Gender dysphoria is not one thing

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

This is the second in a series of articles authored by Drs. Bailey and Blanchard; see here for their first piece.

Many parents who are part of the 4thWaveNow community have daughters who fit the profile of a sudden onset of gender dysphoria in adolescence. This phenomenon is discussed in detail by the authors after the first two types, in the section “Rapid-onset Gender Dysphoria (Mostly Adolescent and Young Adult Females).” Some 4thWave parents will also find the section “Two Rarer Types of Gender Dysphoria” of particular interest (near the end of the article).

We recognize that regular readers and members of 4thWaveNow will not agree with all of what Bailey and Blanchard have to say, but as always, if you wish to challenge the authors, your comments will be more likely to be published if they are delivered respectfully.

As their time permits, Drs. Bailey and Blanchard will be available to interact in the comments section of this post.


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.


One problem with the current mainstream narrative regarding gender dysphoria is that it makes no distinctions among apparently very different kinds of persons. For example, Bruce Jenner appeared to be a very masculine man, an Olympic athlete who was married to three different women and had six children with them, before becoming Caitlyn Jenner. In contrast, Jazz Jennings, a natal male, was so feminine that she earned a diagnosis of gender identity disorder at the age of four. She is attracted to males. Jenner and Jennings are so different in their presentation and history that it is surprising to us that anyone thinks they have the same condition. Jenner and Jennings are examples of two very different kinds of gender dysphoria that have been scientifically well studied, and have fundamentally different motivations, clinical presentations, and likely causes.

The failure of so many therapists and activists to acknowledge this distinction is disturbing for at least two reasons. First, it suggests they are either ignorant of relevant scientific evidence or are purposefully ignoring it. Second, failure to make scientifically valid and fundamental distinctions among different kinds of gender dysphoric persons can only prevent progress toward finding the best approach to helping each. Measles, influenza, and strep throat are all associated with fever. But if we had merely lumped them together as “fever,” we would not have effective treatments for them.

 Types of Gender Dysphoria

Gender dysphoria isn’t common. But there are at least three distinct types of gender dysphoria that, presently, regularly occur in children and adolescents. We summarize these at length here. Two other kinds of gender dysphoria are much less common in these age groups, and so we address them less fully near the end of this essay. The main three types differ in their age of onset (childhood, adolescence, or adulthood), their speed of onset (gradual or sudden), their associated sexual orientations (members of the same sex or the fantasy of belonging to the opposite sex), and their sex ratio (equally or unequally likely in males and females).

The first type—childhood-onset gender dysphoria—definitely occurs in both biological boys and girls. It is highly correlated with homosexuality–the sexual preference for one’s own biological sex–especially in natal males. (Sexual orientation is usually not apparent until a child reaches adolescence or adulthood, however.) This is the type that Jazz Jennings had before her gender transition. The second type—autogynephilic gender dysphoria—occurs only in males. It is associated with a tendency to be sexually aroused by the thought or image of oneself as a female. This type of gender dysphoria sometimes starts during adolescence and sometimes during adulthood, and its onset is typically gradual. (Onset may appear sudden to family members, however.) Although Caitlyn Jenner has not discussed her feelings openly, we strongly suspect she is autogynephilic. The third type—rapid-onset gender dysphoria—mostly occurs in adolescent girls. This type is primarily characterized by the age and speed of onset rather than the associated sexual orientation, and it may not be limited to one sex, as the second type is. Our impression is that rapid-onset gender dysphoria is especially common among daughters of parents who read 4thWaveNow as well as those who post on the support board at gendercriticalresources.com.

The first two types (childhood-onset gender dysphoria and autogynephilic gender dysphoria) have been well studied, although autogynephilic gender dysphoria has primarily been studied in adults. The third (rapid-onset gender dysphoria) has only recently been noticed, and it is possible that it didn’t occur much until recently.

How do you know which type of gender dysphoria your child has? If there were clear signs well before puberty that your child was gender dysphoric, s/he has child-onset gender dysphoria. (You would certainly have noticed signs at the time; at the very least you would have coded your child as extremely gender nonconforming.) If your child showed signs of gender dysphoria for the first time during adolescence, s/he has one of the other types. Remember, autogynephilic gender dysphoria occurs only in natal males, and it starts either during adolescence or adulthood. (And to a parent, it usually seems sudden.) We describe the three types more thoroughly below.

Childhood-onset Gender Dysphoria (Boys and Girls)

The most obvious feature that distinguishes childhood-onset gender dysphoria from the other types is early appearance of gender nonconformity. Gender nonconformity is a persistent tendency to behave like the other sex in a variety of ways, including preferences of dress and appearance, play style, playmate preferences, and interests and goals. A very gender nonconforming boy may dress up as a girl, play with dolls, dislike rough play, show indifference to team sports or contact sports, prefer girl playmates, try to be around adult women rather than adult men, and be known by other children as a “sissy” (a term generally used to ridicule and shame feminine boys). A very gender nonconforming girl shows an opposite pattern, with the less derogatory word “tomboy” replacing sissy.

Onset of gender nonconformity is childhood cases is very early, typically about as early as gendered behavior can be noticed.

It is important to understand that not all gender nonconforming children (even very gender nonconforming children) have gender dysphoria. Probably most don’t, in fact. But we know of no cases of childhood-onset gender dysphoria without gender nonconformity.

Gender dysphoria in the childhood cases requires that children are unhappy with their birth sex. Furthermore, they typically yearn to be–or even assert that they are–the other sex.

What do we know about childhood-onset gender dysphoria?

Childhood-onset gender dysphoria has been systematically studied by two high quality international research centers (one in Toronto, which was led by Kenneth Zucker, and one in the Netherlands, which was led by Peggy Cohen-Kettenis). Both centers have assessed and followed representative samples of gender dysphoric children seen at their clinics. Reassuringly, results are fairly similar across the two sites. Furthermore, their results are similar to less representative samples studied earlier in the United States.

The published literature shows that at least in the past, 60-90% of children whose gender dysphoria began before puberty adjusted to their birth sex without requiring gender transition. That may be changing, however, due to changes in clinical practice that encourage gender transition. (See below.)

It is important to realize that childhood-onset gender dysphoria is the only kind of gender dysphoria that has been well-studied in children and adolescents. This means, for example, that the persistence and desistance figures we have provided apply only to that type. We do not know comparable figures about autogynephilic or rapid-onset gender dysphoria. Furthermore, most people, when they think of “transgender children and adolescents” have childhood-onset gender dysphoria in mind. (And they think of happy Jazz more than they think of Jazz’s serious medical surgeries and hormonal treatment for life.) But this association is misleading for all cases of gender dysphoria that are not childhood-onset. Autogynephilic and rapid-onset gender dysphoria have very different causes and presentations than childhood-onset gender dysphoria.

Sexuality

Children with childhood-onset gender dysphoria have a much higher likelihood of non-heterosexual (i.e., homosexual or bisexual) adult outcomes compared with typical children. Childhood-onset gender dysphoric boys who desist usually become nonheterosexual men. A smaller percentage have reported that they are heterosexual at follow up. Those who transition become transwomen attracted to men.

Although most childhood-onset gender dysphoric girls who have been followed identify as heterosexual, those who desist have a much higher rate of nonheterosexuality compared with the general population. Among those who transition, most are attracted to women.

We repeat: there is no evidence that parents can change their children’s eventual sexual orientation, and we don’t think they should try.

Risk Factors for Persistence of Childhood-onset Gender Dysphoria

Which childhood-onset gender dysphoric children will persist, and which will desist? Evidence suggests that we can’t distinguish these two groups with high confidence, although we can distinguish them better than chance.

There is some evidence that the severity of gender dysphoria distinguishes these two groups, although it is far from a perfect predictor. Children who not only say they want to be the other sex but who assert that they are the other sex may be especially likely to persist. The reasons why a child’s expressed belief that s/he is the other sex predicts persistence remain unclear, and this variable does not allow even near-perfect prediction. The idea that it is the essential test of “true trans” is an overstatement.

Other empirically supported risk factors include being of lower socioeconomic status and having autistic traits, both of which predict persistence. Why should these factors matter? Researchers have speculated that socioeconomically disadvantaged families are more likely to have problems that prevent them from providing the consistent supportive social environment that may be most likely to help the gender dysphoric child desist. Autistic traits include perseverative and obsessional thinking, both of which may make desistance more difficult. Furthermore, parents of children with autistic traits may be so concerned about other problems that they are permissive about things likely to foster gender transition.

One powerful predictor of persistence is social transition, or a child’s living as the other sex. Until recently this was practically unheard of. Increasingly, however, it is not only known but encouraged by many gender therapists. (Watch an episode of “I am Jazz.”) In the Netherlands social transition has been common longer than in the United States. A recent study found that social transition was the most powerful predictor of persistence among natal males. That is, gender dysphoric boys allowed to live as girls strongly tended to want to become adult women. (The same trend occurred for natal females, but it was less robust.) This is not surprising. If a gender dysphoric child is allowed to live as the other sex, what will change his/her mind? No one disputes that gender dysphoric children really, really would like to change sex.

What should you do?

The necessary studies have not been conducted to be certain. But based on the overall picture, we suggest:

If you want your childhood-onset gender dysphoric child to desist, and if your child is still well below the age of puberty (which varies, but let’s say, younger than 11 years), you should firmly (but kindly and patiently) insist that your child is a member of his/her birth sex. You should consider finding a therapist if this is difficult for you and your child. You should not allow your child to engage in behaviors such as cross dressing and fantasy play as the other sex. Above all else, you should not let your child socially transition to the other sex.

At the same time, you should recognize that despite your best efforts, your child may ultimately need to transition to be happy. If your child’s gender dysphoria persists well into adolescence (again, the ages vary by child, but let’s say age 14 or so), s/he is much more likely to transition. At that point, in our opinion, parents should consider supporting transition.

Autogynephilic Gender Dysphoria (Adolescent Boys and Men)

From a parent’s perspective, autogynephilic gender dysphoria (which occurs only in natal males) often seems to come out of the blue. This is likely to be true whether the onset is during adolescence or adulthood. A teenage boy may suddenly announce that he is actually a woman trapped in a man’s body, or that he is transgender, or that he wants gender transition. Typically, this revelation follows his intensive internet research and participation in internet transgender forums. Importantly, the adolescent showed no clear, consistent signs of either gender nonconformity or gender dysphoria during childhood (that is, before puberty).

There is an important distinction between rapid-onset gender dysphoria and autogynephilic gender dysphoria that happens to have an adolescent onset. Rapid-onset gender dysphoria is suddenly acquired, whereas autogynephilic gender dysphoria may be suddenly revealed, after having grown in secret for a number of years. We will talk more about this later.

Where does autogynephilic gender dysphoria come from? We know a lot about the motivation of this kind of gender dysphoria. Most of our knowledge comes from studies of adults born male who transitioned during adulthood. Some of these adults had gender dysphoria during adolescence, but all of them had the root cause of their condition: autogynephilia.

(Warning: Autogynephilia is about sex. We understand that it is awkward and uncomfortable for any parent to consider their children’s sexual fantasies. But you can’t understand your son with this kind of gender dysphoria without doing so.)

Autogynephilia is a male’s sexual arousal by the fantasy of being a woman. That is, autogynephilic males are turned on by thinking about themselves as women, or behaving like women. The typical heterosexual adolescent boy has sexual fantasies about attractive girls or women. The autogynephilic adolescent boy’s may also have such fantasies, but in addition he fantasizes that he is an attractive, sexy woman. The most common behavior associated with autogynephilia during adolescence is fetishistic cross dressing. In this behavior, the adolescent male wears female clothing (typically, lingerie) in private, looks at himself in the mirror, and masturbates. Some autogynephilic males are not only sexually aroused by cross dressing, but also by the idea of having female body parts. These body-related fantasies are especially likely to be associated with gender dysphoria.

It is important to distinguish between autogynephilia and autogynephilic gender dysphoria. Autogynephilia is basically a sexual orientation, and once present does not go away, although its intensity may wax and wane. Autogynephilic gender dysphoria sometimes follows autogynephilia, and is the strong wish to transition from male to female. A male must have autogynephilia to have autogynephilic gender dysphoria, but just because he is autogynephilic doesn’t mean he will be gender dysphoric. Many autogynephilic males live their lives contented to remain male. Furthermore, sometimes autogynephilic gender dysphoria remits so that a male who wanted to change sex no longer does so.

In general, adolescent boys are unlikely to divulge their sexual fantasies to their parents. This is likely especially true of boys with autogynephilia. Furthermore, many boys who engage in cross dressing feel ashamed for doing so. The fact that autogynephilic fantasies and behaviors are largely private is one reason why autogynephilic gender dysphoria usually seems to emerge from nowhere. Another reason is that autogynephilic males are not naturally very feminine. An adolescent boy with autogynephilia does not give off obvious signals of gender nonconformity or gender dysphoria.

It is likely that most autogynephilic males do not pursue gender reassignment, but this is difficult to know. (We would need to conduct a representative survey of all persons born male, asking about both autogynephilia and gender transition. This has not been done and won’t be done anytime soon.) Many males with autogynephilia are content to cross dress occasionally. Some get married to women and many also have children. Family formation is no guarantee against later transition, although that may slow it up somewhat. In past decades, when autogynephilic males have transitioned, they have most often done so during the ages 30-50, after having married women and fathered children. It is possible that autogynephilic males have recently been attempting transition at younger ages, including adolescence.

The relationship between autogynephilia and (autogynephilic-type) gender dysphoria is uncertain. One view is that gender dysphoria may arise as a complication of autogynephilia, depending perhaps on chance events or environmental factors. Another view is that autogynephiles who become progressively gender dysphoric were somewhat different from simple autogynephiles from the beginning (for example, more obsessional). Because we do not actually know the causes of autogynephilia, it is quite difficult to sort out these various interpretations at present.

Autogynephilia—the central motivation of autogynephilic gender dysphoria—can be considered an unusual sexual orientation. As with other kinds of male sexual orientation, we do not know how to change it, and we shouldn’t try. The dilemma is how to live with autogynephilia in a way that allows the most happiness. For some with autogynephilia, this will mean staying male. For others, it will mean transitioning to female.

What do we know about autogynephilic gender dysphoria?

Much of what we know about autogynephilic gender dysphoria comes from research conducted on adults. Most of the early research was conducted by the scientist who developed the theory of autogynephilia, Ray Blanchard. This work was subsequently confirmed and extended by other researchers, especially Anne Lawrence, Michael Bailey, and Bailey’s students.

Blanchard’s research identified two distinct subtypes of gender dysphoria among adult male gender patients. One type, which he called “homosexual gender dysphoria” is identical to childhood onset male gender dysphoria. Males with this condition are homosexual, in the sense that they are attracted to other biological males. Blanchard provided persuasive evidence that the other male gender patients were autogynephilic. We currently favor the theory that there are only two well established kinds of gender dysphoria among males, because no convincing evidence for any other types has been offered. This could change­–we are committed to a scientific open-mindedness. In particular, it is possible that some cases of adolescent-onset gender dysphoria among males are essentially the same as Rapid-onset Gender Dysphoria that occurs among natal females. This will require more research to establish, however.

Autogynephilia is a probably rare, although it is difficult to know for certain. Among males who seek gender transition, however, it is common. In fact, in Western countries in recent years, including the United States, autogynephilia has accounted for at least 75% of cases of male-to-female transsexualism.

Given how important autogynephilia is for understanding gender dysphoria, it may surprise you that you had never heard of it. Autogynephilia remains a largely hidden idea because most people–including journalists, families, and many males with autogynephilia–strongly prefer the standard, though false, narrative: “Transsexualism is about having the mind of one sex in the body of the other sex.” Many people find this narrative both easier to understand and less disturbing than the idea that some males want a sex change because they find that idea strongly erotic.

Although many autogynephilic males find discovery of the idea of autogynephilia to be a positive revelation–autogynephilia has been as puzzling to them as it is to you–some others are enraged at the idea. There are two main reasons why some autogynephilic males are in denial. First, they correctly believe that many people find a sexual explanation of gender dysphoria unappealing–discomfort with sexuality is rampant. Second, they find this explanation of their own feelings less satisfying than the standard “woman trapped in man’s body” explanation. This is because autogynephilia is a male trait, and autogynephilia is about wanting to be female.

It is good to be aware of autogynephilia’s controversial status, because transgender activists are often hostile to the idea. You will not learn more about it from the activists. And if your son has frequented internet discussions, he may also resent the idea. We emphasize that autogynephilia is controversial for social reasons, not for scientific ones. No scientific data have seriously challenged it.

Sexuality

Males with autogynephilia can have a variety of autogynephilic fantasies and interests, from cross dressing to fantasizing about having female bodies to enjoying (for erotic reasons) stereotypical female activities such as knitting to fantasizing about being pregnant or menstruating. One study found that autogynephilic males who fantasize about having female genitalia also tended to be those with the greatest gender dysphoria.

Autogynephilic males sometimes identify as heterosexual (i.e., attracted exclusively to women); sometimes as bisexual (attracted to both men and women), and sometimes as asexual (i.e., attracted to no individuals). Blanchard’s work has shown that autogynephilia can be thought of as a type of male heterosexuality, one that is inwardly directed. Autogynephilia often coexists with outward-directed heterosexuality, and so autogynephilic males usually say they are also attracted to women. Some autogynephilic males enjoy the idea that they are attractive, as women, to other men. They may have sexual fantasies about having sex with men (in the female role); some may even act on these fantasies. This accounts for the bisexual identification among some autogynephilic males. In some others, the intensity of the autogynephilia–which is attraction to an imagined “inner woman”–is so great that there are no erotic feelings left for other people. This accounts for asexual identification. (Asexual autogynephilic males have plenty of sexual fantasies, but these fantasies tend not to involve other people.)

When autogynephilic males receive female hormones as part of their gender transition, they typically experience a noticeable decrease in their sex drive. Some have reported that this has diminished their desire for gender transition as well. Others, however, have reported no change in their desire for transition. (In any case, hormonal therapy is a medical intervention with serious potential side effects, and we do not recommend it as a way to treat gender dysphoria, except in cases in which after very careful consideration, gender transition is pursued.)

Autogynephilia is a paraphilia, meaning an unusual sexual interest nearly exclusively found in males.

We repeat: Autogynephilia is a sexual orientation–to be sure, an unusual orientation that is difficult to understand. There is no evidence that parents can change their children’s sexual orientations. And we don’t think they should try.

What should you do?

Consistent with our values, knowledge, and common sense, we believe that males with autogynephilic gender dysphoria should not pursue gender transition right away, as soon as they first have the idea. Transition ultimately requires serious medical procedures with irreversible consequences. But we are unsure what the right approach to autogynephilic gender dysphoria is. In part, this is because there has been too little outcome research conducted by scientists knowledgeable and open about autogynephilia.

First, we recommend that your son be informed about autogynephilia. The best way to do this is up to you. There is probably no non-awkward way. Consider showing them this blog. People should make important life decisions based upon facts, and for males autogynephilic gender dysphoria, autogynephilia is a fact. The standard “female mind/brain in male body” is a fiction.

Some males become less motivated to pursue gender change when they understand their autogynephilia. However, some do not become less motivated. We know far less about patterns of persistence and desistance of autogynephilic gender dysphoria than we do about childhood onset gender dysphoria.

If an autogynephilic male has become familiar with the scientific evidence, has patiently considered the potential consequences of gender transition over a non-trivial time period, and still wishes to transition, we do not oppose this decision. It is possible that many autogynephilic males are happier after gender transition. But there is no rush for any adolescent to decide.

Rapid-onset Gender Dysphoria (Mostly Adolescent and Young Adult Females)

Rapid-onset gender dysphoria (ROGD) seems to come out of the blue. We think this is because ROGD does come out of the blue. This is not to say that all adolescents with ROGD were happy and mentally healthy before their ROGD began. But importantly, they had no sign of gender dysphoria as young children (before puberty).

The typical case of ROGD involves an adolescent or young adult female whose social world outside the family glorifies transgender phenomena and exaggerates their prevalence. Furthermore, it likely includes a heavy dose of internet involvement. The adolescent female acquires the conviction that she is transgender. (Not uncommonly, others in her peer group acquire the same conviction.) These peer groups encouraged each other to believe that all unhappiness, anxiety, and life problems are likely due to their being transgender, and that gender transition is the only solution. Subsequently, there may be a rush towards gender transition, including hormones. Parental opposition to gender transition often leads to family discord, even estrangement. Suicidal threats are common.*

We believe that ROGD is a socially contagious phenomenon in which a young person–typically a natal female–comes to believe that she has a condition that she does not have. ROGD is not about discovering gender dysphoria that was there all along; rather, it is about falsely coming to believe that one’s problems have been due to gender dysphoria previously hidden (from the self and others). Let us be clear: People with ROGD do have a kind of gender dysphoria, but it is gender dysphoria due to persuasion of those especially vulnerable to a false idea. It is not gender dysphoria due to anything like having the mind/brain of one sex trapped in the body of the other. Those with ROGD do, of course, wish to gender transition, and they often obsess over this prospect.

The subculture that fosters ROGD appears to share aspects with cults. These aspects include expectation of absolute ideological agreement, use of very specific jargon, thinking of the world as “us” versus “them” (even more than typical adolescents do), and encouragement to cut off ties with family and friends who are not “with the program.” It also has uncanny similarities to a very harmful epidemic that occurred a generation ago: the epidemic of false “recovered memories” of childhood sexual abuse and the associated epidemic of multiple personality disorder. We discuss these more below. First, however, we review what little we know about ROGD.

What About Natal Males?

Why do we keep emphasizing natal females versus natal males? There are three reasons. First, the single study that has been conducted on ROGD found substantially higher numbers of females than males (more than 80% female cases). Second, there has been a striking surge in the number of adolescent females identifying as transgender and presenting at gender clinics. Third, there is a different kind of gender dysphoria–Autogynephilic Gender Dysphoria–that likely accounts for most or all of the apparent cases of ROGD in natal males. However, we cannot be completely sure that the smallish number of ROGD cases in natal males are due to autogynephilia. It’s possible, therefore, that what we discuss here applies to some natal males as well.

What Do We Know?

ROGD is such a recent phenomenon that we know little for certain. We have four sources of data. First, an important study of ROGD has been presented by Lisa Littman at the annual meeting of the International Academy of Sex Research. (It has not yet been published, but we suspect it will be soon.) This is the only systematic empirical study to date. Second, we have had numerous conversations with mothers of girls with ROGD. Third, we have read several case studies of the phenomenon. Fourth, we have been in touch with clinicians who work (either as therapists or consultants) with children with ROGD, or their families. Fortunately, the sources have provided convergent findings. We are fairly confident about the following generalizations:

–The large majority of persons with ROGD are female, and the most typical age of onset ranges from high school to college ages.

–Persons with ROGD have a high rate of non-heterosexual identities before the onset of their ROGD.

–Signs of extreme social contagion are typical. For example, this includes multiple peer group members who all began to identify as transgender. Sometimes this occurs after school-sponsored transgender educational programs.

–Persons with ROGD have high rates of certain psychiatric problems, especially aspects related to borderline personality disorder (e.g., non-suicidal self-harm) and mild forms of autism (that used to be called “Asperger Syndrome).

–In general, the mental health and social relationships of children with ROGD get much worse once they adopt transgender identities.

