Gender dysphoria is not one thing

Posted on December 7, 2017 by 4thwavenow

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

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

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

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

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

Michael Bailey is Professor of Psychology at Northwestern University. His book The Man Who Would Be Queen provides a readable scientific account of two kinds of gender dysphoria among natal males, and is available as a free download here.

Ray Blanchard received his A.B. in psychology from the University of Pennsylvania in 1967 and his Ph.D. from the University of Illinois in 1973. He was the psychologist in the Adult Gender Identity Clinic of Toronto’s Centre for Addiction and Mental Health (CAMH) from 1980–1995 and the Head of CAMH’s Clinical Sexology Services from 1995–2010.

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

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

Types of Gender Dysphoria

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

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

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

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

Childhood-onset Gender Dysphoria (Boys and Girls)

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

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

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

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

What do we know about childhood-onset gender dysphoria?

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

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

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

Sexuality

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

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

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

Risk Factors for Persistence of Childhood-onset Gender Dysphoria

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

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

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

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

What should you do?

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

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

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

Autogynephilic Gender Dysphoria (Adolescent Boys and Men)

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

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

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

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

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

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

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

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

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

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

What do we know about autogynephilic gender dysphoria?

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

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

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

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

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

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

Sexuality

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

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

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

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

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

What should you do?

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

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

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

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

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

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

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

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

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

What About Natal Males?

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

What Do We Know?

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

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

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

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

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

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

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

Our Current Take on ROGD

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

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

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

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

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

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

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

What to do

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

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

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

Two Rarer Types of Gender Dysphoria

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

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

Autohomoerotic Gender Dysphoria

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

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

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

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

Gender Dysphoria Caused by Psychotic Delusions

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

Not Just One Type of Gender Dysphoria: Some Implications

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

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

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

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

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

Call the Police! Mom questions transgender treatment model, gets banned from support group

Posted on December 1, 2017 by 4thwavenow

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If liberty means anything at all, it means the right to tell people what they do not want to hear. ~ George Orwell, from the original preface to Animal Farm

by Linda MacDonald

Linda is a left-leaning Canadian mom, believer in science and common sense, who is navigating life with her 19-year-old trans-identified biological daughter. She hopes that her daughter will opt out of medical transition and eventually come to a more genuine understanding of who she really is.

The events described in this article recently took place in a support group jointly sponsored by Family Services Ottawa and Children’s Hospital of Eastern Ontario for “parents & caregivers of gender creative, trans, transgender children, youth or young adults.”

It was my turn to introduce myself. “Oh God,” I thought nervously, “here it goes!”

I glanced around at the others in the circle. Like me, they were all parents of children who had decided they were transgender. They were smiling politely, looking at me expectantly. I gripped the top of the spiral-bound notebook in my lap with both hands and, ignoring the group leader’s request to “state your name and preferred pronouns,” I began.

“Hi, my name is Linda and I am the mother of a 19-year-old girl who thinks she’s transgender. Well, she thinks she’s a boy, but really, she’s a girl. I mean, you can’t change your sex, right? It’s scientifically impossible.”

I paused and looked around. The friendly smiles froze in place. People shifted uncomfortably in their seats.

I had attended this support group sporadically since my daughter announced she was a boy three and a half years ago. The 25-30 parents who regularly attended all appeared to accept their child’s self-declaration without question, and seemed happy to follow their doctors’ recommendation that they “affirm” their children.

Of the 18-20 children represented by these parents, all but approximately three were teenage girls, including my own. Yet, none of the parents seemed bothered by this wildly skewed statistic. They all unquestioningly, even enthusiastically, supported their children’s wish to transition—fighting for better, faster access to medical transitioning services, cheering when they heard our Children’s Hospital was about to start offering mastectomies to children under the age of 18.

I found it disheartening. To me, the group seemed like little more than a cheering section, where each parent proudly announced their child’s latest achievement—their first Lupron shot! their mastectomy, finally! And they were roundly congratulated by the other parents. These days, I attended only now and then, hoping to find someone else who was as skeptical as I was.

Once I had started talking, there was no going back. I had come here to tell them something important, and I was determined to finish. The words came tumbling out now.

“I think she has something called rapid-onset gender dysphoria. It’s new. Something scientists are only beginning to notice. It happens to kids—mostly teenage girls—who are really bright, but have trouble fitting in—well, my kid had a little trouble, but not a lot. And they spend too much time on the Internet—way too much—on sites like Tumblr and Reddit and YouTube—my kid spent too much time on this site called DeviantArt. I think that’s where it started—anyway they get brainwashed by transgender sites on the Internet. Oh, and another thing, kids with rapid-onset usually have friends who think they’re trans, too. It’s a social contagion. If one kid transitions, their friends get the idea, too. It spreads.”

This had sounded way better in my head. My nerves were getting the better of me.

suzannah pic I had intended to alert the parents to a new type of gender dysphoria that has emerged only within the last ten years or so, and scientists are only now beginning to study. Researchers are calling it Rapid-Onset Gender Dysphoria (ROGD). And it seemed to describe most of the children in this group.

Until about ten years ago, most cases of childhood gender dysphoria began very early, around age three or four. It was extremely rare, occurred predominantly in boys, and usually resolved on its own by the time the child reached adolescence.

This new type of gender dysphoria comes on rather suddenly in adolescence, after an unremarkable childhood in which the child did not display any discomfort with their gender. It typically involves highly intelligent children who have pre-existing emotional issues, and who often have difficulty fitting in with their peers. They also spend far too much time on the Internet, immersing themselves in websites, videos and chat rooms that actively promote the transgender lifestyle as cool, fun and the solution to all of their problems. Most children with ROGD have friends who have also declared themselves transgender, providing evidence of a social contagion at work.

And ROGD predominantly affects girls. It has become so frequent and pervasive that it is turning long-held statistics of transgender children on their head. Today, it is mostly teenage girls who are presenting to gender clinics, and their numbers are exploding.

I pressed on…

“…But I’m not supporting my daughter in her trans identification. I don’t want her to start hormones or have surgery or anything like that. I have made that clear to her. I don’t want her to do anything that might harm her body. I mean, there are no long-term studies to show these things are safe, right? So I told her I wouldn’t support any medical interventions; that she’ll have to pay for that herself if she wants it. She knows that and is OK with it, I think. At least, I don’t think she has done anything.”

I finished my speech and looked around. The silence was deafening.

Out of the corner of my eye, I saw one woman looking pointedly at the leaders and gesturing towards me, silently mouthing “why is she here?”

After a long, uncomfortable pause, one of the group leaders, a female-to-trans, spoke.

“OK. I’m going to take a minute to address this issue right now, because some things were said that are starting to make some of the other parents have…feelings.” S/he approached me, bent down and said in a quiet voice, “Why did you come here? This is a support group for parents of transgender kids.”

“I am a parent of a transgender teen,” I protested, “I came here to warn the other parents about rapid-onset gender dysphoria and to find other parents like myself who are skeptical of transitioning their kids, because I know they’re out there—”

“Not here!” called out one parent firmly. “Yeah, not here!” echoed another.

The group leader continued, “We are here to support our children on their transgender journey. You do not support your child. You belong in another group.”

“I asked if there was another group,” I replied. “I was told there wasn’t one.”

I wasn’t kidding. Earlier in the year, I had emailed the group’s administrator, asking if there was a group for parents like me, who wanted to take a more cautious approach and consider alternative ways to treat their child’s gender dysphoria. She politely replied no, this was the only support group available, but I should feel welcome to attend at any time.

I was not feeling welcome. And things were rapidly getting worse.

“Why are you taking notes?” one of the parents demanded. “I was wondering the same thing!” said another, angrily. I showed them my notebook. I had written only the group leader’s email address, some first names, and a tally of boys to girls who thought they were transgender.

“Check her phone. I bet she’s recording us, too!” I held up my phone to show them it wasn’t recording and turned it off for good measure.

“You’re making me feel unsafe!” cried a woman. Sobbing, she rushed from the room, and was quickly followed by another weeping mother.

A security guard appeared. “I’m sorry. I’m going to have to ask you to leave.”

“This is a group for parents of transgender kids. I am a parent of a transgender kid. I belong here,” I insisted. “This is a public building and I pay my taxes. I’m not doing anything wrong. You can’t kick me out.”

I was on a roll. They weren’t going to get rid of me if I could help it.

Suddenly, the room was empty and I found myself sitting alone. Apparently, the group had decided if I wasn’t going to leave, then they would, and they found another room.

Someone said the police had been called.

I decided this would be a good time to leave.

As I was leaving the building, I encountered the female-to-trans group leader consoling one of the sobbing mothers. I stopped to speak to her, thinking this might be my last chance to explain myself. But as I approached, she pulled out her phone, turned the video camera on, pointed it at me like a cross fending off a vampire, and said in slow, measured words, “I FEEL UNSAFE. YOU MUST LEAVE!”

The next day, I received a phone call from the group administrator.

I had been banned from the group.

Looking back, I feel nothing but sympathy for these parents. I am sure they truly love their children and want to do what’s best for them. And they are doing exactly what their doctors and social workers advise. These parents are simply trusting in the system.

They don’t realize the system has been gamed.

From the politicians, who pass laws forcing us to use “preferred pronouns” and “affirm” our children or risk losing them.

To the schools, who teach children as young as five that they can change their sex, and hide it from their parents at school.

To the media, who normalize transgenderism by featuring transgender characters in movies, television and the news, casting them as victims and presenting them with awards for their “bravery”.

To the Internet, where sites like YouTube, Tumblr and Reddit provide a steady stream of trans-affirming propaganda.

To the universities, where women’s and gender studies departments openly deny science and rewrite history, and where health centres ‘counsel’ students on how to transition and bankroll hormone injections and surgery.

To the medical community, which is dominated by “gender specialists” who espouse The Gender Affirmative Model—a seriously flawed and unethical approach that is little more than political ideology dressed as science, while ethical professionals who speak out are fired or intimidated into silence.

The system has been gamed.

And our children, naïve and trusting, are its pawns.

A careful step into a field of landmines

Posted on November 24, 2017 by 4thwavenow

by Jenny Cyphers

Jenny Cyphers is a homeschooling parent. She has been writing about that experience for many years, in various online forums. Jenny has been married for 24 yrs to the father of their two children, one adult and one teenager. They all live, work, and create, in Oregon. Jenny is available to interact in the comments section of this post.

“Jenny, you’re wrong. You’re playing with your child’s life. It’s that simple. Putting your misguided beliefs before your child’s well-being could cause irreversible harm.”

This scathing judgment came from another mother in a trans-support group for parents. I’ve seen many fads and trends over the years, but I’d like to talk about the transgender fad, which has impacted my life.

