Tag Archives: gender dysphoria

The trans-kid honeymoon is sweet—while it lasts

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I recently received comments from two readers (here and here) regarding a 2014 Dutch survey study of 55 young transgender adults (average age 20). The study, which reported overall positive psychological outcomes after medical transition, surveyed youth who had been diagnosed with gender dysphoria, after which they had received puberty blockers, then cross-sex hormone treatments, and finally SRS surgery. The average length of time from first pre-treatment assessment to post-surgery was 6 years.

RESULTS:
After gender reassignment, in young adulthood, the GD was
alleviated and psychological functioning had steadily improved. Well-
being was similar to or better than same-age young adults from
the general population. Improvements in psychological functioning

were positively correlated with postsurgical subjective well-being.

These findings would likely reassure parents and others who have ushered children down the medical transition road. And frankly, anyone who has watched even a few YouTube teen transition vlogs would not find these results particularly surprising. For these kids, it must be an exhilarating experience, to feel they can escape their dissatisfaction with sex-role stereotypes and/or physical characteristics, and embark upon the long-awaited transformation into the opposite sex.  The speed with which the metamorphosis happens—with many young people “passing” as the opposite sex after only a few months of hormone treatment–is  downright magical.

No doubt, at least some of these people will go on to live happy, long lives with no regrets. But it’s likely some will begin to question (at what age? 30? 40? 50? 60?) whether giving up their fertility; permanently altering their bodies; and facing a lifelong regimen of injections and medical monitoring were ultimately worth the price.

Here is one young woman who has begun to raise a few questions. In a recent video entitled “Gender Troubles” (uploaded 6 years after she first decided to “transition,” and after 4 years of videos on her channel that mostly celebrated that choice), she acknowledges what she values about her “transition,” while sharing her realization that things are not quite as simple as they originally seemed to her younger self:

 When I decided to go on hormones…it seemed like the most logical choice for me. I was in a very bad place emotionally…I hated myself a lot. I hated my body. I didn’t identify with it….and I felt very separate from my body. And finding YouTube videos of other people who were transitioning and finding out it was an option to do so kind of deeply affected me. It was very difficult to resist those changes….to resist taking hormones, to see those changes in myself, especially because feeling so disconnected from myself it seemed like the best idea….and you don’t often see other narratives out there, on YouTube, about gender…

…. I struggled with the changes, how I felt about them, how it made me feel and why. At first I accepted them. It was exciting. It was euphoric. It was certainly a ride. And I really liked seeing myself with more muscle, I liked my voice deepening, the hair that was growing…

… My parents were really cool with it. They were not cool with me being a lesbian at all…. [now] they didn’t have to say “I have a lesbian daughter. I have a son who’s straight”….My family was supportive of my transition, so we became a lot closer because of that…

…As time went on, I really felt like…I didn’t identify with the changes I was seeing…I didn’t like the fact that these changes weren’t natural. Part of it felt like I was burying a piece of myself…

…The other night, I cried, because I realized I really want to be able to get pregnant. And I really want to be able to breastfeed. … Maybe it’s me getting older, the internal clock…ultimately I don’t regret getting top surgery…but there are elements where I miss having them….only about 15% of the time. But I can’t deny that this happens…

…There’s a lot more that happens besides achieving a male body or a more masculine body….a lot of things change and you don’t realize it. I don’t think I realized it as much until  …  a year or two off hormones. Things started kind of affecting me…

…When I was transitioning I was really caught up in the thrill of it, the excitement of it, the endorphins that went along with it…[but now]  I’ve been thinking about things I wasn’t before.

Transition regret videos aside, even if we restrict our focus to the 55 subjects in the Dutch research study cited above–young people who (so far) are reporting largely positive benefits from their transition–there is more nuance to this study than first meets the eye. 4thWaveNow contributor fightingunreality delves into some of the study’s unexamined implications in the post below.

As you read fightingunreality’s analysis, consider whether survey studies like this one might be subject to the  “interpersonal expectancy ” of researchers and “supportive” parents. The interpersonal expectancy effect is also known as self-fulfilling prophecy, or the Pygmalian effect, extensively studied by preeminent psychological researcher Robert Rosenthal:

 …the tendency for experimenters to obtain results they expect, not simply because they have correctly anticipated nature’s response, but rather because they have helped to shape that response through their expectations. When behavioral researchers expect certain results from their human or animal subjects, they appear unwittingly to treat them in such a way as to increase the probability that they will respond as expected…

In more recent years….research has been extended from experiments, to teachers, employers, and therapists whose expectations for their…patients might also come to serve as interpersonal self-fulfilling prophecies.

Analysis of the 2014 Dutch study (available in full at the link, and introduced above),

by fightingunreality

Any discussion of the “outcomes” for those children chosen for the experimental use of puberty-blocking drugs would be remiss without first addressing the ethics of what has been done.

First, this study is about young people, many of whom initially presented to the clinic as prepubescent children. Children’s understanding of gender is primarily comprised of the simplistic social stereotypes through which they have learned to perceive the meaning of biological sex, and which they lack the certainty of identity to resist. Developmentally unable to fully comprehend abstract concepts, they have little understanding of the social forces which inform and compel both them and the adults to behave in certain manners deemed to be “appropriate” on the basis of sex. The vast majority of these children were socially transitioned by their parents prior to their arrival at the clinic, thereby disrupting the chance that they may have had to experience a typical childhood.

hormone graph 2

Because 85% of the fathers and 95% of the mothers were supportive of their children’s desire to live as the other gender, and since virtually all of the children were living for all intents and purposes as socially transitioned, we can assume, with little doubt, that these parents subscribed to the idea of sex-based gender roles for their children akin to those we have seen in the plethora of news stories of (mostly) moms citing wrong toys and early color preferences as indications that their children were different.

Since none of these child-transition studies (this Dutch study being no exception) report the extent to which parents enforce traditional gender roles, we have no real sense of the degree of their influence on these children or how much they might affect the kids’ willingness to defy them in order to express their non-traditional likes and dislikes– without the expressed belief that they are in fact, a different sex. Is it only a coincidence that 94% of the males in this study were either same-sex attracted or bisexual (87.9% SSA, 6.1% BI) or that 100% of the females (89.2 SSA, 10.8% BI) had same sex attractions? Are we really expected to believe that social and parental attitudes in regards to homosexuality play no part in either the formation of the children’s understandings of what constitutes “feeling like the other sex,” or, more importantly, the acceptability to parents of what, in effect, becomes medicalized gay conversion therapy?

Since the stated protocol by these researchers is to provide a six-months to a year “diagnostic phase,” this means that prior to the first assessment for this particular study, they had already been living as cross-gendered for at least that amount of time, plus the previously acknowledged but unspecified duration of social transition. During the actual diagnostic phase, all of them “officially transitioned” –including name changes. Since the youngest, at the time just prior to the administration of hormone blockers, was 11.1 years old, that means this child had been living cross-gendered since a minimum age of 10.6 years old –in addition to the time prior to arriving at the clinic. What can such a child actually know about what it means to live as his or her own natal sex?

Given the willingness, as noted in the study, of peers and parents to promote and solidify by reinforcement these children’s sense of being wrong-bodied, it is hard to see how such children could establish a basis by which they could reasonably fully comprehend–let alone reevaluate–their child-based understanding of gender and gender roles. As has been noted in previous posts on this blog, identity formation throughout childhood and adolescence is both malleable and fluid. It is impossible to believe that the interventions by both the parents and the clinicians did not directly interfere with these children’s identity development. How does a child who has basically reordered their family’s lives by their insistence that they are actually the other sex back down from such claims? How do they tell their friends? We are not talking about adults, here, after all. By the time these children reached the point of choosing to delay their puberty, they had been living as the other gender for years –in some instances possibly half of their young lives. By the time it came to choose whether or not to imbibe cross-sex hormones, it is no surprise that none of these children chose to revert to living as their own sex: they had been socialized trans.

It’s interesting to note from the information in this paper that during the time between starting hormone blockers and their choice to be put on cross-sex hormones, these kids –especially the girls –actually experienced greater levels of “gender dysphoria.” I think it’s important to ask ourselves why that is. These kids were not facing the risk of further development of secondary sexual characteristics. They were living as their chosen gender. Why wouldn’t they be at least somewhat relieved of their dysphoria? Since levels of such dysphoria consist of self-assessment, this worsening could merely reflect the child’s desire to fully transition along with the knowledge that admitting a decreasing level of dysphoria might threaten the willingness of the clinicians to advance their transitions. That is one possibility. The other more likely possibility is that living as fully socially transitioned children, their awareness of not physically “matching” their chosen gender while assuming that role actually worsens the sense of being wrong-bodied. In other words, telling someone that you are actually a boy or a girl when you clearly are not increases self-awareness of and discomfort with your actual sex.

As was articulated in a BBC documentary by a gay Iranian who was pressured into transition, prior to transitioning he often heard, “He’s so girly. He’s so feminine.” After the surgery, whenever [he] wanted to feel like a woman or behave like a woman, everybody would say “look, she’s like a man. She’s manly.” This phenomenon can readily be applied to children who may have been considered like the other sex prior to living akin to that sex, but become seemingly less like the other sex when attempting to assume that role. The very fact that they are attempting to live as the other gender may very well increase the dysphoria that assuming such a role is meant to lessen. Is it a wonder that 100% of the children that comprised this cohort chose to go on to cross-sex hormones?

The gender specialists promoting these studies want us to believe that the use of hormone blockers provides extra time without the stressful development of secondary sexual characteristics. They’d like us to believe that the children are being given a sort of “time-out” to consider their choices and become more mature before committing to irreversible changes, but is that really the case? The hormones required for adolescent brain reorganization and development are not released when a child has received GnRh agonists. Physical development typical for teenagers is prevented, setting the children even farther apart from their peers, and sexual and romantic involvements –a key factor in desistance –are avoided.

Ultimately, 100% of the children who chose to utilize hormone blockers in this study went on to fully transition. In fact, virtually all children inducted for such therapy demonstrate 100% persistence rates despite that fact that even today, major proponents of this therapy (such as Johanna Olson-Kennedy and Robert Garofalo, in their 2016 paper detailing research priorities on gender identity development and biopsychosocial outcomes) acknowledge that “Clinically useful information for predicting individual psychosexual development pathways is lacking.” They do not have reliable information on who will or will not desist. Are we really expected to believe that these hormone blocker advocates are exceptionally lucky in their selection process when they themselves profess such uncertainty and bemoan the lack of adequate research? Or should such absolute rates of persistence be setting off alarm bells to those of us concerned with the practice of funneling children into a pipeline that flows in only one direction: towards lifelong medicalization with unknown long-term consequences?

Because of the extraordinary persistence rates of children infused with hormone blockers, it’s obvious that hormone blockers do not allow these children extra time. The choice to participate in this protocol becomes the decision to transition, because it prevents the aspects of maturation necessary for desistance from ever occurring. The one thing it does do, however, is to make it seem safer to interfere with the children’s natural course of development. Parents are assured that the effects of blockers are reversible, and the moral burden of placing young children in the position of making adult decisions is put aside.   As a result, even more children are being swept up by this 21st century version of reparative therapy. Altogether, we will never know the number of children who would have desisted had they been allowed to develop without social and medical intervention. This is a travesty.

As far as the “positive outcomes” this study purports, there are numerous problems. First, in order to understand this study, we must consider the selection process detailed in a previous paper by the same authors.  The 70 children chosen for this study were selected from an original cohort of 111 (out of 196 children arriving at the UV hospital seeking treatment for GD) eligible for hormone blockers, after having been “thoroughly screened after a comprehensive psychological evaluation with many sessions over a longer period of time” and found “eligible for puberty suppression and cross-sex hormones.” It was a group chosen on the basis of their likelihood of coping with the transition process. They had “no psychosocial problems interfering with assessment or treatment,” and “adequate” (in the case of this cohort, very high) “family or other support,” and what the researchers described as “good comprehension of the impact of medical interventions.” (We can only guess what that could mean, given the fact that pre-adolescents and adolescents do not have the frontal lobe development to fully project themselves into the future.) Altogether, they seem very unlike the average children and adolescents who are currently being inducted into this process of life-long medicalization either in regard to screening or support and ongoing therapy, which the study notes was provided to them for an average of 6 years “after first presenting at the clinic.”

Fifteen of the cohort of 55 had “some missing data” which we are assured resulted in “no significant differences” on the pre-treatment tests.   I think, too, that when considering the outcomes of these children, it would be remiss to ignore the 15 members of the original cohort of 70 who did not participate in follow up: six had not met the one year gender reassignment surgery anniversary for this study and were, therefore, excluded. Two refused to complete the assessment, and two did not return their questionnaires. (Why?) Three had health problems which prevented them from undergoing gender reassignment surgery, one “dropped out of care” (no clarification) and 1 died from complications from surgery. (How does one weigh such a loss against “positive outcomes?”)

Given the fact that all of these children had what is in essence a “gender obsession” since childhood and had been socially transitioned for years, it comes as no surprise that they experienced relief at finally accomplishing their goals. The kids as a whole did overall demonstrate better functioning than at their initial assessment –possibly from the counselling and special attention they were getting –but “it cannot be ruled out that it relates instead or as well to the benefits that accrue from being validated and accepted for treatment.” They were getting what they wanted, after all. Research has shown that gender non-conforming children and adolescents are at higher risk for PTSD due to abuse and bullying because of being different, and the prospect of “fitting in” provided by merely initiating action towards this goal certainly provides a degree of psychological relief- regardless of the actual physical changes that have yet to take place. This is evidenced by the “significant quadratic effect” that commences immediately upon initiation of cross-sex hormones, well before significant physiological effects of the hormones could possibly have occurred.

Would body image and psychological well-being have improved in these children had they been allowed to experience a natural childhood and identity formation without medical intervention? It is well known in the field of child development that children go through a period of significant peer gender enforcement which corresponds with their concrete thinking and familial socialization which certainly affects the self-image of those who fail to conform. This rigidity begins to relax at around 8 to 10 years –after some of the children in this study have already been socially transitioned due to the discomfort this rigidity has created. Would they have come to a more nuanced understanding of gender roles had they made it past this stage? We –and they –will never know. Logically, children have been shown to be more accepted by members of the sex with which they share interests, rather than those whose similarities are based solely on sex, and gender enforcement prior to adolescence tends to be enacted by members of the same sex. Is it any wonder that children tend to “identify” with those who seemingly accept them and share common interests? Would a more mature understanding of abstract concepts assist them in accepting their own bodies without conforming to artificial gender roles as it did for many of us who matured without the alluring possibility of appearing to actually change sex?

As adolescence progresses, criticism is most likely directed by male peers who are not known for impulse control or empathy. Certainly those of us who have been on the receiving end of such mockery can attest to the resulting social stigma and humiliations we suffered in light of it due to our vulnerability at that age and the fact that we were insecure in our own identities and lacking the self-assurance that maturity brings. It has been demonstrated that peer and social disapproval for gender non-conformity peaks in the adolescent years and gradually decreases throughout young adulthood and adulthood. Not only do we mature, but the peers responsible for the harassment mature, as well. The insults decrease. As gay rights activists in the past often said, in an attempt to help bullied gay and lesbian children, “it really does get better.”