–Parents resisting their children’s ROGD are not “transphobic” or socially intolerant. These are parents who, for example, usually approve of gay marriage and equal rights for transgender persons.

Our Current Take on ROGD

Rapid-onset Gender Dysphoria (ROGD) occurs when a young person (generally an adolescent female) is persuaded that she is transgender, despite strong evidence that the young person had few or no signs associated with established forms of transgender. How and why does this happen?

Despite the very limited available research to date, we have strong intuitions and hunches about what is going on, based on its similarity to similar phenomena in the past: the recovered memories and multiple personality epidemics. We spend considerable effort in this section both explaining these past epidemics and drawing the parallels to the current one that concerns us now: Rapid-onset Gender Dysphoria. We believe that she who forgets (or ignores) the past is doomed to repeat it.

During the 1990s there was an explosion of cases in which women came to believe that they had been sexually molested, usually by their fathers and often repeatedly and brutally. They believed these things even though prior to “recovering” these “memories”–most often during psychotherapy–they did not remember anything like them. They believed in the memories even though the memories were often highly implausible (for example, family members would have noticed). Many women with recovered memories cut off relationships with their families. Some developed symptoms of multiple personality disorder. We know now that the recovered memories were false. And multiple personality disorder doesn’t exist, at least in the way those affected and their therapists believed. We refer to recovered memories and multiple personality disorder, which have similar causes–and also some similar causes to ROGD–as RM/MPD

Here are the main similarities between ROGD and RM/MPD:

  1. Cases consistent with RM/MPD were very rare prior to the 1980s but became an epidemic. The same appears to be happening with ROGD.
  2. Both have primarily affected young females, although RM/MPD began substantially later (on average, age 32) than ROGD (typically during adolescence). (Another destructive epidemic of social contagion–witch accusations in colonial Salem–primarily involved adolescent girls.)
  3. The explanations of both RM/MPD and ROGD by “true believers” are contradicted by past experience, common sense, and science. Memory and personality integration did not work the way that therapists treating RM/MPD believed they did. For example, children and adults who experienced trauma can’t repress them–they remember them despite their best attempts. And gender dysphoria in natal females does not begin after childhood–unless it is the acquired condition that is ROGD.
  4. Both show ample evidence of social contagion of false, harmful beliefs. In RM/MPD, the “infection route” usually went from therapists who strongly believed in RM/MPD to their suggestible patients, who acquired a similar belief, applied it to their own lives, and manufactured false and monstrous accusations against previously loved ones. (A harmful result of therapy or medical treatment is called iatrogenic,) In ROGD, the infection route appears to be primarily directly from youngster to youngster. To be sure, therapists get into the act after the person with ROGD acquires the belief that she is transgender, and then they are complicit in tremendous harm. But it seems rarely to occur (yet) for a youngster to be talked into ROGD by a therapist.
  5. Both are associated with sociopolitical ideologies. (Interestingly, both ideologies still find comfortable homes in Gender Studies programs in many universities.) For RM/MPD, the ideological system was that men’s sexual abuse of children has not only been too common (true), but that it has been rampant, even the rule (false). Couple this ideology with a belief in Freudian theory and methods (like hypnosis), and what could go wrong? Plenty, it turned out. For ROGD, the relevant ideology is less coherent, but includes the seemingly contradictory ideas that gender is “fluid” (here meaning that not everyone fits into a male-female dichotomy); that forcing people into rigid gender categories is a common cause of societal and personal anguish; but that gender transition is an underused way of helping people.
  6. Both RM/MPD and ROGD are associated with mental health issues, generally, and especially a personality profile consistent with borderline personality disorder (BPD). This is not to say that all persons with either RM/MPD or ROGD have BPD; simply that evidence suggests that it is common in these groups. For example, the high rate of non-suicidal self-injury we have noticed from the aforementioned sources is striking. Such behavior is strongly associated with BPD. (For a discussion of BPD among those with RM/MPD, see this article, pages 510ff.)
  7. Adopting the belief that one has either RM/MPD or ROGD has been associated with a marked decline in functioning and mental health.

Some of the factors that seem to be common in ROGD–and some that are similar between ROGD and RM/MPD–likely encourage the adoption of false beliefs and identities. These include a fragile sense of self (BPD), attention seeking (BPD), social difficulties (BPD and autistic traits), social malleability (BPD, and adolescence), social pressure (adolescence), and strongly held (if irrational and poorly supported) beliefs that make embracing false conclusions especially likely (sociopolitical indoctrination). Adolescents with an actual history of gender nonconformity, or whose sexual orientations are non-heterosexual, may be especially vulnerable to believing that these are signs they have always been transgender. Adolescents whose lives have not been going well may be especially looking for an explanation and may be especially receptive to drastic change.

Based on the aforementioned data sources with which we are familiar, and on our informed hunches, we suspect that many persons with ROGD were usually troubled before they decided they were gender dysphoric and many will lead somewhat troubled lives even after their ROGD (hopefully) dissipates. Of course, ROGD can only make things worse, both for the affected person and her family.

What to do

Because ROGD is such a recent phenomenon, there is very little guidance about helping affected persons. Lisa Marchiano has written two excellent essays abounding with good sense, and we recommend starting with those.

Second, set aside, for now, rapid-onset gender dysphoria. Identify your child’s problems that existed before ROGD and that may have contributed to it. Attending to these problems will be useful for everybody, and perhaps your child will even agree.

Third, with respect to ROGD, do what you can to delay any consideration of gender transition. Of the different kinds of gender dysphoria, ROGD is the type for which gender transition is least justifiable and least researched. Remember, ROGD is based on a false belief acquired through social means. None of the aforementioned factors that have caused your child to embrace this false belief will be corrected by allowing her to transition.

Two Rarer Types of Gender Dysphoria

For the sake of completeness, we include two other kinds of gender dysphoria. We suspect that both are rare, even among persons with gender dysphoria. One of us (Blanchard) has seen cases of the first type, autohomoerotic gender dysphoria, which appears to be an erotically motivated gender dysphoria. In this case, sexually mature natal females (i.e., not biologically still children) become sexually preoccupied with the idea of becoming a gay man and interacting with other gay men. Neither of us has seen someone clearly fitting the second type, gender dysphoria resulting from psychosis. (Our inclusion of this type was motivated in large part by the argument of Dr. Anne Lawrence, an important scholar we both respect.) In this type, a person (either male or female by birth) acquires the delusion that s/he is the other sex, because s/he is suffering from gross thinking deficiencies.

Superficially, both of these conditions have some similarities to some other kinds of gender dysphoria. For example, a female with rapid onset gender dysphoria may be sexually attracted to males and thus strive to become a gay man, similar to autohomoerotic gender dysphoria. The important difference is that the female with rapid onset gender dysphoria is not primarily motivated by an erotic desire to be a gay man. Instead, having the prospect of having sex with gay men is a by-product of her condition, not the main point of it. The female with rapid onset gender dysphoria acquires it via social contagion, broadly speaking (i.e., including cultural signals that gender dysphoria is in some crucial ways desirable). With respect to the other rare subtype, we have both known gender dysphoric persons with psychosis. However, in these cases, the psychosis was not the cause of the gender dysphoria. It was simply an additional problem that the gender dysphoric person had. In the case of gender dysphoria resulting from psychosis, the belief that one is transgender (or the other sex) is clearly a delusion resulting from disordered thinking–and not, for example, from social contagion or autogynephilia.

Autohomoerotic Gender Dysphoria

This rare type of gender dysphoria is limited to females. Published cases have consisted of women whose gender dysphoria began in late adolescence or adulthood. (It is conceivable that it might begin earlier in some cases.) It occurs in (heterosexual) females who are sexually attracted to men, but who wish to undergo sex reassignment so that they can have “homosexual” relations with other men. These females appear to be sexually aroused by the thought or image of themselves as gay men. We have created the label autohomoerotic gender dysphoria to denote this sexual orientation. There are little systematic data on this type of gender dysphoria, although clinical mentions of heterosexual women with strong masculine traits, who say that they feel as if they were homosexual men, and who feel strongly attracted to effeminate men go back over 100 years.

It is well documented that at least a few autohomoerotic gender dysphorics have undergone surgical sex reassignment and were satisfied with their decision to do so. There is no compelling reason to question such self-reports of postoperative satisfaction, although current surgical techniques do not produce fully convincing or functional artificial penises, and it is difficult to imagine that autohomoerotics find it easy to attract gay male partners who can overlook this.

This type of gender dysphoria does not appear to be the female counterpart of autogynephilic gender dysphoria, although the differences might appear subtle. Autogynephilic (male) gender dysphorics are attracted to the idea of having a woman’s body; autohomoerotic (female) gender dysphorics are attracted to the idea of participating in gay male sex. For autogynephiles, becoming a lesbian woman is a secondary goal—the logical consequence of being attracted to women and wanting to become a woman. For autohomoerotics, becoming a gay man appears to be the primary goal or very close to it.

The few available case reports suggest that autohomoerotic gender dysphoria may have ideational or behavioral antecedents in childhood. However, these females are not as conspicuously masculine as girls with (pre-homosexual) Childhood Onset Gender Dysphoria. For this reason, and because it is rare to start with, it is unlikely that many parents will detect this syndrome in daughters. It is conceivable, however, that when they occur, cases of autohomoerotic gender dysphoria may be perceived by others as Rapid Onset Gender Dysphoria. This is not because their gender dysphoria arose suddenly, but rather because their early, atypical erotic fantasies were invisible to their parents.

Gender Dysphoria Caused by Psychotic Delusions

The idea that gender dysphoria can sometimes reflect psychotic delusions is certainly plausible. Delusions in schizophrenia, for example, are often bizarre but compelling to the person who has them. Unfortunately, neither of us (Ray Blanchard or Michael Bailey) has had direct contact with a person clearly meeting this profile, and so we have less confidence in this gender dysphoria category than in the others. Our lack of direct familiarity doesn’t necessarily mean that much. Even if gender dysphoria due to psychosis were fairly common (compared with other forms of gender dysphoria), we wouldn’t have expected to come across it. Persons with severe mental illness have generally been treated for their mental illness and not for gender dysphoria. Until recently, clinics treating persons with gender dysphoria would have screened out patients with severe mental illness, because of concerns that their diagnosis and treatment might be compromised. But we are hesitant to embrace this kind of gender dysphoria as “definitely existing,” because we worry that psychiatrists who have claimed to see it may have been insufficiently trained to notice other kinds of gender dysphoria, such as autogynephilia. Thus, they may have concluded that psychosis caused the gender dysphoria, when in fact, psychosis may have simply occurred with autogynephilia within the same person. One of us (Bailey) has recently been in touch with a mother of a young man who appears to have the profile we would expect for gender dysphoria due to psychotic delusions, and there was no evidence that this young man was autogynephilic. Still, we are least sure about the existence–much less the prevalence–of this kind of gender dysphoria.

Not Just One Type of Gender Dysphoria: Some Implications

It should be clear by now that “gender dysphoria” is not a precise enough term. Parents of gender dysphoric children should know which type of gender dysphoria their child has. To do so it is necessary to learn about all three of the most common types. That is, in order to understand why one’s child is Type X, it is necessary to know why s/he is not Type Y or Type Z. This is not simply academic. There are essential differences between the different types of gender dysphoria.

If knowledge is power, then lack of knowledge is malpractice. The ignorance of some leading gender clinicians regarding all scientific aspects of gender dysphoria is scandalous. To do better, they should start here. We recommend against hiring gender clinicians who are hostile to our typology. Ideally, they would agree with it.

Knowing there are very distinct kinds of gender dysphoria also raises questions–and concerns–about transgender persons of one type using their own experiences to make recommendations for children/adolescents of other types. Nothing in Caitlyn Jenner’s experience allows her to understand what it was like to be Jazz Jennings–and vice versa. Yet a number of vocal transgender activists who have histories typical of autogynephilic gender dysphorics do not hesitate to pressure parents, legislators, and clinicians for acquiescence, laws, and therapies that do not distinguish among types of gender dysphoric children. Moreover, they not infrequently claim inside knowledge based on their own experiences. Yet their experiences are irrelevant to the two types of gender dysphoria that they don’t have. And even with respect to autogynephilia, these transgender activists are nearly all in denial. This means that their public recollections of their experiences are either distorted or outright lies. A notable exception is Dr. Anne Lawrence, who has become an important researcher of gender dysphoria, and who has been honest and open about her autogynephilia. Dr. Lawrence has taken the time to learn the scientific literature regarding different types of gender dysphoria and does not insist that her personal experiences apply to non-autogynephilic gender dysphorics. The biggest victims in the attempts by autogynephiles-in-denial to steer the narrative towards sameness are, in fact, other persons with autogynephilia. These include honest autogynephiles, who frequently contact us but are fearful of public attacks by those in denial. Most relevant to this blog as potential victims are autogynephilic youngsters, who are at risk of being swayed toward decisions they would not otherwise make, on the basis of inaccurate fantasies embraced by those who cannot face the truth of their own condition.

To us, the most tragic group, along with their families, includes those who have acquired rapid-onset gender dysphoria. That condition appears to be the tragic interaction of the current transgender zeitgeist (“It’s everywhere, and it’s great!”) and social media with the vulnerability of troubled adolescents, especially adolescent girls. They are at risk for unnecessary, disfiguring, and unhealthy medical interventions.


*Note. Suicide is tragic and awful, and because of this, we recommend taking seriously your child’s suicidal ideas, threats, and gestures. We have written elsewhere about the risk of suicide among gender dysphoric persons, and we think that this risk is elevated compared with non-gender-dysphoric persons, but still unlikely.


 

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213 thoughts on “Gender dysphoria is not one thing

    • As someone who considers herself to be a particularly good parent I would like to jump in here. What I would say about my own daughter is that her father and I separated when she was 3. She has had a mix of good and bad “step parents” and did not see her father for 2 years which I think was very much due to one step mother who sadly died. I also had a partner for a while who was very selfish and put his own children first. That coupled with her being attracted to another girl and the reaction of the parents of said girl and her total exlclusion from what had previously been a good group of friends due to the girls mother (and lots of other “smaller” things) I believe have contributed to her disphoria. I found this article very good and may well ask my daughter to read it.

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    • I agree with Ray. I would add that the likelihood that a gender dysphoric child may ultimately transition is likely linked to parenting. I would not call this “good” or “bad” parenting, but it concerns, for example, whether a parent lets a child socially transition. We are dubious that this is wise, at least for young children, but probably many parents believe they have their child’s interest in mind

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    • I agree with Ray. That said, I do think that parental behavior can make a difference regarding whether a child or adolescent with gender dysphoria will transition.

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      • I apologize if how I worded the question was confusing. What I meant was if there is a child with childhood-onset GD, can a toxic home life affect how the dysphoria is expressed and the age in which they ultimately transition?

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    • A belated thought in reply to lovewins24. Ken Zucker, who has treated more gender dysphoric children than anyone, does believe that family stress is a cause of gender dysphoria, in a vulnerable child. That is, he thinks that some children are born quite gender nonconformity, and perhaps they contemplate gender switching more than other children for that reason. He believes, though, that gender dysphoria can be a symptom of underlying family dynamics.

      Frankly, I have been skeptical of this. Sounds pretty Freudian to me. Still, Ken is far more knowledgeable and experienced in such cases than I am, so I don’t reject the possibility. I’d like to see some data, though they’d undoubtedly be difficult to collect.

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  1. If you have a rapid onset gender dysphoric situation with a teen female who calls herself
    “gay” because she “identifies as a boy” and is interested in boys, does that mean she is “Autohomoerotic”?

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    • Saying “I’m so gay” has become so popular in the social circles being described here that a lot of bisexuals prefer to call themselves gay now, too. Most of the FTMs that call themselves gay are watching anime romances with gay male protagonists (yuri on ice, for instance). I don’t think most of them are thinking about it in sexual terms really, they barely understand their own sexuality much less the sexuality of gay males. There are a minority of tumlbr FTMs that post a lot of pornographic depictions of homosexual males, I would suspect that it has to do with exposure to pornography and heavy usage of it.

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      • My ROGD biological daughter calls herself “gay” because she’s in a relationship with another RODG biological girl. I guess two “transmen” together are gay men in their world. But peeling away the masks they’ve created for themselves to hide behind and all you have are two lesbians.

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      • “Most of the FTMs that call themselves gay are watching anime romances with gay male protagonists (yuri on ice, for instance).”

        This reminds me of my friend from high school, who now identifies as a gay man. We both read a lot of slash fiction and male/male romance, and she was also into anime. I don’t think anything we read or watched could be considered pornography, but it was definitely sexual. I grew up to aspire to do as great a job writing gay male romance as Patricia Nell Warren, Annie Proulx, Mary Renault, or Maria McCann; she grew up to get a double mastectomy.

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    • If such a girl were a true autohomoerotic gender dysphoric, she would have a long-standing history of sexual/romantic fantasies of two men being together or of herself as a gay man (e.g., imagining during vaginal intercourse that she is actually a male being penetrated anally). I doubt such a girl would advise her parents of those details.

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    • I wonder if “autohomoerotic” is a safer way for a natal female to express their sexual orientation. Especially if we are discussing teen girls who are “supposed” to like boys, but maybe don’t. Trying on this transgender identity and liking boys is a way to play with the idea of being gay. In the hierarchy of gay culture, lesbians are the bottom wrung. That’s got to be hard to come to terms with. An attempt to enter the members only club may seem easier for a teen with little sexual experience.

      Lesbians, in all sorts of media, seem to be more about the male gaze than the female one, in which it is intended. I notice it. I’m sure teens do also. (small note to thank Ellen for keeping it real)

      The 2nd thought I had about “autohomoerotic” is if those diagnosed with this are in the process of transitioning. The reason I wonder is because I know from talking to females taking Testosterone, that they have a greatly increased libido, which could account for autohomoerotic experiences. Which brings me to my last thought on this, what is the onset age for this?

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      • I think it is unlikely that autohomoeroticism, which amounts to getting a sex change to be a man to have gay sex with men, is due to feeling safer having sex with men.

        Autohomoerotic GD precedes decisions to transition. Indeed it is the cause of transition when that happens. Which is why it isn’t a thing in rapid onset, even among girls attracted to boys. In those cases, social contagion appears to be the cause of the gender dysphoria.

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    • TroubledMom, my daughter once identified as a gay boy who was attracted to males. (She has since desisted.) I think she would have likely been diagnosed as ROGD–her gender dysphoria came on suddenly at age 16.

      It appears that many girls with ROGD are lesbians, but there are definitely some heterosexuals too. Quite a variety of young people have become ensnared in this trend.

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  2. In attending a recent gender conference I can say what these pro early transition professionals will say. The appearance of 2ndary sex characteristics in females at puberty wholly explains ROGD. Penises are more noticeable than breasts, so young males are more body dysphoric and females experience this when they get breasts. And it’s a very positive thing they can get medical intervention now. A major clinician admitted they are seeing a high number of BPD females and attributed their BPD symptoms to the fact that they are really trans (and living in an invalidating society is causing the BPD like symptoms).

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    • This excellent article makes it clear that research has been dominated to date by pursuing an understanding of gender dysphoria in males. My take away is how little we know with regard females (young and old) who wish to transition. And that The New Trans is being directed by the autogynephilic males who for one reason or another don’t want their sexuality to be known. I am glad Bailey and Blanchard acknowledge that the research and our understanding is open to refinement and additional nuance — would that genderists had the same attitude. Particularly, in light of the medical risks.

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  3. First, thank you both SO much for writing this and validating us parents. It is nearly impossible to get proper therapy for children like mine who are suffering when the entire profession has been misguided by their professional associations and the endorsement of the “affirmation only” approach. Add to this the medicalization factor (gender therapist tried to scare me into putting my child on hormones) and this is no innocent passing fad. The indoctrination of entire school systems left me with no choice but to homeschool my daughter. I hope your blog can be submitted broadly to shed some much needed light on what is really going on.

    I would love to ask you a specific question about treatment recommendations. My daughter is on the autism spectrum and highly gifted. She beginning identifying as transgender at the age of 13 after attending a school presentation where 5% of the students identify as trans. No signs of BPD or any significant mental health issues or trauma — and definitely heterosexual.

    I took her (ignorantly) to two gender therapists where all they did was affirm her identity and tried to scare me into putting her on hormones. I did (ignorantly) allow her to socially transition. After (finally) realizing the truth, I no longer support the name change and pronouns and threw away the binder. I withdrew her from school to homeschool.

    It has been three long stressful years and she still thinks she is a boy. She sees a therapist who shares my belief, but we are both at a loss as to how to address the gender issue.

    Do you have any specific recommendations for therapists and parents of ASD teens? The rigid thinking makes this particularly difficult. Some parents I have talked to believe it is important to confront their kids with the truth and show them stories of detransitioners to help dissuade them. Others believe it is better to ignore the gender issue entirely and focus on strengthening the relationship. Any guidance you might recommend would be greatly appreciate.

    Thank you again!

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    • Neither of us treats patients (although Ray Blanchard used to). We do not claim to know how to do so. Our article is a first step towards getting the right information, which requires distinguishing very different kinds of gender dysphoria.

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      • I was primarily involved in the clinical care of adult gender-dysphoric patients from 1980-1995. I did not see child or adolescent patients, and in those days ROGD was extremely rare, if it happened at all. So I can’t offer concrete recommendations about these cases based on my own specific experience.

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    • Hello FightingToGetHerBack,
      I’m a detransition woman and I identify a lot with your daughter. I have written about my story if you scroll down to the latest comments, and also given some advice to what I think parents /adults can think about. Maybe it can be helpful!

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  4. If your child’s gender dysphoria persists well into adolescence (again, the ages vary by child, but let’s say age 14 or so), s/he is much more likely to transition.

    I would be interested to know the evidence for this.

    I note that WPATH SoC v7 states:

    ‘… the persistence of gender dysphoria into adulthood appears to be much higher for adolescents. *No formal prospective studies exist.* However, in a follow-up study of 70 adolescents who were diagnosed with gender dysphoria *and given puberty-suppressing hormones*, all continued with actual sex reassignment, beginning with feminizing/masculinizing hormone therapy (de Vries, Steensma, Doreleijers, & Cohen-Kettenis, 2010).’ (p. 172) [My emphases]

    But the participants in that study had all been prescribed so-called “puberty blockers”: their development, as I understand it, had been chemically arrested. Have there been any follow-up studies of adolescents diagnosed with gender dysphoria who were not prescribed puberty-suppressing hormones?

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    • I don’t have time to find a citation right now. But with respect to child-onset gender dysphoria (and NOT rapid onset gender dysphoria), both Ken Zucker and the Dutch group have told me and written (and published data in support of) the fact that persistence into adolescence is associated with much higher transition rates.

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      • And this is where my daughter’s psychologist just assumed that since she is 18 she is destined to stay transgender although it came out of the blue.

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  5. Suicide is serious yes. Which is why it’s so disgusting that adult transgenders positively enforce use of this tactic by confused minors. Suicide is serious, yes, which is why we should pay close attention to where children and youth spend their online and social time and with whom, and the effect of social contagion on their decision making. Suicide is serious, yes, which is why we should question the use of SSRIs for children and youth, because this class of drugs (and others) especially, can cause suicide and violence ideation. And the medical profession is shoveling these drugs down children’s throats.

