Carol F. is a 39-year old woman (adult human female) from a conservative area in California. She was raised in a religious environment. From ages 35 to 38, she identified as a transgender male and lived her life being perceived as such. The disconnect between her lived experience as female and how she was treated while being seen as male caused her to begin to question the trans narrative. A few months ago, Carol began to detransition, after being on testosterone for almost 4 years and undergoing a bilateral mastectomy.
Carol has spent her time since starting detransition being vocal about how the push for transition harms women and girls, particularly those who do not perform femininity in the “traditional” way. In this essay, she talks about her own transition-detransition process, as well as the often negative impact of the transgender movement on the lesbian community, spouses, and family members.
My decision to detransition began when I started taking antidepressants for depression and anxiety. A month into treatment I felt like my whole world had come alive. I could feel true joy for the first time in years and I could take pleasure in everyday things. I had struggled with being very angry and agitated and often had enraged outbursts over nothing, but it had begun to be less overwhelming and I found I could manage and control my emotions.
I suddenly–and with some horror–realized that I had never needed to transition. My life didn’t feel overwhelming anymore. I could feel my emotions more clearly and sort through what had seemed before to be a complete disaster of thoughts and feelings. I started to question my motives, my perceptions, and my feelings, not only around transition but around all the life decisions I had made. I began asking myself what it would be like to live as a woman again, but I had gone so far with transitioning. How could I admit just a month into taking anti-depressants that I was wrong, how could I turn back? No, I told myself, it couldn’t have been that simple.
We are told that being transgender is this deep-rooted thing, that it is part of our being, our core. It’s who we are, it’s our truth or truest self. I believed this when I started transition, how could this have been so flawed? How could my feelings have been so wrong? I kept these thoughts and feelings to myself and decided I would just continue living as a man, that it was too late to change this. I made my bed now I will lie in it.
I continued living my life as I had. I graduated college that spring and began working in the mental health field. I got a job working at a youth psychiatric hospital. This is when the second realization happened that made me question further being trans and trans ideology. At this hospital I saw so many young gender nonconforming girls come in claiming they were trans men. They wanted to go by male pronouns and male names. They were 13 years old, they were 15, they were 17. They all looked like little butch lesbians to me, and I felt a pang of shame and sadness. I saw myself in them. I saw their pain and fear and the abuse some had experienced. I saw the mental health issues they struggled with and how these issues left them longing for escape. They harmed themselves, they tried to end their lives, and they hurt. I wanted to reach out to them; I wanted to tell them it’s ok to be a lesbian woman. I wanted to show them a strong functioning butch woman. But how could I, when all they could see when they looked at me was a bearded man? How could I tell them what I couldn’t tell myself?
It was at this facility that I also began to work closely with men, something I had never really done before in my life. I had steered clear of being close to men in any way, although I had not realized I had done this; it was all unconscious at the time. Being considered “one of the guys” and having to play that role as much as I could left me with a deep sadness and longing for connection with women again. I knew I didn’t fit in. I hadn’t had a boyhood or been socialized as a male. I had had abuse and discrimination thrown at me just for being born a female, something they could never understand. Socialization makes up much of who we are, dictating the kind of path we are set on at birth. It has expectations and demands; it molds us and forms us in ways we are rarely aware of until you cross over to the other side in a kind of covert way. I often felt like an interloper in the male world–an alien observing private behavior and culture rarely seen by the outside world. This experience of being an intruder or imposter in the male world more than anything informed me that, yes, I was in fact a woman. There was no changing that. In a strange way this experience let me see how much of a woman I am. I had always labored under the impression that I was more male than female because of my mannerisms, likes, and way of dress. However, being on the other side with men solidified the truth that I was female and a woman through and through. My mannerisms, the way I dressed, and all the rest were just window dressing. It didn’t make me woman or a man, it was just me.
Then there were the London lesbians. There was the protest at London Pride where a handful of radical feminist lesbians stepped in front of thousands and made their voices heard. I had been following a well-known transman on social media and he had posted a story from Pink News. The headline went something like “transphobic lesbians storm the parade” or some kind of nonsense like that. I read the story but was a little annoyed because it didn’t say what they were protesting. Just that they were transphobic. I posted on social media asking others why the women had been protesting and what their message was. The response I got was basically “who knows, they are just transphobic and being hateful.” Well, I thought, maybe so but it’s always better to know the full story before making a decision to write people off. I began my internet search, and wouldn’t you know it, that led me to radical feminism. And that was the hammer that broke my illusion right open. The next several months was me and radical feminism and I heard the phrase I wish I had heard years ago, “The only thing that makes you a woman is that you are female.” A simple, to the point, and really quite obvious observation. How could I have thought otherwise? I agreed with it, but had still not taken the final step to detransition. But the push to do so began to be ever-present and its whispers grew louder every day.
My stubbornness is both a hindrance to me and my great strength. Sometimes it takes getting to the tender and protected parts of me to push me into a kind of submission, letting go of the thing I have been gripping so tightly for so long. It was the lesbian stand-up comic Hannah Gadsby who broke that grip. I saw her Netflix special, Nannette, and it hit parts of me I didn’t know were there. Her raw anger slapped me right in the face and told me something I hadn’t wanted to ever admit: Being a butch lesbian woman was fucking hard, it could be sad, it could be vicious, and it could break a woman.
When you walk through the world as a living example of everything that the world tells you is ugly and disgusting it can break you. And it had broken me. I knew, as I sat there in my room sobbing, that I had some real truths to face about myself. About my motivations for transition and the deep pain I carried with me. My internalized homophobia was something I always denied but it was damn strong and I had used it as another tool to hurt myself with. But the time had come to stop hurting myself, I knew this.
I contacted my doctor the next day and told her I wanting to quit my testosterone shots. It’s now been 4 ½ months since I last injected testosterone. I feel good and healthy. I’m on the mend and it’s wonderful.
The factors
ADHD is a very misunderstood disorder by most people. It affects almost every aspect of your life. I was not diagnosed with ADHD until I was 36, but after receiving the diagnosis it made a lot of the way my brain works finally make sense to me. I now see that ADHD played a large role in my fixation and desire to transition. People with ADHD often get hyper-focused on a particular thing. That thing becomes an obsession and we think about it nonstop for days, months, or even years. I got it in my head at 22 that I was trans and there it stayed for 15 years until medical transition had become almost completely unregulated. When I was 34, I found myself in a very mentally vulnerable place. Often when people with ADHD become mentally overwhelmed, we go back to a fixation we might have had or one we have kept with us but maybe have ignored for a while. We go to these fixations for comfort and organization, to feel better and safe again. I went back to my ideas about being a trans man and transitioning.
Looking back now, I think this was probably one of the most devastating times in my life. I had recently become a parent, which although a happy life change, is also a very stressful one. Around the same time, I lost my grandmother (who was more of a mother to me). I cut ties with my mother because I could not in good conscience allow her around my child and for this my brother and sister refused to have anything to do with me. I lost my good friend and brother-in-law to suicide. My wife literally lost her mind with grief and I felt like I was drowning. I became very depressed and wanted out of my life. I isolated myself, watching transition videos nonstop for months. I wanted to kill myself but knew what a shit move that would be to my family, so I latched onto transition as a way to feel at peace again. ADHD also affects one’s ability to reason though things thoroughly. Even though we may think about a subject nonstop we are not actually doing any kind of real analysis. It’s more like a movie that just keeps playing our favorite scene. The scene I played was one in which I was a strong man who lived a happy life.
When you are told from the age of 8 that the way you walk, talk, and act is like a boy by your mother, your schoolmates and other adults, it’s so easy to buy into the idea that you really are a man and that makes you completely normal after all.
I was raised in a very religious household where we were taught that women were put on this earth to serve men. I was not allowed to cut my hair or wear anything but long dresses, as my body was deemed immodest by default. My father had died when I was 2 in an accident and my mother had remarried into this religious atmosphere. My stepfather and mother abused me extensively from the age of 4 to 9. I learned to cope with the abuse by detaching myself from my body. I took back my power by never allowing my abusers to make me cry, I withstood the pain upon my body by disassociating. I believe this early abuse and dissociation from my body gave rise to the feelings that my body was wrong, not my own, and some kind of foreign entity—the same things people describe when talking about gender dysphoria. The sense of “wrongness” that one feels with their body.
When I was 9 my stepfather and mother divorced. I had a little more freedom to be myself and I began to express my likes and dislikes, as is normal for children to do. I wanted to play football, I liked boys’ clothing and style and I loved the idea of having short hair. My mother, although not as religiously fervent as she had been with my stepfather, was still a staunch fire-and-brimstone Christian, and very homophobic. She would become angry at me for wanting these “boy” things and punish me if I behaved “like a boy.” She ridiculed the way I walked and my mannerisms, telling me that I needed to walk and act like a girl. I had one bright spot in my childhood, and that was my paternal grandparents. They allowed me to wear boys’ clothes when I stayed with them and do my hair any way I wanted. Of course, I had to be very careful that my mother never found out, and we all knew it.
My mother’s behavior introduced an internal hate inside myself as a gender non-conforming girl. This would later be compounded by the homophobia I faced when I came out as a lesbian. I had never given the trauma I had to go though as a young lesbian the kind of gravity it deserves. When I was 17 my mother was growing very worried because I was showing no interest in boys or men. She decided to set me up on a blind date with one of her friends’ 22-year-old son. I was sheltered and ignorant and scared of my mother, so I went out with him. She had never met the guy and had not actually seen her friend in years; they only occasionally talked on the phone. I knew within the first 5 minutes of being in the car with him that he was very dangerous and unpredictable. I could feel with everything that I was that he was fully capable of killing me. I knew I couldn’t set him off, he would use any excuse to become angry. I spent the next 30 minutes of the car ride being as polite and submissive as possible, all the while strategizing on how I could get out of this. When we got to a town I lied and told him my mother wanted me to call her and let her know we arrived and I faked exasperation with my mother’s request. I went to a payphone and called my mother. I told her I wasn’t feeling well and was coming home. I then told him that she had told me I needed to return home because her employer had called her into work due to an emergency and I had to watch my sister and brother. He was displeased, and I made every effort to ensure him of how upset I was that our night had been ruined and assured him that we would go out next week. The drive home was the longest drive I’ve ever taken. I made it home safe and for the first time ever I yelled at my mother for her stupidity in putting me in a dangerous situation. This showed me how expendable I was as a woman if I could not adhere to the roles expected of me. I was better off dead than a dyke.
When I finally did come out as a lesbian at 19 years old, I was put through hell by most of the people most important to me in my life at the time. I lost friends, I was told I was never allowed at family gatherings because I was sick and would cause harm to the little kids. I was ridiculed and called every nasty name in the book. I was propositioned by men who were sure they could make me straight if I allowed them to have sex with me. I was told I was too pretty to be a lesbian, I was trying to be a man, I had been turned by a child molesting dyke, and the list goes on. I faced harassment in public life, mostly by men who would yell out “dyke” to me as I walked down the street or became confrontational with me if I looked at their girlfriend or god forbid smiled and said hi. I was not even safe at my job. There were men who would make jokes about raping a woman who got out of line, men who called me “spike” and “sir” to my face and refused to work with me. Men who talked openly about beating up fags or killing their sons if they were gay. It was enough to make anyone want to escape. I just wanted to live my life, I wanted to be unnoticed, but I couldn’t be. I hated this, I hated myself, and I felt like I must be the most disgusting creature in the world—that I must be wrong.
Trans explains why I’m wrong
The first time I heard the word transgender applied to women was in 2002 when I was 22 years old. It seemed as if overnight the young lesbian community had started to embrace this trans idea. Most of the butch lesbians I knew refused the label “butch” and instead said they were trans men. My wife and I were friends with several lesbian couples at the time and every butch woman in that couple now claimed to be trans. The first time I was corrected by a young butch named Lacy, she said “Oh I’m not butch, I’m really a trans man.” I had no idea what she was talking about so I asked. As I remember, she gave the simple answer, she was a man trapped in a female body. I was disgusted by this and repulsed even, but it never left my mind. I then began to ponder what it meant to be a trans man. A man who had a female body seemed to tick a lot of boxes for me. After all, I was always told I behaved like a boy. I walked like one, I acted like one, I was attracted to women. I liked men’s clothes and short hair. It started to make sense. It explained everything that was wrong with me. All the ridicule, all the abuse I had suffered through wasn’t my fault, or even the fault of the people who did it. What I suspected must be true, these people saw something in me that was wrong and broken. I latched onto the trans label very quickly and began telling friends and family that I was trans and that I wanted to transition.
However, this was 2002 and standards of care were still relatively strict compared to today. I had to see a gender specialist, live as my desired sex for at least six months, and undergo at least 6 months of therapy before being allowed to receive cross-sex hormones. I managed to find a gender specialist in my hometown and began working with her. She demanded that if I wanted hormones I needed to start living as a man, going by a male name and pronouns and being in male-only spaces. This was impossible for me. I had large breasts that could not be hidden and a curvy, obviously female body. I was also stricken with fear at the idea of going into male-only spaces. This seemed incredibly dangerous to me. I refused and decided to let go of transitioning. However, I always kept it in my mind as the explanation for why I was the way I was. I didn’t demand people recognize me as a trans man but I saw myself as such, and it brought me comfort that I was normal.
Transition wasn’t what I thought it would be
I made the decision to start medical transition in spring 2015 at the age of 35. Older than most transitioning woman to be sure, but not unheard of. Although many teens and younger women are transitioning, there is also a large population of adult women, mostly butch lesbians, who have also transitioned in the last 5 years or so. These mostly go unnoted because we are adults and already living on the outskirts of society. A simple look at a butch-lesbian dedicated subreddit or Facebook group will show many conversations about butches transitioning. The loss is very real and is leaving devastation in its wake in the lesbian community. I’m just one of the many. Only four months after I started testosterone injections, I had top surgery, or more precisely a double mastectomy. I hit the ground running with regards to transitioning. I couldn’t seem to do it quick enough.
Detransitioners know about the honeymoon period of transition. It lasts anywhere from 6 month to 3 years, depending on the person. Two years seems to be about average. Transitioning, although it ends up not helping in the long run, does help for a while. This is what makes it so hard to explain to those who are either still trans or those who have never been in this situation, because transition did help, for a while. I felt better when I started taking testosterone. I had more energy, I was less depressed, and my mood seemed more stable. I thought this meant I had made the right choice, and even my therapist and doctors saw this as proof that hormones were good for me.
I have done a little research into testosterone use in females, and although there isn’t much out there, what I have found seems to indicate that elevated mood and energy are some of the positive effects of testosterone use. Even males who use testosterone experience this. But what made me feel good was not some spiritual lining up of my brain with the right hormones (yes, a therapist did say this to me) but a simple side effect of a drug. No different than drinking alcohol or using any other substance to ease emotional pain. Another reason transition helped was that being seen as male enabled me to walk through the world like just another person. I didn’t draw attention and I got treated better than I ever had, by my co-workers and strangers alike. I have since heard of some trans-identified females who make the decision to continue living as men, not because they actually believe they are men but because they know it’s safer and easier for them than if they were to detransition and live as woman again. I honestly can’t blame them. It was wonderful to experience the freedom and safety of moving through the world being thought of as a man, if only for 3 years.
After about 2 years on testosterone I noticed that my anxiety had started to become much worse. I discussed this with doctors and psychiatrists, but they didn’t think the testosterone could cause this effect. As time went on my anxiety became worse, to the point where I was taking an anti-anxiety medication daily. It reached a breaking point when I could no longer leave my bedroom without having a panic attack. I couldn’t drive because that triggered a panic attack as well. I really couldn’t do anything but keep myself sedated on benzos and stay in bed. This is when I hit bottom. I went to a psychiatrist and got an antidepressant called Viibryd that is also used for panic disorders. Starting antidepressants is both mentally and physically hard. Those first 2 weeks on the medication were like hell. My brain felt like it was ripping apart and I had panic attacks that were so bad that I really did want to die so I would not have to feel them anymore. But by week 4 the side effects dissipated, and I began to feel joy, a sense of peace, calm and clearer headed.
On top of the anxiety and depression, transitioning had ended up making my dysphoria worse. Why? Because now I was worried that men would discover I didn’t have a penis when I used the male bathroom. Because I was smaller than most males. Because my voice wasn’t as deep. Because my hands & feet were smaller. Because my body shape was more feminine then male. Because the way I talked and gestured was seen as feminine. Because my chest had scars across it. Because I was soft spoken and not aggressive. Because I was raised as a girl and was never part of the boy’s club, so I didn’t know how to interact in male culture. Because every day, I stepped outside my house and was consumed with not being found out for what and who I really was: a woman. It seemed like I had switched one set of problems for another.
There were also the health side effects I was experiencing. My skin seemed to always have something wrong with it. The first year I had terrible acne, which is expected, but after that subsided, I always seemed to have some kind of rash or irritation that I hadn’t had before. My vagina was showing signs of atrophy and was painful all the time. To alleviate this, I would have needed to start taking a topical estrogen cream that you insert into your vagina. For someone with dysphoria around their genitalia, this is really the last thing you want to have to deal with. I was always aware of my female genitals because they hurt and were unhealthy. Again, not helpful if you have dysphoria around this area. I was also seeing my cholesterol climb every time I had a blood panel done, which was every six months. I knew it was a matter of time before I would need to be on medication for this. I was also starting to creep into the range of concern for diabetes. Additionally, I was quickly losing my hair and, in another year or two would likely be bald. All this happened in a span of 4 years on testosterone. I was completely healthy with thick beautiful hair before starting testosterone.
As of this writing, I have been a little over four months off testosterone. My cholesterol levels have dropped, risk for diabetes has gone down, and my hair is starting to fill in a little. The atrophy to my genitals and uterus has reversed and I am in good health. I feel happy and content. There are some things I will never get back, though. I had a double mastectomy only 4 months into transition, so my breasts are gone. I mourn this, I mourn that I will never get the chance to make peace with them like I have started doing with my sex and body. We all carry scars from life, and these are mine.
The family suffers too
I believe it’s very important to recognize the pain transition and trans ideology can cause to the family members of the trans-identified person. The families are the forgotten victims in all this, and this is unacceptable. The trans community takes little care in the impact transition has on not only the trans person themselves, but also their family. These are some common things I heard when I began my transition.
“You are the same person you have always been”
“You will be a better person/spouse/parent because now you will be living your true self”
“Your journey is important”
If the family is upset, sad, angry or generally just confused about the transition of their family member, here are the things said to the spouse/parents/child/family member.
“This isn’t about you, it’s their journey”
“You aren’t being supportive”
“You are being transphobic”
“They have always been this person, you just didn’t know”
This is so problematic because trans ideology is, at its core, extremely self-centered sometimes even in the narcissistic range. The trans person is encouraged to view the family’s emotional state as hateful or transphobic towards them if they experience normal human emotions of sadness, loss, confusion, or anger. Trans people are not encouraged by the community to see transition as the major life-changing event that it is. Instead, it’s downplayed and given the emotional weight of a new haircut or a change of clothes. The family members are expected to say nothing but positive things and show no “negative” emotions. They are shamed into silence. Mandated to keep their feelings to themselves lest they be labeled the most horrible thing one could be called in our society right now: transphobic.
When I began transition my wife who I had been with for 15 years was devastated, and rightfully so. In the beginning she believed as I did in most of what trans ideology had to say. She really did think I was trans and she was supportive. However, her life was also being turned upside down emotionally. She had lost her brother to suicide only a year earlier, she was a new mother, and now her wife was trying to become a man. She was scared, sad and feeling loss. She naively turned to the trans community for support during this time, trying to find other spouses of transitioning people to talk to. She thought these “support groups” would be a place for support. A place one could talk openly about the emotions they had as they went through transition with their family member. What she got instead was everyone saying how happy they were for their spouse and how exciting this all was. No negative emotions. When she started expressing her confusion, fear and anger over my transition it wasn’t long before she got the “TERF” word thrown at her. She had never heard the word before and after multiple people labeled her a TERF and eventually ran her out of the support group, she went online searching for “TERF” (as we all would if we didn’t know what something meant). She found gender critical and radical feminist information, chats and web sites. It was there she found support. I find it quite funny that it was the trans community itself that drove someone to turn into a “TERF”.
What I’m trying to show here is the very unhealthy & damaging effect trans ideology has not only on the trans-identified person but also their families. I really do believe this is cult-like, even religious behavior. It is divorced from reality, basing everything on a belief supported by feelings and very little science. It is faith-based and you must believe. It is all or nothing, good versus evil with no room for nuance or critical analysis. I’ve seen this before, as I wrote about in the beginning of this article, because I was raised in religious extremism. Trans ideology mimics this very closely. It can capture people on the fringes of society, people with mental health issues and people in pain from trauma. It promises relief from symptoms, an answer for which people are searching.
The community positions itself as the most oppressed demographic in society, while holding the people on the outside hostage with threats of suicide and blame for murders committed against the trans community. It showers acceptance and validation on its members as long as they adhere to trans dogma. The trans people who do not adhere to the ideology are called truscum, traitors or TERFs. People such as myself who detransition are told we no longer have a right to say anything about the trans experience because we are no longer trans or never were trans to begin with. Many of us are shunned from the community — like a dirty secret. This shunning of former members is a great deterrent to detransitioning for some. For those who do detransition, we usually slink away and are never heard from again. For those who do speak out we are labeled TERFs (a label that has come to mean nothing but a person who doesn’t completely agree with trans ideology), or ridiculed for not knowing we weren’t trans. We are told that we took valuable resources away from “real” trans people and that we should be quiet and go away.
