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:
- 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.
- Mental health problems, including suicide, are associated with some forms of gender dysphoria. But suicide is rare even among gender dysphoric persons.
- There is no persuasive evidence that gender transition reduces gender dysphoric children’s likelihood of killing themselves.
- 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 Psychiatry, 55(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 one, 6(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 psychiatry, 28(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 reviews, 30(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 endocrinology, 47(3), 337-343.
(I’m not a parent, so apologies if i’m invading this space, etc.)
Is there any difference in suicidiality/severe psychiatric issues/what have you between ‘traditional’ FTM teens, i.e. those who have always been extremely gender non conforming, and those who are in the ‘new wave’ of trans-ness, i.e. those who were previously feminine in some degree and have autism/other social deficits? If you believe the first group are ‘true transsexuals’ or experience ‘true gender dysphoria’ (or what have you) and the second does not, does this contribute to differences in mental health issues?
Hi Lilly—
I will chime in one more time here. I am a parent and not an expert.
I agree with you that there seem to be two types of FTMs. The first type is a girl who is gender-atypical in interests. Without interference or interruption in her natural development, she would grow up to be an unfeminine woman and her sexual orientation would likely be lesbian. She would be fine.
The second type, sudden-onset gender dysphoria is something entirely different. Most of these girls are not at all gender-atypical. Many girls have gotten scooped into this trans narrative. I personally think of it as the ultimate in disaffection. Risk factors are feeling different–reasons spanning being very bright, highly sensitive, autistic, often autistic and bright, social contagion on the internet and amongst peers, etc.
I do not know how many of these sudden-onset gender dysphoria girls consider themselves lesbian. The majority? I don’t know.
Mental health problems are the norm in these girls Their generalized dysphoria is looking for an outlet= gender dysphoria.
Our daughter had virtually every symptom listed below for BPD. Was it diagnosed properly? No. The gender dysphoria did not present until after she was away in college (or was totally hidden from us). Daughter was a lovely girl. She did not present in a masculine way. She blended in with many peers and would have thought of herself as a nerd, a rising academic superstar.
Killing oneself off (which is often what these girls are doing) is not part of natural human development. It is not normal identity development. It does not exist in the natural world.
That is my inexpert take on all of this. Here is a link and list of symptoms for BPD:
https://www.nimh.nih.gov/health/topics/borderline-personality-disorder/index.shtml
People with borderline personality disorder may experience extreme mood swings and can display uncertainty about who they are. As a result, their interests and values can change rapidly.
Other symptoms include:
• Frantic efforts to avoid real or imagined abandonment
• A pattern of intense and unstable relationships with family, friends, and loved ones, often swinging from extreme closeness and love (idealization) to extreme dislike or anger (devaluation)
• Distorted and unstable self-image or sense of self
• Impulsive and often dangerous behaviors, such as spending sprees, unsafe sex, substance abuse, reckless driving, and binge eating
• Recurring suicidal behaviors or threats or self-harming behavior, such as cutting
• Intense and highly changeable moods, with each episode lasting from a few hours to a few days
• Chronic feelings of emptiness
• Inappropriate, intense anger or problems controlling anger
• Having stress-related paranoid thoughts
• Having severe dissociative symptoms, such as feeling cut off from oneself, observing oneself from outside the body, or losing touch with reality
Seemingly ordinary events may trigger symptoms. For example, people with borderline personality disorder may feel angry and distressed over minor separations—such as vacations, business trips, or sudden changes of plans—from people to whom they feel close. Studies show that people with this disorder may see anger in an emotionally neutral face and have a stronger reaction to words with negative meanings than people who do not have the disorder.
I am thinking that there are at least 2 types of FTMs as well – exactly as missing daughter described above – one GNC (with a history of not being a “typical girl”) and one sudden onset due to some forces inside and outside of themselves.
I wonder what the doctors, Bailey and Blanchard (and others!) think. I can’t wait to read their next article on their proposed 3 types!