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    • I understand your frustration. It’s not the medical professional as a whole that is promoting early gender transition for children; it’s a tiny subset of self-selected practitioners. Similarly, policy statements by organizations that seem biased are often driven by a relatively small number of activists who have the motivation to get themselves on the committees that draft such policy statements.

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      • But when they lead and everyone else sits silently or follows along, policy changes. And then everyone becomes a sheep and nobody helps. And the advocates themselves need studies done on them. There’s are those that want their suffering retroactively fixed by changing policies for kids. There are those that just want to mess with the families of cis normative people. There are those who are overly sympathetic and feel the world must fix this problem for them at the expense of others. There are those that have done it for their kid and want more people on their team. There are those that believe the how that suicide is the only other option. There are those that have given up on helping patients overcome this because they don’t know how. There are people who profit from the surgeries and medications. There are an awful lot of people who have no desire or reason to listen to parents who feel this comes from some other reason. And then they try to make it cruel and illegal to open discussions with the children.

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  6. Hi, Drs. Bailey and Blanchard. Thanks for writing this blog. Dr. Bailey, I read “The Man Who Would Be Queen” a few weeks ago.

    I have some thoughts and questions about autogynephilia. As much as I can understand that sexual orientation is something that people shouldn’t try to change, I also have serious moral qualms about treating natal males like females if treating them this way is going to be sexually arousing to them. As a married woman, I don’t want to be providing erotic satisfaction for other men, even if the way they achieve this satisfaction doesn’t involve any explicit sexual behavior from me. As the mother of a daughter, the thought of her sharing a locker room or other semi-private space with natal males who are later going to go home and masturbate over having been naked “with all the other girls” frankly makes me want to vomit.

    I get that this is not something autogynephilic men choose, and that a lot of them would rather not have these thoughts and feelings. If they want to cross-dress in private or with consenting partners, I don’t care, but I draw the line at being asked to take part in their sexual fantasies. What are your thoughts on this? A teenage son of one of my husband’s friends identifies as genderqueer and basically looks like a long-haired boy in a skirt. This started when he was maybe fifteen and, like a lot of other potentially autogynephiliac types I’ve heard about, he’s autistic. I like the kid, but I have to admit that reading more about autogynephilia has made me start to feel more uncomfortable around him. Right now I’m friendly to him when he’s in our home and do my best to avoid referring to him by pronouns.

    I’m glad ROGD is being recognized. Unlike a lot of other commenters here, I don’t have a child with these symptoms, but one of my friends from high school (I’m in my early thirties) began showing signs of this after graduating and attending a women’s college with a lot of other FTM students. She was always a very traditionally feminine person and has acknowledged in print online that she didn’t struggle with gender dysphoria as a child, but rather decided during college that she wanted to be a man. I haven’t seen her in person for years, but from following her on Facebook I can tell that she is no longer the same cheerful, open person I used to know. I only ever see comments from her on my Facebook page when she’s criticizing something I wrote – usually something most people would view as benign. (For example, I pointed out, on my own page and in response to an article, that some women with young children are not interested in climbing corporate ladders and would rather spend more time at home with their children. Despite claiming to be a man and having no children herself, she decided to start lecturing me about feminism and about how women should reconsider that choice.)

    Another friend of mine has identified as genderqueer for the last several years, also starting in adulthood. I have less of an issue with this because she at least isn’t requiring that everyone around her pretend she’s a man, but I do find it interesting that she used to identify as a lesbian and worry that no one would find her attractive enough to date (she was born with some facial deformities). Pretty much every FTM person I’ve ever met – and I graduated from a women’s college in 2008, so that’s quite a few – has had some sort of other issue in their lives that might make them question their identity, from adoption to sexual assault.

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    • There is no way that anybody can completely opt out of other peoples’ sexual fantasies. You have no way to know what the person sitting across from you on the bus is thinking, let alone be able to control it. However, if someone seems to be hinting that you play along in some way to gratify their erotic desires, and if that makes you uncomfortable, you have every right to avoid that person.

      Regarding the issue of women’s private spaces: I think it is reasonable to allow a postoperative male-to-female transsexual (who now has a neovagina) to use the woman’s washroom.

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      • Thanks for responding.

        You can’t completely opt out of other people’s fantasies, but according to this post, if you know someone used to be a traditionally masculine type who transitioned later in life, it’s reasonable to conclude they transitioned for autogynephilia reasons. If that’s the case, I don’t know if I’m comfortable referring to such people as female at all if it’s going to play into their fantasy.

        I don’t have an issue with surgically transitioned MTF people using women’s facilities. It’s not like I’m going to be looking at anyone carefully and concluding whether their genitals are surgically created or not. I don’t think most women have an issue with that, simply because most of the time you don’t know if a somewhat masculine-looking woman changing next to you in the locker room is transgender or simply a more masculine-looking woman. The “accept my female penis” types, on the other hand, are a different story.

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      • Allow post-operative males to use the women’s (and children’s) bathroom and change areas because he’s had surgery? Did that surgery include his brain? Has he stopped being a male in ways other than lack of a penis?

        Not my children’s washroom. Male sexual predators count on familiarizing and grooming their prey.

        Didn’t I read one of you acknowledge that paraphilias cluster, and if so would that assume autogynephilia and pedophilia?

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      • What about a passing pre-op male-to-female transsexual? I ask because I have always had the sense that I would get in trouble using the men’s restroom because it would get me accused of being female-to-male… and that I prefer not to out myself to others by doing so…

        Perhaps this inquiry answers itself.

        Autogynephiles are the reason why I don’t associate much with the “trans community” though. They’re an off-putting bunch that get waaayy to excited about “femininity” and self-labeling themselves as “lesbian.” But I’m not allowed to say anything about it. Stuff like that gets you burned in such circles.

        Thank goodness there exists a space where I can let loose such frustrations…

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      • Aren’t these two statements contradictory? We have the “right” to avoid someone (man) who want us to play along with their erotic desires, yet we should allow males w/ neovaginas into washroom? When you’ve acknowledged they find it erotic to be seen as women? And the washroom is pretty much the only public place we can avoid men w/ erotic desires that they want us to play into?

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    • P. S. I should probably note that my high school friend seems to be an Autohomoerotic Gender Dysphoria type. She and I both read a lot of slash fiction and male/male romance in high school, and now she identifies as an effeminate gay man. I’m not sure how much of this has to do with erotic identification and how much has to do with dissatisfaction with being seen as female. My friend is Asian, short, and used to be read as a “cute little girl,” which she didn’t like. I don’t know if she was so desperate to no longer be one that she decided being a man was preferable – and then concluded that, being attracted to men, she must be a gay man – or if this comes from a primarily erotic place. Again, she acknowledges she was happy being female and didn’t question her gender until college.

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      • Seconded. With all due respect I do not think Drs. Bailey and Blanchard are seeped enough in popular culture to know how prevalent this is. Ten years ago when I was in high school my entire friend group (myself included) was like this.

        FWIW, I read The Man Who Would be Queen and have read deeply and extensively on gender critical and radical feminist theory.

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      • Hi, Old-School Butch Feminist. We appear to be within a few years of each other’s ages. By “like this,” do you mean into slash fiction and m/m romance?

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      • I’d second the idea that more exploration of popular culture might be helpful in understanding this. Some trans-identified females are so obviously slash fans, and an element of roleplay is common in the community -cosplay, and online roleplay- which can include M/M sexual stuff. As from my observation -I was a member of the anime society at Uni- are autistic spectrum disorders. I’d wonder if they would really just desire to be male, or if it’s that, their erotic fantasies having centred on M/M fiction for so long, while likely not having much success sexually in real life, the idea of becoming male takes hold as a way to fulfil their sexual desires? Male characters can also be a lot easier to relate to, as being more rounded, perhaps esp. for a autistic female who is not especially femininity conforming.

        It’s hard to separate the channer trolls from the genuinely trans-identified, but is there also any tendency for AGP males to be into anime culture? There seem to be a lot with anime avatars etc. I’d figure the autistic spectrum link might explain it if so.

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      • Leo: I wonder – and this is total speculation – if it might be heterosexual slash fans who are more likely to decide they’re gay men, because otherwise they’re in the comparatively “less interesting” position of being straight allies. I’m bisexual, so I always felt like m/m romance was about one of my fellow branches in the LGB “family,” so to speak. In the culture that these girls are interested in, being a heterosexual female straight ally is not nearly as cool as being LGBT.

        I continue to love well-written, well-plotted, in-character slash fiction as an adult, but let’s face it, the heterosexual female characters in slash don’t tend to be what anyone would aspire to be. They’re the canonical love interest (for those unfamiliar with fanfic terminology, the character who’s the love interest in the original work) who needs to be disposed of or written out so the main couple can be together. Or they’re the deluded girl who doesn’t get that she has no chance with one half of the couple. Sometimes they’re the Cupid plotting to get the couple together, but again, that’s a “boring straight ally” role. The focus is on the couple, so female characters are secondary by definition (as are other male characters). I don’t have an issue with that on a personal level because I’ve never seen gender as a factor in whether I can relate to a character, and I’ve never looked to fiction to show me how to be a woman. But if somebody does see gender as a factor and is looking to fiction for a sort of road map to being an adult woman, I could see where they might decide being a a straight adult woman is boring and it’s more romantic, daring and adventurous to be a cutting-edge gay transman, defying society.

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    • M0506, you are right to exercise caution around men who practice sexual fetishes in public. Women don’t have to accommodate men who get a sexual thrill from imagining themselves as women. They have admitted to being turned on when people call them by female pronouns and pretend to believe they are really women. We women have developed a set of alarm bells that go off when we encounter men who behave inappropriately, and when it’s obvious we’ve been pulled unwillingly into participating in someone’s sexual fantasy, we know we are unsafe. You are allowed to trust your instincts and protect yourself, and this does not make you a bigot.

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      • Say it sister!!

        We are under no obligation to be their perv fodder, nor to be polite to them.

        This is what they fight for: to get into our private spaces to id as women and to perv on us. Oh, they didn’t rape us? We survive a lifetime of Russian roulette everytime we have to pee. “Am I ok this time…??” heart pounding and trying to be nonchalant.

        They can fuck right off. It ends here, teaching our daughters to be nice.

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  7. While I have met people who find life more bearable living as members of the opposite sex and undoubtedly Gender Dysphoria in its various forms does exist, in its various forms as an experience shared by many people. I really cannot believe in the idea of a “female brain in a male body”.

    Yes there may be features of brains that correlate with sex, and some people may have features that are usually found in the opposite sex. But that is like saying big feet mean your a man.

    You seem to say SOGD is not really trans,

    Men can get sexually fixated on all sorts of stuff. Is AG not really just a fixation on feminine ‘stuff’.

    I’d love to see how the attitudes of the parents (or other carers including teachers) of early onset GD children compare to the general population. How does it relate to munchausen by proxy or attempts to make children gender conforming. Are parents and carers more comfortable with the idea of a trans kids than a camp little boy or a butch girl?

    I’m seeing the whole thing a lot more like this:

    https://pbs.twimg.com/media/DQddo6aU8AAvfk1.jpg:large

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    • You are correct that human males can and do develop all kinds of unusual sexual interests. However, the great majority of these unusual sexual interests fall under perhaps 10 or so headings (pedophilia, fetishism, sadism, exhibitionism, etc.) Autogynephilia is one of the major “paraphilias,” as they are called in psychiatry and psychology, and it has relatively specific features.

      I don’t know where the (perhaps overly supportive) parents of transitioning children are coming from. They deserve a study in their own right.

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    • I see it a mixture between the above and the diagnostic model of Dr Blanchard and Dr Bailey. I think some caution is needed with all the types described by Dr Bailey and Dr Blanchard, as there is so much influence by social media, and well-meaning but hopelessly misinformed teachers, parents, psychologists etc etc. Preschoolers are being read books about being transgender. They are going to get extremely confused, and tease every girl who looks at a truck. What is that going to do to her psyche? I think these influences extend beyond ROGDs. But it is fantastic to see these influences being recognised.
      Also there is the factor of parents who deep down would prefer to have a transitioned child than a gay/lesbian child; or who display so much subtle or not so subtle homophobia, that their kids gravitate towards being transgender as a refuge. And so many more factors.
      It is a real soup!

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      • Certain types of gender-dysphoric persons have been repeated described by clinicians since 1910, so our typology does not depend on observations “contaminated” by social media. The exception is ROGD, which arose after the ubiquity of social media. Of course there will always be individual cases that are hard to classify as one type or another, but the model types still exist.

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  8. Dr. Bailey and Dr. Blanchard, thank you for this essay! I especially appreciate your description of Rapid Onset Gender Dysphoria. It is validating for me, as a parent, to see professionals clearly state that it’s a socially contagious phenomenon and that it’s “the type for which gender transition is least justifiable and least researched.”

    You are in the forefront of this. Thank you for trying to raise alarm bells, to warn that what we are seeing is similar to the Repressed Memories/Multiple Personality Disorder epidemic. I hope that your essay will prod more concerned mental and medical health professionals to come forward. To speak up. To be more cautious. It appears to be quite widespread and many, many young people and their families are being impacted.

    One thing, though, based on how I’ve seen ROGD spread among my children’s friends, I suspect that a significant number of boys–especially ones that are socially awkward, academically gifted, and have autistic traits–are caught up in this trend too. Obviously not as frequently as girls. But I’m seeing it happen here in my neck of the woods. Statistically, I think it unlikely that they are all autogynephilic.

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  9. I suspect that the ROGD cases are a heterogeneous group with various personality disorders, adjustment disorders, and other vulnerabilities, and I would not hazard a guess what percentage of the males are autogynephilic. Research on this group is just beginning.

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    • I doubt it. FYI, I think that childhood sexual abuse is way overrated as a cause of problems. (Not an endorsement of it, but hysteria about it has caused a lot of problems.)

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      • It’s very clear this is primarily an academic pursuit for these gentlemen and some others of their colleagues, while for us, it’s our lives, and the lives of our children. We are not studying some career making fascination: women are fighting male sexual perversion and we are dying from it.

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      • Well that was too quick and too short of an answer. I’m thinking the longer version is something like this… Sexual exploitation is actually so rampant that if it caused transgender feelings then essentially everyone could be transgender. There were studies done on rape and homosexuality and apparently it was found that it ended up being 50 50 with those who grew to be straight and those who grew to be gay. Therefore it has not been firmly supported that sexual trauma causes homosexuality. Then somehow it was assumed from that, all homosexuality comes from birth although I (who don’t know too many people) have spoken to people who have clearly said they want nothing to do with the opposite sex due to the way they were treated by them…. as a conscious decision. And of course we all know that whatever is said about gay and lesbian people and their sexual attraction automatically applies in the exact same manner to transgenderism which is about identity.

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  10. Thank you so much for writing this really clear outline of what is known about gender dysphoria based on the actual research. I agree that this is an epidemic with similarities to previous epidemics and I am struck by the fact that all have affected predominantly young females. The first two could be said to have originated from over-zealous therapists but I don’t think this last one has, it’s more of a political movement sold to young people as a social justice issue which has been enabled by a medical profession who are as indoctrinated / afraid of speaking out as everyone else. Whereas doctors may have exhibited gender bias in the previous two epidemics (and been more likely to apply their theories to females) this latest movement is open to everyone and yet it’s still girls who are the most vulnerable to its influence. Along with the factors you have outlined I would suggest that there is an existing problem of body-hatred and disassociation for girls in adolescence which has a strong cultural component underpinning it. Co-existing problems in gender dysphoric girls are similar to those noted in the APA taskforce on the sexualisation of girls (2007) and in the UK we see evidence of girls’ worsening mental health and distress caused by the increasingly hyper-sexualised culture / impossible beauty standards / social media pressure etc through studies including annual Girlguiding surveys. This pressure to be ‘hot’ is also beginning to affect boys with the spread of ‘gym culture’ concurrent with increasing rates of anorexia / eating disorders amongst boys. The children of parents who contact me fit the 80 / 20 girl / boy ratio and I wonder if this cultural factor may be one of the components of the development of a trans identity in both girls and boys. Of the boys I hear about, 100% are ASD and tend to be perfectionist and obsessive rather than there being any sign of sexual motivation. They also do not appear to be gay. I wonder if we are seeing a new etiology for gender dysphoria in boys as well as girls which is more to do with social vulnerability and resulting susceptibility to indoctrination.

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    • ” I wonder if we are seeing a new etiology for gender dysphoria in boys as well as girls which is more to do with social vulnerability and resulting susceptibility to indoctrination.”

      Well said. This makes sense with my experience. Social isolation , puberty , depression , ASD traits , struggling with sexuality– – easy target for “wrong body” narrative online ! Add to the mix the lionization of trans issues in the media and the information of “gender theory” into our schools….

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    • Although I don’t have a limited sample sIze, here is what I’ve observed:

      At my youngest daughter’s high school, 5% identified as trans. All had autism or signs of. Half were boys.

      At my oldest daughter’s college, she reports that all the trans kids appear to have autism.

      At my former support group, there were more boys than girls. All had autism.

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      • We are aware that “autism” is related to gender dysphoria. We are unsure what this means, and emphasize that “autism,” like “borderline personality disorder,” is not an especially precise diagnosis. Still, worth clarifying.

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      • I remember reading a Dutch study which claimed that all (well basically the extreme majority) of the autism was in the transpopulation that was not homosexual.

        Is that something you recognize? Know of any studies on this?

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    • “I wonder if we are seeing a new etiology for gender dysphoria in boys as well as girls which is more to do with social vulnerability and resulting susceptibility to indoctrination.“

      I agree – we are in a New Era and that is what we are seeing. You laid it out quite well. I don’t think Trans Activists who have ushered in this New Era anticipated the extent of ROGD in females and I don’t think they are prepared to contend with the pushback that is mounting as a result.

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    • For much of recorded history, women have been more vulnerable to mass hysteria epidemics than men. The cat nuns in medieval France, the Strawberries with Sugar virus and Tanganyika laughter epidemic are a few examples of mass hysteria that primarily affected women. There does seem to be evidence than, on average, women are more people-oriented, and I think this could make them more susceptible to pick up the contagion from those around them. When we watch someone perform an action, the same area in our brain is activated, which is called the mirror-neuron system. Some people have theorized that women may have a stronger mirror-neuron system, but there haven’t been enough conclusive studies yet.

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    • Stephanie, I hear what you are saying in relation to boys. The ASD I am sure is a factor, but nowadays you have to have lived on another planet to not have heard of transgenderism and the “born in the wrong body” meme. 20 years ago a boy with autogynephilia would probably never have heard of being transgender, would have kept his fantasies to himself and tried to of conform; get married, have children. So it was with my ex. I’ve posted a longer comment about my own experience with my ex. I really don’t know whether it is better that men try and cope and then disrupt their own families or they “come out” at a younger age and save all that heart ache. The ASD, autogynephilia, male-entitlement combo seems to me to be a recipe for disaster unless managed and addressed (which it is clearly not being). We just have to look to the example of teenage boys being elected as “women’s” representatives within political organisations looking for politically-correct kudos. Not only that, these are the young male trans activists targeting lesbians to accept them as partners. Another thing that mainstream politics is not addressing.

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  11. Blanchard/Bailey: Do you think problems with same-sex peer group socializing is a factor in child onset gender dysphoria. When I was practicing as a child/family therapist (before transing children became an issue), I always suspected problems in the same-sex social group and addressed that immediately. Not all my patients were on the autism spectrum, but most had a mental disorder that impacted on social interaction (as many mental disorders in childhood do). The few children I treated desisted rapidly, although even then I knew they were likely to desist anyway. I was more concerned about dysphoria as a symptom of poor peer interaction, and that the parents needed come to terms with the likelihood that their child was gay. Though I can’t take credit for any desistance, since it was probably destined to happen anyway, I still tend to think my instinct that social group and social skills was a strong factor was correct.

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  12. Dr. Bailey and Dr. Blanchard, thank you so much for your post. I do hope it gets the attention it deserves, specifically within the school psychologist community. Those psychologists are in the thick of the ROGD affirmation on high school and college campuses, and for them to see it through that lens will be invaluable.

    So, I don’t know if this is a question or just a plea for help….testosterone needs to really be a controlled substance. Trans regrets are real. The health effects are real and should only be initiated by someone mature enough to truly understand what they are embarking on under the care of endocrinologists. There seems to be this mystic belief in these “dudes” that taking testosterone will make life so much better; never an effort made to ask why the huge hurry to escape their biological reality?

    Do these “dudes” (and their parents) understand that a hysteroctomy will be needed in about 5 years? will they meet the criteria for this surgery? Do these happy college “dudes” keep up with the lab testing they should be getting, and if not, their liver isn’t so happy. It is all very irresponsible.

    Thanks for your help.

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  13. Thank you, thank you, THANK YOU!!
    One thing that obfuscates the diagnosis of ROGD for unknowing therapists and the general public is that a lot of these kids re-write their histories to fit the trans narrative. They clinically present as a child-onset type due to claims that they always felt this way. They even give examples like that they hated their gender-typical clothes but didn’t tell their parents, or that they mostly played with kids from the biologically opposite sex, or that gendered toys were “forced” on them.
    Our child’s claims were so ludicrous that when we caught her in the right moment, even she was laughing a bit about how far she went to explain herself as a transboy. This was only possible after she started to desist though. She was so convincing for quite a while!

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    • Similar experience for us. The first time I asked how long my 16-year-old daughter had felt she was trans,she very solemnly told me she had tried on her Dad’s tie a year ago. When she learned that persistence was a criteria for being trans, pretty soon she was talking about how she felt this way in 5th grade.

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    • Adult gender-dysphoric patients also re-write their histories. This is particularly true of male-to-female transsexuals with heterosexual histories of marriage and fatherhood and past careers in stereotypically masculine professions (eg, military, construction work, etc.). They often “explain away” their masculine pasts as active attempts to suppress their essential femininity.

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    • thinkandblink, yes, I agree that ROGD kids often re-write their histories. My daughter did too and appeared to convince a therapist that she had been gender dysphoric from a young age. (I honestly don’t think she was intentionally trying to be manipulative. I think she genuinely believed it herself.)

      We ended up finding a new therapist. I told him about my daughter’s history (no gender dysphoria before age 16) and he wasn’t surprised. He had seen many teens presenting with similar histories. He was actually able to help my daughter without affirming her. After several months of therapy, she ended up discarding her transgender identity.

      Hopefully some therapists are reading these comments and are gleaning information from our experiences.

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      • I encourage you to write up your daughter’s case (without revealing information). If you do, please contact me. I’d love to read.

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  14. For the record here, for other women and now grown children reading, and strongly contradicting whichever of your two guests completely dismissed late remembered childhood sexual abuse: I know of two children (and I’m not a therapist whom I bet would know many more) who have NO memory of being abused, but display cues to it repeatedly, and whose PARENT was told by the child shortly after the abuse, saw physical signs of it, and can swear it occured. I’m one such parent. I don’t CARE how many initials are after your name, you are WRONG on this one.

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  15. “Autogynephilia is a paraphilia, meaning an unusual sexual interest nearly exclusively found in males.
    We repeat: Autogynephilia is a sexual orientation–to be sure, an unusual orientation that is difficult to understand.”