I have a transgender teen. My teen has held tightly to this identification for just over 2 years. Throughout this time, I’ve heard many stories from parents whose children are gender non-conforming or questioning their gender, their identities. Like most parents, we want to support our children and help them through their obvious suffering and pain.

In order to examine the “Jenny, you’re wrong” statement, I need to address what causes “irreversible harm”. Within the trans support groups, there are two diametrically opposed camps. One–and this is important because it is the predominant narrative–is the camp that believes If a child or teen says they are transgender, the protocol is to confirm, affirm, and transition. If parents opt to not transition their child, it puts you in the other camp.

What is transgender? That’s the crucial question. As far as I can tell, the answer is a definition based off individual philosophy. I’ll let others do the defining. One aspect that’s generally accepted is that a person can be transgender whether or not they medically or surgically transition.

But there’s one exception to that accepted definition: a transgender child or teen. As the predominant narrative goes, we’re supposed to confirm, affirm, and transition a transgender child or teen. But the irreversible harm I want to avoid for my transgender child is medical and surgical harm. I made the error in a trans support group of admitting that.

“Jenny, so your support is conditional based upon what you chose to believe. So what makes you qualified to make that decision for your child aside from being the parent?”

What makes any parent qualified to make any medical decision on behalf of their children? This is both an honest question and a rhetorical one. Parents get to make all sorts of decisions for their children. We decide what to feed them, which doctors to take them to, and how and where they’ll be schooled. We decide whether to circumcise and whether to vaccinate. Both of those are medical choices fraught with contention in either direction one chooses.

How do parents make these choices? We talk to our doctors. We talk to our own parents. We talk to our friends and people we respect. We read books. We ask questions. We research and research. The more controversial, the more we research. What parent would NOT do these things?

So, what do I believe? Nobody asks that in honesty unless they are friends who genuinely care. Trans support groups do not care what individuals believe, especially if it questions the necessity of medical intervention for a transgender child.

I’ve had surgery. I know how traumatic it is. I’ve had to take medication with terrible side effects. I know how it feels to be dependent on medicine that makes you feel sick. That experience caused me to question the side effects of drugs used to transition children. What I discovered was surprising.

“When it comes to situations that may require medical assistance parents have the responsibility to seek professional advice.”

“Your support is absolutely conditional. You have essentially decided to control how your child transitions based upon personal belief and nothing more.”

“You’ve drawn a line in the sand with nothing more than personal belief to back it up and you’re controlling how your child transitions despite what the medical establishment recommends. Disagree all you like but your prejudices should not be more important than the wellbeing of your child.”

When I started to ask questions, I found it difficult to get basic answers to the most basic of my questions. It was especially hard to get that information from trans support groups and doctors. I expected to find experts who had done their research. I did get answers, but not the sort I was looking for. I wanted to know actual data and statistics about safety of cross-sex hormone treatment. Instead, what they insisted, without corroborating evidence, was that it was safe and not a big deal at all. Given my own experience with taking medication, I did not automatically believe that. I dug deeper.

I had only ever heard of puberty blockers from knowing a child with precocious puberty. The puberty blockers had dangerous side effects. I knew that already from listening to the mother of that child and hearing her weigh the pros and cons of whether the puberty blockers were worth the risk of broken bones and eventually needing a wheelchair to support fragile bones. These are the exact same puberty blockers being used on transgender children. That alone gave me pause. My own kid was already about a year and a half into puberty, so we weren’t looking at blockers anyway.

While reading about puberty blockers, I also learned that in the United States, nearly 100% of children who choose to take puberty blockers then go on to use cross-sex hormones. So, despite hearing that blockers are meant to give a child time to figure things out, that is not actually what happens. When you stall puberty, you go on to transition. All data that I’ve read, anecdotal and otherwise, supports that. What surprised me even more, in researching, is that when a child uses puberty blockers and then goes on to transition with cross-sex hormones, it results in permanent sterilization.

That fact deeply disturbed me. Bringing up the subject of sterilizing children also brings up the question of ethics and eugenics. Currently, from what I’ve seen, we- the collective we- are okay with sterilizing transgender children. I was surprised to find that many parents were okay with this. It didn’t bother them in the least.

My personal belief, and I do believe I’m entitled to one, is that sterilizing children is wrong.

If an adult is allowed to be transgender without medically or surgically altering their body, then a child should be allowed the same. Furthermore, my bias is that children should not be medically and surgically altered based on being transgender.

I didn’t come to that decision overnight. It took a lot of research and a lot of reading. My teen may have been too old for puberty blockers, but still wanted to transition through hormone replacement therapy. But there is a huge risk of sterilization from hormone replacement therapy. It’s not 100%, all the time, but the percentage is high for all people who do hormone replacement therapy. At 14-years-old, my child didn’t care about sterilization. Very few young teens want children; it’s not on their radar, which is totally normal. That’s why parents make life-altering decisions for their children. Parents are able to see the larger picture.

“So, your answer is that you have no credible information that supports your child because everyone who says you should can’t be trusted?”

“It really sounds like you want to wear the label of supportive so you can feel better but don’t want to “walk the walk,” as they say.”

Let’s talk about support. What is valid support for a child dealing with this?

When our child told us they were transgender, we’d already experienced many teens changing their names and adopting nicknames, which made it easy to adopt a new name for our youngest kid. The insistence of pronoun changes was difficult, but we tried. My husband,who’s a lot like our child, was a champ at being supportive.

The steadfast identity of being transgender grew over time. Nearly every conversation I had with my child was like a careful step into a field of landmines, in which everything was about being trans, but we couldn’t actually discuss it without upset. The only acceptable discussion was my being supportive. One time, when I tried asking my kid honest questions, I realized I had stepped on the landmine known as being one of “those moms”. The unaccepting ones my kid was reading about online, who didn’t accept their kids’ trans identity, and who made their kids complain about how terrible and miserable their lives were because they had bigoted parents who didn’t accept their trans identity. The reality of how our actual relationship had always been up until this point was ignored in favor of feeling oppressed. Being transgender became the focus of every aspect of life.

We were already used to doing life a little differently to accommodate a sensitive child’s odd quirks. Accommodating transgender was just another step down this path. Right up until we could travel no farther down the path. And this is important. The insistence on personal gender identity is so pervasive that one cannot question it. To question it is tantamount to cruelty and violence and bigotry. Transgender is a deeply felt sense of self. Questioning a person’s sense of self is a personal violation. Framed as a personal violation of self, questioning the transgender identity invalidates their very existence. In social groups, both in person and online, there is one accepted dialog: that identities are to be accepted at face value. For most involved, it’s already an accepted truth that anyone can be whatever they identify as, that this is healthy and good and right.

Right around this time, National Geographic put out a specialty magazine about transgender and other identities. When I studied the cover, it was glaringly obvious to me what wasn’t represented, a regular run of the mill female person. Of the kids and teens and adults represented, there is a female identified person, and it isn’t a natal female woman. There is a transman. There is a person marked as male, but nobody marked as female. To be fair, the magazine did some in depth coverage of the material reality of being female across the world. However, the cover was a tiny glimpse into transgender ideology, in which women are being erased- unless of course a transwoman identifies as one.

From that point, it was like a cascade of ideas came into focus for me. I had small epiphanies about how this all impacted civil rights. The transgender politics and policies have the potential to undo civil rights for all people. If civil rights are not based on material reality, then anyone anywhere can undo them and change them. This seemed extremely dangerous to me. When that idea hit me, it was like a sucker punch; it was the pulling of the thread that began to unravel the tapestry of transgender ideology.

Just before this time, my kid was insistent on seeing a gender therapist and getting into a gender clinic to start transitioning. I dragged my feet. Doctor appointments cost precious money we have little of. We finally did make the appointment, and my kid started seeing a regular therapist also. This is when the massive anxiety and depression started taking hold. The combination of seeking out a gender therapist and the deeply held identity of being transgender caused so much distress, which led to more anxiety and more depression. But seeing a therapist was a good thing, anyway. Right?

The cascade of ideas swept over me, just as coverage of the BBC Two documentary “Transgender Kids: Who Knows Best”. I watched it, and then rewatched it with my transgender teen. It’s no longer available to watch, which is really unfortunate. It’s a well-done documentary that helped bridge a conversation gap with my child. The unsupportive parents in the documentary really made my kid mad, and we were able to talk about their feelings. For my part, I was looking at this trans issue in light of civil rights issues and bathroom bills, and the documentary opened up a way for me to discuss civil rights with my kid. The documentary was the first and only really in-depth discussion I’ve been able to have with my kid about transgender issues.

In the profound conversation that came out of that documentary, in a moment of very deep pain, my child shared that no amount of wishing or believing or transitioning would ever make her into a he, even if they looked the part and acted the part. It was a moment filled with tears and vulnerability, as my child admitted aloud that she would never be biologically male, even with surgery.

My child was very sad about this, and I could see the struggle. The struggle is very real. Every parent who has a child going through this will understand this feeling, this pain, this struggle. This is what drives parents to do anything to make that pain stop. I get that completely. And deep inside of me, I knew there were answers that didn’t involve medical and surgical transitioning. I talked about it with my oldest daughter and she said something really important. She said, of her sibling experiencing the pain, “What’s wrong with that?” and what she meant was that it’s normal for people, for kids, for teens to feel pain and express it.

I tried to understand where this was coming from, this desire to be male, to change this body, this personhood so drastically. For years, I’d been looking at what drives individual behavior, in part to ease the frustrations my child had from being a sensitive person in a callous world. Had there been an inciting moment that had caused the identity crisis?

When this child was 11, and in the throes of the onset of puberty, I almost died. I had two heart attacks and emergency double bypass heart surgery. I didn’t make the connection right away. Nobody seems to look at underlying trauma of trans-identifying kids. I brought the subject up with both the regular therapist and the gender therapist. The gender therapist we found was surprisingly thoughtful. I didn’t expect that. I shared with her my reservations about allowing my child to transition without first addressing underlying issues. I shared with her my feelings about how impulsive this particular child was and how firm they held ideas they impulsively grabbed onto. I suggested this may be one of those ideas. She took my feelings into account when I told her I was wanting to wait until my child turned 18 to transition, that I wanted everything to go very, very slowly.

My kid was mad at the therapist’s final assessment that waiting until 18 was prudent. I made all the therapist’s paperwork available to all medical professionals that were to be working with my kid, but the pressure to transition didn’t stop.

In Oregon, the age of medical consent is 15. Since medical professionals were unwilling to read available medical charts explicitly recommending waiting until age 18 to transition, I made sure that I had access to all medical care and records. I had my child sign all medical release papers for that to happen. Every parent living in a state with low consent age should do this.

