Monthly Archives: June 2018

What I wish the Atlantic article hadn’t censored

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by Jenny Cyphers

Jenny Cyphers is a homeschooling parent. She has been writing about that experience for many years, in various online forums. Jenny has been married for 24 yrs to the father of their two children, one adult and one teenager. They all live, work, and create, in Oregon. Jenny and her teen daughter were recently interviewed for an article about gender-dysphoric youth in The Atlantic.

4thWaveNow editorial note: We are grateful for Jesse Singal’s reporting on this complex issue and appreciate that he included the seldom-heard voices of teens who desisted from a trans identity, and their parents, in his article. We are aware that in some circles, the discussions we host on our site are considered transphobic and that we, a loosely-organized group of parents writing on this site, have been defamed as a “hate group” by those on the extreme end of the activist spectrum.

As always, we encourage those interested in the issue to read as widely as possible so they may come to their own conclusions. We contend that by leaving out all mention of 4thWaveNow, The Atlantic not only failed to offer parents the alternative opinions and resources we offer, but they also contributed to an environment that, due to censorship of critical voices, continues to propagate the distorted idea that cautiousness around medical interventions for minors is inherently harmful to trans-identified people in general.

I knew, when I agreed to be interviewed for The Atlantic article “When Children Say They’re Transgender,” that some of my words might be cut, or changed in ways I didn’t intend. But Jesse Singal is a good journalist. He’s personable and honest and willing to take on some really difficult subjects. He digs deep, records, researches, cites sources and ties things together in a nuanced way. Along with editors, he carefully adds and discards words, phrases, sources, quotes, and relevant ideas that lend themselves to the overall picture of what people will read and take away from what they’ve read. That’s what good journalism is.

There are a few things about our story and the way it was presented in The Atlantic that I’d like to clarify. First and foremost, the last-minute editorial decision to unlink the essay “A Careful Step into a Field of Landmines,” I’d written for 4thWaveNow, combined with removal of all mention of the site, needs to be highlighted because in doing so, The Atlantic failed to include important resources created to help parents support their gender dysphoric and nonconforming youth. The result is an article focused on the “situation” of “trans kids” that obscures parent-led examination and support for youth to explore identity without harmful medical interventions, the consequences of which can last a lifetime.

There are more choices for families than to either support their teens’ requests for pharmaceuticals and surgery on the one hand, and disowning or otherwise invalidating their interest in exploring their identity and nonconformity on the other. The Atlantic editors’ choice to remove 4thWaveNow from the discussion in effect denied parents access to important analysis that offers a balanced and middle ground.

Delta pic

The Atlantic photo editor had to dig deep in the several photos we provided to find the pensive one they chose for their article. Here’s one my daughter likes better; she suggested it be included with this post.

Part of my agreeing to contribute to this important debate is helping to create a platform. This website is such a platform. In talking with Jesse, I was upfront about my beliefs, which in part have been informed by 4thWaveNow and the great many array of voices shared here. It isn’t a monolith. Some of us are very liberal, left-leaning people in liberal left-leaning parts of the country, doing liberal left-leaning activities. Some of us are middle-of-the road, a minority of us are conservative, some of us are doctors, therapists, professors, and teachers. Some of us have allowed full social transition to give space to figure things out while still not agreeing to medical transitioning, and some have not. Excluding mention of 4thWaveNow, a site that gets 60K hits a month, fails to tell the whole story. Why do that? Why leave out one of my main sources of information and the ways that information helped me help my child?

Two of the most important aspects of my family’s experience that are not adequately addressed in the Atlantic article, are: 1) my daughter was given a clinical diagnosis of gender dysphoria, so she was just as “truly trans” as the next kid, and 2) it was my insistence that my child wait to medically transition, not her therapist’s. My teen’s therapist, Laura Edwards-Leeper, listened to me and agreed. We were lucky. While there are some cautious, thoughtful providers, the current situation in the US is that there is also no oversight. The most vocal professionals are firmly in the affirmation camp which believes, without any long-term data to validate, that withholding hormonal interventions is tantamount to abuse.

I didn’t know, going into Delta’s first appointment, what the outcome would be. That’s how difficult this is for parents; we have no idea what the outcome will be when we have very “insistent, consistent, and persistent” children requesting immediate medical interventions. It’s a matter of luck to find a therapist who respects parents’ knowledge of their children, who takes parental concerns and insights seriously, and who are not afraid to support slow, cautious progression.

While many transgender activists argue that they understand our children better than we do, there is no evidence to support their claim. Rapid Onset Gender Dysphoria is seen primarily, although not exclusively, in natal females during puberty. It is important to understand that what separates my daughter and many of the kids of 4thWaveNow parents, is this: None of these kids experienced distress over their sexed bodies until they came into contact with the idea that there might be something wrong with them. In other words, the dysphoria is what was “rapid onset,” not necessarily their gender atypicality. These are not kids with “early-onset,” nor do they resemble later in life transitioning people who frequently claim to have always “felt like” a girl but were too afraid or oppressed by family dynamics to admit their feelings. Then, making wide sweeping projections of their own experiences, they mark our children as being in need of the help they believe they should have had. With our kids, as with the group of young people described in Lisa Littman’s survey where ROGD was first named, their dysphoria set in quickly during puberty, often after spending hours online watching/reading others discuss their distress.

