“Reportable trauma”? US gender docs “train” judges & call CPS on balking parents

Posted on February 25, 2017 by 4thwavenow

The meteoric rise in kids diagnosed as transgender in the last five years has caught many parents by surprise. Gender specialists, trans activists, and their media handmaidens explain this accelerating trend as simply the welcome result of society becoming more accepting of trans people; a continuation of the tolerance that ushered in same-sex marriage. Indeed, activist-clinicians are quick to claim equivalence between trans and being gay or lesbian, despite their fundamental differences.

For one thing, lesbians and gay men ask only to be accepted for who they love, while we are asked to believe that being “authentic” as trans may require us to approve drastic medical interventions–for our own kids. And no mental gymnastics are necessary for parents to see with their own eyes when a daughter or son is homosexual. But a sudden pronouncement by one’s kid that they are really the opposite sex requires a suspension of disbelief; a demand to ignore one’s own insight, perception, and knowledge in order to “validate” the “identity” of our kids.

Despite the insistence that hormones and surgeries are “life-saving” medical necessities, the push is on to “depathologize” trans identity as a “normal human variation.” Yet nearly to a one, the parents who have gathered on- and offline as part of the 4thWaveNow community report a history of mental illness, social difficulties, frequently multiple diagnoses that predate the sudden announcement “I’m trans!” Indeed, a cursory hunt through decades of medical and psychological literature reveals that gender dysphoria occurs with troubling frequency in concert with a range of other mental disturbances, including personality disorders, depression, anxiety, and autism. To take but one example, this 2003 survey of nearly 200 Dutch psychiatrists found that a large majority of people with gender dysphoria had comorbid psychiatric problems.

What has actually changed since 2003, apart from trans activism overruling sensible debate and clinical experience?

Given the experience of so many parents, corroborated by research evidence and clinical experience around the world, is it any wonder parents might balk at the idea that their (often troubled) tween or teen needs immediate “affirmation” and “validation” of their trans ID—complete with puberty blockers and/or cross-sex hormones?

But in 2017, at least in the US, pediatric gender specialists see co-occurring mental illness as no barrier to prescribing puberty blockers or cross sex hormones–even in the case of obviously troubled young people who have undergone multiple psychiatric hospitalizations. To these gender clinicians, puberty blockers are absolutely vital—even when the psychiatric team isn’t on board. (And even, apparently, when new information has come to light about the serious adverse effects of Lupron on children and adults.)

The inaugural conference of USPATH, the newly formed offshoot of WPATH, was held the first weekend of February in Los Angeles. At a session entitled “PUBERTY SUPPRESSION IN THE UNITED STATES; PRACTICE MODELS, LESSONS LEARNED, AND UNANSWERED QUESTIONS,” gender doctor Michelle Forcier presented a case study of a young teen “K.” who had been seen in Forcier’s gender clinic. K., born female, had been hospitalized multiple times for suicidality, cutting, an eating disorder, and other self harm. K’s mother was reluctant to use a male name and pronouns, and was not initially willing to consent to Lupron.

During one of K’s months-long hospitalizations, Forcier pushed for the child to start blockers, despite the fact that the psychiatric team caring for K. was not in agreement, but was intent on medically stabilizing the child before contemplating other interventions.

After the child was released from hospital, the mother eventually consented to puberty blockers; the child was hospitalized again a few weeks after the Lupron injection. In her presentation, Forcier said that the time spent without blockers was one of many “missed opportunities;” she used the case as an example of how psychiatrists need to be better “educated.”

This notion that “gender care” (Forcier’s term) is the curative elixir, the pharmacological key to solving a whole host of other psychiatric issues, is a common refrain with US gender specialists. Parental reluctance to go along with this recommendation is viewed with, at best, condescension, and at worst, bald contempt. Do these providers stop for an instant to think maybe, just maybe, these parents have some wisdom regarding their own kids, whom they have raised and loved from birth? Nope.

Even young people who identify as “nonbinary” are encouraged if they choose hormones—or even surgeries. The USPATH conference devoted plenty of time to medical interventions for youth who want to dabble in irreversible chemical or surgical interventions:

Balking parents must be “educated”, cajoled into going against their deepest protective instincts. If this indoctrination process doesn’t work, there’s the frequent threat your kid will kill themselves because of your hesitations. This weaponization of adult self-harm statistics is wielded by activists, clinicians, and the media alike, to terrorize parents into handing their offspring off to be drugged, sterilized, and (increasingly) surgically “corrected” by therapists and doctors who are confident they know best when it comes to other people’s children.

Never mind that there is scant evidence that medical transition cures self harm in the long run; never mind that the constantly quoted 41% trans suicide attempt rate didn’t control for mental illness (a flaw readily admitted by the survey authors). Never mind that the 41% survey was of adults over 18, not kids. Never mind that there is no prior historical evidence of “trans kids” so desperate to escape their “wrong” bodies that they become suicidal; never mind that the highly publicized clusters of transgender teen suicides have mostly been young people who were supported in their desire to transition. Never mind that no one is studying the mental health of formerly trans-identified youth who were fully supported in gender nonconformity but not endorsed as being in the “wrong body.” And never mind that only mentally ill people see suicide as a solution to life’s frustrations. (As an analogy, the suicide rate for white Americans is much higher than for other ethnic groups, who by any measure face more discrimination and difficulties, yet manage to maintain more psychological resilience.)

But none of this stops irresponsible journalists and activists from spreading suicide contagion to vulnerable gender-confused youth.

When it comes to coercing parents, the suicide trump card usually works. The daily onslaught of celebratory “trans kid” stories often includes a statement by a parent that they’d “rather have a live son than a dead daughter” (or vice versa). Not surprisingly, scaring parents with their worst possible nightmare has been quite effective in many cases (including that of Ryland, one of the better known celebrity trans kids).

Hillary Googled the word “transgender” and came across a horrifying statistic: 41% of transgender Americans attempt suicide.

“This made things very clear to me,” says Hillary. “Did I want a living son or a dead daughter? I wasn’t going to take the risk by waiting around and doing nothing.”

So Hillary and Jeff spoke to psychologists, psychiatrists and gender therapists, who all reached the same conclusion: Ryland is transgender. As Hillary describes it, “Although Ryland was born with the anatomy of a girl, her brain identifies with that of a boy.”

That day, Hillary and Jeff – both churchgoing Christians who were raised in conservative families – made a vow: to bring up Ryland as a boy, without any strings attached.

Not only do the people most invested in medically transitioning children push suicide or transition as the only two alternatives; they are not shy about blaming the parents themselves for the child’s self harming behaviors.

Towards the end of a USPATH session, ADDRESSING SUICIDALITY IN TRANSGENDER YOUTH: A MULTI-DIMENSIONAL APPROACH, presenters Elizabeth Burke, Matthew Oransky, and Sarah McGrew touched on what to do about parents who weren’t on board with “gender care.”

And the final piece on suicidality is family non-acceptance. This is where you have a family who is saying, no, no, no…and then you realize that actually the family is contributing to some of that negativity at home. So the family is creating a toxic environment. And that’s where we have let the young person know the potential ramifications of calling DHS and saying that this is an unsafe environment. And that we’ve given the family every chance. To learn, to grow. And they’re continuing to be part of the problem. So thankfully this was an important time when I realized it was worthwhile in starting the clinic at children’s hospital to have lots of meetings with the lawyers in risk management. To be able to say, “alright. I have the ethicist, I have the lawyer, I have the guru from risk management, I’m gonna sit down and say, I need to describe a case to you and make sure this is actually parents being negligent in the healthcare needs of their child.

Thankfully we’ve had a lot of support in that realm. Because of the trainings we’ve done with DHS workers in Delaware, Pennsylvania, and New Jersey. DHS workers will go and say you’re creating an unsafe environment for your child. And we need to have that stop.…unfortunately staying in that home environment is going to result in a child’s suicide.

So we see that gender specialists and activists are being proactive about going after parents who are saying “no no no” to the dictate that they must “affirm” their child as the opposite sex. They are “training” child protective services workers to pressure parents into “gender care”—or risk losing custody of their sons and daughters.