My daugther is in the feminine/mostly gender conforming camp (except for the one year where she dressed more masculine during her questioning phase). She is very bright (IQ 135), a perfectionist, and felt different from the other girls (inside forces). She said one big reason she thought she was trans was because she has always hated gossip and most all the other girls gossiped a lot. (eye roll, palleeeasse). She avoided most of the girl groups and focused on a few close friends (girls mostly). This was similar to a reason for being trans given by Miles (formerly Amanda) McKenna that my daugher admired and watched on youtube (outside force).
I don’t see the BPD diagnosis in my daughter very much though – but I would give her at least a few ticks on the syptom list (cutting, some anger issues but mostly directed at her sibling, and of course the distorted self-image).
My daughter says she doesn’t know if she’s lesbian or not because she isn’t attracted to anyone yet. She says some of her friends are worried because they don’t feel all that attracted to boys (and it was implied that they aren’t attracted to girls either). I think it is normal and sometimes you don’t go “boy-crazy” or “girl-crazy” until High School or later – sometimes never – but just crazy over the one person or few people you bond with. So she says she’ll wait and see how life develops and consider herself a normal 13-year-old girl for now (hallelujah!).
But you can be lifelong “GNC” and also exhibit “sudden onset.” My kid has always enjoyed stereotypically “boy” activities, had few preferences re dress/hair — she’d happily wear whatever I put her in, generally — but never had any notion of being “really a boy” until puberty hit, she started feeling gross about her body, and she also got heavily into social media. Only after a lot of youtubing did she decide she had a name for this icky thing she was feeling, and decide she needed boy clothes, much shorter hair, a binder, and a future plan for transition.
Absent youtube? she’d still be slogging her way toward some kind of acceptance of herself as a female who likes “boy stuff.” (And likely lesbian. Though she claims not to know, even at 19. But she “knows” lesbians are icky. Geez louise. She did not learn this from me.)
She also has a lifelong history of psych issues of various sorts, so that’s another … thing. Attachment disorder, ADD, some OCD tendencies.
So I don’t think these FTM “types” shake out so neatly.
What’s for sure is, this phenom of a massive number of natal females attempting to check out of womanhood by “becoming” male is a new thing. (I think a LOT of females have wanted to check out of womanhood at various times. The idea that you can actually do it, and should do it, with drugs and surgery is the different twist.)
I agree with Puzzled…my daughter was never very feminine. Puberty arrived and she never made the leap to caring much about how she looked. Eventually she wore out on trying to fit in with the girls and wore out on all things girl including her body, and decided blending in with men sounded much better. But she actually has a boyfriend she insists is a gay man (which can’t really be)…but she is not a lesbian…at least not yet (she is 20).
I have a strong hunch here, but I don’t want to provide it here until I can check more closely. I don’t know how soon that will be.
We look forward to your research.
This is a great question that would be great to research. Just a mom here but here are some of my thoughts from many things I have read.
Dysphoria is an anxiety about your body. Every human that had ever lived has had moments of insecurity about their body. Teenagers often face this strongly for the first time and it adds to the many other changes that are going on in their lives.
Gender is currently defined as how someone perceives themselves within the male – female spectrum. It was once defined as the behaviors of a particular sex. I have a dictionary that gives the definition of gender as plainly sex. So, this definition is changing. There are people who believe there are 52 different genders, not including the ones that like to add in kin. So it’s hard to base a science around an inconsistently defined word.
Science is trying to learn so much about male and female differences, the brain, and the effects of hormones on the brain. There are studies that show white or gray matter being different in transgender people (before hormone replacement therapy) than cis people. But there are also studies that show the same changes in people with major depressive disorders. That’s the nature side, but what about the external forces of society, surely that can be an influence as well. Transgender supporters believe all depression and anxiety comes from being transgender. Most of us here believe there is a very strong chance (at least for our kids) that these forces of depression, anxiety, social abandonment, etc. are leading kids to believe they are transgender.