Another outlandish claim (made repeatedly by some activists and “affirming” clinicians) is that we simply missed all the signs our children were suffering earlier. I can assure you that, as a homeschooling mom who spent all day every day with my daughter, she never thought she was or wanted to be a boy prior to encountering the idea from transgender kids in her social circle. In fact, between ages 9-11, she was often “misgendered” (referred to as “he” or “him”) and hated it. It saddens me that these activists experienced such awful childhoods. However, their childhoods seem to have been negatively influenced by the religious fundamentalism and/or abusiveness of their parents; their childhoods do not remotely resemble the experiences of my daughter or the many other young people experiencing ROGD whom I’ve met.

atlantic coverTeens and tweens with ROGD often meet all the clinical diagnostic criteria for transitioning. They are often “insistent, persistent, and consistent” for more than six months, or in our case, for two years. Teens with ROGD also typically meet the clinical threshold for gender dysphoria, as mine did. It’s in her medical file. That’s correct, my “never really trans kid” had a clinical diagnosis of gender dysphoria under the DSM-V. This is what we hope others understand: our kids are suffering, they hate their bodies, they want and need help. In many cases, our kids had trouble making friends, experienced some form of earlier trauma, and struggle in other important ways, completely unrelated to gender, that should not be overlooked or seen as secondary to their dysphoria.

I know, because I was in pro-transitioning parent support groups, that parents are going to “gender specialists” and demanding medical interventions for their children without thoroughly considering why their children feel the way they do. I know, because I’ve heard from parents, that some therapists will give the green light to medical pathways without addressing any mental health issues. Dr. Johanna Olson-Kennedy, who treats 900 youth at her LA clinic, is quoted in Singal’s article as saying that she “believes that therapy can be helpful for many TGNC young people, but she opposes mandating mental-health assessments for all kids seeking to transition.” As many 4thWaveNow parents and teens will tell you, this attitude denies young people the opportunity to deeply explore why they want to alter their bodies and shuts down learning about other non-medical means of managing their distress.

When I was approached to do an interview, I needed to carefully consider my motivation for doing so, and if I should agree to discuss my family’s situation at all. Ultimately, I agreed because people need to hear that there are other ways to support trans-identifying kids. Gender dysphoria is very real and it hurts. My child’s life wasn’t easy because of the intense pain of GD. I knew there had to be answers other than what I saw everywhere around me, that suggested agreeing to medical interventions was the loving and kind thing to do, and that these interventions were harmless and helpful. I agreed to be interviewed because I wanted to highlight for other parents that there are other choices: most notably, offering support (buying clothing, getting haircuts, using a new name, finding a decent therapist) while also saying “I don’t think there is anything incongruent about your body/feelings.” The Atlantic axed this part of our story, the part where parents can offer tremendous support for their children without ever setting foot in a gender clinic in search of medical interventions.

I used to be a lot more open to the idea of transitioning children, in part because I know and like many transgender people. It wasn’t until I found that in the US, girls as young as 13 are getting mastectomies, that I began to question gender affirming medicine. In the new genderist language it’s called “chest,” “top,” or “confirmation” surgery. It sounds so much nicer than a double mastectomy, almost positive and pleasant. Cutting healthy body parts off of children should not be a thing. Ever. That was the moment I decided I would never stop talking about this.

My part of the interview with Jesse Singal–although about my daughter–was really more about how to support, in general, a child going through this very difficult experience. It is challenging, if not impossible, to find places to discuss supporting teens as they explore their identity in non-medical ways. 4thWaveNow is the only US-based resource that allows this. We need to talk about how to support gender non-conforming kids; things like buying clothing from the boys’ department if you have a daughter, or buying girl clothing if you have a son. My part of the interview wasn’t aimed at kids, but at parents who really need more and better tools for helping their distressed children than the “transition or die” option. Without choices, how can people really make one? Pick one of the two? No thanks.

Someone asked me the other day why I care. Why can’t I just let people do what they want? The answer is really simple. As humans we are guided to protect our young. If our culture fails to do so, each of us have failed to protect our children. This is why there are laws against abusing children, laws preventing minors from smoking or drinking, laws to keep kids from driving, laws for educating children. We can argue against any one of those things, but the cultural “we” have agreed that this is for the good of protecting children from harm, and for promoting welfare. In the US, unlike in other countries, there are no laws or regulations about transitioning children. Until there are, this is up for debate and I’m weighing in.

The fact that so many parents are left with this narrative that there is only one right way to help a confused kid, is what drives a wedge between the parent and child, leaving children vulnerable to self-proclaimed internet “experts”, like Zinnia Jones, who are more than willing to validate their feelings, further dividing parent and child.

Look, I understand that there are some truly not-very-nice parents out there, but we should not be making policy around them. That’s the sort of thing that creates bad case law. Let’s assume that the vast majority of parents want what’s best for their children, even if they have no idea what that looks like.