This isn’t a brand-new strategy. For example, at least as far back as June 2015, Jenn Burleton, an MTF and director of TransActive Gender Center, put out a call for attorneys to intervene in custody disputes involving “trans kids”, to enthusiastic responses on Burleton’s Facebook page.

Asaf Orr, for those who don’t know, is the lead staff attorney for the inaccurately named “National Center for Lesbian Rights” (NCLR). Given the fact that an increasingly large number of same-sex attracted adolescent girls are being transitioned, it’s hard to imagine any organization straying further from its mission than NCLR.

Regular readers of 4thWaveNow know that Burleton has been in the business of sneaking behind the backs of “unsupportive” parents with TransActive’s “In a Bind” free binder distribution program. Previously offered to young women 22 and under, the program now only sends binders to 18 and unders—secretly, if need be, subverting the will of parents who might have concerns about the unhealthy effects on their daughters: crushing pubescent breast tissue, bruising ribs, breathing and musculoskeletal problems, and more.

The topic of bending reluctant parents to the will of gender experts is a popular one for WPATH. In mid-February, we find some familiar people scheming away about what to do about parents who won’t give in, again including Jenn Burleton, who has had “some success” in convincing authorities that a parent’s unwillingness to approve hormones for their minor children is a form of “reportable trauma.”

At the February USPATH conference, Drs. Johanna Olson-Kennedy and Michelle Forcier, during the Q&A portion of their aforementioned talk on puberty suppression, tell their audience that they’re not afraid to involve the courts when they must to “bring along” the “recalcitrant” parents. One questioner, a psychologist who runs a gender clinic, wants to know whether there is a way to legally “force parents” to go along with the recommendations of a gender therapist to administer puberty blockers.

OLSON-KENNEDY: I can say that the stickiest situations I’ve had is where one parent is supportive and one isn’t and they share medical custody. And so we work really hard to bring both parents in and bring them both on board. Because even if you get a court order, the most protective factor for a good outcome is parental support. So it’s not my first line to go to court to get somebody what they need. But it is my second line and I will do it. We’ve been pretty successful in 5 or 6 situations where…we really had a recalcitrant parent that we just could not bring along.

For her part, Forcier says her team has been busy training family court judges in her region:

FORCIER: Yeah, there’s no precedent but you can again work with the child protection team for medical neglect. Work with one parent…at least to get things started. And again, you can do some education. We did education with judges in Rhode Island. We spent a half day with family court judges, telling them this is what gender and transgender is…

So there we have it. Activists/clinicians aren’t content to simply “educate,” cajole, or negotiate with parents. If parents aren’t terrorized into medically transitioning their kids by the relentless scolding that the only alternative is suicide, these people are perfectly willing to call the authorities on you; even to try to take your children away from you. And woe betide you if you’re a divorced or divorcing parent trying to put the brakes on hormones or surgeries for your minor child. The likes of Asaf Orr and other assorted attorneys assembled by adult trans activists will intervene in your custody dispute. (How ironic is it that an organization purporting to protect lesbian rights can be instrumental in forcing parents of lesbian teens to “transition” them to the opposite sex?).

Lest we simply dismiss all this as a form of mind-numbing hubris from people who should mind their own business, this excerpt from a letter written by four activist MtoFs in 2004 as part of a campaign to discredit sexologist Michael Bailey, might shed some light on the motivations of key activists who have been at the forefront of the pediatric transition explosion.

We are socially assimilated trans women who are mentors to many young transsexuals in transition. Unable to bear children of our own, the girls we mentor become like children to us. These young women depend on us for guidance during the difficult period of transition and then on during their adventures afterwards – dating, careers, marriages and sometimes adoption of their own children. As a result, we have large extended families and are blessed by these relationships. …

You may have wondered why hundreds of successful, assimilated trans women like us, women from all across the country, are being so persistent in investigating Mr. Bailey and in uncovering and reporting his misdeeds. Now you have your answer: We are hundreds of loving moms whose children he is tormenting!

So some trans activists fancy themselves the “loving moms” of (our) trans-identified kids, young people they consider their “extended family.” Not content to fight for their own rights to non-discrimination in housing and employment, activists like these were and still are the driving force behind the proliferation of pediatric gender clinics and activist organizations that have sprung up like mushrooms across the Western world in the last decade.

As should be clear from the examples in this post (representing only the tip of the iceberg), certain trans activists and gender clinicians will stop at nothing to force their will on parents who resist the affirm-only, puberty-blocking, sterilizing doctrine of pediatric medical transition. Rather than demonstrating a willingness to learn; rather than having the humility to consider that parents just might have a better handle on who their children are and what they need than a group of professionals beholden to an activist juggernaut, gender doctors and trans activists like Jenn Burleton may well try to take your children away from you.

What can be done? If you believe a gender specialist, psychologist, or doctor has rushed to “affirm” your troubled child as “trans”; if you believe someone entrusted with your child’s care has not adequately explored your child’s mental health and other underlying issues which may be contributing to their gender confusion, report them to their professional organizations and regulating boards.

Shriveled raisins: The bitter harvest of “affirmative” care

Posted on January 26, 2017 by 4thwavenow

Note to readers: This is another in an ongoing series of posts which shine a light on the public statements made by gender specialists in various forums. The aim here, as always, is to inform the public, particularly parents, about the actions and self-reported thoughts and plans of individuals who are currently involved in providing hormones and surgeries to minors. All screen captures are from publicly accessible (i.e. not password-protected or otherwise private) websites. We intend to continue to exercise our free-speech right to report on these public statements, as well as publishing our personal opinions on pediatric transition and those who enable and promote it.

To anyone who may object to our work in this area, hear this: The backlash represented by 4thWaveNow, Transgender Trend, Youth Gender Professionals, and the increasing number of individuals and organizations who question the burgeoning increase in child and youth transition is precisely that: a backlash against the decision taken by trans activists and their media handmaidens to relentlessly promote pediatric transition—especially MEDICAL transition.

The final straw, for many of us, has been the shameless and daily attempts by activists, journalists, and some clinicians to misuse self-harm statistics as a weapon to bludgeon parents into submission. A recent article in Spiked Online exposed this immoral and deeply destructive tactic, and we will continue to expose it on 4thWaveNow.

Scattered through the posts on this site, we have discussed the fact that puberty blockers followed by (or used concurrently with) cross-sex hormones to prevent the “wrong puberty” in prepubertal kids results in irreversible sterilization. This is well-recognized fact, openly acknowledged by researchers and top pediatric gender specialists alike [see the bottom of this post for a collection of links on this matter].

The reason is that gametes (sperm and ova) require natural, biological puberty to mature to the point that they are viable for reproduction. It is not currently possible to freeze immature gametes, as it is for those of adult trans people who have been allowed to go through natal puberty.

Our point is not that anyone and everyone should have biological children or that women are only fit to be baby machines (a red herring “argument” that has been used against us by trans activists). It also has nothing to do with the demographics of who will ultimately decide to bear or father children. (I notice none of these activists cavalierly argue for sterilization of disabled or gay people, both of whom have a lower statistical rate of becoming biological parents). The point is that it is a human rights violation to sterilize minors, who by definition cannot consent nor understand what it means to give up that future right. And given that the majority of “persisting” trans kids are same-sex attracted, it is not a stretch to see that prepubescent sterilization of “trans kids” amounts in many cases to a form of proactive anti-gay eugenics—even if that is not the conscious intention. What’s more, as many parents know, the decision to reproduce may come later in life, even if we thought in our youth that we wouldn’t have wanted children. Most young people naturally don’t spend their time thinking about having kids of their own; they have other priorities at that stage of life, as well they should.

But does any of this matter if adult trans people aren’t particularly interested in reproduction?

Well, it turns out that several studies have shown that a majority of trans men and trans women desire to have biological children of their own.

But even setting aside research evidence, all you have to do is look at the increasing number of (sometimes sensationalized) media stories about “pregnant men” to know this is “a thing”.

There are a sufficient number of trans men becoming pregnant and giving birth that the premier midwifery organization in the United States has changed all its literature to be “gender neutral” in an ostensible effort to avoid “triggering” its clients with words like “woman” and “breasts.” Planned Parenthood now campaigns on behalf of “menstruators” and the venerable La Leche League has even scrubbed its language of inconvenient mentions of biological reality, to ensure that trans men who want to “chest feed” won’t feel excluded.