Unfortunately, none of the children in this study will ever know whether this would have been the case for them, because they left behind in childhood the bodies which they very well may have come to accept in the absence of such criticism. In a study in which there is no viable way to create a control group with which to compare these children, there’s no way of knowing how well they would have fared with just the extensive psychotherapy alone, nor of desistance which may have taken place without these prolonged social and medical interventions which prevented the maturation and social and sexual experience that would have occurred otherwise.

As a gender non-conforming adult, I am occasionally harassed by what are typically groups of two or three teen boys out to impress their friends. Because I am an adult with a fully-formed sense of self, my identity is not threatened as are those of the children who have not yet discovered, through experience and physical development, who they really are or can be. Sadly, the ultimate result of medicalized disruption of identity formation –which would have included their whole selves, bodies included –creates an identity which is dependent upon exogenous substances, conscious gendered performance, and the willingness of others to deny their own perception in order to validate it. As such, the identity is not sustainable without significant degrees of external support, and remains more highly vulnerable to what are perceived as being threats to self when it is not validated.   As a result, they may be “at increased risk for the development of narcissistic disorders…as a consequence of the inevitable difficulties they face in having their cross-gender feelings and identities affirmed by others.” (Note: While the linked study is not specifically of children, it seems to me children subjected to early medical transition would also be at some risk of narcissism, given the confluence of factors brought to bear upon them.)

Perhaps the greatest hindrance to accurately critiquing this study is related to the ages and the timing of this so-called “long-term” study: it was completed after only a minimum of one year after gender reassignment surgery. These now young adults had barely any life-experience living as fully transitioned persons. They were still in the honeymoon phase of what had become a fully supported childhood desire. A significant portion of them were still living at home with their supportive parents and attending school. Their lives as fully transitioned adults were just beginning, and the difficulties of navigating sexual relationships and the hardships that entails for those not of their natal sex were in their infancy. They were many years away from the rise in suicidality noted in a Swedish long-term study of adult transgendered persons, which began to rise around 8-10 years after transition.

Because of the failure of the Dutch authors to denote significant variables among these youths (as I’ve outlined in this post), their study inspires more questions than it provides answers.   Have these children been harmed by the parental and medical reification of childhood fantasy and desire? We have primarily their own self-reports to rely on –the reports of young adults who never were given the opportunity to experience childhood or adolescence as one would experience their own actual sex. They have nothing with which they can compare their current experienced “gender.” They will not know what it’s like to have sex in their natural bodies, nor be loved as such. Certainly, as partially formed adults (remember- maturation takes place concurrently with hormonal action and resulting brain development and theirs was delayed), they had not reached fully adult status at the time of their self-assessment. We do not know how the difficulties of living as transgendered people will affect them. We do not know if the long-term effects of injecting artificial cross-sex hormones will damage them physically (or mentally). We will never know whether they might have resolved their gender dysphoria, as others have, and pressed on through life, because they were never given the chance to find out.

Their childhood fantasies were to become a different sex. What they have been given, instead, is the means of promoting that illusion—and the reality of becoming a life-long medical patient.

 

What the hell are you talking about? No. You’re a girl.

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In this guest post, 25-year-old Charlie Rae (a pen name) shares her experiences living as a gender-dysphoric girl with a no-nonsense mother who didn’t for a minute subscribe to the notion that Charlie was really a boy. 

Charlie credits her mom, along with her training in martial arts and a peer group full of rough-and-tumble girls, with helping her realize who she really is.

Charlie is available to respond to comments and questions in the comments section below the post (her WordPress screen name  is artistarmy).

by Charlie Rae

I suffered from undiagnosed gender dysphoria for the first half of my life. I still often have the feeling that I am trapped in the wrong body, and that there is, somehow, another person living inside of me that my body isn’t represented by. I still try and change who I am all the time, endlessly searching for a way to look that fits who I feel like I am, but to no avail. It’s confusing, and sometimes painful, but I’ve come to see that it has more to do with society than with me as an individual.

It started as young as I can recall, in my family, where any and all activities were sex segregated: boys/men doing one thing, girls/women doing another. The older we got, the less accepting the boys were that a girl wanted to be around them all the time, and the harder it got to live in my own skin. I basically ignored my girlhood; I didn’t speak of it, and when they joked about it, I would ignore them. I didn’t want it to be a topic of conversation. I just wanted to be a boy. I thought something had gone wrong when my mom was pregnant with me.

Girls always talked a lot, about clothes and boys. They would try on outfits and go shopping. I would ask them, “aren’t you bored?” but they always said they weren’t. Once, at the beach, I tried to lie around and tan with them. “This is what you do all day?” “Here,” they said, and drew a little picture on my stomach with sunscreen. “Now you just wait until you’re tan enough to see the picture.” I thought, “I’m definitely not a girl,” and went back to playing pickle, and football, and getting dirty.

When I was in elementary school, the sex-segregated spaces continued. At recess the boys would play soccer, and the girls would be on the jungle gym. Once when I tried to play soccer, the boy who I was told had a crush on me (and that’s why he picked me), close-lined me as I was running for the ball. Everyone laughed. I was already in Tae Kwon Do by then, and I had been told never to use my skills to hurt anyone unless I really had to. So I didn’t. I just left. At recess, I started walking the perimeter of the field alone.

My mom never did entertain my idea of thinking I was a boy. Instead she just put me in martial arts class, which helped me in many ways but also perpetuated my confusion. As inclusive as Tae Kwon Do could be, some parts were still sex-segregated. Girls couldn’t fight or partner with boys. I was way too strong for the girls, and I was told to hold back on them. I would get pulled aside by the instructors and given talkings-to. “I’m a boy,” I thought, and I would ask, “Why can’t I fight a boy?” “It’s against the rules,” I was told.

But that changed as I rose higher and higher in rank. It was a fairly new martial arts school, and I ended up being the first person ever awarded a black belt at 8 years old. Something shifted then because I became such an authority. And my instructor started letting me fight boys. I felt somehow…accepted. That I had proven myself. I acted “like a boy” in mannerisms and speech, I fought “like a boy,” and I trained like the male instructors did, but I was the only girl. And I was only 3 feet tall.

I started to become somewhat of a freak show, the girl who was really good. I was featured in demonstrations, because, “look at that little girl!” I wanted to stop being a girl, though. I wanted to be taken seriously.

When I was 9 or 10 years old, something happened to me that must have deeply impacted me. There was a male-to-female transgender person named Kate who we met when my mother was taking care of a dying old woman named Pat. I only vaguely remember Kate. He sort of looked like a woman but he had man hands, and big feet, and something looked different about him. He was transsexual, and he had gotten all of the surgeries.

According to my mom, Kate went to my mother and said, “your kids are asking me questions, can I tell them?” My mother said, “yeah, tell them whatever you want.” My mother didn’t hide things from us; she didn’t whisper under her breath or spell words to keep things secret. She was flat out. She answered our questions, and she let other adults talk to us candidly.

He evidently told us he regretted transitioning. That after everything he’d done to his body, he said “I don’t know what I am.” He also said he knew he was a man, that it was never his body that was wrong. He called himself a he-she. I don’t remember this story. Maybe it was over my head at the time.  I do remember hanging out with Kate, and him laughing when I would ride Pat’s wheelchair around the apartment. I think I block a lot out because I loved the old lady, Pat, and Pat died. But I have no doubt that it had an impact on me.

Now’s as good a time as any to tell you more about my mother. I haven’t mentioned her much in this story so far because being a boy was just not something she entertained. My mom was a full-disclosure kind of mom, and she was also frank, and certain. About everything, it seemed. She would say, “What the hell are you talking about? No. You’re a girl.” She didn’t have an existential crisis, she didn’t send me to therapy, she didn’t sit me down to talk. She answered the question like she answered any other questions: to the point, with conviction, and then went on with her day.

She also blurred the lines of gender for me. I didn’t grow up with a father, and when I would get sad about it, she would tell me, “I am the mommy and the daddy.” She wore suits sometimes. She cut her hair short. She talked like my uncle, sometimes, when she was angry. She used body language that men used. I just remember thinking, “alright.” Because that’s how it was, she’d told me the answer, and I accepted it. Even though it didn’t feel that way, and I still hated it.

When it came to Tae Kwon Do, she’d say, “you’re not a boy, you’re better than the boys.” She was always proud to have two daughters. When everyone would make fun of me for wanting to do stuff with the boys, mom would say, “Rachel can do whatever she wants.” She was strong, and fierce, and when she was around, what she said would go. When people would make fun of me, she would say, “Fuck ‘em.” She never called me a “tomboy,” she mostly called me peanut and babygirl.

She wasn’t afraid of what people thought of her. I started to pick that up from her. People would get on her about how open she was with us, about swearing, about “adult stuff” and burping, and how rude we seemed to other people. “Oh, get over it. They’re kids,” she would tell them, and she would write them off.

When I wanted to cut all my hair off, she just told me how good it looked on me. It wasn’t an ordeal. None of my “boyish” qualities were an ordeal. They were what they were, and I was a girl.

When I got to middle school, and I found other girls who were weird, and wanted to be weird, and get dirty, and be unlady-like, was when I started cherishing the idea of being a girl. I kept my hair short, and everyone called me a dyke. I didn’t know what that meant, but it was okay, because I had all of my weird friends–all girls, 10 of us, and we called ourselves the Golden Mangoes. Four of us were what would be considered “tomboys,” and none would have been considered “girly girls.” We started food fights, got into trouble, loved rock climbing in gym class, and we didn’t talk about clothes and styles. We made sculptures out of garbage and told people off that were picking on us. We weren’t afraid to get dirty when we went outside for science class. We were loud and obnoxious. For the first time in my life, I recall loving being a girl, because it meant I could be in that group.

One of the Golden Mangoes started to transition to male in high school. It caused a huge rift in the whole group. She would get angry with us when we would misgender her, and I mean, really angry. This was when the idea that I was not a boy really sunk in. I saw her desperately trying to convince everyone that she was a boy, and we all knew it wasn’t true.

The group started meeting behind her back, not to be cruel, but to talk about how uncomfortable we were with it, and how mean she was to us about it. We didn’t try to misgender her, we had just known her as a girl for so long that it was hard to change. There were other things as well. She was touchy-feely with us. We had all always been touchy-feely with each other, but, we thought, if she wanted to be a boy, the rules would have to change. We didn’t want her to touch us anymore, we didn’t want her to be at sleepovers. Everything shifted in response to her anger at us. I knew that if I joined her thinking I was a boy, that would happen to me too. I gave up thinking I was born in the wrong body then.

I’m telling you, it’s all about finding your place. That’s what gender dysphoria is all about. I mean it.

It’s literally in Maslow’s hierarchy of needs. If your daughter or son’s self-actualization depends on having friends, feelings of accomplishment, recognition from society, and they can’t get those things in the body they are in, it makes perfect sense to me that they would think they are born in the wrong one.

Maslow

I chose to do a speech about hair removal for my public speaking course last summer. I had read about a sociology professor who would get her students to change their shaving rituals for the remainder of the class. She remarked how she was surprised that the women quickly bonded over their behavior of not shaving. Though I’ve only taken intro level sociology courses, this didn’t shock me. We are reflections of our environment, always. When the environments change, we change, if only sometimes marginally.

The energy and attention around the trans issue isn’t just something happening in the home, it’s happening in society at large. See, some radical feminists (I think a little crudely) call liberal feminist ideologies “Special Snowflake Syndrome,” but in a way, they’re right. And it’s a paradox. Everyone does want to be special. That’s absolutely obvious in everyone’s life, even those of us who know that certain things are false because of the knowledge we’ve acquired. The paradox is, we all have a context in which that specialness is able to blossom, and self-actualization doesn’t come until we are accepted somewhere for who we are, for all of our special talents.

My conclusion is this: in society, and in the home, we are giving trans issues too much of our energy. Period. On a social, activist level, everyone seems to be in lockstep, because the trans platform is national and pervasive. It’s a fight that needs to be argued with logic. But in the home, especially in the sense of what’s actually happening around us in real life, we’re all becoming obsessed with a complete lie. Our bodies are our bodies. Period. No one was “born in the wrong body.” Body mutilation is body mutilation.

That’s easier for women, for feminists, to realize when we think about how we react to breast implants, and Botox, and all of these surgeries and medical mutations women are going through because they’re brainwashed by society to think they have to be beautiful and perfect. The trans thing is no different.

But the thing about thoughts is, the more weight you give them, the more important they become. That’s why mass media is so repetitive. It won’t stick the one time. You have to say something so many times to make it important.

The advice I would give to mothers, in all honesty, is stop taking this so seriously. I don’t mean to be callous, or write anyone off, and if it’s a struggle for you, then there certainly needs to be work and research done behind-the-scenes to deal with this.

But as a thought experiment, what if your 13-year-old daughter came to you and told you she wanted breast implants. Would you take her seriously? Or would you say “absolutely not, go do your homework”? Kids are uncomfortable in their bodies. Always. Being alive, growing up, is uncomfortable. To have intense reactions to this, to send kids to therapy, is to make it a big thing. It puts importance on it. Not all of kids’ thoughts are valid. They might mean something to them, but that doesn’t make them reasonable. Kids go through all kinds of phases. This might be one of them.

There’s something my mom used to tell me when I wanted something that she didn’t want for me. “When you’re 18, do whatever the hell you want.” This was how it was. My mom didn’t let me convince her that I knew more about the world than she did. She never let that get into her head. She let me get my ears pierced, but when I was 18, I could do whatever the hell I wanted. She didn’t take me to get my body piercings, she made me wait.

But when I was 18, she didn’t take me to get my piercings, she wouldn’t pay for them, sometimes she would say, “what are you doing to your beautiful body?” But I got some. After a few years, I took them out. They were uncomfortable. I couldn’t really move when I had them. And they were impermanent.

Injecting kids with hormones or giving them puberty stoppers isn’t good for their bodies. You don’t need any other reason not to let your kids have these things. Let them wear what they want, dress how they want, don’t make a big deal out of that.

But find them a place that they fit in. We are social creatures; we need that in order to become ourselves. You and your daughter need to find girls that like to do what she likes to do. And then give that all of the attention.

Blocking puberty–and the right to an identity crisis

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I recently wrote about research findings that gay and lesbian youth are typically older than their heterosexual counterparts when they first act upon and realize their sexual orientation. While same-sex attracted girls, in particular, reach this milestone between 19-early 20s, the current trend is to “socially transition,” then puberty block, and finally move on to cross sex hormones at age 16.

It’s easy to see that many of these teens are being set up to short-circuit the natural discovery of their sexual orientation. But is that the only potential problem with social transition and puberty blocking—the preemptive conversion of likely gay and lesbian youth to transgender?

Not by a longshot. There are so many important things that happen at puberty which are critically important to the maturation necessary to make informed decisions about major life changes (you know–things like sterility, loss of breasts, and a permanently deepened voice) that a developmental psychologist or cognitive scientist could write a doctoral dissertation about the subject.