So if gender dysphoria comes from nature, is it inevitable that someone must transition? There are certain people who are biologically predisposed to becoming alcoholics and drug addicts. Do we just accept that fate for them?
If gender dysphoria comes from internal or external forces, will that change the treatment plan? Diabetes is a well known illness. Some people can keep diabetes away by eating a healthy diet. If that doesn’t work, they may go to insulin. Then they may need to go to dialysis. Finally they may need surgery of a kidney transplant. Should every person with sugar imbalances go straight to kidney transplants? No. So there are logical steps to follow. But in the meantime science is still looking for other alternatives as well.
Going back to gender dysphoria. For those who suffer with dysphoria, it is horrible. They need support. Parents get this. What I question is what is the best treatment? Why would we want our kids to be part of an experimental trial of hormones and surgery? Why would we want them to be a patient their entire life? Why wouldn’t we want our children to become the strong, beautiful girl or boy they were born to be? Why aren’t there options available for these struggling kids? Why are they being fed a rhetoric that they must hide and change their physical body or kill themselves and that their parents don’t understand or love them? The young children of today that are being transitioned: will they feel betrayed when they are adults like some intersex people do because people made decisions for them when they were too little to understand the consequences?
As a parent, I would like legitimate options in graduating steps that are the least possible changes. I would like kids to be able to find why they don’t feel congruency with their body and gender and empower them to address that. I would like doctor’s and counselors to understand that there is a difference as to why each person has gender dysphoria and that not every person needs the same treatment. And I feel schools are dangerously overstepping their boundaries when they encourage a student to erase who they are to become someone else.
You asked about suicidality. The percentages thrown around are not pure.
what is being measured and compared? The desire to be dead? Self harm? Suicide ideation? Suicide plan? How often? How many severely depressed kids are suicidal? How many with BPD? How do those numbers compare to transgender kids?
Things I always do when I research are… ask how this study could have been better… see how it was influenced (is the person a transgender activist)… are there hateful words in the writhing? See if I can find valid arguments against my point of view.
I would love these things, too, “Fighting.” I would love an actual sequence of steps based on “first do no harm” — rather than the leap to the most extreme steps that currently characterizes treatment and is rapidly being written into laws. At least in the U.S.
I am beyond, beyond frustrated at our inability to find counseling services that are not the one-way express path to transition. I would LOVE to get some decent professional help for my kid to help her unpack what is going on, and help her deal with dysphoria using a variety of tools. (Not to talk her out of her plan, but to help her better understand her feelings and where they came from, before she executes said irreversible plan.)
People who are gender essentialists (not sex essentialists) say “of course they are what they say, everybody knows what they are from a young age.” But this new mantra doesn’t have a lot of science to back it up. Why should this one self-assessment be so much more inviolable and permanent than all the other pronouncements young people make about themselves that later change?
(Because there are a lot of those, for a lot of people.) Evidence does not show that this is innate/permanent — unless, of course, it gets early and constant reinforcement from all adults in the kid’s world.
History proves that medicine based on sociopolitics isn’t great medicine, and right now, especially in this area, that’s the kind of medicine we’ve got.
That was on point. Great use of the tool we use called the brain! It’s nice to read some thoughts that make sense.
Maybe, at least with MtF, thoughts of transitioning give some kind of relief to overall patterns of depression and suicidality. It is incredibly complex. My ex suffered bouts of depression, his relief was to fantasise a better life as the opposite sex. He also had a brother who did commit suicide. Not until my ex came out did we discover that his brother also had cross-dressing tendencies/gender dysphoria. Something that his widow kept to herself. In my opinion it is the depression/relief by cross dressing cycle that needs to be addressed. The relief experienced by these fantasies needs further investigation otherwise they take over and become the focal point.
Thanks for your comment. The perspective of “trans widows” is rarely discussed and is almost completely absent from the mainstream media. 4thWaveNow readers who don’t yet know about the excellent blog “My Only Path to Power: Diary of a Trans Widow” are encouraged to check it out.