But when it comes to the fertility of trans people, trans activists want to have their cake and eat it too: Celebrate and support adult trans who decide (often unexpectedly) to reproduce, while fiercely lobbying for medical intervention which permanently sterilizes prepubescent children. There is really no way to square this contradiction. They constantly claim that stopping the “wrong puberty” is the only antidote to suicide, yet that “wrong” puberty is the one and only pathway to possible reproduction in the future.

Not to put too fine a point on it, but the very people arguing that the only alternative to these sterilizing pediatric treatments is suicide are very much alive, and quite a fair few of them (notably, several top MTF trans activists) have biological children of their own. “Do as I say, not as I do” is rightly ridiculed as hypocrisy when it comes to any other subject. How on earth did these people survive to adulthood, father children, yet now harangue us that the “wrong” puberty of these children must be stopped?

As to the weaponization of suicidality: There is no record in the history of medicine of children and teenagers killing themselves because they could not medically transition in childhood, or because they were “born in the wrong body.” (Since August when this piece was posted, we’ve been waiting for any evidence to the contrary.) Even the most frequently cited “41%” study of trans adults who have reported suicidal ideation doesn’t assert that medical transition cures suicidality.

Source: Williams Institute, 2014

So, given that

large numbers of adult trans men and women express a desire to have biological children;
no child or pre-adolescent can know for certain whether or not they will eventually want to reproduce;
it is a universally acknowledged human rights violation to sterilize minors;
and there is no evidence that early medical transition will ultimately reduce self harming behaviors,

we must ask: Why do gender specialists continue the reckless practice of promoting sterilizing hormones and surgical interventions on prepubescent children, who, by virtue of their undeveloped powers of reason and judgment, cannot meaningfully consent to such treatments? On what authority does any adult—including these children’s parents—have the right to make a decision for a minor that should solely belong to adults of reproductive age themselves?

Even if it turns out to be true that most of these kids won’t opt for biological reproduction in the future, what of the (already limited) pool of potential life partners they might fall in love with? It’s not at all uncommon for couples to part company over disagreements about whether to have children. And then there’s the issue of what genital surgeries do to sexual response and function. None of this is ever discussed in the glowing portraits of “trans kids” that we see daily in the mainstream media (though it is by the clinicians themselves—as you’ll see shortly).

The gender specialists are fully aware of the irreversible effects of their interventions. Gender clinics detail the risks of infertility and other permanent changes on their consent forms. Research articles, public statements, and news articles capture the admissions by prominent gender specialists (again, see the bottom of this piece for links). Some express reservations (but no accompanying intention to cease and desist or even slow down their caseloads); some mention it in passing. And some, as you’ll see in a moment, appear to lose no sleep at night over what they’re doing, but only express interest in the future market for even more high tech interventions for the young people entrusted to their care.

Last March, Johanna Olson-Kennedy, MD (herself a parent), one of the world’s most successful and best known pediatric gender specialists, posted a call on the publicly accessible WPATH Facebook page for earlier genital surgeries on minors. We wrote about it at the time in this post.

The irony is inescapable: By puberty blocking young people, endocrinologists create a situation where these youth naturally yearn for puberty, as they watch their unblocked peers mature and move on. Olson-Kennedy’s solution? More high-tech, expensive medical intervention; earlier cross-sex hormones, earlier sex reassignment surgery. An iatrogenic problem created in the first place by suppressing the perfectly healthy bodies of young people.

Just a few days ago, Olson’s original post was revived via several new comments supporting her radical idea. This one, by Susan Maasch, founder of the Trans Youth Equality Foundation (TYEF) is particularly striking. ( We wrote about TYEF—a purveyor of free breast binders (secretly to girls with “unsupportive” parents) and youth transition propaganda, last year.)

“Shriveled raisins”: The outcome of years of hormone treatment unnatural to the female body.

Other activists and pediatric gender specialists, including Rixt Luikenaar (ironically, an OB-GYN), Kathie Moelig (founder of TransFamily Support Services), and others acknowledge that sterilization (which their clients may someday regret) will result from early surgeries and hormones, but place their faith in high-tech medicine to find a way around it—eventually.

This unquestioning belief that medical technology will solve the problems created by zealous “affirmative” gender specialists is widely shared. Just a couple of days ago, NPR ran an article acknowledging that immature gametes can’t currently be preserved for future reproduction. But by drawing on fertility preservation research in cancer survivors treated with sterilizing chemotherapy, the pediatric-transition pushers hope that puberty-blocked children’s ova and sperm can eventually be coaxed to reproductive viability in a petri dish.

Both groups — young cancer patients and trans kids hoping to transition early — have a demand for fertility preservation at an age where it has not usually been possible. But researchers say they are drawing closer to a solution with new techniques to freeze, or cryopreserve, immature reproductive cells…

… they started to look for ways to grow that tissue in a petri dish, so it can develop into a mature egg. “We’ve had to borrow knowledge from other disciplines and sort of figure out how that applies to trans people … What can be frustrating sometimes is having to adapt and extrapolate all of this information from work that is not done for trans people.” — Zil Goldstein, Mount Sinai

Brave New World. Puts a whole new spin on “test tube babies.” Not to mention a future boost for the surrogacy industry.

No one in the mainstream media—in this case, NPR– seems willing to point out the obvious: If you let these kids simply mature naturally–as their healthy bodies are desperately fighting to be allowed to do–they can preserve their fertility and decide whether they want to choose hormonal or surgical interventions when they reach adulthood, with mature judgment and reasoning powers. There would be the added benefit of giving kids a chance to desist before it’s too late—as so many were allowed to do before “gender affirmative” treatment was advertised 24 hours a day, 7 days a week. Only a few years ago, this would have been seen as just common sense caution. Adults-only transition was the norm.

There are other ramifications besides infertility resulting from this reckless rush for earlier and earlier surgeries and hormonal treatments. Here, Olson-Kennedy and other commenters analyze the impact of surgeries on sexual function—but disagree on how much should be discussed with the kids themselves about their future orgasm potential after their genitalia have been surgically rejiggered.

At least one “practitioner” seems not to want concerns about orgasm potential to be a “hindrance” to a child achieving their “authentic self”:

Bringing us into 2017, Jenn Burleton, head of Transactive Gender Center, assured the Facebook group on January 18 that orgasm is a discussion topic amongst “caregivers” in Transactive support groups. Good to know parents and other adults feel empowered to make decisions for these kids about their adult sexual function and fertility in their “support groups.”

(Just a thought: how many of these people publicly pontificating about the sexual function of children consider how they’d have felt as teens if adults had been scheming about their orgasm potential, and the impact thereon from a surgeon’s scalpel?)

In January 2017, nearly a year after Olson-Kennedy’s original post calling for the WPATH Standards of Care 8 to support earlier genital surgeries, many clinicians, activists, and parent leaders of trans youth groups remain keenly interested in lowering age of surgeries for youth. From the sounds of it, “many many” surgeons are eager to oblige.

Dan Karasic, MD, director of a gender clinic at UC San Francisco, moderator of the WPATH Facebook page, and a key player in WPATH and the co-chair of the recently formed USPATH, helpfully informs us that a discussion on under-18 surgeries will take place at the inaugural USPATH conference February 5 2017. “Advocacy” to pressure insurance companies to get onboard and pay for genital surgeries on minors is also an important part of the discussion.

This isn’t the first time we’ve seen Dr. Karasic advocating for lowering the age for surgeries. In this post, we discussed his public support for a mother obtaining double mastectomy for her 15-year-old and her attempts to get her insurance company to foot the bill for it.

Again: The people advocating for drastic and irreversible medical interventions on minors have enormous power over the future lives of children. The decisions they have taken with their careers and activism will impact a generation of youth for a lifetime. These adults, trans or not, were allowed to mature without medical interference in the era preceding this Age of the Trans Child.

Some of the people weighing in are trans adults, among them MTFs who have fathered children and had successful careers, who were not subjected to tampering and scheming about their most private and personal bodily functions as children. And as much as the trans activists may claim they’d have welcomed such interventions as children, the fact remains: Somehow they made it to adulthood, fertility and sexual function intact, without killing themselves.