In fact, many have; the research and clinical literature going back to the mid-20th century is chock-a-block with replicated studies, clinical observations, and meta-analyses. More recently, we have MRI and fMRI studies corroborating earlier observations.

What we don’t have, at least not yet, are the PhD theses showing how the experimental “treatments” currently being implemented by pediatric endocrinologists and gender specialists—many of whom have no professional background in child or adolescent psychology—fly in the face of that large body of literature.

I have spent hundreds of hours poring over the literature on gender dysphoria and pediatric transition. But in all the studies and papers I’ve read, I have not seen mention of the vast body of extant knowledge about child and adolescent psychology. It’s as if these gender specialists just started from scratch.

Erik-Erikson-portrait

Erik Erikson

What exactly are they ignoring? Well, for starters, there’s the work of Erik Erikson, a preeminent child and adolescent psychology expert of the 20th century. You can’t read the scholarly or clinical literature on pediatric psychology without finding a reference to Erikson’s work; in fact, much of the current knowledge in the field is built upon his fundamental insights. A blog post is not adequate to even summarize it, but his bedrock finding about the psychological journey of adolescence is this: Developing an identity takes place in stages, culminating in an integrated adult personality; and “identity work”—including an identity crisis—is critical to healthy adult psychological functioning.

erikson capAdolescent psychology expert James Marcia was another foundational thinker who built upon Erikson’s framework:

… two distinct parts form an adolescent’s identity: crisis (i.e., a time when one’s values and choices are being reevaluated) and commitment. He defined a crisis as a time of upheaval where old values or choices are being reexamined. The end outcome of a crisis leads to a commitment made to a certain role or value.

But we don’t need a study, a theory, or someone with a PhD after their name to prove this to us, do we? Any adult who has lived through that time of life called “adolescence” can attest to the fact that questioning, and trying on and discarding different ways of being, go with the territory. And it’s a rough time. How many adults would willingly relive the fraught and tumultuous days of middle and high school? Every psychologist (until the Age of the Trans Child) has agreed: it’s not supposed to be an easy ride. In fact, without the essential but painful work of adolescence, a person will not reach their adult potential: “unable to achieve an integrated adult identity, either because they have failed to resolve the identity crisis or because they have experienced no crisis. ”

Contrast this long-accepted understanding of adolescence with the approach taken by today’s gender specialists. Instead of helping children weather the natural and not necessarily comfortable process of cognitive and emotional development, they concretize and freeze in place the certainties of childhood, in what should be a time for exploration, not stasis.

It would be one thing if these gender clinics were really in the business of helping a child expand or explore different gender identities, without medical interference. But we know that they support and encourage “transition” from one sex to the other, with all the permanent physical changes that entails. In terms of adolescent psychological development, once these kids have taken the irrevocable step of moving from blockers to cross sex hormones, they have been denied the opportunity to go through an identity crisis.  So, a 16-year-old girl who has lost her fertility and her breasts, and who has already committed to a permanent testosterone-deepened voice and increased body hair — how easy will it be for her to experience James Marcia’s “time of upheaval where old values or choices are being reexamined?” That adolescent girl has been cheated of that stage of life. And when did we, as a society, decide that was a good thing?

The media stories and anecdotes from gender clinics are all the same: The kids are uncomfortable, so they and their parents seek relief. Then, according to everyone, the treatment “works” because the kids are happy. For how long? No one knows.

Be that as it may, an identity crisis isn’t supposed to be resolved in preschool, or kindergarten, or even middle or high school: It is the work and the challenge of adolescence, not complete until late adolescence.

 Adolescence has long been characterized as a time when individuals begin to explore and examine psychological characteristics of the self in order to discover who they really are, and how they fit in the social world in which they live. Especially since Erikson’s (1968) theory of the adolescent identity crisis was introduced, scholars have viewed adolescence as a time of self-exploration. In general, research has supported Erikson’s model, with one important exception: the timetable. It now appears that, at least in contemporary society, the bulk of identity “work” occurs late in adolescence, and perhaps not even until young adulthood.

“Late in adolescence”—after the time when most “trans” youth have moved on from puberty blockers to cross-sex hormones, thus bypassing the period when they would have been able to explore possibilities in their original bodies—including, but not limited to, their sexual orientation and other essential aspects of their identities and personalities.

The insights of the earlier child development experts have been corroborated by advanced visualization technologies, such as MRI and fMRI, which have revolutionized our understanding of the human brain and psychological development. In recent years, we have come to understand that full maturation occurs much later than previously thought.

Recent research has shown that human brain circuitry is not mature until the early 20s (some would add, “if ever”). Among the last connections to be fully established are the links between the prefrontal cortex, seat of judgment and problem-solving, and the emotional centers in the limbic system, especially the amygdala. These links are critical for emotional learning and high-level self-regulation.

Beginning at puberty, the brain is reshaped. Neurons (gray matter) and synapses (junctions between neurons) proliferate in the cerebral cortex and are then gradually pruned throughout adolescence. Eventually, more than 40% of all synapses are eliminated, largely in the frontal lobes. Meanwhile, the white insulating coat of myelin on the axons that carry signals between nerve cells continues to accumulate, gradually improving the precision and efficiency of neuronal communication — a process not completed until the early 20s.

In addition to reading research studies, I spend a fair bit of time reading the blogs, tweets, and social media writings of trans-identified teens. While most teens are pretty self-absorbed, with these kids, I am always struck by the depth of self-involvement, the extreme obsession with looks and appearance, and the constant focus on getting what they want, when they want it.

What is conspicuously absent in the narratives of many of these teens is another key aspect of pubertal maturation: self reflection and awareness. Concrete, literalist thinking is a hallmark of childhood. So a preadolescent frozen at Tanner Stage 2 of pubertal development (when blockers normally begin to be administered) may still think literally and concretely: “I am a boy.” Instead of: “Maybe I think I’m a boy because I like trucks and hate girly clothes. Maybe there’s a reason I think I’m a boy, but I’m really not.” The name for such higher level reflection, or “thinking about thinking,” is metacognition.

So when these young people, frozen at an earlier stage of cognitive development, are asked at age 15 or 16, “Are you SURE you’re really a boy?” why would any of them say “no”? And in fact, in the small number of studies that have looked at kids who have been socially transitioned and puberty blocked, none of them have failed to move on to cross sex hormones. Is this because they are “truly trans” and their clinicians have godlike diagnostic skills, with zero—zero!—false positives? Or is it because the very act of endorsing and reifying their self-proclaimed concretized self-images has helped them persist in those self-perceptions?

 No adolescent withdrew from puberty suppression, and all started cross-sex hormone treatment, the first step of actual gender reassignment.

It’s not just metacognitive and abstract thinking that develops slowly, reaching fruition in late adolescence. As I wrote about in this post, executive function—the ability to make decisions, plan, and think of future consequences (like, “do I want to have children of my own, ever”?) doesn’t begin to consolidate until the mid-20s.

Then there’s social maturity and a more nuanced understanding of how to interact with one’s peers. Who doesn’t remember the awkwardness, the trying-to-fit-in, seasick self-consciousness of adolescence? Social development takes place in concert with one’s peers, along with the slow dawning of self-reflection. A socially transitioned, puberty-blocked 14-year-old who has avoided the rigors of hormone-fueled social issues won’t  understand any of this.  How will that lack of experience inform their decision to continue on to cross sex hormones?

 We previously investigated how the ability to understand social emotional scenarios using mixed emotions varied across puberty in girls aged 9–16 (Burnett et al., 2011). There was a change between early and late puberty in the number of emotional responses that participants gave in social emotion scenarios, with girls in late puberty attributing a wider combination of emotions in social scenarios than their peers in early puberty

… Our findings of puberty-related changes in neural activation, together with those shown in other recent fMRI studies using different ‘social’ tasks as described in the introduction, suggest that aspects of functional brain development in adolescence, like these behavioral changes, may be more closely linked to the physical and hormonal changes of puberty than chronological age.

 As the authors note, social intelligence—a more nuanced understanding of “social emotion” scenarios—develops as a result of the release of hormones, not chronological age. This is so obvious it hardly seems worth studying (or proving on a functional MRI study).  Yet gender specialists talk as if the brain develops separately from the body; as if hormones are only important for secondary sexual characteristics. They are constantly reassuring skeptics that blocking puberty gives these incredibly immature kids the time to figure out if this is really what they want—without the benefit of the cognitive, emotional, and social maturation processes that comes with the secretion of pubertal hormones.

I’ve touched upon only a few facets of adolescent cognitive-emotional development in this post. The literature in this area is vast, still accumulating, and spans decades and millions of pages of writing. Contemporary cognitive scientists like Russell Viner, Sarah-Jayne Blakemore and Jay Giedd are continuing to add to the body of knowledge. But their work on adolescent psychology and brain development is not referenced in the media or in the writings of trans activists or pediatric gender specialists. In point of fact, what little peer-reviewed research there is in the field of “gender identity” is going in the exact opposite direction of the rest of developmental psychology and cognitive science—towards a reification of rigid, unchanging identity and decision-making “agency” for younger and younger children; while the replicated research of developmental psychology and neuroscience is moving toward an understanding of neuroplasticity, the necessity of undergoing an identity crisis, and a later age for brain maturation than was previously thought.

Cognitive scientist Jay Giedd:

One of the most exciting discoveries from recent neuroscience research is how incredibly plastic the human brain is. For a long time, we used to think that the brain, because it’s already 95 percent of adult size by age six, things were largely set in place early in life. … [There was the] saying. “Give me your child, and by the age of five, I can make him a priest or a thief or a scholar.”

[There was] this notion that things were largely set at fairly early ages. And now we realize that isn’t true; that even throughout childhood and even the teen years, there’s enormous capacity for change. We think that this capacity for change is very empowering for teens. …

Instead of respecting this “enormous capacity for change,” gender specialists are tampering with the endocrine system, freezing gender dysphoric children in a state of suspended development—and then expecting these psychologically and emotionally immature children to make permanent decisions about their future as adults. It’s a huge clinical gamble. What it amounts to is hoping for the best.

But is anyone preparing for the worst?

Guest post: I put the shotgun down

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This personal narrative by Juniper, a frequent commenter on 4thWaveNow, touches on and corroborates several themes that have been previously written about on this blog:

  •  A formerly dysphoric girl child (now in her mid-40s) who comes to terms with and accepts herself as female—but only after weathering an intense personal struggle in adolescence and early adulthood.
  • A lesbian identity that was not fully claimed until early adulthood, with a first sexual relationship at 19—right on target with the data showing that same-sex attracted women are late to fully realize their sexual orientation. (If Juniper had been born later, it’s likely, as she herself says, that she’d have been identified as “transgender” and in need of medical intervention, long before she came to terms with herself as female and same-sex attracted.)
  • Shame and shunning due to “gender nonconforming” behavior and homosexuality, which led to self hatred, self harm, and even suicide attempts.
  • The profound and currently unmet need of dysphoric or “gender nonconforming” girls to have adult role models and mentors who aren’t egging them on to “transition.”

 Juniper makes a strong case, as I have, that medical transition ought to be an adult decision, made (if at all) no earlier than one’s mid-to-late 20s. Her story is a testament to how much things can change in a young person’s mind as their mental capacities mature.

 And her story is a reminder of how very important it is to experience the storms of adolescence, because out of that struggle is born a depth of character and self-realization that might not be possible otherwise—that is, if puberty were “blocked” and a childhood insistence on being the opposite sex were coddled and celebrated.

Juniper is available to respond to comments and questions below her piece.

Update 2/7/2016: Please see the comments section for an in-depth discussion and expansion of the many points Juniper introduces in her autobiographical account.

by Juniper

I grew up with a twin brother; I’m female, and we are fraternal twins. My brother was sensitive and gentle, while I was tough and rugged. At age five, I remember the two of us looking into a mirror as my brother said, “I should have been the girl and you should have been the boy, because I am the pretty one.”  Indeed, my brother was prettier than I was and I nodded in silent agreement.

We were socialized in a restrictive, gender stereotypical home.  My brother watched wrestling on TV with my dad while I made breakfast with my mom. My dad was into health and fitness and I was allowed to do push-ups and sit-ups with them but I was scolded if I ever did more reps than my brother. My brother was ridiculed for crying or showing signs of weakness. When we went off to grade school, my brother was bullied.  He would run to me for help, and I would then confront the boy who was picking on him, even if it meant that I would end up in a fistfight. Before I knew it, every little boy came running to me if a larger boy was after him. I became the kid who would protect the ones who were being bullied. My brother made me promise never to tell our parents and we agreed this was best for everyone concerned. We kept our secret. My brother thought of me as a brother and not as a sister.

I felt like god must have made some type of mistake and that surely, a miracle would happen and I would awake one day as a boy. At a very early age, perhaps age 5 or 6, I began to self-harm. I felt such intense shame about my body and sex-related anatomy. I wanted to scrub those parts away. I would scrub until I bled from the abrasions.

I began puberty at a young age and started menstruation in the 4th grade, before any sex education at school or “heart-to-heart talks” at home. I was devastated to learn that I had become a “woman” despite my prayers, despite my efforts to stop the changes. My parents and other adults seemed displeased with my inability to adopt or cultivate some semblance of femininity. My body had betrayed me. Because I developed early, I was targeted with harassment and unwanted sexual attention from boys (and men.) This contributed greatly to extreme feelings of isolation and hopelessness.

The self-harm escalated and became much more serious at age 11. I began contemplating suicide and made several unsuccessful attempts. I began to wear my clothes as baggy as possible. It became commonplace that I was mistaken to be a boy by people who did not know me.  (Today, I am still most often called “sir” by clerks in stores and other strangers.)

I began to come to terms with my history of sexual abuse at about this same time: age 11 or 12. Meanwhile, my brother began exploring his own sexuality and started cross-dressing and experimenting with my mother’s make-up with another boy while my mom was at work. (My parents had divorced by this time.)  My brother and the other boy were chased down and threatened. They were called “faggots” by a truck full of young men one day when they decided to venture outside while cross-dressing. My brother became more cautious, closeted and secretive about his cross-dressing after this incident.

After puberty, we remained close as siblings. We loved each other, but his friendships with other boys became increasingly important to him and he began to prefer their company instead of mine. At age 12, the bullying stopped for my brother as he began developing into a very muscular young man. Unfortunately, he also seemed to pair his new masculinity with misogyny and violence.

When we entered junior high school (now called “middle school”), my brother and his friends no longer wanted to associate with me because I was a “girl.”  I had been considered a gifted student through grade school but I began to struggle to concentrate on my studies. The boys lifted weights and did “guy things” without me. I felt intensely isolated. I became increasingly introverted and depressed, and I continued self-injurious behaviors. The suicidal ideation intensified and I developed bulimia. I would sneak out at night to take long runs of 10 to 20 miles, several times a week.

At 15, I became very involved in religion. I was quite fanatical, and this was a new escape from my struggles. I also began working after school. I found ways to keep myself as busy as possible so that I could avoid thinking about my body, my past history of sexual abuse, and my feelings of loneliness.

At 18, I began to come to terms with my attraction to women, but I had not yet acted on my feelings.  I told my youth pastor that I was concerned that I was homosexual and he told me that I would not be welcomed back until I was straight. This was a very dark time for me and I attempted to overdose on a mix of aspirin and Tylenol.