I also wanted to recommend Straight Spouse Network: http://www.straightspouse.org/
They’ve been around for a long time, and at least at one point were providing in-person support (with very carefully guarded and vetted meetup opportunities). From a quick look at their site, they do appear to be dealing with the transgender spouse phenomena and it might be worth a review, for anyone who is interested/has a need. I thought it was especially interesting that they appear to have resources for the children of “mixed orientation” parents.
Thanks worriedmom, I have looked at Straight Spouse Network in the past. They do offer support, but within a framework of being “supportive” of the transgender spouse. That was never a possibility in my case. I have, however, left it to my children to come to terms with things in the way which seemed best for them, along with the help of a “neutral” child psychologist. My ex wanted an “affermative”
psychologist who would fill their heads full of “born in the wrong body” nonsense. The courts appointed my choice, thankfully. My divorce has been painful, complicated and drawn out, but I do feel that the needs of my children have come first and been listened to along the way.
It has been hard to rise above the pain and bitterness that there is still between us.
Four years on my children have a relationship with their father; they see him every week and recently went on holiday together. They are not ready to have him visit them at school, for example. Their life with him is totally separate from their everyday life, but that has become their new “normal”. Setting boundaries was extremely important. They have adjusted better than I could ever have imagined and still have parents who love and care for them in their own way. My youngest does have some anxiety issues, but nothing major.
I’ve said it before, but time is a great healer. Something that the transgender community never allows.
I am also a “transwidow.” 4th Wave Now you are correct that our perspective is rarely acknowledged or discussed, except in terms of those who fully affirmed their spouse’s “transition.” How I would like to change that narrative!
I would second the recommendation of the blog “My Only Path to Power,” which I found sanity-saving for me. I recommend you start with the earliest posts and work your way forward.
As for the Straight Spouse Network, I am a current contributor (I post under “Out of His Closet”) . I am a gender critical feminist, and I don’t post from the perspective of “gender affirmative.” I think you would find a number of other posters who are undergoing the shock of rapid onset AGP/transgenderism and who share my perspective.
To some degree, the SSN walks the tightrope of trying to help spouses but not run afoul of the psychological community’s affirmation of gender dysphoria. So, for example, the “official” page of SSN on transgenderism lists as resources those that are definitely trans affirmative (Boylan’s memoir, for example, but not Benevenuto’s). But posters to the forum constitute a counter narrative.
In the year that I’ve been posting to the forum, I’ve seen a rash of new “transwidows” write in. If anyone has information on a forum like this one for transwidows, I’d appreciate knowing about it.
Just for clarification I am a different “trans widow” than that in the blog cited by 4thwavenow. The original Transwidow was Christine Benvenuto who wrote a book, “Sex Changes”, about her experiences. Here reviewed in the Guardian, https://www.theguardian.com/society/2012/nov/02/my-husbands-sex-change
We “trans widows” are a small group and, for various reasons, fearful of publicity. Speaking for myself I do feel a solidarity with parents going through these issues. My ex’s actions have impacted on my children’s lives to various degrees. As they mature, I hope that they are able to put into perspective their father’s life style choices.
My daughter’s desire for medical transition sometimes reminds me of an addict’s belief in a “geographical cure.” That is when an addict believes moving would solve all their problems, and they could control their drinking in the right environment. I think my daughter believes passing as a boy would solve all her problems and dissatisfaction with herself. She won’t entertain the idea that exercise, talk therapy, getting enough sleep, and staying busy doing things she likes could make a difference because she is utterly convinced that transition is the only cure. I have told her people who are depressed should not make major, life-changing decisions like modifying their bodies. She tells me that I do not understand that being a girl is what makes her depressed, so changing that is the only thing that could help.
Honestly, I do not know why professionals are so resistant to the concept of trying non-invasive, proven baseline functioning behaviors and enforcing them for a specific period of time, and seeing what the results are.