When we went to doctor appointments for totally unrelated things, they would refer my child to the gender clinic, even though we’d already been, and tell my child they shouldn’t have to suffer and that they could easily take testosterone to alleviate these horrible symptoms like periods and breast development. But they wouldn’t actually prescribe my child testosterone; they’d instead just reiterate that it was an option. My child already knew that this was an option, but that the gender specialist had said to wait until age 18. It felt like hope being held out of reach, like a cruel bait yanked away.

It happened every time. The doctors wouldn’t stop dangling the bait. Because of the turmoil this caused, I had to stop taking my child to the doctor, unless it was an emergency.

“So let’s not pretend you are supporting your child. You’ve clearly convinced yourself that you are but the fact is that you could be causing your child grievous harm and you seem totally unconcerned.”

Meanwhile, I intentionally started focusing on big-picture ideas with my kid. We acquired a telescope and fixed it up. Now, we discuss stars and planets and the universe. We used our now freed up money, that we were spending on doctor appointments, to take more dance classes. My husband, a musician, includes our kid in making music. I bring my kid with me to help in the theatre I work in, where their quick engineering skills are valued. We support their new interest in herbs and plants and research how to care for them and what to use them for. We use websites and books to identify rocks and stones. We drive to visit friends that live in nearby cities, for a change of scenery.

When we started on the new transgender journey, together, my child and I decided that no matter what, this was not going to be the life focus. We opted not to join any queer youth support groups. What I’ve seen in those groups is that life becomes very narrow. One doesn’t play music, they play queer music. One doesn’t do art, they make queer art. My kid even began to notice this and didn’t want to make life all about being transgender. A too-narrow focus goes against the very fabric of our family life, the one we built by bringing the world to our children and our children to the world. Our life has evened out a little.

Our teen is now desisting. The goal wasn’t desistence though; it was to prevent irreversible medical intervention of a teen, whose identity is malleable and in flux, as all teens’ are. If one can BE transgender based on feelings, deep seated and strongly held and persistent feelings, then why must the push be towards chemically and surgically altering one’s body? If we are to accept each person’s identity at face value, what does it actually mean to BE transgender? If my child desists, does that mean they weren’t ever transgender to begin with?

If I’d opted to follow through with all the current protocols, my kid would be taking testosterone right now, with an eye towards mastectomies and a hysterectomy. If we’d done that, and my child desisted, would they have been truly transgender? What if I’d gone into the gender therapist’s office and pushed for transitioning? If being transgender means that one is the other gender born into the wrong body, but not everyone fully transitions medically and surgically, then why must children do so to be truly transgender?

I’ve been accused of causing grievous harm to my child by not following this path of hormonal and surgical transitioning. I’ll be the first to say, I could’ve been super supportive of transitioning my child. I could have entered that gender therapist’s office and insisted that we jump through whatever hoops were necessary. I know of people who have done that. I’m sure that’s what my kid expected me to do. I’ve been accused of being unsupportive of my child by not confirming, affirming, and transitioning my child. This is laughable that anyone who knows me would say such a thing. My kids are my life, literally and figuratively. I think that’s true of most parents, even the ones who make terrible mistakes that destroy relationships. Even those parents who are lost and don’t know how to deal with transgenderism, but love their child and don’t readily accept whatever their kids say. Even parents who are religious and object on moral grounds. Even parents that are very liberal and accepting.

For every parent reading this, remember that most mistakes are recoverable. You can apologize and move towards restoring the relationship. Don’t buy into the emotional blackmail so common among the transgender community. Keep your children close. Make all the choices in the world to build up your relationship. Do it as if their life depends on it, because it does. If they can wait until they are older, and they do end up transitioning, they will need you as their support. Let me be very clear here. You do NOT have to agree with the choices your adult children make while still supporting them as people. If your focus is on imparting bigger ideas than self-identity, there will always be ways to support your child, no matter what choices they end up making.

I’m much more concerned with mental health and maturity to handle the long-term effects of transitioning, than I am about identities. Identities are always changing as you grow and learn, and while some aspects of your past will always remain a part of you, some things you choose to discard when they cease to be relevant. Teenhood and childhood are all about trying on ways of doing and being in the world and seeing how it works.

You cannot discard a body that’s been altered to bring back the old one.

Get angry, read, research. Seek help when you need it, from people you know, trust, and respect. Then get out there and focus on the things that bring you joy and include your children. Be brave. Most of all, don’t be afraid to question the prevailing narratives.

An open letter to the medical profession

Posted on November 19, 2017 by 4thwavenow

“I know better than most how precious a career in medicine is and I am willing to risk it for the sake of preventing harm. Why aren’t you?”

This fine article (reblogged below) launches a new website by a detransitioned Welsh medical student, “More Rote Than Meaning.”

In her first paragraph, MoreRote mentions the case of Helen Webberley, the UK GP under investigation by the UK General Medical Council for prescribing cross-sex hormones to 12-year-olds. In the US, gender doctors do the same with impunity–with no media or medical-board scrutiny in sight. We tweeted about the stark contrast between the two countries here:

Compare and contrast.

UK MD is probed by Brit Med Council for giving cross-sex hormones to 12-yr-old. In the US? Gender docs publish in med. journals about doing the same--including to "genderqueer" & "nonbinary" youth. Maverick MDs unregulated in the US, with no media scrutiny. pic.twitter.com/rFUEwJEuSW
— 4thWaveNow (@4th_WaveNow) November 20, 2017

Many thanks to MoreRote for telling her story, and for raising crucial ethical questions about medical transition of children and young adults.

It’s not conversion therapy to learn to love your body: A teen desister tells her story

Posted on November 7, 2017 by 4thwavenow

Update 28 August 2019

At her request, we have removed our interview with Maxine. She told us:

“I’m still happily desisted from my former trans identification. In fact, I have moved on to the point that I am no longer interested in talking or even thinking about ‘gender.’ My life is full and rich, and I’m very glad I did not medically transition. But I am a private person, and at this time, am no longer willing to share my very personal story with the world via the Internet.

I wasted a lot of precious time believing I was trans. At the time of this interview nearly two years ago, I was very angry about that, and wanted to help other people, so I wasn’t thinking about my privacy.

I’m really glad that sharing my story helped other young people become more comfortable with their bodies. Best wishes to all.”

Moving on

No glitter life: Don’t be swayed by middle-aged transitioners–including me

Posted on November 2, 2017 by 4thwavenow

by Helen Johnson

As time permits, Helen will be available to interact in the comments section of this post. As always on 4thWaveNow, comments that challenge the author will have a better chance of publication if they are delivered respectfully.

My name is Helen Johnson and I am a trans woman.

That’s partly true. I am trans, but I’m not telling you my real name. After you have read my piece, I hope you’ll understand why. Transgender activists reserve a special kind of treatment for apostates who speak out against their dogma. I have no wish to deal with their threats and intimidation, but neither can I remain silent when those transgender activists are driving a contagion that is consuming our young people.

Much has been written about the explosion in the number of children who have come to believe that they were born in the wrong body. I’ve said nothing because — like other trans women who transitioned as adults — I’ve nothing to offer. I’ve no childhood experience of living as the opposite sex and my own kids are thankfully unscathed by this epidemic. I can therefore only sympathize with other parents whose children are struggling with their gender. Some have asked me directly, but I have always suggested that they seek support from other parents in the same position. Certainly not from me.

Unfortunately, other trans women think differently and some of them seem to think they know best. Entire pieces have been written about trans activists like Rachel McKinnon, who told trans kids to dump their moms on Mother’s day and join the “glitter-queer” family of adult trans activists. Worryingly, Dr McKinnon is far from alone. The message is pervasive, and it is sinister: transition your kids or lose them. Sometimes it is subtle. For example, Julia Serano, a leading figure in the trans community, suggested that children will grow distant unless parents affirm the transgender behavior. Others are more blatant. Caitlyn Jenner is one of many who throw suicide statistics around like confetti.

None of them are experts. All they have to offer is their own experience of growing up. But if they can do that so can I and, unlike deluded fantasists like Zinnia Jones who thinks they actually were an adolescent girl, I am in touch with reality.

Gender dysphoria was present in my earliest memories; it persisted throughout my childhood and stayed with me in adulthood. It made me socially uncomfortable and I struggled to make friends. My dreams of becoming a girl were never fulfilled and I reluctantly accepted that there was no alternative to becoming a man. I’ll say no more about that. The trans narrative is repetitive and it is tedious. But just like McKinnon, Serano, Jenner, and Jones, I survived childhood and everything it threw at me. Yes I had difficulties, but lots of children have difficulties. Growing up is hard.

Today’s youngsters are being fed dangerous and fallacious nonsense. Society has been infected by post-modern, post-facts, post-truth ideas that spread unchecked on social media. Opinions and feelings are on the ascendancy, while facts and evidence are cast aside. For socially awkward children struggling to understand themselves, McKinnon’s “glitter-queer” family may look superficially attractive; an easy escape from reality. But it comes at huge cost.

I am glad that I did not succumb as a child. Male puberty was a mixed blessing for me. It changed my body in ways that I did not like, but it enabled me to have my own children. Today they are my pride and joy: fine kids who are now making their own way in the world. They would not be here had I been transitioned in childhood.

It’s now becoming all too clear that the first generation of child transitioners may have thrown away more than the chance to be parents. Sex reassignment surgeons need material to work with. Only after male puberty did I have sufficient tissue for my vaginoplasty. Children who never experience natural puberty, like Jazz Jennings for example, are finding that they have a serious problem. To be blunt, there is no way that a functional vagina can be created from a penis only two inches long and an inch and a half in circumference. Sadly, Jazz may never be able to enjoy the sex that adult male-to-female transitioners take for granted.

Even transitioning later is a mixed blessing. I am in remission from the gender dysphoria but that is only half the story. My life is harder in other ways. Whenever I am clocked as trans I am treated differently, and not better. Mostly I deal with this by living in stealth. In my day-to-day life I just don’t mention it. People can’t discriminate if they don’t know. But that brings troubles of its own: when I’m asked about my childhood, I obfuscate; when asked about my children, I fudge; when asked about my private life, I create back stories. I hope they are consistent. When acquaintances become friends, I anguish over whether to come out to them, then when to do it and finally how to do it. Lying about your past is not great, but admitting it is harder especially in the early stages of a new friendship. Securing a life partner is something else. Trans people are seen as exotic curiosities rather than possible suitors. Rarely are we seen as human beings, usually as trans human beings. Not quite the same and not quite suitable.

