Self harm & the need for more possibilities for “gender variant” kids

Posted on December 24, 2015 by 4thwavenow

Holidays can be rough for people who are experiencing family discord–or worse, total estrangement from loved ones. A time like Christmas is also particularly hard on those who are depressed or suicidal for any reason. You’re supposed to feel merry and festive, and the discrepancy between the holiday cheer surrounding you and your own feelings of despair can make that misery stand out in relief.

Joel Nowak, who describes himself as a retransitioned man and social work graduate student, authors the blog Retransition. Today, Joel posted a really important letter he received from a reader named Juniper, who talks about the great need that “gender variant” young people have for options and positive role models apart from medical transition.

Juniper shares thoughts similar to my own regarding suicide risk amongst gender nonconforming young people: Maybe some of the increased risk is not necessarily because these kids are prevented from “transitioning” medically for some reason, but more because they feel it is imperative that they do transition, or risk being consigned to a miserable life. As Juniper explains, these teens perhaps feel trapped by the transition-or-die message that surrounds them:

A young person who is gender-variant may feel that they have few options but to pursue transition or to live inauthentically. People overwhelmingly hear in the media that surgeries and hormones are absolutely necessary for people who are transgender to live meaningful and happy lives.

There is no representation in the media for people who live quite well and enjoy balanced and well-adjusted lives yet radically defy gender stereotypes.

Our story is not told. People like you and I are virtually invisible.

So, what happens to the kid who is questioning their gender? They look into their options and literally see a DEAD END. No matter what they do, no matter how far they go with surgeries and hormones, they cannot change their DNA or their root socialization. How can they be sure that society will change their perception of them? Can they be sure that they will “pass?” Can they be sure that the secret of their sex at birth will ever be exposed?

They hear that it will be difficult to find a life-partner, that the surgeries are prohibitively expensive and that they will never be 100% like other men and/or women. They learn that surgeries and hormones can only do so much.For instance, if they are FtM, it is unlikely that they will ever have a successful “bottom surgery” even after paying $100,000. And if you are 5’1 as a woman … guess what … you will be 5’1 as a man.

They hear from the media that their future is bleak. This is a lot of stress for a young person to handle. They seek support in the transgender community and there is no Transgender “Pride” parade but rather a Trans Day of Remembrance to remind them that suicide and murder are very real outcomes in their community and that they are disproportionately at risk.

Earlier this year, there was a cluster of suicides of trans-identified San Diego teenagers. At least two of them were seen as leaders in the LGBTQ community, and family, teachers, and friends supported them in their transition.

What went wrong? I wrote about this on Tumblr in October:

The fact that their parents and other adults were supportive and helping them along the road to transition should have made them feel better, if transition were the answer to the horrible depression and self harm these kids were obviously experiencing. Being “gender nonconforming” in this day and age is also really stressful. Gay and lesbian kids who aren’t interested in transition are also bullied and some have parents who are not supportive of them stepping outside gender stereotypes.

Suicide contagion is a real, known phenomenon. The press should not be advertising these suicides the way it has been. The fact that several of these kids have stepped into heavy traffic as a way to die also indicates a “copycat” aspect. And FOUR of them in the same city? Someone should be looking into the reasons for this cluster.

I have also long felt that some of the trans-identified kids who are socially transitioning, with an eye towards medical transition, could be made even more depressed when they think their only option is painful, lifelong medical treatments. That they can’t be accepted as the unique and unusual people they are, without having to constantly worry about how they are perceived by others. We are not looking at the full picture with these kids. The assumption that assuming a trans identity is somehow the solution to this terrible problem of teen suicidality is so overly simplified. And the pressure so many kids feel now to claim a certain identity vs. just being themselves with no “identity” required has to add to the despair.

Also this year, the first trans-male high school homecoming king Blake Brockington jumped off a bridge in Charlotte, NC. Like some of the San Diego teens, Blake was a well respected leader in the Charlotte, NC LGBTQ community. And in September of this year, another 16-year-old LGBTQ community leader, Skylar Lee of Madison, WI, took their own life. Skylar had earlier spoken about claiming, then rejecting, a series of gender identities, shifting every two weeks, before “discovering” s/he was trans.

Again, from Juniper in today’s post on Retransition:

No wonder young “transgender” people commit suicide. They are trying to find themselves and figure things out and when they seek help they are told that they have no option but to change themselves if they want to be loved. No one tells them that they are perfect just as they are. No one tells them that there are many ways to live. No one says “Hey, I made it … I am happily married, I have a good life … it will get better … I was a lot like you in High School and I am glad that I kept my body as it is and/or that I learned to love myself for who I am.”

Many people who are diagnosed as transgender may not be aware that there are lots of ways to live outside of the gender lines. More perspectives need to be shared so that young people can decide for themselves what what resonates, and feels right for them.

How else can we reduce the risk? One reader on Tumblr offered some simple but powerful advice that seems to me compassionate and practical–no matter what your position may be on the wisdom of “transition” or a transgender identity:

The real way to reduce the rate of suicide among transgender teens:

1. Stop telling people that they have to hurry up and transition or they’ll regret it for the rest of their life. They can transition later and have a happy life.

2. Stop glamorizing transgender teens who commit suicide.

3. Encourage them to get good therapy for their problems and think carefully about whether or not they should transition.

4. Encourage them to stay connected to their family, even if their family is skeptical.

I hope everyone reading this can find a way to connect or reconnect with loved ones and family during the coming week–even if it’s just a text message, a Facebook “like,” a quick phone call, or an unexpected hug. I have to believe that most families that may be under stress right now because of something to do with a loved one’s identity or transition status still have some reservoir of good will to tap…even if only a few drops to quench the thirst we all have for mutual understanding and support.

Internalized homophobia & teen dysphoria: More reader comments

Posted on December 23, 2015 by 4thwavenow

This week, I’ve been featuring comments submitted to this blog. Today, there are two selections: a commenter asking what the solution is (if not transition) for a female who is sexually attracted to other females, but cannot tolerate the idea of being a woman herself; and a 15-year-old who identifies as trans male. This teen feels angered by what I and others write here, believing we don’t understand.

First, from Dagis:

What if the sexual preference for a natal female is for a female, but only if the natal female were male? That is, what if the natal female does not self-identify as lesbian, could not conceive of being a female having an intimate sexual relationship with a female, but desires an intimate sexual relationship with a female as a male? I’ve yet to see this addressed by critics of “transition,” and yet I have seen this expressed by those considering FtM transition. Perhaps this is generally dismissed as “oh this person is just a ‘closet lesbian/gay,’ and therefore it’s not actually examined. But if it is a real issue for someone who identifies in anyway as having difficulty with their birth assigned sex, and such a person does indeed express desire for intimate sexual relationship (not homosexual), then what is a compassionate and logically sound response to such a person?

“I am attracted to women but I’m actually not a lesbian, I’m a straight man.” This assertion is a key part of nearly every transition account I’ve seen–including from women like Aydian Dowling, who lived happily as a lesbian before deciding she was a man. (I always wonder why the prior lesbian life is presented as somehow less real than the subsequent life as a heterosexual man).

Trans-identified natal females stringently deny that their desire to convert to heterosexual males is in the least motivated by internalized homophobia. But why else, then, would a woman be unable to “conceive of being a female having an intimate sexual relationship with a female”?

The accounts of female-to-male transitioners often revolve around a feeling of disgust for one’s own female body. Transition vloggers are careful not to use anatomically accurate words that might “trigger” their viewers; euphemisms like “down there” and “junk” are substituted for the rejected body parts. But clearly, for these women who desire to be heterosexual men, it’s not a generalized revulsion for female bodies; they want to be intimate with other women. Yet dis-identifying with and speaking disparagingly about one’s own female body, and taking comfort in the thought that they can be transformed, via hormones and surgery, into straight men–how is that not, at base, a form of internalized homophobia?

As I’ve said many times, I have no difficulty acknowledging that some trans-identified people do feel intense dysphoria or dissociation from their bodies. That is an experience, and as such, it is subjectively real. What right would I have to deny the feelings and thoughts of another person?

So as Dagis asks, what’s the compassionate and “logically sound” response (apart from simply agreeing that transition is the answer) to same-sex attracted women who are adamant that they cannot stand the thought of being sexually involved with someone of their own sex? I hate to say it, but I suspect most of them are just going to cover their ears if all they hear is feminist analysis.

Next, there is this comment from Kenneth, a 15-year-old who identifies as trans male.