I was even more puzzled about the Atlantic‘s last-minute editorial decisions when I saw thaZinnia Jones cheap puberty blockers onlinet, not only was any mention of 4thwavenow scrubbed in the final version of the article, but a statement by Jones and reference to Jones’ website were included. Jones has written multiple screeds denying the existence of the rapid-onset dysphoria in adolescent girls that more and more people (including clinicians) are noticing. Further,  Jones recommends (on Twitter) that young people secretly obtain puberty blockers online if their parents aren’t onboard.

Unfortunately, many therapists, and others invested in the transgender narrative, seem to be heavily influenced by activists like Zack Ford, an opinion writer for the website Think Progress who, in response to Singal’s article, enunciates the activist-notion that parental concern and insight is irrelevant to the discussion. He writes,

“Whether a parent doubts the legitimacy of a child’s transition has zero relevance to whether transitioning is best for their child. Humoring this doubt is exactly what makes the story so harmful.”

Read that quote again. Read it several times to see just how dismissive it is of parents, the very people transgender and gender non-conforming kids rely on for support. You know–the people who would be signing the informed consent paperwork at the doctor’s office, agreeing to allow doctors to prescribe permanent, sometimes sterilizing, experimental off-label use of medications, and body-altering irreversible surgeries.

The collective, cultural “we” cannot dismiss parents as trivial when we are discussing our children, whom we will protect with our lives. This protective mechanism is the prime role of parents and an important part of being human and all the moral and ethical things that come with it. This is not a divide between liberal and conservative. There are too many divisions in this world, and this country, as it is. This is about whether “we” have an ethical imperative to protect our children. Yes, we need to listen to kids. We also need to listen to parents who are not interested in stifling their children’s interests or gender presentation, but who also know their children better than any therapist ever will.

 

Testosterone & young females: What is known about lifelong effects?

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by Kerry Smith, MD

Kerry Smith [a pseudonym], MD, is a board-certified internist in the US who has been practicing since 2004. She is the mother of several children, including a 12-year-old daughter who suddenly developed the notion that she is transgender after being exposed to the idea in her 6th grade classroom. It was this development that led Dr. Smith to research the protocol for medical transition of children. She believes that most physicians are blissfully unaware, as she recently was, of the current standards which aggressively promote unstudied and off-label irreversible medical interventions in children too young to drink, smoke, vote, drive, consent to sex, or even watch an R-rated movie.

Dr. Smith is available to interact in the comments section of her article.

What are the risks of giving testosterone to a female for a lifetime?

As the mother of a girl trying on a trans identity, and as a practicing physician, I need an answer to this question.

I’m not the only one. Every day more of us join this club, as the rate of girls questioning their “gender identity” continues to skyrocket, outstripping boys at a previously unimaginable pace. Surely, those who advocate for the medical interventions known as “transitioning” must have a risk-benefit analysis available for parents and patients, before committing young people to a lifetime of pharmaceutical (and potentially surgical) treatment for a poorly defined psychiatric condition?

As a physician who has sworn to do no harm, that’s what I would have assumed.

As it turns out, the WPATH-inspired standard of care, adopted by the US Endocrine Society, has pushed boldly ahead where no medical society has gone before, promoting radical, irreversible body modifications for adolescents using powerful, off-label hormone regimens in the absence of any longterm data about safety.

They are perfectly open about this choice, stating in the standards:

These recommendations place a high value on avoiding the increasing likelihood of an unsatisfactory physical change when secondary sexual characteristics have become manifest and irreversible, as well as a high value on offering the adolescent the experience of the desired gender. These recommendations place a lower value on avoiding potential harm from early hormone therapy.

I suppose it is considered “transphobic” of parents to persist in the nit-picky demand for actual data about what that “potential harm” might consist of, but so be it. Teenagers have always resisted parental concerns about their risky activities. Last time I checked, that didn’t keep us from trying to stop them from using dangerous drugs. Why should testosterone (a schedule III drug in the same category as Suboxone and ketamine) get a free pass?

Sex hormones have a long and checkered history in the US, having been widely celebrated as the fountain of youth before falling from grace after studies belatedly showed multiple adverse health outcomes. This was most striking when the evidence from huge studies WHI, HERS and HERS II demonstrated that, contrary to what earlier observational studies seemed to show, hormone replacement therapy for postmenopausal women actually increased rather than decreased the risk of heart attack, stroke and cancer.

Testosterone had its day in the sun as well, being prescribed not just for the medical condition of hypogonadism, but gleefully promoted as a panacea for the vitality and wellbeing of aging men, for the supposed diagnosis of “low T.” Recently the serious risks of this approach have been described, including increased heart attack and stroke; the FDA eventually placed a warning on testosterone products, and lawsuits are underway; however the shameless promotion to men continues unabated.

As a physician, my first stop for drug information is usually the evidence-based clinical resource UpToDate, which contains full prescribing information for medications available in the US and Canada including dosing, indications, risks, interactions, and other details. I reviewed the entry on testosterone and found that, to my surprise, there is no mention of any suggested dosing regimens for female to male transsexuals.

In the US, once a drug is FDA approved for one use, it is often used “off-label” for other conditions, which is a generally accepted practice. These common, accepted off-label uses will be listed in resources such as UpToDate along with relevant dosing information and warnings. For example, the entry for modafinil, a stimulant, has dosing information listed for the FDA approved indications of narcolepsy, obstructive sleep apnea, and shift-work sleep disorder, as well as for the off-label indications of ADHD, cancer related fatigue, major depressive disorder, and multiple sclerosis related fatigue.