I began as a true believer, I thought I had found my answers, I thought it all made sense. I had euphoric feelings of relief and happiness when I began transition. Four and a half years later, and I am rebuilding my life from the ashes. I burned myself and my family up into a million pieces and now we have to make sense out of the disaster. I am very lucky and grateful that I have a wonderful wife who has stuck with me more than she ever should have and a son who is immensely forgiving of his mother’s flaws. I find that every day is better than the last, if only by a half step. The resilience of the human spirit is amazing to me. Never give up.
The government of the state of Vermont is currently accepting public comments on a proposal to remove all age limits on sex reassignment surgery (SRS) for Medicaid recipients. The full, four-page proposed rule is available on the Vermont Human Services website.
Vermont’s Department of Financial Regulation issued a press release on June 24, signaling the state’s intention to move ahead with the rule change. Governor Phil Scott “recently proposed updates to Vermont’s Health Care Administrative Rules to allow transgender youth under age 21 to undergo gender-affirming surgery through Medicaid.”
Medicaid is a federal program that provides health insurance to low-income individuals. Although minimum benefits for all states are determined by the Centers for Medicare and Medicaid Services (CMS), each state administers its own Medicaid program and decides for itself which other procedures will be covered and which will not be. (Note: Some states have adopted a different name for their Medicaid program; e.g., California’s Medi-Cal and Oregon’s Oregon Health Plan.)
The public comment period for the Vermont Medicaid policy change is open until July 17. You do not have to be a Vermont resident to submit a comment regarding this change. If this proposal sounds to you like the wrong thing for a state government to do, please take a few moments to comment. See instructions at the bottom of this article.
Why should you care about this issue? We’ll have more to say about that later in this post, but for now, here’s what Rachel Inker, who works at the Transgender Health Clinic at Community of Health Centers of Burlington, had to say when interviewed by the Burlington Free Press:
“The choice to have surgery is a personal one that should be explored in every age group.”
Is Vermont an outlier with the proposed change to its Medicaid SRS policy? Let’s take a look.
Only two states have explicitly removed minimum age limits for SRS
In our research for this article, we were unable to find an online resource that compiles information about Medicaid rules for under-18 surgeries in all 50 states. The information we provide below is based on our painstaking search of the Medicaid websites in all 50 states, as well as the websites for HRC, ACLU, and TranscendLegal, all organizations that lobby for medical transition coverage in the United States. Some of the information we found is based on a review of recent news articles on the topic. Note: It is possible we have missed something; if we have, please provide your corrections in the comments section of this post, and please provide links for the missing or incorrect information.
In quite a few cases, the information about Medicaid coverage of SRS is buried in obscure documents that are not available via a standard search for terms like “gender dysphoria.” For example, the Oregon Health Plan (OHP) indicated it would cover medical transition beginning in 2015, but many previously active links now land on unrelated pages (e.g., https://www.oregon.gov/OHA/HPA/CSI-HERC/FactSheets/Gender-dysphoria.pdf) or are broken. A search of the list of covered services on OHP comes up empty for the keywords “gender dysphoria” and “transgender,” but a deeper investigation uncovers the full policy. It’s worth asking: Why is clear policy information about gender transition so difficult to find?
As of this writing, this is what we have found regarding SRS coverage for Medicaid recipients under the age of 18:
Only 2 states have removed minimum age limits for SRS, New York and New Hampshire. But in contrast to the proposed Vermont rule change, the policy statements for these states seem to express reservations. For example, the New York statement contains this caveat: “Although the minimum age for Medicaid coverage of gender reassignment surgery is generally 18 years of age, the revised regulations allow for coverage for individuals under 18 in specific cases if medical necessity is demonstrated and prior approval is received.”
In 19 states, SRS is not included in the standard Medicaid benefits for any age—that is, they do not explicitly list SRS among covered procedures. That generally means they would consider it on a case-by-case basis. It’s worth noting that this is also the policy of Medicare (the federal insurance program for adults over 65 and disabled persons), which as of 2016 declined to cover medical transition as a standard benefit because of the poor quality of research supporting it.
The remaining 21 states (including Washington, D.C.) expressly cover SRS (see slide 10 of this document on fenwayhealth.org); Colorado, Hawaii, Nevada, and Massachusetts specify that Medicaid SRS coverage is only for adults over 18. Several others–including California and Oregon (see page 205)–indicate that they follow the WPATH Standards of Care 7 guidelines (which specify SRS for adults only, see page 27), while others (such as Connecticut and Washington ) appear to make no explicit stipulation as to whether they cover under-18 SRS. The Connecticut policy document hedges: “Genital surgery is typically not carried out in adolescents until the adolescent has the capacity to make fully informed decisions and consent to treatment.”
WPATH SOC 7 genital surgery guideline
So even some very liberal states (like Massachusetts) only cover gender reassignment surgeries for people over 18. (Note: In some states where Medicaid will not cover genital surgeries for those under 18, it will cover mastectomies on a case-by-case basis. This is in alignment with the WPATH Standards of Care 7.)
A caveat: When it comes to medical transition coverage by Medicaid (for any age), the landscape is rapidly changing. State Medicaid offices are under increasing pressure by trans activist organizations to provide these services. For example, last year a federal judge in Wisconsin ordered the state Medicaid office to cover surgeries for two patients (FTM and MTF). A caveat is also in order when discussing the WPATH Standards of Care since certain activist clinicians are in favor of abolishing minimum-age guidelines in the upcoming SOC 8.
The numbers of children and young people seeking gender services in Vermont have grown rapidly in recent years. And one reason for this rapid growth may have to do with the activities of this small but very influential charity. Charity Navigator.com, which provides information about a large number of charities, lists Outright Vermont – inexplicably – as a disaster relief organization. It was founded in 1989 for the laudable purpose of supporting lesbian, gay, and bisexual youth. However, if you look at its activities in recent years, it seems to be largely concentrated on transgender issues.
One of the ways the charity uses its funds (some of which are provided from government sources) is to run summer camps and provide gender-identity programs to Vermont public schools. Outright Vermont has more than 60 volunteers who go into schools across the state. Because the charity fails to consider the possibility that social contagion may account for a significant portion of the increase in transgender-identifying kids, it fails to see how much it may be perpetuating the very distress it seeks to alleviate. Through its work in schools, the charity could be serving as a vector of social contagion. (To read about how efforts to raise public awareness about anorexia created a contagion among adolescent girls in Hong Kong in the mid-1990s, see the first chapter of Crazy Like Us by Ethan Watters.)
4thWaveNow has been following with great interest the ongoing news coverage about Mermaids in the UK and the large influence that charity has exerted on policy and clinical decisions at Tavistock and Portman, the NHS youth gender clinic in the UK. Charities like Outright Vermont and the larger and better-funded California organization Gender Spectrum appear to be exerting a similar influence in the United States.
“Both Outright Vermont and the Community Health Centers of Burlington — the organizations that Kaplan and Inker are a part of, respectively — participated in drafting and providing feedback on the rule. According to Inker, the process began last fall, and several additional groups took part.”
Is the charity simply unaware of the increasing number of desisters and detransitioners? Surprisingly, no. The website links to a document developed by the University of Vermont that states “many children who are trans will end up identifying with their sex assigned at birth post puberty.” The document even acknowledges that “there is no way to predict which children will persist or desist as adults.”
Excerpt from U. of Vermont brochure
At the same time, the Outright Vermont website states that no age is too young for transition. How can this be? If many children desist after puberty, how can the charity justify puberty blockers, followed by cross-sex hormones? Such a protocol prevents the child from ever experiencing natural puberty, so they never have the opportunity to desist. Even social transition, often claimed to be a benign course of action, may reduce the likelihood that a child will eventually become comfortable in their natural body. (See Could social transition increase persistence rates in “trans” kids?)
Why this policy change is a bad idea
There are at least two important reasons this policy change is a bad idea. First, we know that many young people desist from a trans identity. Anyone who follows detransitioner accounts on Twitter and other social media will have noticed a rapidly increasing number of people, particularly women, who are speaking out about the negative effects transition has had on their lives. With the numbers of detransitioners increasing rapidly, how then does it make sense to pass a policy to make it even easier for young people to make irreversible changes earlier than they already can?
Another reason this policy change doesn’t make sense is the compelling evidence for social contagion. The study published last year by Dr. Lisa Littman suggests that social contagion may be a significant factor in the increase of trans-identifying young people. Many people, particularly activists, have criticized her study for only talking to parents, but she acknowledges the limitations of her study and indicates this is only preliminary research. Much more is warranted. But in the meantime, many detransitioners have begun speaking out about their own experiences, which corroborate Dr. Littman’s findings.
Although Littman’s is the first study to focus exclusively on the possibility of social contagion, other studies have suggested the role it may play. For example, this 2015 qualitative study surveyed 17 gender clinics around the world; some clinicians pointed out the influence of the Internet on the rise in youth clamoring for medical intervention:
“They [adolescents] are living in their rooms, on the Internet during night-time, and thinking about this [gender dysphoria]. Then they come to the clinic and they are convinced that this [gender dysphoria] explains all their problems and now they have to be made a boy. I think these kinds of adolescents also take the idea from the media. But of course you cannot prevent this in the current area of free information spreading.” –Psychiatrist
A better use of resources
Outright Vermont has done important work for gay, lesbian, and bi youth since its establishment in 1989. We also support its efforts to prevent bullying. No child, regardless of how they present themselves or who they’re attracted to, should be bullied. But the charity fails to see that some aspects of gender identity undermine support for GLB youth—in fact, all youth. Because of the serious, irreversible, and lifelong health effects from hormones and surgery, medical transition should be the last resort for young people experiencing discomfort with their bodies.
So instead of pushing for a policy to lower the age limit and making it easier for kids to make decisions they may come to regret, wouldn’t it make more sense for this charity to spend its resources on looking at ways, other than transition, to help girls and boys become more comfortable in their bodies without the need to become medical patients for the rest of their lives?
Outright Vermont Facebook posting 13th June 2019
Insult to injury
Perhaps the most distressing part about the Vermont proposed rule is this statement near the end of it:
“Vermont Medicaid does not cover reversal or modification of the surgeries approved under this rule.”
If incongruence between your biological sex and your perceived gender is sufficiently distressful to put you at risk of suicide, then it would work the same way in the other direction, wouldn’t it? If, after you transitioned, you then regret the effects on your body and decide you would like to return to living as your biological sex, how is it any less life-saving to provide you with those services?
If the change in policy is really driven by the desire to eliminate the distress of incongruence between biological sex and gender identity, then surely Medicaid should cover gender reassignment reversal surgeries just as willingly, right?
The article in the Burlington Free Press begins with the sentence, “Vermont health insurance regulators are planning to tweak Medicaid rules so transgender youth no longer have to wait until age 21 to seek gender-affirming surgery.” The word “youth” suggests adolescents. But in reality the rule opens the possibility of surgery at any age, including prepubescent children.
We can hear the objections now: “No one is proposing to give SRS to prepubescent children.” But is this strictly true? Further down in the same article, we find this very interesting quote from Dr. Rachel Inker, who runs the Transgender Health Clinic at the Community Health Centers of Burlington:
“The choice to have surgery is a personal one that should be explored in every age group.”
Everyage group?
The Swedish Pediatric Society recently published a statement [English translation] saying that “giving children the right to independently make life-changing decisions [about hormonal interventions for gender dysphoria…] lacks scientific evidence and is contrary to medical practice.”
In addition, more and more people—even among those who promote gender affirmation—acknowledge the possible ill health effects of puberty blockers like Lupron. Johanna Olson-Kennedy, director of The Center for Transyouth Health and Development at Children’s Hospital Los Angeles, the largest pediatric gender clinic in the world, has been worried for the past eight years that youth who spend too long on blockers, as per the Endocrine Society guidelines that suggest blocking in Tanner 2 and cross-sex hormones at 16, will suffer significant bone density loss. In her “Puberty Suppression: What, When, and How” presentation at the 2017 Seattle Gender Odyssey Conference, she stated:
“You need to have sex steroids for bone protection and probably a lot of other things that we are not nearly as clued in as we need to be. … For the young people in my practice, I hesitate to have people on just blockers in that age range for more than two years.”
She’s also concerned about “emotional lability [which] is really common with blockers.” In addition, she rightfully points out that,
“if you practice a model where you don’t start hormones until 16, you’re putting a 14-year-old trans boy in menopause, which you just have to understand is potentially going to be a trainwreck.” (clip of excerpted section and audio of full presentation)
In fact, some of the clinicians who are the most aggressive in promoting early transition urge skipping blockers altogether and going straight to cross-sex hormones. Since cross-sex hormones administered before the end of puberty permanently sterilize them anyway and (in the case of natal males) prevent the development of sufficient penile tissue to create a neovagina, what’s to stop them from proceeding straight to surgery? In addition, some parents are resorting to tucking and taping their natal sons’ penises, while others are purchasing plastic penises for their natal female daughters. Earlier surgeries would eliminate the need for these interventions, so it’s not a stretch to imagine that removing minimum age limits entirely could open up the door to prepubescent surgeries.
In fact, a similar rationale is already driving down the age for “top surgery,” the euphemism for double mastectomies. To prevent the pain and harm that binders cause girls, clinicians are removing their breasts at earlier and earlier ages—sometimes as early as 12 or 13 years of age.
As one provider from Vermont says in the Burlington Free Press article, “Having young people have to wait until they were 21 just didn’t really make any sense.”
So let’s not be under any illusions here. This rule change opens the door to the government paying not only for double mastectomies for 12-year-old girls but also the removal of the penises and testicles of prepubescent boys. Can under-18 phalloplasties be far behind?
According to an email we received from the Vermont Agency of Human Services, “after the close of the public comment period on 7/17/19, comments will be reviewed and considered. When ready, the final proposed rule will be filed with the Secretary of State and the Legislative Committee on Administrative Rules (LCAR). The meeting schedule for LCAR can be found on the LCAR website. It is unknown at this time which meeting this final proposed rule would be scheduled for, but when it is filed and scheduled it will be posted on the LCAR agenda online. The rule does not take effect immediately after the LCAR hearing–an adopted rule must be filed. The timelines and procedures for filing an adopted rule are outlined at 3 V.S.A. §843.”
GuessImAfab is a 22-year-old re-identified female who identified first as nonbinary, and then a transgender man, from the ages of 18-21. She lives in the United States. GuessImAfab was on testosterone for a year and a half and spent a … Continue reading →
At 4thWaveNow we are serious about fact-checking and providing sources so that our readers can verify information for themselves.
It is well known that Susie Green of Mermaids took her child to Thailand to undergo SRS, which was carried out on the child’s sixteenth birthday. As 4thWaveNow contributor Artemisia pointed out in a post last year, this operation would not be legal in Thailand nowadays. Under the Thai laws currently in force, it is illegal to perform SRS on anyone below the age of 18, while patients aged 18 to 20 require parental consent.
It has come to our attention that there is a rumor on social media that the law was changed because the people of Thailand were shocked and revolted by Mrs Green’s action. This is completely untrue. We do not know where that story originated; we’ve attempted to correct it several times on Twitter, yet the rumor persists.
For the benefit of those who want to know more about the real reasons for the legal changes, Artemisia has provided us with the following detailed account.
Recently Mrs Green tweeted her approval of a statement by a US specialist in genital surgery who argues that ‘surgery should be allowed based on competency’ — that is, ability to give informed consent to treatment — rather than ‘age of majority’.
Why did Mrs Green take Jackie to Thailand? During the course of the last forty years, Thailand has built up a reputation as a place where male persons seeking feminisation surgery can have various procedures, including vaginoplasty, performed by competent surgeons for far less money than it would cost them in Europe or the United States. The development of this highly specialised trade certainly owes something to the presence of a strong indigenous tradition of males who present as female: the kathoey, often referred to as ‘ladyboys’. It is reported that many of them undergo feminisation surgeries, including vaginoplasties.
Until 2008 there were few or no legal controls over such operations. In April that year the Thai government imposed a ban on the castration of males below the age of eighteen. According to a report in the Telegraph (a reputable London newspaper) the new law was a response to pressure from the Medical Council of Thailand, which had issued a warning about the health risks of teenage castration: damage to ‘hormone growth and physical development’. Boys as young as 11 or 12 were undergoing castration in the belief that it would help them present a more feminine appearance as they grew older. It was a preliminary to later feminisation surgeries. In that respect, its use was similar in purpose to the current use of GnRH agonists as ‘puberty blockers’.
The move to make it illegal was strongly supported by the Gay Political Group of Thailand, whose leader, Natee Teerarojjanapongs, told The Bangkok Post, “These youngsters should wait until they are mature enough to thoroughly consider the pros and cons of such an operation.” In another, later interview he said, “I got so many calls where they said they are so sorry that they did a sex change … They make a big mistake and they want to come back and be the same. But they cannot!”
The Medical Council of Thailand is a professional body that has statutory authority. In April 2009, a year after the ban on castrating under-age boys, the Council issued a new regulation: in future, ‘sex change surgery’ would be permitted only if the patient was over 18. Furthermore, patients of 18 and over who had not yet reached the age of 20 must have the permission of ‘an authorized guardian’. (In Thailand 20 is the age of majority.) This regulation was to come into force 180 days after publication in the Government Gazette. It was during this period of grace that Susie Green took Jackie to Thailand for an operation to create an artificial vagina.
There is a rumour that sometimes surfaces on Twitter that it was because of Susie Green that Thailand imposed the age limit – supposedly the authorities were so horrified at a mother bringing her sixteen-year-old for a vaginoplasty that they brought in a law to stop anyone else from doing this. There is absolutely no truth in this rumour. It is not clear who began it, and as stated above, 4thWaveNow has attempted to correct it on Twitter, with little success.
This is what actually happened: on 20th April 2009 the Thai medical authorities announced a forthcoming ban on ‘sex change’ operations on any person under 18. The intention was to protect young people from undergoing irreversible surgeries that they might later come to regret. Jackie’s vaginoplasty was carried out on the child’s sixteenth birthday. This dates it to 16th July: three months after the new regulation was announced and before it came into force on 29 November. In other words, the operation took place at a point when it was known that it would soon be illegal for such a drastic procedure to be performed on a patient so young.
Did Mrs Green and her advisers know that the law was about to change? It seems unlikely that Norman Spack of Boston Children’s Hospital, a well-known promoter of medical transition for teens, was unaware of the steps being taken in Thailand. Jackie was a patient of his at the time. Dr Spack has described at a TEDx event how, as an experiment (‘something a little bit innovative’), he prescribed Jackie ‘a blocking hormone’ (GnRH agonist) to block testosterone and later ‘added estrogen’ when Jackie was only 13. Following which, ‘on her 16th birthday, she went to Thailand, where they would do a genital plastic surgery.’ Helpfully, he added, ‘They will do it at 18 now.’
It echoes a claim that was earlier made about a German teenager, Kim Petras. In February 2009, shortly before Jackie and Susie travelled to Thailand, the Telegraph reported: ‘German teenager Kim Petras has become the world’s youngest transsexual after undergoing an operation at the age of just 16.’ The story was also published in the Sun and the Daily Mail. Kim was reported as saying in an interview, “I had to wait until my 16th birthday but once that was past I was able legally to have the operation.” So when Susie Green arranged for her child’s surgery to take place on the day that Jackie turned sixteen, it meant that in future it would be Jackie who could make a plausible claim to that distinction.
The following year Jackie competed in the Miss England beauty contest, reaching the final, and became the subject of a BBC documentary: Transsexual Teen, Beauty Queen. In a memorable section, Susie Green talks about her child’s operation. She reveals that because Jackie had not gone through a natural puberty (as a result of the hormone treatments prescribed by Dr Spack), the surgeon was unable to carry out a penile inversion procedure:
38:57: Susie Green (to camera). The majority of surgeons around the world do something called penile inversion where they basically use the skin from the penis to create the vagina. And she hadn’t developed through full puberty so to not put too fine a point on it there wasn’t much there to work with [starts to smile] –; sorry Jackie (she’ll hate that) [turns away from camera and convulses with laughter].
39.15: cuts to a still photo of 16-year-old Jackie on a hospital bed waiting to go into the operating theatre.
4thWaveNow postscript: As Artemisia has amply demonstrated in her article, it has never been in dispute—least of all by the Greens—that Jackie underwent SRS in Thailand at the age of 16. Interestingly, the UK Daily Mirror, in a story just last October, reported that Jackie’s surgery took place in the United States.
This is an error 4thWaveNow pointed out (as did a commenter on the article itself), but as of this writing nearly 6 months later, that error remains standing. Moreover, it seems safe to assume that the Greens are aware of the Mirror piece; apparently, neither Jackie nor Susie have required the newspaper to correct this significant error of fact.
Helena is a 20-year-old woman who identified first as nonbinary, and later as a transgender man, from 2013 through 2018. In 2016, she began medical transition by taking testosterone, and detransitioned two years later. Helena was an avid Tumblr user during the time she thought she was trans. In retrospect she can see the profound influence the social media platform had on her life and the development of her trans identity — and the impact it continues to have on many young people. In this article, Helena dissects Tumblr as a platform, explaining to the uninitiated that its very structure lends itself to the self-referential ruminations of troubled teens–teens attempting to navigate and find their place in the identity-besotted cyber-culture that has all but replaced in-person interactions in the 21st century.