This blog absolutely has pissed me off. To the people who have been saying that this whole Transgender thing is wrong and that people who identify as trans are only going through a phase, you have no idea about it. There are are thirty year olds who have identified as trans since they were old enough to understand that the gender of the their body did not match the one inside their head. I have identified myself as male before I barely knew what Internet was, I’d like to see you calling me ‘brainwashed’ by the internet. But at the age of twelve I was mildly obsessed over YouTube, I enjoyed watching YouTubers such as Smosh and Annoying Orange and etc. but I soon found a YouTuber that goes by the name of Alex Bertie, who has been identifying as male since he was fourteen; as of now he is 21 and personally goes and makes his appointments for his gender needs and hasn’t once had any doubts his doings.

I’m currently fifteen, I do identify as male regardless of what my body is. Could I possibly change my mind in a couple years or even months? Possibly, I’m not going to say it’s impossible but you sure as hell aren’t going to find me doing it right now; wearing girls clothes or mildly looking like a girl? No, that sounds like absolute hell and feel sorry for the children who have to go through that now. Normally children go back to their birth gender because society says that what they’re doing is wrong, some children even commit suicide because of this horrible issue. It isn’t wrong. I’d like to see your reaction if you were somehow ‘magically’ put into a male/female body but were born male/female. Would you like that? Would you try your hardest to become the gender you know yourself as?

Children also do not wish to tell their parent they are trans because the fact they feel like they’re going to be rejected. Many children of the LGBT+ community are thrown into the streets or are still allowed at home but are abused because of this ‘issue’.

I don’t doubt that Kenneth decided s/he was stereotypically male as a child, before being exposed to the Internet–although Kenneth’s subsequent experiences watching other trans-identified people (like Alex, one of the many “YouTube famous” transitioners) had an impact in cementing that identity, no doubt.

But notice what Kenneth defines as being female: to “wear girls’ clothes or mildly look like a girl.” Because what is it to be a 15-year-old girl, apart from clothes and looks and–what? Which video games you prefer? What does “girl” even mean to a teen like Kenneth?

I have never once heard an adult trans-identified person actually answer the question: What is a man? What is a woman? apart from saying “it’s whatever I feel I am.” And I sure don’t expect a teen trans-identified person to be able to respond with any more clarity. But Kenneth: Are your feelings of being the opposite sex rooted in your preferences for the activities and appearances of the boys you’ve been around? What exactly is wrong with being a “gender nonconforming” girl?

Maybe this is what’s wrong: Kenneth brings up being rejected by parents. There is no doubt that “gender nonconforming” kids are more at risk for self harm, and that some do actually kill themselves due to, as Kenneth rightly calls it, this “horrible issue.” One of the risk factors for poor self esteem in LGBT teens is lack of family support, but how much of that is down to the pressure to conform to rigid gender stereotypes and norms?

Kenneth, parents like me aren’t rejecting our kids. We want to support them in expanding what it means to be a girl (or boy). In fact, we actually see medical transition as another, potentially very serious form of self harm–even self hate. And transition does not appear to be a magic long-term solution for many young people; witness the rash of teen suicides in 2015, several of whom were fully supported in their transition by family, teachers, and friends.

Kenneth presents this challenge:

I’d like to see your reaction if you were somehow ‘magically’ put into a male/female body but were born male/female. Would you like that? Would you try your hardest to become the gender you know yourself as?

What Kenneth is saying is: I hate this body. I want out of it. If you hated your body as much as I hate mine, wouldn’t you do everything in your power to escape its prison?

Kenneth, I don’t know what it’s like to feel extreme dysphoria; to want to drastically alter my body, even if it means a lifetime of surgeries and doctor’s appointments. I have fantasized, on more than one occasion, about being a man–down to every anatomical detail. I can even say that I’ve mightily wished I were a man at certain times in my life. But it has not caused me the misery you are talking about here. There are quite a few women who have been there, though, like this one. And there are several more in my blogroll (linked on the right side of the page) who have been down the same path you’re on–but returned home to realizing themselves as female.

I don’t doubt your pain, and your determination to do something to relieve that pain. Nor do I doubt that you sincerely believe your mind knows better than your body; that you think your body is alien and wrong.

But I don’t believe the intense desire to be something you are not means you are actually male.

I wish there were more therapists and caring adults who could support teens in exploring options apart from “transgender.” Breaking out of gender stereotypes is a good thing, a brave thing for a teen to do. But where are the non-trans-identified role models for these young people? Where are the YouTube stars who have chosen not to transition? Wouldn’t it be great to see a series of vlogs that aren’t “one year on “T,” but “one year in my journey to reclaim myself as a strong and independent girl?”

Chest tumors and rape gashes: Do trans activists realize they enable this kind of misogyny and self hatred?

Posted on December 20, 2015 by 4thwavenow

This is a comment submitted to my blog this morning on my post discussing my daughter’s desistance from her prior trans identification:

I’m forty. I came out to my parents at nineteen, from an Ivy League school. They took the same hard line you did. Now I’m a happy guy, on T, having shoveled off those gross chest tumors and gotten rid of the disgusting babymaking internals. The rape gash is no more; I happily penetrate my feminine, gay-leaning bi boyfriend of seven years with the genital I should have had at birth. And my parents? I haven’t spoken to them in years, and I couldn’t care less. Do you want your kid to feel like me? All because you want them to accept something that makes them miserable? If you really are a radfem, you should accept reality: celebrating female biology is like celebrating cancer. Read Firestone and Dworkin.

Regular readers know I don’t generally provide a platform for hateful and abusive argument in my comment sections. But on occasion, I do believe it’s instructive to highlight the self-hatred and vitriol that some people feel compelled to hurl at parents like me; parents who question whether the “community” their kids are thinking of joining is actually a healthy neighborhood.

Does this “happy guy” think this spittle-flecked rant makes a parent like me feel guilty for wanting to protect my daughter from falling into a cesspit like this?
Do gender therapists have any idea they enable a person like this to “transition” to a “man” who hates women to this extent?
What happened to this woman that would make her detest herself so much that she would not only label her own amputated and re-purposed body parts as a “rape gash” and “chest tumors,” but also feel compelled to send filth like this to the parent of a teenager who actually decided on her own not to continue down the path of self-loathing?
Why would a stranger, reading about a teen girl who has begun to accept her whole self, become filled with such venom?
Why wouldn’t someone who actually cares about “trans” people celebrate a teenager who won’t have to endure years of injections and surgeries? It would be like a cancer patient becoming enraged when another patient goes into remission.
What makes a stranger think that a mother who refuses to march in lockstep with the propaganda spewed by a close-minded cult is equivalent to somehow forcing her child to change?
Is not speaking to one’s parents for decades and feeling indifferent about that supposed to be some indicator of mental health and a fulfilling life?
Is mentioning they came from an “Ivy League school” supposed to somehow rationalize the crude and offensive words they want to assault me with?
And a bit of irony: Telling me to go read books by feminist authors who pointed out the exact same extreme misogyny this “man” is spouting is proof of—what? Certainly not that celebrating female biology is “cancer.” What it is, is proof that the depth of self hatred women like this commenter experience, their extreme dysphoria, ought to merit serious attention from a psychologist.
Does anyone reading this honestly think that hormones and surgery were the solution to this person’s troubles?

That a female could dissociate from her own body to the extent of proudly wearing the most hateful misogyny as a badge of honor should cause a lot of soul searching amongst those who purport to care about women with gender dysphoria.

Gender specialists? Are we to understand that hating femaleness to this degree is what constitutes manhood? Or a cure for dysphoria?

Because, trust me: although it is an extreme exemplar, this isn’t the first comment like this I’ve received. And it won’t be the last.

Nothing wrong with your body that the truth can’t cure: Guest post

Posted on December 9, 2015 by 4thwavenow

This guest post by “fightingunreality,” a regular commenter on this blog, is the second in an ongoing series of accounts by women who at one time experienced gender dysphoria or the desire to become the opposite sex—but who turned away from “transition” without undergoing hormones or surgery. (The first in the series is “Abandoning the Ship of Woman,” by guest poster “Dot.”)

I am looking for more guest posts from formerly dysphoric women and girls, of all ages, who did not take steps to “transition” medically. There are some fine writings/blogs authored by detransitioned/detransitioning women who did embark upon medical transition but returned to embracing their femaleness; I will leave it to those women to continue elucidating their experiences for us. One excellent blog by a detransitioned woman is that of Maria Catt, who wrote powerfully yesterday about the hazards of transition and specifically testosterone—both from the perspective of someone who has used “T” herself, and as a worker in a medical clinic which served transgender people. Another fine blog by a detransitioned woman is “Hot Flanks,” who writes sensitively about her journey home to female after years of trans-identification.