In contrast, the UpToDate entry for testosterone makes no mention of any approved or off-label use for the treatment of transgenderism or gender dysphoria. The only indication for testosterone in females listed is for the adjuvant treatment of postmenopausal women with metastatic breast cancer.

I then checked the FDA prescribing information for Depo-Testosterone (injection) and Androgel (topical), and found a total lack of any reference to use in females for any purpose whatsoever.

testosterone

Testosterone:  Schedule-III controlled substance. The US FDA doesn’t acknowledge or mention its use, on- or off-label, for FTMs

This absence speaks volumes. While the WPATH Standards of Care would have us believe that “[f]eminizing/masculinizing hormone therapy – the administration of exogenous endocrine agents to induce feminizing or masculinizing changes – is a medically necessary intervention for many transsexual, transgender, and gender nonconforming individuals with gender dysphoria,” the reality is that this treatment is so far out of the mainstream of modern medical standards that it is not yet anywhere reflected in basic prescribing reference materials, even as an off-label use.

Because “transgender medicine” is a new field, there is as yet no meaningful body of data that can definitively answer the question of what risks my daughter might face if she embarks on decades of testosterone injections. Studies promoting this treatment as “safe and effective” are generally limited to a few dozen patients and a year or two of follow up. A review article in the Lancet published in April 2016 touted as providing “an evidence-based overview of the benefits, risks, and effects of testosterone therapy in transgender men” observed that “testosterone decreases HDL cholesterol, increases triglycerides, might increase systolic blood pressure, and might increase the incidence of [type 2] diabetes and metabolic syndrome” but was forced to ultimately conclude that the long term effects are largely unknown due to “a paucity of high-quality data” in this area, a disclaimer found in most articles regarding cross-sex hormone treatment.

The desired effects of testosterone for transgender-identified females are the development of male secondary sex characteristics: hair growth on the face and body, changes in bone structure, increased muscle mass, redistribution/decrease of body fat, deepening of the voice, cessation of menstruation, decreased fertility and clitoral growth are all expected. Of note, even these desired effects may not live up to the hype; clitoral growth can cause pain or numbness and, in some cases, appears to lead to difficulty attaining orgasm; voice changes may not reach the desired pitch, leading some patients to seek out voice deepening surgery; some reports suggest increased muscle mass on a female frame can lead to thoracic outlet syndrome.

Of these effects, the changes to body composition, menstruation and fertility may be reversible (if testosterone is started post-puberty; if administered immediately after puberty blockers, irreversible sterility is the norm). Though testosterone is a known teratogen, there is no shortage of glamorous stories celebrating transmen who manage to conceive and give birth after stopping testosterone. However, changes to voice, bone structure, hair distribution and genitals are usually permanent, even if the hormone is stopped.

Then there are the undesired effects. The most commonly reported one is acne, which is often severe enough to require treatment. Male pattern baldness is also unmasked in those who are genetically predisposed.

More important than cosmetic effects are the changes in markers for cardiovascular disease. Studies tend to show that exogenous testosterone increases LDL (bad cholesterol), lowers HDL (good cholesterol), increases erythrocytes (red blood cells) potentially leading to venous thromboembolism (blood clots) from polycythemia, and increases blood pressure. It has also been shown to increase fluid retention which can contribute to heart failure.

Studies suggest as well that in women (but not men), higher endogenous testosterone levels correlate with insulin resistance and the development of diabetes, and studies suggest that adding testosterone in the form of a drug may increase risk for diabetes.

Even in male patients, studies clearly indicate that testosterone therapy increases the risk of cardiovascular disease including heart attack. One review article notes dryly:

“The effects of testosterone on cardiovascular-related events varied with source of funding. Nevertheless, overall and particularly in trials not funded by the pharmaceutical industry, exogenous testosterone increased the risk of cardiovascular-related events, with corresponding implications for the use of testosterone therapy.” [emphasis added.]

In other words, all studies showed an increase in cardiovascular disease, but this effect was “less prominent” in Big Pharma funded studies. What a surprising coincidence!

Testosterone may cause mood changes. Small studies suggest testosterone treatment in transmen can increase anger, which makes sense, given that abuse of testosterone by bodybuilders is known to sometimes result in “roid rage,” a condition of unchecked anger and aggression. One article reports a case of late onset psychosis associated with testosterone use in a trans-identified female, in whom no other cause could be found.

Testosterone has also been associated with liver damage or tumors, though more often in oral formulations rather than the injectables favored by transgender medicine practitioners. It has been known to impair kidney function. It has been shown to impair mitochondrial function leading to oxidative stress. The list of recommended laboratory tests for monitoring is long.

The effects of testosterone on the ovaries and uterus are not well defined. Early research suggested testosterone administration causes enlarged and cystic ovaries similar to what is seen in polycystic ovary syndrome. While studies in postmenopausal women suggest that testosterone does not stimulate abnormal growth of the endometrium (uterine lining), small studies of young FTM patients suggest that in younger females, testosterone administration does induce proliferative changes in the endometrium, which could theoretically progress to cancer. Cases of ovarian cancer have been noted in females treated with testosterone. These changes to the ovaries and endometrium explain why removal of the uterus and ovaries are often suggested for FTM patients on long term testosterone treatment, though there is no medical consensus on this as there is minimal data.

