnerability to experience gender dysphoria) is currently popular and politically correct. It is, however, unproven and as likely to be false as true.

Suicide vs Suicidality vs Non-suicidal Self-injury

Suicide is a rare event. In the United States in 2014, about 13 out of every 100,000 persons committed suicide. Suicide was most common among middle aged white males, who accounted for about 7 out of 10 known suicides.

It is helpful to distinguish at least four different things: Completed suicide means death by suicide. Suicidality means either thinking about committing suicide or attempting suicide. Non-suicidal self-injury means injuring oneself (most often by cutting one’s skin) without intending to die. Finally, mental illness includes a variety of conditions, from depression to conduct disorder to personality disorders (such as borderline personality disorder) to schizophrenia–some of which are especially strongly associated with completed suicide and suicidality, others of which are more strongly associated with non-suicidal self-injury.

Obviously, completed suicide is what we are most worried about. Because it is so rare, however, and because it is often difficult to know about the dead person’s motivations for suicide, it has been especially difficult to study. There are fewer studies focusing on gender dysphoria and completed suicide than on gender dysphoria and either suicidality or non-suicidal self-injury. Studies of suicidality must rely on self-report (for example, someone must report that they are, or have been, thinking about committing suicide), and this complicates interpretations of results. (Maybe some people, some times, are especially likely to say they have been suicidal, even if they haven’t been.) Also there is more than one kind of gender dysphoria–we think there are three (this is a topic for another day)–and we should not expect risks to be identical for all types.

The Scientific Literature

Our aim here is not to review every available study, but to focus on the best evidence. Larger, more representative studies–and most importantly, studies of completed suicide–are most informative.

Studies of Completed Suicides

 Two large systematic studies of completed suicide and gender dysphoria have been published, one from the Netherlands, the other from Sweden. Notably, both countries are socially liberal, and both studies were conducted fairly recently (1997 and 2011). Both studies focused on patients who had been treated medically at national gender clinics. These patients all either began or completed medical gender transition, and we refer to them as “transsexuals.” (We don’t know how many of the patients there were from each of the three types we believe exist.)

The Dutch study’s suicide data were of male-to-female transsexuals (natal males transitioned to females) treated with cross-sex hormones (and many also with surgery). Of 816 male-to-female transsexuals, 13 (1.6%) completed suicide. This was 9 times higher than expected. Still, suicide was rare in the sample. The Swedish study found an even larger increase in the rate of suicide, 19 times higher among the transsexuals than among a non-transsexual control group. Still, only 10 out of 324 transsexuals (i.e., 3.1% of the group) committed suicide. Again, still rare. Note that both studies were of gender dysphoric persons who transitioned. As such, their results hardly support the curative effects of transition.

The Dutch and Swedish studies were of adults whose gender dysphoria may or may not have begun in childhood. No published study has focused only on childhood onset cases. However, psychologist Kenneth Zucker has tracked the outcome of more than 150 childhood onset cases treated at the Centre for Addiction and Mental Health into adolescence and young adulthood. He has generously shared with us (in a personal communication) his outcome data for suicide. Out of those more than 150 cases followed, only one had committed suicide. Furthermore, Dr. Zucker’s understanding (based on parent report) is that this suicide was not due to gender dysphoria, but rather to an unrelated psychiatric illness. On the one hand, one suicide out of 150 cases is more than we’d expect by chance. On the other hand, it is a rare outcome among gender dysphoric children and adults.

Studies of Suicidality and Non-suicidal Self-injury

People who commit suicide were suicidal before they did so. But most people who are suicidal do not commit suicide. “Suicidal” is necessarily a vague word, encompassing “intends to commit suicide” and “thinks about suicide,” both in a wide range of intensity. Furthermore, most studies would include as “suicidal” someone who falsely reports a past or present intention to commit suicide.

Why would anyone falsely report being suicidal? One reason is to influence the behavior of others. Saying that one is suicidal usually gets attention–sympathy, for example. It can be a way of impressing others with the seriousness of one’s feelings or needs. Although this possibility has not been directly studied, reporting suicidality may sometimes be a strategy for advancing a social cause.