    “Autogynephilia—the central motivation of autogynephilic gender dysphoria—can be considered an unusual sexual orientation. As with other kinds of male sexual orientation, we do not know how to change it, and we shouldn’t try. The dilemma is how to live with autogynephilia in a way that allows the most happiness. For some with autogynephilia, this will mean staying male. For others, it will mean transitioning to female.”

    It looks as though you are arguing that autogynephilia is at once a paraphilia and a sexual orientation. It’s alarming to see paraphilia compared to sexual orientation like this. Sexual orientation means who you fall in love with and feel attracted to, which refers to regular pair-bonding and sexual activity. However, paraphilia is another word for perversion and can refer to “recurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving a non-human object, the suffering or humiliation of oneself or one’s partner, children, and non-consenting persons.” (Quote from American Journal of Psychiatry, accessed in Wikipedia).

    I would agree that autogynephilia is a paraphilia (perversion) because it stems from the objectification of women, the view of women as naturally submissive, and the eroticization of submission. Autogynephiles enjoy crossing women’s boundaries, they have masochistic fantasies, and they often learn their fetish from porn. This is indicative of a sexual fetish, not an orientation.

    To compare being gay or lesbian to being a pervert is homophobic; gays and lesbians are regular people who form regular relationships, not people with sexual disorders that cause anti-social behaviour.

    I find it alarming that you can admit that autogynephilia is a perversion and still accept gender transition for such men, knowing the danger this poses for women. That it makes perverts happier to practice their sexual fetish in public doesn’t make it acceptable. There are more considerations here than just men’s happiness, such as the safety of women and children and public decency.

    Autogynephilia is possible because the oppression of women is presented as titillating for men, and fetish items such as high heels and stockings are symbols of the sexiness of our subordination. If we didn’t associate being a woman with being sexually submissive and if our bodies weren’t synonymous with sex, then men wouldn’t develop fetishes for imagining themselves as women.

    You don’t seem to know what to do about autogynephilia, but there are some obvious considerations when you face the fact that this is a disorder. People who have a sexual disorder that becomes anti-social when practiced in public should obviously be discouraged from practicing in public. They need to learn that while it’s not inherently wrong for a man to imagine himself as a woman or to cross-dress as a sexual fetish, it’s wrong for him to play out his masturbation fantasies outside the house.

    If repeated fixation on imagining himself as a woman causes gender dysphoria, then he needs to redirect his attention and stop focusing on it, in order to alleviate the dysphoria, rather than increasing the dysphoria by attempting to “pass” as a woman. When men begin trying to pass as woman they end up obsessing over their looks and feeling overly anxious because passing is so difficult. Autogynephiles should quit using porn and should engage themselves in interests other than fantasy and masturbation. They should also make an effort to unpack how they are objectifying women and sexualizing dominance and submission. A man who respects women and sees us as full human beings won’t be able to spend his time sexualizing our subordination.

    It may not be possible to entirely eradicate thoughts of wanting to be a woman from the AG’s mind, but he can certainly reduce the amount of time he spends indulging it and the power it holds over him. I appreciate that you approach this issue scientifically and don’t cave in to the cult, but it’s disappointing that you think the primary “dilemma” around autogynephilia is how to make such men happier, rather than how to integrate them into the public without them harming anyone. Your disregard for women is apparent.

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    • I was not going to respond to the anti-autogynephilia comment by PurpleSageFem, but I decided to do so, for the sake of clarifying why people should reject her positions.

      The question of whether to consider autogynephilia a sexual orientation is scientifically interesting, one that I have written about. (Another issue I suspect I’d disagree with PurpleSageFem about is whether pedophilia should be considered a sexual orientation. I think it should be.) Sexual orientations are early-emerging sexual interests that are fixed and that exclude other interests. This applies to AGP, with the exception that many AGPs are attracted to real women as well as to themselves. (Interestingly and importantly, their attraction to particular real women tends to wane over time, while their interest in their inner-created female does not.) And with respect to sexual orientation as orienting attachment and love, this happens too in autogynephilia: http://annelawrence.com/becoming_what_we_love.pdf

      AGP is no more about objectification of women than male heterosexuality is. That is, both are to some non-trivial extent. That is how men are built. Gonna change men into lesbians with penises? Good luck with that. This does not mean tolerating mistreatment of women. But it does mean getting things correct about where problems are and how they can be addressed effectively.

      I believe that PurpleSageFem has little interest in intellectual exploration or thoughtful discussion of these ideas and intends, instead, to diminish sympathy and tolerance towards people with autogynephilia. (I note that this accusation has been made, much more frequently and unfairly, towards me.) Although I agree with (and wrote about) the contention that autognephiles-in-denial who push the false idea that they are women trapped in men’s bodies have been leaders in current bad developments, I stop well short of condemning all autogynephiles. Autogynephiles who recognize their condition include many thoughtful and caring individuals who do not try to intrude erotically into the lives of others. Furthermore, these are people with lives to lead, and I think it is better to help them lead good lives–satisfying and decent lives–than it is to condemn them unnecessarily. Persons with AGP are stuck with their sexuality, and it does not require them to hurt others, so helping them figure out how to live with it seems like a good plan.

      I oppose demonizing transgender skeptics as “TERFs.” At the same time, I oppose demonizing transgender persons, including autogynephilic transgender persons. This happens too often, and I think that PurpleSageFem is trying to do this.

      I regularly read GenderTrender, and I often agree with her point of view, including when she’s very critical of AGP natal males being aggressive towards natal women. Where I part from her, and from PurpleSageFem, is in their meanness towards AGP persons who are good, including for example Anne Lawrence and Maxine Petersen. Things like calling them “him” and “men.” This hurts their feelings and is just plain mean. One need not accept that they are the same as natal women; I don’t (nor does either Anne or Maxine). Meanness is unnecessary and won’t get GenderTrender and PurpleSageFem where they should want to go.

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      • This is obviously a contentious and hugely painful subject which has broken open between PurpleSageFem and Michael Bailey, but it’s a conversation worth having. Should others care to join this thread, please keep your comments civil and on-topic. There are points of agreement here which could lead to some constructive understanding and action.

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      • I had a feeling your response would be dismissive of my valid concerns, and I was right. I can rest my case, then, you don’t care about women, and you don’t care to further your understanding of autogynephilia by learning from feminist theory. I understand why 4thWaveNow wants to publish your work on the variety of types of gender dysphoria, because there is some good research there, but your usefulness as an activist on this topic is very limited by your refusal to consider women’s knowledge as valid.
        It’s almost amusing that you think that turning women’s bodies into fetish objects is no different from normal male heterosexuality. That sounds like an insult to straight men to me. I think that straight men are capable of feeling romantic and sexual feelings for women while still understanding that women are fully human and without reducing them to the status of sex toy.
        People who believe that men can behave like mature human beings are not being “mean” to men. Those who believe that men are unable to stop engaging in abusive and anti-social behaviors, such as practicing sexual fetishes in public, have a poor opinion of men indeed.

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      • Just one very quick point here – I would hope that Drs. Blanchard and Bailey do not see themselves as “activists” in the transgender area (viz the comment regarding “your usefulness as an activist” below). I don’t think people doing research in this area SHOULD see themselves, or be, “activists.” This is what the pro-transgender medical professionals such as Johanna Olson and Norman Spack are doing, permitting their ideological biases to over-ride or certainly influence their professional judgment. The science is going to show what it’s going to show, we can argue about the implications of that, but it’s better to keep the political considerations separate.

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      • We could debate the meaning of the word “activism” and come up with lots of different answers, I’m sure. I will just explain what my intention is in using this word. Bailey and Blanchard are participating in a very political discussion involving competing rights between two opposing groups. I do not mean to imply that they are engaging in the type of activism that involves marching in the streets, waving signs, and chanting slogans, and I definitely wouldn’t expect them to do that. However, they are taking positions in a political debate and choosing to have a public influence on a political matter.

        It appears that the researchers and some commenters here view them as objective and concerned only with facts, but they actually have taken a political position. Even though their research shows that autogynephilia is a sexual fetish, they believe it’s acceptable for these men to transition and live “as women,” despite women’s objections. This is not a neutral position; this is a position in favor of men with sexual fetishes and against women.

        To address Bailey specifically, he has stated that he reads Gender Trender, and that he is aware that autogynephiles behave “aggressively” toward women. Gallus Mag has been documenting the deluge of abhorrent behavior from male autogynephiles toward women for 7 years now, which includes everything from sexual harassment to rape and murder. Knowing this information, Bailey still paints women as “mean” for not wanting to cater to these men.

        By refusing to consider the feminist analysis of gender which puts autogynephilia in a social context and offers men a framework for understanding how they came to develop this fetish, Bailey is limiting his effectiveness in his role—whatever this role should be called.

        I know I am taking the conversation away from the topic of teens who identify as trans, which is normally the purpose of this blog, but I think the above points are important to note, and I think that a feminist analysis of autogynephilia could be helpful even for teen boys who are showing signs of this. Deconstructing what they have learned about women from porn and from patriarchal culture in general would go a long way toward helping them understand why putting on women’s sexy underwear is a such a strong urge for them, and could steer them toward a healthier sexuality as they mature.

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      • If they were really “nice” they would stop demanding that strangers participate in their fetish! Just because a person’s kink is something the average person doesn’t consider sexual doesn’t mean it’s okay to go around trying to guilt random people into participating. Being shamed into referring to adult males (men) as women because that turns them on, is being made to participate in their sexual fantasy. Someone who tries to force me to participate in their sex life is behaving inappropriately, no matter how “nice” they are about it. It’s comparable to men who go around begging women for foot pics or taking stealth pics of their feet, except for some reason with AGPs, women are supposed to feel bad about telling the creeps to shove off. Maybe there is really nothing wrong with having AGP in itself (dubious but okay), but there is a big difference between having a fetish and demanding that the world cater to your fetish. If you really must pretend to be a woman for sexual pleasure, do it in a private place with consenting partners (or by yourself), same with anything else you do for sexual pleasure.

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      • You know who else says we’re Meanies? Yup, the autogynephiles who post soooo nice at GT and other separatist blogs, then when we still say shove off, they get violently mad, and the delicate slides right off them.

        “I’m going to stab you all over then fuck you in ever hole I made”. Said by a rejected princess to a radical feminist.

        Damn right we’re Meanies.

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      • I am married to a 60 year old autogynephile; his announcement not quite three years ago came out of the blue (the classic case of a man who has lived an apparently happy life as a man). I have therefore had a ringside seat and high motivation to understand him and this condition.
        I am also an academic, one whose own work proceeds from a feminist perspective, and I directed a women and gender studies program for some years. So I’ve got a fair understanding of feminist theory.
        I do not dispute Dr. Bailey’s professional assessment that autogynephilia is a sexual orientation, in that males with this condition are oriented toward themselves, in their fantasy of themselves as women, and are driven to “bring this woman into being” through the practice of femininzing themselves, through clothing and behavior coded as feminine. The orientation is toward the self; the practice of the orientation, however, introduces the idea of fetish (the unusual focus of sexual attention). It is not a contradiction to say, then, as Purple Sage has, that autogynephilia can be considered both a sexual orientation and a paraphilia.
        Purple Sage, however, has a point about the autogynephile’s choice of clothing and femininity. We live in a patriarchy that posits and upholds male superiority over women, and gender and the naturalizing of gender traits is one way this system perpetuates itself. We’ve known this for a long time (John Stuart Mill’s “The Subjection of Women,” in which he attacked such naturalization of gender, was published in 1869!). Autogynephiles, in their desire to be women, often mime woman with the most extreme versions of femininity, and, in my experience, a lot of it comes right out of the images of male, heterosexual pornography–the “I am infinitely available to you”; “Do with me what you will”; “I need to be penetrated”–while wearing clothing that reinforces such femininity and female submission.
        Garter belts, stockings, and 6-inch heels, of course, do not signify in and of themselves; they are not “naturally” attractive to males. Rather, they signify a particular relation between men and women, a particular idea about woman, in which women are subordinate. A pretty air-tight case has been made, over time, that femininity works to disadvantage women in relation to men. It’s fair to say that a man who is living in the semblance and guise of a woman and who is fixated on feminine clothing and appearance and behaviors is not, therefore, exactly helping the cause of those he wishes to join.
        But Purple Sage suggests not that autogynephiles, in their desire to feminize themselves, seek out feminine clothing, but that the fetishizing of feminine clothing is the root cause of autogynephilia. This would mean that if we were to eliminate our gendered and unequal system, and dismantle the patriarchy, that autogynephilia would cease to exist. The scientific data refutes this idea, and I believe it is Dr. Bailey who has written that if a man’s shirt and a woman’s shirt were identical in all other details except on which side the buttons were placed, an autogynephile would still want to wear the women’s shirt.
        I myself would certainly prefer the kind of world in which men and women were equal and systematic gendering no longer a practice; it would be interesting to see how autogynephiles would express their desire to be women then.

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      • Drs. Bailey and Blanchard, I refuse to use the pronouns my ROGD daughter wants me to use. I tell her I am using pronouns the way they have been used for hundreds of years and still are used by the majority of people to refer to biological sex not gender. The dictionary still defines pronouns as referring to biological sex. There are people who want to change the meaning of pronouns, so they are a reference to gender rather than sex. My opinion is just as valid as theirs. I do not think I am being mean to my daughter by refusing to use the pronouns she requests. I think it would be wrong for me to feed her delusion. Do you think it would be a good idea to honor an ROGD kid’s pronoun request? Am I being mean? If not, why is it mean to use pronouns to refer to sex rather than gender when talking to someone with autogynephelia? I am not trying to be sarcastic. I am really curious about if or how you see the situations as different.

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      • ‘I believe that PurpleSageFem has little interest in intellectual exploration or thoughtful discussion of these ideas and intends, instead, to diminish sympathy and tolerance towards people with autogynephilia.’
        I have to ask, what sympathy or tolerance, anyway? Even most other men aren’t that sympathetic to men with paraphilias, so it seems unfair that women should be expected to be more so. A woman simply saying ‘no’ is, however, not unsympathetic. It’s unfair that PurpleSageFem’s discussion of the power dynamics and insight that ‘If we didn’t associate being a woman with being sexually submissive and if our bodies weren’t synonymous with sex, then men wouldn’t develop fetishes for imagining themselves as women’ should be dismissed as though it’s not an intellectual exploration of the causes. What of the AGPs for whom submission is explicitly part of the fantasy, does that not seem to tally? Doesn’t it make sense to consider social causes or factors in paraphilias? Even with usual attraction preference, it seems it can be shaped by familiarity, influencing which faces a person finds attractive, so is it such a jump to suggest other aspects in the environment could influence the development of a paraphilia?

        Simple honesty about someone’s sex is not mean – especially when the man finds it sexually arousing to be referred to as the opposite sex. Anything else is just male sex right, placing it over women. We’re not here to turn men on, refusing to do so isn’t mean. It doesn’t matter if it’s their orientation. What about ours, anyway? Sage is a lesbian – and has every right to object to her orientation being conflated with a paraphilia. I’m asexual, and the thought of actively participating in anyone’s sexuality makes me feel ill and panicked. Why is an AGP male’s feelings about his orientation, if indeed it is one, though I’m still sceptical, more important than my feelings about my orientation? I don’t do sexual acts, including participating in anyone’s fantasy. Not that any male-attracted women should be expected to do so unwillingly, either.

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    • I’m with Nina. I have sympathy for autogynephilic people who keep their behavior private, but if it’s “mean” to refuse to participate in behavior that sexually arouses them, well, too bad. It’s not my job to be nice to people who try to guilt me into accommodating their fetishes.

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      • I have had my say, and nowhere did I say that bad behavior by autogynephiles (or anyone) should be tolerated. Feel free to continue to rail against all autogynephiles, no matter what they do. I don’t have time to engage in pointless argument with you.

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      • Anne Lawrence, an important researcher and AGP (mentioned by Dr. Bailey), has written about the destructive impact of trans activists, including on WPATH. One example: the terms “transvestic fetishism” and “autogynephilia” were removed from the latest version of the WPATH Standards of Care under pressure from well known trans activists. See this recent article:
        http://www.annelawrence.com/autogynephilia_&_MtF_typology.html

        If you search for the following passage, you’ll see a discussion of how reasoned discussion about trans issues has been suppressed by trans activists:

        “The fact that Cohen-Kettenis and Pfäfflin cited Winters (2008) suggests that complying with the demands of transgender activists by suppressing references to Blanchard’s ideas in the DSM-5 was clearly on their minds. “

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      • In the same article (it’s recent, BTW, 2017), Lawrence draws attention to evidence of coexisting severe mental illness in some males with GD:

        Some cases of MtF transsexualism are associated with and plausibly attributable to other comorbid psychiatric disorders, especially psychotic conditions such as schizophrenia or bipolar disorder. Á Campo, Nijman, Merckelbach, and Evers (2003) reported on a large survey of Dutch psychiatrists, who had evaluated 584 patients with cross-gender identification and possible GID; in 46% of these patients, the psychiatrists interpreted cross-gender identification as an epiphenomenon of other psychiatric problems, including psychotic, mood, dissociative, and personality disorders. Brown and Jones (2016) observed that, among 5135 persons (69% male) diagnosed with GID, transsexualism, or transvestism who had received care from the U.S. Veterans Administration, 32% had also received a diagnosis of “serious mental illness,” meaning “diagnoses associated with psychotic symptoms” (p. 128), including schizophrenia- and bipolar-spectrum disorders. Thus, comorbid psychotic disorders and other severe mental illnesses may account for some cases of MtF transsexualism in nonandrophilic persons who deny autogynephilia — and for some cases of MtF transsexualism in androphilic persons as well.

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      • “Feel free to continue to rail against all autogynephiles, no matter what they do.”

        I never did that. I said that I had no problem with autogynephiles who want to cross-dress in private, by themselves or with consenting partners. When they ask me to refer to them as female, however, they’re drawing me into their fetish, and I don’t want to be involved in their fetish. I’m sorry you think this is a “pointless argument,” but if you’re going to misconstrue my position, I’ll have to agree that this is pointless. Frankly, I’m disappointed that someone whose own position has been unfairly misconstrued so often in the past would turn around and do the same to someone else.

        What is it you find so objectionable about someone not wanting to engage in behavior that they know will be sexually arousing to a person they have no interest in sexually arousing?

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  16. Thank you for your research and analysis. Hopefully my daughter will make it back home to herself someday. She is not autistic but has suffered with migraines, and every side effect imaginable since puberty. Her social life diminished and she found her answers on Tumblr. I am about ready to file a complaint against her therapist which set up a deeper wall between us and prepared her to fail out of college. I’m sick of doctors negligently applying their “knowledge” to my child. How could they not see how her health is a major trigger to her dysphoria? How could doctors who teach DBT get everything so horribly stupidly wrong?

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  17. Do you believe trauma plays a role in ROGD? I saw a connection very clearly with my own kid. I have 2 kids that both experienced the same trauma and both reacted and recovered very differently. What do you think may be at play for trauma to impact ROGD, if you believe it does?

    I look at it in terms of an identity crisis, dealing with trauma, and I see ROGD as an identity bandaid that doesn’t address what’s under the surface.

    Great article! Thanks!

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    • I have become reflexively skeptical about “trauma” as an important cause of behavior. It is vastly overrated as a cause of human traits and behavior. Furthermore, “trauma” is often quite subjective (and has even been imagined, as in recovered memories of sexual abuse). I think it more likely that ROGD is more common in youth who have a tendency to create trauma (yes people do that) or react to it than that trauma per se is important.

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      • Hello Dr. Bailey…you say “I think it more likely that ROGD is more common in youth who have a tendency to create trauma (yes people do that)…” I agree. There has been a lot of discussion of the overlap between ASD and GD, but there is also an overlap between ADHD and GD. As you know, us parents compare notes, and ADHD is mentioned a lot. I’m learning that female ADHD can go undetected for many years, especially in gifted girls…and one reason is that the hyperactivity component is internalized and can lead to extreme anxiety and overthinking.

        So, yes, I can see how ADHD can lead to a tendency to create trauma. I hope that ADHD researchers will pay attention to how many females showing up at gender clinics actually have undiagnosed ADHD, and how do these females respond to appropriate ADHD treatments (which means referring them to a specialist).

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      • Dr. Bailey – After reading the newest Williams Institute study that found no difference between suicidal thoughts or actions between gender non conforming kids and gender conforming kids BUT which found that gender non conforming kids (self) report a higher rate “Severe psychological distress,” I couldn’t help but think of your comment that you think “it more likely that ROGD is more common in youth who have a tendency to create trauma (yes people do that) or react to it than that trauma per se is important.”

        Here’s the study: https://williamsinstitute.law.ucla.edu/wp-content/uploads/CHIS-Transgender-Teens-FINAL.pdf

        Excerpt:
        “Mental health
        The CHIS adolescent questionnaire included several indicators of mental health, including psychological distress, suicidal ideation, and suicide attempts. GNC and gender conforming youth did not statistically differ in their rates of lifetime suicidal thoughts and suicide attempts. However, GNC youth were significantly more likely to report severe psychological distress5 in the past year compared to gender conforming youth (17 percent vs. 7 percent)”

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  18. Thanks for an informative and authoritative read. What jumps out is the lack of evidence for this new wave of gender dysphoric young people, so hopefully more will be done.
    The psychiatrist who diagnosed my daughter with autism also grouped gender dysphoric people into 3 broad groups – intractable cases starting very young; older men; and third young people struggling with identity through autism and other causes.
    My question is whether there is a general difficulty in those with autism (and BPD etc) with the development of a secure psychological identity that happens now to be manifesting itself through gender, but if it were not gender might be something else. We had no idea that our daughter was autistic until late teenagehood. I wonder if we had known at an earlier age we might have found a way to help her develop a better sense of self?
    The other observation is that my daughter is definitely reluctant to grow up (hence her appearance now makes her look like a pre-pubescent boy), and she much less emotionally mature than her siblings. She is effectively opting herself out of any sexual relationships. I doubt that will be explored at the gender clinic any time soon.

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  19. I understand that the term “autogynephilia” refers to a paraphilia only nonhomosexual males can have, but I wonder if there wouldn’t be something comparable to it in adult dysphoric homosexual males (whether they have ROGD or childhood-onset dysphoria).

    I am asking because some of these males seem to adopt a very feminine style and behaviour (that I have heard being referred to as a “pornified” look): lots and lots of make-up and dyed hair, strong mannerisms, occasionally choice of a new name that is reminiscent of a porn star’s… And they seem to have a strong taste in receiving sexual attention from straight men (hence my question about a form of autogynephilia). I have a few examples in mind of such persons if you want.

    I would be interested to hear what you think about this.

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    • Maybe jacking the femininity up to 11 is just the most sensible way for them to “become more attractive”? Most can’t “pass” as female in person, but they can work to become very feminine, and there are “straight” men out there who are more attracted to feminine traits than female traits. I think attention from men who identify as straight would be more validating than a bi/gay man since it would be an indicator that they’re “succeeding as being a woman”.

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    • In the years when I interviewed gender-dysphoric patients all the time, I saw exactly one who I thought was truly homosexual and truly autogynephilic, after interviewing him minutely about his sexual experiences and sexual fantasies.