There is some experience giving testosterone off-label to postmenopausal women for hypoactive sexual desire disorder (HSDD); indeed this treatment is still promoted online and prescribed by some physicians. However, despite promising results for women’s libidos, studies suggest that even low dose testosterone may increase risks for endometrial and breast cancer, and as of yet there is no FDA approval for any form of testosterone for this indication.

So, the state of the art of transgender medicine for a young girl who believes she is a boy is to affirm this belief using hormones and possibly surgery. Current standards promoted by WPATH include puberty suppression using Lupron as young as age 10, followed by cross-sex hormone treatment with testosterone by age 16. It should be noted that in the United States, top gender doctors who see the greatest number of patients often begin cross-sex hormone treatment much earlier (as young as 12 in this recently published study).

We don’t know all the side effects this regimen may produce, but when started before puberty, one effect is certain: permanent sterility.

Aside from that pesky side effect, the expected effects of testosterone treatment include changes in body fat and muscle composition, changes in bone structure, facial/body hair growth and male pattern hair loss, clitoral growth, changes in sexual function, voice deepening, cessation of menstruation, and increased acne.

Likely side effects include adverse changes in cholesterol and blood pressure, leading to increased risk for heart attack and stroke; increased red blood cell mass which increases risks for blood clots; and changes in the ovaries and uterus potentially leading to increased risk of cancer, for which many experts recommend hysterectomy and bilateral salpingo-oophorectomy.

Possible side effects include increased risk of diabetes (another risk factor for heart disease and stroke), possible liver damage, possible kidney damage, risk of mitochondrial damage, and perhaps an increased risk for psychiatric disease.

How significant are these risks? Will they be worth it to a generation of “gender nonconforming” kids as they start their adult lives already committed to a lifetime as chronic medical patients? Will they face premature disability and death?

No one knows. Maybe it will all work out fine. Maybe testosterone really is the fountain of youth, providing strength, energy, vitality and virility to brave young gender outlaws, as they sacrifice their fertility to give birth to their authentic selves with the eager assistance of the medical and pharmaceutical industries.

Maybe.

But medical history is littered with miracle cures gone wrong. Future historians will judge whether the massive increase in girls and young women prescribed testosterone will go down as a triumph of medicine–or an ill-begotten disaster.

 

Why I supported my autistic daughter’s social transition to a man

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by FightingToGetHerBack

FightingToGetHerBack lives in the United States with her husband and 17-year old daughter Zoe. Four years ago, Zoe made the surprise announcement that she was transgender. 

FightingToGetHerBack shares her personal story to illustrate how even smart, educated parents can be emotionally blackmailed into supporting their children’s transition. She is available to interact in the comments section of this post, and can be found on Twitter @FightingToGetHerBack

 For almost a year, I actively supported my daughter’s social transition to appear as a man. I called Zoe by her preferred masculine name and pronouns, and introduced her to others as my son. I was by her side as she marched in a Trans Pride Parade, waving pink and blue flags and dancing to Lady Gaga’s “Born This Way.” I purchased the binder she wore to flatten her breasts.

Outwardly, I appeared as the supportive, loving mother of a transgender child. Inwardly, I was conflicted. Privately, I grieved. Alone, I cried.

As I look back on all I did to affirm Zoe’s mistaken identity as a man, I am mortified.

What caused me to ignore what seems like common sense: that my daughter could not possibly be my son?

Why did I dismiss my initial intuition: that Zoe was caught up in a false identity that was actively promoted at her school and online?

How did I fall for the unsupported scare tactics of “affirmative” gender specialists and the narrative widely promoted by lazy journalism: that Zoe’s mental well-being — and indeed, her life — hinged on my unquestioned support of her sudden self-proclaimed identity as a man?

Like my daughter, I became a victim of transgender ideology: a non-scientific, activist-driven dogma that inexplicably dictates protocol for medical practices, mental health counseling, school policies, media coverage, and an increasing number of laws in the U.S. and abroad.

Let me begin by telling you about Zoe. Throughout her childhood, she preferred feminine clothing and hairstyles, in marked contrast to my own low-maintenance appearance. As a pre-teen, she seemed to embrace the changes brought about by puberty, expressed excitement when her period began, and enjoyed shopping for bras and body-hugging clothes. When she started 7th grade, she begged for permission to shave her legs and wear make-up. Zoe had no stereotypical male interests and shied away from all sports, hating to get dirty or sweaty. There was nothing about her childhood that I would consider boyish, except for one: her difficulty in fitting in with other girls.

Zoe is autistic and highly gifted; socially challenged, yet intellectually precocious. When she was little, she talked to her peers as if they were adults and didn’t understand when they were bored by her academic monologues. Though we invited children to our house for playdates, the invitations were rarely reciprocated. At her annual birthday parties, the other kids ignored her and played mostly with each other. Fortunately, she was oblivious to their social rejection.