I do not think that eating better and lots of physical activity and more sleep is healing my kid. But I do know that those things are contributing to a natural anti-depressant and anti-anxiety effect which is then helped by a proper diagnosis, proper meds, and engaging in her therapy.
Someone on here said that people think of trans as ‘super gay’, and I think this is related.
Imagine a depressed gay teen who tells parents they’re struggling with their sexuality and then is sent to therapy. Therapist works with teen on, like, ‘living as their true self’, or whatever, and maybe she wants to cut her hair and he wants to paint his nails and it’s all good. Teen gets happier, maybe starts dating someone of the same gender and is enjoying it, and therapist sees a job well done.
And they they start seeing trans teens, probably without any training on them. And they don’t do meds so they don’t know anything about how hormones work. But they know that it’s L, G, B, and /T/ and they go on that. I think this makes more sense then there being a massive therapist conspiracy to make kids trans.
I don’t for a second believe therapist are naive or conspiring. There are several factors that go into this.
1) They are not certain how to help and refer to current standards and “experts”. A therapist told me this.
2) They have been taught that conversion therapy is wrong (yes torture is wrong) but society is lumping all open discussions into the definition of conversion therapy. This is a huge part of this problem.
3) They are afraid of losing their license and livelihood if they don’t affirm the identity as true. A psychologist told me exactly that. Because this circles back into #2.
4) I would definitely say that therapist can hold a bias. A therapist or surgeon who is transgender could be inclined to point a patient towards their own beliefs. Also, a therapist who believes that transition is the only humane treatment is not going to consider or provide other options.
5) In my opinion, medical treatment has become somewhat of a service industry rather than a necessity. People have the means to shop around and find providers who will give them what they want not necessarily what they need. Look at all of the cosmetic surgery there is in this world. Look at all the pain medicines that are given out. And if the new trend is affirmation, psychologists know that most patients aren’t coming in to debate ideas but to be affirmed.
Anyone in the U.K. who thinks that the NHS at least bases treatment on evidence should read this – and participate in the consultation. It would be especially valuable if any psychologists or other concerned professionals did.
https://www.transgendertrend.com/nhs-public-consultation/
I can’t speak to ALL of today’s therapists, but I have spoken to a few who had the shiny eyes and unquestioning certainty of the true believer. They feel they are in on the great new thing and it seemed to me like they were getting a lot out of supporting the teens and savaging any parent who dared to question. They did not make use of any actual facts, just stated the usual trans talking points and brushed aside everything else. I took notes and may try to ask around a little more to get a more representative sample from my area.
Lilly, it’s not a conspiracy — it’s what is considered best practice in the field. This is something which is taught — affirmation only and loved ones have to completely accept and agree with this position and there’s no other path to a united, functioning family.
I met true believers in this and I also met skeptics in our very liberal state. The skeptics always said they thought my kid had other issues and that she wasn’t “really trans,” but not to quote them because they’d deny it.
If there’s a conspiracy, it’s a conspiracy of silence.
Very lengthy and thought out post. I’ll put my thoughts later when I’m not trying to type on a phone screen getting annoyed by the predictive text but I will just leave this for now. Transition isn’t the one size fits all answer, and even for those that do transition, are happy, but then later attempt or succeed at suicide, it doesn’t automatically mean it’s because of their gender issues, (plenty of people commit suicide that aren’t trans for a whole array of various reasons), but if it were, we’re still seen as pariahs by some, still treated like a joke, still treated incredibly bad by some parts of society, and all this builds up to a point that you just can’t take any more and suicide seems like the only way to end it.