According to data from the Centers for Disease Control (CDC), the rates of intentional but non-fatal self-injury peak during adolescence at about 450 per 100,000 girls and a bit fewer than 250 per 100,000 boys. These rates are much higher than the 13 per 100,000 American completed suicides per year (and remember that suicide is more common among adults than adolescents). So it is reasonable to assume that most adolescent self-injury is not intended to end one’s life. We are not suggesting that parents ignore children’s self-injury. We simply mean that self-injury often has motives besides genuinely suicidal intent.

 Not surprisingly, given the increased rates of suicide among gender dysphoric adults, suicidality (i.e., self-reported suicidal thoughts and past “suicide attempts”) is also higher among the transgendered. One recent survey statistically analyzed by the Williams Institute reported that 41% of transgender adults had ever made a suicide attempt, compared with a rate of 4.6% for controls. This survey recruited respondents using convenience sampling, however, and this may have inflated the rate of suicidal reports. Additionally, the authors of the survey included the following (admirable) disclaimer):

Data from the U.S. population at large, however, show clear demographic differences between suicide attempters and those who die by suicide. While almost 80 percent of all suicide deaths occur among males, about 75 percent of suicide attempts are made by females. Adolescents, who overall have a relatively low suicide rate of about 7 per 100,000 people, account for a substantial proportion of suicide attempts, making perhaps 100 or more attempts for every suicide death. By contrast, the elderly have a much higher suicide rate of about 15 per 100,000, but make only four attempts for every completed suicide. Although making a suicide attempt generally increases the risk of subsequent suicidal behavior, six separate studies that have followed suicide attempters for periods of five to 37 years found death by suicide to occur in 7 to 13 percent of the samples (Tidemalm et al., 2008). We do not know whether these general population patterns hold true for transgender people but in the absence of supporting data, we should be especially careful not to extrapolate findings about suicide attempts among transgender adults to imply conclusions about completed suicide in this population.

That is, importantly, the authors realize that suicidality and completed suicide are very different things, and it is suicidality that they have studied. Completed suicides in their group will be much, much lower.

Increased suicidality for gender dysphoric children was also reported by parents in a recent study by Kenneth Zucker’s research group.

A systematic review of non-suicidal self-injurious behavior in “trans people” found a higher rate, especially for trans men (i.e., natal females who have transitioned to males). The most common method mentioned was self-cutting. (Self-cutting is a common symptom of borderline personality disorder, which is also far more common among non-transgender natal females than among natal males.)

Is Transition the Answer, After All?

In a very recent study psychologist Kristina Olson reported that parents who supported their gender dysphoric children’s social transition rated them just as mentally healthy as their non-gender-dysphoric siblings. Furthermore, parents’ reports suggested that the socially transitioned gender dysphoric children were not less mentally healthy than a random sample would be expected to be.

This research falls far short of negating or explaining the findings we have reviewed above. First, it was relatively small, including only 73 gender dysphoric children. Second, families were recruited via convenience sampling, increasing the likelihood of various selection biases. For example, it is possible that especially mentally healthy families volunteer for this kind of research. Third, the assessment was a brief snapshot; we would expect socially transitioned gender dysphoric children to be faring better at that snapshot compared with children struggling with their gender dysphoria. (There is little doubt that at first, gender dysphoric children are happier if allowed to socially transition.) Young gender dysphoric children do not show that many psychological or behavior problems, aside from their gender issues. The aforementioned study by Kenneth Zucker’s research group showed that mental health problems, including suicidality, increased with age. Perhaps this won’t happen with Olson’s participants, but it’s too soon to know.

Why Is Gender Dysphoria Associated with Mental Problems, Including Suicidality?

 We don’t know.

The current conventional wisdom is that gender dysphoria creates a need for gender transition that, if frustrated, causes all the problems. That is a convenient position for pro-transition clinicians and activists. But they simply don’t know that this is true. Furthermore, both our past experience studying mental illness scientifically and specific findings related to gender dysphoria suggests the conventional wisdom is unlikely to be correct.

As an example, Leelah Alcorn’s suicide (like most suicides) was tragic, but she appears to have had problems that were not obviously caused by her gender dysphoria. She posted as Joshua (her male identity) on Tumblr:

“I’m literally such a bitch. shit happens in my life that isn’t even really that bad and all I do is complain about it to everyone around me and threaten to commit suicide and make them feel sorry for me, then they view me as sub-human and someone they have to take care of like a child. then when they don’t meet my each and every single expectation I lash out at them and make them feel like shit and like they weren’t good enough to take care of me. since I can only find imperfections in myself I try my hardest to find imperfections in everyone around me and use them as a way to one up myself and make others feel bad to make myself look better.”