But as Zoe grew older, many girls became cliquish and exclusive. They judged each other on their appearances and their fashion choices. They were turned off by my daughter’s social immaturity and her low social status. My intellectual autistic girl had a hard time navigating their complex social cues. She was not aggressively bullied, but she was left out, and she began to realize that she was different.

Around 5th grade, she started to associate more with boys than girls; not because she shared their interests or participated in their rough-and-tumble play, but for their lack of drama. Thankfully, the boys were accepting of her quirky off-putting ways. Hanging out with them was much easier and preferable to being alone. And though the boys accepted her, she still felt disconnected from her peers. “Why doesn’t anyone like me?” she asked me more than once.

So when Zoe suddenly announced that she was transgender at the age of 13, this seemed to come out of nowhere. Zoe was confused, I thought, and had misinterpreted her difficulty in fitting in with the girls as a sign that she was a boy. My disbelief was not a reflexive reaction based on intolerance or prejudice (in fact, I have leaned toward the left side of the political spectrum, and have a career devoted to progressive causes), but based on a lifetime of observations as her attentive mother.

But I was concerned: How could such a smart girl believe she was a boy? What happened to make her believe this so strongly and so suddenly?

I asked Zoe to tell me when it was that she first started thinking she was transgender. She said she got the idea after attending a school presentation. I was appalled. I had no idea this was part of the school curriculum. Zoe also told me about other kids she knew who were transgender. I was stunned to learn that this was so common. Interestingly, all of the “trans” kids that Zoe knew were very similar: highly intelligent and with apparent autistic traits–and with a history of not fitting in.

I asked Zoe, “If you hadn’t known there were other kids who were trans, would you believe you were a boy?” Her answer was telling: “No, because I would not have known it was an option. But I don’t think I am a boy; I am a boy.” She patiently explained to me the differences between gender identity and sex assigned at birth. When I expressed confusion, she told me I wouldn’t understand because I am cis. I had never heard that word before. Clearly, she had been doing some online research.

I began to do some research of my own. But nothing I found confirmed my theory: that my child’s autistic thinking and history of not fitting in made her vulnerable to the false belief that she was transgender. To the contrary, all of my online searches told me that a child’s gender identity was not to be questioned, and that children, no matter their age, know who they are. Still, I held onto my belief that this was likely a phase that would pass.

I decided the best approach was to ignore the gender issue and help Zoe develop her identity based on her interests, not on her feelings. I signed her up for 4H and nature groups. I did everything I could to help her connect to who she really was, and help her find other kids who shared her passions.

isolated girl.jpgOver the course of a year, Zoe’s anger toward me grew. Our once strong, loving relationship deteriorated, and she threatened to leave home many times. She blamed her worsening depression on me and my lack of acceptance of her “true” self. It became clear that this was no simple phase that would fade away on its own, but I didn’t know what to do. Maybe she was really transgender, I wondered. My husband thought Zoe was just being a selfish, belligerent teen. But I decided that I needed someone to help me sort this out, a trained and experienced professional to answer some questions: Is my daughter really transgender? If she is, what should I do? And if she’s not, how do I convince her otherwise? I turned to gender specialists for help.

This was my first big mistake.

I went to the Psychology Today website and contacted ten local therapists who claimed a specialty with transgender issues. After explaining a bit about my daughter’s history, every single therapist responded in a similar manner: “A child would not choose this.” “A child would not make this up.” “Once teens reach puberty, there is no question that their gender identity is set.” They all ignored the fact of Zoe’s autism. “Even autistics know who they are.” They ignored the possibility of social contagion. “It’s becoming more common now because society is more accepting.” They did not see this as a temporary identity crisis, but as an absolute, undeniable truth that was dangerous to question.

Perhaps if I had found just one authoritative professional to confirm my misgivings, I would never have doubted myself.

Instead, I deferred to the apparently unanimous consensus of the experts and decided to work with Dr. Brown [not his real name], a therapist in private practice whose clinical specialties were transgender care and autism, and who was a member of WPATH, an organization that I ignorantly assumed was grounded in a scientifically-based, expert approach to transgender care.

My husband went along with my plan. We both met with Dr. Brown before he met Zoe. Surely, based upon his extensive experience, he could tell us if our daughter was really transgender. After hearing our story, he confirmed that she was. Since it had been over a year since Zoe came out to us, and because she had been “insistent, persistent, and consistent” in her identity, this meant that yes, this was real.

Dr. Brown comforted us by telling us what great parents we were for finding support for our son; that many parents refuse to believe their children are transgender and they become estranged from them. He told us that as a transgender teen, our son is at high risk of suicide and that research shows that the best way to prevent this is parental acceptance. Dr. Brown told us to start slowly by allowing him to transition at home using his preferred name and pronouns, but to wait several months until the summer to start coming out to friends and family, and to wait until the fall to come out at school.

I loved — and love — Zoe unconditionally, fiercely, and deeply. I would do anything to save her life and minimize her suffering. I have always sought the best care for her, no matter the cost. I was — and am — a vulnerable, confused, and scared mother. So I did what Dr. Brown told me I MUST do or my daughter would kill herself. I fell for the “live son” vs “dead daughter” scare tactic.