Your comment says that some people who transition are happy with it, at least initially. This happiness could be for a variety of reasons including being happier presenting and living as the opposite sex, having a whole new peer group of people who support and agree with each other, getting attention for your transgender stance, enjoying the novelty of all the changes that drugs and surgery produces in your body, and many others. Happy people don’t commit suicide. So, the suicides you refer to are people who may once have been happy with their transitions, but are no longer so happy with how things have turned out. You blame this on other people who you see as obligated to fully accept and embrace trans identified people who are choosing, for a variety of reasons, to live what is an alternative lifestyle, wanting to be seen and treated as the opposite sex from the one they were born as. This is often to the detriment of others, especially girls and women. Trans identified people are demanding that everyone see them as they see themselves. They want us all to agree with them that biological sex is a social construct rather than a material reality. As with all the other people in the world, basing your own happiness on trying to force other people to agree with, accept, and like you no matter how you talk and act is not a recipe for happiness. Perhaps detransition, or a more sane view of transition in which a trans identified person acknowledges that they were born into one biological sex, but choose to present as the other, or attempting to acknowledge and accommodate the legitimate concerns of females would be better ways of handling the social problems trans identified people create for themselves. If the only answer some of these people can see is suicide, that is sad.
That wasn’t what I said or meant at all. We all have things that get us down, but it’s generally never just one thing but a combination. As an adult, if someone doesn’t like me or gives me abuse for being trans, I can just say to myself “fuck ’em, I don’t need people like that in my life”.
Transition is right for some, but not all. There’s no one size fits all solution for everyone questions their gender.
But the interesting thing about suicide is that, as I understand the research anyway, it isn’t a product of what’s on the outside, but what’s on the inside. In other words, people are VERY rarely “driven to suicide” by society treating them like a joke or a pariah or “incredibly bad;” if that were so, you’d see historically oppressed or mis-treated groups having significantly higher suicide rates – and in fact, those rates are typically lower than in more privileged groups (in the U.S., for instance, the group with the highest suicide rate is white males). Only in the most extreme cases, for instance when someone is imprisoned unjustly, or in a military-type context, or a genocide-type context, does suicide tend to increase. I think it’s very harmful to suggest to people that suicide is a rational or understandable response to societal mis-treatment. In fact, to the extent that “suicide is a meme” in the transgender community, this potentially does vulnerable people a great deal of damage.
I think I’m not explaining my thoughts as well as I could, so I’ll try again later (was in stop start traffic all afternoon and I’m worn out now).
This is one thing that is so very wrong with this entire ideology. The debate of it being biologically induced or socially induced ultimately doesn’t matter. Being biologically inclined does not mean a person is destined to one solution. Telling people that have gender dysphoria they are not going to be able to work through this unless they transition or kill themselves is malpractice.
I am not really sure why the connection needs to be found out. The main thing is what treatment options are there? Why is the medical community so stumped with the therapy option they they’ve given up on helping people process why they have dysphoria and how to overcome it?
Dr. Zucker, what are your thoughts on the proposed bills in the U.S.? https://www.congress.gov/bill/115th-congress/house-bill/2119/actions
Very interesting article, and lots of interesting comments; I read most of them, although I skimmed some of the longer ones, so it’s possible that what I’m about to say has been said already. It’s also possible that some may find it offensive. You have been warned.
Gender transition, for many young people, is itself a form of suicide — a way of killing yourself without actually dying. Having gone through severe depression and suicidal thoughts myself, I have a lot of sympathy for people who suffer from either or both; but I’m also very thankful that no one ever encouraged me to harm myself in any way. People who are already thinking of killing or mutilating themselves are very vulnerable and sometimes it doesn’t take much to push them over the brink.
Young people experiencing sudden-onset gender dysphoria are often just unhappy with themselves and their lives — common enough feelings among teenagers generally — and thus feel as though they need to make a drastic change of some sort. Some might even feel as though they want to die, but also fear dying, especially by their own hand, and the prospect of gender reassignment offers them a way out — especially if they tend to be kind of gender non-conforming to begin with. They can kill off their old self and create a new one, start over with a clean slate, obliterate the memory of the former self (you’re not allowed to use their old name or their old pronouns), and insist that everyone go along with their new identity. In some ways it’s almost like a religious conversion: I have become a new creature! The old things have passed away! Behold, all things have become new!
