Does 4thWaveNow promote conversion therapy?

We oppose any form of therapy that seeks to change a child’s sexual orientation. And we oppose any form of therapy that pushes a child to conform to sex role stereotypes.

However, we are deeply concerned about the impact of recent so-called conversion therapy legislation forbidding careful, nuanced treatment of children and young people with gender dysphoria. This legislation often conflates sexual orientation and gender identity as a single issue. This is not helpful.

Why? Because sexual orientation does not involve drastic, irreversible medical treatment. Gender transition does. In addition, the very existence of detransitioned people who once fervently believed they were trans makes it clear that some people can and do change their minds about their transgender identification. Some detransitioned individuals have themselves stated they received inadequate psychological care prior to medically transitioning.

Transitioning is very different from coming out as gay or lesbian. A person who discovers she is lesbian does not have to take off-label synthetic hormones for the rest of her life. She doesn’t have to have surgery to remove her breasts or to construct something that resembles a penis. She doesn’t have to legally change her name. She doesn’t have to face the prospect of revealing to every would-be sexual partner that her body is not what they may expect it to be.

Undergoing gender transition involves all of these things. These are major challenges. If gender dysphoria is severe and persistent enough, the disadvantages of living with these challenges may be worth it. But we believe that therapy is critical to ensuring that an individual has explored other dysphoria-management strategies and performed a careful cost-benefit analysis to ensure she doesn’t trade one problem for much greater problems. We’ve learned from a number of transgender people that dysphoria, while possibly reduced, is not always eliminated with medical transition. We believe that all people with gender dysphoria deserve more thoughtful and informed mental health care.

This therapy should involve asking an individual to consider why she feels uncomfortable in her body. For example, many individuals have found that their dysphoria sprang up or became stronger following sexual assault or harassment. In these cases, it makes sense to try to therapeutically work through the trauma at the root of their dysphoria before undertaking more drastic, irreversible interventions. For example, in this Economist interview, Rachel (a desister) expresses gratitude that she had a chance to explore underlying reasons for wanting to transition, thus avoiding a life as a permanent medical patient.

Another source of dysphoria may be discomfort with sexual orientation. A person who has been bullied by peers for her sexual orientation or rejected by family may develop dysphoria and a keen desire to transition. (See the March 2018 study in the Journal of Youth and Adolescence.) Therapy that helps this person feel comfortable with her sexual orientation may alleviate her dysphoria and eliminate the need to undergo medical transition.

That’s why it’s critical for children and young people who wish to transition to receive careful therapy that encourages them to explore why they wish to transition and how that transition could affect their lives. Unfortunately, conversion therapy legislation either explicitly or implicitly prohibits this type of self-exploration.

As a result, we believe that many young people will be unprepared for the physical and the emotional challenges they will face after transition and that some of them may come to profoundly regret their transitions.  We know this has already occurred, based on the writings of many detransitioned people.

Isn’t gender or sex dysphoria clear evidence that a person is trans?

Absolutely not. This is one of the most harmful messages disseminated by trans activists. In fact, most human beings probably experience some degree of dysphoria (gender or otherwise) at some point in their lives, particularly when they hit puberty. The word “dysphoria” simply means a state of feeling very unhappy, uneasy, or unsatisfied. Until about 10 years ago, most of us outside the psychiatric profession didn’t know this word, but we have experienced the feelings.

Unfortunately, in recent years, some activist-clinicians have promoted the idea that any dysphoria or discomfort a person may have around his or her sex or gender role is conclusive proof the individual is transgender. This encourages young people to interpret the normal angst and awkwardness of youth—particularly around puberty—as evidence there is something “wrong” with their physical bodies. Also, as even trans activist groups like WPATH acknowledge, most children with gender dysphoria outgrow it—often to become gay or lesbian adults.

So we believe parents and therapists should provide other strategies to help young people manage their dysphoria until it fades or diminishes, or until they are old enough to fully understand the consequences of medical intervention.

Do you oppose providing medical transition even to individuals over the age of 18?

In our society, individuals who are 18 years or older have the legal right to medically transition if they so choose. We do not seek to change this. We believe that adults should have autonomy over their lives.

However, several decades of neuroscientific research have established that the higher functions of the human brain do not reach maturity until around the age of 25; referred to as “executive function,” this includes impulse control, awareness of future consequences, planning, organized decision making, and the capacity to self-reflect . We do believe that healthcare providers owe it to individuals who are less than 25 years of age to carefully assess and counsel them before providing cross-sex hormones and surgery, both of which entail irreversible changes and significant long-term health risks.

What do you say to all the parents who are allowing their children to medically transition? Are they bad parents?

Of course not! They’re trying to do the right thing for their children just as we are. In fact, many of them are desperately sad and anxious about allowing their children’s medical transition, but too many therapists and other authority figures have drilled into them the terrifying idea that allowing their children to transition is the only way to prevent probable suicide. There is no evidence to support this assertion. In addition, nearly all research done on trans suicidality rates is limited to people over age 18, and it is flawed at best.

So is it your belief that all transgender people should return to living as their natal sex?

No. If you are an adult who has chosen to undertake medical intervention to transition and you are happy with your decision to do so, we wish you well. We don’t believe that there is one right answer for everyone; everyone should have the right to self-determination. We simply want to challenge the notion that the only effective way to manage dysphoria is to transition, and we particularly want to challenge this in the context of children and adolescents because of their much greater vulnerability.

Does 4thWaveNow partner with conservative organizations?

No, we do not. Although we provide this website as a source of information and support for people across the political spectrum, we (the founder, spokesperson, and others involved in running this organization) are center- or left-leaning liberals. We support civil rights for all people (no exceptions), marriage equality, and abortion rights.

Because we disagree with the position that many conservative organizations take on these issues, we have chosen to refrain from any alliances with them. In addition, we receive no funding from any organization – conservative or otherwise. We are volunteers who work independently.

However, many organizations and individuals of all political stripes link to our website, Twitter feed, and other resources. We have no objection to this because we want the information we provide to reach as wide an audience as possible. In addition, we are open to debate and discussion with people on all sides of the political spectrum; there are many well-intentioned people we disagree with but whom we may choose to engage in constructive dialogue. This includes not just political conservatives, but trans people, clinicians, politicians, and others who value the free exchange of ideas in good faith.

The mission of 4thWaveNow is to provide a forum for an alternative understanding of how to support children and young people who desire to transition. We believe the medical and psychological establishments are making a grave mistake by rushing to diagnose young people as transgender and then to promote their medical transition.

Although we choose to work independently, we have formed some informal, working relationships with those who have detransitioned or desisted from a trans identity. We greatly value these relationships and are pleased to help support detransitioners and amplify their voices.