Though it was hard to hear those words — that my daughter was really transgender and that my actions were critical to preventing her possible suicide —  in a way, it was a relief. Finally, I could stop debating with myself and just work on accepting my daughter as my son. It was easier to put my faith in Dr. Brown and his expertise than to constantly question myself. I rationalized that I had been in denial for the past year, but now I needed to face reality and focus on Zoe’s mental health, our relationship, and keeping her alive.

I began supporting the first step in Zoe’s social transition that evening when I used masculine pronouns and called Zoe by his chosen name, Joe. I told Joe about Dr. Brown and his recommendations. I apologized to Joe for my lack of support over the past year. Joe was overjoyed. Later that night, I sobbed privately while I grieved the loss of my daughter.

Joe started seeing Dr. Brown right away. After each session, Joe did not seem happy or content. He seemed more fixated on transitioning. Despite the original plan to take this slowly, he immediately changed his name and pronouns at school. The school never notified me of this change, nor asked my permission. Since there were already several other “trans” kids at the school, this was seen as a normal request that did not need to involve parents.

Joe’s transition at school, as with the other “trans” students, was met with complete unquestioning acceptance by peers and teachers alike. Trans teens had become so common that no one acted like this was a big deal. And after years of not fitting in, Joe thought he had finally found his tribe.

Though I was upset with the school staff and concerned with how fast things were moving, I said nothing. I needed to support my son and maintain his mental health, so I kept my concerns to myself.

Now that Joe was “out,” I helped with his social transition by taking him to a barber followed by shopping for “boy” clothes. But that wasn’t enough. Joe begged me for a binder. I discussed this with Dr. Brown who told me it was now psychologically necessary for Joe’s social transition to be complete. Dr. Brown assured me that as long as I bought one from a reputable company, there were no dangers. He told me if I didn’t buy one, Joe would just use duct tape, which was very dangerous. Given the alternative, I felt like I had no choice. I complied.

Within one month of seeing Dr. Brown, Joe’s physical transformation was dramatic. His appearance disturbed me in a deep and visceral way. My once curvy 14-year old daughter now resembled a pudgy, unattractive 11-year old boy. I was ashamed of my feelings and felt guilty for caring about his physical appearance. I told myself it was his mental health I should be focused on, but I still found it painful to look at him.

Dr. Brown kept telling me what a good job I was doing, that Joe is so happy now, and that for the first time in his life, he feels like he belongs. Despite Dr. Brown’s assurances of Joe’s happiness, that was not my observation at home. Joe seemed more and more depressed. His periods, which had been non-events until he started seeing the gender therapist, now became a crisis. Joe refused to go to school on those days and became angrier and more depressed. After each step in Joe’s transition process, he became fixated on the next. So after binding his breasts, his new obsession was medically stopping his periods.

During the time that I supported Joe’s social transition, I purposely avoided any news articles on the topic. And when I heard critical voices — which at that time seemed to come only from ultra-conservative gay-bashers  — the unintended consequence of their hurtful words served only to harden my support for my son’s transition and bias my thinking.

As Joe continued to see Dr. Brown, I sensed that his “therapy” was mostly about validating Joe’s conviction that his was trans, while pushing the next step in transitioning. I eavesdropped on one session where I listened to Dr. Brown ask Joe about his week, how much he enjoyed being his authentic self, and about his next plans for transition. I did not hear Dr. Brown ask Joe about his increasing depression, or explore the basis for his growing discomfort with his body.

Despite this, we continued to see Dr. Brown and followed his expert advice. Although I never stopped having fears and doubts, I tried to convince myself that I was just a worried mom lacking objectivity. Meanwhile, my husband was mostly disengaged, refusing to talk with me about my worries, but willing to go along with whatever I decided.

Dr. Brown’s experienced, authoritative, and persuasive voice continued to convince me that my actions were the key to preventing Joe’s suicide. I deferred to his self-proclaimed authority, which was seemingly consistent with the overwhelming majority of the medical and psychological establishment. So when Dr. Brown recommended that I enroll Joe in a therapeutic support group for trans kids, I complied.

This was my second big mistake.

I selected a support group at a well-respected gender clinic, a collaborative practice that included clinicians who specialize in autism, clinical psychology, and adolescent gynecology. Their approach was described as research-based and conservative.

Before Joe started attending the support group, I met privately with the head of the clinic, Dr. Jones, to learn more. He told me that every meeting began with the kids announcing their preferred name, their pronouns, and the gender that they identified with on that particular day. He explained that the goal was to impress upon the kids that their current gender identity was not necessarily fixed. He told me that every child in the group had either been diagnosed with Autism Spectrum Disorder or had symptoms that suggested autism. I was reassured that Joe would fit in well with the other participants.

When I told Dr. Jones that over 5% of the students at Joe’s school thought they were trans, he denied the role of social contagion. He said the increasing numbers were a result of society and schools becoming more tolerant.

I asked Dr. Jones why kids with ASD were more likely to identify as transgender. He told me researchers do not know, but theorized that both transgenderism and ASD were caused by prenatal exposure to an excess of androgens. I asked if gender identity were innate, then why would it appear so suddenly with no signs throughout childhood? Dr. Jones explained that this was probably because ASD prevents children from thinking flexibly about gender until they are older. So although Joe’s gender identity was always that of a boy, Dr. Jones explained, Joe didn’t know his identity until recently because the ASD precluded the flexible thinking required to come to this realization when he was younger.