Exactly what authority gives these people the right to advocate for and perform medical experiments on children, “trans” or not? This is a question a lot more people need to be asking.

Meanwhile, the USPATH conference session on surgery in minors is on Sunday, February 5 at 10:15 AM in Los Angeles.

Readers will undoubtedly recognize some of the names on this panel.

For more information about the irreversible sterilizing effects of puberty blockers followed by cross-sex hormones on prepubescent children, see below. Readers contributions are welcome and will be added to this list.

Sahar Sadjadi, The Endocrinologist’s Office—Puberty Suppression: Saving Children from a Natural Disaster?

It must be remembered that puberty suppression as the first step to medical transition, if followed by cross-sex hormones, which has been the case for almost all reported cases, leads to infertility due to the permanent immaturity of the gonads and the reproductive tract. The absence of the discussion of sterilization of children as a major ethical challenge in this bioethics article, and many other clinical debates on puberty suppression, is striking. For any other group of children, such an intervention would be discussed extensively with ethics review boards. (What grounds might justify the permanent elimination of the child’s reproductive ability? Should parents be able to make such a decision for the child? Which futures are opened by the treatment and which ones are foreclosed? How might benefits be weighed in relation to the loss of reproductive capacity?) The media would likely react with investigations and questions about the long-term consequences of treatment. These “queer” children’s bodily integrity and reproductive rights should not be any less pressing than other children’s. Needless to say, children are not legally capable of consent, and 9–10 year olds are not capable of understanding all the health consequences of the treatment. Parents are asked to make life decisions on issues as critical as fertility for young children. Can they make an informed decision and evaluate benefits vis a vis risks when confronted with such horrendous forecasts for their children?

Unique ethical and legal implications of fertility preservation research in the pediatric population

Norman Spack, MD, founder of first US pediatric gender clinic:

The biggest challenge is the issue of fertility. When young people halt their puberty before their bodies have developed, and then take cross-hormones for a few years, they’ll probably be infertile. You have to explain to the patients that if they go ahead, they may not be able to have children. When you’re talking to a 12-year-old, that’s a heavy-duty conversation. Does a kid that age really think about fertility? But if you don’t start treatment, they will always have trouble fitting in. And my patients always remind me that what’s most important to them is their identity.

Brill & Pepper, The Transgender Child, 2008, p. 216

“The choice to progress from GnRH inhibitors to estrogen without fully experiencing male puberty should be viewed as giving up one’s fertility, and the family and child should be counseled accordingly”. For girls, sterilization is the outcome too, because “eggs do not mature until the body goes through puberty”

Diane Ehrensaft, video clip from conference. Time stamp: 5:06

“Another thing that’s a show-stopper around [parents] giving consent is the fertility issue. That if the child goes directly from puberty blockers to cross- sex hormones they are pretty much forfeiting their fertility and won’t be able to have a genetically related child.”

Robert Garofolo, PBS.org:

“It’s an imperfect field with regards to decisions we are asking these families to make,” acknowledged Dr. Robert Garofalo, who co-directs the Center for Gender, Sexuality and HIV Prevention at Chicago’s Lurie Children’s Hospital and is also working on the transgender youth study. Garofalo hopes the team will be able to study patients far beyond the current five-year term to address a host of questions that currently have no answers. Does hormone use in trans youth increase breast cancer risk? How well do adults who have transitioned as teens grapple with their loss of fertility? “These are things that are entirely unknown,” Garofalo said.

Announcing a new online survey for detransitioned women

Posted on August 16, 2016 by 4thwavenow

Cari is a 22-year-old detransitioned woman who was interviewed recently on 4thWaveNow about her experiences as a former teen client of Transactive Gender Center in Portland, OR. Cari wrote to us today to announce an online survey she has created for women who are reclaiming themselves as female. I’ll let her introduce her work in her own words shortly. But first, if you have not had a chance to watch Cari’s very powerful YouTube video, please do so. In it, she deftly takes apart a post on trans youth, desistance, and detransition by trans activist MtoF Julia Serano.

A real live 22-year-old detransitioned woman

Cari is not the only detransitioner talking back to Serano. Several other women have come forward in recent days to eloquently and incisively describe the many facets of the female detransitioned experience, including Maria Catt and crashchaoscats. Transgender Trend also posted an excellent response to Serano.

Now I’ll let Cari introduce her Survey of female detransition and reidentification. Please share widely!

This survey is for anyone female/AFAB who formerly self-described as transgender. This includes women who transitioned, whether socially and/or medically, and have subsequently detransitioned, as well as individuals who still identify as nonbinary or genderfluid, but have desisted from medical or social transition. The purpose of this survey is to provide information about the demographics of those who detransition and reidentification, motivations of individuals to detransition, and survey general attitudes of female detransitioners towards transition.

I’m posting this as a way of getting some data about detransitioned women where none seems to exist, particularly regarding motivation to detransition and the efficacy of managing dysphoria without transition. This survey is short due to surveymonkey’s question limit, and not very scientific, however I may create a longer and more controlled one in the future, should there be interest in that.

Please share this survey widely

An inconvenient survey: Activists scheme to squelch research on teen social contagion

Posted on August 14, 2016 by 4thwavenow

One might think that purported pediatric gender experts would have a vested interest in investigating all facets of the current worldwide massive increase in kids wanting to chemically and surgically transition to the opposite sex. After all, in most civilized societies, adults want to protect young people and seriously ponder what’s best for them—all of them. Certainly, when it comes to permanent, lifelong medical interventions, most responsible professionals who work with youth would realize that not everyone who wants a treatment is necessarily a good candidate for it; as one bioethicist memorably put it, “a doctor is not a candy seller.”

But at least one director of a well known pediatric gender center and national trans activist lobbying group in Portland, OR—a full-grown adult who nevertheless takes to Facebook to brand anyone not fully on board with the organization’s mission as a “TERF ” or “anti-trans hate group” —evidently cannot tolerate a researcher even studying the phenomenon of teens who came quite suddenly to the idea of transgender identity. [Note: All screen captures are from Burleton’s publicly accessible Facebook page.]

The survey study, “Rapid onset gender dysphoria, social media, and peer groups” (still actively recruiting participants) seeks to better understand, via parent survey, the phenomenon of teenagers who (after never previously expressing gender dysphoria) suddenly announce they are the opposite sex. Many parents in the 4thWaveNow community have teens who, in many cases, have demanded immediate access to medical transition, with all that entails—cross sex hormones (with concomitant permanent body changes, particularly for biological females), and major surgery, often involving removal of both breasts. Some of these teens changed their minds about transition, while others have not–but all are worth studying in the interests of discovering whether there is (as many of us have observed) a social contagion contributing to the increase in teens (especially teen girls) who express a desire to become the opposite sex.

Wouldn’t any reputable purveyor of a treatment which will change the lives of teenagers forever have even a modicum of intellectual curiosity about what such a survey might reveal? One would think, also, that Jenn Burleton might feel slightly chastened after recently hearing from a detransitioned, former teen client who was unhappy about the fast-track transition that was enabled by TransActive gender counselors. Instead, Burleton (whose Facebook description lists only studying “Resilience at the University of Life“ as professional credentials) would rather cast aspersions on the MD/MPH conducting the “bogus” study, as well as the organizations and websites (including this one) which have publicized the research effort.

Commenters on Burleton’s post (who were obviously approved by Burleton) go even further, with one intending to deliberately “throw off the statistics” on the survey.

Burleton obviously approves of the “throw off the statistics” scheme:

If trans activists are so confident that kids as young as 3 or 4 can be legitimately and reliably diagnosed as “transgender” and in dire need of intervention by organizations like TransActive, why would the executive director need to stoop to childish tactics like screaming “TERF” and encouraging Facebook followers to gum up a survey study? What’s the worry? Why wouldn’t someone with such a huge responsibility for the well being of teenagers want to learn more about teens who were simply following a social trend, later changed their minds, or who actually might not be appropriate for treatment?