Watching so many vulnerable young people go through this (including one who is very close to me, and about whom I care very much) is absolutely heartbreaking. I feel helpless and just wish something would stop the insanity.
Exactly! And what a sad state we are in when therapists encourage this. That is not therapy or healing or helpful. It is creating a world of the walking dead. There are no winners when a soul is not valued enough to be saved.
Thank you for this. Very well and succinctly put.
Absolutely! It is a suicide of self. I am not erasing history and my brain– but that is what we are all being asked to do.
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Absurdysphoria:
I am sorry to hear about your son. These are very difficult issues with no easy answers… in my opinion a successful transition should bring an individual closer to his/her family, not further away.
Many of you are quite liberal in thought, which says quite a lot about these cases of spontaneous onset GD. You’d think a child of liberal parents who was having such feelings would have come out earlier…
I wanted to give some of my perspective since some of your stories have triggered memories of my past growing up. My parents were homophobic, and when I told them I was attracted to other boys they dismissed my feelings and asked me very invasive questions that I’d rather not repeat because they were vulgar and not something a parent should ever ask a child. They also refused to let me experiment with makeup since they believed that I’d receive abuse from other kids at school as a result. I became scared of how they’d react if I confessed to them my struggles with sexual identity as well (my body issues and the distress that puberty caused me) so I hid it. I also became very harsh with myself about my sexuality. I didn’t want to be gay because if I was gay then my parents would be disappointed and probably send me away to have me “fixed” (a bit of a far-fetched fear, but after I was hospitalized and my parents threw out all my belonging that they thought had some sort of demonic influence on me it felt all too real).
A lot of the language they used when telling me that me feelings about sexuality were false was similar to some of the phrases I’m hearing on this thread. “We know you and we know you are not this.” But my parents didn’t live my life and they weren’t there at school to see me kissing boys and texting boys and asking out boys… they didn’t know my feelings. They knew stereotypes of how gay/bisexual men were and knew I didn’t fit it… or at least not enough to count. More and more I began to doubt my own thoughts and my own feelings. I became hyper-apologetic and more passive. I let people walk over me and take advantage of me for years because I stopped asserting myself. I thought my feelings didn’t matter. Everything became about keeping my parents happy at my own expense.
I don’t say any of this to demonize them, they are great people. They just had some flaws, as I did and still do. But some of the things they did and said scarred me and hurt me for a very long time.
Speaking as a child who has struggled with her parents when coming out to them as trans because to them it appeared “out of nowhere”, I am saying that how the situation is approached and how things are said really make a difference, and perhaps looking back on past behaviors that may have caused a child to feel guilty of certain feelings can help bring some understanding as to why it’s all coming up now.
There is something very suspicious about suddenly developing a trans identity without prior “signs,” and the lack of open communication between child and parent, and the obsession with trans-centric media online is a serious cause for concern. I think that many of the cases you all are describing are examples of “trans-trending” and I hope your children desist before making permanent changes that they will regret.
I wish you all the best<3
And Absurdysphoria, if your son is not researching counter-arguments and cases of transition regret for MTFs, then he is operating based on fantasy and has no grounding in the reality of what he plans to embark on. This is serious business and I have a feeling that it will not yield the results he thinks it will bring him. Dig up as many articles as you can. Flood his e-mail inbox with information. Get him to think about what he's doing. Transition is medicine for a specific illness, it is not a magic wand that will fix male guilt, or fill the role of a significant female other, or make you feel attractive, or give you purpose in life. Understanding this is the key to knowing if it is truly something that is needed. He might not read any of it, but at least it's something, and who knows, one day he might just open one of your links and have a revelation.
Little tiny nudges… if his conviction is a house of cards than that'll be enough to send it tumbling down.
Thank you for your insight Alex.