This piece will is the first of three that analyze aspects of Tumblr Helena has observed as detrimental to the massive numbers of youth who call the site their virtual home. Part 2 can be found here. Helena can be found on Twitter @lacroicsz and is a member of the Pique Resilience Project. She is available to interact in the comments section of this post.
We’ve all read Lord of the Flies, right? A bunch of tween boys get stranded on an island and all of their deepest, most repressed urges surface as they desperately attempt to organize and manage the tiny preteen society they’ve found themselves in. The novel ends in bloodshed, as the author theorizes that the immaturity, communication breakdown, and decision making difficulties one would find in a group of adolescent boys would create a chamber of destruction. How would it have ended differently, some have asked, if the story was one of a stranded group of girls? What would happen if every troubled, isolated, self-loathing, depressed, and emotionally overwrought teenage girl in the world wound up alone on an island?
Tumblr. Tumblr would happen.
Tumblr: you either love it, hate it, or have no clue what it is. Tumblr is the microblogging platform that has given birth to some of the most intensely devoted fan bases online, with over 456 million registered accounts as of 2019. While known widely for fandom-related art, writing, and discussion, there is another, darker aspect of Tumblr that requires a better acquaintance with online communities to understand. In many corners of the internet, Tumblr is known as the core of a certain brand of leftist ideology, not-so-affectionately dubbed the “Social Justice Warriors.” It is these “SJWs” that have taken the site from a platform for fan content to a highly influential ideological powerhouse.
However, an analysis of Tumblr as simply a bunch of “crazy SJWs” does not do the site justice. To understand Tumblr and its influence in youth mental health, culture and politics, you must realize that Tumblr is not simply a site some people visit to share their opinions or look at pictures. You must stop viewing it as merely a website, but as more of a dimension: it has its own social rules, hierarchies, ideologies, and interconnected communities. As a site where millions of people, mainly teenage girls cut off from the outside world, maintain constant daily connection, it has developed into a true culture–the mammoth hub of alternative teenage lifestyle.
Most people are aware of the new challenges our increasingly online culture presents to us. The internet has given rise to a slew of new concerns about psychological impacts, particularly pertaining to previously nonexistent and more covert forms of predatory or manipulative behavior. Tumblr is, of course, just one website out of many that raises these concerns, so why does Tumblr specifically matter? It matters because Tumblr, to millions of its users, is not simply a social media platform. It is their world, the place where these teens make their deepest friendships, express their most vulnerable selves, and begin to develop their own identities. It is also the world from which a surprising amount of our modern-day social justice ideology emerges.
The internet is the 21st century town square, and it is no secret that the discourse that takes place on it is at the forefront of every aspect of our society and politics, Twitter being perhaps the most notable example. On Tumblr, there is a running joke that “Twitter is everything Tumblr was three years ago;” in other words, whatever social justice topic is fashionable on Twitter at any given time has long since been beaten dead on Tumblr. As someone who spent 2011 to 2016 on Tumblr, and 2016 to 2019 on Twitter, I can confirm this as true–the discourse we see on the liberal sides of Twitter would have been seen on Tumblr three years ago.
Recursive antiterf virtue signaling
When I check up on some of the current Twitter topics (such as queer theory) on Tumblr in 2019, the conversations are far more intricate and removed from reality than they are currently on Twitter. As time progresses, the seriously confused debates and ideas cooking within the Tumblr echo chamber find their way to other platforms and push those user bases in the same direction. This is scary because, unlike Tumblr, Twitter is taken very seriously. Citizens can converse with politicians, celebrities, and influencers in a way that was never possible before, and activists can reach a spectrum of people who would have otherwise never listened to them. Now, when I think about the kind of ideologies I subscribed to as a teenager on Tumblr, and as I see them being played out on Twitter and in the real world years later, it deeply concerns me. My concern about this trend is exacerbated even further when I realize that most people do not understand the planet from which many aspects of online activism emerge. And this lack of understanding is shared by a wide demographic, including professionals, parents, and confused Leftists and Liberals blindsided by the turn activism has taken in the last half decade.
Now, before I begin the first installment of this adventure through the space-Tumblr continuum, I must issue a disclaimer: I am no expert in psychology, sociology, or social media. Research into the complexities of social media and the various platforms’ effects on human communication and mental health is a growing field, with new empirical studies emerging rapidly. My observations as a former daily user of Tumblr are purely that: my observations. This being said, I have insight into the site that gives me an advantage over those who may be curious from the outside, experts or not. When I look back on my time spent on Tumblr, I am overwhelmed by the many malignant qualities I see reflected in my own actions and beliefs, and those of the site’s current and former user base. After mulling it over (and spending way too much time scouring the site for visible patterns of dysfunctional behavior), I have identified three crucial aspects that make Tumblr the problem it is, the first of which I’ll discuss in this article.
#1 Tumblr is designed in a way that fundamentally enables extreme groupthink, manipulation of information, destructive interactions, and distorted ways of thinking.
Information on Tumblr is shared in two main ways: posts and reblogs. Posts are content that users share on their Tumblr blogs. Posts can take the form of text, imagery, quotes, links, audio, or video. Reblogs are posts that users share that originally appeared on the blogs of other Tumblr users. If you are familiar with Twitter, the concept of “tweets” and “retweets” is a good comparison. When a user reblogs a post, they have the option to add a comment that will appear below the original post’s text. Other users may reblog the content further, each time adding their own comments. Eventually, you may have a long comment chain emerging from a single reblog.
Above is an example of Tumblr’s reblog and caption system at work. At the top is the original post, and the bottom two comments are the comments that existed on the version of this post at the time the person who reblogged the chain onto my dashboard chose to reblog it. There may be countless other versions of this post that others are reblogging, with different captions added onto it, all under the same original post. All the interactions, including likes, reblogs, captions, and replies that exist for this post can be seen by clicking the “notes” indicator on the bottom left hand side.
Innocuous as this may seem from the screenshot above, it is this very feature of Tumblr that I find to be one of the most problematic. On posts that are more emotionally or politically charged, it’s not uncommon for users to reblog full blown arguments that, by the last visible caption in that particular version of the post, arrive at a conclusion, often reflecting the beliefs of their established social circle. This prevents the reader from ingesting the point the original poster was trying to make and coming to their own logical conclusion, because they have a certain version of a back and forth dialogue laid out for them, often expressed in a very intense and polarized way that makes the final conclusion seem more correct simply because of the way the argument is framed. Unless one has the self awareness to check the full amalgamation of comments in the notes section and attempt to decipher the jumbled mess of heated additions to the post, one isn’t going to get every side of the argument. Unbeknownst to the reader, there could be yet another comment after the “conclusion” that could completely flip their view on the topic once again.
After months, or years of developing opinions and a worldview through spoon-fed arguments that disengage the mind from processing the information at hand autonomously, critical thinking skills can take a serious hit. When one listens to a live debate or has an engaging conversation with another human being, information can be shared back and forth, enabling all parties present to grow from the debate, learn from each other, sharpen their critical thinking skills, and refine their own arguments and world views. On Tumblr, this necessary form of communication and intellectual development is often lost to this new sort of “factory farmed” way of forming opinions and debate (or lack thereof), resulting in highly opinionated youth who have never actually thought about what they believe and why they believe it. I once passionately held beliefs that I believed were my own, but when I tried to describe them in my own words, I would often arrive at a sort of mental barrier. As my peers and I exchanged scripted rationalizations, we were unable to connect the dots between the intellectual blind spots in our own minds.
As users read through the captions on a contentious post, especially if they are unfamiliar with the topic, it’s not uncommon for their opinions on the matter to flip back and forth with every comment they read as they go down the post. The reader then eventually arrives at the stern conclusion, which they are likely to adopt as their own. Readers may also feel pressure to agree with the dominant opinion in that particular snippet of the conversation, as the person framed as being “wrong” or the “loser” typically is indicated to be bigoted or stupid, often receiving backlash or public humiliation based on the particular version of the post a certain circle of users is reblogging.
When you try to navigate the world of Tumblr posts, the task of separating fact from fiction is herculean. A major part of the online experience for people with better critical-thinking skills is the constant effort to contextualize and cross-check events, claims, and sources. Children and teens often do not have these skills just yet, and it seems that Tumblr’s developers have failed to compensate for this at all. Sites like Facebook have claimed to take a stand against “fake news” while many users on Twitter and other sites encourage others to refrain from knee-jerk reactions to “news,” and to cross-check claims before letting the starving Rottweiler of outrage out of its kennel. Tumblr, however, has neither the self-aware user base to encourage such attitudes, nor a team of developers who seem to care about whether or not the confusion of Tumblr users is affecting their mental health, let alone influencing international public discourse.
Users can also interact more interpersonally in the form of “asks” (direct messages that can be answered either publicly or privately and have the option to be sent anonymously), as well as instant messaging via the Tumblr chat function. “Asks” will appear in the inbox, and are more often than not a variety of different types of messages as opposed to actual questions. The option for anonymity has allowed for this feature to be used as the primary method of bullying or harassment, as well as, interestingly enough, a method for users to send themselves messages, often hateful, to gain sympathy or manipulate discourse happening within their social circle.
When a user makes a statement that another group considers “problematic”, it is not uncommon for that user to be absolutely obliterated with anonymous messages demanding changed behavior, apologies, or simply exercising the sender’s desire to decimate someone online. When someone is harassed like this over a heretical statement, the entire situation, along with the mental state of the user being attacked, often descends into complete chaos.
It is expected that when you are called out, you immediately and calmly apologize (flog yourself) and promise to never do whatever it is you are being called out for again. Even then, it is hard to satiate the hungry mob. People who appear too calm can be accused of not taking the situation seriously or disrespecting the feelings and concerns of those who were offended. It is always a lose-lose-lose-lose….lose… situation, and as you may have already discerned, critical thinking in this atmosphere is nearly impossible. Without the anonymity of the ask feature, and the capability for one user to send multiple messages causing an illusion of a mass attack, mole hills would not be perceived as mountains as often as they are. What is in reality more likely to be an individual perceiving your words as offensive begins to feel like you have stepped on a mine that has just decimated the peace and order of your entire community, even if it really is just one or two people sending dozens of anonymous hate messages (often including to your friends and followers) and calling enough attention to the situation that your entire social circle is pressured to stand up and persecute you for your crimes.
To a young teen who knows no better source of community, this can feel devastating. There is intense pressure to avoid critical thought and embrace toxic tribal attitudes, heavily valuing conformance with ideology over individualism and loyalty to important relationships. When someone is accused, their friends are expected to sever ties with the accused, lest they themselves be accused of supporting or conspiring with a convicted transphobe, racist, or abuser, as perceived by the community. These experiences sound crazy, and they most certainly are, but they would not be happening to the extent and in the fashion that they do on different social media sites without some of the particular features mentioned above.
If that wasn’t enough, there is a final piece of inspiring web development that makes Tumblr unique: Tumblr posts don’t have timestamps. Unlike your timeline on Twitter, Reddit, or YouTube, your Tumblr dashboard offers no way of knowing when something was posted. It could have been four hours ago or four years ago. It’s not uncommon for posts written in urgency about a certain situation, oftentimes having been previously debunked (even in the notes sometimes! Too bad 99% of the user base would never think to check. See what I mean about that being a problem?) to continue circulating years later, inspiring misinformed or unnecessary fear within readers. This lack of time context can seriously distort a person’s perception of events or political and social climate. Too many users are getting their news, partaking in a community, developing a sociopolitical ideology, and curating their own identities based on internet posts floating around in a vacuum devoid of reference to reality; not even time.
“Call-out culture,” the pervasive danger of groupthink, attitudes towards mental illness, and militant activism are all topics I will analyze in more depth as this investigation progresses in later installments. As concerned adults or Tumblr veterans, we must understand that these noxious conditions are a result of the site’s fundamental building blocks and not purely a reflection of the character of the individuals who use it. Tumblr seems to be designed for destruction, and it’s incredibly sad that one of the only places so many young people feel able to express themselves is also oriented in a way that seriously compromises their emotional and intellectual development. This online world feels like a necessity for so many young people. I myself wonder if I would have survived the most turbulent and depressed years of my young adolescence if it were not for the capacity for self expression and friendship I found on Tumblr. This is why we have to understand the many ways in which the site has gone wrong, and how these outcomes can be traced down to Tumblr’s very roots. Consider the fact that adolescent distress is being fed into a convoluted mechanism designed for distortion, and the whole thing begins to make a lot more sense.
Thank you for reading, and I look forward to sharing more of this online world with the real one. Stay tuned for Parts 2 and 3.
In this interview with Chiara Caignon, one of the co-founders of the Pique Resilience Project (PRP), and her mother, Denise Caignon (aka “Marie Verite”), the founder of 4thWaveNow, the two women tell the story of Chiara’s temporary trans identification and how this inspired the creation of 4thWaveNow. They talk about what life was like for both mother and daughter during the teenage years when Chiara believed she was a man, and Chiara describes the influences that eventually led to her desistance.
For several years now, 4thWaveNow has been administered and edited by a small, dedicated group of parents; it’s no longer a one-woman show. In the meantime, Chiara has gone her own way, recently joining forces with three other detransitioned women — Dagny, Helena, and Jesse — to launch the Pique Resilience Project. The purpose of PRP is to offer support to the growing number of young people who have realized that transition was a mistake for them, as well as to young people who are questioning their gender identity but have not yet transitioned. PRP has so far released two videos (here and here) and a podcast. Chiara was also interviewed by Benjamin Boyce about her experiences with trans identification and desistance on Feb. 21, 2019.
Grace Williams conducted this interview with Chiara and Denise via email. “I am one of the thousands of parents who have benefited greatly from 4thWaveNow,” says Grace, “and I’m deeply grateful to Chiara and the other young women of the Pique Resilience Project for their work to help young people like my daughter.”
Chiara, I’ve watched the videos you and the other women of the Pique Resilience Project have made and I’ve been really impressed with how articulate you all are. This is something new: a group of detransitioned/desisted women starting a YouTube channel. Can you tell us a bit about what inspired you to do this and how things are going so far?
I was put in contact with Dagny, Helena, and Jesse a few months ago, and we had our first meetup in January. The initial goal was to create an ongoing multimedia project, focused mainly on raising awareness. All four of us have unique experiences and are committed to sharing those in the hopes of informing others about the dangers of automatic gender affirmation and the influences of social media. We also dive in to other factors that fuel dysphoria, and the importance of exploring those before embarking on medical transition.
We’ve had incredible, overwhelmingly positive feedback so far, as well as a ton of opportunities that have arisen for us to expand our platform. Several parents and young people who are questioning their gender have contacted us for advice, and I personally have helped two so far in the process of self-reflecting and moving toward desisting. I’m very excited about the future for us and this project.
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Denise, what are your thoughts about PRP?
Chiara has always done things her own way. She’s tough and intelligent, so in one sense I’m not surprised that she could pull off something this important. And at the same time, what she and the other three women of PRP have created far surpasses what I could ever have imagined five years ago. Their message is one of strength and hope—not only for their primary audience, young people who are questioning their gender, but for parents whose daughters and sons have pursued and/or desisted from a trans identity. Not every young person will desist or detransition, but these women show and tell what that can be like. By joining together as a group, the PRP women are offering an alternative vision that we haven’t seen in quite this way previously (although there have been some really inspiring detransitioners who’ve been writing and vlogging about their experiences for several years now). I really think their insights and experiences will help many people in the years to come—and that includes not only those who detransition/desist and their families, but also others who continue to live as trans-identified people.
Obviously, it’s been a long and sometimes difficult road for both of you, starting with Chiara’s initial announcement that she was trans in late 2014. Let’s jump into that story, starting from the beginning. First, how did Chiara tell you she thought she was trans?
Chiara told me she was trans soon after her 17th birthday, in a text message consisting solely of a link to an online informed consent clinic that would prescribe testosterone for minors, with parental permission. Medical transition was her goal from the get-go, and pretty much out of the blue. She had never previously said one word about feeling “wrong” as a girl—in fact, quite the opposite. I had thought for quite some time that she was likely a lesbian (which I fully supported), but there had never been any indication that she despised her body or wished she were the opposite sex.
But we had just watched the TV series “Transparent” together, and good liberal that I’ve always been, my initial reaction was “maybe she IS trans.” If she had not abruptly and immediately expressed such an intense interest in testosterone and top surgery, I might not have embarked on a research mission which in rather short order resulted in alarm bells—primarily because I learned the effects of T are mostly irreversible, and I well remembered my own dead-certainties at age 17 that turned out to be mistaken when I got older. Her constant demand for hormones (and later “can I at least have top surgery”?), coupled with my phone calls to some gender therapists, all of whom in so many words told me if she said she was trans, then she was, intensified my skepticism.
When I asked one of the gender therapists how we could know she was trans as opposed to lesbian, she said, “Oh, it is very rare for a trans man to actually be a lesbian. Very, very rare.” Then there was the (very nice) FTM therapist who, when I mentioned Chiara had not had a full-on relationship yet, said, “A lot of trans teens just skip that step” and added “he’d” be welcome at the next trans teen support group that week. I actually did schedule an appointment with this therapist, as well as signed her up for the group, until my crash online course in all things trans made me think better of it and cancel. Not long after, Chiara and I together found a therapist who used a mental-health (vs. “affirmative”) model and agreed to work with Chiara without enabling medical transition.
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Chiara, why do you think you came to believe you were transgender? What forces were acting on you?
At the time, I of course believed that I was “a man trapped in a woman’s body,” and that I would truly not survive if I was not allowed to transition. (I wasn’t constantly or seriously suicidal, though I had ideation at times—it was more that I saw no future for myself as female; the only option in my mind was living as male. Additionally, suicide rates by trans-identified kids are misrepresented and used to threaten and manipulate people into “validating” identities without question.) In hindsight, however, I was struggling to deal with trauma, internalized homophobia, and social isolation. I was at a vulnerable place, and not all that happy being a girl, so I latched onto a trans identity almost as soon as I first heard about it online.
Was there a lot of talk about suicide online? If so, did that influence you in any way?
There was a large amount, the most notable being the case of Leelah Alcorn, an MtF teenager who committed suicide in 2014. Her death affected me, along with many others, as it was sensationalized and widely held up as a warning to parents: “This is what happens when you don’t let your kid transition.” This mantra continues to be repeated online and everywhere, and perpetuates the idea that suicide is the “only way out” for kids whose parents will not accept their gender identity—this is a false statement that should under no circumstance be peddled to impressionable young people.
What made you feel unhappy about being a girl?
I was dealing with trauma, which caused me to want to escape my body. This, in addition to my resistance to accepting my same-sex attraction, resulted in a rejection of being female.
How did your dysphoria manifest itself? What “triggered” it for you?
It came on in the span of a couple months, but was still a fairly gradual process. The main triggers were my increased usage of social media, which facilitated my exposure to trans ideology and activism, as well as my social isolation and beginning to learn about and come to terms with past trauma. My dysphoria caused me to adopt an appearance that was as masculine as possible—I cut my hair short, wore men’s clothes, bound my chest, and packed off and on for over a year. I even used the men’s bathrooms in public, and felt good about myself when I passed successfully.
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Denise, as every parent knows who has experienced something similar, hearing your daughter suddenly declare she is transgender and tell you she needs hormones immediately is very stressful. How did you cope?
Starting the website—which was initially a cry into the wilderness, just hoping to find and speak to other parents who were skeptical of their teen’s desire to embark on medical transition—was crucial in helping me to cope with the situation. I suspect there would have been more arguments and difficult times between Chiara and me if I had not had the outlet of writing and finding others online who were in the same boat.
Pretty much all my “in real life” friends at the time were lifelong liberals/lefties like me, who saw (as I had) everything to do with trans activism as purely and simply the next civil rights movement; they hadn’t had a reason to look into some of the more controversial aspects because their lives hadn’t been touched by the issue. So, for the most part, I couldn’t talk to them openly about what was happening in my family.
This was, of course, a very difficult time for Chiara as well. She wanted desperately to transition. Did you make any concessions to her at the time?
I did. At her request, I bought boxer shorts, “men’s” clothing, “men’s” dress shoes, and repeatedly paid for very short haircuts. I was happy to do this, in part, because being “gender nonconforming” in clothing, hairstyles, etc. doesn’t mean a person is actually the opposite sex. I was well aware, however, that these outward expressions of gender meant to Chiara that she was a man (at the time). I drew the line at hormones or surgery, and I didn’t purchase the binder she asked for. (Whether she ever got a binder herself from one of the websites that offer them free, I don’t know.)
What were conversations between you like at the time?
We pretty much had a communication breakdown. Once we were a few months into it, I began to realize that I needed to say as little as possible, because after all, in just a few months, this was all going to be out of my hands (she was 17). Also, parental lectures—or even attempts at meaningful conversation—were becoming counterproductive (that can be true for any parent and teen in conflict, trans-identified or not!). When I did say something, I tried hard to be succinct, instead of going on and on. I would say things like: “You’re a strong, gender-nonconforming young woman. That doesn’t mean you are literally a man. In fact, you could be a role model for other young women in the same boat.” At the time, this all seemed to fall on deaf ears.