Burleton’s open hostility and the jeering, sophomoric reaction of the post’s followers lead inexorably to a question: Are some key activists in the forefront of pediatric transition genuinely interested in looking at all the evidence about “trans kids”? Or are they, instead, driven by a desire to shut down any and all inconvenient fact-finding efforts when it comes to promoting drastic medical interventions for other people’s children?

Anyone with a rudimentary understanding of the meaning of a Facebook “like” won’t have much difficulty answering that question.

Jenn Burleton, director of youth transition org, dismisses ex-client’s complaints as “TERF infestation”

Posted on June 12, 2016 by 4thwavenow

This is an update to Friday’s post. Please read it first for background.

UPDATE June 14, 2016: TransActive Gender Center and director Jenn Burleton have issued public statements on their Facebook pages. TransActive has labeled 4thWaveNow an “anti-trans hate site” because we have provided a platform for Cari to tell her story.

It’s a common tactic of trans-activist organizations, which can tolerate no dissent, to dismiss critics of pediatric transition as “transphobic” or “hating trans children.” We at 4thWaveNow–the majority of us being concerned parents of gender nonconforming youth–invite all readers to investigate the posts, interviews, and research-based information on our site and decide for yourselves whether 4thWaveNow “dispenses anti-trans youth rhetoric.”

Cari, a detransitioning 22-year-old ex-client of TransActive Gender Center, has written on her Tumblr blog about her dissatisfaction with the services provided by that organization when she was a gender-dysphoric teenager.

Jenn Burleton, director and founder of TransActive, chose to respond indirectly to Cari via a public Facebook post. When reading Burleton’s screed, bear in mind that Burleton runs an organization which has considerable influence over the lives of gender-defiant youth. In addition, Burleton is an advocate for lowering the age of medical consent nationwide, and was instrumental in changing Oregon law to allow teens as young as 15 to obtain surgeries (including mastectomy and “bottom” surgeries) without parental consent. Burleton also believes (and has stated on the WPATH public Facebook page) that TransActive’s no-questions-asked youth transition program disproves decades of peer-reviewed research demonstrating that most gender-dysphoric youth desist. In the linked post, Burleton claims a 0% desistance rate for clients seen at TransActive. Clearly, Cari’s case calls for–at the very least–some soul searching and re-evaluation of TransActive’s policies and public statements.

Burleton’s public Facebook response—aimed at a 22-year-old who was only 16 years old when she was encouraged and enabled by TransActive to medically transition–refers to Cari’s Tumblr posts as a “TERF infestation” and a “harassment campaign.” Decide for yourself, after reading Burleton’s Facebook post and Cari’s response (which Burleton has not made public), who is the injured party in this situation.

Cari told 4thWaveNow that she is grateful for any support readers can offer in publicizing her former and now current experiences with representatives of TransActive Gender Center. At her request, we are reproducing screenshots Cari posted on her Tumblr blog yesterday.

Cari’s response, sent to Burleton via Facebook Messenger:

TransActive doubles down on fast-track transition policy with clueless reblog of ex-client who decries their lack of gatekeeping

Posted on June 10, 2016 by 4thwavenow

UPDATE June 12, 2016: Jenn Burleton, Director of TransActive Gender Center, has responded. See this post for details.

Regular readers will recall ”In praise of gatekeepers,” the 4thWaveNow interview with Cari, a former teen client of TransActive Gender Center in Portland, OR. In her interview, Cari, now 22, told us that TransActive “counselors” made it far too easy for her to be referred for medical transition at age 16; she started testosterone at 17 and moved on to “top surgery” (double mastectomy) soon thereafter. In retrospect, Cari wishes there had been a lot more gatekeeping at TransActive—especially because her counselor never suggested investigating whether Cari’s history of trauma and comorbid mental health issues might have played a part in her desire to transition.

A few days ago, Cari wrote a post pointedly criticizing TransActive’s gatekeeper-free teen transition policies.

Whoever manages TransActive’s official Tumblr blog reblogged Cari’s post, but instead of addressing her concerns, they simply doubled down on their propaganda:

Either this TransActive employee has trouble with reading comprehension, or they just figured that spamming Cari’s Tumblr followers with their superRAD!-no-mean-cis-gatekeeping policy would somehow drown out her silly concerns. But either way, as Cari told 4thWaveNow, “This should give people some insight into how TransActive treats detransitioned ex-clients. Whoever runs their social media accounts has so little empathy, they reblogged a post by a woman who was irreparably harmed by their org and acted like I was praising their services. ”

Additionally, Cari told 4thWaveNow that she had previously written to TransActive to ask what services they could provide to someone who was unhappy with transition and wanted some support for detransitioning. TransActive’s response was to send Cari a list of therapists—all of whom were trained by TransActive, and one of which is an employee of the LLC, BraveSpace, a newly established trans youth counseling org which has replaced TransActive’s in-house therapy program. “This concerns me,” Cari told us. “While I’m speculating here, I know many detransitioned women I’ve spoken with have issues with therapists who think they are simply experiencing “internalized transphobia” or social pressure and therefore try to convince them to retransition.”

Given TransActive’s track record of spurring kids and teens on to hormones and surgeries—as well as the complete absence of any acknowledgement that regretters or detransitioners exist (let alone listing any resources for detransitioners on their very professional looking website), it’s unlikely an unhappy ex-client like Cari would find a sympathetic ear from any of the “counselors” affiliated with TransActive.

A couple of days ago, Cari tagged TransActive (i.e., she invited them to respond) in a followup post with a very clear message about the failings of her former TransActive “counselor” Sheryl:

As of this writing, TransActive hasn’t reblogged nor replied to Cari’s latest post. Maybe they’ll be better at taking a hint with pictures than with words? Stay tuned.

In praise of gatekeepers: An interview with a former teen client of TransActive Gender Center

Posted on April 21, 2016 by 4thwavenow

Cari is a 22-year-old woman who previously identified as a trans man. She pursued medical transition at 16, with the support of TransActive Gender Center in Portland, OR. She was on testosterone by the age of 17, and had “top surgery”(double mastectomy) a few years later. Cari says she has been moving towards detransition for over a year now, and started taking concrete steps towards it a couple of months ago, including stopping testosterone.

In this interview, Cari shares her thoughts on transition, parents of trans-identified kids, and her experience with TransActive Gender Center, with a particular emphasis on that organization’s exclusionary focus on medical transition. For gender-dysphoric young people, Cari advocates for greater mental health support, as well as the chance to explore alternatives to hormones and surgery as treatments for gender/sex dysphoria. You can read more of her thoughts on her Tumblr blog.

Cari brings up a number of interesting and controversial points; your comments and questions are encouraged, and Cari is available to respond to them in the comments section of this post.

How old were you when you first began working with TransActive? What brought you there?

I was 16, and I had come out as transgender about a year prior. I found them through a friend who had received therapy there. They were the only gender therapists I could find who offered a sliding scale, which was huge for me since I was paying for my own therapy.

What services did TransActive provide or recommend?

I was given therapy there primarily for the purpose of transition care—getting a referral to an endocrinologist for hormone therapy, and a letter to change the gender marker on my driver’s license. I had been hospitalized about a year prior to starting counseling there due to suicidal ideation and non-suicidal self-harming behavior, but this was not a focus of treatment, other than discussing ways that transition would help with my depression. I was not receiving any other form of counseling for my mental health at the time.

They also recommended their therapy groups and “FreeZone,” which is a social group for trans children, their parents, and TransActive staff, but I didn’t attend those. FreeZone struck me as kind of a weird thing, since it would entail seeing my therapist and probably her other clients in a social setting.

Did any counselors there attempt to explore whether there might be other underlying issues which could contribute to you claiming a transgender identity? Was there ever a concern that other mental health problems could interfere with a “successful” transition?

My counselor did not explore this with me, other than what seems to be the standard, cursory question of “Would you be able to be happy being a butch lesbian?” or something along those lines. It seems like everyone asks this question, thinking it’s somehow going to help dissuade people who are transitioning for the wrong reasons, but with all the other positive things that are said about transition, it doesn’t really work. I didn’t know that I was a lesbian until after I had started to detransition (primarily due to dating trans men), so this question didn’t strike me as relevant at the time, and there wasn’t any discussion of alternative ways to deal with sex dysphoria. This may simply be because there isn’t much information about alternative treatments in general.