Nothing wrong with your body that the truth can’t cure

by fightingunreality

As one of many women who have faced some of the issues confronting teenagers who call themselves “transgender,” I feel reasonably certain that, had these girls been born in an era before the all-out indoctrination that has taken place in the past decade, they would not only not be seriously considering altering their bodies; they would be developing a framework for understanding why they ever felt the female sex was not their own.

Such dysphoric females would most likely eventually connect, as I have, with other women who had the same difficulties–even if those difficulties remained unspoken. Instead of demanding hormones and surgery, these girls would be learning to cope with the ongoing changes that take place as they gradually mature, physically and socially. And it wouldn’t be easy, but nothing of importance ever is. Especially during the teenage years.

I imagine a self-identified trans teen reading this and thinking, “Eh, what could she possibly know? She was never ‘really trans’.” In response, I ask: What IS “really trans”?

Dysphoric teens often talk about depression and anxiety spiking during their middle school years, when their bodies begin changing in ways they don’t want and can’t stop; changes that feel wrong.

Do you have any idea how common these feelings are? For the longest time, I wouldn’t talk about them because I thought they were weird and embarrassing. But it turns out that a lot of my friends felt the same way and weren’t talking about it either. Nothing seems right when your body starts to change, and it doesn’t help that the hormones that are causing the changes fuel emotional highs and lows that are really intense and hard to handle. I know it doesn’t really seem like it, but things get a lot easier to deal with. It just takes time.

I remember this time period very well. I panicked. I was depressed. I didn’t know what to do because I could not imagine myself becoming what I believed it was to be a woman. I was neither like the women I knew nor those I saw on television. The idea of having to buy or wear a bra was repugnant. As a result, I did the only thing that seemed logical at the time: I hid my breasts and tried to carry on as if nothing had changed. I wore layers and vests and spent a lot of time worrying about other people noticing.

I remember feeling ashamed, especially when my older sisters made fun of me for trying to deny this development, or alternately, for acting or feeling like I was a boy (something that I never verbalized for fear of perpetual teasing). I had been obsessed with becoming a boy prior to hitting puberty, and what I considered to be my body’s betrayal seemed like the ultimate cruelty. Like some sort of unfair punishment.

Remembering those times, I wonder what it would have been like if I’d had someone I trusted who I could talk with about it–someone who understood the depth of my despair, who’d been through something similar. I did not have any such confidante. Yet in retrospect, I consider myself extremely lucky, because what I also did not have–which virtually every other child and adolescent has now–is someone who would have reinforced my belief that I really was meant to be a boy; that I was “trans.” I have to tell you, I would have bought into that belief with everything I had because I did not want to be female. I did not want to wear dresses or makeup, bleed every month, date boys or get married—ever. Being “trans” would have been the perfect out for all of those things, and once your body starts to develop, the pressure is on. Everything changes.

Thinking back, it was around age 5–the time when I started kindergarten –when I began to realize I wasn’t quite like the other girls. To be honest, I can’t even remember what activities the girls engaged in because I didn’t pay much attention. I guess it must have been dolls, since the note inscribed on my very first report card said that I didn’t like to play with them, but instead played with “trains and boys’ toys.” It made it seem like it was a bad thing–like I was bad–and I can recall from that point on a growing alienation from whatever it was that “girl” was supposed to mean. I actually remember at one point feeling sorry for *them,* for the girls, as if I weren’t one myself.

By the time puberty hit, my friends were all boys, so I guess you can imagine the additional issues that started to develop right along with my budding breasts. Suddenly the pressure was really on from the adults to act more ladylike, and there came rules about spending time alone with the boys and separating us for activities. We couldn’t play together as easily. There was increasing snark from the girls at school who marked me out as “other” for my failure to socially conform. I didn’t really need to hear their comments, though, because my changing body was a constant reminder of how I was supposed to behave and look which had nothing to do with how I felt about or saw myself. I felt trapped.

Worse, it wasn’t just the girls who had become suddenly self-conscious about their increasing need to conform: the boys who had been my peers and best friends began to see me as “other,” too. It didn’t matter that I was just as good as any of them when it came to sports, or that in a fight I would most likely win. I was a girl, and that alone altered the dynamic in our little group. It was even worse outside of our circle of friends. Individually, my friends seemed the same, but around the other boys, it was like they had to prove something to each other. Influenced by their own surging hormones, some of them began to make sexualized comments to impress each other with the pretense of worldliness, and the situation became increasingly intolerable. Former friends would dis me in the presence of others in order to get a laugh or to prove their masculinity. Hanging out with a girl wasn’t cool at this age unless it had some sort of sexual connotation. My sense of betrayal was devastating and complete.

It was at this point that I found myself alone. No longer accepted as a peer, I was closed out of the boys’ club and realized that I had little in common with the girls. I hadn’t really learned the rules very well, and from what I saw, I didn’t want to. Girls seemed helpless sometimes–interested in things that were incomprehensible to me. They began to cover the backs of their notebooks with popular boys’ names, plus theirs, surrounded by hearts. I just didn’t get it. It was pretty clear that I did not really fit in: I was not like them, and I certainly wasn’t going to grow up to be like their moms who I understood even less. I had no role models–I knew no one like me. As an adult, I can acknowledge a multitude of contributing factors, but at the time I could see only one real source of my pain: my body had betrayed me. I was alone, I was depressed, and I couldn’t see any way out of my situation. I felt like a mistake and I too often just wanted to be dead. As it was, I did what I could to simply hide. I sought invisibility and spent a lot of time by myself.

What if, along with my rejection of my maturing body, my growing depression, the loss of my peer group and my increasing alienation, I’d been told that there was a cure? I, along with a number of my friends, have asked that question. What if I’d been told that I must have a “male brain” or that there was science that showed that I had a “medical condition” that caused all of the problems? What would I have done? It didn’t happen, fortunately, but I think I understand my former self well enough to know: I would have attributed all of my social difficulties to that “condition.” I would have believed that if I could just fix that “condition,” all of the other issues would be resolved or at least lessened. They were, after all, entirely related to being the wrong sex. Weren’t they?

Having been raised in a very religious household, I actually believed as a young child that god would give me a boy’s body if I prayed often enough and hard enough. As a result, every time I was made aware that I was, in fact, a girl, I would repeat my litany with the sincere belief that my prayers would be answered. I would imagine myself as having changed, as having all the qualities I believed that entailed. When I showered, I’d plaster my soapy hair to my head so it would feel and look short. I’d shape lather on my face in the form of a beard, imagining how I would look when things were “fixed.” Each time, as my fantasy washed away, I would experience an even greater disappointment in the reality I faced. The more I engaged in the fantasy in its varying forms, the more distressed I was at what was: my body seemed to grow worse and I prayed even harder. I bargained with god, formulated deals, but each morning I awoke to the same disappointment. Despite my lack of progress, I continued praying for a few years because I convinced myself that my long-term dedication would somehow prove my faith, and that would make a difference. It was only the loss of that faith which eventually caused me to give up: I became convinced that god couldn’t hear me. I hadn’t lost my body shame, only the idea that there was anything I could do about it.

Testosterone and mastectomies don’t require a god or magic–just money and a psychologist’s approval. It’s a real thing that you can find out about now without even trying. You can watch hours of videos online as some girls/women sprout beards and their voices are lowered. You can see them pose with fading scars, pectoral muscles now hormonally enlarged and visible in the absence of those hated breasts. You can read all of the accompanying comments supporting her choice and your desire, and you can find a ready-made community to replace the one you lost, to accept and agree with the idea that something is terribly wrong with the way you are now that can be fixed with hormones and surgery. They’ll even tell you how to go about getting them. This is a real thing. But the magical thinking involved is the belief that you can actually change your sex; that you will be indistinguishable from actual males. The unreality of this is easy enough to overlook if you want something bad enough, even if you have no way of knowing what it actually means to be what you want. With “gender reassignment” and T, there’s no need to ever give up hoping for a miracle, because unlike god, the purveyors of gender change are listening very closely. They even advertise, making sure you can hear them. They are waiting for you. They’ve published books to help you, a teen, lay out all of the talking points that will help you convince your parents that you need this “cure.” They’ve made it easy.

As it was, as a teen, I had nothing of the sort. Oh, I’d heard of “sex change” operations, and for awhile clung to the idea of one as I tried to maintain that possibility, but the reality was that they were still really rare and impossible for someone so young and with no money, and there was no question that my family would not approve. As a result, I was forced to face reality. I was female, and I had to accept that and do what it took to learn to navigate the world as such.