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  20. In my limited experience of ROGD I believe that it is very tempting to look for causes and to say that it is happened to our children because of this or that reason. I believe that the causes that can contribute to it are so huge that it is almost impossible to list them all – it is as if transitioning to the opposite sex is seen by an adolescent as the ultimate re-invention of self. A magic wand that will wave away all their problems. Whilst it is obviously important to study this new phenomenon and look for reasons why it is happening, I think that the most important thing that we can do is to avoid social transition for these children. The child/adolescent needs lots of time, therapy and support to discover what the underlying reasons for these feelings are. This sounds simple enough to do but is near to impossible when the child’s peers, school and therapist all agree to name and pronoun changes. The parents are left to feel like the bad guys. Social transition is seen by society as a harmless issue. However, social transition for ROGD does not allow the child to take a step back from it and see the bigger picture. All these teachers and therapists who think they are ‘doing the right thing’ by supporting the child’s social transition are in fact causing deep harm.

    Liked by 7 people

  21. Thank you for this thoughtful and in-depth article. I work in the medical unit of a correctional facility. In my experience, the care that we provide to inmates claiming to be transgender has been influenced more by activism than science. For instance, we see males with a history of significant psychiatric illnesses making the claim of being women, and what we are supposed to do is follow the Guidelines and Protocols for Trans Care from the Sherbourne Health Centre, which states that the waitlist for gender dysphoria clinics is so long, primary care providers are encouraged to give hormones in advance of a formal diagnosis.

    In no other area of healthcare do we medicate people on the basis of a self-diagnosis. I have seen a few men transition, go on hormones, and even get transferred to the women’s jail, only to remit, and end up back in the male jail. I believe we are not only harming children with the recent trans trend, but also vulnerable people with cluster B type personality disorders who have had difficult lives, perhaps never having received the kind of validation they get from a claim of being transgender.

    I don’t have a question. I just want to thank you for keeping the focus on the kind of evidence-based medicine that seems to be lacking in so much transgender care.

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    • I assume that you are talking about the Sherbourne Health Centre in Toronto. The Rainbow Health consulting group within the Sherbourne instigated Ken Zucker’s firing from CAMH, because Zucker believed that the first approach with prepubertal gender-dysphoric children is to help them accept their anatomic sex. (If the gender dysphoria proved intractable by adolescence, he supported transition and even puberty blockers.) Thus, the only clinic for gender-dysphoric children in Toronto that was staffed by experienced professionals was closed.

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      • Yes I am referring to the Sherbourne Health Centre. The guidelines (page 5, under “Diagnosis”) state that “The provision of hormone therapy is generally preceded by a diagnosis of Gender Dysphoria as outlined in the DSM-V.” But a couple of pages later, it says, “Provision of hormone treatment may be undertaken, in some cases, without definitively establishing a diagnosis of Gender Dysphoria or excluding other possible diagnoses. This is primarily under the rubric of harm reduction; namely, there are situations wherein it would cause harm to the client if treatment were delayed.”

        But if there’s no diagnosis, what are they treating? I trained in harm reduction at the Addiction Research Foundation (now CAMH) in the 1980s, and giving someone without a diagnosis a potent and potentially harmful drug for the patient to take long-term is a misuse of the term “harm reduction” if I ever saw one. Hormones are not inconsequential. We learned from the Women’s Health Initiative study that HRT increased the risks of cardiovascular disease and some cancers in women. The long-term risks of estrogen in males are completely unknown. Furthermore, Health Canada released a safety alert in 2014 stating unequivocally that testosterone products “should not be used by women” due to cardiovascular risks. But the trans guidelines not only have recommendations for testosterone dosing in women, they also state that they are covered by Ontario Drug Benefit under the Exceptional Access Program.

        The trans guidelines state that “The trans population has suffered a great deal of … harm from the medical community…” That might be true, but not in the way they think.

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  22. I have no data, but many anecdotal experiences, to explain the SOGD in young women. One of the current ideological foundations of trans doctrine is that ‘a woman is whoever identifies as a woman.’ Being female, and the social expectations on women, are not a factual state of existence that we enjoy, accept or endure – it’s a feeling and an identity. Young women, especially young lesbians, are exposed to this idea when they are asked to accept trans-identified males. If you mentally accept that complete doctrine (and they are under significant social pressure to do so), you must also ask yourself “well, what’s my gender then? What gender do I feel like?’
    Because gender roles are inherently restrictive, most people feel some discomfort with them to some degree. However, for young women, the odds that they’ve already been exposed to uncomfortable sexual approaches from men, teasing about their developing bodies or even harassment and rape, are relatively high. The experience of becoming a woman is often uncomfortable and frightening. For same-sex attracted young women, homosexuality is inherently gender non-conforming and involves active mental resistance against the expectations of society. When those women ask themselves the question “do you identify with being a woman?” it’s not surprising that the answer is no. But if you aren’t a woman, then what are you?
    Not finding any obvious internal ‘gender identity’, they will look externally for words that describe their feelings in order to construct one. If they are gay, have been abused, or have difficulty parsing gender roles in general (as in autistic teens), they are not going to have much attachment to the traditional gender role of ‘woman’. Trans doctrine provides a language for them. ‘Agender’ and ‘non-binary’ are ways to express a personality that is more complex than traditional femininity and masculinity – virtually every human being would place themselves in these categories if they followed this logic. But rather than seeing this as a normal human state, it’s given a unique gender identity. If your personality falls further on the masculine social role, you might decide you are best described as transmasculine, or even a trans man. It’s literally just trying on an idea and seeing what works for you, since gender is entirely optional and declarative.
    The emotional distress at restrictive gender roles for girls is repackaged into gender dysphoria with a newly minted ‘trans’ identity. The new pronouns you will assume act as a ‘call and response’ interaction with your acquaintances to let you know they support your fully human identity. In this way, the identity is highly social and takes on the aspect of a membership club or religion where everyone can play and everyone has a role to perform.
    These identities help girls navigate their sexuality. If your parents are religious and disapproving of homosexuality, perhaps reframing yourself as a straight man will ‘make sense’ within their framework. Masculine women are often harassed and bullied and feel like a failure at performing femininity. A young girl might hope this discomfort is resolve with transition. Heterosexual women see it as an opportunity to negotiate their interactions with men. If they don’t want the social baggage of being ‘the girl’ in a heterosexual dynamic, they make think that approaching men as a peer, ie. as a man, as a way to change that. A route for young lesbians that promised escape from homophobia a decade ago has been discovered by straight girls as an exit from sexism.
    From where I stand as a gender non-conforming older lesbian, this is unsustainable. This only makes sense to young girls who have mentally accepted the rather incredible assertion that some men are (literally) women, but young girls have terrible personal boundaries and the rest of the world does not. Exerting your ability to be treated as a man (who happens to look like a 18 year old girl with a quirky haircut and men’s clothes) is doomed to failure.
    While the gender labels begin with dissatisfaction at the gender role, it can eventually morph into sex dysphoria when your gender is not ‘respected’ and your interactions are not altered in the desired way. From what I’ve seen, young women who don’t take steps to medically transition (and even some who do) get frustrated by the realities of this process in roughly 5-6 years years when they don’t get the results they want. At that point, they either drop the identity as suddenly as it arrived, or they will start to seek out medical transformations to get the kind of social interactions they are looking for.

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    • The definition of what transgender is has become so wide that anyone and everyone is transgender. Basically anyone who views themself as different, feels uncomfortable with supposed sex roles or has anxiety fits into this new box. Now if it wasn’t leading to cross hormones and surgeries parents could much more easily let it go for kids to figure it out and work though things. But the narrative constantly being pushed is that this is urgent and should be handled medically right away.

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  23. Thank you for this excellent essay and for your research! Let’s hope new standards of care will be put in place for teen girls and young women experimenting with their identities. Let’s stop maiming these girls with testosterone and surgeries.
    Regarding girls, so many of us have lost our daughters to this cult-like trans dogma that they are steeped in. And then we have medical providers and counselors who encourage it all and fuel the disaster.
    The college campuses abound with this thinking, the gender studies programs, the social justice warriors on steroids. I suspect that many of these girls fall high on the SJW scale and have backgrounds similar to what Ingelhart has measured on those who joined the post-materialist movements—except some of our daughters are intrigued by the notions of a post-gender world.

    The kids are not alright. Many of them do have significant mental health problems. They are disaffected with self and society. Some of these girls are moving in a very limited peer group where they have created their own society with seemingly boundless sexualities and gender identities. Not a good recipe for creating stable mental health. Something is amiss in relationships between the sexes. Ironically, these girls who identify as genderfluid theys, or who now call themselves male, have created their own gender binary, the transman phenomenon.
    A social movement should not be given testosterone. Thank you for sharing your research on ROGD. I hope it will change the course of treatment given to these young women.

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  24. Regarding the idea that gender-nonconforming behavior should be discouraged in young kids: Most of us at 4thwavenow have supported our kids in their hair, clothing, and activity choices, no matter how gender-atypical, while (as the authors suggest) kindly but firmly letting them know we don’t believe they are literally the opposite sex. The message is something like, “you can do or wear anything, but you are still a girl. You may just be an unusual girl by societal standards, but that’s great because you’re helping to expand what it means to be a girl.” Some of us bought boxer shorts and “men’s” clothing for our teens, paid for the buzzcut. Supporting gender nonconformity is not the same as helping with a “social transition,” which would mean endorsing/affirming a sex change.

    I would wonder whether very young children, in particular, who were discouraged from defying gender norms, would be MORE likely to conclude they were in the wrong body (and want even more to be treated as such). There are several cases reported in the media of very young boys who prefer dolls and dresses being shamed repeatedly, having trucks and sports pushed on them, who, after a few years, announced they really WERE girls–and then the parents took this as proof their sons were trans! It seems to be that the “drop the barbie” thing could backfire in this way.
    Kai Shappeley punished as child
    Also, we know from a fair bit of research (Melissa Hines‘ work, and others), that adult gays and lesbians often were extremely gender nonconforming in early childhood in their play behaviors, appearance, etc. We (and others, including many adult lesbians and gay men) have raised concerns that over-focusing on gender nonconformity in childhood may be funneling a lot of kids to gender clinics who would likely grow up to be healthy LGB without tampering by gender professionals.

    Young children, because of their immature cognitive development, have very rigid ideas about gender–what boys and girls look like/do. If the parental message is, “No, those are boy toys/haircuts, we won’t support that,” child logic would dictate that the child conclude they really ARE “in the wrong body” because those gender-defiant desires aren’t just going to vanish.

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    • Once upon a time a kid could simply be a kid without labels. I think there was a lot more tolerance for tomboys versus atypical boys (which is not fair). There wasn’t even a designation for ADHD. A kid (generally a boy) might be “squirrelly” but that wasn’t a label or a medical diagnosis.
      Labeling behavior and medicalizing personalities can be harmful.
      I don’t know what the answer is for parents with gender-atypical kids. There are many ways to be a boy or a girl.
      Many of us with daughters who have been snagged by the transgender movement, first had our daughters come out as lesbians.
      Not all lesbians are gender-atypical. Some of us have daughters who were either feminine or “in the middle” decide that a transgender identity is appealing.

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    • There is a difference between discouraging gender nonconformity and discouraging gender dysphoria. The exact boundaries of that difference are difficult to demarcate. We do not mean to discourage the former, only the latter, and only to the extent that parents can have an influence. We suspect that letting a gender dysphoric 6 year old boy change his name from Mark to Lisa is a bad idea if, as we believe, one thinks it would be better for the boy to adjust to his natal sex rather than transition. We think it is a reasonable hypothesis that letting Mark wear stereotypic girls clothes (dress, etc.) may have a similar effect. We don’t claim to know this for sure, and anyone who disagrees with us doesn’t know it either. We can discuss, for sure, and perhaps we will disagree ultimately. But please do not accuse us of anti-gender-nonconformity. We would not recommend making Mark play football, for example. (I’ve had the fantasy that an ideal intervention would be to let Mark spend some time with gay men, who do not tend to have stereotypic male interests and behavior patterns but who also accept their maleness.)

      BTW, I think it is likely that cross-dressing in natal boys is more gender dysphoria encouraging than is a girl wearing pants, etc. Obviously, there is more flexibility in what girls can wear without announcing that they intend to be seen as male.

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      • Thanks for replying and clarifying, Dr. Bailey, because the first part of this excerpt is the one part of your text where I found myself shaking my head in disagreement:

        “You should not allow your child to engage in behaviors such as cross dressing and fantasy play as the other sex. Above all else, you should not let your child socially transition to the other sex.”

        There is a world of difference between a parent affirming that Mark is really Mary and letting Mark wear whatever he wants to wear. I know that not that long ago, a little boy in a princess dress would have garnered more negative reactions than it would now, at least in some circles, and I understand where some of the reluctance to encourage behavior that might lead to negative reactions might come from.

        How can “we” (parents, educators, health professionals) help nudge our culture(s) to be more accepting of gender nonconformity? I want to believe that if we carve out space for “feminine” boys and “masculine” girls, there will be less need for transgender identification. Do you agree?

        Your parenthetical comment “(I’ve had the fantasy that an ideal intervention would be to let Mark spend some time with gay men, who do not tend to have stereotypic male interests and behavior patterns but who also accept their maleness.)” speaks to something I did – I sought out gender nonconforming females, lesbians especially, to spend time with me and my daughter. This was pivotal for her – to see such a wide range of female presentation.

        In talking to other female desisters and detransitioners, I’ve heard a common complaint: there is an absence of strong gender nonconforming females in society/popular culture/fiction/media. More than one young woman has lamented that they thought there were two choices available to them: sexualized girl or trans boy. Sex role stereotypes are profoundly restrictive – how can we best help young people move beyond them?

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    • This is in reply to Brie who wrote: “I found myself shaking my head in disagreement.” Discouraging cross dressing (in child-onset gender dysphoric natal males) was motivated by discussions with Ken Zucker, who knows more than either of us (your daughter didn’t have child-onset gender dysphoria). On the one hand, I’m not sure that recommendation is right. On the other hand, you can’t be sure it’s wrong. Ken thinks that little boys who want to wear dresses are likely gender dysphoric, and furthermore, that children are not good at the nuance adults are about “being a boy but pretending to be a girl” etc. This seems reasonable to me, but maybe it’s not correct. The fact is we don’t, and can’t, know. Humility is called for (and I acknowledge there’s a lot that I don’t know, and I have studied this as much as almost anybody). But I think that the reaction against the “no Barbies and dresses for gender dysphoric boys” recommendation is knee jerk progressivism. On what basis could anyone be so certain it’s fine for gender dysphoric boys to cross dress whenever they want? I’m happy with Barbies and dresses if they don’t markedly increase the likelihood of transition. But someone with vastly more experience than I (and you–remember, you daughter isn’t child-onset) have thinks these things may in fact increase the likelihood. I think it’s fine to be skeptical, but I don’t understand thinking it’s intolerant, etc. Ken Zucker is not against gender nonconformity.

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      • I appreciate that there needs to be more nuance around “drop the Barbie” both as a practice and

        You’re right that my daughter’s *dysphoria* wasn’t child-onset. Dysphoria set in when she realized she was on the cusp of puberty. Prior to that awareness, she fit all other criteria mentioned here:

        “Gender nonconformity is a persistent tendency to behave like the other sex in a variety of ways, including preferences of dress and appearance, play style, playmate preferences, and interests and goals. A very gender nonconforming boy may dress up as a girl, play with dolls, dislike rough play, show indifference to team sports or contact sports, prefer girl playmates, try to be around adult women rather than adult men, and be known by other children as a “sissy” (a term generally used to ridicule and shame feminine boys). A very gender nonconforming girl shows an opposite pattern, with the less derogatory word “tomboy” replacing sissy.”

        Which is why, anecdotally, I think it is worth looking for ways to support children’s gender nonconforming behaviors and preferences while also reinforcing ideas that biological sex does not determine anything other than reproductive potential. I think (and maybe I’m giving myself more credit than I deserve) part of the reason my daughter was able to turn away from a trans identity is because I “walked the talk” – she knew I had no gendered (or heterosexual) expectations of her.

        Her presentation and preferences never created power struggles between us – I have some confidence that if they had, she would have been less likely to desist.

        (Some) parents can help their kids avoid crippling/trans-pushing dysphoria if they’re more willing to tolerate divergence from norms and/or ambiguity. If a male child is redirected to “boy” clothes, toys, and playmates, he may also determine that his love of the other (“girl”) things means he must really be a girl.

        “Ken thinks that little boys who want to wear dresses are likely gender dysphoric, and furthermore, that children are not good at the nuance adults are about “being a boy but pretending to be a girl” etc.”

        I’ve met little boys who like dresses because it’s easier to make it to the bathroom on time 😉

        Why does what he’s doing have to be “pretend?” There’s something there that pulls the knot of gender stereotypes tighter, doesn’t it?

        How do we move past that?

        Why can’t a boy do all the “girl” things and still be a boy?

        And yeah, I also understand that this won’t be possible for all kids/all families. I get that for some kids, the best advice may well be “drop the Barbie.”

        “On what basis could anyone be so certain it’s fine for gender dysphoric boys to cross dress whenever they want? I’m happy with Barbies and dresses if they don’t markedly increase the likelihood of transition.”

        Laywomen’s guess: it’s culture. Barbies and dresses reinforce the idea that one is in the wrong body when Barbies and dresses are singularly considered “girl” things.

        Like

      • left out a few words, sorry:

        “I appreciate that there needs to be more nuance around “drop the Barbie” both as a practice and wrt criticism of the practice. Zucker had great success – I’m not questioning that. I’m asking if there’s room (and I think you’re saying there is) to expand recommendations about gender nonconformity in certain families/situations?

        Like

      • Discouraging cross-gender behavior was only half of Zucker’s treatment approach. Equally or more, he stressed encouraging children to play with same-sex peers, to explore games and toys typically associated with their anatomic sex, and to see the positive advantages of their anatomic sex. It was as much a policy of gender-expansion as of gender-limitation. This fact often gets lost in the caricature of his approach as “drop-the-Barbie” by trans activists and by journalists.

        Liked by 2 people

      • Fair enough. But how does this square with the data showing that children who grow up to be healthy LGB adults tend to be “gender nonconforming” as well? Is the theory that kids who express a strong desire to be the opposite sex should be steered toward more gender-typical activities (to help them come to terms with their sex), while kids who aren’t expressing dysphoria should not be so discouraged? Since the data shows even extremely dysphoric kids mostly grow up to be LGB adults, how does this all fit together–especially given that those gender-atypical kids often grow up to be happy gender-atypical adults?

        Liked by 2 people

      • I think this has to do with forming rigid ideas and neuroplasticity after a child has shown some gender dysphoria (GD). A kid who has expressed GD and who limits themselves to the opposite sex’s dress and stereo-typical behavior is teaching the mind that they actually ARE the opposite sex.
        If a child never had GD, then they aren’t at risk for developing the rigid idea that they are trapped in the wrong body.
        As Dr. Bailey stated, it is more about not limiting the child (or allowing the child to limit themselves), but encouraging the child to embrace a variety of behaviors, activities, and peers – to see themselves as more than just a boy or a girl. Possibly even more importantly, is the prevention of the reinforcement of their GD thought patterns and coinciding neuroplastic changes during development.

        Liked by 1 person

    • I cannot speak for the authors (who already have replied, anyway), but I would like to point out that kids being all quite androgynous, gender nonconforming kids are likely to be read as the opposite sex if they wear clothes and haircuts typical of the opposite sex. And if they are easily read as the opposite sex, they might be more likely to secretly socially transition on their own, without telling their parents (it does happen, sometimes). I think it could be why it is not recommended for dysphoric kids.

      Also, I noted that in the article, emphasis was put on cross-dressing and fantasy play: ie. presenting as and/or pretending to be the opposite sex. Maybe that still leaves room for gender nonconforming behaviours, as long as they are clearly done as the kid’s birth sex.

      Liked by 2 people

  25. I have a question for the doctors that I’m not sure if it’ll make sense but it’s something I’ve thought about. Is it possible that some autogeniphillic males, due to a restrictive parenting (for instance, religious biases) when young may have have had signs of on-set gender dysphoria but end up repressing it because of parental correction, which then manifests later in life as autogenyphillia? Or is that just silliness on my part?

    Like

  26. Fascinating article Drs Bailey and Blanchard.

    I had some questions and would be grateful for your response:

    – It would be good to know more about your practical experience of this area. Do you have any clinical experience working with children with gender identity issues?

    – “Our impression is that rapid-onset gender dysphoria is especially common among daughters of parents who read 4thWaveNow as well as those who post on the support board at gendercriticalresources.com”
    Have you considered this might say more about those parents who post on those two sites than their children? Have you considered any risks of grounding your advice at second hand remove, from information supplied by their parents, or other commentators, rather than derived from interactions with the young people involved?

    – “The subculture that fosters ROGD appears to share aspects with cults. These aspects include expectation of absolute ideological agreement, use of very specific jargon, thinking of the world as “us” versus “them” (even more than typical adolescents do), and encouragement to cut off ties with family and friends who are not “with the program.” could these aspects not equally apply to the participants of 4thWaveNow, and gendercriticalresources.com?

    Like

    • Not convinced:

      ““Our impression is that rapid-onset gender dysphoria is especially common among daughters of parents who read 4thWaveNow as well as those who post on the support board at gendercriticalresources.com””

      I think this was an attempt at a joke. Like saying that ROGD is caused by parents reading 4thwavenow (or that they have this in common). Though I’m not sure.

      Like

      • I’m not sure what you’re saying. It’s more that having a child develop ROGD causes parents to read 4thWaveNow. (There aren’t too many other places they can go for information or for interaction with other parents in the same situation.)

        Liked by 5 people

    • Ray Blanchard has extensive experience working with gender dysphoric patients, but he stopped before the ROGD epidemic began. I have never done clinical work (beyond my internship). I think this matters little. We are writing about the science behind gender dysphoria. In theory, it is possible for someone who’s never seen anyone with gender dysphoria (I have seen lots) could get a good handle on the literature. And clinicians who see a lot of patients can believe crazy things (e.g., Olson). “Clinical experience” is vastly overrated as an indicator of useful expertise. (My frequent deferring to Ken Zucker on this basis is not simply about his clinical experience. He has also been the most important scientist in the world concerning gender dysphoria in children and adolescents.)