Privately, I thought all of his explanations seemed far-fetched, but as I had been doing with increasing frequency, I kept my doubts to myself, followed the “expert” advice, and agreed to allow Joe to participate in the program.

The kids in the group had many traits in common besides autism. Their trans identity came on suddenly when they were teens, they seemed really smart, and they were obvious social misfits. All had serious mental health issues. Compared to the other kids, my daughter appeared the most well-adjusted.

Although the clinicians acknowledged that these kids may change their minds, all of the parents were told to put their children on hormone blockers. When I questioned the possibility of side effects, my concerns were arrogantly dismissed. The head clinician told me that blockers were well-studied and perfectly safe, and encouraged me to set up an appointment with the clinic’s gynecologist. He recommended that Joe take blockers for one year, which he euphemistically described as “buying time.” At the end of his year on blockers, Joe would likely be ready to proceed to the next step: testosterone. Unconvinced, I refused to consent.

While Joe was in group, I got to know the other parents. We were all genuinely troubled by our children’s trans identity. We talked about how we lost friends and family members over this issue; how we had become more socially isolated; how our marriages had become strained; how surprised we were when our kids announced they were trans; how there had been no signs of this throughout their childhoods. Like me, these were caring, thoughtful parents who were determined to help their children in any way they could.

Unlike me, all of the other parents consented to medical treatment for their kids. Some were on blockers; others were already on cross-sex hormones. Apparently, I was the only one who had concerns about the medical protocol, and the only one who still harbored doubts about my child’s transgender identity. As the months passed, I felt more disconnected from the other parents. They began to question why I refused medical treatment for my son, told me I was endangering his mental health, and seemed personally offended by my non-compliance. I started to keep my opinions to myself and wondered if there was something wrong with me. Were my doubts and concerns well-founded? Or could I just not accept the reality of having a transgender child? I now believe that if I had met at least one other parent who shared my misgivings, I would have had the courage of my convictions to question the trans narrative much sooner than I did and would have escaped the power of groupthink.

So what finally woke me up? It was when the head of the program, Dr. Jones, the  well-respected “expert” threatened me: “Your choice is between a mental hospital or hormone blockers.” That’s when I finally realized the clinic’s true agenda: not to therapeutically help my child, but to push her on a dangerous path to medically transition under the pretense of it being a psychological necessity.

That night, I turned to the internet to figure out what to do next. That’s when I discovered 4thWaveNow, TransgenderTrend, GenderCriticalDad, and other reasonable gender-critical voices.

I could not stop reading for days. All of my original theories were shared by a group of intelligent, thoughtful, and eloquent parents and therapists.. For the first time since my daughter announced she was my son, I found evidence-based information to support my own ideas. My God, how could I have been so stupid to doubt myself? How did I fall for this? How could I have played along with her ridiculous belief that she is a boy? How did I not see that this sudden increase in trans-identifying teens at her school was part of a psychic epidemic? That these vulnerable children were being medicalized by unscrupulous professionals? That most journalists were singularly focused on portraying transgenderism as a human rights issue, rather than what was obviously a psychological and sociological phenomena?

It has now been over one year since I discovered the online support I needed to realize the truth. But my daughter remains a victim. It is as if she has been brainwashed. And increasingly, it seems as if society has been brainwashed.

Thanks to Zoe’s school, her gender therapists, professional health organizations, the media, and the internet, my daughter is still certain that she is really a boy. She refuses to discuss the topic with me, and refuses to listen to my concerns. She is also convinced that medical transition is necessary for her future happiness, a process she plans to begin when she turns 18 next year. And I will be powerless to stop her.

The only thing I can do is speak the truth and encourage others to do the same.

If you are a doctor or therapist, please don’t reflexively endorse a child’s belief that s/he is the opposite sex. Children need good therapy to explore underlying issues that are likely fueling their discontent.

If you are a member of a professional health organization, please demand that they base their professional guidelines for gender-confused children on science, not politics or ideology. Organizations like the American Academy of Pediatrics, the American Psychological Association, the American Psychiatric Association, and the Endocrine Society will continue to irresponsibly promote ideologically driven protocol as settled science until they are held accountable by their membership.

If you are a college professor, administrator, or counselor: Please speak up about a phenomenon that is becoming increasingly common across college campuses. Although most college students are legal adults, their brains are still developing and they are just as prone to social contagion as young teens. Those with underlying mental issues, often exacerbated by the stress of college life, are especially vulnerable. Many students begin their medical transition services as part of their college health plan — with little or no mental health counseling to explore other underlying factors.

If you are a journalist, please re-think the currently popular mainstream narrative and investigate this issue more deeply. Why are there suddenly so many kids who think they are trapped in the wrong body? Does science really support “an innate gender identity?” Why have the number of gender clinics treating children skyrocketed in the past ten years? What is the source of the millions of dollars that is funding this movement?  Does it really make sense to treat children medically on the basis of a belief which is likely to change over time?

Whoever you are, please speak up. Please help prevent more children’s minds from being poisoned by lies, bodies from being irreversibly altered, and families like mine from being destroyed.