One of the interesting things that happens when someone wants something badly is that they begin to fantasize about having it. They imagine themselves in possession of their want and it gives them pleasure, the fantasy itself becoming the reward. Unfortunately, reality is not changed and it often seems even worse or even less real when compared to what has been imagined. For myself, I know that the more I visualized myself as a boy, the worse I felt about who I actually was. The more I saw myself as being what I wanted, the more that want took on the characteristics of a need, something that I had to have; that I could not live without. I was wrong, of course, but had “gender reassignment” existed back then, it would have served as the material manifestation of that need –the promise of a wish fulfilled, that which god would not grant me. There would have been no reason for me to resolve the conflict that I had with my body. The time and experience I had which allowed me to come to terms with my sex would have been spent instead on fueling the same fantasy which had intensified my previous despair: my fantasy visualization would have prolonged my rejection of my body, and the degree of my dysphoria and dysmorphia would have increased.

As it was, I went through an intensely lonely and depressing time, but at some point, after about a year I guess, one of the girls in my class decided to befriend me. To be honest, I think it was because she felt sorry for me, but really, I didn’t care why. What mattered is that through her I gained entry into her circle of friends and my isolation ended. It would, of course, be convenient to slap some happy ending on the story and tell you that all was happily ever after from that point, but I think that kind of thing only happens in made-for-TV movies. I was still a teenager, with adolescent mood swings and depression, and I still was not one with my body. I had my issues, and so did my new friends. We were all pretty messed up, but at least we were messed up together.

In retrospect, I think it’s highly likely that I would have been dragged irretrievably into the world of crime and drugs that many of them fell into had my love of sport not provided a diversion from complete immersion into that subculture. Title IX had just been passed the year before, and even my small rural school was forced to provide some girls’ sport teams in order to comply. It wasn’t the football or baseball that I had formerly enjoyed playing with the boys, but basketball provided me with the opportunity to develop and prove my strength and my skill in a way that as a girl I had been denied. Not only did the physical activity help me gain a new relationship with my body –which believe me, was a very, very big deal. But for the first time, I was in constant contact with other girls whose strength and ability I admired, and with whom I could develop a sense of camaraderie and teamwork. I think maybe it was the first time I really realized that female was something to be.

The bravest and smartest and strongest people I have known have always been women. I just had to open my eyes to see it.

I am not “trans.” I never was “trans.” I was a girl, a female who’s grown up in a culture that makes us feel like less because of our sex. It is a world that teaches us that our opinions are not valued, that our knowledge is incomplete, that we are weak and that we are never safe if we go out alone. It is a place where we’re made to feel that merely being female is an invitation to men to do what they will despite our objections. To be female in this age and this place is to be convinced that the more we mature, the more limited our options become, and it is this belief we must resist, not our sexed bodies.

For myself, I was lucky. I managed to arrive at maturity at a time when women were actively fighting to shatter these myths and I was able to hear their voices over the constant murmurings of those who had and would define me by my use to them. These women were not popular then—they were mocked and reviled just as women are now, but they would not be silenced. Their words let me know that I had truly never wanted to be a boy, but rather that I didn’t want the limitations that were being forced on me as a girl. I was–we all are–more than our culture tells us we can be, and ultimately, there’s nothing wrong with your body that the truth cannot cure.

If you can manage to listen to the voices of the strong women who came before you, voices that are currently being drowned out by the popular trans-narrative, you may just hear them, too.

UK pediatric transition referrals DOUBLE in SIX months, girls far outnumber boys, many under 10 years old

Posted on November 5, 2015 by 4thwavenow

Scanning through my Twitter feed this morning, I nearly scrolled past this little news item tweeted by the Guardian:

According to a freedom of information response obtained by the Guardian, the number of children referred to the Tavistock has jumped from 314 referrals in 2012-13 to 697 referrals in 2014-15. In the last six months the service has seen a further increase in referrals with 634 children referred between April and September.

Children? LITTLE children:

Many of the referrals – 151 from 2012-13 to 2014-15 – relate to children under the age of 10, including one three-year-old and 12 four-year-olds.

Yesterday, I posted about a very recent research survey conducted by members of the Dutch team of clinicians who pioneered pediatric medical transition. They found that, worldwide, there is a growing sense of unease amongst clinicians working in child gender clinics. It is widely acknowledged that there is no long-term research to support the current medical paradigm for “treating” children with gender dysphoria–to the point that some providers are even forming “moral deliberation” groups to “rethink” aspects of the pediatric “treatment” protocol.

Does the Guardian article hint at any such doubts? To be fair, the director of London’s Tavistock clinic, Polly Carmichael, does hint:

“The increase is challenging,” Carmichael said. “We are keen to provide space for young people to fully explore their options and find their own way forward. It is a very complicated issue.”

If Guardian reporters would bother to read the 17-clinic survey study, they might be able to expand a bit more on some of these “complicated issues.” Oh wait, they do–in one paragraph, written in the passive voice, accompanied by a glamorous photo of Laverne Cox:

Increased media interest, the proliferation of social media where children and young people can discuss gender identity issues, and the prevalence of trans figures in popular culture such as Caitlyn Jenner and Laverne Cox, is thought to be part of the reason why there has been such a significant increase in these referrals.

“Thought to be”–it is thought by whom? Couldn’t you find anyone to go on the record to say this publicly? And just how ironic is it that this reporter touches on “increased media interest” without even a phrase devoted to her OWN role, in this very article, in promoting the media circus.

But never mind, because the rest of the article makes clear that the real issue is how important it is to serve all these kids and parents who are demanding transition services.

The Tavistock and Portman NHS trust gender identity development service in London has said that attempting to meet the demand from children seeking their services has put them under huge pressure…

A spokeswoman for the Tavistock said: “Gender expression is diversifying”, adding that it was important for young people to explore and develop their own path.

Let’s see: Should some of those kids with their “diversifying” identities perhaps just be advised to be comfortable in their own bodies? Is it the duty of the NHS to be “candy sellers” (to quote the wise ethicist in the Journal of Adolescent Health survey) vs. raising a few questions with primary-school children and their doting parents? If question-raising or encouraging other, less extreme options is part of what “support from specialist services” means, it is certainly not stated in this article.

Instead, we get to hear from none other than Jay Stewart, of “Gendered Intelligence,” that NGO which has been teaching preschoolers ~~to obsess~~ about gender for the last 7 years.

Jay Stewart, director of Gendered Intelligence, an NGO that promotes greater understanding of gender diversity, said there are now more than 50 gender options on Facebook rather than the traditional two.

Tail wagging the dog much? Kid signs up for an account on Facebook. Kid has 50 “identity” options to choose from. Hm, kid ponders. Guess this gender thing is really something I need to worry about. Guess I need to decide whether my body is some alien appendage attached to my all-knowing, gender-generating mind. Because I can’t possibly actually BE my healthy, evolution-crafted body, can I? I am only my ideas, my notions–one of the “identities” Facebook helpfully cooked up with the help of trans-identified employees.

“This is the tip of the iceberg of what gender identity is going to look like in the future,” [Stewart] said. “Young people have a very sophisticated understanding of gender yet the world is lagging behind. There is poor understanding of these issues and a lot of hostility and discrimination. Everyone’s gender identity and journey is unique and the numbers of children and young people wishing to transition are going to keep going up and up.”

If it wasn’t clear from other statements Stewart has made publicly, this paragraph crystallizes the matter. “Gendered Intelligence” is not in the business of helping children (with their “sophisticated understanding”) feel positively about who they are. Stewart isn’t teaching 4-year-olds to break gender stereotypes. Right here in black and white, we see that children “wishing to transition” is what those drug-company-taxpayer-funded “lessons” are all about. Because the word “transition” means only one thing: rejecting the sex you are to become one you aren’t. And as we know from the story reported a couple of days ago, granting childish wishes is what Stewart and his minions are all about:

It’s so important to be teaching children in schools that they can be anything that they want regardless of the gender that they have been given at birth.

Seems Jay Stewart might as well be appointed as a government minister in the UK. Yesterday’s Guardian also featured Stewart as the key advocate for what sounds like soon-to-be-implemented governmental oversight of social media for UK residents who use Twitter, Facebook, or other online networking sites:

Jay Stewart, the director of Gendered Intelligence, a transgender youth group, agreed that more needed to be done about transphobic abuse online…

…“There needs to be more regulation. If people behaved like that in a school or at work it would be dealt with.

Dealt with how? Jail terms? Firings?