At 19, I fell in love with a young woman.  I began a relationship and as the result of this, my church rejected me and my closest friends abandoned me. My family was also very unsupportive.

When the relationship ended, I felt ashamed and hopeless and I decided to end my life. I loaded up a shotgun and I was ready to pull the trigger when I suddenly realized that “this is it … there’s no turning back.” Something told me “You could pull the trigger and have a shitty ending to a very shitty life, or you can decide to live and have a chance of changing the story.”

I put the shotgun down.

This was my final suicide attempt.

I told my mom and stepdad what had happened. They were angry with me, and said they would keep the rifle loaded in the house, where it had been, and that I had no right to touch it. I finally realized that they were toxic people and I could not continue to be around them, since they contributed significantly to my depression.

My brother had gotten into drugs and joined a gang by now; he was gone and I was completely on my own.

I moved out and rented a room. I worked two full-time jobs and started to build a new life. As my confidence grew and as I learned to not be ashamed of my sexuality, I grew stronger. I began to wear the clothes I liked, “men’s” clothes. I cut my hair very short and I finally felt comfortable with my appearance. I became healthier as I started to lift weights and feel better about my body. I was able to free myself of my eating disorder – on my own. I started to make friends who accepted me. Most were lesbians.

I made a few friends in my early twenties who confided that they were transgender. These friends came out to me because they thought I was also transgender. This has happened several times over the course of my life, and I have questioned my gender very seriously. This was before it was common to hear of transgenderism.  I could have easily succumbed to the pressure to transition had I been younger or less confident in my identity. I felt at one time in my life that life would be easier had I been born male, but looking back over the last two decades, I see that my brother had his own struggles and that his life is not enviable.

Ultimately, I realized that I was a strong woman and that I did not identify as a man. My path has not been easy. I have been “gay bashed” several times.  I have been blatantly discriminated against at work and in housing (before laws included sexual orientation as a protected group.) I lost most of my friends from high school, as they were all very religious. But I moved forward and I eventually built a good life with my partner of 13 years (who is now my legal wife thanks to recent marriage equality laws.) I have created a life that is meaningful – a life that helps others. I have created a life worth living. My wife and friends today accept me completely for who I am.

My brother eventually found his way also.

The story of my brother and me is not picture perfect. (Most people’s true stories seldom are.) But we were able to find our way and make choices about our bodies and our gender identities, as we matured in our adulthood.  We both now identify comfortably with our birth sex.

I have friends who are transgender, who have personal stories that are similar to mine but who pursued transitioning in adulthood. Some have de-transitioned; others work to manage serious health conditions that have resulted from the use of hormones. We deal with similar social issues despite the fact that we have taken different paths in life.

Transition brings new challenges that are unexpected. Hormones and surgeries have limitations and complications. Still, I support everyone’s right to make their own choices about their bodies and identity. I think that for the great majority of people, with the exception of some children who are medically defined as intersexed, it takes time –perhaps well into one’s early twenties to sort out one’s identity in relation to gender, physical anatomy, and sexual orientation.

As difficult as my past was, I am grateful that I was not rushed into hormone blockers, hormones, or sex re-assignment surgeries.  For me (and my twin brother), this would have been a grave mistake as our issues with gender identity were rooted in traumatic histories and external societal pressures, which resolved when he at (age 12) and I (in my early 20’s) found kinship and support in our communities.

Societal pressures are even more complicated today because the transgender narrative omits stories like my own.

My oldest niece ended up being very “bookish.” She was also artistic and enjoyed wearing make-up and following fashion trends. Her younger sister loved athletics and hated anything “frilly or foofy.” Their mother was supportive and loving toward both of her daughters. She also had no problem with me, a “gender nonconforming” lesbian, being in the girls’ lives. She asked only that I never talked about “gay stuff” around them as she held the belief that homosexuality was a “sin.” She was a good mom who never pressured either child to conform to gender stereotypes. She seemed to love them both and did not prefer my “feminine” niece over her “rough and tumble” younger daughter.

Still, my athletic niece was taunted at school and her sister sometimes teased her at home. One time, when I came to visit, we were walking and I heard my older niece teasing her sister. My niece, who was eight at the time, ran up to me sobbing. “My sister says I am a boy!” I was in my early twenties and without thinking replied gruffly, “You aren’t a boy, you are a tomboy like me and that’s alright.” At that point, my young niece stood up tall, marched back to her older sister, leaned into her face and repeated what I had said to her, putting a quick end to their quarrel.

I didn’t think much about the incident but years later, when my younger niece came out as lesbian, she told me how important that brief conversation was. She said this was when she “knew” that she was “like me.” My niece was about twenty when she came out. I asked her during our conversation about gender and sexual orientation, if she ever wondered if she might be transgender. Without hesitation my niece said “No, I’m just a regular ole’ lesbian.” That gave us both a chuckle, but I assured her that I would love her either way. After a brief pause, I added that I was glad she would not need to change her body.

If my niece had told me that she was a boy at 8 years and that her sister was insisting that she was a girl, I would have asked the two what it means to be a “boy.” I would have explained my own past and how lots of people thought I was a boy and still seem to think I am a man when they first meet me. I would explain that for me, this does not affect my identity as a woman. I would explain that we are all different and that this is what makes us so amazing.

Guest post: For teen girls with autistic traits — a plea for watchful waiting

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This guest post by 4thWaveNow community member neverfallingforit is second in a series exploring the increasingly well known connection between autism spectrum disorder (ASD) and gender dysphoria (or other gender-related issues).

 Many of us have shared observations that our kids show signs of ASD. Unfortunately, the current treatment paradigm tends to view ASD as no barrier to “transitioning” kids and young adults.

 A word about the title of this post. The current approach fostered by WPATH is generally referred to as “watchful waiting” with regard to diagnosing younger children as transgender. While this sounds like a hands-off approach, in reality “watchful waiting,” to trans activists and many gender specialists,  often includes the use of “preferred pronouns,” “social transition,” and (frequently) puberty blockers. Once these kids reach adolescence, “watchful waiting” ends and the path to full medical transition becomes available.

There is much that is still unexplored (and unstudied) about the impact of these supposedly benign interventions on actually helping to create a persistent transgender identity in children and young people. I’ll have more to say about this in a future post.

by neverfallingforit

When my daughter first started identifying as transgender, I quickly and easily found articles online which posed a link between autism and gender identity issues. I bought the books Aspergirls by Rudy Simone and I am Aspiengirl by Tania A Marshall. At the back of each book there is a checklist of traits for girls with Asperger Syndrome, many of which I learned were different from those which appear in the male Asperger profile.

146 cropped small

I also learned that formal research on the autistic female profile is relatively new, and as such, is years behind clinical and anecdotal observations. After reading the books, my daughter herself placed ticks next to a whole host of these traits, and I began to suspect that an autistic spectrum disorder (ASD) was in the mix here somewhere. Several traits particularly jumped out at me:

  • may have androgynous traits despite an outwardly feminine appearance. Thinks of herself as half-male/half-female (well balanced anima/animus)
  • may not have a strong sense of identity and can be very chameleon-like, especially before diagnosis
  •  will not have many girlfriends and will not do “girly” things like shopping with them or have get-togethers to “hang out”
  •  emotionally immature and emotionally sensitive
  •  strong sensory issues – sounds, sights, smells, touch and prone to overload
  •  will have obsessions but they are not as unusual as her male counterpart (less likely to be a “trainspotter”)

After finding 4thWaveNow, I read that gender identity clinics are seeing a higher number of natal girls in their referrals than they would expect from previous epidemiological knowledge, and also that it is very common to find that these girls had autism spectrum characteristics. Some of the studies alluded to the fact that cultural factors could also be at play in the increasing referral rates.

As I read the comments on many of 4thWaveNow’s posts, I could see a profile emerging of a subset of teenage girls who had come to believe that they were born in the wrong body. Most had never previously mentioned gender dysphoric feelings to their parents, although many had never been “girly girls.” They often seem to share the same personality traits; traits which fitted right into the female Asperger profile. 4thWaves’s comprehensive article on autism discusses how autistic spectrum traits could lead to a transgender presentation and I could clearly see how this applied to my daughter.

What really caught my attention was how these girls also seemed to share the same cultural traits. My parental antennae kicked in.

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Then, I found an article on GenderTrender, and some more pennies began to drop. Way back in 2010, that blog was insightfully covering the transgender trend in ‘tween and teenage girls

 who believe that rejection of increasingly constrictive female norms means they must be male. These girls don’t want to act out a ‘female’ role in relationships with boys.

Here was an apt description of my daughter, who kept telling me that she must be a boy because she was a “rubbish girl,” that she wanted “to be the boy in the relationship, saying the lines and making the moves.”

She and her friends had recently been watching porn videos on their phones at school, and a letter had been sent home to parents. I wondered if the images she had seen had frightened her. Girls with ASD often have sensory issues which can mean they don’t like to be touched much, or hugged; a few in my daughter’s online social group describe themselves as asexual. Maybe she felt that taking on a male presentation would ensure that she wasn’t pressured into situations which she was uncomfortable with? She refuses to discuss it with me.

As the same article also observed,

 they don’t want to be marginalized as the gender non-conforming women that they are. Femininity rejecting females simply DO NOT EXIST in the media reflection that is so important to children and teens in western culture. These kids want to fit into social norms, wear the right brands, get the right haircuts, and look like the people in magazines. “Transgender” has a certain cachet, a certain alterna-cool about it for those in middle school and high school years. Declaring one’s trans status is like getting the ultimate cool tattoo or piercing body mod and provides girls with special status and treatment amongst their peers as well as school officials, employers, parents and other authorities.

This, too, has been my experience. My daughter’s social popularity rose on her transgender announcement, and what teenager wouldn’t rejoice in that–especially one who had previously had trouble maintaining friends? She attracted much encouragement and support.

I read all the statistics about suicide rates, the suffering of those with crippling dysphoria, about the bravery of coming out as trans in a hostile world — and yet my daughter displayed no such angst. She declared herself the happiest ever and demanded that we catch up with the rest of the world. Her anger and distress were only directed at us, her parents, when we questioned her transgender narrative.

One of the most heartbreaking parts of my story is the way my daughter has been encouraged to believe that we, her parents, don’t love and respect her because “we don’t want her to be happy.” Outside of our family, her friends, college teachers and the media are cheering and validating her male presentation. She is genuinely bewildered, disappointed and hurt by our inability to sign up to her self-diagnosis, without question, without due diligence. Not long ago, she reblogged a popular post on her Tumblr account. It is an illustration of a parent cutting the multicolored wings on the back of a “transgender” child.

suicide meme pink wings cropped
It’s common knowledge that teenagers always run with their peer group. They try out identities and refute parental opposition. There’s nothing new in that. That’s healthy. But it’s the untested lifelong medical treatments and surgery involved here which frighten us, and make us cautious parents – not “transphobes.” And, if my daughter does have Asperger Syndrome, does she have the ‘theory of mind’ to understand the long-term implications of what she is proposing?

Back to GenderTrender:

 The trans tweener trenders bond and encourage online via YouTube groups and web forums which function much like pro-ana, pro mia and trans-abled communities, encouraging dysphoria and censoring questioning and dissent.

The online spaces my daughter visits have become saturated with transgenderism. Many 4thWaveNow parents mention that their girls spend a great deal of time on Tumblr in particular. During Trans Awareness Week recently Tumblr was described glowingly:

 Tumblr seems like a natural fit for young transgender people to gather online, with a thriving social justice community and fandom devotees advocating LGBTQ rights, Tumblr fosters a culture of reaching out for advice from caring, experienced strangers… Tumblr’s also important because through finding one person who is similar to you, you’ll find 10 more, because they’ll be following people like themselves. When I was first working out I was trans, I didn’t follow that many other girls, but now I follow loads… the most important thing Tumblr’s trans community can give its members may be a sense of affirmation.

How intoxicating must that be? A legion of like-minded girls, with similar interests – after so many years of feeling like you don’t fit in. And how normalizing!

In my daughter’s case, I would also add into the mix the androgyny, cosplay and cross-play associated with anime and manga, and the androgyny, parental estrangement, disassociation, and angst messages that she absorbed during her previous obsession with the “emo” scene too.

Not feeling either stereotypically male or female is fine. Androgyny is fine. Trying on many identities is fine. But how did these feelings become conflated with a transgender diagnosis, when they all fit firmly into the Asperger girls’ profile too?

Here are a few quotes from parents of girls with Asperger Syndrome, which feature in the  I am Aspiengirl  book:

 “She went from princess, to tomboy, to punk, to emo to goth. She is having trouble finding out just who she is and has gotten involved with the wrong types of people. She is not interested in dating and finds flirting very confusing. She also does not seem to have a solid gender identity.”

“She has recently given up trying to fit in. She is going through very challenging teenage years, feeling even more outcast. We are now watching her embrace opposite conventions, despise femininity, social and gender rules. She is now a tomboy and a bit confused about her gender.”

“We all thought she had gone to the “dark side”. She just didn’t fit in anywhere and had no idea who she was. She seemed to despise femininity and defined social and gender rules. When she has friends, she tends to naively and blindly follow wherever they go, their rules, taking on their traits, from the way they dress to the way they talk and act.” 

“Just a few months ago, she was wearing frilly dresses and looked like a princess. Now she’s Goth and won’t let anyone call her by her new name. She has depression and panic attacks that sneak up on her from out of nowhere.”

“She really struggles with sensory sensitivities, social anxiety, panic attacks and depression. She must have gone through at least three or four different lifestyle changes.”

Do any of these anecdotes sound familiar to other parents in my position?

So what now? I strongly suspect that my daughter is on the autistic spectrum. I feel that she has Asperger-related issues which are impacting on her self-diagnosis of being trans. I feel transgenderism has become a special interest/ obsession that gives her relief from anxiety. All I want is to be reassured that clinicians will take care, be cautious, give her time to experience more life, to mature.

But will they?

Until I believe they will exercise proper caution, I am too scared to lead her into a therapist’s waiting room. Because I fear that, in some medical quarters, as soon as the word “transgender” is uttered, Asperger syndrome becomes downgraded to a mere co-existing condition.

In a recent small retrospective study of children presenting to a gender clinic in Boston, it was found that 23% of the patients potentially could be given an Asperger diagnosis but instead of urging caution, the researcher Daniel Shumer seemed to imply that it merely meant these kids may need to have the transition process explained more clearly.

 Given the growth of gender programs and general awareness of gender dysphoria in the U.S., Shumer said it helps to know that there’s a link between it and Asperger syndrome. He said he hopes his work will help persuade doctors to screen transgender patients for ASD and know that they may need to take more care to explain hormonal interventions to their patients on the autism spectrum.

Aron Janssen, MD, a child psychiatrist at NYU Langone Medical Center, who was not involved in the study had this to say,

It’s really about assessing what gender means to a population that may think of gender in a different way than the way most of us do,” Janssen said, explaining that thinking differently about gender shouldn’t limit treatment options for patients with ASD. In a way, people with ASD may express their gender more authentically because they’re not as swayed by social stereotypes, Janssen said.