      Liked by 6 people

  27. It is probably very hard to figure out how or where gender dysphoria arises in any individual. The born in the wrong body narrative is easier and much more palatable for most people to accept and the one pushed relentlessly by trans-activists. I believe that my ex-husband’s sudden change from closet cross-dresser to announcing that he had always been a woman trapped in the wrong body was the only narrative option left open to him.
    We were 17 years old when we met and I didn’t become aware of anything awry until shortly after our engagement some 3 years later. In my naivety I thought a happy marriage would be more satisfying to him than occasionally dressing up in women’s clothes. In fact I couldn’t think of anything more boring than sitting around in a dress doing nothing. Like many women in my position I was blissfully unaware about the obsessive, sexual element to it. Over 30 years of marriage I saw ups and downs; cycles of purging all the clothes etc only for them to return. I became convinced that he was on the autism spectrum (I still am). I bought Tony Atwood’s book and tried to discuss his difficulties with him, but he didn’t want to know. Now that I know about autogynephilia I see it as an obsession which leads to a mid-life crisis in many men like my ex. It was, and still is, his coping mechanism, but, like any addict, he needed a bigger fix each time. He needed other people to take part in his fantasy and once he had psychologists and hospital’s giving him the green light there was no turning back; the autogynephilia had won.
    Professor Bailey, I know that you are sympathetic to the experience of women in my position. I followed Christine Benvenuto’s blog and saw how you were hounded for your opinions even there. As a result of my experiences; the personality changes I witnessed in my ex and the emotional abuse I endured once it became clear that I was not on board, I needed to see a therapist for the first time in my life. The thing that made the most sense to me was at the end of one session when she said to me that my husband had ticked all the boxes for Narcissistic Personality Disorder. Researching NPD was areal light bulb moment. Autogynephilia, coupled with a sense of shame and a strong sense of entitlement in an individual who has zero empathy for any one who stands in his way is a ticking time bomb. These men are used to male privilege and, as you know, they are not going to give that up.
    So we are left with a medical profession whose only remedy is to give these men what they want. In order to do that everyone around them has to enter into their fantasy. Those of us who question their narratives have to be silenced; families are torn apart, women’s rights undermined, language no longer means anything, laws are rewritten, but, most shamefully of all, young gender non-conforming children are soaking up the trans propaganda and being celebrated for changing pronouns and sadly, in some cases, permanently altering their bodies
    I know that you have spoken out in the past, but where do you see this all heading? Hopefully before all the law-suits start accumulating.

    Liked by 5 people

    • I am sorry for your experience with your husband. Several well-known autogynephilic persons who transitioned to the female role (with surgery) appear to be incredibly narcissistic. This includes Benvenuto’s ex-husband. I do not think this is a feature of autogynephilia, but perhaps of men who put their own feelings so much higher than those of their families. This will cause a correlation between autogynephilic transsexualism and narcissism. Also, you mention “midlife crisis” and I think that transition in the married autogynephilic man is quite akin to deciding to leave one’s family for another woman. Narcissists are more likely to do this.

      It is hard to know what the best world would look like with respect to males with autogynephilia. I suspect many who marry should never have done so. This would decrease the rate of bad family outcomes. Perhaps some who transition are making a mistake as well. (They do have slightly higher rates of regrets.)

      I don’t think lawsuits will be very relevant with respect to adult males with autogynephilia. Perhaps adolescents with ROGD.

      Liked by 3 people

  28. Drs. First thank you so very much for acknowledging the different types of gender dysphoria. My question is how did the affirmative approach become so widely accepted by professionals? You say it is the mind set of a tiny minority and not all or most in the medical field. Yet my daughter who is a young adult has been blindly affirmed by four different mental health professionals. My child showed no signs of gender dysphoria until the age of 18 and in a peer group that was also coming out as trans. Any advice for parents of young adults (whom we have no rights to medical decisions). My daughter refuses to participate in any dialogue about any of this with me. We always had a good and open relationship in the past. I did send my kids therapist this article but I have very little faith that this will even be considered in a therapy session. I have begged for different perspectives and information to be shown to my child in order for her to be truly informed . It’s like waiting for your child to crash and not having any control over any of it. My child’s life has not improved one iota since socially or medically transitioning. She is stuck and no one can help. Because she has been unquestionably affirmed in her identity by professionals she has dug her heels in even more firmly because I’m just her mom. My heart breaks for my kid and I have had no choice but to drop any discussion about gender because it was driving a serious wedge between us and I don’t want to lose her.

    Liked by 5 people

    • I don’t know where we said that the current trends are a mindset of a “tiny” minority. Would that were true.

      I’m very sorry for you and your daughter.

      Liked by 2 people

      • It was not you. It was here…
        Ray Blanchard
        on December 7, 2017 at 5:38 pm said:
        I understand your frustration. It’s not the medical professional as a whole that is promoting early gender transition for children; it’s a tiny subset of self-selected practitioners.

        Like

  29. Thank you for this fabulous, groundbreaking report!

    If possible can you please help parents with this follow-up issue:

    How to communicate with teens/young adults who have traits of BPD/ASD?

    It seems (from talking to parents) that our kids are impossible to talk to, live in their own heads, and often deny that they have any MH issues (despite official diagnosis).

    So how do we stop them from accelerating their transition, when they cling to their trans identity and believe that life will be wonderful and perfect once they have deep voices and no breasts?

    Thank you.

    Liked by 2 people

    • From the article:

      From Refusal to Reconciliation: Family Relationships After an Accusation Based on Recovered Memories

      by Paul R. McHugh et al.

      In following families who reported to the False Memory Foundation between 1992 and 2001 that a member had charged them with incest, a survey questionnaire (with a 42% return rate) was sent to some 4,400 families. These data demonstrate that 99% of these accusers were white, 93% were female, 77% were graduates, 86% were in psychotherapy, and 82% accused their father. Such accusations were rare events before 1985 but then grew exponentially in frequency, peaking in the 2-year period from 1991 to 1992, with 579 accusations. Thereafter, such accusations steadily declined so that in 1999 and 2000, only 36 accusations occurred. The accusers can be differentiated in the manner with which they reconciled with the situation: 56% refused all family contact, 36% returned but did not discuss the accusation, and 8% retracted completely. These data give evidence of a time-limited craze of therapy-induced incest accusations that has now dissipated.

      Like

  30. I apologize. I must have misunderstood . My daughters psychiatrist was very open to my viewpoint but she only saw him briefly. He was the only one who seemed to truly listen to my viewpoint and try to make sense of the situation. Her ongoing therapist is very kind and my daughter trusts her but unless different perspectives are being presented I feel like she is just placing a bandaid on a gaping wound. Any way I truly do appreciate your article.

    Like

  31. My daughter is positive she is transgender based on online information (I suspect Reddit is one of them) and then was affirmed by two different school psychologists. On another planet, those same school psychologists could also have told her at that critical time that, no, she is actually one of the females that simply doesn’t care for usual girl pursuits, but that doesn’t make her a candidate for transsexual treatment with cross-sex hormones, she is totally awesome as she is, that her body is a gift and she should care for it and live a healthy, productive life. Dream on…..there is not another planet to move to.

    This whole identity-based transgender has swept across school campuses. Any chance of you giving a presentation at conferences of school counselors?

    Liked by 4 people

  32. My 20 year old daughter (bipolar, ADHD, serious anxiety issues) turned to ROGD after immersion in an affirming college environment and LOTS of time online (YouTube, Tumblr, reddit, etc.). She has a therapist who agrees with me that no way is she really transgender and she should not take testosterone, but even in our conservative area he cannot advise her accordingly because his license would be at risk.

    So how in the world can this tide ever be stemmed if even the “good guys” are muzzled??

    Liked by 4 people

  33. Another question…wondering about females over the years….I’d rather not mention names…. who have decided post-puberty to live as men. Based on your categories, they would all be ROGD? I’m guessing more than a few would say their feelings started in childhood and they couldn’t explain those feelings and they weren’t brave enough to act on those feelings until later in life…they would say they are really childhood-onset GD. It would take a good therapist being able to ask questions.

    Also, is there any hope of getting off of self-identification & affirmative-care and back to allowing therapists to ask questions? Where we are now came about so fast and is an excellent example of the Law of Unintended Consequences. For instance, I think everything about my kid’s situation could be explained by ADHD. A good therapist could have helped her understand her anxieties, her friendship issues, her need to fit into a social group.

    Liked by 1 person

    • I feel like this exploded with Leelah Alcorn’s manifesto suicide where parents and therapies were blamed. Additionally the data on transgender suicide is not pristine as it is presented. What is the data of suicide attempts for all people with depression or anxiety or both or BPD or all. What is the data for homosexual groups? What if you consider prostitution as well… comparing all this before transition and then after transition. There is so much more to be considered before saying that transgenderism is exclusively what leads to suicide attempts.

      Liked by 2 people

  34. It’s logical that heterosexual young women with ROGD may first romanticize, then sexualize, GAY MALE RELATIONSHIPS.

    Oppressive gender stereotypes / roles DON’T APPLY to gay couples. And same sex marriage seems to offer the EQUALITY AND MUTUAL RESPECT between partners that we all want and deserve. Our girls are no different!

    ROGD girls would probably benefit from their parents modeling a thriving heterosexual relationship in which both parents are EQUAL and RESPECTED, gender stereotypes and behaviors are recognized and challenged, etc. I realize how difficult this can be with the stress brought on by having a ROGD child!

    ——-

    Let’s be real. We live in a society rooted in PATRIARCHY. Our girls are being raised in a culture which constantly transmits messages – both subtle and obvious – about how men and women “should” look, act, and behave. Gendered appearances and behaviors aren’t innate- they are taught and learned. Girls receive messages through their lived experience (via their educations, family structures, religions, etc, as well as media) that men are in charge, autonomous, wise, capable… and women are subservient, sexual objects, sacrificing, emotional, helpless. For girls raised in traditional / conservative / religious households, these messages are enforced at home daily. (Girls! Help mom in the kitchen while the men watch the game. Dad always has the final word, and “Father” serves the eucharist.) Let’s not exclude the huge issue of the sexualization of women and girls, which co-stems from patriarchy and porn.

    Is it surprising that under these conditions, some girls reject “femininity” (a creation of patriarchy, designed to please men), disassociate from their femaleness and develop body dysphoria? (Typically focused on their breasts, which “mark them as female.”)

    Once the transgender activism reaches them, via the media (ie the media blitz over Bruce/ Caitlyn Jenner) or through the schools (ie “gender is a spectrum” talks), a girl learns that she may in fact actually “be a man” if she is a “failure” at, or doesn’t wish to perform, femininity, isn’t happy with second class status, doesn’t like being sexualized, fears being sexually harassed and / or raped, wants to be treated as an equal with her male friends / love interests, or is uncomfortable with her female body (which is what BRINGS THAT ALL ON, because we are living in a PATRIARCHAL CULTURE.)

    ——

    Our adolescent daughters are trying to find / make a place for themselves in the world. Many have low thresholds for pain, emotion, suffering. Adopting a trans identity could be a maladaptive coping mechanism for their struggles. (Collectively we have noted that our children went through periods of depression, social / general anxiety, social isolation, stress from ASC, etc prior to online trans indoctrination, resulting in sudden ”trans” identities.

    The “wrong body” narrative gives them a framework to explain all of their unhappiness, as well as a route to a better life (“Transition! And do it right away or else you will kill yourself!”) They don’t realize that none of those issues will be magically cured by a social – or medical – transition. A host of new problems will ensue. They will have to battle constant anxiety over passing. They will have to rigidly police every item of clothing, their grooming, body language, demeanor, voice and presentation every moment in order to be seen as “authentic”. (The irony of this!) Stressful situations will occur daily in whatever locker rooms and bathrooms they use (male or female!) as well as at doctor visits, work, school, etc. They will have to live with the constant fear of being “outed” in pretty much every situation. Dating will be a challenge, to say the least, if they won’t (or can’t) accept their bodies, and their natal sex. And I don’t even need to mention the significant health risks of testosterone and surgery, if they make those choices. This is a HARD PATH, and not one that is NECESSARY for these girls. If they can the mountain through the trees, recognize the hypocrisy and reject it, they can save themselves. This may be particularly difficult for girls with rigid thinking and / or ASC.

    Those that find their way home, the “desisters”, are some of the most powerful and wise voices of all in this debate. They expose the transgender contagion for what truly is… a major setback for the rights of women, harmful to the health and wellbeing of our children, totally regressive in that it enforces the gender stereotypes / roles which we need to destroy, a product of our pharmaceutical / capitalistic culture, and an opportunity for the mega rich (George Soros, Jon Stryker, Jennifer Natalya Pritzker, etc) to buy influence over our thoughts, our policies, and even our bodies. Gender-critical trans women are popping up and speaking out against all the madness. Parents of suddenly trans-identified teens are fighting against the trans-machine. Some journalists are starting to challenge transgender ideology. The wheels of change are churning. Let’s pray that our children get through these tough times. Let’s not cave to pressure from transgender activism that has infiltrated our culture to socially and medically transition our daughters!

    “Not all those who wander are lost”
    a line from the poem “All that is gold does not glitter”, written by J. R. R. Tolkien
    for The Lord of the Rings

    Dr.s Bailey and Blanchard , thank you so much for this information. Please let us know if you will be publishing it in a more neutral, scientific setting so that we can refer our children, medical professionals, educators, etc to it.

    Liked by 5 people

    • I am not a parent of a child with any type of gender dysphoria, but from what I’ve read in comments on this site and from what I’ve seen in my own life, a lot of ROGD girls are not from families that adhere to strict gender roles. The ROGD girls and young women I’ve personally met in my life were from families that sent them to all-female schools – at the high school and college level – that prided themselves on developing smart, strong young women and had a decidedly feminist bent.

      I don’t know how much of a factor religion is here. I don’t know why you decided to cite Catholicism in general, but as a lifelong Catholic with a large extended family (by blood and by marriage) of Catholics, who went to school with other Catholics, I personally don’t know ANY Catholic families like the ones you describe, in which men are the unquestioned heads of the household while the women run around catering to their whims. Even the Catholic families I’ve known who were pretty traditionally religious, and I’ve met several of those, include women who are attorneys and mechanical engineering students. Their daughters are very outgoing and opinionated. None of these families I know have, as of yet, produced a daughter with ROGD, but I can think of several much more liberal families I know who have.

      Your experiences may differ, but those are mine.

      Liked by 1 person

      • I didnt mean to imply that Catholicism is the problem here, and I only briefly mentioned it anecdotally in my long winded post in the context of patriarchy and how it affects some of our sensitive daughters. “Why can’t women be priests” is a question my daughter asked. She also asked “why can’t women be the heads of households.” I said that they can in many denominations , but not in the catholic faith, and they can in many households.

        I agree with you that most of the ROGD cases I’ve heard about seem to sprout out of pretty liberal and feminist leaning families.

        Liked by 1 person

      • No worries, Concerned Parent. I just felt compelled to say something because I know a lot of girls raised in traditional / conservative / religious families where priests administer the Eucharist, and the thought of them and their mothers stuck in the kitchen while some all-powerful patriarchal father watches TV is so removed from their reality.

        Personally, as a lifelong Catholic and the niece of a now-retired priest, I’ve never understood why anybody, male or female, would want to enter the priesthood. You’re never supposed to have sex or have children, you get stuck living in shabby little rectories on a low salary, you have to deal with the endless problems and petty squabbles of parishioners, your parish probably has financial issues, you don’t even get a built-in community the way nuns do, and people make pedophile jokes about your profession. Fun. I’ve known girls who were opposed on principle to women not being allowed to be Catholic priests, but none of them actually wanted to be priests themselves.

        (Sorry for the thread hijack, 4thwavenow.)

        Liked by 1 person

      • Well I would have to agree with you to some extent. My daughter was in Catholic school until middle school. After that she attended an arts school. Being a teen, being in an environment with almost no social norms, but most importantly being sick for a long period of time allowed her to lose her faith and want to become anything else. This is how she became part of a group.

        It is a cult but is is voluntary. I think that is quite weird that the ideology can have such a strong hold on someone who says they don’t believe in anything.

        Liked by 1 person

    • Wow, that was a lot. I agree and disagree. Patriarchy had been around forever. Women / girls who identify as transgender and many other women are making this much bigger than it should be. Let’s take Harvey Weinstien for example and Me Too. Acting IS a sexist business. I was going to go into modeling many years ago and decided not to because I did not want to be part of those games. The fact that all of these women feel empowered enough to call these men out on their behavior says a lot. Also, Weinstein was an obnoxious bully to everyone, not just women.

      Take “Me Too”. That’s a lot of women speaking up. That can’t be done in so many counties. And what was done when men said “me too”? They were ignored or questioned if perhaps they wanted it!

      One big complaint many of these girls have is the grueling task of shaving their legs and under their arms. Now in other countries girls have to be concerned about female circumcision, being child brides, being raped and beaten. I don’t think our kids have an issue that is worthy of crying about patriarchy.

      What our kids do have though is a world of strangers through the internet. They have pornography through videos and anime. They have chat rooms where dick pics are sent to them at the age of 10 – 12. They have people asking them for nudes before they are out of training bras. These are not things they should be exposed to. Of course they are petrified to “grow up”.

      As adults, we know how to avoid this. We know how to shut this down and report it whereas they are shocked and scared and think this is how life is. I have read my daughter’s tumblr feed. This is what they discuss. And even if she never posted any of this, she was exposed to it. Do these kids ask us if this is normal? No, because when it appears that everyone is okay with it, they feel it is them that is off. Do they stop and realize that nobody in their life does thus stuff?

      We really can’t blame patriarchy for why they process this the way they do. If these inequalities were so severe and were true, no boys would ever want to be girls….in my opinion.

      Liked by 1 person

  35. This article — and the comment section — is very important and validating, but the most important question remains unanswered: what do we do about ROGD? It’s been three long years since my daughter suddenly announced she was trans, and the longer this goes on the closer she gets to medical transition, the harder it will be for her to realize the truth and learn how to accept her body and her sex.

    What do we do when all of the mainstream professional organizations tell their members to affirm children who suddenly announce they are transgender? What do we do when schools invite speakers to promote the trans agenda and change children’s names and pronouns without parental knowledge? What do we do when mainstream media keeps promoting the same transgender child narrative? What do we do when our legal system does not allow therapists to therapeutically question a child because that is not outlawed by anti-conversion therapy laws? What do we do when we can’t even take our child to a doctor because they have all bought into the current narrative? What do we do when universities provide free testosterone and surgery as part of their health care plans?

    I understand that these are rhetorical questions and outside of the scope of your work, Drs. Bailey and Blanchard. I pose them merely to emphasize the plight of us parents.

    However, it seems to me that one small answer is to involve representatives of groups who are disproportionately impacted by ROGD, such as autism and Borderline Personality Disorder. Drs. Bailey and Blanchard, have you spoken to any prominent leaders/researchers in these fields? If so, what was their response? If not, do you have plans to do so? I have reached out directly to many, but am easily dismissed as an anonymous mother. It is professionally negligent for those who work in these fields to be ignorant of the prevalence and seriousness of ROGD. Their involvement in addressing this issue could be powerful.

    Liked by 6 people

    • Yes. This is the plight parents and their kids face. Just as we remain with pseudonames, providers are not coming forward either due to legislation that had been grossly manipulated and media that is SJW driven.

      In speaking openly, we will be rejecting our delicate child, a risk we cannot take. At the same time medical professionals are scared of losing their livelihood.

      Liked by 4 people

    • Well said! It is incredibly sad and frustrating to lose a child and have everyone–from the medical and psychological community to the press, cheering on the wreckage.
      Note to everyone: say something.

      Liked by 1 person

  36. I don’t think we can really determine which kids are susceptible to developing SOGD. I truly believe there are so many reasons this would be appealing to young women today. I do however thing butch girls (lesbian or straight) are the one group that seems most in danger. These girls already have rejected gender roles so they probably don’t see a big stretch in identifying as transmen. I also think (at least for my daughter) they see this as progressive . My daughter has said many times “the world is changing”. It is changing! We are moving backwards and pathologizing gender non conformity. It’s so sad to me that these kids can’t see that. It is heartbreaking that the price these kids who reject gender rigidity will have to pay with their healthy bodies. I know if I could get my kid to listen to me about all of this .. she would see my point. I think that is what scares her so much about allowing any dialogue. Better to stick your fingers in your ear and forge ahead. Very very sad!

    Liked by 4 people

    • Science seems pretty clear now that prenatal testosterone levels have a huge effect on gender nonconformity and sexual (not gender) orientation. My kid was never dysphoric — NEVER — until puberty hit and she was having a tough time socially in high school. But she was always interested in “boy stuff” and still is. For me to force her into some kind of feminine conformity would’ve been cruel, despite her female reproductive system and (presumably) xx chromosomes.

      What is different now is that girls like mine — who have always been around and who once would have undoubtedly matured into lesbian sexual orientation — are being derailed by the idea that if you like “boy stuff” you are supposed to BE a boy, and you should undertake extreme body modification in the effort to make yourself male. This is, of course, futile and … dangerous from a health standpoint. Physical and emotional.

      I hope we get past this sociopolitical mess before she does some irreversible things to her body. So far she’s still slogging along as an extremely nonconforming female, but who knows how long that’s going to last?

      If the whole science around prenatal testosterone were more widely understood, I think society would have an easier time accepting gender nonconforming people without making them feel forced into extreme physical alterations.

      Liked by 3 people

  37. Thank you this is an excellent and informative article. I work in paediatric medicine nothing in our teaching has covered gender dysphoria as multiple distinct disorders.

    Liked by 2 people

  38. I had the most disturbing revelation today that shakes me to my core and drives me further onto the side of everyone here.

    It is well known at this point how toxic the trans community can be, but oh, it can be ever more disturbing (and quite unintentionally so, which is the most tragic part).

    I can only speak for MTF individuals, because they are a group I have a much greater understanding of, given my own background, and from what I gather, the majority of the young people coming out as trans women seem to be single boys and young men, high school to college age, with a vested interest in video games, anime, science fiction/fantasy, etc. (video games being THE greatest love among them all). And what is it that is so appealing about video games? The ability to customize one’s character and to be one’s dream self. Enter the trans phenomenon. These young men are provided the option to customize themselves and become their own dream self, and not only that, this dream self can fill the void of singleness. He won’t need a woman in his life if he can be the woman in his life. And thus these boys adopt personas of these geeky “girls” who are interested in everything they’re interested in and dress exactly how they would want their girlfriends to dress (if they had them). It is not a fantasy played out because these boys want to control women, but more so to compensate for what they lack and perhaps even to remove the burden that male gender expectations have placed upon them.

    But wait, there is the addition of plastic surgery, which so many trans women online love to vlog about and talk up as being the greatest thing ever for them. It takes our crying out against Hollywood’s plastic standard and throws it to the wind. This mentality is so toxic it created a sense of body dysmorphia in me. Suddenly my face wasn’t the “proper shape” for a woman and I wondered if I should have FFS to fix it. But there is no “proper shape” for a woman’s face. There is no “proper shape” for a woman’s body. The New Trans wants to make it seem like there is (how ironic, given this is the same group that wants us to think a penis is female genitalia).

    What a train wreck…

    These boys don’t know what it means to be a woman. They want to claim the identity, but with their privileges intact. But you can’t have the best of both worlds… I am offended by trans women who want to live as weak, passive creatures and prance around in heels and dresses and act like girls, not women, girls… immature, naive, childish. Life as a woman, so far, has taught me that I need strength and confidence and a voice in order to survive. The harassment and the groping is abhorrent and the way some trans women view it as a turn on or thrill is just gross…

    Many of you are correct. These kids don’t want to grow up. HRT is like a second puberty, and thus a second adolescence. They mentally stay teenagers for longer and feel absolved from any responsibility. That is, until the high wears off and they are compelled to face the reality of their decisions.

    How I pray for everyone here, and your children, and the world…

    Liked by 1 person

    • I concur. I once overheard two MTF teens talking on public transportation. They were going on about how the body is just an “avatar” (their term) and there should be no shame in shaming in altering your avatar to reflect your own desires. It was also clear that they were trying to present themselves as nerdy, kinky girls. They were wearing like bondage gear and baggy goth pants.

      It made me really sad because it is normal for people in their age group to be really full of themselves and their own ideas. I think if most of us heard a recording of ourselves talking about politics as 19 or 20 year-olds, it would be just as embarrassing as how these kids were talking. But they are doing more than just saying embarrassing things, they are altering their bodies and changing the legal definition of womanhood.