“People also think that being trans has something to do with child abuse or they obsess over gender reassignment surgery. All of this comes down to an educational issue and the government can do more here,” Stewart said.

Seems like the government is doing quite enough, paying for Gendered Intelligence to propagandize children in the UK schools, and providing free-at-point-of-service medical transition. But hey, a new Ministry of Thought Police would give taxpayers more bang for their buck, with Stewart at the helm.

Returning to today’s Guardian piece, what about the surge in girls “wishing” to transition, a trend that is being noticed around the world?

According to the Tavistock figures, more girls want to become boys (893) than boys want to become girls (579). Carmichael said the larger number of girls was likely to have a complex explanation. “It might be to do with increased confidence in natal females coming forward but there are lots of unknowns. But we’ve seen a large rise in natal females coming forward, which deserves fuller exploration,” he said.

At least this spokesman thinks the issue “deserves fuller exploration.” But the Guardian reporters aren’t going to do that exploration, now are they? ARE they?

Because, right. It’s just that girls who hate their bodies are feeling more “confident.” Confident of what? Certainly not that it’s perfectly ok to be a “gender nonconforming” female without spending the rest of your life injecting testosterone, undergoing surgery after surgery, and, oh, maybe regretting the kids you never got to have because your parents and people like Jay Stewart–and the “charity” Mermaids–thought it was a brilliant idea to sterilize you instead of allowing you to go through natural puberty.

The charity Mermaids, which provides support to children and families on the issue of gender transition, says children who want to transition can be given gender hormone blockers to prevent the onset of puberty followed by cross-sex hormones. The former are reversible but the latter are less reversible. Currently cross-sex hormones are available from the age of 16 on the NHS.

Signal boost, parents and teens! Just letting you know to come-and-get your free-at-the-point-of-service testosterone when you turn 16! But cross-sex hormones are “less” reversible. That’s a pretty wishy-washy way of saying that your beard, deep voice, and a host of other things that haven’t even been researched are going to be permanent changes. Oh, and then there’s that pesky little problem I keep harping about: that when you follow blockers by cross-sex hormones (as casually mentioned in the paragraph above) you won’t be able to have any kids of your own. But you couldn’t have mentioned that, could you, Diane Taylor, the author of this piece, with your “particular interest” in “human rights”? How about the human right of not being proactively sterilized and permanently altered when you’re too damn young to understand what you’re doing?

Susie Green, the chair of Mermaids, said:“Our children are being failed on a daily basis … There is a crisis. NHS primary care services often don’t understand what is going on with these children and can be dismissive and say, ‘This is just a phase they’re going through.’

Mother’s Day card offered for sale by “Mermaids” on their website

Except that the people who know the most about these issues, including the Dutch clinicians who started this whole pediatric transition thing, say, over and over again, that most prepubescent children ARE usually just “going through a phase.”

Parents, family members, reporters-with-a-conscience, child development specialists: Are you going to let this continue? Are you going to let the media just go on racing ahead with its propaganda, while the rate of children who “wish” to “transition” doubles, triples, quadruples–how many is too many?

And in case it isn’t painfully clear, you bet I am writing this post in anger this morning. When even some of the people who administer these “treatments,” who are profiting from them, are expressing doubts, but the lazy mainstream (and even the supposedly “feminist” media) continues to behave as de facto propaganda organs for adult trans activists, it’s hard not to become infuriated.

I keep thinking I’m past outrage. But the blood pounding in my ears right now tells me I’m nowhere near Peak Trans.

Skeptical ethicist: “A medical doctor is not a candy seller”

Posted on November 4, 2015 by 4thwavenow

In yesterday’s post, I focused on the situation in the United Kingdom, where the school system is deeply enmeshed with a trans activist organization which peddles its message to kids as young as 4 years old. And the majority of posts on this blog document the seemingly unstoppable trend to diagnose and treat children as “transgender.” With this overwhelming level of societal and medical support, the issue must be pretty much settled—right?

Not according to the gender specialists themselves, it isn’t.

Hot off the presses, in the October 2015 issue of the Journal of Adolescent Health, a team of Dutch researcher-clinicians report findings from a survey of gender clinics which serve dysphoric children around the world.

Although you’d never know it, judging by the accelerating trend to socially “transition” kids as young as 3, freeze adolescents’ natural puberty with GnRh agonists, and then move on to chemical sterilization via cross-sex hormones thereafter, there is no consensus amongst gender specialists that this current treatment protocol is the way to go.

The qualitative survey, entitled “Early Medical Treatment of Children and Adolescents With Gender Dysphoria: An Empirical Ethical Study” was conducted by a group of well-known Dutch researchers/gender specialists who are themselves actively involved in administering puberty blockers and other treatments to “transgender” children. The authors surveyed 17 treatment teams (endocrinologists, psychologists, MDs, psychiatrists, ethicists) regarding their views and experiences.

Many of the parents who contribute to and read this blog agonize about their difficulty finding therapists and doctors critical of the I’m-trans-if-I-say-I-am paradigm. I hope this post gives some measure of hope to those parents. While the skeptical specialists (nearly all of them psychologists or psychiatrists, with most endocrinologists and pediatricians apparently submitting pro-transition comments) are quoted anonymously, at least we know they’re out there. And enough of them exist to tell us that the runaway pediatric transition train may not have completely lost its brake pads—yet.

The journal article can be read in its entirety here, and the abstract summarizes the key findings:

The Endocrine Society and the World Professional Association for Transgender Health published guidelines for the treatment of adolescents with gender dysphoria (GD). The guidelines recommend the use of gonadotropin-releasing hormone agonists in adolescence to suppress puberty. However, in actual practice, no consensus exists whether to use these early medical interventions…

Seven themes give rise to different, and even opposing, views on treatment: (1) the (non-)availability of an explanatory model for GD; (2) the nature of GD (normal variation, social construct or [mental] illness); (3) the role of physiological puberty in developing gender identity; (4) the role of comorbidity; (5) possible physical or psychological effects of (refraining from) early medical interventions; (6) child competence and decision making authority; and (7) the role of social context how GD is perceived…

CONCLUSIONS:

As long as debate remains on these seven themes and only limited long-term data are available, there will be no consensus on treatment. Therefore, more systematic interdisciplinary and (worldwide) multicenter research is required.

Because my aim here is to show that gender specialists are not unanimously aboard the child transition bandwagon, this post will mostly highlight the comments from the more skeptical gender specialists surveyed. Amazingly (to me), the doubters seem to hit nearly all the same points I do in my blog posts. [Note: Use of boldface to emphasize certain passages is my own, not that of the authors.]

So what is gender dysphoria?

Is GD a normal variation of gender expression, a social construct, a medical disease, or a mental illness? In the DSM-5 and the to-be-released ICD-11, the main challenge in classifying GD has been to find a balance between concerns related to the stigmatization of mental disorders and the need for diagnostic categories that facilitate access to health care, payment by insurance companies, and the communication between diverse professions.

I spend a fair amount of time reading articles and social media posts authored by gender specialists. It’s quite evident that there is currently pressure to completely de-stigmatize the transgender diagnosis…yet still find a way to get the “treatment” paid for by private insurance companies (or the taxpayer via public insurance such as Medicare or Medicaid). This thread from the WPATH public Facebook page [commenter names redacted] is illustrative of the dilemma the survey authors point to in the passage above.

So, this thread seems to indicate that providers are moving away from gender dysphoria as a disorder; even as an experience which causes distress. But why then would there be a need for medical treatment? This conundrum is addressed by the 17-clinic survey authors:

The interviews and questionnaires show that most informants find it difficult to articulate their thoughts about this aspect. Most see GD as neither a disease nor a social construct, but as a normal, but less frequent variation of gender expression. However, some note that you would not need medical procedures to make the lives of people with GD more satisfying if it were merely a normal variation.

Another thread from the WPATH public Facebook page seems to justify transition services for someone who just wants a “joyful and loving life.”

But when it comes to young people, at least one psychiatrist in the survey study gives us a less sanguine view of such quality-of-life justifications for medical transition:

“I find it extremely dangerous to let an adolescent undergo a medical treatment without the existence of a pathophysiology and I consider it just a medical experimentation that does not justify the risk to which adolescents are exposed. Gender dysphoria is the only situation in which medical intervention does not cure a sick body, but healthy organs are mutilated in the process of adapting physical and congruent psychological identity.” –Psychiatrist

I feel certain at least a few of the parents who frequent this blog wish they had the office phone number for this reasonable clinician. Amirite?