But, people say, at least I have found my true self. Maybe, but I’ve always been my true self. I transitioned to escape the pressures that I faced but I will never really be a woman, I merely live as one, and I am always one step away from being outed. It works but it’s an expedient tactic rather than a fulfilling solution.

But you must be sure, they say. How can I be sure? All I have are circular arguments: because I needed to transition I must be a woman, and I must be a woman because I needed to transition. But I can never know what it is to be a woman. All I can know is what it is to be me. My experience will always be different from the women around me. It isn’t a glitter life, it’s a hard life. It works because I make it work, but it’s not great.

To kids contemplating transition I have no answers, only questions. Do you really need to transition? Give up the chance to grow up and form relationships as a human being rather than a trans human being? Have your own children? Have sex like other adults have sex, and live free from lifelong medication? If gender expression is the issue then be yourself and embrace your gender, but don’t try and change your sex in the process. One day, society may free itself from the shackles of gender norms, and feminine men, masculine women and gender-neutral members of both sexes will be able to take their rightful place in it. Make it your generation that does that, not the ones that follow you.

To your parents I would say, give your children a hug. Love them and nurture them. Let them be free to explore their gender and help them make that break from the crushing weight of society’s restrictions and expectations. But steer them away from transitioning from one gender prison into another, certainly before they can experience what it means to be an adult. If their gender dysphoria persists, as mine did, they can always transition in adulthood. That option will always be there. If it desists, then they will have avoided making a truly catastrophic mistake.

But above all, parents, don’t be swayed by middle-aged transitioners. That includes me, but it also includes McKinnon and the others. You know your children, we don’t; you brought them into the world, we didn’t; you love them and care for them, we don’t even know them.

Have confidence in yourselves because, when it comes to your children, you will always know better than people like me. Never forget that.

Born in the right body: Introducing 4thWaveNow’s new spokesperson, mom of a teen desister

Posted on October 25, 2017 by 4thwavenow

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Brie J is a part-time academic, and a politically liberal mom to an adventurous, wilderness-, insect-, and art-loving teen. She currently lives in the American southwest with her partner and daughter, a huge dog, three cats, and various insects who come and go.

Brie has been a member of the 4thWaveNow community for two years, since her daughter first temporarily identified as transgender. After exploring all kinds of ideas, thoughts, and feelings related to gender identity with her daughter, Brie has decided to speak publicly about her family’s experience. In particular, Brie agreed to be our public spokesperson to counter the untruth that only religious, anti-LGB conservatives are skeptical about medical transition of gender-atypical young people.

Note: Anyone who has spent time on our site knows we are not a monolith, but a diverse group of parents with varying (though generally congruent) views. Brie’s experiences and analysis are her own, but are on the whole in line with those of the other gender-skeptical parents in our community.

In a future article, Brie’s daughter, along with a few other teen desisters will discuss their own thoughts about identity, gender nonconformity, desistance, and more. Stay tuned.

As her time permits, Brie is available to interact in the comments section of this interview.

You are the parent of a teenage girl who temporarily believed she was trans, but changed her mind. Can you tell us something about her journey—and yours?

A few months before my then 11-year-old said she might be transgender, she told me she didn’t want to grow up. She had just met her new pediatric endocrinologist (she has type 1 diabetes) and he told us she was in the early stages of puberty. In the car on the way home from the appointment, crying, my daughter asked me how much longer until she’d start bleeding, until her breasts would grow.

A few weeks after that appointment, Leelah Alcorn, a transgender teen in Ohio, committed suicide by walking onto a highway into the path of a tractor trailer. My daughter was gripped by Leelah’s story, by the horrific choice of death over a seemingly endless painful existence, and she agonized (for weeks) over the details in Leelah’s suicide letter. “What is transgender? Was Leelah a girl trapped in a boy’s body?” “How could her parents not see they were killing her?”

A few months later, my daughter told me she thought she might not be a girl. I asked if that meant she was really a boy and she said she thought so. I said something like, “this is a lot to think about” and asked her permission to speak to her grandfather, a psychologist, and another friend, a genetic biologist and a lesbian. She agreed and sheepishly let me know she’d already told her poppa.

I called my dad that night after she’d gone to bed. He reminded me that she’d always “been her own person” and that imagination and sensitivity could have been heightened by almost obsessively reading/thinking about Leelah Alcorn. He explained body and gender dysphoria, and drew a connection to eating disorders. “You wouldn’t help her starve herself if she thought she was too fat,” he said. “Help her just be her, in her own body, whatever that means.”

Next, I spoke to Audrey, our gay geneticist friend who reminded me of her own teen years and cautioned that she certainly would have considered transition had it been readily available. Together, we looked at the few studies we could find about hormonal suppression in adolescents and testosterone use in healthy female bodies. My friend was horrified by the lack of long-term data available for medical interventions being performed on healthy adolescent bodies. Audrey spoke to my daughter about the hormonal responses which occur in puberty, how besides development of secondary sex characteristics, pubertal hormones are needed for brain development, neural pathways, grey matter. If you “pause” that process, she told us, you’ll be stunting the very growth that will make you into the adult you. “You don’t know who you are yet,” Audrey said, “how can you know that’s not who you want to be?”

My daughter agreed to put medical transition, a process she’d been watching with envy in numerous transmasculine teen videos, on hold while we explored these ideas together.

What followed were two years of emotional upheaval and deep exploration. Family and friends agreed to stop using “girl” and worked hard to remember her requested “kid” in its place.

I pestered anyone who was willing, to talk to me about gender, adolescent development, and hormonal modulation. I talked to someone I knew in the midst of her own gender transition and to her partner. I talked to trans people, gay people, other parents of trans and GNC kids, endocrinologists, a Zohar scholar, educators, radical feminists, postmodern theorists, and child and teen psychologists, including those who designated themselves “gender specialists.” I joined large Facebook groups for parents of trans and gender non-conforming kids (and was subsequently thrown out for posting data about Lupron).

I asked my daughter to show me some of the things she was reading and watching online which led to her realization. Together, we explored all kinds of “you might be trans if…” quizzes and “Am I trans?” posts on Reddit’s “Ask a Transgender” subreddit, various Tumblr blogs, and elsewhere. We talked a lot about stereotypes and gender roles.

At my daughter’s request, we went to the Philadelphia Trans Health Conference, where we met Jazz Jennings and ate pizza with hundreds of transgender kids and their parents. Dinner conversations between parents were clearly divided between stories of natal boys who’d “always been this way,” who “always liked pink” or sparkly princess dresses; who liked to play with dolls and wanted to wear nail polish, and born-girls who, on the cusp of puberty, often friendless, suddenly came out as “trans.” My daughter made a lot of new friends that night, some of whom now, two years later, have been on testosterone for a number of years; some have had mastectomies. Of the teens she met that evening, I’m aware of one other who has also desisted. brie pull 2 Ultimately, what brought her to the realization that she is not “in the wrong body” (about two years later), were endless, ongoing conversations about sex-based norms, gender roles and expectations, and homophobia, between her and lots of other people, mostly women. NO ONE fits neatly into any stereotype associated with their “identity.” She came to understand that her suffering wasn’t because her body was wrong; she was suffering because growing up is hard! To her, “being trans” explained a lot of her discomfort and anxiety, but she came to realize that it wasn’t actually “being trans” that caused any of it.

She came to see medical transition as physician-assisted self-harm. In a twisted way, it helped that she is already dependent on synthetic hormones for her life. She has zero choice about injecting insulin every time she eats, or when her blood glucose is too high, up to ten times a day, for the rest of her life. When her friends who’d started HRT complained about needing injections, something snapped in her. She saw the stark difference between needing pharmaceutical treatment to live (no choice) and desiring it as treatment for a feeling. Her body IS, actually, wrong. It’s verifiably broken and without synthetic hormonal supplementation numerous times a day, every day, she will die. Quickly and painfully.

She realized that her friends had healthy bodies but that their therapists, their friends online and in real life, and sometimes even their parents, were supporting them in the belief it was their bodies that were wrong because they didn’t match their personalities, their preferences, who they were supposed to love. When she realized this, she got angry. She felt tricked into believing there was something wrong with her because she didn’t want to be ogled by teen boys, or wear dresses, or because one of her favorite things was to talk about the difference between aquatic and terrestrial isopods.

So it sounds like she experienced a “rapid onset” gender dysphoria in adolescence, a phenomenon which is now only starting to be recognized.

Yes. And…no. She told me that prior to Alcorn’s suicide, that she wasn’t aware that being transgender was possible, that it even existed. Once she came into contact with the idea, it captivated her and she quickly identified her “transness” as the reason she didn’t want to go through female puberty. She wasn’t alone. Numerous girls in her various peer groups would come out as trans in the coming year.

I think it is critical to this discussion, though, to talk about all the ways she’d been “gender non-conforming” up to identifying as trans.

As liberal, progressive, feminist parents, we never put energy into making sure our daughter adhered to gender norms. As a baby, she wore all the colors and never had a head-squeezing headband to denote “girl.” I never bothered correcting strangers who thought she was a boy. I insisted she wear a dress once, to a wedding, when she was eight. She cried.

When people asked her if she was a boy or a girl, she’d bark, or meow, or roar.

brie pull 4 When she was younger, her favorite toys were stuffed animals, scraps of fabric, cardboard boxes, and small plastic insect, dinosaur, and dragon figures. Then, as she got older LEGO, but never the pink sets. She played lots of imaginative games with her stuffed animals and little figurines and dump trucks; she never wanted a doll and cried once when she was four and someone gifted her one. She couldn’t understand how someone who knew her might think a Mermaid Barbie would be a welcomed present.

Her favorite stuffed animal was a crab named “Crabby” who went almost everywhere with her. When people asked if Crabby was a boy or a girl, she’d answer: “she’s a boy” or “he’s a girl” and laugh. Outside, she liked to pee standing up, like her dad, and somehow figured out how to pee farther than her best friend, a boy.

She mostly preferred “boy’s” clothing: sweatpants and shirts with insects, dragons, monsters, and dinosaurs. We let her choose her own clothing as soon as she wanted to and had no problem with her heading over to the boy’s section of stores.

These are important details because once I turned to trans-affirming websites and books (which were all I could find until I learned the phrase “gender critical”), the gender nonconforming choices she made, her preferences, some of her behaviors, could easily be read as proof that she really was a boy, that she had a “boy brain,” and perhaps, that she was exposed to too much testosterone in utero as evidenced by her relative finger length.

The acute stress she felt over her body (dysphoria) was indeed rapid-onset. However, looking back, there were many incidents which could have been interpreted as signs of an “innate gender identity” that didn’t match her sex.

Trans activists have tried to convince the public that “desistance is a myth”. Yet your daughter did indeed desist. Why do you think activists want to deny the experiences of young people like your daughter?