Aron Janssen has recently taken part in an interview with The Ackerman Institute for the Family, which he has posted to the WPATH Facebook page. In it, he gives his view that gender dysphoria is a completely separate entity from autism spectrum disorder. He states that recent research has found an overlap between individuals who have gender dysphoria and individuals who have an autism spectrum disorder but we don’t really know why that is.

One of the implications for treatment, he says, can be that patients with autism who may have a “theory of mind” impairment could have difficulty in understanding how to communicate their internal gender identity to the outside world; in other words, they may not understand that how you speak, dress, act and appear are important to how people view your gender presentation. They may need help with that.

A Reddit commentator with Asperger’s would agree with that impairment, but reaches a different conclusion on the help needed:

 I can’t speak for all people with autism (I have Asperger’s), but I think a lot of people with autism spectrum disorder are confused by the messages that society puts out about how to act and how to perform gender. I always felt like I didn’t fit in with women when I was growing up. Had I been born later, I have to wonder if I’d be picking up this trans narrative and taking it to heart. This is not the kind of help that young people with autism need. They need appropriate services, help finding their way into jobs and meaningful social connections, not hormones.

Dr Janssen, however, appears to take a different perspective.

 For too long individuals with autism who have had gender dysphoria have had that gender dysphoria dismissed as filling category 2 of autism- that restricted or repetitive interests or behaviors – and their gender identity was thought of as a symptom of autism, as opposed to something that is genuine for each individual.

As such, he believes he needs to help patients express their own autonomy and give them access to the care they say they need.

Which all sounds great, if we weren’t talking about letting children with cognitive vulnerabilities make decisions about irreversible treatments before their brains reach full maturation!

My last point is this:  So much of the research available cites case studies of patients who have experienced gender dysphoria from a very young age. Information about the clinical management of SUDDEN, LATE ONSET gender dysphoria in YOUNG TEENAGE GIRLS has been impossible for me to find on the internet. 4thwave’s blog is the only place I have found where this particular path to transgender presentation is being discussed.

More importantly, parents are also beginning to come here to tell about desistance in their daughters. These stories are important. (These stories give me hope.) If you have a similar one to tell, please share it here. My plea to clinicians is that they read these accounts and adopt a WATCHFUL WAITING approach for this group of teens and young adults.

 

The surgical suite: Modern-day closet for today’s teen lesbian

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Despite the fact that trans activists are diligently trying to lower the age of consent for cross sex hormones and surgeries, as a general rule children under 18 in the US cannot access these “treatments” without parental consent (Oregon being a notable exception). I have argued that even 18 is too young to make such permanent decisions, given that executive function skills are not well developed until the early 20s.

But there is another, equally important reason to question medical transition for adolescent girls. According to several peer-reviewed studies (which I will be discussing in detail in this post),

  • 95-100% of girls who “persist” in gender dysphoria at adolescence are same-sex attracted; these girls are typically offered cross-sex hormones by age 16, and  surgeries as young as 18.
  • The typical age that a young lesbian has her first sexual experience and/or claims her sexual orientation is between the ages of 19 and the early 20s.

Let those two statements sink in for a moment.

Here’s the reality of what’s going on in gender clinics around the world right now. An increasing number of adolescent girls diagnosed with “gender dysphoria” are asking for, and receiving, cross-sex hormones and surgeries. The World Professional Organization for Transgender Health (WPATH) officially recommends cross-sex hormone treatment to begin as early as age 16, with SRS surgeries to be offered at age 18.

The vast majority of these girls presenting to clinics admit to being same-sex attracted. Yet data from studies of LGB (lesbian, gay, and bisexual) people shows that most young women don’t fully crystallize a lesbian orientation until 19 or older.

To take one of several examples, this 1997 study of 147 lesbians and gay men by Gregory Herek et al, “Correlates of Internalized Homophobia in a Community Sample of Lesbians and Gay Men,” found that

 The mean age for first attraction to a member of the same sex was 11.5 for females and 10.3 for males. Mean age for first orgasm with a person of the same sex was 20.2 for females and 17.7 for males. On average, females first identified themselves as lesbian or bisexual at age 20.2, whereas men did so at age 18.7. Mean age for first disclosure of one’s sexual orientation was 20.5 for females and 21.2 for males.

A 2014 study of 396 LGB people, “Variations in Sexual Identity Milestones Among Lesbians, Gay Men, and Bisexuals” [full article behind paywall] by Alexander Martos and colleagues reported a similar finding for age of first sexual experience:

Women self-identified as nonheterosexual when they were almost 3 years older than the men (age 17.6 vs. 14.8) and reported their first same-sex relationship when they were 1.4 years older than men (19.1 vs.17.7).

And not only do young lesbians take longer to realize and accept their sexual orientation than their gay male counterparts. Coming out to oneself, and to loved ones and the world, takes time. It’s a developmental process that evolves over a number of years, from the first signs of puberty into early adulthood, with several stages, as Martos et al say in their 2014 study:

Coming out is not a single event but a series of realizations and disclosures. The age at which sexual minorities first recognize their identity, tell others about their identity, and have same-sex relationships varies, and people may take different amounts of time between one milestone and the next. Scholars have proposed and tested models of sexual identity development for over 30 years. Cass (1979) developed an influential model, which outlined a six-stage linear psychological path of sexual identity development. Troiden (1989) built upon Cass’s model and reframed it within four stages: (a) sensitization, which may include a person’s first same-sex attraction and their first questioning of their heterosexual socialization, (b) identity confusion, a period during early to mid-adolescence that is marked by inner turmoil and often the initiation of same-sex sexual activity, (c) identity assumption, when a youth self-identifies as LGB and begins to reveal their “true self” to select people and seeks community among other LGBs, and (d) commitment, which is marked by the initiation of a same-sex romantic relationship and disclosure to a wide variety of heterosexual people (Floyd and Stein 2002). These models suggest that healthy and stable sexual identity development necessitates the full permeation of sexual identity into all aspects of a person’s life.

So the process of integration–“full permeation”–of one’s sexual orientation is a process that takes place over a period of years.  It involves “identity confusion” and “inner turmoil” in adolescence. And not to put too fine a point on it, but most lesbians don’t even begin to express and realize their orientation until 19 or 20 years old.

Yet same-sex attracted girls who present to gender clinics–many of them still with the concrete, either-or thinking of a child (e.g., if I like girls, I must be a guy), internalized homophobia, and overall lack of maturity and self reflection typical of their age, have been “socially transitioned” for years; have had their puberty “blocked” (such that they don’t have the opportunity or desire, in most cases, to actually experience a physical relationship with a love interest); and then move on to “transitioning” to….a straight male.

Here they are, girls without sexual experience, conditioned to reject their bodies and begin irreversible medical “treatments” before they’ve had a chance to embark on the years-long process of discovering their own bodies as sexual beings.

In a 2011 Dutch study “Desisting and persisting dysphoria after childhood, Steensma et al note that 100% of the girls who “persisted” in gender dysphoria by age 16 were same-sex attracted. As they indicate, this finding corroborates that of other researchers over many decades. A 2013 study,  also by Steensma et al, revealed the same information, but added more granularity: between 95.7 -100% of the 16-year-old (average age) girls reported exclusively same-sex attraction, fantasy, and behavior (defined as “kissing” because, as the authors note, that was the extent of their sexual experience). Age 16–well before the average age of coming out as lesbian noted in the studies I highlighted earlier.

With regard to sexual attraction, all persisters reported feeling exclusively attracted to persons of the same natal sex, which confirmed their gender identity as they viewed this attraction as a hetero­sexual attraction. They did not consider themselves homosexual or lesbian.

…the majority of adolescents kept their sexual attractions to themselves. Both boys and girls indicated that, as a result of fear of rejection, they did not speak about their sexual feelings to others, and did not try to date someone. Furthermore, most adolescents felt uncomfortable responding to romantic gestures from others.

In summarizing their findings, Steensma et al note that

…. The third factor that seemed to be associated with the persistence or desistence of childhood gender dysphoria was the experience of falling in love and sexual attraction. The persisters, all attracted to same- (natal) sex partners, indicated that the awareness of their sexual attractions func­tioned as a confirmation of their cross-gender identification as they viewed this as typically hetero­sexual.

These adolescents at age 16 regarded their same sex attractions as “typically heterosexual.” It’s fascinating that the study authors make this statement without any examination of exactly why the 100%-same-sex-attracted persisters viewed themselves this way, and whether this might give pause to the practice of medical transition—especially since in the very next paragraph, Steensma et al refer to earlier research findings that LGB people are late to claim their sexual orientations:

 All persisters reported feeling exclusively, and as long as they could remember, sexually attracted to individuals of the same natal sex, although none of the persisters considered themselves ‘homosexual’ or ‘lesbian,’ but (because of their cross-gender identity) ‘heterosexual.’

As for the desisters, about half of them were sexually attracted in fantasy to individuals of the same natal sex. Yet, all girls and most of the boys identified as heterosexual. The difference between the reported sexual attractions and identities may be related to the timing of the ‘coming-out’. The literature shows that the average age of the first feel­ings of same-sex attraction is generally during puberty and before the age of 18 (e.g., Barber, 2000; Herek, Cogan, Gillis & Glunt, 1998; Rust, 1996). However, the moment at which men and women identify and come out as gay, lesbian, or bisexual generally lies above the age of 18, at the end of adolescence or in their early twenties (e.g., Barber, 2000; Herek, Cogan, Gillis & Glunt, 1998; Rust, 1996).

Steensma et al give us what we need to know, but they don’t connect the dots: these same-sex attracted young adolescent girls undergo “transition” before they have the opportunity to experience themselves as sexual beings in their healthy, original bodies.

Why are we robbing our kids of the right—the basic human right—to discover their sexuality without preemptive tampering by the medical and psychiatric profession?  “Transition” prevents them from learning whether they might be gay/lesbian, freezing them at an immature stage of development when the only possibility they see is that they are heterosexuals trapped in the wrong body.

Trans activists like to say that gender identity and sexual orientation are completely unrelated. But obviously, it just ain’t so. Study after study, anecdote after anecdote, media story after media story, tells us that most “trans men” start off as same-sex attracted adolescents. But no one outside the blogosphere—no one –is pointing out the obvious: that girls who would naturally mature into lesbian adults are having the process of realizing their sexual orientation short-circuited by medical transition.

Who will step forward to stop this? Who with power in our society—the Congress, the President, the publisher of the New York Times¸ the child and adolescent psychologists–will raise their voices? Where are the lesbian doctors, lawyers, heads of LGBT organizations? Which of you will name this preemptive conversion therapy for what it is?

Teen decides she’s not trans, after all, but struggles with peer pressure

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The guest post below, by pj white, is the personal account of a mother whose teen daughter temporarily identified as “trans,” but at 16, desisted.

While “gender specialists” and researchers often discuss younger children who persist in their gender dysphoria as they reach puberty, next to nothing is said about a phenomenon that more and more of us parents have personally experienced: the teenage daughter who, never having had a problem with being female as a child, suddenly insists she is trans at puberty–after a heaping helping of social media propaganda. And often these girls, like pj’s daughter, have other mental health issues that, once explored and addressed, help alleviate the desire to “transition.”

Every parent will respond to this situation in a different way; I’m grateful to pj for sharing her own parenting journey with us in such detail. And I’m particularly glad to hear directly from a parent about how difficult it can be for an adolescent to desist from trans-identification once they’ve started down the road. The glib insistence by trans activists and some “gender specialists” that social transition and puberty blockers won’t accidentally ensnare kids who really don’t want to persist is clearly unfounded. Peer acceptance and pressure is a real thing—yet another truism about adolescent developmental psychology that is ignored by the media, as well as too many providers entrusted with the care of young people. Luckily, a few researchers and clinicians, notably those in the Netherlands who pioneered the use of “puberty blockers,” are beginning to recognize the impact of media and “social transition” on those who might want to desist.

pj white notes that her daughter could have pursued her desire for “top surgery” had she been 18. But as I wrote a couple of days ago, the trend (supported by WPATH itself) is to allow such irreversible surgery at younger and younger ages. Can a move to permit total hysterectomy for 15-year-olds be far behind?

Pj white is available to respond to any remarks or questions you may have in the comments section of this post.

by pj white

My daughter has always been a dynamo. She hit the ground running as a toddler and didn’t stop until puberty hit her and knocked her flat. She never had the slightest interest in traditional girly gender roles. When she started middle school, I expressed fear that she’d be negatively influenced by other kids and want to start acting like a “Barbie Girl.” She put her hands on her hips, rolled her eyes, and said, “yeah, right, mom – I can’t wait to get in touch with my inner plastic doll.”

But when she started to develop breasts at a young age (11), and men started hooting at her from their cars, her sense of strength and power evaporated. She stopped washing and brushing her hair. She wore baggy dirty clothes, and her hair hung over her face in greasy knots. The other kids made fun of her, and eventually, she became more depressed and started skipping school.

Right after turning 13, she told me she was really a boy. This shocked me, because she had always expressed such pride in being a girl. She was proud when her period started at age 10 (we called it “the good blood”) and I taught her from a young age to be proud of her vulva, too. Girl Pride had been a big part of her life. Now she told me she wanted to have her breasts cut off and to inject testosterone.

I was devastated, but I tried to hide it from her. I didn’t want her to be damaged by my “transphobia.” I had been a single mom for most of her life. It had always been the two of us – mother and daughter – two strong females taking on the world. But my daughter was telling me she didn’t want to be a girl anymore. And I was afraid I would damage her by challenging those feelings.

At her request, I took her to a barber to get a “boy’s” haircut (she looked adorable). I also took her shopping in the “boy’s” section of Target to get her a new “boy’s” wardrobe (which was silly, because her clothing choices had always been androgynous). She also asked me to order her a breast binder, which I did.

Perhaps luckily, I couldn’t afford a psychologist, so I took her to the Castro Mission Health Center in San Francisco where we live. The staff there is absolutely lovely, and did not pressure my daughter to transition. They just accepted her where she was. (This is actually a great resource for kids who are LGBTQ). But the staff could not protect kids from the peer pressure they felt to follow through on transitioning once the decision had been made. And to my knowledge, the topic of having room to change one’s mind was not addressed.

The pressure I felt came more from the pop psychology I’d read on the Internet than from professionals (I couldn’t afford private appointments with professionals). According to social media, I was supposed to wholeheartedly celebrate my daughter’s sudden desire to transition, and was forbidden to question or feel sad about it. I felt as if I had only two choices: to be evil and transphobic like the Duggars, or to be a great mom who loved having a transgender son. There was no room for doubt or fear or grief about losing the daughter I thought I had.

I sent my daughter to a free support group where she met truly wonderful kids. I would gladly have adopted the two young trans men I met through my daughter’s participation in that group. I’d have been proud to have them as my “sons”. But I couldn’t help noticing that they came from very traditional families (one’s family was devoutly Muslim and the other’s had come from rural China). I feared I was being transphobic for thinking they might not have felt compelled to transition had they come from backgrounds more accepting of gender non-conformity/lesbianism.