On the wisdom of puberty blockers

How many of us have asked, “but what if puberty blockers also inhibit the psychological/neurological maturation that comes with puberty–and beyond?” And, because many kids actually outgrow their gender dysphoria, interrupting puberty would deny them the opportunity to become comfortable in their bodies and avoid a life as a permanent medical patient.

It’s a pleasant surprise to see an acknowledgement of some of these concerns here:

In the literature, the concern is raised that interrupting the development of secondary sex characteristics may disrupt the development of a gender identity during puberty that is congruent with the assigned gender. The interviews and questionnaires show that some treatment teams share this view.

One clinician even talks about lesbian women who would have been misdiagnosed as “trans” children in an earlier time.

“I have met gay women who identify as women who would certainly have been diagnosed gender dysphoric as children but who, throughout adolescence, came to accept themselves. This might not have happened on puberty blockers.”–Psychologist

So at least one psychologist who works on a pediatric transition team acknowledges what many, formerly gender dysphoric women, say: that if there had been “gender clinics” for kids in the 1950s, 60s, 70s, or 80s, they would not be happy lesbian adults today, but sterilized “trans men.”

Speaking more broadly, another therapist has this to say:

“I believe that, in adolescence, hypothalamic inhibitors should never be given, because they interfere not only with emotional development, but [also] with the integration process among the various internal and external aspects characterizing the transition to adulthood.” –Psychiatrist

On co-occurring psychological/psychiatric issues

If you read through the part of this blog where most parents congregate and introduce themselves for the first time, some common themes emerge. One is the observation by many parents that their kids have other mental health issues, nearly always predating the (sometimes sudden) announcement that they are transgender. While most activists insist that transition is the cure for what ails a dysphoric child or teen, the clinicians working in the trenches aren’t so sure.

The risk of co-occurring psychiatric problems in children and adolescents with GD is high. The percentage of children referred for GD who fulfilled DSM criteria of at least one diagnosis other than GD is 52%. The psychiatric comorbidity in adolescents with GD is 32%. Another study shows that 43% of the children and adolescents seen in a gender identity clinic suffer from major psychopathology. To date, the precise mechanisms that link GD and coexisting psychopathology are unknown.

Miscellaneous physical and psychological risks of medical transition

The surveyed clinicians acknowledge many of the concerns discussed regularly on this blog.

The possible consequences of suppressing puberty for cognitive and brain development are unclear and debated at this moment. The normal pubertal increase in bone mineral density may be attenuated by puberty suppression, and it is uncertain if there is complete catch-up after treatment with cross-sex hormones.

While it only merits one sentence (and no direct quotes), the surveyed clinicians appear to view sterilization as an important concern:

In the interviews and questionnaires, the loss of fertility was often mentioned as a major consequence of treatment.

And here’s an additional worry I haven’t seen in writing before: the potential negative impact of puberty blockers on future SRS surgery.

In addition, various informants stressed the importance of the fact that the penis and scrotum should be developed enough to be able to use this tissue to create a vagina later in life. Very early use of puberty suppression impairs penile growth and consequently makes certain surgical techniques impossible.

Will we see this rather thorny issue discussed on an episode of the Jazz Jennings reality show? Will the Tumblr trans activists screaming “now or never” take heed?

On whether kids are mature enough to make these decisions

One informant stated that the decision whether to start with hormones should only be made during adulthood: “We should facilitate his or her process of integration in the society and if he or she would undergo hormone- and surgical treatments he or she could decide [on this] during adulthood.” —Psychiatrist

Influence of the Internet and social media

You know how trans activists scoff at our observations that our kids only started talking about “transition” after binging on YouTube and Reddit?

They speculated that television shows and information on the Internet may have a negative effect and, for example, lead to medicalization of gender-variant behavior.

“They [adolescents] are living in their rooms, on the Internet during night-time, and thinking about this [gender dysphoria]. Then they come to the clinic and they are convinced that this [gender dysphoria] explains all their problems and now they have to be made a boy. I think these kinds of adolescents also take the idea from the media. But of course you cannot prevent this in the current area of free information spreading.” –Psychiatrist

Hello? The Advocate? The Boston Globe? The Washington Post? Anybody?

Furthermore, interviews and questionnaires show that treatment teams feel pressure from parents and adolescents to start with treatment at earlier ages.

Puberty suppression has been adopted as part of the treatment protocol by increasing numbers of originally reluctant treatment teams. More and more treatment teams embrace the Dutch protocol but with a feeling of unease…these professionals also have doubts because of the lack of long-term physical and psychological outcomes.

Hey, journalists. Obscure blogger over here quoting actual gender specialists, so you can’t say it’s just a bunch of nervous Nellie-moms making shit up. Need the link again? Oh, that’s just the abstract, here’s the pre-publication full-text, right here.

Self-harm/suicidal ideation

For several informants, a reason to use puberty suppression was the fear of increased suicidality in untreated adolescents with GD. Research shows that transgender youth are at higher risk of suicidal ideation and suicidal attempts. Nevertheless, caution is needed when interpreting these data because they do not show causality or directionality.

The meaning of that last sentence is crystal clear, and entirely in accord with what I, and other critics of the harmful “transition or suicide” meme that adult trans activists continually propagate, have tried to point out. While no one disputes that there is a higher self-harm and suicidality rate amongst trans-identified young people, there is no evidence that such self-harming behaviors and thoughts are ultimately alleviated by “transition.” Further, as this sentence implies, the “directionality” could be the reverse of what trans activists promote. Having a trans identity and/or facing the monumental prospect of medical transition could be a cause of self harming (in addition to the preexisting or comorbid mental health issues so many of these young people seem to have).

This is not the moment for another flippant call for journalists to take heed. This is deadly serious business: the terrible toll of self harm and suicide among trans-identified youth. I have not seen a single news treatment of suicide or suicide risk that has even hinted at what these clinicians are stating baldly. Isn’t it time for a more nuanced discussion?

And finally: Leave it to a medical ethicist to point out the huge logical fallacy in the “informed consent” model of treatment now running rampant:

“The fact that somebody wants something badly, does not mean that a health care provider should do it for that reason; a medical doctor is not a candy seller.”— Professor of health care ethics and health law

Imminently sensible. So how is it that “informed consent” and the demonization of “gatekeepers” is more and more the norm? How is it that self identification as trans, even for young children, is fast becoming the only requirement for obtaining treatment? There is something strange going on here. If even some experienced gender specialists are expressing doubts, why does the media behave as if the issue has been settled?

“The positive attitude of many health care providers in giving hypothalamic blockers…is based on the need to conform to international standards, even if they are conscious of a lack of information about medium and long term side effects.” –Psychiatrist

But how can there be “standards” (they are talking about WPATH here) that these providers feel pressure to conform to, if the standards are not based on solid information about risks and benefits? Exactly which cart is pulling this runaway horse?

As still little is known about the etiology of GD and long-term treatment consequences in children and adolescents, there is great need for more systematic interdisciplinary and (worldwide) multicenter research and debate.

Reason for hope?

The article concludes in a way that makes me feel a whisper of hope for the future.

Several professionals mentioned that participation in the study made them think more explicitly about the various themes, and it encouraged them to discuss the issues in their teams. In the Dutch teams, we therefore introduced moral deliberation sessions to talk about these ethical topics. The first reactions of the professionals were positive; the sessions made them rethink essential aspects of the protocol.

Will this “moral deliberation” and “rethinking” result in more caution, or even a desire to put a halt to the pediatric transition train? Time will tell, but it is encouraging that at least the Dutch researchers may be losing some sleep in pondering the incredible power they wield over the lives of children and their families.

At least we know there is controversy. At least we know they are not all marching in lockstep.

And that is something.

“Insistent, consistent, persistent”: Autism spectrum disorder seen as no barrier to child transition–or sterilization

Posted on October 29, 2015 by 4thwavenow

The headline I chose for this post comes from the oft-repeated axiom (unsupported by any robust research to date) that kids who are “insistent, consistent, and persistent” in their assertion that they are, or want to be, the opposite sex, are somehow innately “transgender.” Yet rigidity (a concise paraphrase for that three-word catchphrase) is also a hallmark of autism spectrum disorder (ASD).

In May, I posted about a recent Finnish study which found that girls presenting to gender clinics in that country have an increased rate of autism spectrum disorder as well as other mental health problems. The researchers found a 26% incidence of ASD in the study cohort.