However, I also had an experience there which I believe to be directly negligent on the part of the therapist. During the course of my therapy, before I received a referral for hormones, I began to have trauma flashbacks, which I hadn’t previously remembered. I brought these up to my therapist, and her only response was to devote one or two sessions to it, and then continue with the transition therapy process. This process seemed to be primarily about validating pretty much whatever I said about my gender/planning and mapping out a timeline for my transition, and it was not brought up at any point that prior trauma might have anything to do with dysphoria. The implication that was always present, in therapy or in the other trans-related discussions I was part of, inside and outside of TransActive, was that if I was trans (and my therapist never gave me the impression that I might not be), my options were “transition now, transition later, or live your life unhappy/commit suicide.” To a teenager who is struggling with mental health issues, this is a very attractive proposal: “This is The Cure for all of the emotional pain you’re feeling”.

How did your parent(s) feel about your trans identity? Were they supportive? How do they feel about your decision to detransition?

My parents were supportive of (if a little confused by) my “social transition” (using my male name/pronouns, binding, etc) but thought that I should wait to transition physically until I was over 18. The staff at TransActive told me I didn’t need their permission for hormones, however, and that they would refer me, so I think eventually my parents may have just gone along with it because they know how stubborn I am.

My parents are supportive of detransition, but told me they wanted me to make sure I was certain about it before “coming out” again. It’s kind of hard to explain that no, your son who used to be your daughter is now your daughter again.

This might be a good place to mention that I pretty recently came to the decision to detransition, so my experiences and opinions are influenced by the rather fluid and unsettled stage of life I’m in right now, and probably not representative of someone who has had more experience living as a detransitioned woman. I can speak as someone who feels that TransActive did not adequately prepare me for transition or present me with alternatives, but I don’t want to try to present my experience as an example of detransitioned women in general, only representative of me, one detransitioning woman.

It seems that many gender specialists, and certainly many activists, are highly critical of attempts to “pathologize” people who identify as transgender. In fact, there is a movement afoot that says attempts to “gatekeep” trans-identified people with other mental illnesses is a form of “ableism.” and that even a person with Down Syndrome or on the autism spectrum should be allowed to medically transition, even as a minor. What are your thoughts on this?

I don’t think that people with comorbid mental illness should necessarily be barred from transition. What I do think is that there should be significant attempts to treat those conditions first, to rule out their involvement in dysphoria. I’m ultimately of the opinion that adults are allowed bodily autonomy, no exceptions, but that if we’re going to medicalize being transgender (which is the basis for having insurance cover it, having it be a protected identity, receiving any kind of special consideration under the law for anything, really), then there needs to be a standard of care that includes ruling out less invasive forms of treatment. It’s not considered best medical practice to jump to major surgery for any other condition, if there’s a reasonable possibility that medication or lifestyle changes could provide the same benefit.

I think that in my case, it’s entirely possible that I would not have been responsive to the idea that transition was not the only means of helping me. I know myself, and how stubborn I am, which I can’t blame TransActive or WPATH or ICATH or the APA or anyone else but myself for. But I do think that they need to be at least exploring these options. If I had been exposed to the idea that transition was not the be-all end-all of treating dysphoria, and that there were other viable options like treating my underlying mental health issues, I would be much more comfortable with their practices. But I wasn’t.

Trans activists vociferously deny that social media/trends could be a factor for some teens wanting to transition, yet it seems obvious to outside observers that the huge increase in girls identifying as trans is at least partly a result of immersion in Tumblr, YouTube, and other online forums. Did “social contagion” play a role in your own identification as trans?

I believe that it’s an oversimplification to blame social media for the increase in early transitioners. I think it has definitely played a role in younger people finding out that transition is a thing they can do, which to my mind isn’t an entirely negative thing—this is the same platform that allows LGBQ youth to connect with others who have similar experiences and find community. I think the increase is probably similar to the increase in teenagers going through a “bisexual phase”—it doesn’t invalidate the experiences of people who really are bisexual and discovered this in their teens, but it does mean that with the increased visibility of LGBQ people, that there is a higher incidence of teenagers questioning their sexuality. Now, with information about transition being readily available online, and a growing community of trans people to connect with, more young people are questioning their gender. The only difference being, questioning your orientation doesn’t make you want to pursue permanent medical interventions to your body, and it isn’t posited as a necessity for an LGBQ person.

To answer the question that you actually asked, though, online forums did play a significant part in my decision to come out as trans. I wasn’t so much into YouTube, though, and this was before Tumblr was a popular site. However, once I actually did come out, many, if not most of my formative interactions with the trans community (i.e., ones that influenced my decision to transition) were in-person ones, either through support groups or social events or LGBTQ youth spaces.

You no longer identify as transgender. What was your process of deciding this wasn’t right for you?

Actually, this is kind of funny, since your last question was about social media influencing people to transition. My decision to detransition was largely informed by social media, Tumblr in particular. Not that the detransition community, such as it is, convinced me to do so; my interactions with other detransitioned women have been limited since it wasn’t until recently that I stopped just reading and actually started interacting. But in the short time I have been communicating with other detransitioned women, I haven’t really ever felt any kind of pressure from them to do something particular about my transition, or to subscribe to any particular ideology. Rather, my experiences of reading the writings of detransitioned women were influential to me because they gave me what organizations like TransActive never did: images of women who had experienced the same things I had, who had struggled with dysphoria, and had found methods of making peace with their bodies in a way that I was starting to realize transition never would for me. Transition was very helpful for me in a lot of ways, and I wouldn’t say that I regret my decisions, but at some point it just ceased to be helpful to me. I think it helped me to be comfortable with my body and at some point I realized I was comfortable enough that I could stop, that I was ready to recognize myself as female again.

Do you believe some kids or teens are “truly trans”? Do you think gender identity is innate or “baked in” at birth? And if so, what differentiates true trans from people who thought they were trans, but eventually decide to detransition?

I think the scariest thing for me in my decision to detransition is that I haven’t really seen a whole lot to differentiate people who transition and are content, and people who transition and realize they made a mistake. I’ve seen people who checked all the “true trans” boxes, who were “transmedicalists” or believed themselves to be “just men with a medical condition,” who later detransitioned, or reidentified with their sex, or at the very least expressed serious doubts about their own motivations for transition, whether they pursued those doubts or not. I’ve also seen people who really didn’t seem to check those boxes, who had been transitioned for years and were still very happy with their decisions. I’d like to say that I know exactly how to tell the difference between the people who will end up happy with their transitions, and those who realize it isn’t the right choice for them, but the truth is I don’t. I think that all we can really do is to ensure that there are attempts being made to present all options, and to rule out other issues that might need to be treated first.

I also think that there are people for whom transition is the best choice, or at least the best choice they could have made under the circumstances. I’m coming to terms with the idea that I really just don’t have conclusive answers, that it doesn’t seem like anyone does, and that perhaps the best we can do in these situations is to try to make peace with our bodies as best we can. That perhaps there just aren’t any easy, unambiguous, black-and-white answers about why people are dysphoric or whether transition is the right choice for them. That’s what I wish organizations like TransActive would embrace–not “this is your only choice,” not “this is not a viable choice at all,” but instead, “we don’t have all the answers, but here’s what we know about your options.”

Partly due to lobbying by TransActive and its director, Jenn Burleton, the state of Oregon now permits trans-identified teens as young as 15 to obtain surgeries (including mastectomies and hysterectomies) without parental consent. TransActive is networking with activists and lawyers in other states to push for lowering the age of medical consent nationwide. Given your own experiences, do you think there should be a minimum age for medical intervention for trans-identified people? What age is appropriate to begin cross-sex hormones? To receive “top surgery?” To undergo bottom surgery and/or hysterectomy?