Because desistance justifies cautious, rational, skepticism. Desistance proves that some people think of themselves as transgender and then come to think of themselves as not trans. Desistance creates doubt.

When I say “desisters,” I’m talking about those who once thought of themselves as trans but do not currently see themselves that way. Desisters like my daughter and the other young people we know, never took steps to medically transition although they considered themselves transgender and in most cases, looked forward to medical intervention of some kind.

Desistance stories are often criticized as being about kids who were never “really trans” to begin with. Brynn Tannehill, a board member of the Trans United Fund, argues that the 84% desistance rate is inflated because it caught up a lot of gender nonconforming kids in place of “true trans” kids–so of course they desisted; they were never trans!

Here’s the thing, neither was my kid. Chances are, most of the kids of parents reading here aren’t trans.

Let’s assume for the moment that there is such a thing as “true trans.” What does that mean? Let’s say there is at least minimal proof that gender identity is innate and biological (there isn’t). Let’s pretend that we have long-term data showing that medical intervention in adolescent development is beneficial to those who don’t fit easily into gendered expectations and norms and to those who suffer from dysphoria.

Now, let’s say that all the previous gender-atypical behavior my daughter exhibited growing up was resultant from a biological abnormality.

So what?

So what if she sits on the far end of the bell-curve’s tail of female behaviors and preferences? How does that make her “other?” Why does that mean she’s in need of medical intervention to “correct” something deeply amiss?

Why can’t she and all other outliers be supported as they are without needing to be fixed? Have we learned nothing from the historical horror show of medical interventions enacted on children with differences in sexual development (“intersex”)? Why does being an outlier mean that she’s “really a boy?” instead of simply, that she’s different than the female norm?

Desistance as a likely possibility gives rise to the “wait-and-see” approach, which according to some “affirmative” gender professionals, is just as dangerous to kids as insisting they’re not trans. This horrifies me, that cautious “wait and see” approaches are discouraged when there is zero evidence that socially and medically transitioning children and teens is beneficial, apart from (parent reported) immediate gratification and short-term validation.

The affirmation model used widely in the US is actually highly controversial. In the UK, a doctor is under investigation for providing cross-sex hormones to children as young as 12—a situation being normalized at pediatric gender clinics in the US. Under-18 surgeries take place in the US, while they are prohibited in the UK—and even Thailand, once known as a go-to place for underage procedures. US “affirmative” clinicians behave as if the debate on child transition is over, even though leading researchers at 17 worldwide locations cautioned in a 2015 journal article that “in actual practice, no consensus exists whether to use these early medical interventions.”

brie pull 3 And still, WPATH argues in favor of lowering age limits for medical and hormonal treatment and easing access to transgender medicine. In the US, some pediatric gender practitioners and their advocates act as if this course of treatment is settled science. It isn’t. Even the gender specialists in the Netherlands who pioneered the use of puberty blockers in “trans kids” caution against socially transitioning younger children, because kids who don’t socially transition seem to mostly work it all out by themselves, and some socially transitioned youth who changed their minds found it very difficult to desist later.

Desistance stories also add weight to recommendations for cautious approaches that focus on first treating underlying mental health issues. That’s problematic in a climate where trans activists want to completely depathologize transgenderism. I know a lot of families whose children currently think they’re trans. In almost every instance, there are prior mental health diagnoses or family experiences of trauma.

Parents like you—many of whom are contributors on 4thWaveNow—are castigated as “transphobes” or (at best) “unsupportive.” What do you say to these charges?

Supporting children in desiring and procuring plastic surgery, synthetic hormonal suppression and supplementation is not healthy, supportive, enlightened, or progressive.

Authentic selves do not require surgical and hormonal treatment unless there is underlying pathology, like for my daughter’s autoimmune condition which requires daily hormonal supplementation. Medical transition should be a last resort for those whose suffering cannot be ameliorated otherwise.

Becoming a life-long medical patient is not liberating; it is enslaving. Being critical and cautious is not hatred, it’s being a good parent.

Gender dysphoria is real and it causes real suffering. My daughter was in deep, profound, pain.

After initial hesitation, I knew my child was not “born into the wrong body” and that as her parent, I would be doing more long-term good (and also less long-term harm) by offering her the time and tools she needed to see herself as whole, capable, and “authentic” as she was instead of affirming that there was something wrong with her.

I think that the most supportive thing we can offer our children is to take apart all our preconceived ideas about gender and identity alongside them. I was told by parents of trans kids and gender therapists that the only expert on my child’s gender identity was my child and that asking “why?” “what does that mean?” “How did you arrive at that conclusion?” “Who are your sources?” and a thousand other questions which would lead down a thousand other rabbit holes, was transphobic, unsupportive, and harmful to her well being.

They weren’t. Those are exactly the questions that helped her make sense of herself, helped her feel whole instead of in need of corrective treatment, helped her be resilient in the face of disappointment and learn to manage both real and perceived limitations.

The stories we’ve been telling aren’t enough. They don’t go far enough. Deep enough. They’re too easy. The answer isn’t a pill or plastic surgery. How many children were prescribed Ritalin simply because their bodies couldn’t stay still? I mean, come on. An entire industry has risen up around trans kids. Careers are being made, not just in the medical field but in education, policy, fashion, the media, all because normal, developmentally appropriate childhood behaviors have been repackaged as (often homophobic) pathologies. We’ve seen this before.

Being “trans” is too easy. It’s an identity picked off a shelf and inside the packaging, there’s a list of other necessary components one must procure before reaching authentic selfhood. “Being trans” to girls like my daughter is like a quest in a video game with each “affirming’ “medical procedure acquired is an “epic win” bringing you one step closer to having all your problems solved. Except no video game exists that suppresses development or leads to the removal of healthy body parts. Being trans isn’t a video game, it’s real life. Real, painful, confusing, life and being trans was the defining aspect not only of identity but also the root of all her suffering.

I supported my child in her journey. What I didn’t do was accept the first and easiest answer. I helped my daughter know that disagreement or unacceptance of any gendered norm was more than okay. I fully supported what my generation quaintly called ‘gender bending” in all ways, but I didn’t agree to let her subject herself to significant bodily harm in an attempt to treat her dysphoria. From the very first announcement, I let her know that she could cut her hair however she wanted, wear whatever clothing she wanted, and use whatever name she chose.

I supported her in her discomfort, to the best of my ability, and I also let her know that discomfort and confusion are legitimate aspects of a meaningful, deeply explored life.

There are two rationales given for the urgent need to medically transition young people: the risk of suicide, and “passing” better as the opposite sex if puberty is blocked. Do you think these reasons are valid, and if not, why?

Major life moves made from a place of fear and lack of choice are rarely successful. Kids don’t kill themselves because they’re trans. Suicidality needs to be treated as a dysfunctional response to unhappiness, not as a symptom of being trans. Anxiety needs to be treated as anxiety and not as a symptom of being trans. Depression needs to be treated as depression and not as a symptom of being trans. And suicide should not be used as a strategy to manipulate vulnerable parents desperate for “expert” advice or to prime kids to take their own lives. Stop already. That stuff’s contagious.

Most of the parents who’ve agreed to support medical transition for their children and the various gender “experts” I’ve talked to over the past few years argue that children who transition young will pass easier. That’s a problem, because prioritizing “passing,” like much of the surrounding ideology, actually reinforces binary perceptions of gender by suggesting there is only one way to be/to look like a man or a woman. I know gorgeous women with broad shoulders. I know handsome men who can’t grow a beard. So what? The effects of testosterone on a natal female are rapid, and some, like the growth of facial hair, male pattern balding, and changes to one’s voice are irreversible. Besides, it’s recommended that natal females taking testosterone for more than a few years have a full hysterectomy to minimize increased risks of some cancers. Therefore, early transition does not limit later medicalization. Sometimes, it even increases the need for more intensive and painful procedures later. I think it would be far healthier for those who are gender-atypical and for society to get rid of the idea of “passing” completely.

Until recently, the only critics of pediatric transition seemed to be people primarily from the conservative right. They tend to conflate transgenderism with gay rights, and are opposed to both. What is your own political affiliation and viewpoint?

Oh, I’m left-of-left. Another reason I want to speak out is because most opposition to trans advocacy comes from the conservative right and IS deeply entrenched in sexist and homophobic beliefs.

Most on the left are too afraid to speak out for fear they’ll be labeled as transphobes, bigots, TERFs, bio essentialists, and just plain old shitty, hateful, shallow-minded people.

Sigh.

Look, if an adult decides after careful and hopefully well researched, in-depth exploration into why they want to undertake surgery and/or HRT, and they fully understand–to the extent it is possible to understand given the lack of long-term data—what their medical choices could mean 5, 10, 40 years down the line, I believe they should be free to make whatever medical choices they and their support team believe to be best. I think insurance policies or better yet, a national health insurance policy (I can dream), should pay for all services related to transgender care.

I believe trans people should be protected against discrimination in education, healthcare, employment, and housing. I want trans people to feel safe walking down the street. I want them to be safe walking down the street.

What do you hope to achieve as public spokesperson for parents of trans-identified young people?

I want to make the conversation larger; I want it to go deeper; I want the medical community to keep their ‘corrective treatments’ away from our children’s bodies. It’s not okay to offer them life-long patienthood without first giving them tools and support to explore the “why?” the “what next?” and a myriad of other possibilities and conclusions.

Currently, the only voices in the discussion are those involved with the industry that’s risen up surrounding transgender medicine. I want to take the discussion beyond the self-declared “experts” who are making entire careers off of the notion that it’s possible to be born into the wrong body.

Many advocates of medical transition for youth claim that there are “true trans” kids who are very different from merely “gender nonconforming” youth. Do you agree?

No. I think almost every human on earth is gender non-conforming in some ways. I was listening to Georgia Warnke recently. She’s largely responsible for getting the medical community to stop performing surgeries on young intersex children, and she helped people learn to be more comfortable with ambiguity in sex and gender presentation. She cautions that we don’t want identities to “go imperial,” a phrase she borrows from Kwame Anthony Appiah who writes that some identities “risk becoming the obsessive focus, the be-all and end-all, of the lives of those who identify with them,” and they “lead people to forget that their individual identities are complex and multifarious.” I’m concerned that’s what’s happening with many of our youth.

Their lives are boring, they’re isolated, the earth is dying, the economy is dying, their families are disintegrating, they’re carrying so much. I can’t imagine a more difficult age to come into ‘ideological’ adulthood than this one. I think a great many young people identifying as trans are doing so because it’s the only life-shaking, meaning-bringing area of their lives they have any control over. Being trans is an answer, a solution, and a meaningful marginal identity during a time in history when being a member of an “oppressed class” also begets greater social currency in some circles.