Sophisticated causal analysis of mental illness and life experiences has invariably shown that things are more complex than previously assumed. For example, although depression is certainly caused by adverse life experiences, those vulnerable to depression have a tendency to generate their own stressful life experiences. So it’s not as simple as depression being caused by life experiences alone. Also, depression has a considerable genetic influence. Similarly, women with borderline personality disorder (BPD) report that they have experienced disproportionate childhood sexual abuse (CSA), and many clinicians and researchers have assumed that CSA causes BPD. But one just can’t assume the causal direction goes that way–one must eliminate alternative possibilities. Recent sophisticated studies suggest that, in fact, CSA does not cause BPD.

Research to understand the link between gender dysphoria, various mental problems (including suicidality), and completed suicides will take time. There is already plenty of reason, however, to doubt the conventional wisdom that all the trouble is caused by delaying gender transition of gender dysphoric persons. We have already mentioned the fact that transitioned adults who had been gender dysphoric (i.e., “transsexuals”) have increased rates of completed suicide. Their transition did not prevent this, evidently. Suicide (and threats to commit suicide) can be socially contagious. Thus, social contagion may play an important role in both suicidality and gender dysphoria itself. Autism is a risk factor for both gender dysphoria and suicidality. No one, to our knowledge, believes that gender dysphoria causes autism.

Conclusions

Parents with gender dysphoric children almost always want the best for them, but many of these parents do not immediately conclude that instant gender transition is the best solution. It serves these parents poorly to exaggerate the likelihood of their children’s suicide, or to assert that suicide or suicidality would be the parents’ fault.


References

Aitken, M., VanderLaan, D. P., Wasserman, L., Stojanovski, S., & Zucker, K. J. (2016). Self-harm and suicidality in children referred for gender dysphoria. Journal of the American Academy of Child & Adolescent Psychiatry55(6), 513-520.

Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L., Långström, N., & Landén, M. (2011). Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PloS one6(2), e16885.

Marshall, E., Claes, L., Bouman, W. P., Witcomb, G. L., & Arcelus, J. (2016). Non-suicidal self-injury and suicidality in trans people: a systematic review of the literature. International review of psychiatry28(1), 58-69.

Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiologic reviews30(1), 133-154.

Van Kesteren, P. J., Asscheman, H., Megens, J. A., & Gooren, L. J. (1997). Mortality and morbidity in transsexual subjects treated with cross‐sex hormones. Clinical endocrinology47(3), 337-343.

Are you sending or losing your teen to college?

The following piece is a collaborative effort by a group of parents whose offspring began “gender transition” at university. They will be responding in the comments section under the username “POSTS”: Parents Of Sudden Transgender Students.


What if you sent your kid off to the Ivory Tower and you never saw her or him again–at least, you never saw a recognizable facsimile of the person you knew and loved for 18 years?

College is a time to “find oneself,” to try on different hats. How about transgender, genderqueer, non-binary? Some teens start to explore a transgender identity in high school, often via the Internet. Others may not have previously considered or even imagined a transgender identity before stepping onto a college campus.

If it were all just identity exploration, it would be one thing; but many college students are quickly advancing into medical treatments–often with the financial support of the university. Diagnostic testing or even basic counseling are no longer necessary, and college-bound teens have quickly figured this out. “Coming out” as transgender is now treated pretty much the same as a gay or lesbian coming out, not as the gender identity disorder it was considered to be only a short time ago.

And colleges compete to show how inclusive they can be of a myriad of transgender identities. The college end game is to be and stay highly ranked.

chronicle of higher ed


For a high school student questioning their identity, there is much advice available to help them select a trans-friendly campus. Your soon-to-be-away-from-home child may click away on the new wealth of information that could feed into their choice of college, as in campus pride, more pride, a pride guide to transforming your body.

There are even scholarship opportunities available for those considering a transgender identity. If one can commit to a new identity (and possibly a new body), the money is waiting. The Internet is full of transgender opportunities that institutions of higher learning offer before and during those formative college years. If we provided an inclusive list, it would all run together into a confusing (to parents) alphabet soup of acronyms. These acronyms and micro-identities are an easy sell to today’s gender-questioning students.