      Liked by 1 person

    • These young men are provided the option to customize themselves and become their own dream self, and not only that, this dream self can fill the void of singleness. He won’t need a woman in his life if he can be the woman in his life. And thus these boys adopt personas of these geeky “girls” who are interested in everything they’re interested in and dress exactly how they would want their girlfriends to dress (if they had them). It is not a fantasy played out because these boys want to control women, but more so to compensate for what they lack and perhaps even to remove the burden that male gender expectations have placed upon them.

      I had already posted my own belated reply to this thread before I got to your comment, but yes, I think this is absolutely what’s going on in some cases, which is why I’m skeptical of the assumption that ROGD in young straight men is always about autogynephilia as a sexual fetish. My own journey down the trans rabbit hole began when I tried in good faith to be an “ally” to a younger friend’s adult-onset MTF transition; I spent a lot of time reading online trans forums to try and understand what they were going through, and as a former lonely adolescent male geek (who has matured into a happily married middle-aged father of two wonderful kids) this is exactly what I saw.

      Like

  39. I’m a U.K. based physician and greatly welcome this article, as it is the first I have read which makes any attempt to look at evidenced-based causes and outcomes. We accept we need understanding of aetiology and evidence-base for treatment in all other areas of medicine, but in contrast gender-dysphoria is being promoted as a consumer choice and in some cases almost reduced to the equivalence of a fashion statement or cult. Our current Minister of State for legislation in this area wants to ‘de-medicalise’ the wish to change gender (despite the resultant likelihood of the medications/surgeries which may follow) – ie she thinks it should simply be a case of: “I think, therefore I am……..”

    However, I agree it is unhelpful to have fixed expectations and stereotypes of gender conformity wrt behaviours/hobbies/talents. I feel the role of social media has played a massive part in the explosion of ROGD – it will have surely played a huge role in promoting unattainable appearances/identities, while also enabling the contagion of confusion as a solution for the gender-questioning. It has replaced parents as a source of stability/reassurance and encourages peer escalation in biased groups. These ‘freedoms’ come at a price.

    On autogynephilia, if this can be regarded as fetishistic, I share the caution some posters have expressed. Society has no obligation to provide and reinforce sexual thrills to others, even less so to accommodate them by eg sacrificing washroom privacy for young females. I also don’t understand the autogynephiliac’s need to transition, as opposed to transdress and fantasise, or enact in the bedroom. I don’t condemn autogynephilia existing, but is it not reasonable to expect, as with other fetishes, that autogynephilia confines itself to the bedrooms of consenting adults?

    Liked by 2 people

    • Thank you also for being here Splotchy. We need more people in the medical field to speak out about this before our kids are sent down a medical path that they don’t need to travel.

      Liked by 2 people

  40. Thanks for the very informative post. I agree that the ROGD is cult-like and reminds me a lot of cutting actually, which also has a “contagious” element. But there seemed to be a few things missing from the discussion of ROGD. First, I think it is significant that it happens around puberty, and not just because that’s a tumultuous time. This is also the time when girls begin to be under the constant male gaze, w/ honking and comments and butt grabbing, etc. (though some of it starts younger of course). It’s also the time that many lesbians start to realize they’re lesbians or not interested in boys, etc. Combine that with the whole “if you’re unhappy about your body you’re a boy” and lesbophobia and “transmania” along with the cultish nature, then there’s fuel to this “movement.”

    I’m wondering if there are studies showing that the numbers of trans are going up more generally, though. It certainly seems to have “cultish” and “contagious” aspects more generally. Listening to clips of a WPATH conference they certainly talk as if they’re the “in group” (not trans participants, but everyone pushing the agenda) and partake in other religious or cult-like behaviors. Groups that go in and speak to kids and schools that ask pre-teens if they’re comfortable in their gender, and the myriad TV programs and articles, all seem to be pushing the idea that trans should be expanded and more people are trans, etc. That of course is what cults do, they don’t passively collect adherents, they do it actively. I know that in my very limited social and family circles there are more “out” “trans” people than out gays and lesbians. It’s anecdotal, but many others have said the same thing.

    I did find some of the comments very troubling and upsetting. The idea that we should view AGP as a sexual orientation was troubling, and the “I won’t use the word ‘TERF’ but you’re a meanie” was upsetting (“sexual molestation isn’t that bad for the victim” was bizarre & I’m going to try to forget it) for example. I’m curious if the doctors think all paraphilias are sexual orientations, and if not, how that distinction is made. It seems to me that AGP is a fetish: it’s a fantasy, and sometimes the fantasy becomes a delusion (from “I get off on seeing myself as a woman,” to “I get off on [women] seeing me as a woman” to I am a woman” to “I am female.”). Sexual orientation involves relationships: sexual and/or romantic. Not fantasies, not fetishes, not delusions. The issue is that their sexual fantasies are now in public and involve coercing others (particularly women) into these fantasies publicly, their delusions are now touted as science, and those of us who don’t want to partake in random men’s delusions and sexual fantasies/role play are “terfs.” (or no, thank so you very much for eschewing the terf word, we’re just “mean.”) For the record, btw, I have had relationships with two men with AGP (I wouldn’t again for various reasons including political). So I am not saying “eww” or that they’re “perverts” (but definitely fetishists) and unlike BDSM or some other fetishes/sexual practices it doesn’t involve harming anyone if it’s in private, so in private I have no problem with it. But they were both men, not “she,” and I was consenting. And if paraphilias are seen in men, and not in women, then that must be significant in some way.

    But men constantly try to force their sexuality onto women when we aren’t interested. Some men get off on masturbating in public, some men get off on hearing women piss, some men get off on secretly watching women undress. All of those things previously were either illegal, or impossible/difficult, because women had private spaces to piss and undress. Now? We don’t. And yeah, the guy next to me on the subway may be fantasizing about me changing his diaper, but that is fantasy in his head. All that is in addition to women (especially in a certain age group, but before and after too) being catcalled and grabbed and whistled at etc. by other men all day every day. (not to mention rape, DV, murder) AND women previously had safe places to go to get away from men and their fetishes (which generally involve women if they don’t involve only themselves or objects, since most men are heterosexual). Now you’re claiming that paraphilia are sexual orientations (and therefore legally protected which is why not saying “she” is now considered a crime in some places), and while acknowledging that most trans males with AGP are in denial, we as women who are better informed than they are about their own “sexual orientation”, have to partake in both the fantasy and the delusion. Being called “she” is part of the sexual fantasy. I am not going to be part of “Danielle” Muscato’s fantasy. Ever. I’ll go to jail if I must. AND, we, women who live with men forcing their sexuality on us all day every day in public (not just trans males, but it’s why we recognize so well that they’re men) are now “mean” for saying no? Frankly this was more upsetting to read than someone who lies or is in denial or uninformed about the issue and calls us “terf.”

    That’s in addition to all the other ways that the “trans” movement itself is harmful to women and women’s rights and women’s liberation movements. Many so-called “terfs” (or “mean feminists”) probably thought differently previously. We called males “she” and defended them from right wing bigots, etc. But this isn’t just the case of people like Miranda Yardsley and Ann Lawrence, who are not bullies, being unfortunate victims in the war between bullying trans males and “mean” feminists. The very idea that a man can “transition” to being a woman (much less female), and that anyone can “be” a woman (and female) just because they say so is harmful to the goal of women’s liberation: it reifies stereotypes, reifies gender, promotes the idea that vaginas are just places for people to shove things in, obscures the biological realities which are the root of women’s oppression,and supports the idea that men’s sexual life is so important that all women in their path have to partake. Sorry (not), refusing all that is not “mean.”

    I also just don’t see how this is helpful to “trans” males with AGP. If a teenage male is in public eye saying he can get pregnant and is exposed to ridicule (not because feminists are “mean” but because we are being told to shut up so he can talk, and that these fantasies are “science”), how does that help him exactly? Shouldn’t he be taught about his fantasies, and how to separate fantasy from realty? How to have fantasies in the bedroom and in his mind but without forcing women to share them if they don’t want to? (and, as was mentioned to also teach him that “woman” doesn’t mean “feminine,” that’s sexist). It’s like teaching teenage boys with other mental issues that they can masturbate in bedroom but not in public. If I call him “she,” how is he to learn he actually can’t get pregnant like most actual “she’s” can? And if I say “well after an operation, you’ll be a “she” how is that helping him? If his fantasy is to be a “she” and out of “compassion” or “respect” or to not be called “mean,” we call post-ops but not pre-ops “she,” then it seems like it only encourages removal of healthy organs and lifelong medications (and encourages anti-science and delusions, since they don’t actually change sex).

    Liked by 1 person

  41. Hello there, thought I would leave a comment here,

    I’m a detransitioned/re-identified woman from Denmark. I was a tomboy as little, but I do identify with ROGD as I didn’t experience any gender dysphoria until after having identified as trans at the age of 19. Today I am 24. I succeeded in reidentifying just 4 month ago, after having had both diagnosis, surgery and HRT. These stories varies a lot between us, but here is mine, maybe it can be helpful to some of you to get some more understanding of this.

    So, this is my story:
    I had a quite happy childhood. I was always different, partly because I was a tomboy, but probably just as much because I was quite mature for my age. I was very good at school, a “top performer”. I was always two years ahead in math, and when I graduated I received the most significant scholarship one can get in my country for excellent studies. I was also very intensely practicing a sport from the age of 11 – 16. At 16 I became a national champion. Being competitive and among the best was always very important to me.
    When it came to femininity that was always something very uncomfortable. For me being feminine meant to be inferior to boys, and I never felt that was right. I felt fake, and I just didn’t get the point with it… and it didn’t fit my other qualities I thought. Being strong and sporty, being more interested in technical stuff and liking to get in to stuff a lot. I think my strategy to not having to deal with those feelings, of not “getting femininity”, was to get into other stuff, like being good at school or practicing my sport.
    At 16 I got worried a bit though, and I start to adapt to my peers. I would grow my hair, wear makeup sometimes and I found a style that worked. A bit tighter/female clothes, but no skirts or dresses. At 17 I had my first boyfriend and things worked out quite well. He was okey with me being a bit different, and because I trusted him a lot being a little feminine with him wasn’t such a big deal. Ofc there was always something uncomfortable with having to adapt to this woman role, I still felt very different, but it worked out and I was over all happy, most importantly.
    So for a couple of years (16-19) I just felt like this very different kind of woman, and me and my friends/family would always joke about how bad I was at wearing skirts and those kinds of things. It was just a joke, nothing more than that.

    But when I finished school at 19, that’s when everything started. I was suddenly in a very different situation. I had almost had a burnout because of the final exams and having three other jobs/projects outside of school, so I had decided to take a brake, to have a gap year. But when I was suddenly not doing lots of things, I felt like I lost the “doer identity” and I started to feel really bad about myself. I felt worthless and started questioning things, and especially myself. That’s when I found the word “trans” and its meaning.
    And it felt so right. From the moment I started looking at all the Youtube videos I felt something very strong. There I was, represented! Feeling uncomfortable with femininity didn’t mean there was something wrong with me! It just meant that I was trans. And that was fine. I could keep it a secret… just tell the closest. I felt like I started loving myself in a way I hadn’t before, I felt safe in myself and I loved being able to express some masculinity. I had mostly been comfortable with being just GNC, but I discovered that I felt good even performing some masculinity. So, keeping it a secret wouldn’t last for long. I felt so strong for wearing boys clothes, all the time, not just in secret, and it started to feel really wired and awkward when people called me “she”. I mean, now I knew that it was fake. It was a lie. There was something male under my skin.
    I don’t think I ever realized how soon, after having found trans, I identified as something male. The “identification shift” probably happened in just a couple of weeks as I watched A LOT of videos and read tons of blogs. But I had a hard time admitting to myself that I really felt like a guy. Cause there were parts of this that freaked me out too. What did it mean exactly? What would people around me think? So even though I for sure had the picture and the feelings of me being something male I started as presenting as “intergender” – admitting to myself that I was thinking of myself as a guy was too radical/scary, even for myself the first year or so– but looking back now, I know that was what happened from a very early stage.

    First I though that my body wouldn’t really be a problem. Why would it be, when I had been comfortable in my body throughout my whole childhood? I had even taken a national medal in it. And saying that I was intergender to family and friends, and ask them to use they/them pronoun would be just enough, that would make them say “ahaaaaa!” and they would understand and don’t expect med to perform femininity anymore – that felt like one of the ultimate goals. In my head, it was very logical and simple. So it wasn’t supposed to be a big thing.
    But things went so differently. I felt like no one really understood what I was saying, most people would just think it was wired and didn’t get the point with not saying she about me, but “they”. Over time I just felt more and more misunderstood, as my identification grew stronger, and I started to have mental health issues. I didn’t feel safe anymore, my self-esteem (even though still having the feeling of being more true to myself now) had gone down really low and social situations got harder and harder. It was wired. I had always been very outgoing, liking to meet new people, leading conversations and being interested in others. Now I felt alien and angry with my surrounding for not understanding.
    Two years after having identified as trans I started to have serious dysphoria, mostly with my breasts. A little more than a year after that I had gone to a gender clinic, had a diagnosis, and got top surgery. At that point I had been depressed most of the time since identifying as trans. I was desperate, and I know I had thoughts about suicide, without doing any serious attempts. But I would cry a lot, and I would hate myself and the world for being in such a hopeless situation. Half year after surgery I started hormones. My voice would get deeper and it felt right, I was preparing to transition to be a guy.
    But then things changed. It started with a meeting with two other transguys who had transitioned more than 10 years back. I had pictured that they would be happy and satisfied with their bodies and their lives as they had gone through transition and had had time to integrate as men. But the impression I got was the other way around. They both still experienced dysphoria, and both still had serious mental health issues. And they would both warn me to not expect hormones to solve everything. I didn’t think it would, but I really thought it would help me with some of my mental health issues that I though was caused by being perceived wrong. Later I learnt that transition helps being perceived “right”, but suddenly having to integrate to a new social gender group/ role would usually bring other mental issues to many transguys. Especially if they are transitioning as adults. We know we see a guy in the mirror, but we don’t know what it is to be a part of that social group. Some of us based our trans identification in GNC, in not fitting as women, not in the want of having to play another gender role that we don’t know much about.
    So, these meetings would make me start questions things that I hadn’t really done before. And I stopped taking the hormones, I was unsure about whether to continue or not. This happened at the same time as I discovered Alison Bechdel. A famous cartoonist from US, who looks almost like a guy (short haircut and male clothes) but call herself a woman. This was so wired to me. How could she not be trans? And I realized that I identified a lot with her. She is smart and intellectual, she had this masculine style and was just cool about it, and in an article, she also said something about being sure that she would just had gone down that road if trans were something known about when she was young, but today she is glad it wasn’t there because “I really like being this kind of unusual woman. I like making this new space in the world.” She said.

    I think that’s when I really started thinking that things just don’t make sense. Even though family and friends were supportive, even though “I knew” that the type of gender identity I had was the static kind of type, (the type that is developed at the age of 5-6 and then is static through life, as the doctors says) and even though “I knew” that only 0,3 % regret transitioning and I really felt like I would want to kill myself if I didn’t get to transition, something was seriously wrong. It didn’t make sense that I had been quite happy growing up, but since identifying as trans been depressed and even suicidal. It was like I was living a total different life now. And statistically, I had now discovered (supporting what the transguys were saying) that I would be mentally just as bad after transitioning as before. Transition would just help me getting rid of the dysphoria that I didn’t even have growing up!
    And it was when I discovered that the 0,3 number wasn’t correct that I decided to not pursue hormones. (The 0,3 % is in fact representing the number of people reporting back to the gender clinics… and most detransitioner wouldn’t want to do that for understandable reasons). It seemed like that number is much higher, some statistics suggests it’s up to 20 %. But after having decided that, I was more depressed than ever and had severe suicidal thoughts. I had no idea what to do, I just knew that my mental health issues was eventually going to kill me following the patterns from the last four years. I saw no future at all.
    But then, some time during the summer I came across a video on youtube, and I discovered that it_is_actually_possible_to_reidentify. I had NEVER heard about a serious case that was similar to mine before, who succeeded in reidentifying as woman. But now I had discovered Cari Stella, and hearing her talking about her process it was almost like we had lived each other’s lives (this is the video: https://www.youtube.com/watch?v=9L2jyEDwpEw&t=688s ) I couldn’t believe what I saw, but I started to think that it was actually an option to reidentify. At least worth trying. It felt like my last hope, and I hadn’t really anything to lose.
    So I started checking up the detransition community online (a community I didn’t even know existed before discovering Cari Stella) but I would find great support and many others I shared the same story with. It was still so absurd to me that it might be possible, I couldn’t intuitively believe it, but again it was worth a shot, I had nothing to lose.

    The first weeks trying to reidentify felt very contra-intuitive. In what had become an unsafe environment to me, I still felt so much comfort in seeing myself as a guy in the mirror. I felt like I had to leave the only safe thing I knew, the feeling of myself. But I would start carefully by just not coming out to new people I met and as I still passed as a woman most of the time, people would naturally say she about me and I wouldn’t correct. It felt wired for some time, scary, and very unfamiliar, but I persisted (with the support from the detransition community) and I tried really hard to picture myself as a woman. I thought about Alison, and I thought about not picturing myself as feminine. That didn’t work, has never worked, and will never work. But picturing myself as a masculine women turned out to work in the end. Finally I realized there was really a shift in the way that I felt about myself and how I looked at my body. It was chocking, EXTREMELEY chocking, and so strange. But once I had come through the uncomfortable phase of going back to old pronoun, picturing myself very differently and actively focusing on the 10 things that I felt that I and other women had in common and not the 1000 things we don’t, it felt really good. When I felt comfortable in that I almost immediately stopped having social dysphoria, and I felt more okey with my body than I had ever felt over the past four years. Lots of anxiety disappeared and in the end I could even feel empowered “reclaiming she” about myself. Trans had given me hope of being accepted and understood as another gender than the assigned one to me, where I could fit important parts of myself better, but what it had actually done to me was to deprive me the one that could actually give me some respect and security if I only struggled a little, as a GNC person. I wasn’t a fake woman only because I didn’t get the point of performing femininity, I was just different. When I started experiencing the feeling of being cis I would regain a lot of self-esteem in that. And I would start to feel more safe again.

    Don’t get me wrong, it’s only been four months since I called myself a woman again, and it has also been/ still is a very tough process. I feel sorrow for what I’ve lost throughout the years, socially, self-esteem wise, all the mental health issues that I’ve had, and the changes I’ve done to my body, it’s a lot, the least to say. And I deal with lots of shame, I feel ashamed that things got as far as they got, and for the people I’ve hurt when I’ve been the most depressed or desperate. It’s also been socially tough because I’ve had to stop interacting with friends who are trans to not risk making them feel uncomfortable/questioned with me, and also to make the process easier for myself.
    So I still have some more to process and get through before I would say that I’m a whole person again. But one thing I know for sure is that I won’t go back to identify as trans again. Gender has been traumatizing to me. Even though I can still relate to the comforting feeling of seeing me as male, it doesn’t feel like ME anymore, and I know by experience that it is not healthy for me. And I’ve found strategies to deal with that. Most of the time I’m happy considering myself a GNC woman. And I do now, for real, see a future again, that’s something I had a really hard time doing the last two years identifying as trans.

    ******************************************************************

    To sum up, and I guess what is interesting here: What made me identify as trans in the first place?
    I think the following,

    AVERSION TO FEMININITY: I think a fundamental precondition is the aversion / not being able to relate to femininity. I’ve had the same feeling about that since little, and I strongly doubt it will change. I feel comfort in expressing some masculinity or being just GNC. It might be a biological factor.

    Apart from that I think all these other things are potential contributors:

    LOSS OF OTHER IDENTITIES: Since I was norm-breaking in gender expression, and felt like I didn’t have much value in being just me and my gender/my appearance, it was essential for me to have other important identities. Like being an athlete, or the excellent student, or the great co-worker. To some it’s not very healthy when it’s too much of that. For me it was probably a good strategy to get through puberty and school with a good self-esteem. I liked being lots of things that didn’t have to do with my appearance. And I would recommend any trans person to build a strong identity around anything else than body and gender.

    BEING GIFTED / EARLY MATURITY: For me I think it has also contributed that I am so called “highly intelligent” (defined by an IQ test). I qualify for MENSA and I think being different makes it more difficult to identify with your peers. It causes a lot of frustrations and if you don’t feel understood you will start questioning yourself. Teachers were more concerned about making me fit among the others, rather than challenging me with more difficult tasks. That did frustrate me a lot. And as I wrote in the text, I think this also reinforce the feeling of not wanting to be feminine, because it wasn’t logic in my head (if you’re “highly intelligent” you are more likely to make your own conclusions and go your own way, rather than just following the norm) and I felt unsafe seeing myself inferior to boys. I know that’s not solely/ or even essentially what femininity is about, but hearing from other trans guys that’s how some of us learnt to perceive it, maybe in combination with bad leadership from adults in bad school environments, I guess that could be a contributing factor. I know there has been an article on this topic on this blog, I’ll link to it here: https://4thwavenow.com/2017/06/25/gender-dysphoria-and-gifted-children/

    GENDER IS POLITICAL When I was 19 I was too young / unexperienced / not enough educated about feminism and what being a woman is really about. A strong belief that I had was that boys and girls are equal in our societies, and from my perspective it seemed like everyone but me was comfortable in their gender. Therefor it wasn’t more than right that I got to find the gender that was comfortable for me too. Now I know that it’s a fact that more women are more uncomfortable with their gender, and there is such thing as the patriarchy and anything that would threaten their power position will get punished. The GNC/masculine woman is a threat. It’s not strange that a we would feel like we are failed as women not getting any attention and/or respect from boys/men. Gender is political, and therefore not just something to identify with, without expecting any serious consequences.

    LACK OF ROLE MODELS Maybe the most important to me, and what helped me the most in reidentifying (Alison – great example!). Not having any GNC/masculine, heterosexual/bi women as role models made it difficult to picture myself as one. I did not identify as being a butch (even though many though I was one because of prejudices), so that kind of “role” wasn’t really an alternative to me either. I needed to get to know more GNC/masculine heterosexual woman that were just cool with themselves.

    So what do I think could have helped, what would I recommend parents/adults to a GNC child like myself?

    First I think that adult people around me should have better accepted my GNC. My mom has always loved me, but she was concerned about me not being like the other girls. That frustrated me too and made me feel failed. There is no way that any adult can force a child to feel femininity / masculinity. It will only cause bad feelings. The challenge is to fit GNC in a girls/woman’s role. Help the child find others like them. I met many of my friends being a scout, i.e. there were other tomboys there. And also letting the child know that it’s okey to not liking to wear makeup or skirts! Sometimes one has to adjust a little, but those occasions are hopefully few and it’s like that with many things in society. The bottom line is that it is okey to feel that it doesn’t fit you or make you uncomfortable, it doesn’t make you less of a woman.

    I do also think it was a risky project to drop everything after graduation, to just have a gap year as most of my peers. I didn’t enjoy travelling and living student life. I should have kept the things / identities I was good at and appreciated for, too me that was safety (I understand now, looking back). I believe adults can be supportive here in saying that you don’t have to do like everyone else. I was different, so I needed to do what was best for me, not what seemed to be best for girls at my age.