I think the idea of someone being able to get transitional surgery underage is concerning—in the state of Oregon, you can’t get a tattoo underage even with parental consent, but you can be permanently sterilized at 15 without any parental input. This is built off the law that minors 15 and older can consent to their own medical and dental diagnosis and treatment, up to and including surgery, but it seems to me that these kinds of surgeries are things that can wait until someone is at least 18. You can’t diagnose many mental disorders, such as personality disorders (which I have personally seen as a contributing factor in people incorrectly thinking they are trans) until the age of 18, and it seems reasonable to me that permanent surgical interventions for what is arguably a psychiatric issue be held off on until that age. I don’t know what I think about underage hormone treatment, but I lean towards the idea that it should be available, but that again, proper alternative treatment and safeguards need to be in place, that it needs to not be the sole focus of treatment or option presented.

What advice would you have for parents who are concerned about the seeming trend in kids identifying as trans? There is very little support for parents who don’t simply go along with their child’s announcement.

I think it can be a very delicate thing, as I’m sure you know. Children and teens who are questioning their gender are usually in a very vulnerable state. I think they often feel that the people around them can’t understand what they’re going through, and that leads to feeing very alone and isolated. I know I felt that way, and when I encountered resistance to my transition, it really made me feel that interacting with those people was unsafe or that they felt contempt or condescension for me and for what I was feeling. I did cut off or restrict contact with a lot of people due to them not supporting my transition.

So I think it is of the utmost importance that parents go about it with a lot of respect for their kids and validation that what they are going through is an incredibly difficult and painful state, without that necessarily meaning you’ll go along with their desires unquestioningly. I think it’s possible to have a child-centered process without it being all about transition. Brainstorm with them about what they might be able to do to help them cope with their dysphoria, support them in going to therapy, but suggest that they examine other modes of treatment in therapy before seeking transition, things like that. Try to make yourself a safe and supportive person for them to trust with their feelings—this not only allows you to make suggestions to them and discover their underlying feelings and motivations for transition, but also means that they might not be as scared to say, “hey, I think I might have made a mistake/I have these questions and the community isn’t answering them.” Knowing that my parents supported me making my own choices and weren’t about to say “I told you so” was a huge factor for me in feeling comfortable when I told them about my decision to detransition

That said, I think it’s entirely reasonable to set the boundary that you aren’t comfortable allowing them to medically transition while underage. As my parents explained it, once you’re 18, you can make whatever decisions you want, but this is something that you should take responsibility for as an adult person, rather than us signing off on it for you. Of course, this didn’t end up working for me, since I lived in Oregon, a state that allowed underage consent to transition. But regardless of that, I think it was a good thought for them to have and express.

Do you think parents should buy binders for their daughters who identify as trans men? Some parents feel it amounts to a “slippery slope” that may lead to their child seeking top surgery.

I don’t know that I think a parent “should” give their kid anything other than, you know, the things any parent should give that have nothing to do with gender identity–food, clothes, medicine, age-appropriate activities, an allowance if you can afford it, etc. I always bought my own binders, and paid for my testosterone prescriptions even when my parents were paying all my other medical expenses. I do think it’s invasive that a lot of parents will cut up their children’s binders or confiscate them. I think if a kid buys something for themselves that’s helping them cope and not making permanent unhealthy changes to their body, then it should be tolerated. Doing something like taking a binder away is really only going to deepen the distrust the kid might have. Obviously if they’re binding with Ace bandages or tape or something, that should be discouraged, but I don’t see an issue with a teenager having a safe means to bind. As to whether it’s a “slippery slope,” I suppose it’s possible. I think I would say the same thing about letting your child bind as I would about anything transition-related: I don’t think it’s right to bar your kid from expressing themselves or exploring their identity, but that the more important factor is making sure they have proper information and resources, including the ways they could cope with their body without these interventions, and ideally, role models who have found a variety of ways of to cope with their gender nonconformity and/or dysphoria.

Suicide risk is often given as the main reason children and teens should be “affirmed” in their trans identity. What do you think about that?

I think it’s something to approach with caution. Suicide risk is a good reason to treat a lot of mental disorders and medical conditions, and I think the fact that gender dysphoria is one of those disorders is not necessarily cause for alarm. Someone being a suicide risk without psychiatric medications is a good reason to give them psychiatric medications, someone being a suicide risk because of neuropathic pain, which isn’t likely to physically kill you, is a good reason to give them pain medicine. Someone being a suicide risk due to feeling disconnected from their physical sex can, I believe, be a good reason to give them cross-sex hormones and surgeries, provided other courses of action have been examined in an objective way, and having really looked at those other options, medical transition still seems to be the best choice.

What I think is more concerning is the trans community’s tendency to present suicide as basically the only alternative to transition, and to martyr trans individuals who do commit suicide, as I think we saw pretty strikingly in the case of Leelah Alcorn.

Trans activists decry “gatekeeping,” with the current trend moving towards “informed consent,” trust in self identification, and earlier and earlier medical intervention, even for children. Do you agree with this trend? Why or why not?

I think this has been pretty well addressed with my answers to other questions, but to make it explicit, my opinion is that gatekeeping is absolutely necessary. Denying someone any kind of care for their issues is medical neglect. Forcibly trying to change someone’s mind about being trans is medical abuse. Showing someone all available options, following a standard of care that takes all of them into account, and ruling out a differential diagnosis that could be treated without permanent bodily alterations, is neither of those; it’s just part of providing good healthcare.

There has been some tension between gender critics—especially gender-critical feminists—and women who have detransitioned. I have read that some detransitioned women feel they are used by feminists to make a point that all transition is harmful. Quite a few detransitioned women write that self hatred and/or internalized misogyny or homophobia were factors leading them to transition in the first place, but when these same factors are pointed out by gender critical feminists, detransitioned women sometimes object. I wonder how much of the tension is down to a generation gap? Some Second Wave feminists who experienced gender dysphoria as children believe that if medical transition had been available at the time, they’d have jumped at the chance and likely been diagnosed as trans. On a political level, if detransitioned women and gender critics could unite, they could have the potential to make important changes in how children/teens are currently treated. How can this rift between gender critics and detransitioned people be healed?

I believe you included this question to address my stated uncertainty about doing this interview, due to my experiences being co-opted by radical feminists in the past. However, my experience of this happening was while I was still in transition, so I don’t have personal experience of what you’re describing.

From what I’ve seen, I think a lot of the backlash from detransitioned women has to do with the, honestly, very unkind and insensitive way that some radical feminists talk about transition—saying that trans people are “delusional,” that transitioned/detransitioned people are “mutilated,” etc. Whether or not transition is a good idea (for anyone), this kind of attitude really trivializes the emotional pain, the social struggle, and the complicated and messy ways in which people come to the decision to make these changes to their bodies. In my own case, I believe I made the best choice I could, given the options I was presented with. I don’t appreciate being called “mutilated” for doing what I felt I had to in order to survive.

I think it’s really great that radical feminism focuses on the social roots of these issues and doesn’t just go with whatever choices people feel like making without examining them critically. But I also think that sometimes can lead to a lack of compassion for the people who make those choices, and a lack of allowance for nuance and grey area around how people interact with and cope with their social realities regarding gender. I don’t have a concrete answer for you about how radical feminists can ally themselves with detransitioning women, but I think it has to start with a good hard look at the way these issues are talked about, to make sure that we’re having these discussions in a way that shows empathy for the people who are affected by this, whether they’re questioning or transitioning or transitioned or detransitioned

How are you doing now? Have you received any support from doctors or therapists/counselors for your detransition? Does TransActive provide any services for people who change their minds?

By the time I decided to detransition, I was not receiving gender identity-related therapy. However, my current therapist knows of my detransition, and is fully supportive of it. In fact, he told me he would not have signed off on my transition if he had been my therapist when I was transitioning, given what I’ve told him of my circumstances.

TransActive does not, to my knowledge, provide any services for transgender adults, so I wouldn’t expect them to provide anything for detransitioning adults. (I’ve recently contacted TransActive asking if they have any services/could refer a detransitioning person to services, and will update this response once they reply).

Guest post: Why do WPATH & the APA scorn desistance?

Posted on January 23, 2016 by 4thwavenow

This post is written by overwhelmed, a 4thWaveNow community member and mother who recently wrote about her own daughter’s desistance from trans identification. Her personal experience inspired her to submit this piece about the current effort by some activists and gender specialists to discredit decades of peer-reviewed evidence that most children with gender dysphoria do indeed change their minds.