We’ve given them surfaces. Reflections of reflections of copies. The Mirror Stage mirrored and misidentified. A rose wet with Photoshop dew on a handheld screen that’s the first thing they touch when they wake up and the last thing they touch before they go to sleep. We parents didn’t realize what was happening. We couldn’t predict how digital lives would bleed into reality, that we’d need to clarify what we mean when we say the word “cloud.” Another mom going through this says, “online worlds seep into life like too much salt in a soup.” Curated personas, best friends you’ve never smelled or touched, avatars brought to life. The Junior Oxford Dictionary removed the words “acorn, ash, buttercup, dandelion, fern, ivy, nectar, pasture and willow” to make room for: “blog, broadband, celebrity, chat-room, mp3 player and voicemail.”

Huge, meaningful and exciting swaths of our kids’ lives have played out in digital worlds while their material worlds have become smaller, more isolated, and disconnected. In many cases, our kids were already disassociated from their bodies, even before they became aware of trans identities. Running, jumping, dancing, wrestling, all these things happen primarily in controlled spaces now. The only remaining place for many young people to gather away from adult-controlled, contrived, and protected spaces, are digital worlds. It follows, in this climate, that “authentic selves” might also be technologically-mediated products to consume. My god, talk about planned obsolescence. This is planned obsolescence of the body from the moment of its birth and our kids are early test subjects in transhumanism. For real. No tinfoil hat needed. Google “postgender.”

No. I don’t believe that there’s such a thing as “true trans.” I believe we’re all mosaics of hormonal, skeletal, emotional, personal, etc. traits and that identity is being commodified in dangerous ways.

Your daughter is only 14. The “affirmative” clinicians will say, see? She just wasn’t really trans. No one can be “made” to be trans, so your daughter just figured out she wasn’t. No harm done.

The only reason my daughter figured out she isn’t trans is because I gave her space, time, and access to diverse people to talk to. I did not, as was advised, immediately affirm her new trans identity. Had I done so, had I said, “oh, yeah, that makes sense” she would most likely, she says, be taking testosterone now. She thanks me regularly for not believing she was a boy trapped in a girl’s body.

Related to the previous question, how do you know your daughter won’t change her mind again and realize she actually is trans? Again, the activists/affirmative clinicians will say maybe she’s just staying “in the closet” about being trans to please you.

I don’t know that my daughter won’t change her mind. How could I? What I know is that she spent the past two years interrogating her dysphoria: where it came from, what purpose it served/didn’t serve in her life; what triggered/increased/decreased its intensity. For the most part, she faced her dysphoria, anxiety, and past trauma head-on and learned ways to live in her body more comfortably.

Is she just waiting until she leaves home to come out again? Best to ask her [Note to readers: We will!] but I don’t think so. She’s angry that she wasted two years of her childhood worrying about her gender identity. She sees her non-conformity with gender roles and her non-compliance with “femininity” as aspects of her individual personality, not as pathology in need of corrective medical care. To her, and she can explain this better than I can, being “trans” means accepting that males/females can only be one way, that some aspects of identity/personality/self-essence beyond biological functions belong to only males or females. She doesn’t believe that’s true.

Do you oppose medical transition for all youth? Why or why not?

No. I believe that for some youth, pharmaceutical treatment might bring the most relief. I do not believe that surgery to remove healthy body parts should ever happen on children or adolescents.

Physically altering (and sterilizing) bodies as a “corrective measure” is nothing new. The history of medicine overflows with horrors enacted on dark skinned and disabled bodies, the bodies of women, and of homosexuals. Doctors in the Netherlands, where homosexual males used to be surgically castrated, were the first to suppress natal puberty in trans identifying children. I think that history, of medically-supported and induced harm on noncompliant bodies, is important to keep in mind when thinking about transgender medical treatment. I mentioned Ritalin earlier. But let’s remember lobotomies, cures for hysterical women, female genital mutilation. Let’s remember that puberty suppressants followed by cross-sex hormones will sterilize a body for life. Gender specialists are sterilizing and greatly increasing the risks of cancer and other debilitating medical conditions in children, many of whom would simply have grown up to be gay in earlier times.

Caution. We have to be more cautious, not open the gates wider. Puberty suppressants, cross-sex hormones, and surgery, all have life-long consequences. Shouldn’t the focus be on helping people learn to accept themselves, in all their messy, unmatched, contradicting, and possibly limiting, glory? We contain multitudes, right? Let’s contain them in the healthiest of possible bodies, with the least amount of dependency on chemical and specialized medicine.

We all want to thank you for stepping forward as public spokesperson for 4thWaveNow. As you are well aware, many parents feel they cannot go public because of the current political climate.

I want those of us who live with and care for young people investigating their gender identities to think more critically and carefully about the idea that humans can be born into “wrong bodies,” and that “authentic selves” are dependent on medical consumption. I want to push the conversation beyond “because I am trans” answers. That’s not good enough. There’s more here and we owe it to our kids and future societies to ask harder questions and to wait, patiently, for more meaningful answers.

I want to speak out because I know others can’t. The risk to one’s livelihood and to the peace of their families and communities is immense. Nothing I am saying is hateful or bigoted but questioning the dominant narratives of innate gender identity and affirmative models of treatment are dangerous moves when even philosophical questions are considered “epistemic violence” against trans people.

This is unacceptable. We cannot think rationally or make well-informed choices if half the conversation is muted. The voices of desisters are important contributions to any discussion focused on dysmorphic adolescents and kids who don’t easily conform to gender norms. I want parents to know that it’s okay to say, “hang on, lets think all this through together.”

You know, if “being trans” simply meant I am who I am who I am and it didn’t often come with a side of medical necessity, I wouldn’t be here insisting we need to talk about this stuff more thoughtfully, more thoroughly.

If sex is socially constructed, like trans advocates argue, why does anyone need to alter their sexed bodies to match their gender identities? It doesn’t make sense. Transgender medicine is being marketed to our young people under the guise that their gender-atypical behavior and/or their developmentally normal bodily discomfort is a sign of incongruity, of imbalance. Normal, healthy teen angst, the challenges of independent identity formation in adolescence, these processes have been pathologized. Instead of helping kids be resilient, many aspects that fall under “gender identity exploration” enable self-perceived and socially-inflicted oppression, hardship, isolation, and malaise.

But, too, in many ways, what’s happening with awareness about gender identities is meaningful and I’m thankful to young people for pushing the rest of us to think about what being “masculine” and “feminine” means in this day and age. Thanks to young people, many are noticing how toys are more gendered now than they were thirty years ago and lots of parents are questioning why boys can’t wear sparkles and why we tell girls to smile. This is all good stuff! But all the good stuff is coming at the cost of our children’s long-term physical and emotional health.

I’m adding our story to the mix because it offers an alternative trajectory to the one that currently dominates the press. In addition to the “courageous trans kid” who lets everyone know that she is a he, I want to highlight young people who’ve come to terms with their sexed bodies and courageously move forward in life without feeling there is something wrong with them, that they’re disabled in some way, that their bodies or other’s perceptions of them are in need of correction.

Both my daughter and I want other parents and young people to know it is possible to work through some/most/all aspects of dysphoria without removing healthy body parts or injecting off-label cancer drugs and cross-sex hormones.

I want parents to know it’s okay to ask questions, to dig deep, to be skeptical. To push your children and those who oversee their care to go beyond “just because” answers like “because that’s how I feel” or, “that’s who I am,” to deeper levels. Push through to “why?” and “what does that mean?” to “where does that feeling come from?” and bravely explore what’s uncovered. What does it mean to “feel” like a woman or a man? Why do those feelings mean healthy bodies are in need of medical intervention? I mean, really, how can it be that so many have suddenly been born “wrong?”

Should Mermaids be permitted to influence UK public policy on ‘trans kids’?

Posted on October 21, 2017 by 4thwavenow

by Artemisia

Mermaids is a UK charity. Its aims are ‘to relieve the mental and emotional stress of all persons aged 19 years and under who are in any manner affected by gender identity issues, and their families, and to advance public education in the same’.

The organisation began a number of years ago as a support group for parents, and it still maintains an online forum. It also undertakes casework, training, advocacy and political campaigning.

In interviews with the press, its Chief Executive Officer, Susie Green, has described her experiences as the perplexed mother of a small boy who was drawn to ‘girly dresses and dolls’ rather than ‘’trucks and football’. When Jackie was nine, permission was obtained for him to wear girls’ clothes to school.

At twelve, his mother took him to the United States for a consultation with Dr Norman Spack, an endocrinologist at Boston Children’s Hospital. Dr Spack prescribed a puberty-blocking hormone, a treatment that at that time was banned in Britain for any child younger than sixteen.

Later, when Jackie was thirteen, Spack put him on estrogen: again, a highly controversial approach. Current policy in the NHS prohibits the prescription of cross-sex hormones to children younger than about 16.

In recent years, under Susie Green’s leadership, Mermaids has pressed insistently, disregarding the concerns of clinicians, for cross-sex hormones to be prescribed to younger children.

For Jackie’s sixteenth birthday, he was flown to Thailand where he underwent a seven-hour operation to fashion a pseudo-vagina. This would not be legal nowadays; soon after Jackie’s operation new regulations were imposed by the Thai Medical Council, restricting ‘sex change operations’ to patients over the age of eighteen. Furthermore, since 2009, young adults aged 18-20 must now obtain parental permission to undergo sex change procedures in Thailand. As can also be seen in this excerpt from a 2009 Telegraph article discussing tightened restrictions, a Thai gay rights activist drew attention to the phenomenon of post-SRS regret experienced by some patients.

In England under the NHS, irreversible gender-related surgery is only available to patients eighteen and older. This is in accordance with international standards of care.

Mrs Green has promoted Mermaids energetically. As CEO, and before that, Chair, she has been regularly quoted and interviewed in the media. In recent years she has been an invited speaker at various forums and conferences. Convenors have included the Westminster Social Policy Forum and the Royal College of Paediatrics and Child Health.

In 2015, Mrs Green was selected to give evidence in person to the inquiry into Transgender Equality conducted by the Women and Equalities Committee of the House of Commons. Mermaids also submitted a written statement. Later in this post I shall have more to say about that.

In a previous post I discussed an episode in which local authority social workers handed over to Mermaids the effective management of a child welfare case. This did not end well. Ultimately the High Court ordered that the child be removed from his mother. The charity was excluded from further contact.

Mermaids also offers training to professionals:

With this in view, it is reasonable to enquire into Mrs Green’s qualifications for the kinds of activity she and her organisation undertake. Under ‘Education’ on her LinkedIn page there is only one institution listed: ‘prince2 academy’.