    I think also identifying that I was intelligent, and stimulating/encouraging that from an earlier age could have helped me. It wasn’t until three years ago that I had a test and understood that I have an exceptionally high IQ. Before I just thought that my way of thinking was different, and I happened to be very ambitious at school. But having understood more of this I can see how it did make me feel different/not understood/ frustrated among my peers, and making me question myself. I do also think there is a gender issue here. Boys are more likely to be assessed as gifted, whereas girls are just ambitious. And as a girl you are not really allowed to say, or even think that you are smarter than others. So there has got to be something different/wrong about you.

    Then I think talking about the fact that we still live in unequal societies also could have helped me. I needed to hear from others that being a woman is not always fun. Far from all women (I know this today) are comfortable with femininity and there is also a spectrum! I think most women have sometimes felt like they have to play a role, that it’s not the most natural thing for them to be feminine, but in order to change the roles and be taken seriously one have to “play the game” and not just announce that they give up and flees somewhere else (even though a trans identification very rarely have a political basis like this – just pointing at the absurdness thinking of it like this). It’s all a part of gender mechanism in society that we have once made up, and probably it’s the same for some guys not being comfortable with macho and hyper masculinity. I can now relate to Alison in feeling pride in being a different kind of woman. We need more of those! One can try to see it as a challenge?

    And then one last thing, and I think this might be the one that is the most difficult to understand, the most contra intuitive as a parent maybe, but I know this affected me hugely. If someone says they are transgender and identify as something other than their sex it has got to be taken seriously. And the person itself should not be blamed for having made this “choice” oneself. It is NOT a choice. Let’s be clear about that. To some the transidentification is static, and the only solution is transitioning. To me it was a psychological coping mechanism to better understand why I didn’t fit. Picturing me as male, I was suddenly logic and right. But it’s all subconscious mechanisms that you can’t control yourself. I don’t know how my mind made me see a guy in the mirror even though I still had the curves and the skin of a woman. And no one could have distinguished my feelings of being trans from someone who needed to transition. When I woke up from surgery I would cry for a whole week just because I was so happy, it felt so right then and I would think that NOW people would believe that my feelings were true, that I was truly trans and how serious it was. Too many times had I felt like people didn’t believe me, or wouldn’t take me seriously. That it was a personal choice, or just an expression of a sexuality or even a political view. And it made me feel so misunderstood, angry and most importantly I lost trust and confidence in people not believing me. I know I wouldn’t have listened a second to any of them if they were suggesting that it is something that can change or that it may be at type of coping mechanism that is possible to address. So, step one is to take it very seriously and respect the feeling. It is not something made up. Confirm it and try to understand The Root to the identification instead. Why did it happen? What may it be a response to? And be open to the fact that it may be something that is static. Again, transition may be the right and only solution to some of us. Only with that kind of openness, and understanding I think a transgender person is willing to listen and talk about it.

    Long text, but these are complicated things with no simple answers. I hope it might be helpful to some of you. Again, our stories varies a lot, I don’t think I could say much from my own experience to a young GNC boy, but it might be helpful to a GNC girl who is also intellectually above the average. You are also welcomed to write any questions if you have!

    / E

    Liked by 8 people

    • Mind. Blown. Thank you for taking the time to do this. The writings of detransitioned / reidentified women like you are nothing short of profound. What a contrast with Transgender ideologues. Your story is important. Girls lives are at stake.

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    • Your commemt should be its own article. Thank you for taking the time to write this and being able to be so honest.

      My concern is in what your last paragraph says. I do understand that my daughter is suffering and needs time to figure this out. However, supporting her to travel that path is not something I can do. I cannot support or watch her get a mastectomy or even take testosterone. As a parent I could not purchase opioids to support her addiction and I could not encourage her to have implants put into her (breast, butt, muscle, horns). I’m not able to support her in a direction that is harmful to her. For anyone to think I should, they have no care for my daughter. If this was not a legal option for our youth, then they would have to address the issues that are actually causing the pain.

      What message does it send to someone when they say “I want to cut off my breast” or even “I want to make my breast size H” and family says, yeah you should because I was wondering when you would notice you’re a freak. Because that’s what supporting transition means to me; it means agreeing that is something terribly wrong with their body.

      Obviously I don’t know the right answer that would fix this for my child and protect her from a journey such as this, but we owe it to teens to find the answer.

      Liked by 1 person

      • I understand what you mean. But I’m not saying you need to support her. You just need to confirm what she feels. Because it’s real. I think if you say you don’t get her, or it’s made up or anything like that, she will also feel like you disqualify probably the strongest feeling she has about herself, and it probably has deep roots from other things (like in my case). This is something she feels and probably thinks about constantly, and for a person not having that experience saying it’s stupid or anything like that… We know!!! We know most people around us thinks we are wired and hard to get, but its one of our strongest feelings about who we are and we can’t ignore it or just change it. (Because gender IS one of our, if not the most, strongest identity – whether we like it or not) I think, starting from accepting that your girl see a guy in the mirror and feels like one might make it possible to continue have a more constructive conversation about this.

        If I were the parent, I would focus on statistics that many who are trans – and even gender clinics(!) – don’t know about (and that’s a huge problem in itself).
        For four years I thought:
        1. That gender identity develop at the age of 5-6 and then it is static. Wrong! Were is the evidence for that?
        2. And it is biologically rooted. A little true, but mostly wrong. A follow up on 100 identical twins where at least one in the couple would identify as trans, showed that in 28 cases the other one would identify as trans too. That suggest there is something biological (28 is still much!) but it’s far from 100.
        3. I though the 0,3 % number was correct. And this might be the most serious one. It’s a follow up study made by Dehjne from Sweden and I’ve seen it cited everywhere. Why would you questions a decision where only 3 in 1000 realise it was wrong. Especially when you feel like your life is at stake. Googling a bit more (and I’m sure there has been written stuff on this blog) one will find many other researches that shows a much higher number. And it’s a HUGE difference on 0,3 and 20 %. 20 I think, would make anyone think twice.
        4. I genuinely thought that transition would make my mental health better. But even Dehjnes research shows that it’s the same. And other research shows that the suicide rate for transmen are as high as 46 %! Where do you ever find a number so high?
        5. I trusted the health care more than I should have (because it’s in general quite good in my country). We don’t know much about the risks of HRT. There is not a single one follow up study for more than 25 years with more than 100 transmen. And we already have implications that it can risks causing both cancer and heart disease. It’s absurd! This should be first thing to be informed about at a gender clinic. But it’s not.
        6. I believed in what I saw on youtube. All the fantastic, very moving storries. And I could cry myself because I felt it should have been me. What we don’t see is how they really feel. How are things working socially? When it comes to relationships? Do they speak honestly about everything, is it more about showing the fantastic and quite amazing transformations? Would they dare saying anything about the other difficulties, already feeling questioned for their life changing decision?
        7. I didn’t know about all the stories of old women who say they might had identified as trans as young? Like Alison. And I’ve read many stories like that. Are they all representing a statistics of suicidal rate of 46 % or more? I guess we don’t have any numbers. But most likeley not!
        8. I never thought about trying to reidentifying, because I thought it was the same as reparative therapy. Seeing myself as a woman after having a picture of myself as a guy for over four years, it felt like I would be a total different person. A scary thought. And unsafe. And as a wrote, for a long time I didn’t know about any good example. But just looking at the video I linked would make me think that something I had considered impossible, was in fact possible. That was mind blowing to me.
        9. I thought that gender was very intimately linked to femininity and masculinity. It is not. In some native – not affected by western culture – tribes, like one in North America (don’t remember name) there is a word for being a masculine woman and a word for being a feminine boy, and those are neutral words. Just categories of “gender”. We have a hard time existing because there are no good, or even neutral accepted words for us. But that’s about society and language, and not signs that we were meant to be men.
        10. I though gender was supposed to feel good to everyone. Gender is not fun. No one really thinks so. But having an accepted gender (man /female) as a social group to belong to – whether you feel like you identify with them or not – is essential to your wellbeing and safety. Reading lots of blogs from detransitioned people, this is what causes the loneliness and alienation, and what speeds up dysphoria and make the transgender person desperate. But what exactly are you rushing to? Many transguys also writes/talks about finding it hard to “integrate” as men. So there is nothing there. You get the body you picture yourself in, and you get to express masculinity. But what about the social situation? What about feeling safe? What about relationships? What about your health? I though that transitioning would make me not having to think about gender all the time. I don’t know any transitioned person who don’t still identify as trans.

        Okey, the last one was more of a personal reflection, and that might be difficult saying as a cis-person, if you have not read all the blogs. But everything that is statistics and research based, anyone (respecting the transgender person ofc) should be able to bring up and discuss.

        I really hope you find a way to talk and understand what’s really going on. I agree with you that we owe it to young girls to find better solutions to all of this.

        (Don’t have the time to find all the sources, but I’m sure most of it is linked on this blog! Let me know if there is anything in specific you’re looking for.)
        Also, If the author of this blog would like it to be an article itself I could rewrite a little and try to fix spelling/grammar stuff.

        Liked by 3 people

    • Thank you, ReidentifiedWoman, for sharing your story. Were you provided much counseling prior to surgery? it is so surprising to me how quickly drastic medical treatments are given to young people who can’t possibly have a grasp of all of the complexities of how they feel…no matter how strongly they feel. Also, are you still in Denmark?

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      • Thank you for sharing your story reidentified woman. Please do share it in a main post and don’t edit it too much – it is a moving and authentic story just the way it is (and the word “weird” will always be “wired” in my head from now on!!).

        You make very important points about how powerful gender identity is and how real it was for you. Parents need to remember that and continue to love and support our kids while they work things out (whatever the outcome).

        The medical profession needs to take urgent note that even after 3 or 4 years an individual may not pursue transition and that gatekeeping is their job – their professional obligation – where irreversible medical treatments are involved. Bowing to activist pressure is not what your oath tells you to do.

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      • No I wasn’t. I was asking for it, but I didn’t get more than three meetings with a psychiatrist as most of us do. Because I seem like such an “obvious case” I don’t think they thought they would want to put more resources on me than necessary.
        It’s treacherous, just because I had a strong identification doesn’t mean I’m an obvious case. I felt like that was the only thing they were trying to understand/measure. No one ever even suggested that it could be a response to something else. They were even the ones making the intelligence test, but no comment on that at all…

        Yes I am, but I’m moving to another city in a neighboring country soon.

        Liked by 1 person

      • And to ScaredMum, Thank you. I’m just hoping that writing and talking about my case, putting it here online, will make our stories more accessible and people from both sides (trans identified and skeptical relatives) will get a better understanding of it all. There is so much incorrect information out there, and I think it starts with both “sides” really understanding each others deep feelings about this.

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    • Don’t know if this comment section is still being read, but I realized I wanted to edit/add some things in my text.
      I write a lot “It is not a choice”. What I mean by that is that you can’t chose weather you will get strong feelings watching a youtube transformation video and feel like that could have been you. That, I think you can’t control.

      However, I do think it is a choice, especially in the beginning (I believe it’s more difficult the longer the time goes by)
      – To watch those videos and read all the blogs (if it’s triggering you).
      – To Not look up (non-angled) information from statistics and research, and to chose to Not listen to the skeptical side at all.
      – To take hasty steps. One might feel like doing it, most do. But there is no one saying it’s a good idea to rush it, not even more serious gender pro people. It’s just common sense to not (In fact I might have that to thank that I don’t pass as a guy today).
      – To not listen to any detransition/reidentified person, instead decide that they are all “TERFS” or fake trans.
      – To not find other distractions/identities (as I wrote a little about). One should try to build a strong identity around something else rather than gender and identity, that might help you realize that there are environments /contexts were gender is not that big of a deal and you could stand being seen as just any gender. (This is something that helped me a lot when I finally found the right education for me. It was very technical and I realized that it occupied me / made me feel so good and competent that gender didn’t feel very relevant anymore.)
      – An maybe most importantly: To think that you have to feel like a woman / man in order to be a part of that social group. This is probably more difficult to go against than what we think, cause this is very much how we talk about gender today… what you feel is what you are. Not what’s the safest for you, or what social group you have actually been raised in and learnt to understand, and what will give you the necessary tools/(cis-privileges) to get through life. (Some radfem theories might be helpful here, they base gender on social groups. – Without saying that they are experts on gender in other regards, but I do think they have a point here.)

      Liked by 1 person

      • Re-identified woman – thank you for those additional wise words!
        All those choices you made are choices which come with time and maturity. This is what our teenage children need. Then if they still want to make medical changes after a mature consideration, there is far less risk of regretting.

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      • Reidentified Woman, thank you from the bottom of my heart for your willingness to share your story. I have been following this thread since the original Bailey and Blanchard post went up and find the comments–yours and so many others–incredibly enlightening.

        If I could impose on you with a particular question: My young-adult daughter, who isn’t persuadable by logic or facts at the moment, currently still depends on me and my husband financially to a greater extent than she probably realizes (cell phone, car insurance, cheap rent, etc. etc.) but is wanting to return to college. She hasn’t yet started hormones but might do so any day; certainly she’s eager to do so.

        We are considering explaining that our paying for college, or even just continuing to subsidize her life, is contingent on her hitting the “pause” button when it comes to testosterone. To us, keeping her from that step is critical in order to give her time to mature. (She’s 20.) She’ll perceive that as blackmail, and could very easily go the other way and tell us to keep our money, she’ll go it alone.

        If someone had offered you the equivalent of four years of free college in return for delaying medical transition, would you have taken them up on it? Would that have caused you to think harder at the time, or were you so entrenched (as I fear my daughter is) that the condition would have seemed unreasonable and oppressive?

        Again, thank you for engaging with all of us sorrowing parents.

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      • Hello Worriedmomtoo,
        I’m happy sharing my experience is valued. Hopefully it helps (us all!) getting a little more understanding. I’m still chocked that something I believed in for four years wasn’t what it was.

        To your question. I don’t know your daughter, and I was never really in such situation. I think my parents never had the courage to really question me. They trusted me a lot and they were taught to only support me. (with best intention ofc…). I can only remember one night when we had had a discussion and my mum was finally realizing that I was saying that I’m transsexual. She couldn’t hold her feelings (there was also alcohol involved) and she would get angry, cry and make a scene. From that day we never really spoke about my gender or what I though I wanted to do and so on. I felt that I couldn’t trust her anymore, because of that reaction. I couldn’t understand why she was angry with me. I hadn’t done anything wrong, in my world I was just a victim of this sexist /transphobic world. My thoughts never went that far that I actually reflected upon why my mum (who I’d always trusted before) had felt so strong about this.
        I think, If my mum would have proposed such deal I’m not sure I would have accepted it. I think I might would have considered it… but I doubt it would have made me think harder. I also think
        1. To me it would also had been a question about independence (I don’t know about your daughter here, maybe we’re different) but I would not have been comfortable being dependent on relatives not supporting my identity and transition.
        2. Even though I would have accepted and then promised to pause for a period, I’m not sure I would have been able to keep it because of desperate feelings that would eventually come to me. And I think that depends a lot on the environment. When I felt that I was not being respected for my identity / being treated like an immature little boy, that would cause a lot of dysphoria, and mental health issues. And I would rush to the gender clinic because I felt like I couldn’t live like that for another day. Maybe if she’s in a more safe/comfortable environment she’ll be able to “control” that better. But it’s a little as RadButch wrote if you scroll up, (I think), being an adult tomboy is a risky project! We believe there shouldn’t be too much of a problem, but most of us either end up transitioning or desisting, it’s not sustainable.

        I don’t know what kind of relationship you have right now, but there is also the risk that if you make it clear to her that you definitely do not support her transitioning, and you get a bad relationship…. The step for her to actually consider detransition, or maybe just desisting if transitioning is really what she is thinking about now, is much bigger. Cause that would send the message that you were right, and that will be tough for her… especially if you also never really confirmed her feeling (and by that I mean, as a wrote in a comment above, you don’t need to say that you support transition, but admitting that you do believe in her that she sees / perceives something very male inside of her (we all know it doesn’t have to be static) ). Because then she will feel like everything that she felt, and what was so real to her was never taken seriously, and didn’t really mean anything, and that’s an awful, undermining feeling. When trans identifying probably is a symptom of something much bigger, feelings of having been “wrong” our whole lives sometimes.
        I can sometimes feel so with the surgery I had. I do regret it today, but I know that it helped me communicate that my experience was real to my surrounding and that was a huge relief / victory to me. Or people would just have thought that I had started acted different, for no reason. And this whole identity thing I was doing, wasn’t really for real. It was just something fun, to provoke a little / a super feminist statement. Not being taken seriously was the worse and did speed up dysphoria to me.

        You said she doesn’t listen to facts. Maybe she doesn’t for a start. And maybe she would never admit that anything coming from you or someone gender critical would be anything she would listen to. But I think that any transgender person getting enough and good resources on this following three would be much more careful about considering transition:
        1. The actual statistics of what the mental health outcome is of transitioning.
        2. The actual number of people regretting
        3. It is actually possible to reidentifying, even though you feel like you’ve had the strongest feeling for years. This one is super counter intuitive, but finding some good stories (maybe like mine… or Cari Stella?) would put a face and a person to it, and that makes it easier to take in.

        Maybe the condition, for you to continuing supporting her, is that she has to find good evidence that transition will make her mental health better, that there are no regretters (or a very, very low number) and that detrans people are fake. You could pretend that you haven’t learnt so much about this (so it doesn’t seem like you know the outcome) and she would take this challenge to prove her point. What she will hopefully discover, doing her research (she thought she would never do, because of everything she hears from trans forums), is the real statistics. And maybe she wouldn’t admit it, but that could be just what’s required for her to start being a little critical. And maybe that’s the difference between rushing to the clinic – and thinking there might be some risks with this, I’ll better do a good, critical research just to rule out the chances that I’m unlucky. And bam, she finds a lot more….

        If she still wants to pursue after that, the odds it’s the right thing for her are a lot higher. I’m convinced that many who transition today are not aware of the reality of those three things I mention.

        Don’t know if this was a helpful answer / what you had hoped for. But I really hope you find a strategy that takes into account both feelings in this, and still enables for you to communicate in a good way. I really hope for the best.

        Like

      • ReidentifiedWoman, I’m not sure I’m replying to the correct post here, but hopefully you’ll see it. First off, I continue to be grateful for your engagement with us parents. I found your answer to my question (about whether you would have been swayed at all by the prospect of being financially cut off) to be really insightful. You’re right, I know, that my daughter isn’t in a position to listen to facts, but I’d never thought about conditioning continued financial support on her doing independent research to “prove” that her mental health would improve by taking hormones.

        Sadly, I learned today that Planned Parenthood has cheerfully agreed to prescribe them for her despite her psychiatric issues, and that she’ll be going in on Monday to be taught how to inject testosterone. But don’t worry, mom, it’s totally safe! I’m so sad and scared for her right now, and can do nothing about it.

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  42. I do find it incredibly ironic that, despite most Western societies having more than a generation of awareness that gender stereotyping is wrong (ie we no longer separate girls for cookery/typing lessons, boys for metalwork/bricklaying, and similar ‘career guidance’), this last decade we seem to have about-turned and more than ever differentiate fashions, styles, behaviours and activities to the extent that some will confidently declare gender preference as though this can be defined. Social media ever heightens this.

    I was born female. However I have no idea whether I ‘feel’ like other females and no interest in whether I ‘feel’ like a male. I just get on with ‘being’. I am confused by the idea that children ‘know’ they are the ‘wrong’ gender – how can they know? It seems entirely likely they are ascenic males or ‘tomboyish’ females, neither of which should be a problem.

    I hope there is more research and more (non-forbidden) debate where we can openly talk about these issues and why they have mushroomed. Understanding is the key to helping, rather than knee jerk affirmation.

    Liked by 2 people

  43. Hi, I am a young adult detransitioned woman who still suffers from gender dysphoria. I probably mostly fit the ROGD profile, however it wasn’t exactly rapid onset…

    I was gender nonconforming since childhood, as puberty approached I got more uncomfortable and basically asked for puberty blockers– I had never heard of them but wanted a med to stop female puberty. In adolescence I was aware of FTMs and though I did not identify as such I did want top surgery and tried to use methods to deepen my voice. I also hated my hips and tried to stop them from growing. I also kind of wanted a penis/strongly hated my vagina since that age, middle school-ish. I was afraid that I would be gatekept from transition, and also did research on FTM bottom surgery and was disappointed, so instead I would watch videos of butch women who had managed to finegle their insurance to get breast reductions, and that appealed to me. I privately thought about changing pronouns in high school as “genderqueer” etc identities were starting to be a little more mainstream but never told anyone about it. I passed as male pretty often. I’ve had sexual experiences with both men and women but my earliest ones were with other girls and I’ve only been romantic with other girls/women, and now identify as a lesbian. I also have a memories from childhood that seem gender dysphoric, like thinking I was half boy/half girl, or of being sad when I realized I would never grow facial hair, but I also suspect that because I fit the ROGD profile in other ways that I may be overvaluing these things. I would say I fit the ROGD profile especially in that my dysphoria from adolescence eventually subsided/went dormant, and then after a traumatic (I know you’re critical of using trauma to explain things but anyway) sexual experience a few years ago my dysphoria returned and was very intense. It was only then that I really started identifying as trans and went quickly into transition (hormones, pursuing surgery, etc.)

    Eventually I became put off by the trans community and started questioning a lot of things, and through listening to “terfs” I heard about other explanations of dysphoria, detransitioners, etc. and decided to give detransition a try

    My problem is, it’s now been about a year since detransitioning, and I’m still dysphoric and depressed. I have a therapist (another ROGD trait, I have a pretty extensive psych history, mostly in late adolescence) and she knows about my feelings about the trans movement and my skepticism about trans medicine and how I want to find other methods to cope with dysphoria. However she doesn’t seem to have much experience with this and hasn’t been much help. I just don’t know what to do. I don’t want to transition because I don’t think I would be satisfied with the results (bottom surgery is just not very good, and my bone structure would still be feminine) and don’t want to be at odds with my body and dependent on hormones for the rest of my life. But I don’t know how to get help for my dysphoria

    Like

    • Hey,

      Glad you’ve decided to detransition. I know other detransitioners who still experience dysphoria, it’s not so uncommon. What helped me was to also work with re-identifying. I’m not non-binary / genderqueer. I belong to the group of females (easier thinking like that rather than saying I’m a woman maybe), and that’s all I have to say about gender, because belonging to either one of the two genders existing today (men /females) is essential for our well being, even though it doesn’t fit how we speak about gender today. At least that’s my conclusion after all years… Do read my story just above if you didn’t see it!
      Also, I can help you get in to detrans community if you haven’t found it yet!

      (also I understand it’s not that easy, environmental factors also plays a role i.e., but I’m hoping you’ll find a way to cope with it. The community helped /helps a lot!)

      Liked by 1 person

    • Hi dysphoricc, are you in contact with the community of detransitioners? They may be able to help you to sort out your feelings and figure out what you need. They’ve all discovered ways of managing dysphoria and they have started sharing them.

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  44. Thank you Doctors Blanchard and Bailey for writing this. I have long thought that the gender affirmative approach to therapy may have been helpful about 15 years ago, but is no longer appropriate or helpful to the many teenagers coming out now. Your essay helped me understand why.

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