Stay tuned for an upcoming post by 4thWaveNow that will take a closer look at the anti-desistance meme being propagated by proponents of pediatric “transition.”

by overwhelmed

There should be regulations in place to protect our children from harmful medical interventions. I think most people would consider this statement a matter of plain common sense. But unfortunately, common sense seems to fly out the window when “trans kids” are involved. More and more gender dysphoric children are being treated with puberty blockers, cross-sex hormones and even surgeries at young ages.

Trans activism has been busily exerting political influence on the medical field. Being closely tied to LGB has given the T legitimacy (even if the aims of T conflict with those of the LGB). Trans activists have helped convince the public that gender identity is comparable to sexual orientation. They insist that helping children become comfortable with their birth sex is as abominable as conversion therapy is to homosexuals; that it is bigoted to want a child to avoid being transgender, just as it is bigoted to not accept a person as gay. But, the thing is, unlike the T, the LGB doesn’t require all of these medical treatments. And, unlike the T, the LGB just want people to accept their sexual orientation. Besides political gain, there really is no good reason to conflate gender identity and sexual orientation.

Recently, trans activism forced the closure of the CAMH Gender Identity Clinic in Toronto. In response to this closure, sexology researcher Dr. James Cantor posted a compilation of childhood gender dysphoria research going back many decades on his site Sexology Today:

Following the closure of the CAMH Gender Identity Clinic for children, I have been receiving requests for what the science says. Do kids grow out of wanting to change sex, or does it continue when they are adults?

In total, there have been three large scale follow-up studies and a handful of smaller ones. I have listed all of them below, together with their results. (In the table, “cis-” means non-transsexual.) Despite the differences in country, culture, decade, and follow-up length and method, all the studies have come to a remarkably similar conclusion: Only very few trans- kids still want to transition by the time they are adults. Instead, they generally turn out to be regular gay or lesbian folks. The exact number varies by study, but roughly 60–90% of trans- kids turn out no longer to be trans by adulthood.

Cantor shared his post on the the World Professional Association for Transgender Health (WPATH) Facebook page. Although WPATH supposedly promotes evidence-based care and research, the vast majority of WPATH Facebook commenters appear to have strongly held opinions that contradict WPATH’s professed mission. Many state that once someone identifies as transgender, they will be transgender for life (regardless of the age of realization). Some commenters say it is a right for anyone (gender dysphoric or not) who wants to have these medical interventions.

When confronted with Dr. Cantor’s research compilation, there were many attempts to discredit the information. Some commented that the studies were old, flawed, invalid, and called them “junk science.” But others were more confrontational:

Another commenter, Colt Keo-Meier, trans activist academic and recent (2013) psychology graduate from the University of Houston, is currently the co-chair of the Committee for Transgender People and Gender Diversity, Division 44 of the American Psychological Association (APA). This committee issued guidelines a few months ago that effectively put a damper on the clinical judgment psychologists and social workers can use when treating their gender nonconforming and trans-identified clients (more on these APA guidelines shortly). Keo-Meier apparently believes that a child’s persistence in a transgender identity is to be desired.

The last commenter on Cantor’s thread I will mention is Jenn Burleton (of “In a Bind” fame), who here discounts the research compiled by Dr. Cantor (referred to by Burleton as “Mr. Candor”) as flawed, while bragging about the 0% desistance rate of the over 200 kids seen at Burleton’s TransActive Gender Center.

Jenn Burleton seems to celebrate the 0% desistance rate, but the fact that it contradicts decades of prior desistance research should raise alarms. What approach do they use at the TransActive Gender Center to obtain these “impressive” results?

Here are TransActive Gender Center’s “Best Practices” :

So gender-confused children seen at TransActive are affirmed as the opposite sex, socially transitioned, and treated to the “empowerment” of pubertal suppression, cross-sex hormones and surgeries. Is it any wonder these kids don’t desist? They are literally being conditioned to keep believing something is wrong with their bodies. Additionally, these socially transitioned children, even if they did start to have doubts, will likely feel tremendous pressure not to go back to their birth sex. Adolescence is already challenging enough without these complications. Just imagine how difficult it would be for a child in public school to start out as Jennifer, but later change to John.

As it turns out, the American Psychological Association (APA) recommends the affirming and accepting approach that Jenn Burleton has put into action. (As an aside, it should be noted that five of the ten members of the Task Force responsible for the guidelines were transgender themselves.) The APA Guidelines mention two different approaches for working with gender dysphoric children, but only one of them is deemed ethical. As you read, please keep in mind that “TGNC” has been defined as Transgender and Gender Non-Conforming people, in effect, conflating these two groups of children:

One approach encourages an affirmation and acceptance of children’s expressed gender identity. This may include assisting children to socially transition and to begin medical transition when their bodies have physically developed, or allowing a child’s gender identity to unfold without expectation of a specific outcome (A. L. de Vries & Cohen-Kettenis, 2012; Edwards-Leeper & Spack, 2012; Ehrensaft, 2012; Hidalgo et al., 2013; Tishelman et al., 2015). Clinicians using this approach believe that an open exploration and affirmation will assist children to develop coping strategies and emotional tools to integrate a positive TGNC identity should gender questioning persist (Edwards-Leeper & Spack, 2012).

Notice how there isn’t any warning about possible negative consequences of the affirming and accepting approach? Just keep validating these kids and telling them it is possible to become the opposite sex. There seems to be no concern from the APA that all of this affirming will condition the child into believing they are transgender (when they may have desisted).

The APA guidelines do mention a second approach, though:

In the second approach, children are encouraged to embrace their given bodies and to align with their assigned gender roles. This includes endorsing and supporting behaviors and attitudes that align with the child’s sex assigned at birth prior to the onset of puberty (Zucker, 2008a; Zucker, Wood, Singh, & Bradley, 2012). Clinicians using this approach believe that undergoing multiple medical interventions and living as a TGNC person in a world that stigmatizes gender nonconformity is a less desirable outcome than one in which children may be assisted to happily align with their sex assigned at birth (Zucker et al., 2012). Consensus does not exist regarding whether this approach may provide benefit (Zucker, 2008a; Zucker et al., 2012) or may cause harm or lead to psychosocial adversities (Hill et al., 2010; Pyne, 2014; Travers et al., 2012; Wallace & Russell, 2013). When addressing psychological interventions for children and adolescents, the World Professional Association for Transgender Health Standards of Care identify interventions “aimed at trying to change gender identity and expression to become more congruent with sex assigned at birth” as unethical (Coleman et al., 2012, p. 175). It is hoped that future research will offer improved guidance in this area of practice (Adelson & AACAP CQI, 2012; Malpas, 2011).

The APA felt the need to add on some warnings to the “embrace their given bodies” approach–just as WPATH members scolded Cantor that encouraging a child to align with their natal body is UNETHICAL. Seemingly defying common sense, we have literally come to the point that it is considered immoral (and in some areas illegal) to help a child feel comfortable with their body.

Yes, I said illegal. In more and more places, legislators are making the “embrace their given bodies” approach unlawful. Since 2012, the United States has banned gender identity “conversion therapy” in California, New Jersey, Illinois, Oregon, the District of Columbia and the city of Cincinnati, Ohio. And, in Canada, the practice has been banned in Ontario.

As parents who haven’t bought into the truth of our children’s sudden trans self-diagnosis, we have found ourselves in the position of going against the advice of WPATH and the APA. We want our children to realign with their bodies, to once again be whole, to be healthy. Desistance is our goal. We are not being transphobic, we sincerely care about the health of our children. We don’t want to “affirm” them as the opposite sex and validate that there is something so wrong with them that it leads to cross-sex hormones, surgeries and becoming lifelong medical patients. Transitioning should be a last-ditch effort, something to be used only when all other options have been thoroughly exhausted.

These guidelines and legislation, however, have made it difficult, and in some areas impossible, for parents to find mental health professionals willing to help their children (many of them with pre-existing mental health issues) feel comfortable in their bodies. Trans activists are using their influence to change medical guidelines and legislation to align with their strongly held beliefs, despite the scientific research that contradicts them. Instead of having desistance as a goal, they are working hard to make it a myth.

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