Campus pride student health clinic

Some students never question their gender identity until after being immersed in college life. Perhaps they take an elective course in Queer Theory in the Gender Studies Department, opening their eyes to viewpoints they didn’t know existed. Ok, isn’t that what an education is all about? But the medicalization of a newfound queer or trans identity can happen astonishingly quickly now.

Many young-adults-in-formation who suddenly announce a trans identity have a history of anxiety; are brilliant misfits with few friends; are gay or lesbian (and thus in no need of medical intervention); are a tad nerdy with possible autism spectrum traits–or perhaps all the above. Your daughter or son may lack a strong identity–in fact, the list gets so long that we could shorten it to “your child, any child.” Any kid who feels a great need to belong somewhere.

Once a transgender identity decision is made, instructions for what to do next are only a click away, such as at Carleton College in Minnesota:

carleton

In the National Geographic special, Gender Revolution, Katie Couric interviewed Tamar Szabo Gendler, Dean of Arts and Sciences at Yale. Dean Gendler is pleased that Yale is at the forefront of the gender revolution:

Universities are places that thrive on new discovery and I think that universities find it thrilling to feel like in the face of new knowledge we are able to figure out how to transform society as a consequence.

Some colleges cover trans medical treatments under the student health insurance plan.  According to Campus Pride, a whopping 86 US institutions cover hormones and surgeries, while another 22 will pay for hormones only. In a story in the New York Times on February 12, 2013, the author notes that no university covered such treatment as recently as 2007, but now exclusive universities like Stanford are onboard.

ny times

“No one knows how many” indeed–though we know that number has grown since the article was written four years ago.  Where once universities provided birth control and routine care on their health plans, now many (like the University of Massachusetts, Amherst) offer the full gamut of major, irreversible sex-reassignment procedures–including phalloplasty and vaginoplasty.

umass amherst

And while it may be hard to imagine how a student could take time out of their busy schedule to have sex reassignment surgery, the coverage of cross-sex hormones on so many student health plans might catch the eye of a gender-defying high school student; especially now that they’re away from the prying eyes of their parents.

Washington State University, in rural Pullman, scores a solid five stars from the CampusPride Index. Why? Trans health care, including (starting fall semester 2017) cross-sex hormones, is available via the student clinic. And as WSU explains, they are continually making changes to meet the needs demanded by their students:

WSU hormone treatment

At the University of California, Santa Cruz, the Queer Center provides a page chock-full of resources, including lists of sex reassignment surgeons, affirmative therapists, and how to get legal name changes on campus and state ID documents.

ucsc

Many colleges embrace the WPATH (World Professional Association for Transgender Health) guidelines:

A mental health screening and/or assessment as outlined above is needed for referral to hormonal and surgical treatments for gender dysphoria. In contrast, psychotherapy – although highly recommended – is not a requirement.

But informed consent gender clinics do not require mental health screenings by licensed therapists, and access to these clinics has been growing in recent years. Under this model, cross-sex hormones can be available even for a “non-binary” presentation; it is the individual’s choice what their goal and treatment protocol is.

Yale has provided gender surgeries on the student health plan since 2013; more recently, gender fluid and nonbinary Yale students have begun agitating for their right to treatment on demand.yale enbies

 

“The medical establishment is prejudiced against nonbinary people, ignoring the fact that gender fluidity exists,” Amend said. “Doctors can propagate a notion of ‘not being trans enough,’ which is toxic to the mental health of patients.”

Amend added that there is a community of nonbinary or gender fluid students at Yale, and that he knows of students who have had to tell psychiatrists that they are “more trans” than they feel, out of a fear that the doctors will withhold treatment if they appear more gender fluid.


Affirmative Care in the Student Counseling and Health Centers

How does this all happen so fast….a teen learning about transgender in high school, and starting cross-sex hormone injections in college?

Every day, young fresh faces, some not looking so fresh anymore, crowd the waiting rooms of student counseling centers all over Campus Country. Being a counselor in a college setting makes for job security: the 18-25-year-old cohort has the highest rate of mental health issues and the waiting list can be long.