Like many parents in this predicament seem to do, I found and looked up to young, detransitioned women who were writing on Tumblr. I thought they somehow had “the answer.” I now know they don’t, and many—if not most—don’t appreciate parents reaching out for help. Nevertheless, I was fortunate to be able to meet two detransitioners I’d discovered online in person when I attended the Michigan Women’s Music Festival in 2015. They were kind enough to reach out to Chiara (with her and their permission) and I remain grateful to them for their generosity.
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Chiara, what turned things around for you? Was there anything that you read or heard that suddenly helped you realize not only that transition was not right for you but that gender identity as a concept was suspect?
At 17, as soon as I graduated high school, I moved to Florida for nine months for an internship on a horse farm. We had very little internet access, and spent most of each day performing physical labor, so I was forced to focus on something apart from trans ideology. Being disconnected from social media, specifically Tumblr and YouTube, allowed me to slowly begin rediscovering myself and my interests and by the time I returned home, I had matured (emotionally, physically, and mentally) enough to return to these social media sites with a critical eye. I found radical feminist blogs, the messages of which resonated with me, and gradually moved away from my trans identity with the support of this new community.
What appealed to you about the radical feminist blogs? What were they saying that resonated with you?
Radical feminism, being focused on women’s issues and liberation, was a breath of fresh air for me in many ways. The people writing about it online were fiercely protective of women and passionate about enacting change. The main points that appealed to me were their acceptance and celebration of lesbian and bisexual women, and their tendency to think critically and question problematic narratives—specifically prostitution, pornography, and, of course, transgenderism. They opened my eyes to the glaring issues behind trans activism (puberty blockers, misogyny, homophobia, women’s loss of rights, etc.), which allowed me to finally realize that I wanted nothing to do with the movement, and the best way for me to fight it was to simply exist as myself and stand up for other women. I definitely do not agree with every aspect of the ideology, but I believe it is the one of the only movements that truly cares about helping women.
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Denise, are you a radical feminist?
I like to think of myself as a “rational” feminist. Some of the tenets of radical feminism seem more ideological than logical—for example, the notion that humans are essentially “blank slates,” with all gendered behaviors being only social constructs. But there is a large body of replicated, cross-cultural scientific evidence that there is a biological basis to typical sex differences, and even some typical gendered behaviors, many of which are rooted in evolutionary selective pressures. Again, we’re talking about averages; individuals should never be assumed to be average. Being gender-atypical doesn’t mean anyone’s brain is mistakenly stuck in the wrong body. Historically, some of the more interesting, accomplished humans have been atypical for their sex. And, importantly, many—though not all—gender-atypical kids grow up to be lesbian, gay, or bisexual adults. This has long been well understood, though in the last few years, the trans movement has obscured this knowledge. There is a very real (even if unintended) risk that proto-LGB kids will be unnecessarily medicalized before they are old enough to realize and accept their sexuality. We already see many detransitioned lesbians who themselves say their difficulty accepting their sexual orientation contributed to their transient trans identification. (Of the essays I’ve written, I am perhaps most proud of the one I wrote on this subject, “The surgical suite: Modern-day closet for today’s teen lesbian”).
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Chiara, you mentioned that internalized homophobia played a role in your belief that you were trans. Why were you more comfortable identifying as a trans man than a lesbian?
In many ways, it felt easier for me to exist as a gender-conforming, “typical” man, as opposed to a gay, gender-nonconforming woman. As I mentioned in my recent interview, I think a lot of my desire to transition was based on a fantasy version of myself as a man—I was convinced that all discrimination against me would disappear as soon as I became a straight man. I also believe that our society is still largely heteronormative and somewhat homophobic, and gay people are often subjected to judgement, hate crimes, and insults. This is something many young people begin realizing in their teenage years, and it is understandably tempting to want to escape those experiences.
Did you talk to a therapist about your questions about gender identity? Did you find the therapy helpful or counterproductive?
I have been in and out of therapy for many years. It was incredibly helpful for me in many regards, and I strongly believe it should be utilized to determine factors contributing to dysphoria, before medical transition is permitted. The two long-term therapists I’ve had in the last few years have allowed me the space to explore mental health, come to terms with past events, and build the skills necessary to advance my life in the direction that I want. I hope that therapists will begin to educate themselves on both sides of gender ideology, and use this knowledge to encourage critical thinking in anyone who may be questioning a trans identity.
What were the things you think your mom got right in parenting you during the period when you identified as trans, and what do you think she got wrong? What could she have done better?
I am grateful that she never allowed medical transition, as I am sure I would have regretted it. I also appreciate that she put me in contact with a couple of detransitioned women, as well as paying for therapy for me to discuss issues behind my dysphoria.
But there were times in which I felt that my privacy was invaded, and this made it difficult for me to trust her intentions. I also had my phone taken away. While I understand that she truly felt that was for the best, I do not believe that trying to cut me off from the internet was helpful—I had multiple other ways to access it without my phone anyway, so this only caused resentment and anger on my end. I do understand that this was a very stressful time for her, but I believe that she could have been more careful about how she phrased several things, and stepped back to look at how some of her actions would impact me in the future.
Teens and their parents often have a hard time communicating with each other, even when the trans issue isn’t on the table. Were the arguments you had with your mom around this subject always counterproductive, or did she occasionally say things that stuck with you and helped you (eventually) see things differently? Conversely, do you think your mom was eventually able to understand some of what you were going through and trying to tell her?
At the time, most of our arguments did nothing to change my mind or outlook. At that point in my life, I was reluctant to change my opinions and take advice, especially from my mother. I can look back now and agree with a lot of what she expressed to me, and I do think that some things she said stuck with me and helped me to open my mind to the idea that transition was not the right path for me. I believe that she did eventually understand a lot of what I was feeling, but it was an unfamiliar topic to her at first.
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Denise, do you have any regrets? Were there any things that you wished you had done differently?
I do have regrets about how I handled some things. I was not (and am not) a perfect parent, and I think the increased stress we both experienced during that time damaged our relationship. We’d been very close pre-puberty, but along with the other garden-variety issues that arise for parents and teens weathering adolescence, the trans issue turned the stress-volume up to max. One night, when Chiara was screaming about how awful I was not to approve medical intervention, I screamed back that she should just leave. I immediately wished I hadn’t said it. She didn’t leave, and I never took any steps to kick her out, but I know how much that must have hurt and probably still does. I’ve apologized, but I still wish I could take it back because I never meant it.
Monitoring and restricting her social media and (temporarily) confiscating her phone are things I feel more conflicted about. At the time, it seemed to me that she was being inducted into a cult: the obsessive nature of her wanting “the two Ts” (testosterone and top surgery), scripted language, and a seeming refusal to examine or explore what might be underlying this (as well as a general refusal to talk to me about much of anything) resulted in my feeling desperate to know what was going on inside her, and to try to keep her safe in any way I could. Besides the rumination on being trans 24-7, her grades had dropped from As and Bs to Ds and Fs, she nearly dropped out of high school, she had drifted away from all the friends who had previously been important to her, and totally abandoned all her hobbies and interests.
In an ideal world, I would not have invaded her privacy, and I know from my own teen years how such actions feel like a huge betrayal of trust. Something similar happened to me when I myself was 17. I discovered one day that my dad had searched my closet and confiscated a baggie of marijuana I had hidden beside a diary. I still remember the burning outrage. I confronted my father and for many years could not forgive him. Now, of course, I can understand how worried he was about me and the choices I’d been making. But whether what he did was justified, or whether my similar actions with Chiara were justified? I’m not sure.
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Chiara, on the PRP website, you, Dagny, Helena, and Jesse state plainly that you all experienced rapid-onset gender dysphoria (ROGD) as described in the paper published by Dr. Lisa Littman last year, but trans activists have tried to dismiss and discredit Dr. Littman’s research, claiming it is based entirely on the claims of bigoted, transphobic parents. Why do you believe that you experienced ROGD? How would you respond to Dr. Littman’s critics?
I believe that ROGD is a very real phenomenon, because I, myself, and many others only began experiencing dysphoria around our teenage years, seemingly in response to significant changes or struggles. I did not begin to have dysphoria until I was a young teenager, and had no desire to transition until I began hearing about others doing so. I became obsessed with the idea that I was a man, and completely fixated on medical transition as the only viable option for me. Since I can look back now and understand that I would not have been happy long-term with that decision, I am very confident in Littman’s study, and believe that discrediting it as “transphobia” is wildly irresponsible. I find it very strange that trans activists see any inkling of criticism as a direct, “violent” attack.
You mentioned that you had no desire to transition until you heard about others doing so. Did your dysphoria increase the more you learned about gender identity and transition?
Absolutely. The more information I consumed on the topic, the more adamant I was that transition was right for me. Other people’s hormonal and surgical results appealed to me at the time, and I desperately wanted that for myself. It was a vicious circle: the more I watched, the more my dysphoria grew, and the more my dysphoria grew, the more I needed to “escape” in the form of this addictive media.
Why do you think so many young people—especially girls—have come to see themselves as transgender?
In many ways, it is incredibly difficult and often painful to exist as a woman in society. Dealing with harassment and strict gender roles is a daily ordeal, and media often portrays us as infantile, sexualized, and unconditionally available to men. Women are targets of assault and murder simply because of their sex—the idea of escaping that, which transitioning to male promises to provide, is very attractive.
What do you think it will take to wake people up to the harm that’s being done in the name of gender ideology?
Honestly, I think this is already starting to happen. The response to our project alone has been big (over 20K video views in the first two weeks) and overwhelmingly positive, which gives me hope that more and more people are beginning to realize the negative effects of this movement. Also, many of the young people who transitioned when the movement was beginning to really take hold a few years ago are now detransitioning, and their voices are growing in number. I am grateful to be part of a project to raise them up, because I believe those experiences are very important and should be shared in order to educate others.
Trans activists claim that only a tiny percentage of people who transition regret their transitions. Do you think the number is this low?
No, I believe that the percentage is actually fairly high. People claim that less than 3% of trans people detransition, but since detransitioners are routinely silenced and discounted, I am hesitant to accept that number as accurate. Also, this estimate generally fails to account for people who desist–that is, abandon a trans identity before taking hormones or undergoing surgery.
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Denise, do you agree?
Yes. And with organizations like Gender Spectrum promulgating immediate affirmation of youth trans identities, we’re likely to see more in the future. Plus, many who detransition don’t return to their gender therapists/MDs, nor are they being systematically tracked otherwise. And regardless of how many detransitioners there are, they matter. Their voices matter. And it shouldn’t be seen as “transphobic” or even controversial to ask that we try—as a society, as parents, as clinicians, even as trans activists—to minimize the number of people who will later feel they were harmed by believing they were trans; particularly people who were irreversibly harmed by medical intervention they later come to regret.
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Chiara, what would you say to the activists and legislators who are pushing for legislation that would make it illegal for therapists to encourage clients to explore why they feel they must transition?
I think that would be blatant malpractice. The job of a therapist is to help people overcome issues and develop the best life possible, and transition is not always the right way forward. This would also prevent therapists from digging into deeper issues behind dysphoria. If this law were to go into effect, if would only increase the number of young people who would later detransition.
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Denise, why have you decided to “come out” now?
After Chiara and her compatriots launched Pique Resilience, I realized we were in a new phase—both as mother and daughter, as well as in the greater effort to raise awareness about the complex issues to do with youth transition. Until now, it was of utmost importance to me to protect Chiara’s identity and privacy, so very little information about her was ever included in anything I wrote. Her courage in bringing her story to light has inspired me to step forward as well. There’s nothing to be ashamed of, anyway. Many families have had very similar experiences to our own, and the more of us who are able to speak publicly about our lives, the better.
I suspect detractors might claim the only reason Chiara desisted is because of something I’ve done or said to somehow cajole her into doing it; that she’ll “retransition” in the future. Or maybe: 4thWaveNow is the master puppeteer pulling the strings of the Pique Resilience Project. But Chiara is an adult, supporting herself, living on her own, making her own decisions. And I’m pretty sure the other three women in PRP are also very much their own persons! As far as our family situation, I feel quite certain that if Chiara had decided to pursue transition (and she told me she absolutely planned to, as recently as age 18), she’d have gone ahead with it. Then I’d be in the position of coming to terms with that decision, which I know I would have. She’s my child. I’ll love her no matter what she does, whether I agree with it or not.
Trans activists have worked very hard to deny the experiences and observations of families impacted by an abrupt onset of gender dysphoria. Just a couple of days ago, trans activist and writer Julia Serano penned a long Medium article, as well as a tweet thread, in which she paints ROGD as some sort of coordinated, grand conspiracy cooked up by bigoted parents and backwards clinicians. It’s strange that activists like Serano (along with many others) refuse to believe there could be some young people (the majority of them female) who identify as trans due to social contagion and other issues (which Chiara and the other women of Pique Resilience Project have eloquently talked about in their videos and social media postings). Why can’t Serano et al understand that people are talking about their own lived experiences? The fact is, if there’s any mutual effort on the part of those of us who’ve experienced or observed ROGD, it’s simply a “grand conspiracy” to tell the truth.
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Chiara, what would you say to trans activists who might claim your mother has brainwashed you into believing that you’re not trans? (They tend to say that about any parent whose kid desisted.)
Parents are often demonized, called “abusive,” and beaten down by trans activists if they dare to question whether transition is right for their child. Parents are generally not in the habit of brainwashing their children—rather, most want to protect and support them. Asking your child to think critically and consider other factors at play is not abusive, it’s just parenting. Further, I am an adult fully capable of making my own decisions and formulating my own opinions. My decision to desist was mostly due to my own experiences and research, not a result of my mother forcing an ideology.
When did you first learn that your mom was the founder of 4thWaveNow?
Just a few months ago, not long after we started Pique Resilience, and years after I desisted. I was very surprised, mainly because I had no idea that my mom was running a blog at all, let alone one of this size. I completely respect and support all the work that has gone into it; it’s become one of the largest and most-visited sites providing an alternate viewpoint, and I’m grateful for the support it gives to both young people and their parents.
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Denise, do you have anything to say to those who criticize parents when they do not immediately affirm their children’s belief that they are transgender?
One of the most pernicious things trans activists and some gender clinicians do is try to drive a wedge between young trans-identified people and their families. While there are certainly abusive parents, the vast majority of us who have serious reservations about the medicalization of our gender-atypical youth do love and care about our kids and only want the best for them. We do our best, given our own personalities and weaknesses (as well as our strengths). While the time during which Chiara believed she was trans was very difficult for us and brought out the worst in us both, I’m very grateful we have moved toward healing the rifts between us, though we have further to go. Above all, I’m very glad that Chiara and the other three intrepid women of the Pique Resilience Project have started their own effort to help young people like them.
When it comes to how this increase in young (mostly) women who believe they’re men will ultimately play out, no one knows; it’s going to unfold over the next few years and decades. But I can say this: the future of the movement to raise awareness about this issue does not belong to 4thWaveNow, or parents. It belongs to resilient young women like Chiara and her friends and colleagues. They are the ones who will make the world a better place for their generation and the next generation of gender-atypical young people to come.
It was a hot summer morning. I was nine or ten, riding my pony from our farmhouse toward the barn where my father was working. This was the first time I had gone riding since a string of bad falls had caused me to lose my nerve, but I loved riding, and was determined to be back in the saddle.
So far, things were going well. The gravel road between our house and the barn was about a mile long, and I was halfway there. My usually cantankerous little mare was being perfectly docile, but I was approaching the house of a quirky neighbor who kept a menagerie of animals – donkeys, zebras, buffalo, and a gaggle of dogs that barked at every passing car. I was mostly worried about the dogs and how my pony would handle the barking – it sometimes made her nervous, but there was no dog in sight as I rode past the house.
I was thinking I was home-free until I heard a commotion from the paddock across from the neighbor’s house. I looked around and saw a giant draft horse push through a dilapidated wire fence and come galloping toward me, neighing and grunting in what I later understood to be equine lust. In an instant he was beside us, rearing and pawing his great, hairy hooves in the air near my face. I thought that was the end of me and my pony.
Then all of a sudden I heard my mother’s voice. I looked around and found her running toward us, yelling and hurling gravel at the big horse. She distracted him just long enough for me to hop off. My pony raced off into the safety of some low-hanging trees, and the neighbor came running out of his house to capture his oversized horse.
As I stood there, weak-kneed from my near-death experience, I saw my mother’s car parked a few yards down the road, the driver’s-side door still open, and I knew what had happened. She had been worried about me, so she had followed from a distance, just to be sure I made it okay.
Illustration by Chiara (Twitter: @chiaracanaan)
I’ve been thinking about that story a lot lately. It was about four years ago that my daughter first told me she thought she might be trans. I believe her story is a classic example of social contagion, since she had never expressed any discomfort with her sexed body until she got Tumblr and DeviantArt accounts and began spending all her time on her phone. Since then, I have felt a bit like my mother, standing in the middle of the road, hurling gravel, trying to protect my daughter from an ideology that has sought to convince her that she was born in the wrong body.
I am fortunate. Unlike some of my friends with kids who became convinced they were trans, I feel reasonably confident that my daughter will not medically transition. She desisted from a social transition more than a year ago, and she told me recently that she no longer identifies as trans. However, she still has many friends in the gender-queer community, and I know we’re not out of the woods. When she turns 18 in a few months, she may exercise her right as a legal adult to start medical transition, and there won’t be anything I can do to dissuade her. This worries me greatly. So, as a matter of self-preservation as much as anything, I’ve been asking myself, what if she does transition? How will I cope?
The short answer is I don’t know, but I certainly won’t disown her or ask her to leave my home. In fact, of all the many gender-critical parents I know who have trans-identified children, I know absolutely no one who has disowned their child or kicked them out of the house. I’m sure it must happen, but I don’t know any. Of course, all parents say things they regret – especially during the highly charged arguments with teens who are demanding immediate medical interventions. In one such argument, one of my best friends even told her then-trans-identified daughter to get out, but she immediately regretted it, took it back, apologized, and asked her daughter to stay (which she did). I also know at least three mothers who have lost contact with their trans-identified children, but in those cases, the kids themselves severed the relationship, not the parents. In fact, the mothers continue to try to reconnect with their children, despite being repeatedly rebuffed.
Although I know I won’t disown or reject my daughter, I also know that I won’t affirm her decision to transition. It’s not really that I’m deciding not to; I simply cannot bring myself to do it. It would be dishonest for me to call her my son when I don’t believe she’s male. Plus, I don’t think it’s helpful for me to allow my daughter to dictate how I define words like “male” and “female.” Does this mean I love my child less than the mothers who affirm their children?
Since I cannot occupy the mind of any of these other mothers, I guess I’ll never know. But I do know that my love for my child is so deep and strong that the idea that she has been misled to believe that her body is wrong depresses me to no end. I am angry — bitterly, bitterly angry that this ideology has taken up almost four years of her life so far and god only know how many more years it may take.
Maybe the reason some parents affirm their children’s transgender claims and some parents question them lies in the parents’ own experiences of puberty. When my daughter felt embarrassed about shopping for bras at 13, I was not surprised because I remembered that feeling vividly. I hated it. I hated knowing that people could see my developing breasts and the outline of the bra straps under my shirt. I especially hated the very feminine bras – the ones with lots of lace and little pink bows where the cups joined in the middle. They made me feel vulnerable and exposed and miserable. I also know I got over it – for the most part, anyway.
Trans activists claim that the number of trans-identifying people has increased so rapidly not because there are more trans people today than in the past but because society has become more accepting and they are no longer afraid to come out. But if this were the case, why are the greatest increases occurring in the population of female teens? Why aren’t middle-aged women like me queuing up for hormones now that we can come out? To me, the answer is clear. Women like me had a chance to come to terms with our bodies and accept ourselves as we are. My daughter didn’t have that chance because an insidious ideology was waiting in the wings to convince her that her feelings about her body meant that it was wrong.
But maybe the mothers who readily affirm their children’s trans self-diagnoses didn’t have this experience at puberty. Maybe they were lucky enough to sail smoothly and happily from childhood through puberty, unambiguously pleased to watch their bodies go from child to woman – so, when their children expressed unhappiness about their developing bodies, they were genuinely puzzled and could only agree their kids must have been born in the wrong body.
Whatever the reason for the difference between those parents and me, I resent the fact that the mainstream media will tell their stories, but they won’t tell mine. I resent the fact that my daughter looks at those parents and wishes I could be like them — because I never can be.
If my daughter does eventually decide to take hormones or undergo surgery to medically transition, the only way I could fully support it is if I had clear scientific evidence that she had a condition requiring such an invasive treatment. If there were a definitive medical test – a brain scan, for example – that proved my child’s distress arose from an incongruence between her brain and the rest of her body that could only be alleviated by transition, I think I could go along with it. But there is no such test because individual brains don’t break down neatly into pink and blue categories. Sexually dimorphic brain features are subject to averages just like other physical characteristics. In general, men are taller than women, but if you plot their height on a bell curve, you will see lots of overlap between the sexes. You’ll also see outliers on the “tails” of the bell curve—6’4’ women, and 5’1” men. This is true with psychological and neurological traits, too. Also, trans activists justify their born-in-the-wrong-body claims by pointing to a few studies which indicate that the brains of trans-identified people are more similar in some respects to the opposite sex than their natal sex. But these studies do not control for many factors, including sexual orientation, and we know already that people who are same-sex-attracted have some brain features more similar to the opposite sex.