PRINCE2 is an acronym for PRojects IN Controlled Environment and as its name suggests, it is a project management system. The PRINCE2 Academy appears to be a set of courses delivering online training in the PRINCE2 method. It is not clear if Mrs Green is a registered PRINCE2 practitioner or whether she has simply taken the foundation course. But that is not particularly important.

Project delivery is about process. Training, advocacy, an advisory role with respect to public policy: these are primarily about content. Delivery of accurate information is key, accompanied with well-informed insight, perceptive analysis.

Let’s look at how Mermaids measures up.

Mermaids submitted erroneous evidence to the Women and Equalities Committee

The following passage is taken from the written evidence submitted by Mermaids to the Transgender Equality Inquiry conducted by the Women and Equalities Committee in 2015.

Mermaids frequently quote the Equality Act, primarily to schools unwilling to accommodate trans children. Antithetically, a young person of 16 wanted their name changing at school but their parents did not consent to this. Although the Equality and Human Rights Committee found the schools refusal to comply was discriminatory, they could not proceed with action against the school as the young person was under 18.

[Recommendation]: Lower or remove the age the Commission could pursue a young person’s complaint without parental consent.

This passage was quoted in the Committee’s report, which duly recommended:

The Equality and Human Rights Commission must be able to investigate complaints of discrimination raised by children and adolescents without the requirement to have their parents’ consent. [See pp. 27, 74, 81]

Following which the Government Equalities Office looked into the matter. Here is the Government response:

No such restriction exists on the Equality and Human Rights Commission’s (EHRC’s) power to investigate complaints of discrimination, and we are not aware of any legal basis for the statement in Mermaids’ written evidence to the Committee that “a young person of 16 wanted their name changing at school but their parents did not consent to this. Although the Equality and Human Rights Committee [sic] found the schools [sic] refusal to comply was discriminatory, they could not proceed with action against the school as the young person was under 18.” The Committee may wish to note that, in order to comply with the Data Protection Act 1998, the Equality Advisory and Support Service may pass an individual’s details to the EHRC only with the explicit consent of the individual. The case referred to in Mermaids’ written evidence was not referred to the EHRC. EHRC staff have met with Mermaids recently to clarify how the referrals process operates. [p. 13]

Rather snarky, it seems to me, but civil servants don’t like having their time wasted.

So: for whatever reason, Mermaids included a claim without foundation in its submission to the Transgender Equality Inquiry. The Committee trusted the organisation to know what it was talking about — and found itself with egg on its face.

Does Mermaids understand how much this matters?

It matters because public policy should be founded on sound evidence — on facts. No one who peddles made-up claims should be advising government committees. Nor should they be involved in training professional people with direct responsibility for children, sick people or families in crisis.

Susie Green refused to acknowledge on the BBC that cross-sex hormones cause sterility

Susie Green

The evidence is there on YouTube for everyone to see. On 1 November 2016 there was a short debate on BBC Newsnight between Susie Green of Mermaids and Stephanie Davies-Arai of Transgender Trend.

Here is a transcript of the key exchange, which begins at around 4:20. Important passages bolded:

Stephanie Davies-Arai: The treatment pathway is the same as transsexual, it’s cross-sex hormones (not cross-gender hormones). It leads to children being sterilised and on medication for life in order to be ‘their authentic selves’.

Evan Davis (interviewer) to Susie Green: Is that correct or …

Susie Green: Well no. I think that in terms of the way that these young people are assessed, they go through very careful assessments before any medical intervention is offered, that’s never before puberty has at least begun and got through to a certain stage …

Susie Green’s denial—’Well no’—and avoidance of the key issues raised by Ms Davies-Arai–are remarkable. Note the following points:

‘The treatment pathway is … cross-sex hormones’

At the Tavistock and Portman Gender Identity Development Service (GIDS) the treatment pathway is cross-sex hormones from the age of 16.

Less than four months before she appeared on Newsnight Susie Green gave a statement to the Guardian in which she called for the age limit for prescribing cross-sex hormones to be lowered.

‘It leads to children being sterilised’

This is a well-recognised effect of administering cross-sex hormones. Here is a concise and comprehensive statement from a medical authority, which also covers the effects of so-called ‘puberty blockers’ and gonadectomy:

Medical treatments—effects on fertility

Pubertal suppression with gonadotropin releasing agonists (GnRH-a) not only prevents development of potentially distressing secondary sex characteristics but also suspends germ cell maturation. Puberty appears to progress normally after discontinuation. However, many transgender individuals initiate gender-affirming hormone therapy concurrently with pubertal suppression, and thus, germ cells never fully mature. …

Gender-affirming hormones produce impairments in gonadal histology that can cause infertility. Estrogen use by transgender women results in impaired spermatogenesis and an absence of Leydig cells in the testis. Testosterone use by transgender men causes ovarian stromal hyperplasia and follicular atresia.

Gonadal effects of gender-affirming hormones are thought to be at least partially reversible. For example, pregnancy has been reported in transgender men who have previously used testosterone. Thresholds have not been established for the amount and duration of exogenous testosterone or estrogen exposure necessary to have a permanent negative effect on fertility.

For patients who elect surgical transition, gonadectomy will render them permanently sterile.

Source: Johnson EK, Finlayson C (2016) ‘Preservation of fertility potential for gender and sex diverse individuals’, Transgender Health 1:1, 41–44

‘It leads to children being … on medication for life’

Here are a couple of relevant statements by medical authorities:

a) ‘Cross-sex hormone treatment has an important role in acquiring the secondary sex characteristics of the desired sex. Transsexuals often start taking sex hormones at young to middle age and in higher than recommended dosages. Fearing loss of secondary characteristics of the reassigned sex, transsexual subjects usually continue hormones lifelong.’

Source: Asscheman, Henk, Giltay, Erik J et al, ‘A long-term follow-up study of mortality in transsexuals receiving treatment with cross-sex hormones’, Eur J Endocrinol April 1, 2011 164, 635-642

b) ‘After reassignment surgery, which includes gonadectomy, hormone therapy must be continued.’

Source: Gooren, Louis J., Giltay, Erik J, Bunck, Mathijs C. ‘Long-Term Treatment of Transsexuals with Cross-Sex Hormones: Extensive Personal Experience’ The Journal of Clinical Endocrinology & Metabolism, Volume 93, Issue 1, 1 January 2008, Pages 19–25

Considering her position as the CEO of an organisation that claims to speak with authority on the transition of children and young people, it is shocking that Susie Green should go on television and mislead the public on these crucial matters.

To say the very least: this is not professional behaviour.

Immediately after saying ‘Well no’, Mrs Green changed the subject with very noticeable promptness. Let’s look at what she said next: ‘in terms of the way that these young people are assessed, they go through very careful assessments before any medical intervention is offered’.

We might find this just a little bit glib, coming as it does from a woman who ignored the settled opinion of experienced clinicians and arranged for her son to have a gonadectomy when he had barely turned sixteen–in a country (Thailand) which now bans such surgeries to people under the age of 18.

Mermaids has falsely stated the survey population when purporting to cite statistics for suicidality among ‘trans youth’

In presentations aimed at concerned professionals, Mermaids has exhibited a PowerPoint slide with the heading ‘Statistics’. It displays a set of figures designed to chill. But let me quickly say: these are not what they seem. They have been fiddled to support an agenda. They are, in fact, completely worthless.

Here are the phony statistics in question:

‘59% trans youth considered suicide
48% attempted suicide
57% actively self-harm’

A subheading claims that the figures come from a survey of ‘more than 2000 trans people in the UK’. The survey, cited at the foot, was conducted by academics from three universities in collaboration with PACE, a now-defunct LGBT+ mental health charity. The report was published in 2014.

There is no mention of the report’s title: LGB&T Mental Health — Risk and Resilience Explored. The foreword records that ‘Over 2000 people completed our survey…’

Spot the obvious mistake. The trans participants in the survey were only a subset of the total number of people who took part. The statement that ‘more than 2000 trans people’ were surveyed is not true.

And this matters enormously, because unless the survey population is of adequate size, the results of the survey have very little meaning. It is not possible to use those results to make useful generalisations about the target population, the group about which the survey is intended to provide information.

In the case of the survey into ‘LGBT&T Mental Health’, the overwhelming majority of respondents were lesbian, gay or bisexual. Only a minority, just over 17%, identified themselves as trans.

And here’s the clincher: Only 27 of the trans respondents were under 26. This is the total size of the survey population on which the claim is based that 48% of ‘trans youth’ have attempted suicide.

There is absolutely no way that the results of such a tiny survey can be mapped onto the whole population of trans-identifying young people in the UK.

That twelve of the 27 reported such an attempt is very sad for them and their families. However, it tells us nothing about the prevalence of suicide attempts among ‘trans youth’ in general. This micro-survey is of no value whatsoever as a basis for determining social policy.

This is not an abstruse matter: it should be obvious to anyone with common sense.

Mermaids has used the supposedly high risk of suicide attempts by trans-identified young people to support its campaign to lower the age at which the NHS prescribes cross-sex hormones to children. It claims that medical transition reduces the likelihood that a gender dysphoric child will commit suicide. In reality, there is no persuasive evidence that this is true.

When Susie Green gave oral evidence to the Transgender Equality Inquiry she argued that the treatment protocols followed by the Gender Identity Development Service are too restrictive and should be relaxed. She claimed that children waiting to be put on cross-sex hormones become ‘self-harming and suicidal’ and referred to ‘a 48% suicide attempt risk’.

This claim was picked up and repeated in the report from the Committee: ‘Mermaids said there was a significant risk of self-harm or suicide where hormone treatment is not yet being given; they drew attention to evidence that the attempted suicide rate among young trans people is 48 per cent.’ [p. 52]

For the 48% figure a footnote refers to an article in the Guardian published in November 2014. The Guardian in turn cites ‘findings released by Pace’. Evidently the journalist had had an advance view of a press release from PACE dated 20 November. This press release predated the publication of the full report of the survey.

The press release gives an overall figure of 485 for ‘survey participants under the age of 26’. Rather strangely, however, it omits to give an overall number for the ‘young trans* participants’ while stating that ‘48.1% … have attempted suicide’. The use of percentages at this point conceals the very small number of respondents. The other figures in the Guardian post also come from PACE: the Guardian has simply rounded them down, so that 48.1% becomes a snappier 48% and the figure of ‘59.3%’ for suicidal thoughts becomes 59%.

It is, perhaps, not coincidental that these misleading and alarmist figures were initially presented by a charity that was forced to shut its doors for lack of funding just over one year later.