Students have many stressors: a new environment, roommates, academic pressures, sexual shenanigans/hook-up culture, social pressures of every kind. Some of these students arrive burned-out by an intense college prep course in high school. Some have pre-existing mental health woes. They are strongly encouraged to use their student mental health center if any issues arise. That’s generally a good thing; we all want our kids to thrive and be healthy. But it can also be a less-positive thing, when the clinic is known as Affirmative Care.

What is Affirmative Care? In the mental health world pertaining to LGBTQetc it means that whatever narrative you bring to the table, you will receive an amen, a yes, a suspension of disbelief from the therapist. A student can make a transgender proclamation, whether this  is sudden, whether it makes any sense in the ongoing narrative of his or her life, and it will be accepted without question by the affirmative therapist. If one brings a tangible mental health diagnosis to the affirming counselor, whether it is mild depression, anxiety, bipolar, psychosis, no problem. Because if you have a mental health concern, it must be because you have not been affirmed and celebrated for identifying differently from your “assigned birth sex”. A life out of line with your gender identity explains all other mental health issues….or so the argument goes.


 Safe Places

Concerned about what your student is doing on campus, suddenly transitioning socially and via hormone use? If over 18 (as most are), they are considered to be adults now, and they can be safe on campus, even from parents, in “Safe Places.” Recently, the proliferation of “Safe Places” on college campuses have received a lot of attention, mirth, and critiques. Some argue that Safe Places magnify victimhood narratives and curtail freedom of speech and thought on college campuses. But the organized Safe Place coalitions do serve a valuable function. There are many people who need shelter and protection: domestic abuse victims, sexual assault/sex trafficked victims, run-away teens, individuals in groups that are marginalized, including LGBTQ people. None of us should tolerate violence or bullying.

If your child claims to be transgender, on most campuses they will be treated as a protected class against anyone who might question this new identity. A young adult caught up in the transgender warp will often say or do anything to have their way, to claim victimhood status. Doubting parents could even be hit by a  Do-notContact Order if they express dismay that their child is using cross-sex hormones via the student (or off-campus) health clinic—after all, the benign and kindly college administrators serve as in loci parentis. So the college clinic that injects students with cross-sex hormones, which cause permanent harm and morphed bodies, is just another “safe place.”

The subject of gender identity and safe spaces is a moving target, with the defining happening on college campuses. From the Los Angeles Times:

The meaning of a “safe space” has shifted dramatically on college campuses. Until about two years ago, a safe space referred to a room where people — often gay and transgender students — could discuss problems they shared in a forum where they were sheltered from epithets and other attacks.

Then temporary meeting spaces morphed into permanent ones. More recently, some advocates have turned their attention to student housing, which they want to turn into safe spaces by segregating student living quarters. Who would have imagined that the original safe space motive — to explore issues in an inclusive environment — would so quickly give way to the impulse to quarantine oneself and create de facto cultural segregation?

Safe space activism stems primarily from the separatist impulses associated with the politics of identity, already rampant on campus. For some individuals, the attraction of a safe space is that it insulates them from not just hostility, but the views of people who are not like them. Students’ frequent demand for protection from uncomfortable ideas on campus — such as so-called trigger warnings — is now paralleled by calls to be physically separated too. Groups contend that their well-being depends on living with their own kind.


In preparing this piece, we talked to several parents whose young adult offspring transitioned while at university. Here are a few of their comments:

 She did have some troubles in high school with anxiety, cutting and anorexia

From three mothers of sons who suddenly decided at university they were trans: all are very bright, nerdy and on the ASD spectrum

She asked us not to come to the Family Weekend at the end of October, she told us she was invited elsewhere for Thanksgiving

He had a romantic rejection, he attended a talk about trans at his university, he spent a lot of time online and developed dissociative disorder, then said he believed if he transitioned he would be more present in his body

We were met at the airport by a stranger: her skin was coarsened with acne, she had noticeable facial hair, her hair was chopped into a severe cut

The trans woman announcement came when my son was depressed and struggling with the complexity of social and romantic life at the university

She said she was lesbian in high school, but next spring in her first year in college there was a shock: a health insurance claim for testosterone

Several months later, it became apparent by both her appearance and mysterious medical bills, that our daughter was receiving testosterone in the college health clinic

His personality changed and he appeared terrified by everything; he told me that his friends thought the university failed to recognize mental illness

It was all hidden from us.

It was all hidden from us.  Until the body morphing started.