These tactics used by such ‘social justice’ organisations are so insidious, and I won’t stand for a second to believe they are honest. This is social contagion and people led to believe that they will kill themselves. We have documented historical evidence for other genders within society, whether or not you believes or agrees in them, how come trans people are not saying they are another gender but ARE women (or transmen are men)… There is currently the active changing of the 3rd gender (and other genders) around the world (such as refering to Kathoey/ladyboys in Thailand as not a 3rd gender but ‘trans woman’, even when they themselves say they are not!). I am thai and when I travel back home kathoey are annoyed at American and European countries and people for coming into thailand, doing documentaries, essays and articles about them as women (‘identify as’ women, no they don’t: some live as women, this means they do ‘women things’ not ARE women) or organisations publicising them as such, even kathoeys that take hormones or do all the surgeries complain about this and that more feel like they need to change their bodies! And it’s even causing problems between kathoeys themselves where some (mostly younger ones exposed to western media and internet), are starting to say they are women and makes tensions with everyone else and now women are pissed off with the kathoeys.
This is insidious, they know what they are doing, they are so unhappy that they cannot be women that they must change the whole world around their desire. They have even written books bashing the third gender showing that they are aware of it but don’t like the truth. It is so completely individualistic and selfish, I can’t stand it.
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I am late to this party so forgive me if everyone has gone on about their business.
I’d be interested to know what it takes for you (general) to know that gender dysphoria and being transgender is “real.” What does it take for you (general) to say, “yes, that’s it,” and stop attempting to pin it on something else?
I have a transgender son. It has not been a quick process, we didn’t jump off the diving board into the deep end, but he is now fully transitioned. He is not and was not, mentally ill. None of the things here describe him.
Sometimes, it just is. What does it take to get there?
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My name is Ennis. I’m 26, and I knew I was trans since I was 15. This marks around eleven years of trying to be normal, push it down, trying to be a regular girl who just happens to have short hair and likes to wear suits, listening to the song “Turn it Off” from the Book of Mormon soundtrack (When you’re feeling certain feels/That just don’t feel right/Treat those pesky feelings like a reading light/And turn ’em off!) and getting bacne from sleeping with sports bras on. I feel like all that time and energy I spent on trying to ignore dysphoria, get rid of transgender feelings, avoid having people take photos of me, watching videos about why being transgender is bad, repeating “i am a woman” affirmations, et cetera, could have been spent on productive pursuits such as school, work, socializing, taking care of myself, and that sort of thing. I’ve always tried to just be a girl who likes boy things, with everyone around me telling me “Girls/women can do whatever they want! Join this group for strong women! Sign up for this female empowerment program! Submit to our literary magazine about female body positivity!” The thing is, hearing “girls can do whatever they want” is only cheering for, well, girls. I’ve never been suicidal because of dysphoria, but it’s lowered my quality of life, and I’m excited to have a higher quality of life instead of just sticking my fingers in my ears and going “la la la la, go away.”
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Here’s another interesting and more recent study that finds that the incidence of suicide in the different stages of transition is nearly the same.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7317390/#__ffn_sectitle
There are some extremely foolish promises going on here.
1. Science isn’t everything, and it doesn’t have nearly the authority/ability assumed here. Science is a fallible human construct. The self-reported feelings of transgender people, which do not align with these findings, are equally, if not more valid than science. The basis of this is, science is constantly changing and updating with new information, and is more likely to be found untrue than typical first hand accounts, especially when dealing with a massive number of consistent accounts. If, you as a scientist, believe that science makes you more capable of understanding someone else’s experience, than first hand experience does, then you are just a delusional fool with a God-complex.
2. There isn’t any evidence whatsoever here for the claim being made, just a lot of elaboration on the lack of hard scientific evidence to the contrary. This would justify claiming either side is as likely to be true as the other, but this ignores all the evidence there is, in the form of self-report.
3. These are really dangerous ideas to be promoting, especially with such little evidence. The claim is essentially, that healthcare does not improve health, as a justification for denying healthcare.
Science is certainly fallible, but it is far more reliable than “self-reported feelings”–which are notoriously fallible.
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