Sixty-four per cent … were having or had had treatment contact due to depression, 55% … due to anxiety disorders, 53% … due to suicidal and self-harming behaviours, 13% due to psychotic symptoms …, 9% … due to conduct disorders, 4% … due to substance abuse, 26% … due to autism spectrum disorder, and 11% …due to ADHD…

…Gender identity issues could arise from autism spectrum people’s predisposition toward unusual interests, or gender dysphoria in ASD could represent OCD rather than genuine gender identity issues. The cross-gender behaviour in ASD minors could also rather represent non-normative sexual interests or unusual sensory preferences. Our clinical impression is that a long-standing feeling of being different and an outsider among peers could play a role in ASD children developing gender dysphoria in adolescence. In our clinical sample of gender dysphoric adolescents, autism spectrum disorders by far exceeded the prevalence of 6/1000 suggested for general population .

It turns out that the link between ASD and GD has been noted by many other researchers, clinicians, and (if the mothers and fathers who comment on this blog are any indication), many parents as well. Poor social and/or communication skills, a hallmark of ASD, as well as a tendency to have obsessive interests, to isolate socially and spend inordinate and unusual amounts of solitary time on the Internet, have been noted by both professionals and parents. I’ve also noticed, on several of the blogs run by parents who are supporting their child’s transition, a theme of frequent temper tantrums and refusal to wear certain clothing.

A 2014 study from Washington, DC found that

compared with normally developing children, young people with ASD were nearly 8 times more likely to express a desire to be other than their biological sex — a phenomenon the authors describe as “gender variance.” Those with a diagnosis of ADHD had more than 6 times the odds of communicating gender variance, according to parent-reported data.

Dr. Strang said they were initially surprised to find an overrepresentation of gender variance among children with ADHD. However, they later realized that prior studies have shown increased levels of disruptive behavior and other behavioral problems among young people with gender variance.

A 2010 Dutch study on found an increased rate of autism in the gender dysphoric children referred to their clinic.

Most individuals with co-occurring gender dysphoria and ASD fulfilled the strict criteria of autistic disorder. For several youth with ASD, their ASD-specific rigidity made enduring gender variant feelings extremely difficult to handle. After all, in our society a considerable amount of flexibility is needed to deal with gender variant feelings. Normally developing young children (age 3–5) display more rigidity in gender-related beliefs than older children; this rigidity decreases after the age of five … Individuals with ASD may not reach this level of flexibility in their gender development.

The implications of this are profound: If some of the very young children with GD (many of whom are currently being profiled in celebratory media portrayals) have co-occurring ASD, yet are being socially transitioned and then put on puberty blockers, how much of their distress is due to the rigid thinking and behavior characteristic of ASD?

Social difficulties are a key trait of people on the ASD spectrum. A 2011 study published in the Journal of Autism and Developmental Disorders that focused particularly on female-to-male transsexuals found that

Autism Spectrum Conditions (ASC) are characterized by difficulties in social interaction and communication, along-side restricted interests and repetitive behavior.

… A recent study of play by girls with ASC found they show masculinization in choosing toys that do not require pretend play …, and women with ASC report higher rates of tomboyism in childhood.

…We speculate that this increased number of autistic traits is likely to have made the transmen (in their childhood and adolescence) less able to assimilate in a female peer group, instead gravitating towards males. This may also have led to difficulties socializing in a female peer group, and a feeling of belonging more in a male group, thus increasing the probability of GID.

One comment on my earlier post on the Finnish study submitted by a teen girl who says she is autistic, appears to support some of these findings.

I’m autistic and a LOT of autistic girls my age (teenagers) I know from support groups (to learn social skills, etc) are questioning their gender/thinking about transition. I mean a much much higher percentage than not-autistic girls I know… The majority of girls in those groups consider themselves genderqueer/bigender/nonbinary & some talk about transitioning or at least “presenting” as a boy…

I wonder if the number of transgender/gender questioning autistic girls is bc autism makes all this gender stuff really hard – there’s hypersensitivity to touch/smell/etc which means many of us can’t shave, can’t wear makeup or tight-fitting feminine clothing, can’t have long hair (bc it touches your skin in unpleasant ways), wear nail polish (it smells too strong) etc.

Also ppl think girls have better social skills than boys… so a lot of autistic teenage girls end up feeling like they’re “not girl enough”, like all the other girls can do those things easily and they can’t & that probably means they should be a boy.

Idk if this explanation is too simple, there’s probably more to it, but I’m really noticing how MANY autistic girls are in this situation, of wanting to be called “he”, to pass as a boy, to get breast surgery, etc, compared to not-autistic girls my age, and I wish the links between autism and transgender/discomfort with gender were explored more, so we could better help them. If autistic/other disabled people are more affected by dysphoria than the general population, we really should be wondering why? instead of just “accepting that their body is wrong for them”… Why would so many autistic girls’ bodies be WRONG? For no reason???”

An adult woman, also diagnosed with ASD, adds

People on the autistic spectrum feel very different from others, and often “wrong”. We often have trouble fitting in and understanding social situations. Since femininity is a social construct that requires a lot of work, autistic girls and women might not feel or be able to act feminine enough.

One common thing is “special interests”. People with AS can easily be obsessed with certain topics.

So, with the combo of feeling different and not like a real girl/boy and all the info about transgenderism on the internet, it could lead to people going from feeling wrong, seeing others online talking about being trans, to researching the topic intensively and thinking it could be me, that it could solve their problems to be trans.

In “Musings of an Aspie” (highly recommended), a blogger diagnosed with high-functioning autism offers insights about her experiences with disconnection from female stereotypes.

Women are expected to be intuitively skilled at social interaction. We are the nurturers, the carers. To be born without natural social instincts can leave you questioning your innate womanhood.

The first hint of what was to come arrived long before I’d given any thought to what being a woman would mean. At some point in sixth grade, many of the girls in my class became huggers. They hugged when they met each other and when they said goodbye. They hugged when they passed in the hallway. They hugged when they were happy or sad. They hugged and cried and squealed with excitement and I watched from a distance, perplexed. What did all this hugging mean? And more importantly, why wasn’t I suddenly feeling the need to hug someone every thirty seconds?

This was the first of many confusing conversations I was to have with myself.

In a very recent review of research (publication date November 2015), the authors observe that

…kids with autism spectrum disorder may hold more rigid views of what it is to be male or female and thus be more at risk toward developing gender dysphoria if they do not feel fit within their binary categories of girls and boys. …and that … the fragility of identity experiences in gender dysphoric minors leads to a more rigid fixation on gender-based stereotypes.

As a critic of pediatric transition, all of this research evidence, as well as the personal anecdotes I’ve shared here, lead me to question: Is it wise to subject children who might have autism to “treatments” that involve permanent administration of hormones, repeated plastic surgeries, and likely sterilization? And further, is a child with ASD even capable of giving “informed consent” for such treatments?

As you might suspect, trans activists–and increasingly, gender specialists and researchers–don’t appear to be much troubled by such questions. In the UK, written evidence recently submitted to Parliament by the Tavistock clinic, one of the key providers of transition services, included this passage:

We offer assessment and treatment not just to those young people who are identifiably resilient and for whom there is an evidence base for a likely ‘successful’ outcome. We have carefully extended our programme to offer physical intervention to those who have a range of psychosocial and psychiatric difficulties, including young people with autism and learning disabilities, and young people who are looked after. We have felt that these young people have a right to be considered for these potentially life-enhancing treatments. This has involved careful liaison with local service mental health providers and Social Care, who may know these young people well and who have particular responsibilities for their well-being. Indeed, the service has no record of refusing anyone who continues to ask for physical intervention after the assessment period. Some young people back off from physical treatment at an early stage, but the majority who choose to undertake physical interventions stay on the programme and continue through to adult gender services where surgery becomes an option.

This March 2015 article, published in the Yale Journal of Biology and Medicine, draws a similar conclusion.

Individuals with ASD have the same rights as other individuals to appropriate assessment, diagnosis, and treatment of gender-related concerns. The challenge that exists surrounds being attentive to the particular concerns that may influence this presentation in ASD individuals; the goal should be to facilitate improved understanding and patient satisfaction and not to increase the number of barriers to appropriate treatment.

It’s likely that some parents might disagree with some of these statements when it comes to their underage kids (though they’d be out of the loop in Oregon, which recently approved gender “confirming” surgeries on children as young as 15 years without parental consent.) But judging by this comment on the publicly viewable Facebook page of Jenn Burleton, the executive director of TransActive, which lobbied for the lowering of the age of consent for gender “transition,” some family members of kids with ASD are aboard the bandwagon, too.