My daughter stood out like a sore thumb in this group for trans boys, because she suddenly decided, for the first time in her life, to start performing femininity. Her femme performance was so over the top she put Ru Paul to shame. Somehow, identifying as a boy gave her permission to perform femininity as an experiment and a game.

My head was spinning. My daughter was now claiming to be a gay male drag queen in a girl’s body. She also insisted, to my relief, that she did not have to cut her breasts off or take testosterone to be a man (I did an internal happy dance). But when I tried to explain to her that gay men would probably not be attracted to her (she looked like Drew Barrymore after an assault by a drunken makeup artist), she got very upset with me. She said only transphobic gay men would refuse to date her. I tried, as gently as I could, to explain that gay men are not usually attracted to people with female bodies. She angrily reminded me that she did not have a female body. When I persisted in explaining that gay men might disagree, she burst into tears.

That was checkmate. She had won. I assured her that any gay man would be thrilled to be with her. Ugh.

During this time, while she was doing female drag and looking more girly than she ever had in her life, she decided to assert her maleness by using men’s public restrooms. I was with her at a park, and when she went off to use the restroom, I assumed she’d use the women’s room. Nope. She walked right into the men’s restroom. And I walked right in after her and dragged her out (The LOOKS we got!). I angrily lectured her on the dangers of men’s public restrooms, especially when, to all appearances, you are a 14-year-old girl. She accused me of not affirming her identity. I said I didn’t give a damn about her identity when her safety was at risk.

Slowly, the hyper-femme drag phase passed, and at 16, my daughter has regained some of the self she lost at puberty. She once again identifies as female, but wears the same type of gender-neutral clothing she wore as a child. She currently identifies as a lesbian, but has not yet had a serious dating relationship.

When I was finally able to take my daughter to a psychiatrist, she was diagnosed with ADD and depression. The doctor explained that many kids with ADD miss out on developing social skills, and when puberty hits, they become very self-conscious – feel inferior – and become depressed. This is compounded in girls who also feel an acute loss of social status when puberty hits. They go from being cute little human beings to pieces of meat subject to adult male harassment and assault. I believe this is what happened to my daughter. She didn’t fit in socially “as a girl” and she loathed the degradation that came with being an adolescent female. She saw transitioning to male as a way out of her pain (sounds crazy, I know, but these are adolescents we’re talking about).

In our case, it was the trendy trans-ideology promoted on Tumblr that caused us the most difficulty. We both bought into the trivialization of a very profound and rare condition: sex dysphoria. I believe we all should be very suspicious of the sudden desire to change sex at puberty. People are so irrational and malleable at that age. Kids need room to experiment and grow without committing to permanent life-altering medical treatments and labels.

It can also be mortifying for an adolescent to change his or her mind about transitioning. My daughter is too embarrassed to face the sweet kids in her former support group. An adolescent’s need for acceptance by peers, and the pressure to follow through on transition when that’s what your peers expect of you, should not be underestimated. This is particularly true when a kid is celebrated as “brave” and “heroic” for coming out as trans. How do you change your mind about transitioning under that kind of pressure? And what if “the courage to be trans” is what people celebrate most about you? My daughter was too ashamed to tell her friends she’d changed her mind – she just withdrew/disappeared from the group. She was homeschooled at the time, which was likely a key factor in allowing her to pull back. If her peer group had been unavoidable (i.e, in school), I don’t know if she’d have been able to desist.

I worked extremely hard not to pressure her during the whole process, because I didn’t want her to defiantly assert her “right” to transition. It’s one of the hardest things I’ve ever done: having to cry alone in another room over her desire to have her breasts cut off. I was terrified and horrified. And although I would never have let her do that under my watch, I knew she could if she were over 18. It was so hard to let her come to her own decision not to transition. In our case it worked, but I know every situation is different. In some other families, more assertive parenting might be necessary.

I am incredibly grateful that my child passed through her desire to transition. I think her depression, ADD, social awkwardness, and “gender nonconforming” personality all contributed to her falsely believing her gender was the problem.

My heart goes out to other parents struggling with this – it’s horrible to be accused of transphobia/bad parenting for not wanting your child to do permanent medical harm to herself. And while I’m very glad my daughter found her way back to herself,  it saddens and frightens me that current trans ideology made her journey back so guilt-ridden and difficult.

And then I woke up: Guest post

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This is Part II (Part I is here) of a guest post by thissoftspace, a woman in her late 30s who experienced gender dysphoria, began transition to FTM, but pulled back and now writes her own Tumblr and WordPress blogs celebrating her return to herself as female. As in Part I, her mother’s thoughts are also included in this piece. thissoftspace is available to respond personally to questions and discussion in the comments section below.

 As I read this second part,  I was struck by the extent to which her insight and overall mental maturity helped thissoftspace to desist from a trans identity:

 I am so grateful I have had the life experience with my mental highs and lows that I was able to recognize the patterns as soon as I did.

How much more difficult must it be for younger people to change their minds? They have so few prior life experiences to reflect upon; they lack the patience and foresight of a woman in her 30s,  who, even so, nearly transitioned herself. Her story has made me feel all the more strongly that we parents must fight for children to be allowed to reach adulthood before considering such monumental, life-changing decisions.

Part II: There and Back Again

by thissoftspace

While using the labels “agender,” “non-binary” or “genderqueer” made me feel better by being not-female, I soon realized those words were meaningless to the general public. In order to get the message across that I was not female, I had to bend my presentation further towards male – just like so many other “non-binary” young women I had seen online. Once I did so, everything seemed to slide neatly into a more traditional trans narrative. I clung to the gender-neutral labels a little longer, but it was clear my intentions were to escape female by transitioning to male. Why not just use male pronouns, a male name, to make the message loud and clear?

My mother’s words:

I truly wished to keep the matter personal and give it time. I wanted to see how things worked with her changing her name with a few friends who would understand, rather than be out in public with a male presentation. I did purchase her some new men’s clothing and spent many hours tailoring shirts so they fit properly. I felt this I could do, this was how I could help. I had trouble with the male pronouns, often saying “he/she” instead of just “he”. I tried to keep things as normal as possible. We spoke about giving space and trusting more, but there was a current of stress at the time.

Articles and pamphlets from PFLAG and GLAAD and the HRC insisted my new identity should be embraced and recognized. Bruce Jenner’s interview on broadcast television supported my “feeling” of being more male than female as perfectly valid. I watched videos and read blogs of various female-to-trans people and took in all their enthusiasm and encouragement, all their happiness and all the celebration surrounding their lives. PBS News Hour ran a special on transgender kids that was heartbreaking. Look at them! Don’t they deserve happiness? Don’t they deserve the freedom to be who they are? I shared some of these things with my mom. I told her I could be a man, a straight, normal man, dress the way I wanted, be the person I’ve always wanted to be. I could freely love women if I wanted to. I could be my brother’s cool younger brother instead of his weird little sister. I could finally just be myself. She couldn’t have tried harder to be patient and understanding.

My mom said, “As long as you don’t cut your body.” I didn’t understand why this body I so hated was so precious to her. I would lie awake at night thinking about physical transition. Despite looking in the bathroom mirror and telling myself I had a male body because I said I was male, I knew others wouldn’t see so clearly. For so many reasons, I wanted to fully transition. I wanted to get rid of the breasts and the organs I’d feared all my life. A third of my hypochondriac worries could be gone in a few operations. I wanted to use testosterone to shrink my thighs, to build my shoulders and arms. Big boned? No, I would be strong, as I had always been, but now it would be right. As a transgender man, everything that had always seemed wrong about me would finally be right.

My mother’s words:

I knew very little about transgender and seeing she had done research on the Internet, checking doctors and psychiatrists as well as interviews from those who had transitioned, I trusted her opinion. We also watched the Bruce Jenner interview and a few other shows about transgender issues. I became convinced this was the best for her. However, I believed firmly that the body should not be cut to conform, and I was not supportive about using hormones either. What would happen to her overall health? Even with the name change through the courts, I was concerned about the cost—let alone, her paying for medical changes.

I had travel plans coming up in several months, so I decided to work on transition without making any permanent changes until after my trip. This would give time to experiment and see if I was right or wrong about it all (and I am so thankful for this now.) I researched how to change my name, settling on a male one. I styled my hair to resemble those cool eccentric guys I’d always loved. For the first time since my early teens I let every hair on my body grow out, my big dark eyebrows, my legs, my armpits. I was thrilled at how many dark chin-hairs I had, that I had been plucking forever. One night I ended up staying up late looking at how to shape a goatee. What a difference that would make! I shaved my face because a “passing” guide said it would help me pass as male, with no “female peach fuzz” to be seen.

I bought a binder from a very friendly, helpful company run by “queer and trans people.” When I wore it in public, people called me “young man” – enough of a triumph to make me ignore the back pain it caused. I went to an air show and stood right up against the fence with the men with their cameras, asserting myself as having the right to be there because I was one of them, not some weird woman trying to worm her way in, as I had always felt before. It was so exciting to feel possibilities opening up before me like that. I spoke lower, spoke less. I pushed myself out physically. For some reason, I felt a little angry all the time.

Deep down, a part of me was grieving. A part of me felt I was betraying all I had ever really loved, all the wonderful lesbian characters I had written of and my faith in the invincibility of strong women. Deep down, I felt a part of me had given up, had surrendered. Maybe other women were invincible, but not me. I could only assure myself life would get better as a man; life could only get better when I wasn’t a woman at all.

In the midst of this, friends new and old supportively told me, “Whatever. We like you whatever.” I can’t express how much the word “whatever” stung. It sounds like such a sincere offer of unconditional love and support, but please understand: I did not want anyone to remain attached to any part of the person I had been. I had decided that person was a failure. Worthless. Something I hated deeply, something I was trying to escape. I didn’t want to hear “We like you whatever.” I wanted to hear “We love the new you!” I didn’t want unconditional acceptance of who I was. I wanted absolute celebration of what I was becoming. I wanted my new identity validated so badly it consumed my days and began affecting my health.

My mother’s words:

Try as she might, she never did look like a man, certainly not a man her age. She looked like a teenage boy, similar to her nephew, though when people called her “young man” I was supportive as it seemed to make her happy. I didn’t want people to be confused, so while in public, I had to be sure to support her and even say “my son.” I felt I was walking on eggshells, trying to give as much support and keep her as happy as possible because it was so stressful and she seemed so strained.

We no longer could talk openly and honestly without anger and emotion; I couldn’t say “You keep trying but you can’t totally look like a male. Why can’t you go back to being my daughter?” I did insist, however, that she be honest and present when friends visited – I would not let her hide in her room and become totally obsessed with this transition. I wanted her to know that even if she changed herself to a point, life would still be the same, with the same challenges and expectations. When people responded positively to her changes and new identity, I thought,wow, she really is accomplishing something, but I always woke up wondering what new thing would she be experimenting with today. I would go to bed wondering how everything would work out.

Looming before me was The Bathroom Issue. I was anxious about using a men’s bathroom, but increasingly afraid of being “caught” in the women’s bathroom. I had trouble sleeping, worrying how I would handle it all. My digestive system ran amok with the stress. I felt terrible, unfocused, distracted, unhappy. I played simple puzzle games for hours as my mind spun. How would I get the money for T and for surgeries? How would I bring this up to my doctor? Would T end up giving me cancer? Would I lose my hair? What would my brother think of me? Would I ever see my nephew and nieces again? How could I continue my work, so tied to my name and identity? How would any of this ever work out?

Time and time again I thought, stressed to my limit, “If it doesn’t work out, I may as well kill myself. There is nothing else. There is no alternative.” I felt trapped on a treadmill. Sometimes exhilarating – but I wondered how long I could run.

It happened that in the midst of this I volunteered to drive my mother and her friend to an opera three hours away. It was Mozart’s The Magic Flute. He had been one of my special cool guys growing up and I’d always wanted to see The Magic Flute, so I was happy to go along and do the driving. But the night before I found myself staring at the ceiling, wondering how I would use the bathroom. The venue, I knew, would be full of older conservative people. As this weird in-between thing, how could I use the bathroom? What would I look like to them? Could I ever just walk into a bathroom again? Would life ever be normal again? The ordeal before me – six months? a year? three years? five? – loomed in the darkness, full of impossible costs and fears.

In that frustrated and tearful moment, I wanted this transition to be over, but couldn’t see any possible end. I checked the time and the night had slipped away in sleepless worries. Feeling sick and so very tired I tossed and turned, desperate to get some sleep so I could drive safely, knowing I had six hours on the road ahead of me the next day. I would not be able to keep my eyes open. I could get us in a terrible accident.

Then it suddenly dawned on me: my quest for this new identity had become so overwhelming I was now putting other people’s lives in danger because of it. That thought struck me like an arrow. This was deeply unhealthy. This could not be right.

The push for validation and the self-absorbed mindset I had seen in some trans blogging and trans communities had always rubbed me the wrong way, but finally seeing it in myself was stunning and humiliating. This was not the kind of person I was, not the kind of person – male or female – I wanted to be. I wanted to be useful; I wanted to be happy. As I stepped back and looked at it objectively, not only was this fixation on transition potentially harmful to the people around me, it was also not helping me at all. It was obsessive, inescapable misery, as much as any bout of hypochondria or depressive cycle. Despite the flashes of hopeful possibility, at the end of the day it didn’t actually fix anything. It only made everything worse. If I had been self-conscious before, it was nothing compared to the constant struggle to assert myself as the opposite sex, both to others and to myself. And that constant self-involvement was destroying all the best parts of me.

I am so grateful I have had the life experience with my mental highs and lows that I was able to recognize the patterns as soon as I did. I had spent almost six months dedicated to this desperate hope that transition would solve all my problems – six months of trying to change everything from my name to my underwear – none of it easy, none of it comfortable. And then I woke up.

The next morning as I hurriedly ate breakfast, I told my mom to drop the male pronouns and just call me by my real name because there had to be another way. Somehow in that night of turmoil I had realized the transgender narrative would not solve my problems. It was just too difficult, too much, too illogical, too separated from material reality. I had no idea where to go from there, but I knew there had to be another way.

The opera was lovely, and though tiring, the drive turned out fine.

The next day I sat down at the computer and with great trepidation typed “transgender critical” in the search bar. I found Third Way Trans and my eyes were opened to some of the psychological issues behind gender confusion. I found 4th Wave Now and my eyes were opened to the societal issues, leading me to begin reading about radical feminism, which led me to deeper reading about lesbianism and the experiences of detransitioned women. Gleaning all of this information, so long unknown to me, was like waking up in a hospital after a horrible accident. Suddenly I was surrounded by voices that could explain how I had been hurt, why I had been hurt, and what was being done to repair the damage. These were no linguistic band-aids, no cosmetic cover-ups of old wounds. This was major surgery and strong medicine. It made me angry and it made me sad – there was so much about myself and the rest of the world I had to finally see and accept – but little by little, I began to heal.