Without tools to reliably predict who will benefit from transition, I simply cannot support medical interventions for young people whose brains have not fully matured (generally understood to be around age 25). I want desperately for my daughter to accept her body and to avoid the irreversible changes and the many health risks that are inherent in medical transition. But she will soon be 18 years old, and she will have the power to transition no matter what I want – even though she is still at least seven years away from brain maturity. There’s a real chance that she could. Would that be the end of the world?
No, I know that it wouldn’t. As worried as I am about this outcome and as fixated as I’ve been on preventing it for four years, I do have to remind myself that her transitioning would not be the worst thing that could happen. Plus, I will still be able to hold onto the hope that she will detransition before the hormones can cause too much damage to her long-term health. Every day it seems that I read about a new detransitioner. More and more young people are saying enough is enough. They are reclaiming their bodies and their lives, and I find their stories inspiring.
A few days ago I watched a video in which four young women, who formerly identified as trans, answer questions about their experience and share their insights. Their video gave me hope for a couple of reasons. First, they acknowledge the role that social contagion plays in driving the huge increase in kids (especially girls) who are identifying as trans today. It takes real courage to speak up and share stories that contradict the popular understanding of why people transition. These stories not only challenge the narrative of why people transition; they also show that, for many young people, transition does not make their lives better.
But another reason that video gave me hope is that I can see these girls are all okay. In fact, they’re better than okay. They are strong and smart, and they are living with purpose and a sense of future. They reminded me that transition – even medical transition — is not the end of the world. Three of the girls were on hormones for more than a year. Their voices are changed, but they are healthy and well, and that’s a beautiful thing.
Detransitioners have been giving hope to me and other parents for many years, but the relationship between the groups has been difficult at times. Some detransitioners have understandably resented how parents sometimes try to use their stories as cautionary tales to warn their kids about the dangers of medical transition. A big part of the problem is the language people sometimes use when talking about medical transition. For example, referring to the bodies of detransitioners as “mutilated,” their voices as “broken,” or their stories as “heart-breaking” has not been helpful.
One of the most powerful and positive messages of the gender-critical movement is that no one is born in the wrong body. Gender-critical parents like me are constantly trying to encourage our kids to accept their bodies just as they are. Yet I believe we need to extend that same acceptance to all bodies – even bodies post transition. To feel good about themselves and their lives, all people need to be able to accept themselves physically and mentally, and words like “mutilated” don’t help them do that.
Online, the interactions between detransitioners and parents has also been a little rocky at times because parents sometimes overstep boundaries that detransitioners need to be healthy. Parents often reach out to detransitioners for help with their personal situations – to seek parenting advice and guidance. But most detransitioners who speak out publicly are quite young; they don’t have children and they aren’t parenting experts, nor is it fair to saddle them with the responsibility of helping us. They’re dealing with their own issues, are often most focused on helping each other, and they don’t (and can’t be expected to) understand the situation and struggles of parents. What’s more, many have written or vlogged about their own, often fraught, relationships with their own parents, so when other parents reach out to them, they can feel “triggered” by being reminded of their own family relationships. These young people are still maturing and processing what their transition and detransition mean to them. They need time and space to be able to do that, and desperate appeals from parents they’ve never met, for help with kids they don’t know, could interfere with that process.
Also, detransitioners are not a monolithic group. Not everyone who detransitions regrets transitioning. Deciding that transition is not right for you and regretting transition are not necessarily the same thing. Detransitioners who do not regret their transition naturally resent it when people use their stories to make a case against medical transition.
At the same time, those detransitioners who are willing to speak out about the harms of transitioning and the power of reidentifying with your birth sex can be powerful allies in the fight to raise awareness about the regressiveness of gender ideology and potential harms to other young people – whether we’re trying to raise this awareness in the culture at large or just in our own homes. I hope my daughter will listen to the stories of some of these detransitioners and decide to first try some other strategies for becoming comfortable in her natural body.
If, however, she does eventually transition, I hope she can be honest with herself about it and accept that she can never be male – however much she may be able to look like one. I follow several gender-critical trans women on Twitter. Although they have sought medical intervention for palliative reasons, they acknowledge they are male and support sex-based protections for women. They don’t demand that the world repeat the mantra that trans women are women. They have a healthier outlook on the world and a healthier sense of self because they aren’t trying to change anyone’s perception of material reality (like male and female). I appreciate the courage they are showing. Their stance as gender critical has cut them off from the support of the larger trans community, which regards them as heretics and traitors. And it must be noted that they’re not universally accepted among women who are gender critical, some of whom regard them with suspicion.
Of course, my daughter may never come to recognize the bill of goods she’s been sold. She may transition, remain transitioned, and remain committed to an ideology I find regressive. If that’s the case, it will be my life’s task to love her and support her in spite of these things. But that doesn’t mean I will ever abandon my own sense of reality, because doing so would be inauthentic, and parents should not have to subordinate their own authenticity to their children’s quest for it.
What I can do is look after her, help her financially to achieve non-transition-related goals, cook her favorite foods, hold her hand when she’s feeling down. I can even go out of my way to avoid gendered language so as not to provoke or upset her, but I simply cannot utter beliefs I don’t hold. Our relationship needs to be based on mutual respect. I must respect her autonomy, but she must also respect mine.
Also, I want my daughter to understand that it’s ok for other people (even her parents!) to disagree with her and hold different views; that doesn’t mean we don’t love her. Far from it. I want my daughter to be strong and resilient enough to face the reality that life will be full of other people who disagree with her for any number of reasons. I’d rather she learn resilience than fragility that is triggered whenever she encounters disagreement or disapproval from others.
I feel such a sense of solidarity with the other gender-critical moms I’ve met here on 4thWaveNow, on Twitter, and in real life because they’ve seen what I have seen – that this ideology has made our children less resilient, it has alienated them from their families, their former friends, and, worst of all, their own bodies. Most of us have watched as our children went from well-adjusted kids to teens preoccupied with online worlds, feeling oppressed and seeking medical transition.
For our efforts to call attention to the regressive nature of the ideology, we have been called “bigots,” “transphobes,” even “Nazis.” So-called gender therapists gaslight us and pretend to know our children better than we do. And some journalists, blind to their sexism, have dismissed us (in one case, as merely a “bunch of mothers”), despite the advanced degrees and professional careers many of us hold, not to mention the voluminous research we have done to educate ourselves about this particular subject.
And, yes, we have made mistakes. We are certainly not perfect. There are so many things I have said to my daughter that I wish I could unsay or at least say differently. There are so many times when my strong emotional reaction to things she was telling me created a barrier and shut down communication between us. Of course, she has said things that hurt me too, but as her mother and the adult in the relationship, I rightfully bear a larger share of the burden to try to make things right between us.
I can’t change the past, of course. What’s done is done. But I do know this: My mother has been dead for more than 20 years, but I think about her every day. She was far from a perfect parent, but she loved me fiercely. The love she gave me in the first 30 years of my life still sustains me today. I know that now, in a way I didn’t fully understand when I was younger.
I don’t know what the future holds for my daughter. My fervent hope is that she will reject the idea that she needs to change who she is, but whether or not she does, I hope one day she will look back on my resistance to her transition as the act of love that it is. I hope that her knowledge and memory of the fierceness of my love will sustain her, as my mother’s sustains me.
GNC-centric is a detransitioned dysphoric lesbian. She lived as a trans man for most of her teen years in Canada. For many of those years she attended book readings and lectures on gender and LGBT events, and studied queer ideology. She now uses social media to speak critically about the harms she witnessed and experienced as a member of the transgender community.
She can be found on Twitter @gnc-centric
Foreword
Many readers may be familiar with Morgan Page as the creator of the Planned Parenthood Toronto workshop “Overcoming the Cotton Ceiling: Breaking Down Sexual Barriers for Queer Trans Women” in 2012. I never heard about this before meeting gender critical feminists after leaving the trans community, years later. I honestly don’t remember anything like that topic coming up while I was in the youth group, although it may have.
I am writing this years after my experience, so there isn’t a ton of detail. I am avoiding using any names, save for Morgan Page, the leader of the youth group I attended. I am using “she” pronouns for Morgan since that is what I used when I knew her; to do otherwise feels disingenuous. This specific group (Trans Youth Toronto) doesn’t exist anymore, although The 519 in Toronto now has other groups for trans youth. Morgan Page no longer works there.
I first met Morgan Page in 2012 at a conference for Gay-Straight Alliances from high schools in the greater Toronto area. Though I’ve since detransitioned, I identified as trans at that time, but I didn’t know any trans people in real life, only online. Morgan was a super nice, friendly person and invited me to the youth group she ran at The 519 in Toronto (LGBT Community Centre). Most of the time, the Trans Youth Group attendees were majority MTFs and “nonbinary” (NB) males. There was an upper age limit (somewhere between 21-25) but it was a pretty small group, usually fewer than 10 people; so when people aged out they just stuck around. I guess others learned that the age limit wasn’t being enforced because more and more older (30-40 year old) MTFs started to join.
I remember one day, there were three MTFs over 40 who were hitting on the teen FTMs, very explicitly. It was obviously making us uncomfortable, but almost no one ever said anything, only changed the topic or tried to engage them in a conversation away from us. The only time I remember them being asked to leave was when Morgan was away and the group was led by an FTM substitute.
The 519 LGBT Community Centre, Toronto
It was very common for the group to discuss the logistics of sex before and after SRS, kinky sex, and erotic fanfiction. I remember Morgan asking the three teens in the room, including me, if we were comfortable talking about this, but obviously we weren’t going to say no now that the conversation had already been started by these older people. I know of at least three FTMs who entered into relationships with older MTFs while in this group, all of which seemed very unhealthy to me. To me, FTMs under 18 dating or sleeping with (usually kinky) MTFs over 20 seemed very sexually exploitative. Healthy boundaries between adults and minors were foreign to this group, much like in the greater queer and trans community.
Morgan didn’t present herself as someone to emulate, but as someone to share her trans experiences with us. She spoke of her time as a teen prostitute, her SRS, her art, her writing, and her connections in the queer community. I think most of the teens saw her as someone to just give us advice and support, since she could recommend which clinics or doctors to see to start HRT and tell you what you needed to say to doctors so they’d sign off on SRS. She’d talk about what to expect after SRS. She knew the MTF side personally, but she also was intimate with a fair number of trans men so she told us about the FTM side too. At the time, to me, she seemed like the magic key to accessing all the medical transition resources I wanted. This was a trans support group, so one might assume this was normal—and it may have been for such a gathering—but in retrospect, I find elements of this concerning.
Unsurprisingly, most of the teens seemed to be there without their parents’ knowledge (as I was), but there was unquestioning support for all of them to medically transition as soon as they wanted. There was one male nonbinary who complained about how they had to perform more femininity in order for their doctor to get them a prescription for estrogen. To us in the group, this doctor was evil for trying to deny our friend what they needed. Looking back now, the only thing that made this person “trans” was their clothing and nail polish. They made no attempt to pass as female, so I understand why a doctor might have been hesitant.
One of the most memorable experiences I had there was when I was 16 and had brought my 15-year-old non-trans female friend with me. We were hanging out, talking about the usual stuff, when Morgan mentioned she was going to be a judge at the Porn Awards that night and invited my friend and I to go with her for free. We said no—I knew right away I would probably see penises, and that would make my dysphoria worse. At that point in my life I had only seen porn once, and since then had only talked to porn actors and cam girls in the queer/trans community online. I honestly thought it was all empowering and fun. Still, my gut reaction was “no,” thank god.
Morgan’s personal life would often come up. This wasn’t a problem in and of itself, but I believe it normalized some harmful behaviour for us younger people. She would talk about when she was a teen and had a 30 year old boyfriend, then one of the teen FTMs would chime in how they had an adult boyfriend. She would talk about the drugs she did as a teen—weed, coke, poppers, etc; people would chime in about doing drugs in high school. She would talk about her time as a prostitute/sex worker, and others would accept this as a normal part of most MTFs’ lives. It’s one thing to be open about these topics so teens can discuss them without fear or shame, but another to present them as typical behaviour for trans people.
Usually, these things came up because someone other than Morgan started in on the topic. I don’t think she had any negative intentions, but most of the young people there had never been exposed to these things, and because of her, our first received message was that these were positive and mostly-harmless choices.
When I was 16, I started seeing a counselor for my family situation, my mental health, failing in school, and to help with my trans identification. This was the first time in my life I had met someone who really wanted to help me with my crippling social anxiety. I expected to learn coping techniques, not only for my anxiety but also for my dysphoria. She never gave me any advice for handling dysphoria directly. In one of my last sessions with her, I mentioned maybe using some of the techniques used by people with Body Dysmorphic Disorder. My counselor, a lesbian with an FTM partner, seemed surprised by this idea. Much like Morgan’s group, she didn’t attempt to tackle dysphoria, but merely took it as a sign that I needed HRT as soon as possible.
I was one of very few people in that group who got help for my mental health. This is horrifying considering how many of us openly talked about being suicidal and self-harming. It was a given that all the members of this group had struggled with depression and anxiety at some point. A lot of us had also experienced trauma, and many of us had ADHD or were on the autism spectrum. For some reason, none of this was ever discussed as seriously as other topics.
As mentioned previously, Morgan Page was the creator of the Planned Parenthood Toronto workshop “Overcoming the Cotton Ceiling: Breaking Down Sexual Barriers for Queer Trans Women” in 2012. And although I had never heard about this until after leaving the trans community, years later, those of us in Morgan’s youth group definitely identified as members of our chosen sex class, which is the cornerstone of the Cotton Ceiling movement: that sex-based attraction can be reclassified as gender-based attraction.
The only context in which lesbians were ever discussed was in regards to “trans lesbians”. Most of the MTFs & male NBs there would lecture the few FTMs and female NBs about our “masculine/male privilege,” explaining to us that they experienced “transmisogyny” and therefore we needed to know when to be quiet and listen. These beliefs and attitudes were essential in the aforementioned relationships between FTMs and older MTFs in the group. I remember one time I was discussing how I didn’t pass somewhere and was treated like a woman and called “dyke”, but they insisted it was just transphobia, and that I could no longer experience misogyny now that I identified as male. The idea that I might be a lesbian or that I might have experienced lesbophobia never came up. Isn’t this the perfect group mindset to facilitate abuse? Is this really the right dynamic for teens trying to discuss their trans issues, family, school, and mental health problems?
In conclusion, I believe that Morgan treated us like adults when we were only teens. She expressed unwavering support for anyone to transition regardless of their history, age, family situation, trauma, etc. The group viewed most therapists as “gatekeepers,” so she advised teens to find doctors who practiced Informed Consent. This means that many of the teens in that group started HRT without seeing anyone for their mental health first, after signing what amounted to a non-liability waiver. Strangely enough, we almost never talked about post-op complications nor the long-term negative effects of HRT, a lack of concern for which is sadly the norm in the trans community. She spoke about sex, drugs, porn, and kink as if it were a normal part of our lives because we were trans.
Honestly, my friends and I thought we might find help for our dysphoria, help understanding how trans identities and sexual orientation intersect, and yes, how to get HRT & SRS. Dysphoric and gender-nonconforming kids and teens need support groups that help address their everyday problems, without automatically being labeled as trans. In retrospect, that group was a breeding ground for predators and narcissistic trans males, with trans females discouraged from pointing this out on account of their “masc privilege”. At the end of the day, I think the members of the group internalized the prioritizing of MTFs and the silencing of FTMs, a mindset that now permeates almost all of the LGBT community.
Carrie-Anne is a thirtysomething historical novelist, historian, and lover of many things from bygone eras (except for the sexism, racism, and homophobia). She can be found at Welcome to My Magick Theatre, where she primarily blogs about writing, historical topics, names, silent and early sound cinema, and classic rock and pop; and at Onomastics Outside the Box, where she blogs about names and naming-related issues. Her only “child,” an 18-year-old spider plant named Kalanit, has thankfully never had any issues with her gender identity!
Carrie-Anne has written two other pieces for 4thWaveNow: “The boy with no penis” (about the case of David Reimer) and “Transing the dead,” a companion piece to this article.
As trans activists have demonstrated many a time, propagating their ideology takes precedence over accurately representing history. They have a long track record of posthumously declaring famously gender-defiant people (many of them LGB) to be trans, despite a complete lack of evidence (from either primary or secondary sources) to support such an extraordinary claim. Many have also declared old works of literature about LGB people, and women who posed as men to live freer lives and have more opportunities, to be part of a trans canon. Seeing as the modern-day trans umbrella is so broad and vague, trans activists feel confident in including anyone who wasn’t or isn’t one million percent a collection of rigid stereotypes.
Enter the latest trend in this misrepresentation of history: Genderqueering the dead.
In December, Katie Byford, a photographer, filmmaker, and poet, started a Twitter thread about nineteenth century female photographers, such as Eveleen Myers, Emma Barton, Constance Fox Talbot, Minna Keene, and Clementina Hawarden. After this wonderful celebration of female pioneers in photography, Ms. Byford made another thread, this one holding up Claude Cahun, Marianne Breslauer, Florence Henri, and Annemarie Schwarzenbach as “transfemale,” “genderqueer,” “trans,” and “queer.”
These lesbians were referred to with “they” pronouns, in spite of never having claimed to be anything but women, and no other evidence pointing to a trans identity. Like many other lesbians and gender-defiant women throughout history, they had short hair, wore stereotypical men’s clothes, and shunned the role of dainty little ladies immersed in all things domestic and stereotypically feminine.
Before these women’s true stories are presented, let’s look at the history of the term “genderqueer,” and the concept of claiming to be neither male nor female.
According to anthropologist April Scarlette Callis, in “Bisexual, pansexual, queer: Non-binary identities and the sexual borderlands,” people only began “identifying” as homosexual in the nineteenth century, when sexuality was medicalized in the wake of modern scientific developments and the decreased influence of religion. She quotes George Chauncey, a Yale history professor, as saying that gender roles, not sexual partners, were used to determine sexual orientation in the early twentieth century. E.g., only butch lesbians and effeminate gay men had labels attached to themselves, not lesbians and gay men who had less gender-defiant style and behavior. Only in the mid-twentieth century were people officially labeled homosexual or heterosexual.
The first recorded use of the word “genderqueer” is in an article from August 1995 by Riki Anne Wilchins, published in In Your Face: Political Activism Against Gender Oppression. Ms. Wilchins used this word to describe those with unnamed or complex gender expressions. In her 1997 autobiography, Read My Lips: Sexual Subversion and the End of Gender, she identified herself as genderqueer.
In June 2001, in The Village Voice, E.J. Graff used the word in “My Trans Problem,” in which she pondered whether trans people belong in the LGB movement:
“Many of us who are homoqueer, or queer in our sexual desires, are also at least a little genderqueer—more butch or sissy than we’re supposed to be…For lesbians as well, genderqueer (a masculine woman) has at times trumped homoqueer (a woman who has sex with a woman) as the defining stigmata…As many gender-passable homos win a place at the Thanksgiving table, our genderqueered sibs are still beaten, fired, harassed, and murdered not for the sex they have but for the sex they appear to be.”
Also in 2001, “GenderQueer Revolution” and “United Genders of the Universe” were founded to fill a perceived gap in the representation and celebration of people who considered themselves neither male nor female. In 2002, the term went mainstream with the publication of GenderQueer: Voices from Beyond the Sexual Binary, a collection of thirty-eight essays edited by Joan Nestle, Clare Howell, and Riki Anne Wilchins. Ever since, usage of the term and identification with the concept have been steadily rising.
While Ms. Wilchins may have had sincere intentions and a specific identity in mind when she coined the word, as had those who were early adapters of the concept, the explosion of identity politics, queer theory, and postmodernism over the past 5–10 years have rendered it as meaningless and catch-all as “queer.” Today, many consider “genderqueer” an umbrella term which includes identities such as “non-binary,” “demigender,” “trigender,” “bigender,” “agender,” “neutrois,” and “pangender.” Some people involved in identity politics even consider the word offensive and archaic nowadays, and have supplanted it with “non-binary.”
Marcel Moore and Claude Cahun, Self-Portraits Reflected in a Mirror, ca. 1920, Jersey Heritage Collections.
Thus, this concept didn’t exist when the abovementioned female photographers were alive. Claude Cahun, the first cited, was born as Lucie Renée Mathilde Schwob in 1894, and adopted the unisex name Claude sometime between 1917 and 1919. She experimented with several different surnames before settling on Cahun. Historically, it’s hardly been uncommon for lesbians to adopt male names, but this did not mean they were trans men or “genderqueer.”
In 1909, at age fifteen, she met seventeen-year-old Suzanne Alberte Malherbe, who later adopted her own new name, Marcel Moore. They quickly became friends, creative partners, and lesbian partners. In 1917, Moore’s widowed mother married Cahun’s divorced father, making them stepsisters. Their creative partnership may have diverted attention from their lesbian relationship. Both were active in the anti-Nazi resistance movement on the island of Jersey during World War II, and were imprisoned and sentenced to death after being discovered. They were saved by the island’s 1945 liberation (“Acting Out: Claude Cahun and Marcel Moore,” Tirza True Latimer).