“Gatekeeping”–the imposition of any restrictions on obtaining transition services–is a dirty word to trans activists, and increasingly, compliant gender specialists. “Informed consent” (essentially, giving the patient whatever they ask for, based strictly on self identification) is the new norm. And this push for an end to gatekeeping extends to children and people with disabilities; the hot term is personal “agency,” and trans activists have little patience for the idea that perhaps not all people have equal capacity to make sound decisions. To take but one recent example, the mother of a young woman with Down Syndrome created a fundraising website, which, while mentioning that her daughter had been hospitalized in an intensive care unit, insisted that she still needed “top surgery.” A prominent Los Angeles gender therapist, who happens to be FTM, helped with fundraising for the double mastectomy on a public post on Facebook, which as of this writing is still a live link, despite some scathing coverage in the gender critical blogosphere.

But I digress.

Providers are now recommending treatments for childhood gender dysphoria (puberty blockers followed immediately by cross sex hormones to prevent the “wrong” puberty) that will result in sterilization of minor girls, at least some of whom will have ASD. This is a strange reversal, given that sterilization of minors with any sort of disability is controversial, to say the least. Another hotly debated issue is the sterilization of intersex children. In fact, as this article emphasizes,

“Generally, consent of a parent or guardian is not legally adequate to authorize sterilization — a court order is necessary… How can a physician address this uncertainty? It is certainly prudent to consult with an experienced attorney before undertaking elective gonadectomy or other procedures that could affect fertility. To avoid conflicts of interest, the attorney should represent the medical providers, not the parents. The child may need separate representation. It will be important for counsel to understand the medical issues involved…”

In another strange twist, Lupron, a puberty blocker, is administered to prepubescent children (some, obviously, with diagnosed ASD), despite the fact that lawsuits have halted the drug’s use by some doctors to treat ASD.

So off-label Lupron is the answer for gender dysphoria in a child with autism, but is forbidden to be used to treat the autism? Well, given the current trend in medicine and psychiatry to treat GD as the core problem, perhaps this is not so strange. None other than the American Psychological Association, in its recent guidelines for treatment of trans-identified young people, actually supports the notion (on page 21) that treating GD is something of a panacea for all and sundry mental disorders:

In addition, the presence of autism spectrum disorder may complicate a TGNC person’s articulation and exploration of gender identity (Jones et al., 2012). In cases where gender dysphoria is contributing to other mental health concerns, treatment of gender dysphoria may be helpful in alleviating those concerns as well (Keo‐Meier et al., 2015).

With the lofty endorsement of the APA, what parent wouldn’t look to “transition” as the magic answer for their gender dysphoric, autistic child? And what APA-certified therapist would dare to question these guidelines? (We know of at least one who is raising concerns.)

The sister of an autistic FTM has written an article cheering on her “female-born” sibling. As is usual in such articles, the preference for stereotypical male clothing, interests, and haircuts is used as evidence that this natal female is actually male.

Draped in a royal blue wool cape, my female-born autistic brother wears a homemade pin that reads, “I am a transgender male and I’m proud.” The 23-year-old points to it whenever he’s at restaurants, anticipating people making pronoun mistakes, which have been aggravating him for nearly two years.

For several years, he has been dressing like a boy, though his interpretation of what is “masculine” differs from most transgender males. For him, the color blue signifies masculinity more than attempting to “pass” as a man, and so he chooses to wear only monochromatic blue athletic clothing all the time.

He has been cutting his hair at a man’s barbershop for a decade, but he only came to identify as male roughly two years ago. He said the epiphany came to him after waking up from a nap, kind of like in Virginia Woolf’s Orlando, in which the male-born protagonist suddenly awakens a woman.

And Wenn Lawson, a trans-identified “highly regarded psychologist, lecturer and author” on the autism spectrum, pushes the idea that stereotyped interests and gender presentation in an autistic child are indicative of true “gender dysphoria”:

But, in children especially, the possibility of gender dysphoria must be considered, and parents need to watch out for the clues. These might be:

looking for gender biased separate interests
wishing they were a girl (or boy)
dressing in girls (or boys) clothes,
wanting to play with toys stereotypically used by the opposite gender

But what of the young people who are “on the spectrum” themselves? Are they all on board with the no-questions-asked, informed consent model of treatment? Put another way: Are the gender specialists providing these people with the best possible care, care that actually provides the most benefit with the least harm?

There is a large online support forum for the autism community called “Wrong Planet.” A search for “gender dysphoria” turns up numerous threads, with commenters discussing their feelings of discomfort or confusion with their bodies and gender identity. Opinions appear to be mixed, with some commenters attributing their dysphoria to their ASD (and denying the need for “transition”), and others discussing their desire to change genders. Interestingly, another commenter on my earlier Finland post had this less-than-rosy observation:

[Wrong Planet] has been co opted by the trans community in other places, and they skew the facts about ASD, and some get kicked off the board for pushing an agenda and posting incorrect facts[which bother people with AS like myself]. I don’t even like to talk about my own AS, because- ‘Maybe you are trans’ gets forced on me[been there-done that] outside of a Wrong Planet board. Men also use this as an excuse to bully women online.

The trans community tries to convince non conforming ASD people to join their cult, but some can’t stand it if someone keep misquoting science, or making things up even after corrected[like they do].

That is a dead give away too, Many ASD people, if you can prove your facts, they will correct themselves with the new information, and not feel badly about having the wrong information previously. They will update everything accordingly. If you are saying ‘bullshit’ and non reality is true, they will kick you off that site for teasing them.

It does appear that at least some people on the ASD spectrum have come to terms with their childhood feelings of gender incongruence and resolved them as adults. Once again, we hear from the author of “Musings of an Aspie”:

At five, I wanted to be a boy. I don’t know what I thought being a boy meant. Maybe I thought it meant playing outside in the summer, shirtless and barefoot. Maybe I thought it meant not wearing dresses.

Dresses were all scratchy lace trim and tight elastic sleeves. Stiff patent leather shoes pinched my sensitive feet. Perfume tickled my nose. Tights made my legs itch and had maddening seams at the toes.

Too young to understand sensory sensitivities, I followed my instincts. While other girls favored frilly clothes, I gravitated toward the soft comfort of cotton shirts and worn corduroys.

Somehow, comfort got mixed up with gender in my head. For decades, “dressing like a girl” meant being uncomfortable. And so began a lifelong tension between being female and being autistic.

Teen suicide and the chilling effect on dialogue

Posted on March 25, 2015 by 4thwavenow

Another teenager who identified as transgender committed suicide yesterday. Blake Brockington, the first trans homecoming king in the nation, jumped off a bridge in Charlotte, NC and died immediately.

Teen suicide is the most horrible thing imaginable, and we all need to do whatever we can to prevent it. Gender dysphoria—the pain resulting from a sense of dissociation from one’s own body and biological sex—is a very real phenomenon, as anyone who has experienced it will tell you. After one of these tragedies, the dominant message is that suicidal ideation in people who are “gender non-conforming” is solely the result of transphobia and the lack of (usually) parental support for “transition.” Parents, family members, and anyone else who was not fully on-board with the young person’s desire or efforts to change his or her gender are vilified, often to the point of death threats and stalking.

But maybe, just maybe, some of these young people want to die because 21^st century society has given them the message that they cannot live their lives legitimately and happily in the bodies they were born in if they do not conform to gender stereotypes. That if they don’t like “girly” things or are “sissy boys,” or if they identify with and enjoy pursuits and body ornamentation traditionally associated with the opposite sex, they and their families must push for a medical diagnosis that will commit them to a chronic, expensive health condition involving lifelong drug treatment and repeated plastic surgeries; that they will have to live like Type 1 diabetics, requiring treatment for the rest of their lives. How can all of this pressure to conform not contribute to a sense of hopelessness and despair?

When a young person takes his or her own life, we must absolutely ask “why.” But a teen suicide should not shut down an open-minded discussion about root causes and conditions. Blake was out as trans. While Blake faced a lack of family support for “transition,” things seemed to be improving. The high school was open-minded enough to allow Blake to be their homecoming king. Blake was an activist with a purpose, well respected by many, with a long life to look forward to. Is the reason for Blake’s suicide simply that society or family weren’t supportive enough of the dominant transgender paradigm, or could there be a more complex explanation? Is gender therapy the only answer for a gender non-conforming person in pain?

I write this not to trigger hate or anger against any person, no matter how he or she identifies. I write as the parent of a gender non-conforming child whom I love more than anything on earth. Reading about another teen taking their own life is awful. But Blake’s suicide does not make me question gender politics less: it makes me question more.

4thWaveNow

A community of people who question the medicalization of gender-atypical youth

Tag Archives: gender dysphoria