My dis-identification from being female was healed by the knowledge that I was born female, down to my very chromosomes. No one – not even myself – can deny that natural fact or take away my right to be female. I was female when I was the kid with muddy knees, I was female when I was being mistaken for male, I was female when I was telling myself I had a male body. As a female human being, I can be useful and I can be happy without any confusion, without ever having to prove what I am. Those hated parts of my body? The bushy eyebrows, the fat thighs, the breadth of my shoulders and the sound of my voice: I learned that those, too, are all natural parts of the female human body. I am a perfectly good female human being. I can just be, residing in this body, and at last – at last – feel a real connection with other women, other female human beings, for the first time in my life.

My sense of shame and failure at being a woman was healed by the knowledge that the things I thought made a female a real woman – beauty standards, pornographic sexuality, submission to men – were not natural inclinations I was somehow missing, but rather forced upon all women by an oppressive society. Others have treated me the way they have only because I existed outside their frame of reference; I was something foreign to their idea of what a female human being should be. I can understand this myself, because it was my own limited ideas of what a woman should be that drove me to believe I was not one. Those views, however, only serve to reveal the narrowness of an individual perspective; they do nothing to actually invalidate who I am. The harsh judgment of “what a woman should be” is something I imagine all women, at least now and then, experience and endure in our society. Now I live with the constant hope to see all women free from those judgments, free to just be themselves, sweatshirts and jeans and all.

My rejection of my sexual orientation was finally healed by the knowledge passed down from mature lesbians – not lesbians depicted in the media or young women just beginning to experience their sexuality – but older lesbians embodying what a female-loving female actually is. All my life I have feared and repressed my attraction towards women because I had only ever learned what male attraction is, and as a lesbian, I wanted no part of it. The knowledge that lesbian attraction and sexuality exists distinct and separate from the male gaze – that lesbians are not like men – was revolutionary to me. At last I could open my heart, regardless of how I present myself or what clothes I wear. The only thing that has ever mattered was the sincere love I have always held for other female human beings.

My mother’s words:

What a relief when she said she would just be my daughter again, and when she shared with me the new information explaining how transition is not always the answer. When she spoke of what she had learned, I felt she was very sincere about it – there was no possibility left for her to change her mind. The information she brought me made so much more sense, I wondered why I hadn’t known about it before.

I still wonder why both sides of the transgender issue are not presented together. The material from trans-positive sources now sounds like propaganda in comparison. So much difficulty could be avoided if the right information were available to both young people and their parents.

 Our relationship is now better than ever. Going through the process over several months built a stronger trust and friendship, allowing us to be more honest about everything. I respect and love her as who she is, a gay woman with many talents and a wonderful human being. For the first time I believe she finally knows who she is, and has the confidence and independence to move forward in both her work and personal life. This has lifted a weight from my shoulders, as I had always worried about her, not knowing how to help. Now I know so much more about the issues and challenges she has faced and can even relate them to some of my own, so that we can properly support each other through them. Though she had to find all this out on her own, we really took the journey together and became better friends because of it. It was not easy, but thank heavens she discovered her true self.

Now, for the first time in my life, I feel like I have the right to exist just as I am. Yes, the words matter – embracing the words “female human being” and “lesbian” matter a great deal – but underneath those words is, at last, an understanding of the basic truths of human nature, that we are what we are and deserve to be loved and respected for that alone. It is only longstanding societal fears and ignorance that insist otherwise, and their effects are more subtly damaging to vulnerable individuals than we might often assume.

People tend to approach a person struggling with their gender identity with the words “I support you in whatever you need to do, even though I don’t understand,” as if gender confusion happens in a personal bubble. In the current cultural climate, it’s now seen as rude and harmful to even question a person who is considering transition – certainly no one ever questioned me. But I so wish they had. Nothing I experienced stemmed from some essential “feeling,” some innate discord between body and mind. All of it, as I’ve written about here, emerged from a lifetime of experiencing oppressive gender roles and confusing expectations, ignorance about what it meant to be a homosexual woman and both internal and external homophobia. It added up to the long-term reinforcement, in a very susceptible mind, of the idea that I was “wrong” in my body and my sex, and that led me to identify as transgender. Transition to male seemed to be the only fix for what I had deemed so unacceptable in a female. For the sake of so many others, I hope these root causes are further discussed and explored, so that transition is no longer viewed as the immediate answer to gender identity confusion. It is an act of compassion to ask “Why do you feel this way?” It is an act of compassion to ask, “Where do you hurt?” We may be surprised by how many of these pains we share.

For myself, I feel like I can finally start living as who and what I am, no longer obsessively worried about how I appear to others or what sort of strange being I might be. I am simply a female human being who loves other women. And it’s a consolation to know that the kid in her sweatshirt and muddy jeans was always okay just as she was. I just wish she had known all along.

To crush every doubt: Just pronouns and a name

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This is a guest post by commenter thissoftspace, a woman who experienced gender dysphoria, began transition to FTM, but pulled back to embrace herself as female.

This account is a bit different from the previous two in my ongoing series of guest posts from women who’ve experienced dysphoria or dis-identification from female. Woven into the narrative are vignettes from thissofstspace‘s mother, who shares her own thoughts and feelings about her daughter’s journey.

Parents and their offspring who decide to “transition” are sometimes ripped away from each other in the process–whether the transitioner is a child or an adult with the right to make her own medical decisions. Some online trans activists even encourage young, questioning people to forsake their “transphobic” families and seek community only with strangers on Internet forums. This account from thissoftspace and her mother is a testament to the bond that endures between us parents and our kids—no matter what decisions are made, or how well we understand each other at a given time.

I’ll be publishing her piece in two parts. Here, in Part I, thissoftspace takes us through her “gender nonconforming” childhood and on to identifying as an “asexual agender aromantic.” Part II will chronicle her decision to transition and begin testosterone–until an epiphany one night leads her to return to her original female self.

thissoftspace will be available to respond personally to questions and discussion in the comments section below.

Please also visit her on WordPress and Tumblr, both blogs entitled “Nurturing a Healthier Habitat for Female Human Beings.” And if you know any young women who struggle to identify as female, send them here for a boost of self love.

Part I: There and Back Again

by thissoftspace

I can only tell the story as I experienced it. I can only tell how I grew up, how I came to view myself through the lens of others, how that led me to identify as transgender, and how I found my way back to myself. I’ve been living with these issues for nearly four decades, though the height of my gender identity crisis happened within the past two years. My mother, with whom I share a home and a close friendship, has been along for the journey, and I’ll be including some of her thoughts.

There is no definitive path for any person who identifies as transgender for any length of time – there are too many variables involved – but I hope this account gives some perspective on the internal and external forces involved, what I was going through while I was identifying as trans, and the hope there is to find another way.

My mother’s words:

I did not wish to see my daughter change into a man. She was my child, a young lady whom I admired. Why did she have to be a man? Yet I did not wish to lose her. I was afraid of her emotions, worried about her stability as a person. I wanted her happy and to be able to be a person who could function in the world.

It began with my name.

My first and middle names are both old, traditional feminine names. Looked at objectively, they really are quite lovely together. My first name happens to be similar to that of an international personality, and when I was very young, I was often (and still am) called by her nickname. The problem was, when I looked at her on television, I saw the pinnacle of what a woman should be. She was blonde and blue-eyed, gentle, poised, elegant, gracious, always dressed to a T. Flawless. Beautiful. Every time I was called by her name I felt an uncomfortable dissonance. I was nothing like her. Why did people call me by her name?

I was a kid in jeans and a sweatshirt with an oft-uncombed pageboy haircut, knee-deep in the pond after polliwogs. I was hollering as I set off fireworks with my older brother and I was galloping around the fields like a horse. I was climbing trees, pulling night crawlers out of the soil on damp summer nights, playing with Erector Sets, Legos, Transformers, model airplanes. Growing up, I never imagined any difference between my brother and myself. I have no memory of being held back from any activity because I was a girl, though I’m sure there were occasions. If there was a reason he played football and I didn’t, I never thought about it. When he removed himself as my playmate in his teens I felt an immense loss, and never could fathom why he had left me.

I didn’t think much about being a boy or a girl. I was what I was. My concept of what it meant to be female was fuzzy and confused from a young age, my default always leaning towards male. The only stuffed animal in my massive pile of furry friends that I called “she” was a dog that had puppies zipped into her tummy. Back then I couldn’t yet argue with biology. All of my other stuffed animals were male, to the point of cutting the “feminine” eyelashes off a toucan with scissors.

Away from home, I crashed into femininity in church and at school. I hated the tights and the dresses and the shoes I had to wear for church, always so itchy and restrictive and uncomfortable – and I was so terrified of spilling my Sunday School juice on them. On my first day of kindergarten, my grandmother had to drag me out from under her kitchen table and carry me onto the bus.

I was lost at school from the beginning. I had no idea how to relate to the other girls, watching them skeptically in their dresses and skirts with little colorful clips in their long hair, playing clapping rhyming games I’d never heard. I felt like a visitor from another planet and just kept trying to do my usual things. I got in trouble for taking a group of kids back to the stream that ran behind the playground and for keeping a grasshopper in my desk. Though I tried, I never seemed to have more than one real friend at a time. I remember going to a girl’s birthday party and being so overwhelmed and feeling so out of place I had My Very First Panic Attack and threw up. Social anxiety starts young.

The sense of otherness slipped into more than just social roles. When we would line up to be weighed for our yearly physicals, I always seemed bigger and heavier than the girls around me, though I was fit. I remember turning to the nurse, feeling self-conscious, and saying “I have big bones.” My body wasn’t even like their bodies. They were so small and delicate. I was… something else, broad-shouldered with big hands and big feet. I came in for picture day in 4th grade after being out sick, wearing jeans and a sweatshirt. The teacher asked me, “Are you sure you don’t want to have it done on the rain date?” I said no, I was fine as I was. In the picture, I look like one of the boys. It’s one of my favorite pictures from elementary school. I was comfortable, a big smile on my face. I was me.

 

My mother’s words:

My daughter was a bright-eyed, inquisitive, joyous little girl. I was confused as to why she didn’t like dolls, as I had loved them when I was a child. However, she did have many other interests and toys, including many beloved stuffed animals. When she began coming home from school early due to stomach pains, and when she was sick at a little girl’s birthday party, I did have my concerns. Her first grade teacher debated whether she should be placed in the gifted program due to her intelligence and creativity, or tested for learning disabilities due to her distraction and lack of involvement at school. I worried about her dislike of school, as I had always loved school myself, but she always succeeded in her classes. She remained happy on her own and when playing with her brother or a few special friends.

Then one night while lying in bed I felt something funny in my chest – a little bump right under my nipple. Nancy Reagan had been on TV talking about breast cancer, and I was filled with fear. Absolute terror. Something was very wrong with me. My mom took me to see the school nurse, who examined me and said it was perfectly normal. I was just developing, going through puberty. I was becoming a woman. I thought of Nancy Reagan and breast cancer and did not want to become that. I was terrified.

I never have lost the sense of something being physically wrong with me. Hypochondria has been with me for as long as I can remember. Worries about breast cancer still float through my mind almost every day.

With puberty came the further separation between girls and boys, and consequently between the girls and me. Girls spoke of liking boys and I didn’t understand what they were talking about. In the girl’s lavatory one day while a group of us were gossiping, my best friend at the time said to me, “What, are you gay?” No no, I quickly retorted. No, I just didn’t like that guy you were talking about.

But… I liked Mozart. I liked Edward Scissorhands. I liked the Phantom of the Opera. As my friends found their feminine identities and began wearing skirts and makeup and dating boys, I came to identify with a collection of eccentric male characters, so often misfits and underdogs who loved the girl but were denied her affections. I could relate to them. When I began writing stories, the first-person voice was of a 14-year-old boy. His presence as I grew older served a dual purpose: through him I could have some sense of freely expressing myself, and due to my preoccupation with this male character, no one would assume I was gay.

Of course I didn’t realize any of this at the time, all of these subtle coping mechanisms. Being a lesbian wasn’t an option for me. I had no reference for it; I didn’t know of any lesbians in my community. Sometimes kids would snicker and point at a gym teacher, but no one mentioned homosexuality openly. The homogeneity of the surrounding population was overwhelmingly white, straight, middle-class, and religious – nothing else was spoken of in anything but hushed whispers. I knew nothing other.

I watched Ellen Degeneres come out on her sitcom and lose her show. For some reason it made me incredibly angry, but I didn’t know why. I listened to Melissa Etheridge and thought she was awesome, but wouldn’t think about how she was singing the songs I loved to women. I got my hands on a copy of Rita Mae Brown’s Rubyfruit Jungle when my brother’s girlfriend was reading it for a college class. I read it in a few days, enthralled. But I never could make the leap to applying any of it to me.

 

My mother’s words:

Having been a 6th grade teacher, I had often picked up on little girls beginning to like little boys and vice versa. My daughter did not seem interested at all. When boys would express an interest, I would wonder, “He’s such a nice boy, why doesn’t she like him?” I wondered if she did not know what getting kissed, dating, etc. was all about. I worried about her appearance, looking square and boxy in large men’s shirts, and tried to encourage her to choose dressier clothes she liked and felt comfortable in. She had to wear dresses or skirts for band and orchestra concerts, and I thought she looked beautiful, but she clearly preferred the pantsuit we bought for her senior picture. In high school she had a number of friends from the marching band and gifted program, and I thought these were the intelligent, creative people she needed for her friends, which provided a supportive group for her. When others wondered why she was not dating, I spoke honestly that she was more involved with her interests and hobbies – writing, drawing, and art – than boys, and that was fine with me as long as she was happy. I was concerned, however, if she would be able to handle life away from home, as she spent so much time alone with her creative pursuits.

At college, I avoided male attention like the plague, which wasn’t difficult since my “masculine” dress and lack of interest served as a kind of ward against their gaze, as it probably had been – possibly intentionally – for a long time. I couldn’t help but be envious of all the other girls, though, and how effortlessly groups of students, male and female, came together so naturally. There were girls I desperately wanted to get to know but didn’t dare approach; after all, I didn’t want to be misconstrued as gay. My best friend at the time seemed to assimilate without much difficulty, and gradually abandoned our regular hangouts to go on dates with men and out for drinks with women with whom she related better. We eventually fell out; she would be the last close friend I would have for a long time.

I dropped out of college after two years, never fitting in, never getting a foothold on figuring out what I wanted to pursue. I had become painfully self-conscious about how I looked and presented myself. I dressed “too masculine” in flannels and jeans, yet I loathed my wide hips and big thighs. I began a continuous cycle of exercising and dieting trying to get rid of the natural fat on my legs, even though I was never overweight according to the scale. I felt caught in a place between what looked like “male” and what was supposed to be “female.” I plucked my naturally full, dark eyebrows almost out of existence, because looking “male” was so wrong though I disliked looking “female” as well. Even my voice seemed too low for a woman’s, but I hated the thought I might sound like a man.

Anxiety followed hypochondria followed panic attacks followed depression. I got a diagnosis of panic disorder and some pills but no one ever offered therapy. I wonder now if that wasn’t a blessing, if it wouldn’t have put me on the path to identifying as trans at a much sooner and more vulnerable time. Instead of therapy, I ended up on the Internet.