Claude Cahun Jersey Heritage Collection
Cahun described Moore as l’autre moi (the other me), and they remained partnered until Cahun’s death in 1954. After Moore’s 1972 suicide, she was buried next to her lifelong partner at St. Brelade’s Church on the island of Jersey. Over the course of their lifetimes, neither claimed to be anything but women; they were gender-defiant lesbians.
The second photographer to be posthumously genderqueered was Florence Henri, born in 1893. Though she was a very prolific, well-known avant-garde photographer in her heyday, her name is largely unknown today. “Meet Florence Henri, The Under-Acknowledged Queen Of Surrealist Photography,” a Huffington Post article by Priscilla Frank, claims she “toyed with gender binaries, using her personal appearance to emphasize the performative nature of gender.”
Henri’s 1928 self-portrait is cited as an example of this, because it features herself “dolled up almost as if in drag” (i.e., short hair and a so-called man’s shirt), and two silver balls reflected against a mirror, “equivocal symbols of both testicles and breasts.” Posthumously identifying Henri as “genderqueer” on account of this is a huge stretch. She was bisexual and at times adopted a tomboyish, androgynous style. She never claimed to be anything but female!
The third and fourth photographers cited, Marianne Breslauer and Annemarie Schwarzenbach, were close friends, though not romantic partners. While Schwarzenbach was a lesbian (who entered into a lavender marriage of convenience with bisexual Achille-Claude Clarac in 1935), Breslauer appears to have been heterosexual. Breslauer was born in 1909, and rose to become one of the leading photographers of the Weimar Republic. Her anti-fascist activism and Jewish background eventually drove her out of her native Germany. After World War II, she and her husband became art dealers (“Beautiful Tomboys of the 1930s”).
Schwarzenbach was born in 1908, and dressed and acted “like a boy” from a very young age. She also adopted the name Fritz. Neither of her parents ever forced her to adopt a more stereotypically feminine role. Her own mother was also bisexual, and had a long-running affair with opera singer Emmy Krüger, as well as other women, which her father raised no objections to (“Swiss writer’s life was stranger than fiction,” Isobel Leybold-Johnson).
Throughout her life, Schwarzenbach continued dressing and behaving “like a man,” and exclusively had relationships with other women. Many times, she was mistaken for a man. Her attempted suicide, not her personal style, caused a much greater scandal among her family and their conservative circle. Breslauer described her as “neither a man nor a woman, but an angel, an archangel.” She travelled all over Europe and Asia as a prolific photographer and journalist, and tragically died from a bicycle accident at age thirty-four (“Beautiful Tomboys of the 1930s”).
On a related note, LGBTQ Nation and Ha’Aretz recently reported the discovery of alleged trans or “third gender” burials in a 3,000-year-old grave in Hansalu, Iran. This ancient city was almost continuously inhabited from the sixth millennium BCE till the third century of the Common Era. Among its claims to fame are the Golden Bowl of Hansalu and the Hansalu lovers, two male skeletons who seem to be embracing. The city was violently sacked and burnt around 800 CE, possibly by Urartians, which froze one of its layers in time, much like the eruption of Mount Vesuvius did to Pompeii. Thus, researchers have found a wealth of incredibly well-preserved artifacts, buildings, and skeletons (“Iran’s Pompeii: Astounding story of a massacre buried for millennia,” Catherine Brahic).
Biologically female skeletons were typically found with jewelry, needles, and garment pins, while biologically male skeletons were usually found with weapons, metal vessels, and armor. Simply because 20% of skeletons were discovered with objects associated with the opposite sex, or a mixture of objects, art historian Megan Cifarelli has presented this as evidence of “non-binary individuals” and “a third gender.”
Predictably, the Ha’Aretz article goes on to appropriate and misunderstand known “third genders,” such as India’s hijra and the Two-Spirits found in various Native American cultures. The evidence of such social categories doesn’t negate the reality of being male or female, nor does it have anything to do with post-modernist, queer, trans activist theory. On the contrary, they’re based upon a sex binary. People who don’t fit into either role find a place in these “third genders,” and thus are freed from the expectation of heterosexual marriage and sex, childbearing, having to wear certain clothes, accepting certain social and familial roles, and so forth. Most importantly, everyone around these people understands they’re still the biological sex they were born as.
Native Americans have repeatedly asked people to stop claiming to be Two-Spirit when they haven’t any Native American blood. Not only does this appropriate their culture, it doesn’t take into account how diverse Native American culture is. Not all tribes had/have Two-Spirits. For example, the Iroquois, who kept a much more extensive documentation of their people’s history and daily lives than many other tribes, never recorded Two-Spirits among their ranks. The Apache likewise have no records of them, though they were kind and respectful to Two-Spirits from other tribes (ibid).
Both the Apache and Iroquois had very egalitarian societies, in different ways. Apache adults typically had sex-segregated roles, but children were raised to do things associated with both sexes. Because their tribe was almost constantly at war with other tribes, it was essential to know how to do basic life tasks (e.g., sewing, cooking, hunting, construction) in the event of a sex imbalance either at home or in the trenches. Meanwhile, Iroquois women enjoyed great amounts of political power and authority. Hence, there was no need for Two-Spirits (ibid.).
One tribe that does have Two-Spirits is the Lakota Sioux. Their record of such a category extends as far back as their written history. They also had extremely sex-segregated roles from a very early age, and permitted polygyny. Lakota Two-Spirits were always men, never women. Men who didn’t conform to their tribe’s rigid rules about “proper” behavior were put in the camp with women and children, which didn’t enjoy as high a quality of life or social standing as the men’s camp (ibid.).
Another tribe with Two-Spirits, the Dene of Alberta, Canada, historically treated their women horribly. To give just one example, Dene women were forced to go hungry, if their husbands dictated it, during famines and food shortages. They were among the most mistreated, oppressed women among all North American tribes. Thus, the evidence makes it clear that progressive tribes had no need for Two-Spirits, while ones with the harshest, most rigidly-enforced sex roles required this social category as a way to deal with gay and gender-defiant men. In spite of not being regarded as “real men,” they still had the social power to opt out of manhood. Women weren’t allowed to opt out of womanhood. And again, none of these Two-Spirit men ever claimed to be women, nor were they seen as such (ibid.).
To get back to the topic of the grave, it seems more logical to conclude that the presence of stereotypically male or female objects with the opposite sex is evidence of gender-defiant individuals, possibly lesbians and gay men. If there were indeed a “third gender” in this society, it had nothing to do with modern-day views on the subject. It just goes to show that society may have had great acceptance towards non-conformity, so much so they buried these people with said objects. There also may have been other reasons they were buried with those objects; e.g., a soldier wanting to mend his uniform, both men’s and women’s clothes using garment pins, or women passing themselves off as men to fight in a war or rise to a more prominent social position.
The most recent paleoanthropological evidence reveals that our Neanderthal cousins had a very egalitarian society, with women as well as men hunting dangerous game face-to-face and taking equal part in all aspects of their daily lives, far more so than our own direct ancestors in the Homo sapiens sapiens line (The Neanderthals Rediscovered: How Modern Science Is Rewriting Their Story, Dimitra Papagianni and Michael A. Morse). Does that mean Neanderthals were all “genderqueer” themselves?
By declaring all these people “genderqueer,” part of a “third gender,” and automatically under the trans umbrella, young people who are gender-defiant themselves are being done a grave disservice. When they see no role models from history, in whichever field they may be passionate about (art, photography, music, writing, acting, science, medicine, mathematics, etc.), in addition to a dearth of gender-defiant examples in their own real lives or modern society, they’ll be more likely to believe they must be trans or “genderqueer” themselves. There are almost no available counterexamples to convince them otherwise — to help them see that it’s very possible to be a perfectly normal, happy woman or man who doesn’t behave like a walking, talking stereotype.
Youth in previous generations, not all that long ago, had high-profile gender-bending examples like Annie Lennox, Boy George, David Bowie, Grace Jones, Prince, Marlene Dietrich, and just about everyone with a New Romantic style in the Eighties. Today, however, young people are being sent the message that preferring short hair, trousers, boxer underwear, button-down shirts, and no makeup; or pink, makeup, long hair, stereotypically feminine clothing, and jewelry, means they must be trans or “genderqueer,” instead of simply a normal tomboyish, effeminate, or androgynous person.
Calling strong, proud women and lesbians “genderqueer” and using “they” pronouns erases, insults, and demeans who they truly were, in addition to doing a disservice to today’s young women. Respect for the dead is a common value across cultures and eras, and this is a painful example of the exact opposite.
This article is a long read, and includes detailed analysis of several research studies. Interested readers may want to review the bibliography and familiarize themselves with the relevant studies in order to engage most meaningfully with this post.
As with all articles and comments on 4thWaveNow, the views expressed by the author in this piece are his own.
by Hacsi Horváth, MA, PgCert (Sheffield)
I am an adjunct Lecturer in the Department of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). I’m an expert in clinical epidemiology, particularly in systematic review methods, epidemiologic bias and evidence quality assessment. As a researcher at UCSF, I managed the Cochrane HIV/AIDS Group for over a decade and on several occasions served as a consultant to the World Health Organization (WHO) in their HIV guideline development processes.
For about 13 years, I also masqueraded “as a woman,” taking medical measures which suggest, shall we say, that I was completely committed to that lifestyle. Most men would have recoiled from this, but in my estrogen-drug-soaked stupor it seemed like a good idea. In 2013 I stopped taking estrogen for health reasons and very rapidly came back to my senses. I ceased all effort to convey the impression that I was a woman and carried on with life.
At 12, I believed I would grow up to be a woman. I was mistaken.
As you may imagine, I have a lot of anger at transgenderism and its enablers, as well as an “inward bruise” (as Melville called it). I am not a happy camper. I have been badly harmed. However–as a father myself–I am far angrier that thousands of young people are being irreversibly altered and sterilized as they are inducted into a drug-dependent and medically-maimed lifestyle. I’m furious that women and girls are being steamrolled by trans activists into accepting any man who claims to be a woman in sex-segregated changing rooms, prisons, shelters, women’s sports, and elsewhere. If any man can simply announce that he’s a woman, then what is a woman?
My strong feelings often show through in what I write. On Twitter, in blogs and elsewhere online, I have often taken a very strident, confrontational tone. I have offended many with my refusal to utter words that I consider to be unsubstantiated, politically motivated jargon, along with my unrepentant “misgendering,” among other sins. In contrast, in real life, I try to get along with everyone and tend to be diplomatic with people whose views conflict with mine. I’m somewhat reclusive and generally not very keen to blast other people with peremptory critique.
Prologue
Where gender dysphoria (GD) is discussed, “suicide risk” and “transphobia” may lurk nearby, especially when the topic concerns adolescents and young adults (AYA). Why is this so? In this article, I will demonstrate that activists have created the false impression that the risk of suicide in adolescents and young adults (AYA) with GD (AYA-GD) is unique and unparalleled, that AYA-GD suicides are common and that “transphobia” is the main cause of such suicides. I will show why the shockingly high suicide attempt rates they commonly cite are not credible. I will also show evidence that AYA-GD suicide attempt rates are likely similar to those of other populations with similar risk factors. While these rates are higher than in the general population, they are much lower than they are touted to be in transgender activist propaganda.
Finally, I will look at the statistics for completed suicide in AYA-GD, before closing with some observations about losses to follow-up in studies looking into outcomes in people with GD, some years after their trans-related surgeries.
GD is a poorly-defined syndrome comprising one or more mental health problems, commonly including anxiety or depression, among others. It includes a “strong desire” to “be” the opposite sex, or at least to perform its stereotypes. At minimum, patients may have come to believe that they are utterly unsuited to fulfil the stereotypic roles and gestures socially prescribed for their actual sex, even if they have had tremendous lifelong success in doing so, and even though they are quite free to ignore such stereotypes. Gender dysphoria’s concomitant cognitive bias may keep the patient from ever getting better. The reason they may never recover from it is that this cognitive bias tells them this mental illness is really “mental wellness” (Levine 2018). They typically only visit doctors and psychotherapists who are willing (or even eager) to “affirm” their opinion that they are somehow inhabiting the wrong body. They are steered with increasing ease into a transgender trajectory and the mysteries of “transition.” Costume change, with or without cosmetic surgery, is an ineffective means of changing sex. Indeed, changing sex is impossible. “Transition” is thus mostly concerned with personality expression and receiving (in my view) unnecessary medical care. It can begin almost at a moment’s notice. In the US, self-diagnosed adolescent and adult GD patients may even receive prescriptions for cross-sex synthetic hormone drugs on the day of their first clinical visit.
Until recently, having GD and “being trans” were considered synonymous. This belief has shifted somewhat, as the phenomenon of “non-binary” people emerged. Also, it’s apparently no longer necessary even to have GD to be considered transgender. In San Francisco, if you want to be “trans,” they will “rubber-stamp” you and you’ll have your genitals inverted (or your breasts will be gone) in no time.
I don’t believe GD reflects any kind of problem or glitch in the human body. Here’s what I suggest, in broad strokes, is going on with adolescents and adults:
Heterosexual males (the vast majority of men with GD) have autogynephilia.
Homosexual males with GD enjoy “femininity” and mistakenly believe this means they are “trans” or even women.
Females with GD have internalized misogyny and/or internalized homophobia.
In my opinion—which is based upon extensive research, as well as my own 13-year-long experience in pretending to be a woman–GD is only superficially concerned with one’s sex. It’s more a disturbance of identity, of mistaking the signifier for the signified. Patients have whatever mental illnesses they may have, or that develop while in the ruminations and hypomanic states that typically precede “coming out as trans.” I propose that GD is a moody, brooding syndrome that accompanies these mental illnesses. People with GD have cultivated an idealized vision of themselves as the opposite sex. At a critical point of rumination, after the patient has sufficiently disparaged his or her actual life and idealized life as the opposite sex, he or she realizes that body parts of the opposite sex may be obtained through the services of doctors (Raymond 1979, Billings 1982). Actually transforming into the opposite sex starts to seem feasible. The self-conception “splits” in two, and idealization becomes identity. Having negated any value in their actual male or female presence in the world, and now feeling themselves to actually be the self-generated persona, patients perseveratively ask themselves, “what’s stopping me?” “Feasibility” seems to trigger the split. Here begins the acute phase of GD.
Patients become obsessed with “transition.” To the same extent that they can be energized by the belief that they are making “progress,” as their bodies morph via the hormone drugs and shop clerks address them by their preferred honorifics (i.e. Miss or Ma’am for the males, Sir for the females), they can also feel destroyed by any little delay or perceived setback—including being “misgendered” or identified by others as their actual sex. Nothing else matters but “transition.” The apparent certainty of these patients, as well as their zeal to continue, is seen by “affirmative care” doctors as evidence of “being trans.”
Gender is a hierarchal framework that stratifies and categorizes “masculine” and “feminine” attributes and behaviors. In the context of transgenderism, it is also a convenient rhetorical device to elide the problem of sexed bodies and to label oneself as endorsing one or the other sets of sex role stereotypes. Earlier articulations of GD as “gender identity disorder” made more sense, but it seems that most people understood it to mean “having an opposite-sex gender identity.” I would suggest that it may more accurately be understood as simply an identity disorder, a disordered or disturbed identity, with a fixation on gender.
I agree with the late French psychoanalyst Colette Chiland when she said: “Transsexuals stage everything in the theatre of the body, and nothing in that of the psyche” (Chiland 2003). It is true that persons in the driven, obsessed stages of gender dysphoria can seemingly think of nothing except transition. No-one dreams of asking them to slow down, to seek psychotherapy, perhaps even find a way through this work to prevent transition, which can be costly on so many levels. It would be like standing in the way of a bolting, bucking horse. The fact that people with gender dysphoria are like this is a sign that something is wrong, yet they are not impeded at all.
But doctors are doctors and patients are patients. These surgeries and lifelong hormonal drug regimens didn’t used to be given out like crackerjack prizes. Virtually no research has been done in psychotherapeutic methods to alleviate the symptoms of gender dysphoria, prevent it, or get rid of it altogether. The entire literature comprises a couple of dozen case reports and small case series, some promising, nearly all from before 1990, and all using archaic methods. Based primarily on the pronouncement of Harry Benjamin, the “godfather” of transsexualism, that psychotherapy with these patients was a waste of time, the medical profession increasingly found ways to justify surgical and hormonal transition as the standard of care (Billings 1982). I will get back to this near the end of the article.
There are three main models for treating children and adolescents who seem to have GD (Byne 2012, Costa 2016, Ristori 2016). The most sensible one helps kids to become more comfortable with who they are in material reality (Byne 2012, Costa 2016, Ristori 2016).
Another at first glance appears neutral about the question of whether the child should have a normal life or become a transsexual and therefore a permanent patient. Children subject to this strategy are often given drugs to block their puberty (Byne 2012, Costa 2016, Ristori 2016). Ostensibly, this is done to “give them time to decide,” but while deciding (and emulating the opposite sex) they surely become more deeply invested in rocketing further down that road.
The most hazardous approach of all is “affirmative care” (Byne 2012, Costa 2016, Ristori 2016), which is mainly seen in North America. According to this model, young people and adults who keenly desire to emulate opposite sex stereotypes, or perhaps show an indication that they might someday be homosexuals, are assured that they definitely “are trans,” and that it is essential to help them transition immediately (Byne 2012, Costa 2016, Ristori 2016). This model even encourages toddlers to “socially transition,” with boys being indoctrinated into stereotypic femininity and “girlhood,” and girls into masculinity and “boyhood.” Yet social transition has been shown to be predictive of persistence of GD (Ristori 2016). This means that even though young children nearly always desist from believing they are the opposite sex, socially transitioned kids are much more likely to begin puberty-blocking drugs at age 8 or 9, and then carry on with the rest of the complex medicalized transition process. If parents make any objection or refuse to “affirm” their child’s plan, they are shamed and belittled as “transphobes.” In some instances, parents can even be prosecuted and have their children taken away by the government.
Under the affirmative model, adolescents and adults are generally enabled to pursue medical interventions right away, seldom being told by their doctors “no, you are making a mistake.”
In this article, when I speak of trans activism, trans ideology and the like, I am referring especially to the “affirmative care” model. The old “gatekeeping” of patients with gender identity problems, which was developed in the 1950s to keep these often mentally unstable persons from rushing into irreversible, experimental interventions, is a ghost of what it once was. In cities like San Francisco, it has essentially been replaced by “informed consent” – which in practice translates to “on demand.”
Proponents of affirmative care have dealt the deathblow to what little gatekeeping that remains. Their activities could well be described as marketing and recruitment for “being trans.” Patients of any age need only say they think they are really the opposite sex, or wish they were, and affirmative care clinicians are happy to get busy, scheduling surgeries and prescribing lifelong drug regimens. They seem to see themselves as affirmative pioneers, especially those who work tirelessly to provide medical interventions to more and more children and teens, thus creating an iatrogenic illusion from which the kids may never emerge. A few examples follow.
Dr. Johanna Olson-Kennedy of Children’s Hospital Los Angeles is a prominent affirmative care physician. Earlier this year at a gender conference, she described radical mastectomy outcomes in gender-confused girls as young as age 13. She doubled-down on this affront to Hippocrates by suggesting that if teen girls later regretted the loss of their breasts, they could “go and get” new breasts, suggesting that breast implants would make them as good as new. There has been a tremendous surge over the past decade in girls and young women presenting to gender clinics (Zucker 2017, Littman 2018), and Olson-Kennedy says she has personally ushered more than 1100 of them into the medicalized trans lifestyle. In a 2018 paper, she recommends referring girls for this “top surgery” first, and only afterwards prescribing testosterone – thus removing the option for what might have been a little more time to think through this irreversible decision (Olson-Kennedy, 2018).
Psychologist Dr. Diane Ehrensaft of University of California, San Francisco (UCSF) is keen for toddlers and small kids to begin a “social transition” and likely continue along the path to medical transition (Ristori 2016). As mentioned above, children and adolescents no longer need to have GD; all are welcome to begin transition. At a symposium earlier this year, UCSF paediatrician Dr. Ilana Sherer told of feeling “challenged” when “lots and lots of kids” presented to her gender clinic without feeling any gender dysphoria. The “challenge” to which she alludes is that insurance companies (rightly) require evidence that these kids are receiving psychological support before the company agrees to cover the trans-related medical interventions they seek. Sherer spoke of the solution to this problem. After a brief meeting with a child, Ehrensaft (as Sherer describes it) essentially “rubber-stamps” the youth’s paperwork so that insurance companies will pay. In other words, she is approving services for patients who not meet diagnostic criteria and indeed do not have any distress. A question comes to mind: are health insurance companies and/or the health care fraud division at the US Department of Health and Human Services aware of this practice? It seems likely that if they knew, they would feel quite “challenged” to let it just go on.
Cross-sex hormone drugs have a drastic effect on the body and carry serious health risks. Notwithstanding this, UCSF’s guidelines suggest that almost anyone is qualified to prescribe a lifelong regimen of the drugs – even physician assistants, naturopathic providers (!) and nurse midwives. It is unclear why the MTF author of these guidelines, Dr. Madeline Deutsch, who trained as an emergency room physician, thought this would be wise. A healthy endocrine system’s ecological balance can easily be thrown into chaos – which is what happens when one takes cross-sex hormones anyway.