Meanwhile, the Guardian confused matters further by implying that all of the ‘more than 2,000 people’ surveyed were ‘trans’. Presumably this was due to a careless misreading of the statement from PACE.

Given that the Mermaids PowerPoint slide refers to a ‘survey of more than 2000 trans people’ it seems likely that the figures on the slide came by way of the Guardian report. Even assuming that this is the case, it does not let Mermaids off the hook.

It is simply not professional to quote statistics from a newspaper report without attempting to check them at source. In this case the survey report is easily found on the web. Although PACE has closed down, the report has been archived on several sites by interested parties.

Regardless of what it was intending to do, Mermaids deceived the audiences to whom it presented that PowerPoint slide. Even more important and worrying, it gave misleading information to the Women and Equalities Committee.

There is more. The problems with the figures on the PowerPoint slide have been pointed out in detail in at least two important blog posts:

Mermaids TG are either lying or hopelessly unprofessional – TELI16 and distressed teens on Fair Play for Women [28th November 2016]
A Scientist Reviews Transgender Suicide Stats on Transgender Trend [3rd December 2016]

So far as I am aware Mermaids has never acknowledged either of these critiques, nor has it qualified Susie Green’s statement to the Women and Equalities Committee.

The organisation does not seem to have cited the 48% figure recently. But last month Mrs Green was back beating the same old drum, this time in an article on Huffington Post UK. This time she kept things vague, asserting that there are ‘shockingly high statistics for suicide attempts by transgender young people’ without citing any source at all.

These serious misstatements of fact are not acceptable

Mermaids presents itself as a repository of wisdom on the subject of transgender children and youth and in many quarters it is accepted as such. The inaccurate statements detailed above are not minor matters. The UK, as a society, cannot afford such lapses in an organisation that trains professionals and advises on public policy.

Moreover, none of this is helpful to children who show symptoms of gender dysphoria or gender identity disorder (as currently defined), or their anxious and more or less bewildered parents. They deserve a more professional service than Mermaids is currently providing.

Meanwhile, it should, unfortunately, be recognised that it is never safe to take on trust any statement that comes from Mermaids.

‘Bridging hormones’: Increasing number of UK GPs leery of prescribing treatment

Posted on October 13, 2017 by 4thwavenow

by SunMum

SunMum is a UK parent with kids who have been affected by gender ideology. She can be found on Twitter @Mum3Sun

If you are a medical care provider and you have concerns about the safety and appropriateness of prescribing hormones and surgery to young people who are uncomfortable with their bodies, you are not alone. Trans activists frequently cite the non-existent ‘consensus of the medical community’ to argue that the only effective way of treating gender dysphoria is social and medical transition. However, in this carefully researched piece, SunMum reveals that a growing number of general practitioners (GPs) in the UK appear to feel uncomfortable providing transgender health services.

Special note to UK readers: If you are concerned about proposed changes regarding transgender health services in this country, please complete the NHS survey by October 16. A helpful guide can be found here.

The recent sudden increase in young people identifying as trans presents a quandary for the UK’s National Health Service. Trans activists demand access to ‘life saving’ health care but there are simply not enough gender specialists to deal with all the new patients. Currently NHS England is holding a twelve –week public consultation on specialised gender identity services for adults who, worryingly, they define as ‘17 and above’. But it seems that not all GPs are happy with the role they are being asked to play. The current arrangement is that the patient’s own GP is responsible for ‘prescribing, on the recommendation of the specialist team’. But according to the Guide to Consultation ‘a small but significant and increasing proportion of GPs do not feel able to accept responsibility for prescribing’.

Why are GPs increasingly unhappy to prescribe gender medicine? Surely the profile of transgender has never been higher as trans charities work to ‘Embrace. Empower. Educate’?

Zara Aziz, a GP partner in Bristol w riting in the Guardian newspaper in August 2017 in response to the consultation, is concerned about the demands placed on GPs by what she describes as ‘a niche field’ of medicine. GPs are asked to monitor gender treatment through blood and hormone levels. And since 2016, new British Medical Association guidelines ask them in some circumstances – where patients are self-medicating with hormones or where there is self-harm or risk of suicide – to provide “bridging prescriptions” for emergency hormones. This new demand has met with resistance from the General Practitioners Committee which states that GPs ‘should not be obliged to prescribe “bridging prescriptions’’’. So the BMA and the GPs own organisation are in conflict. According to the GPC, the British Medical Association’s report ‘fails to address the resulting significant medicolegal implications for GPs, and neglects the non-pharmacological needs of [gender dysphoric] patients.’ It almost sounds as if GPs would prefer psychotherapy to medication for these patients. As Dr Aziz put it, GPs are worried about ‘the risk of complaints and litigation against family doctors’.

GPs have clearly noticed the sudden increase in demand for gender medicine. Zara Aziz reports that ‘this year I have seen three gender dysphoria patients (although I have not prescribed any treatment for them yet), but before that it was that many in nine years.’ Like many of us, these reluctant GPs seem to be waking up to the realisation that something strange is going on. Just 10 years ago the number of adolescents who wanted to transition to the opposite gender was vanishingly small; today they seem to be in every school.

If a GP does go ahead and offer a ‘bridging prescription’ for hormones, she will be doing so off-label; these drugs are tested and licensed for other uses. As the NHS consultation document points out: ‘This arrangement differs from prescribing practice in many other secondary and tertiary care services, particularly when prescribing for ‘off label’ indications.’

Gender medicine asks GPs to behave in ways for which they have not been trained. Perhaps the protocols of gender specialists are increasingly diverging from those of other medical specialties, and this gives the doctors pause?

From left: Susie Green, CEO Mermaids, and Anna Lee, first “queer trans disabled lesbian woman” to run for women’s officer at the National Union of Students, listen to Bernadette Wren (on right), consultant clinical psychologist at Tavistock clinic.

Or perhaps these GPs are concerned about the influence that activist groups like Mermaids and Action for Trans Health are having on transgender health care. After all, these groups are pushing for earlier and swifter intervention. In evidence to the UK Parliament Transgender Equality Inquiry in 2015, Susie Green of Mermaids spoke of the frustration of parents with NHS treatment pathways and explained that her organisation helped them to access early intervention abroad:

‘We have current conversations going on; I have at least six families who have children who are pubertal who are looking at that option now and are actively contacting the Hamburg centres and America to access that treatment, because they know that they are not going to get it here within the NHS.’ (Q58)

Many activist groups believe the role of the clinician is only to supply the drugs and medication requested by the transgender patient. Perhaps GPs are concerned that activists are driving treatment decisions that rightfully belong in the hands of medical professionals.

In 2009, one of the leading British gender specialists, Dr Stuart Lorimer, a psychiatric consultant at Charing Cross Gender Identity Clinic and founder of GenderCare, a London private gender clinic, was asked what he saw as his biggest impediment in the development of gender identity services. The answer was ‘medical colleagues, GPs, other psychiatrists’. Lorimer mentioned a survey of 1,000 doctors of which 84 percent felt that gender services are ‘not legitimate, not deserved, should not be in the NHS’.

It is clear that a consensus on the protocols of transgender medicine does not exist outside the small group of specialists. A much-cited Swedish study from 2011 describes the standard treatment for gender dysphoria as ‘a unique intervention not only in psychiatry but in all of medicine’. Searching for parallels, one contributor to 4thwavenow had to go as far back as lobotomy. No other contemporary psychiatric therapy, after all, includes ‘the surgical removal of [healthy] body parts.’

Transgender medicine is not just a specialized field but something of a club. A 2003 Dutch study asked 382 Dutch psychiatrists about their experience of ‘diagnosing and treating patients with gender identity disorder’ and found that ‘[a] small number of psychiatrists’ were responsible for a large proportion of the referrals to ‘specialized sex reassignment therapy centres’. The study concludes that ‘the therapy options proposed to patients with gender identity disorder depend heavily on the personal preferences of psychiatrists’. (Am J Psychiatry 2003; 160:1332–1336) Personal preference is not a reassuring basis for medical treatment.

In the UK it seems that nothing much has changed in the 14 years since the Dutch study. Transgender medicine continues to be in the hands of a small group of clinicians and the NHS consultation guide cited above notes that ‘there is limited collaboration and sharing of best practice across the current providers’. A small number of treatment centres operate on the basis of limited evidence about outcomes.

It’s both welcome – and worrying – that the NHS is only now bidding for research into gender medicine. The commissioning brief acknowledges ‘the lack of a UK evidence base for the NHS to inform decisions about gender identity health services’. And the research bid notes that ‘the long-term iatrogenic impacts of hormonal treatments and surgeries on young people and adults are largely unknown, but some studies show some treatments increase risks of several long-term conditions including cardiovascular and renal diseases, and fracture risk, while research on user satisfaction and psychological outcomes in the UK is of small scale and duration.’ These treatment protocols, in other words, could be causing long term damage – we don’t know enough to rule this out.

When evidence is lacking, we might expect doctors to be cautious. But instead of trying to understand the reluctance of so many GPs, trans activists demand swifter interventions and ascribe medical caution to bigotry. Zara Aziz explains that ‘any reticence on our part to prescribe can be challenged and can sometimes be misinterpreted for prejudice.’ Specialists and activists work to bypass the caution of mainstream doctors. Lorimer’s private GenderCare clinic is designed specifically to get round the reservations of GPs. He explains that:

In my GenderCare clinic, I saw those people who’d yet to reach a GIC, whose GPs had stalled, dismissed or, in one memorable case, informed them that no such service had ever existed in the UK.

Guidance for NHS clinicians who also offer private treatment issued in May 2009 recommended that ‘specialists should as a general rule make it clear to members of the public that they usually do not accept patients without a referral from a GP or other practitioner.’

GPs may not subscribe to the conventions of gender clinicians, but they do tend to know their patients and their family situations. And that, more than anything else, may explain the increasing reluctance of many GPs to provide transgender health services. Just as parents know their children, GPs know their patients. Perhaps more and more of them are seeing young patients who never expressed discomfort with their bodies as children suddenly demanding transgender health services. That would certainly be enough to make a good GP think hard before writing a prescription for cross-sex hormones.

Transgender Children PREDATOR ALERT: Riley Byerly

Posted on October 5, 2017 by 4thwavenow

Warning: This is a highly disturbing, important piece of investigative journalism by GenderTrender. All parents of trans-identified youth need to read it.

Many parents turn to adult trans activists for advice on how to parent their kids. While no one would suggest every such “advisor” is a dangerous predator, is it really a wise idea to seek counsel from such individuals? Particularly since some better-known trans activists, and organizations run by such activists, encourage young people to abandon parents if they won’t endorse their transgender identity–and seek solace in “glitter families” of strangers on the Internet.