Thank goodness for the Internet in so many ways, because it finally gave me a community outside of the conservative pocket in which I lived. I found others who loved writing, drawing, building things, creativity, video games. I found stories that introduced me to women who loved women in a way I could finally grasp, and at last – at 30! – I was able to accept and explore the idea for myself. Coming out as gay was like a new life blossoming. Though I still had to deal with the conservatism of my family and surrounding environment, I could at least drop the pretense of being straight and explore parts of myself I’d repressed for a very long time. My mother was supportive. I was open with my new friends. I wrote stories about lesbian characters and drew their portraits and it was wonderful.

My mother’s words:

When my daughter told me she was gay, I was relieved and happy, as before that time she had often seemed angry and withdrawn. Once she opened up about it I knew I could support her in whatever she was working through, and I let her know I would welcome any female partner she brought into our lives and our home. Of course, I had some fears and preferred to keep quiet about the subject. I did not want anyone to attack our way of life, including her brother due to his religious beliefs. I have always liked and admired the gay people I have met in my life, but I have also been aware of how people have attacked them due to their difference. I did not want to see her hurt in any way. These were my worries as her parent, and I understand now how my concerns might have been frightening or stifling to her at the time.

Yet I could not find a foothold in the gay community, a role model or identity to connect with. I looked online, joined this forum and that, talked to people, read articles. I was turned off first by the overt sexuality I saw everywhere, the importance placed on physical attractiveness, just like the mainstream media. But worse, I could not find myself among the plethora of gay faces. The butch/femme divide looked too much like straight gender roles to me. I was not a lesbian in makeup and a dress, after all; neither was I the picture of butchness with a buzzcut and men’s button-down shirts. Frightened by those apparent “gender roles” looming in front of me, I shrank away from a lesbian identity. There was too much I couldn’t come to terms with, not only in the homophobia in the world around me, but also in the sense that I wasn’t butch enough or femme enough – not man enough or woman enough (and definitely not “sexy” enough) in my mind. It was the same struggle I’d always had, and in retrospect a terrible misunderstanding of what it means to be a lesbian.

Then, a few years ago, I got the flu. While I was lying on the couch recovering, I was watching one of my favorite TV shows, featuring one of those slightly eccentric men I had always idolized. Maybe it was the haze of the flu, being tired, being stressed, being unhappy, but I looked at him and I thought, “Maybe I should try to be him. Maybe that’s the answer. Maybe I should grow my hair out and wear paisley shirts and just be him, and maybe then everything would get better.” It was that simple, that sincere. I had run out of solutions to try to fix my conundrum of not fitting in until this one last possibility occurred to me: Maybe I was transgender. Maybe I never should have been a woman at all. Maybe I was supposed to be a man.

I dipped my toes in a little at a time, reading, watching, learning from the Internet. I was both filled with hope and terrified. I made no big moves. I got together with some of my online friends but told them nothing of what was lurking in the back of my mind. But in the back of my mind, I felt so very different from them, more than ever before. Because now it was a big deal. Now they were “cis,” and I was “trans.” Now I was on a journey none of them could understand. It was especially alienating being with my female friends, some of the best friends I have ever had. It was heartbreaking to sit beside them and think, “You don’t know it yet, but I’m really nothing like you.” I felt sure all of my friendships were soon to come to an end.

So I withdrew to explore the idea of being transgender and figure out how to rebuild myself from scratch. It was a good time for it; my previous online community had dissolved and my work was in flux, leaving me socially isolated much of the time. Exploring all these little things that made me different filled the gaps. I ended up on the AVEN forum – the Asexual Visibility and Education Network community – because I had never had an intimate relationship. That’s where I was introduced to the plethora of labels. Within a week I had discovered I was an agender aromantic asexual. There were so many like me! It was wonderful. A vast community of people coming together to celebrate labels without ever really wondering why they needed them.

All I can say about this crucial turn is this: When I felt like I could no longer be identified by others – whether due to social isolation, mental illness, trauma, sexual orientation, lack of gender role conformation or a combination of all these things – I became desperate for some way to identify, to validate my unique existence. I felt unidentifiable, and the current “queer theory” offered identification and validation. There are so many labels to choose from. From the moment I picked up “agender” I severed myself from identifying as female, and all of the confusion and embarrassment that came with being female began to evaporate. It was easy then to try on new pronouns and names; with the backing of so many others who also identified as agender, I no longer felt afraid to try it myself. Remarkably, when I announced to my mother and my friends I needed to be called by another name and gender-neutral pronouns, they were more supportive than I ever imagined.

My mother’s words:

When she came to me with the different name and pronouns, I was skeptical, but I also wondered if this was the final answer. Had she had finally worked out what had been holding her back for so long? The names she experimented with were never fully male names, and with the gender-neutral terms and her physical body, I was relieved she was keeping a little part of her femaleness and not going 100% male. I could support the name, the clothes, the haircut, as she never did seem to be trying to be just like a man, though I felt I had to handle all of this with kid gloves. All the information she gave me was so positive, but her enthusiasm did not seem entirely natural to me, and I wondered what exactly she was doing. As her mother, it did not seem quite right, but what did I know?

It seems like such a small thing, just a handful of words, just pronouns and a name. But those words, when spoken by others, validate every belief and crush every doubt. Those words were a statement of who I wanted to be. And when you have never been able to be yourself, finally having an identity recognized by others is the most precious thing.

But everything after that becomes an effort to support and maintain that identity.

 

(continued in Part II)

 

Activist-clinicians tout “cultural humility” & surgery-on-demand for “nonbinaries” & “genderfluids”

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Update Dec. 31, 2015: Please see here for instructions on how to submit comments to the World Health Organization (WHO) on their proposed new diagnosis code “Gender Incongruence” and “Gender Incongruence of Childhood.” The public comment period will end soon, so time is of the essence.

A funny thing happened to me recently as I was trudging down yet another Got-Dysphoria?-Must-Transition-or Die rabbit hole.

I came to the realization that those of us who are wringing our hands over the rush to diagnose dysphoric children as trans are way, way behind the curve. That battle has mostly been won (and not in our favor).

Trans activists and “gender specialists” have moved on. Now, they are advocating for fully “depathologizing” transgender, yet at the same time, normalizing the idea that even part-time demiboys, “gender fluids,” and other assorted “nonbinaries,” aka “NBs” (the catchall term for anyone who doesn’t fall neatly into the trans man or trans woman box) deserve hormones and surgeries on demand— fully paid for by insurers.

It’s a neat trick they’re trying to accomplish: convince the public that being on the “trans spectrum” is normal, just like being gay or lesbian. Yet, paradoxically, extreme treatment is still medically necessary for some. How does that work?

As they have been all along, trans activists are riding the gay and lesbian liberation movement coattails to further their agenda. Once classified as a psychiatric disorder, homosexuality is now considered normal; it was removed from the DSM (the Diagnostic & Statistical Manual of Mental Disorders) in 1973. In other words, being gay or lesbian has long been depathologized—in my view, a very good thing.

Now trans activists are pushing for the same thing for transgender. In the DSM-IV, “gender identity disorder” (GID) was the label for what ailed a person who wasn’t happy with their biological sex. That was replaced by  gender dysphoria in the DSM-V. No longer a “disorder,” it was the name for the feeling of discomfort or distress with one’s sex.

The next step?  Activists and gender specialists (I’m starting not to see a lot of difference between the two) want to get rid of the idea of distress or dysphoria as a prerequisite for “transition.” The new term they’re after is “gender incongruence:” a mismatch between one’s idea of gender and one’s actual biological sex. The talk amongst activists and clinicians is that there is no disorder, dysphoria, or distress of any kind necessary to obtain services. “Gender incongruence” is a normal variation in human experience.  But you still need some code to be in the DSM, because–reimbursement. You know, billing.

Funny: When homosexuality was depathologized, the need for billing and treatment for that former “disorder” disappeared entirely.

(Note: The screen capture below was taken from a 9/24/15 post on the WPATH page which, oddly, has since been removed. )

wpath gender incongruence

But wait: How can something that is normal still require treatment? Major, possibly lifelong, medical procedures and drugs?

Let’s hear from one activist-clinician who can explain this a whole lot better than I can. Because it turns out, in certain places, this depathologized-yet-highly-medicalized normal variation is already being implemented as a matter of policy, and fully paid for by the taxpayer. And not only that: you don’t even have to have full time “incongruence” to get your breasts or penis lopped off, on demand. You get it just because you say you need it. And if your gender clinic operates under the increasingly common “informed consent” model,  no psychologist or psychiatrist is going to stand in your way. You, and only you, will have the right to diagnose yourself as needing the wallet-busting fully funded services of plastic surgeons and endocrinologists.

Dan Karasic, MD, is a psychiatrist affiliated with the San Francisco Center for Excellence in Transgender Health. He also is a key player in WPATH and one of several activists and clinicians crafting revisions to the DSM and the WPATH Standards of Care (SOC).

Karasic is quite active on the WPATH public Facebook page, frequently advocating for depathologization and greater access to surgery and hormones for those on the “gender spectrum.” [Please note: The WPATH Facebook page is viewable by the public, so all the information revealed in the screenshots below, as of this writing, is a click away.]

As Dr. Karasic says here, the San Francisco Department of Public Health will fully fund surgeries for even “nonbinary” folks:

WPATH Karasic cultural humilty and SFDPH cropped

Lest any wayward clinician have questions about the wisdom of all this, doubts are no longer acceptable. Acceptance and understanding are not enough in San Francisco. One must have humility. And that extends to “nonbinaries.” Only they/them know. They/them get to decide. Not you, with your outmoded and quaint “clinical judgment.” (Question: If you’re nonbinary, what would you be transitioning to? Oops, sorry. Humility lapse here.)

There are several members on the WPATH Facebook page who agree that any skeptical doctors (such as, evidently, some at San Francisco General Hospital–SFGH) need to be brought firmly into line, and that nonbinaries should get their top surgery too. 

WPATH top surgery for non binaries

Are nonbinaries only receiving surgeries and hormones in cutting-edge San Francisco? Apparently not. In March of this year, WBUR Boston touted reported on medical treatments for nonbinaries on the US East Coast in Not Male Or Female: Molding Bodies To Fit A Genderfluid Identity. 

Jones is part of a growing group of young adults who are genderfluid and are using hormone therapy and surgery to create bodies that matches this identity.

“It’s molding my body to fit my mind, physically changing myself so that I feel more comfortable as a person,” said Dale Jackson, a 33-year-old author who lives in Atlanta. Jackson takes a low dose of testosterone for two reasons. First, because he’s worried that a full dose would exacerbate his anxiety. And second, because a half dose helps him moderate the effects.

“I like the idea of being in the middle,” Jackson said. “This allows me to explore my masculine side, but I don’t want to push it too far.” Jackson does not want a big bushy beard or arms so hairy “that gorillas were looking at me like, is that our cousin?”

Comfort, exploration, wants, not wants–what’s not to like? And it’s certainly important to calibrate the testosterone dosage so as not to increase pre-existing anxiety.

Both Jones and Jackson are under the care of physicians who are helping them pursue a more gender neutral body. But there are no guidelines. So far, in the emerging world of transgender medicine, protocols assume that patients want to end up on one end of the spectrum or the other, male or female, says Dr. Tim Cavanaugh, who runs the transgender health program at Fenway Health.

An estimated 100 to 150 of Fenways Health’s 1,500 transgender patients are genderfluid. Most of the genderfluid patients are transitioning from female towards male. So how do doctors know how much testosterone will produce the effects these patients are looking for?

“To a certain extent we’re making it up, but I’d like to think of it more as finessing the regimens that we have based on the individual person’s desires and needs,” Cavanaugh said.

Ten percent of your caseload is “genderfluids” who are trying to “mold” their bodies to be more “gender neutral.” And most of them are female. (Wouldn’t a paragraph asking why that is be of value here? Silly me. That’s old school journalism.)

“There are no guidelines”—yet. And if you’re genderfluid, you are transitioning “towards” the opposite sex (even though, presumably, if you’re “fluid” you’re already somewhere in between, but the logic of gender identity is not…logical).

…some genderfluid patients say they cannot find peace without medical intervention.

“I had an incredible amount of dysphoria around my chest, it was consuming. I got to the point where in order for me to thrive and to do the work I wanted to be able to do and just live my life, I needed to have surgery,” said Taan Shapiro, a 33-year-old a teacher and parent in Boston who had surgery to create a flatter, more masculine looking chest.

Shapiro, who uses the pronouns they and them, says some strangers assume they are a teenage boy, others that Shapiro is female. Shapiro is not planning any more surgery or hormone therapy.

“Where I am is where I’m at and I feel good about myself,” Shapiro said, “[in a place] somewhere between male and female.”

This sounds an awful lot like elective surgery. People get procedures like breast augmentation, liposuction, face lifts, tummy tucks, to “feel more comfortable.” Someone might even say they need a taxpayer-funded nose job to “thrive” and just “live their life.” That the “incredible amount of dysphoria” they experience because of their big nose is all consuming. (Likely the late Michael Jackson would have agreed.)

To be fair, Dr. Cavanaugh does voice a few words of doubt about all that money he’s making the wisdom of medical treatment for nonbinaries:

If gender is a product of social construction, then using medicine to fix every patient’s discomfort may not be the best long term solution, Cavanaugh says.

“I hope we are headed to a place where we recognize that gender is not one thing or the other, not male or female, and that culturally we can become more comfortable with that idea,” Cavanaugh said. “Hormones and surgery are always going to be options for people, but I really hope that we won’t feel compelled to use them as much as we do now.”

Hm. I wonder what other means there might be to address people’s discomfort with a socially constructed gender identity?

The WBUR article was discussed on the WPATH Facebook page, and some members were not pleased with this meek bit of dissension in the ranks: the medical model is the way to go!

WPATH nonbinaries surgery critique wbur

So there you have it.  It’s “super problematic” for Dr. Cavanaugh to suggest that some “nonbinaries” (i.e, people without rigid gender-stereotyped personalities) aren’t going to be served by the “medical model.”

How will activist-clinicians continue to walk the delicate line between normalization/depathologizing the “trans spectrum” while still hoodwinking encouraging the taxpayer to pay for expensive plastic surgeries and long-term hormone treatment? Stay tuned!

For now, there’s lots more to read in this thread on the WPATH Facebook page. Rest assured that the activist-clinicians are hard at work to make sure insurers are on board with any and all treatment, on demand, for transmasculine, transfeminine, genderfluid, and nonbinary folks. After all, gold-plated body modification is not just for the garden variety, binary transgender man or woman. That is so 2013.

But sarcasm aside (for now), if these activists and clinicians are really serious about depathologizing? Here’s what they’d do:

Celebrate gender nonconformity. Teach people to respect and take care of their bodies, just as they are.  Work to build self esteem in teens, and mentor them to know that their bodies, the product of millions of years of evolution, are good and whole, and that there is no need to cut or drug themselves to be “comfortable” or to fit anyone’s idea of male or female. Develop therapies that help people realize their bodies and brains are not two disconnected units, but indivisible, complete,  and right. Encourage kids to dress, think, and pursue interests as they like. Celebrate uniqueness and diversity in men and women.

I realize my prescription for truly depathologizing gender nonconformity might put a few people out of work. But our kids are worth it. Aren’t they?