So, these are some of the better known members of the clinician crowd I am speaking about most directly in this article. Their approach is not the global standard – its recklessness seems clear to most people outside North America – but they are certainly marketing it aggressively.
Weaponizing our instinct to protect the vulnerable
Few things in life break our hearts more than to learn of a young person’s death, especially by suicide. We can’t help but have an emotional response to such news. The trans industry – comprising the activists, academics, healthcare providers, clinics, and pharmaceutical companies that benefit from transgender ideology, financially or otherwise – understands this well. The spectre of suicide in AYA-GD is a key component of trans activism. Not merely a talking point, it is a truncheon that activists and trans industry clinicians, other industry partners and virtue-signalling “allies” wield to force full compliance with their demands. To prevent trans suicides, the trans industry requires nothing less than a world that is utterly purged of transphobia.
Well, what is transphobia? Is it, as activists insist, a type of “hatred” that people who are not confused about the sex to which they belong (“cis,” in industry jargon) aim at the oppressed, still emerging masses of women and men, boys and girls who were “born in the wrong body”? No, of course not. Criticizing transgender ideology has nothing to do with hate and everything to do with mammalian evolution over the past 200 million years, the scientific method and common sense.
Then is it really homophobia, perhaps? Yes, in some cases it might be, because (in my view) no one is actually “trans.” Gay men and lesbians who take the transgender path are still essentially gay men and lesbians. But transphobia is much, much more than this.
“That’s transphobic.”
In real terms, transphobia could be defined as anything that an ordinary person does, says or even believes that “invalidates” transgenderism and its core principles, or invalidates any belief of a person claiming to be trans. In other words, factually stating that men cannot become women, nor can women become men, has a high probability of increasing GD in any trans persons within earshot. It would be considered transphobic. When a “trans woman” is made to feel that it is inappropriate for him to be in the women’s restroom or changing room, he feels tremendously dysphoric and “invalidated.” Similarly, to “misgender” a trans person – to accurately refer to a male with masculine pronouns, or a female with feminine ones (“gender” does, after all, exist in the grammar of many languages) – can send dysphoria through the roof, as validation plummets. People need to feel validated! But validating a lie so they might feel better for a minute is not helpful. Trans activists insist that misgendering is an “act of violence” that “literally kills” – meaning that being addressed with the wrong pronoun might drive them to suicide.
A common meme on social media.
Why do many clinicians and other educated people go along with this nonsense? The trans activists insist on “validation” in everything they do or say, without objection. Objections or disagreement are transphobic. Any utterance or action that increases GD for anyone is transphobic. Unwillingness of society or any individual to accommodate any desire of men or women claiming to be trans is transphobic. Mirrors are transphobic. Biology is transphobic. Reality is transphobic.
Lifesavers
In contrast, every type of medical or social intervention for the supposed benefit of people with GD, especially youth, is described as “life-saving.” The refrain of “life-saving” echoes everywhere in the discourse around this topic. This has been a key strategy in convincing people that major surgeries are a “medical necessity” – “the basic healthcare they need to survive.” According to the trans industry and its friends, spikes in GD due to transphobia seem to lead almost automatically to AYA-GD wanting to end their lives. It is as if they are always on a ledge, ready to jump. This incessant repetition of purported suicide risk is like a strange new variation of Munchausen syndrome by proxy, wherewith trans activist adults and some clinicians effectively threaten suicide on behalf of the young people. They do this to socially-engineer, manipulate and intimidate non-industry doctors, politicians, community leaders and families of AYA-GD. They are well aware of the emotional responses they will get with this rhetoric. Meanwhile, experts in suicide prevention have always recommended against strongly emphasizing suicide risk in a given population.
On a related tangent, clinicians in the earlier days of proper gatekeeping often reported that their male trans patients commonly used manipulative suicide threats to get more rapid approval for hormone drugs and genital de-masculinization surgery (Burchard 1965, Pauly 1965, Limentani 1979, among others).
Most parents and other reasonable adults would easily reject the notion that healthy adolescents urgently need hormonal and/or surgical intervention so that they can be their “authentic selves.” It doesn’t make any sense. They’re healthy; and until a few weeks or months ago she was just an ordinary girl, he just an ordinary boy. However, activists and industry clinicians mess with everyone’s sense of reality by insisting that without such “care,” there’s a fair chance these suddenly troubled youth will commit suicide. Parents and policy makers alike are thus terrorized into going along with trans ideology, and the general public begins to believe it’s true.
Suicidal behaviour is learned (Strosahl 2006). The degree to which AYA-GD have internalized the notion that they may not live long is disturbing: Most seem to have taken on board not only that they are abnormal, hated by the “cis” world, but that they are also expected to kill themselves. On a mobile phone app called Whisper, thousands of AYA-GD create these “posters” in which they briefly express what’s on their minds, and people respond. It’s tragic and alarming that many of these young people are apparently in such deep distress, especially when the reasons for this distress are not true. They have been manipulated into a cultish belief system.
How serious are these young people? It may indeed be true that AYA-GD attempt suicide at higher rates than most other AYA, but these rates are not uniquely high, as I will soon show. They are also likely lower than the shockingly high estimates frequently broadcast through trans activism. Completed suicides in AYA-GD are rare, and estimates of suicide attempt rates do not translate into rates for completed suicide. There are around 100 to 200 suicide attempts for every completed suicide in adolescents (Sarchiapone 2016). Suicide attempts may vary greatly in both the seriousness of the effort and the lethality of the method used (Liotta 2015). “Cutting” or other forms of non-suicidal self-injury may be construed as suicide attempts. Suicidal ideation is even further removed from completed suicide.
I’m now going to critically appraise the most commonly cited surveys of suicide attempt rates in AYA-GD and other relevant populations, and then we’ll look at some of better quality. Fair warning: The following sections delve into research methodology to an extent some readers may have difficulty following. I would suggest reading the cited studies (if you haven’t already) for context and to aid in understanding the points I’ll be making.
Surveys in AYA-GD & adults with GD. Several surveys have tried to quantify the rate of attempted suicide in adults or adolescents with GD. In general, one can say that the flimsier the survey methods used, the more likely the estimates will not reflect reality in the population being studied. Many have heard about survey results suggesting that over 40% of adults (Haas 2014, James 2015) or adolescents (Toomey 2018) who identify as transgender have attempted suicide at some point in life. There is good reason to mistrust the accuracy of these claims, as two surveys in adults (Haas 2014, James 2015) were inherently at high risk of bias due to their design; the other in adolescents (Toomey 2018) for a similar reason, as well as a high risk of bias due to extreme looseness in survey data collection. Non-probability convenience samples, such as those used in the above surveys, are not appropriate to use when trying to quantify an outcome (such as suicide attempts) in a given population (Gideon 2018). It is a rather haphazard means of data collection.
Unfortunately for the researchers conducting these surveys, their use of convenience samples pretty much guaranteed that their estimates would be far off the mark. Citing estimates from such surveys, let alone hyping them, is inappropriate (Gideon 2012). They each needed a sample that was representative of the populations in question, and to obtain that they would have needed to use probability sampling methods. These are more complex to implement. Even so, it is unclear why they didn’t do so, especially in the case of the National Transgender Discrimination Survey (Grant 2011), which was analyzed by the Williams Institute (Haas 2014), and the US Transgender Survey (James 2015). Judging by their very lengthy and glossy published reports, these projects seemed to have more than sufficient resources to do their surveys correctly.
The latter survey (James 2015) seems to have had an identity crisis in terms of its sampling methods. The document claims in two places to have used convenience sampling and in one place to have used purposive sampling. Purposive sampling is typically used in qualitative research when a comprehensive, “saturated” understanding is desired. Researchers seek informants who have abundant experience and expertise. This method has an intentional selection bias. In describing its supposed “purposive sampling” method, the document lists “direct outreach” (by which was meant convenience sampling) and then several methods for network sampling.
Network sampling is commonly used in HIV research in developed countries to reach “hidden” or stigmatized populations, such as injection drug users. In countries where it is illegal for men to wear women’s clothing & accoutrements, let’s say in Uganda, HIV prevention researchers will commonly use respondent-driven sampling, snowball sampling and other network sampling methods to find such men. Doing this in the United States in 2014 would likely have resulted in responses from injection drug users or people with serious mental illness who were also transvestites. That may be fine if the survey’s goal is to collect data from people with big problems in their lives, but it is not appropriate for obtaining representative data from the population of interest (Heckathorn 2017). In any case, the vast majority of US Transgender Survey data were definitely collected through convenience sampling, such as advertising on various websites and other simplistic efforts. It was not a purposive sample. Any data collected through their alleged network sampling methods would likely have made their findings even less representative of the US population who believe themselves to be transgender.
This is not to say that convenience sampling is always bad. No indeed – there are certainly appropriate uses for convenience samples. Researchers may use convenience samples when they wish to make a rapid, exploratory assessment of a new or changing phenomenon, such as rapid onset gender dysphoria (ROGD) and other epidemic outbreaks. Data can be collected more quickly than when probability-based methods are used, and can then inform the development of more rigorous research, which may (or may not) replicate the initial findings. Convenience samples are fine to use if researchers wish to describe and even quantify the characteristics of the sample itself. They are not fine if the goal is to extrapolate from the sample to describe or especially to quantify characteristics of the overall population (Heckathorn 2017).
A closer look at the recent paper by Toomey et al (2018). Some may object that the study by Toomey and colleagues did not use a convenience sample. At first glance, it may not seem so. Indeed, with the large overall sample size mentioned prominently in the abstract, it may have the appearance of a rigorous study. However, even Toomey acknowledges that the sample was unlikely to be a representative one.
Consider what transpired prior to the authors’ obtaining survey data for more than 120,000 adolescents from a Minnesota-based organization called “Search Institute.” Over a period of three years (2012-2015), the company had sold its do-it-yourself survey services to an unknown number of school districts in various regions of the US (not reported, but said to be “national in scope”). After the Search Institute provided a complicated instruction book to officials from each district, the schools were on their own in administering the surveys. Schools could decide for themselves who would be in charge of administering the survey, whether it be the school principal, math teacher, bus driver, football coach or someone else.
Students completed the surveys online. The company received the survey data from each school, analysed it, and sent reports of these analyses back to the districts.
For the school districts, a well-conducted survey that reached all or nearly all of the district’s students, as a census would do, could potentially provide very good data. It’s rather different when you conduct a secondary analysis, as Toomey and colleagues have done, of aggregated data from the unknown number of school districts. Even if every student in every one of these districts was reached, the data mean very little at the national or international level. The sample has very little if any generalizability to the broader population. In fact, after the data are pooled, these data no longer have particular relevance to any of the individual school districts. At this point these are just some mixed data that happened conveniently to be available. They are not representative of anything except that collection of districts, en banc. This would still be all right if, for example, these specific school districts were exactly all the school districts in a given region, and you were only interested in responses from youth in that specific region – but this is not the case.
There are indications in the article that things may not have gone so well with these surveys. For example, Toomey reports overall 12-month suicide attempt data for all survey respondents at 14.1%. He suggests that this figure is “consistent with” the 12-month suicide attempt rate in the US Centers for Disease Control and Prevention’s (CDC) 2015 Youth Risk Behavior Surveillance System (YRBSS) survey finding of 8.6%. Inexplicably, Toomey also throws in CDC’s estimate for “made a plan to attempt suicide” of 14.6%. Making a plan is not the same as actually attempting suicide. An estimate of 14.1% is not consistent with an estimate of 8.6%. It’s an overestimation by close to 40%. If we are paying attention, we see this discrepancy as a sign that the Search Institute’s aggregated survey data are not even relevant to the general population of youth.
Following this, it is time to figure out just who is being surveyed. Recall that the article’s title is “Transgender Adolescent Suicide Behavior.” This reader was surprised and somewhat impressed to read that data from “N = 120 617 adolescents” were “used to achieve [their] objectives.” Surely the aggregated survey data didn’t include that many trans youth. Indeed, they only looked closely at data from a few hundred such youth, a tiny subset of that much larger number. Why prominently mention the overall number when the analysis is only about those who say they are trans? It might have been appropriate to mention the larger number, as long as they also reported there the number of respondents whose data they examined.
Toomey and colleagues set themselves up for additional failure by including responses from kids who did not even claim to be trans. The fact that survey data came from youth as young as age 11, unlikely to have become fluent in trans ideology quite yet, compounds the problem of trans being some kind of an umbrella, a cookie, a unicorn or whatever else one wants it to be.
Table: Self-description of trans-identified respondents in Toomey 2018
Category
Number identifying as such
“transgender, male to female”
202
“transgender, female to male”
175
“transgender, not exclusively male or female”
344
“not sure”
1052
So, the big 120,000+ number reported in the abstract was a sleight-of-hand manoeuvre for the reader in a hurry — cooked up to convey the false impression that this was a seriously large pool of data. It was actually quite small. I say again, we have no evidence that anyone in the world “is transgender” – born with some essential or innate gender identity that is “incongruent” with their biological sex. Even if “being trans” in any essential way were as real as paint, these researchers have data from fewer than 400 adolescents, along with a few hundred kids who claim to be “non-binary” and another thousand or so who have no idea what they’re supposed to say.
Next, Toomey and colleagues report that suicidal behaviour history was assessed with just one question: “Have you ever tried to kill yourself?” The question is direct, but experts in designing surveys for assessing suicidality suggest that overestimates are less likely if respondents are asked several times, in different ways (Strosahl 2006, Horn 2016).
Contrary to the assurances of Toomey and colleagues (2018), detailed methods for this survey were not available on the Search Institute website. Some cursory characteristics were provided, but these were on the order of advertising. A “user guide,” intended for the use of school personnel conducting the survey, highlighted the difficulties that school administrators, teachers and other staff might have in preparing for and administering this survey. They are encouraged to take a National Institutes of Health online training in ethical conduct of research with human subjects. They are told that a “census” survey method would be best to use, but are immediately given instruction in estimating necessary sample sizes and in methods for conducting systematic random sampling. It is unlikely that most of these school districts had staff on hand who were up to the task of conducting the survey with competence. The truth is we have no idea what happened in those schools or how faithful they were in following the user guide. The Search Institute organization left school districts to their own devices. With a Search Institute employee as a co-author, Toomey and colleagues (2018) may have known more detail about the schools and how data were collected, but they do not report it.
Finally, Toomey and colleagues (2018) calculate adjusted odds ratios to estimate probabilities of suicide attempt by demographic characteristics and “gender identity.” They needn’t have gone to the trouble. It gives their analysis a simulation of gravitas, but given the “convenient,” admittedly non-representative data, there’s no reason to believe that these estimates are anywhere close to accurate.
Better quality surveys of AYA-GD. Interestingly, in addition to analysing data from the survey reported by Haas and colleagues (2014), the Williams Institute at University of California, Los Angeles, also conducted one that was much more rigorous (Wilson 2017). This organization was contracted with the state of California in 2015-2016 to survey a sample of adolescents in the state. They were required to use much stronger methods than had been used in the other surveys or their other implausible analyses. For example, instead of asking respondents who happened to be nearby to fill out surveys online, they used trained interviewers who spoke over the telephone directly with each adolescent. Among other aspects, this enabled them to clarify any potential misunderstandings. Unlike the other surveys, questions about suicide attempt history in the California Health Interview Survey (CHIS) were asked in several nuanced variations, reducing the potential for an overestimate (Strosahl 2006, Stone 2016). Also, in contrast to the other surveys which used convenience samples and were not intended to be representative of the population (Haas 2014, James 2015, Toomey 2018), this survey was intended to be representative of California’s adolescent population (Wilson 2017).
The CHIS did not explore GD or whether students considered themselves to be trans, but it did explore degrees of gender nonconformity. I realize that these are not the same. In our current epidemic of ROGD (Littman 2018), I would suggest that data from students whose personality & style expression is strongly at variance to that of their respective sex stereotypes might serve as a proxy for data from students who considered themselves to be trans. If a boy today endorses that he is “very feminine” or a girl that she is “very masculine,” I’d bet a dollar that these kids believe they are trans.
Only 3% of adolescents ages 12-17 who thought their peers regarded them as “very masculine” (if girls) or “very feminine” (if boys), categorized as “highly gender non-conforming” by investigators, reported having attempted suicide. This rate was statistically similar (i.e. not different) to the 2% rate reported by peers who felt other students considered them to be “gender conforming” (Wilson 2017). Considering that no one yet has adequately defined “trans” and that GD’s diagnostic criteria are similarly hazy, the survey with stronger methods may provide a more accurate picture of AYA-GD attempted suicides than the ones with weaker methods. It’s a bit unclear, as “highly gender nonconforming” youth are not necessarily the same as youth with GD – though one would expect youth with GD to be highly gender nonconforming.
On the other hand, it is rather telling that the file name of the Williams Institute report actually includes the phrase “transgender teens.” I’m pretty sure this is what they meant by “highly gender nonconforming.”
A parallel survey conducted by the same team in California in adults ages 18-70, who were explicitly asked if they considered themselves to be transgender, found that 22% reported suicide attempts (Herman 2017). The authors do not comment on their institute’s previous finding of nearly double that proportion in trans adults across the US as a whole (Haas 2014).
In any case, the Williams Institute’s “highly gender nonconforming” adolescent estimate of 3% is lower than that of the CDC’s well-conducted YRBSS survey of high school students (of any level of gender conformity) across the US. In 2017, the survey found that 7.4% reported ever having attempted suicide, down from 2015’s estimate of 8.6%, mentioned above.
Lowry and colleagues (2018) conducted a secondary analysis of CDC 2015 YRBSS data, focusing on students in two urban California school districts and one in Florida (n=6,082). As with the Williams Institute survey, investigators explored gender nonconformity, not GD or “trans” status. They found that 23.5% of urban high school girls who felt peers considered them to be “somewhat masculine” reported a suicide attempt in the preceding 12 months. Investigators did not report separately the proportions of girls who said they were seen to be “very” or “mostly” masculine, because there were fewer than 30 responses for each. Instead, they pooled data for these with the “somewhat” masculine responses. In this composite category, 20.5% of girls had attempted suicide in the preceding year. However, this was not statistically associated with their gender nonconformity (adjusted prevalence ratio [APR] 1.60; 95% confidence interval [CI] 0.81 to 3.16). Gender nonconformity was not associated with suicide attempts in any of the other female “masculinity” categories.
In “very feminine” urban boys, 14.7% reported suicide attempts, compared to 17.7% and 26.4% respectively in boys who thought they were perceived to be mostly or somewhat feminine. In somewhat, mostly and very masculine boys, suicide attempts were reported by 6.1%, 3.4% and 4.6%, respectively. In “equally masculine and feminine” boys, 9.3% reported suicide attempts. However, researchers could not directly associate these rates with gender nonconformity in any of the somewhat, very or mostly categories. In other words, several factors besides being highly gender nonconforming likely played a role in the suicide attempts of somewhat, mostly and very feminine boys.
There are other adolescent populations besides trans youth whose lives commonly include significant challenges. Suicide attempt rates in these populations are similar to those in “highly gender nonconforming youth” that we have seen with the better quality surveys. We already know that adolescents and adults with GD tend to have much higher psychiatric comorbidity than the general population (Hepp 2005, Duišin 2014, Heylens 2014, Connolly 2016, Reisner 2016, Wise 2016, Alastanos 2017, among the more recent references). Indeed, before making such clinical observations put one at risk of breaking the law (or at least being banned from Twitter), numerous clinicians observed that the personalities and behaviors of their patients with “gender identity” problems were often consistent with those of people with borderline personality disorder (Hoenig 1974, Levine 1981, Meyer 1982, Lothstein 1984), a condition with higher suicidality than the general population.
Rates of clinically significant psychopathology in youth referred to gender clinics are similar to those of youth referred for non-gender reasons to mental health clinics (Kaltiala-Heino 2018). We also know that many are gay or lesbian. Many also have experienced bullying. Let’s look at what well-conducted surveys sampling these other populations more specifically have found.
Survey in youth with mental illness. Around 96% of adolescents in the US who attempt suicide meet lifetime criteria for at least one mental illness (Nock 2013). The most prevalent DSM-IV disorders found in youth attempting suicide included major depressive disorder, eating disorders, attention-deficit/hyperactivity disorder, conduct disorder and intermittent explosive disorder (Nock 2013). Personality disorders are seldom assessed.
Husky and colleagues (2012) with the US National Co-morbidity Survey conducted computer-assisted face-to-face interviews with more than 10,000 adolescents ages 13-18. In youth with any psychiatric condition (n=2,341), 6.8% had attempted suicide in the preceding 12 months. In youth diagnosed with mood disorders (n=1,021), 14.4% had made an attempt in the preceding year. The proportions respectively for substance use disorders, anxiety disorders and disruptive behaviour disorders were 8.3%, 6.0% and 11.7%. Numbers were small (n=76) for youth with eating disorders, but 26.9% had attempted suicide in the preceding 12 months (adjusted odds ratio 11.40, 95% CI 3.18 to 40.87).
Survey in sexual minority youth. Sexual minority adolescent (i.e., lesbian, gay and bisexual) populations face similar challenges to trans-identified adolescents. Indeed, there is very significant overlap of the populations, as many trans youth identify (or formerly identified) as lesbian or gay.
Stone and colleagues (2014) analysed CDC YRBSS data from five US metropolitan regions for the years 2001-2009, with the objective to identify suicide risk factors in sexual minority youth. They aggregated data and stratified those for youth who declared their sexual orientation to be heterosexual, lesbian, gay male, bisexual or unsure. Investigators do not report the overall denominator of adolescents surveyed, but 20,545 reported ever having attempted suicide. Summary data for reported suicide attempts, stratified by sexual orientation, are presented in the table below.
Table: Prevalence of sexual minority youth suicide attempt and medically serious suicide attempt, five US cities, 2001-2009
Sexual identity (females)
Lifetime suicide attempt
Medically serious suicide attempt
Heterosexual
8.8%
2.2
Lesbian
28.3%
9.0
Bisexual
30.1%
8.0
Unsure
17.9%
4.4
Sexual identity (males)
Lifetime suicide attempt
Medically serious suicide attempt
Heterosexual
6.8%
2.7
Gay
23.4%
8.7
Bisexual
26.4%
11.6
Unsure
18.2%
9.8
These 2001-2009 estimates seem somewhat higher than estimates using composite data from the 2017 round of the YRBSS, showing that in students self-describing as lesbian, gay or bisexual, 23.7% (95% CI 19.4 to 28.5) of girls and 18.3% (95% CI 11.5 to 27.9) of boys had attempted suicide in the preceding 12 months, with an overall estimate of 23.0% (95% CI 18.6 to 28.0) (CDC 2018). This suggests that suicide attempts may be declining in this population. Medically serious suicide attempts were reported by 7.5% (95% CI 5.7 to 9.8) of lesbian, gay or bisexual youth (CDC 2018).
Survey in youth who have been bullied. Messias and colleagues (2014) analysed data from the CDC’s 2011 YRBSS to determine the impact of bullying on suicidal behaviour in adolescents. In youth who reported any bullying victimization, either school bullying or cyber-bullying (n=3429), 24.7% reported ever having attempted suicide in the preceding 12 months. In youth who reported both school bullying and cyber-bullying (n=1,122), 21.1% reported a suicide attempt (Messias 2014).
How well can we believe any of this evidence? Finally, in regard to the evidence from all of these surveys, it’s important to remember that according to the global standard GRADE approach to assessing the quality (certainty) of scientific evidence, even the population-based surveys using relatively strong methods would contribute only very low-quality evidence. I have not given it a full analysis, which would require a systematic review to be done, but that’s my quick informal assessment. Very low-quality means that the true proportions could still be quite different from these estimates. In the surveys with weaker methods, well, let’s just say they don’t inspire much confidence.
Survey
Population
Method
Timeframe
Suicide attempt
CDC YRBSS / Lowry 2018
“Highly gender nonconforming” adolescents across USA
Three-stage cluster sample
Past 12 months
23.5% girls
14.9% boys
CDC YRBSS / Stone 2014
Sexual minority (lesbian, gay, bisexual) youth in five US cities
Three-stage cluster sample
Inconsistent among sites; investigators treat composite data as “ever”
Data collected 2001-2009
28.3% lesbian
30.1% bisexual F
17.9% unsure F
23.4% gay
26.4% bisexual M
18.2% unsure M
CDC YRBSS / main report
Sexual minority (lesbian, gay, bisexual) youth in 38 US states
Three-stage cluster sample
Past 12 months
Data collected 2017
23.0% overall
7.5% of attempts were medically serious
CDC YRBSS / Messias 2014
Youth who experienced bullying in 38 US states
Three-stage cluster sample
Lifetime
Data collected 2011
School or cyber: 24.7%
Both school and cyber: 21.1%
National Co-morbidity / Husky 2012
Adolescents with DSM-IV diagnoses
Multistage household probability
Past 12 months
Data collected 2001-2004
6.0%-26.9%
California Health Information Survey (CHIS) / Wilson 2017
“Highly gender nonconforming” adolescents ages 11-17, California, USA
Dual-frame, random digit dial
Past 12 months
Data collected 2015-16
3%
National Transgender Discrimination Survey
Adults ≥18 yrs self- identifying as trans or “gender non-conforming, USA
Convenience
Lifetime
Data collected 2011
41%
Toomey 2018
Adolescent students in an unknown number of schools across US, though not large cities
Convenience
Lifetime
Data collected 2013-2015
48%
US Transgender Survey
Adults ≥18 yrs self-identifying as trans, US
Convenience
Lifetime
Data collected 2015
40%
Completed suicides
If transphobia were really driving large numbers of AYA-GD to suicide, we would need to get a handle on what those numbers might be. Let’s try.
Wikipedia’s “List of LGBT-related Suicides” lists 11 names of people deemed trans. The first trans name listed is that of a man who died in 2009. Next is the suicide of troubled teen, Joshua “Leelah” Alcorn of Ohio, USA, in December 2014. His death was heavily exploited by trans activists and the mass media covered the tragedy quite intensively for several weeks. There were even death threats made to Alcorn’s parents. According to the Wikipedia suicide list, eight additional AYA-GD took their lives in the five months following Alcorn’s death. Although this Wikipedia page has been edited dozens of times since mid-2015, no additional “trans” names have been added to the list since then.
By no means am I suggesting that anything is proven by this, or that anything on Wikipedia should even be believed. I do want to point out that if it were true that large numbers of AYA-GD were dying at their own hand, that list would likely be a great deal longer. The other thing I want to highlight is the apparent contagion of Alcorn’s suicide to several other AYA-GD. Around 5% of all youth suicide can be attributed in part to discussion and media coverage of other suicides (Kennebeck 2018).
People don’t kill themselves for just one reason, like feeling worried about the future (the main theme of Alcorn’s suicide note). It’s a complex behaviour that may have several factors contributing to the decision. The most prominent of these are mood disorders and other types of mental illness (Gili 2019). Others include “all or nothing” thinking, substance abuse, a family history of suicide and feelings of hopelessness. Another important contributing factor is exposure to other suicides (Strosahl 2006) and news and discussion about suicides.
Real conditions. It is certain that suicide remains a serious problem in AYA, with or without GD. Overall, suicide is the third leading cause of death in AYA ages 15-24 in the United States. However, we must consider this statement in context. Relatively few young people die from cardiovascular disease, cancer and many other illnesses that contribute to mortality in older age strata. The two leading causes of death in AYA ages 15-24 in the US are accidents (unintentional injuries) and homicide (CDC 2018). Between 1999 and 2016, a total of 80,866 AYA in the US committed suicide, of whom 14,051 (17%) were female (CDC 2018). There is a significant disparity between the sexes in this proportion, which may be due to males using more lethal means (CDC 2014). Females more frequently report suicidal ideation and suicide attempts than do males (Nowotny 2015). In AYA of both sexes ages 15-24 in the 1999-2016 period, the overall rate of completed suicide was around 10.6 per 100,000 suicides (CDC 2018). Corresponding to their proportions, rates for females and males respectively ages 15-24 were 3.8 and 17.1 per 100,000 suicides across the 1999-2016 period (CDC 2018).
Paradox. Let’s look for a moment back to 1950, when gender roles, sex-specific dress codes, laws regulating sexuality and other aspects of social control were much more rigidly “enforced.” The suicide rate for AYA in the US was much lower than it is now. For both sexes, it was only 4.5 suicides per 100,000 AYA. As is usual, the rate for boys was higher than that of girls, 6.5 vs. 2.6. From that year, through our society’s sturm und drang of the ‘60s and ‘70s, AYA suicides trended upward, reaching a peak in 1994 with a combined rate of 13.6. The overall trend declined slightly and then was more or less flat until 2011, when it began again to climb.
A problem emerges. Why have rates of completed suicide in AYA increased in recent years, during an era when public awareness of transgenderism and GD has increased dramatically? Not just “awareness” – by 2018, organizations and individual people make bizarrely intense efforts to seem the most supportive “trans ally.” Other populations with elevated suicide rates include people with mood disorders or other mental illness (Nock 2013) and people who are sexually attracted to others of the same sex (Hottes 2016). These populations would likely also have experienced the earlier times with much greater distress than they would today. If the trans industry’s logic were consistent, they would also have had higher rates of suicide. Were young people more psychologically stable and resilient in the old days than they are now?
Taking that trans logic a step further, why don’t we see epidemics of suicide in populations that really have to deal with systemic bias? Are AYA-GD frequently pulled over by the police, frisked and hassled more than other AYA? Are they followed around in grocery stores and department stores more than other AYA? On rainy or sunny days, are their waving hands regularly ignored by taxicab drivers with empty cars, who then stop to pick up other AYA?
Although AYA-GD are relatively few in number, so too are the numbers of AYA completed suicides. If society now cranks out transphobia at lower levels than before, and if it were true that transphobia-induced dysphoria leads to suicide in AYA-GD, we would have expected to see very high rates of completed suicide in earlier decades. We should have seen these rates decline, if only a little. However, after warbling up and down for a few decades, they went up.
The relationship of “regret” to study attrition and possibly to suicide
Before finishing this article, I want to point out something explicitly. Long-term follow-up studies have shown that completed suicide rates in people who received trans hormones and surgeries, and supposedly “transitioned,” are in fact much higher than in the general population (Asscheman 2011, Dhejne 2011, among others). Few follow-up studies assess “regret” in their study populations. Those that do assess regret may also have very narrow criteria for defining “regret,” or will follow-up after too short a time for patients to realize their regret. No-one really knows the right interval, but assessments of regret after three or five years are of limited value. Regret should still be assessed at such intervals, but those rates may not indicate the proportion of patients with regret at 10 or 15 years, particularly if there is high loss to follow-up. Loss to follow-up is generally judged to be high when it exceeds 20% (Higgins 2011).
Investigators often report very low regret rates. Consider that the feelings of regret one might experience in this context may be very deep and complex. It may seem pointless to change one’s paperwork or to inform the doctor. At the same time, many of these studies have exceptionally high losses to follow-up; either they can’t find these patients or they get no responses from them. On a personal level, I can tell you that I had zero interest in explaining my situation to anyone, and I never wanted to see a doctor again. Paperwork was the last thing on my mind. I only wanted to melt into the Earth.
I performed my pain for many years instead of exploring it on the symbolic level
Although I “detransitioned” (i.e. ceased trying to make people think I was a woman), it’s important to bear in mind that “regret” and “detransition” are not synonymous. A person may experience profound regret but not feel prepared to “detransition,” a very intense, emotionally painful and often frightening process.
And where did all those “lost” people go? They need medication for the rest of their lives. Are the ones in Wiepjes 2018, for example, lost somewhere in the Netherlands? How does that happen in a high-tech society? Other areas of medicine at least try to keep good patient follow-up, even in countries with few resources. I just wanted to suggest that some of these “lost” may in fact have expressed “regret” through intentionally losing their lives. Some may have quietly “detransitioned,” but those not taking testosterone or estrogen would be living in increasingly poor health. Others may have continued in their “transsexual” status –but regretting what they had done. There has been no peer-reviewed research into this – only happy stories about “tiny” regret rates. It is remarkable that individual stories in YouTube videos, blogs and books, as well asnewspaperarticles and other journalistic accounts, provide the best available evidence about regret.
Zucker and colleagues (2016) usefully examine the report of Dhejne and colleagues (2014), in which “regret” data for Sweden are reported in patients receiving “sex re-assignment surgery” (SRS) between 1960 and 2010. This paper suggests a regret rate of 2.2%, based on a very narrow criterion: formal application to the government to restore their original sex designation. Zucker and colleagues (2016) note that with a median follow-up of eight years, more recent regret may not yet have emerged, and then draw from Dhejne’s earlier (2011) paper on health, suicidality and criminality outcomes in the Swedish transsexual population to show why a 2.2% regret rate is likely a gross underestimate. Zucker and colleagues (2016) point out that while 10 of 666 (1.5%) of patients receiving SRS between 1972 and 2010 made formal regret applications, 10 of 324 (3.1%) who received SRS between 1973 and 2003 had killed themselves (Dhejne 2011, Zucker 2016). Another 29 of 324 (8.9%) receiving SRS in that period had made documented suicide attempts (Dhejne 2011, Zucker 2016).
If anyone wishes to suggest that this was all in the transphobic bad old days, I would remind them of the title of Hoenig’s 1977 paper: “The legal position of the transsexual: mostly unsatisfactory outside Sweden” (Hoenig 1977). In other words, Sweden had a very liberal and accepting society.
What’s clear is that there is currently a strange desire in the ideology and culture of transgenderism to ruthlessly extirpate any evidence that contradicts the official narrative of “born this way.” The fact is that people with gender dysphoria really do have quite serious mental health issues that for the most part are either ignored or celebrated. The existence of “regret” and detransition is a huge thorn in their side, a threat to their “validity.” This may be the reason that few studies bother to assess regret; or even keep good track of their patients, as is done in other areas of medicine that commonly maintain patients in long-term chronic disease care. It’s not right to ignore evidence of suicides or imply that those lost to follow-up are probably just living happily ever after. This is how researchers can create the impression that regret rates are low. Some investigators assess regret after too short an interval, such as the “less than one year” (and possibly as little as two weeks) to five years for radical mastectomy in young women age 13-25, reported in Olson-Kennedy 2018. But is Dhejne’s 2.2% really a low proportion? If you were keen to skydive, and you learned that 2.2% of parachutes didn’t open – would you jump?
Table: Losses to follow-up (Partial, incomplete list of studies)
Study
Country
Follow-up
Lost to follow-up
De Cuypere 2006
Belgium
MtF mean 4.1 yr
FtM mean 7.6 yr
28%
Hepp 2002
Switzerland
67 mo (19-114 mo)
30%
Kaube 1991
Germany
3-6 yr (0.8-11 yr)
53%
Rauchfleisch 1998
Germany
MtF mean 14 yr
FtM mean 9.5 yr
75%
Revol 2006
France
10 yr
65%
Smith 2005
Netherlands
1-4 yr
33%
van de Grift 2018
NL, BE, DE
4-6 years
63%
Wiepjes 2018
Netherlands
6.4 yr (0.4 yr-41.6 yr)
36%
Table: Reported regret and criteria for regret (Partial, incomplete list of studies)
Study
Country
Regret criteria
Regret
Lost to follow-up
Dhejne 2014
Sweden
Formal application to government to restore original sex marker
2.2%
n/a
Imbimbo 2009
Italy
Interview
6%
15%
Smith 2005
Netherlands
Interview
2.6%
33%
Van de Grift 2018
NL, BE, DE
Interview
6% (deemed “minor”)
63%
Wiepjes 2018
Netherlands
Note in patient’s medical record
0.5%
36%
Conclusion
In summary, the high estimates commonly bandied about by trans activists and the mass media in regard to suicide and suicide attempts in AYA-GD are likely much too high. Completed suicide and suicide attempt rates in the AYA-GD population may vary significantly by region and socio-economic context. In my opinion, however, they are likely to remain consistent (in a given setting) with those of other populations of which they are also constituents — sexual minority AYA populations, AYA who experience bullying and AYA living with other mental health problems. The trans industry’s insistence and hype that AYA-GD are constantly on the brink of transphobia-related suicide at rates that far exceed those of other highly relevant populations is a shameful social engineering strategy to keep society’s focus preferentially on transgenderism–perhaps to cast themselves as visionary pioneers in the field. I don’t think it will turn out that way for the clinicians: history will not absolve them.
As I mentioned earlier in this article, there have been no rigorous studies conducted (ever) of any psychological intervention to help AYA-GD (or anyone) to cope effectively with their GD and thereby become more comfortable in their bodies. I’m working on another paper on this topic, because it is very deep and rich and there is much to cover, but here are some preliminary thoughts.
Again, there has not been even one study that tested psychological interventions to alleviate GD symptoms, much less any of the new ones. Why not? Because Harry Benjamin declared it to be a “useless undertaking”! Sure, it may have been “hard to treat” using the arcane psychoanalytic or Kleinian object relations methods that used to be popular, but trans industry “hormones and surgery” dogma has kept anyone from testing the new methods. When simple remedies are untried, it is not preferable to put healthy but confused patients on lifelong drug regimens and offer them drastic surgeries that do not accomplish what patients hope they will do and are often accompanied by significant complications.
If it is possible to help people with GD to cope with, and perhaps even recover from GD, using an inexpensive approach that is feasible to implement anywhere, this would surely be better than the extreme and lifelong medical interventions currently presented as the only alternative to a life of misery (or a life lost to suicide).
This piece is already long; I will more thoroughly explore the topic of alternative approaches to gender dysphoria in a future article.
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Then there were the London lesbians. There was the protest at London Pride where a handful of radical feminist lesbians stepped in front of thousands and made their voices heard. I had been following a well-known transman on social media and he had posted a story from Pink News. The headline went something like “transphobic lesbians storm the parade” or some kind of nonsense like that. I read the story but was a little annoyed because it didn’t say what they were protesting. Just that they were transphobic. I posted on social media asking others why the women had been protesting and what their message was. The response I got was basically “who knows, they are just transphobic and being hateful.” Well, I thought, maybe so but it’s always better to know the full story before making a decision to write people off. I began my internet search, and wouldn’t you know it, that led me to radical feminism. And that was the hammer that broke my illusion right open. The next several months was me and radical feminism and I heard the phrase I wish I had heard years ago, “The only thing that makes you a woman is that you are female.” A simple, to the point, and really quite obvious observation. How could I have thought otherwise? I agreed with it, but had still not taken the final step to detransition. But the push to do so began to be ever-present and its whispers grew louder every day.
I was raised in a very religious household where we were taught that women were put on this earth to serve men. I was not allowed to cut my hair or wear anything but long dresses, as my body was deemed immodest by default. My father had died when I was 2 in an accident and my mother had remarried into this religious atmosphere. My stepfather and mother abused me extensively from the age of 4 to 9. I learned to cope with the abuse by detaching myself from my body. I took back my power by never allowing my abusers to make me cry, I withstood the pain upon my body by disassociating. I believe this early abuse and dissociation from my body gave rise to the feelings that my body was wrong, not my own, and some kind of foreign entity—the same things people describe when talking about gender dysphoria. The sense of “wrongness” that one feels with their body.
After about 2 years on testosterone I noticed that my anxiety had started to become much worse. I discussed this with doctors and psychiatrists, but they didn’t think the testosterone could cause this effect. As time went on my anxiety became worse, to the point where I was taking an anti-anxiety medication daily. It reached a breaking point when I could no longer leave my bedroom without having a panic attack. I couldn’t drive because that triggered a panic attack as well. I really couldn’t do anything but keep myself sedated on benzos and stay in bed. This is when I hit bottom. I went to a psychiatrist and got an antidepressant called Viibryd that is also used for panic disorders. Starting antidepressants is both mentally and physically hard. Those first 2 weeks on the medication were like hell. My brain felt like it was ripping apart and I had panic attacks that were so bad that I really did want to die so I would not have to feel them anymore. But by week 4 the side effects dissipated, and I began to feel joy, a sense of peace, calm and clearer headed.
The community positions itself as the most oppressed demographic in society, while holding the people on the outside hostage with threats of suicide and blame for murders committed against the trans community. It showers acceptance and validation on its members as long as they adhere to trans dogma. The trans people who do not adhere to the ideology are called truscum, traitors or TERFs. People such as myself who detransition are told we no longer have a right to say anything about the trans experience because we are no longer trans or never were trans to begin with. Many of us are shunned from the community — like a dirty secret. This shunning of former members is a great deterrent to detransitioning for some. For those who do detransition, we usually slink away and are never heard from again. For those who do speak out we are labeled TERFs (a label that has come to mean nothing but a person who doesn’t completely agree with trans ideology), or ridiculed for not knowing we weren’t trans. We are told that we took valuable resources away from “real” trans people and that we should be quiet and go away.
We’ve all read Lord of the Flies, right? A bunch of tween boys get stranded on an island and all of their deepest, most repressed urges surface as they desperately attempt to organize and manage the tiny preteen society they’ve found themselves in. The novel ends in bloodshed, as the author theorizes that the immaturity, communication breakdown, and decision making difficulties one would find in a group of adolescent boys would create a chamber of destruction. How would it have ended differently, some have asked, if the story was one of a stranded group of girls? What would happen if every troubled, isolated, self-loathing, depressed, and emotionally overwrought teenage girl in the world wound up alone on an island?
However, an analysis of Tumblr as simply a bunch of “crazy SJWs” does not do the site justice. To understand Tumblr and its influence in youth mental health, culture and politics, you must realize that Tumblr is not simply a site some people visit to share their opinions or look at pictures. You must stop viewing it as merely a website, but as more of a dimension: it has its own social rules, hierarchies, ideologies, and interconnected communities. As a site where millions of people, mainly teenage girls cut off from the outside world, maintain constant daily connection, it has developed into a true culture–the mammoth hub of alternative teenage lifestyle.
When I asked one of the gender therapists how we could know she was trans as opposed to lesbian, she said, “Oh, it is very rare for a trans man to actually be a lesbian. Very, very rare.” Then there was the (very nice) FTM therapist who, when I mentioned Chiara had not had a full-on relationship yet, said, “A lot of trans teens just skip that step” and added “he’d” be welcome at the next trans teen support group that week. I actually did schedule an appointment with this therapist, as well as signed her up for the group, until my crash online course in all things trans made me think better of it and cancel. Not long after, Chiara and I together found a therapist who used a mental-health (vs. “affirmative”) model and agreed to work with Chiara without enabling medical transition.
