No menses, no mustache: Gender doctor touts nonbinary hormones & surgery for self-sacrificing youth

This is another in a series of posts examining statements made by top gender specialists at the inaugural USPATH conference in Los Angeles in February 2017.  (See here and here for more.)


Not so long ago, unremitting distress about one’s gender was the one and only reason for medical transition. Those days are over. With activists clamoring for a change from “gender dysphoria” to “gender incongruence” in the next revision to the international register of diagnosis codes, the ICD-11, the push is on for insurance-paid hormones and surgeries for anyone who believes their body is in any way “incongruent” with their “gender identity.” And this effort includes medical intervention for children and adolescents.

In this clip, excerpted from a USPATH symposium entitled “OUTSIDE OF THE BINARY – CARE FOR NON-BINARY ADOLESCENTS AND YOUNG ADULTS,” pediatric gender specialist Johanna Olson-Kennedy MD, discusses her views on medical interventions for “nonbinary” youth.

As always, we recommend that you listen to the recorded excerpt yourself, as well as reading the transcript included in this post. Time stamps are indicated by square brackets. []

 

According to Dr. Olson-Kennedy,

There are still people who want to embark on phenotypic gender transition—hormones and surgeries—who don’t meet this criterion [for gender dysphoria]. Well, what are we to do?

…And it’s great. I love this. I don’t like the word “pass” at all. Passing as a member of the other sex is not a criterion for treatment, whereas achievement of personal comfort and well being are. And that is really the crux of what should guide our care, as medical providers, as professionals in the mental health role.

How is this any different from elective cosmetic surgery? Trans activists will say it’s “medically necessary” because it is a guaranteed suicide preventative, a dubious claim at best. But how about a teen girl who hates herself and is self-harming because her breasts are (to her) too large or too small? What about her “comfort and well being”?

[:52] So, there are a lot of medical intervention possibilities for folks who have nonbinary identities. And again, this is really not for me to determine. It’s really for me to work with a person to determine what it is they’re interested in.

As we all know by now, the idea that a medical or psych provider should use diagnostic skills to determine whether a young person ought to undergo permanent drug or surgical treatments is so 20th century.

[1:06] Some people are like, oh! no menses, no mustache. You know, assigned female at birth, “I really don’t want facial hair, I don’t want [inaudible], I’m super dysphoric about bleeding.”

So, there’s lots of options, certainly for menstrual suppression. I love—I was so excited to be in one of  the first sessions that I went to, which was gynecologic care for trans-masculine folks, this “leave a gonad” thing.

So, it was this idea of, you know, maybe you don’t wanna have bleeding but you still want estrogen, and you want that support from a medical perspective. Or you just don’t want to go on testosterone.

It’s 2017, and designer endocrine systems are all the rage. Human beings should tinker and tamper with their delicate hormonal balance, because it’s what they want right here, right now. Mix and match–why not?

[1:48] There’s lots of these different things.  Maybe a central blocker and low dose testosterone. I had a young person who went on testosterone for a year, and it was like, that’s enough, I’m fine with it.  I’m masculinized enough, and that’s good for me. Or no medical intervention at all.  That’s absolutely possible.

The slide below,  from a different talk at the same USPATH conference, pretty well encapsulates this “treatment” approach:

nonbinary medical pathways slide

So we see the mindset of “affirm-only gender doctors here; why so many of them don’t acknowledge there might be permanent harm done to young people who eventually detransition. There are no mistakes. It’s all part of the gender journey.

 

[2:06] So, for nonbinary assigned males, maybe just Spironolactone [an androgen blocker] or using a peripheral blocker only. That might be something that people opt for. I had a young person who really [inaudible] nonbinary identity, but kind of, very very huge fear of a large nipple areola complex. Like, “I just can’t even deal with that.”

All you women with large nipple areolas that you just can’t even deal with, maybe you can get Medicaid to cover that in your state? Worth a try.

It would be one thing if these people were arguing for elective, cosmetic treatments on demand, for adults. But activists and gender specialists not only want to retain a medical diagnosis, gender incongruence in the next version of the ICD-11;  they want insurance to cover all trans-related treatments, for nonbinaries and anyone else who wants them.  In fact, some public and private insurance policies (such as that of the San Francisco Department of Public Health) already provide such coverage.

wpath-karasic-cultural-humilty-and-sfdph-cropped1

Back to Olson-Kennedy and her areola-avoidant patient:

[2:33] So, we put them on Spironolactone for a while, and then eventually she came back and said I wanna go on estrogen.  So there’s selective estrogen receptor modulators for people who do not want breast development. That could be a possibility.  Maybe hormones, no surgery. No medical intervention, another possibility.

No medical intervention: Just one of many dishes in the smorgasbord of options for nonbinary, gender fluid youth. Who’s to say (certainly not a medical doctor), which is the least harmful of those possibilities in the long run?

[2:51] My observations: Sometimes nonbinary identities are strategic…to protect themselves, to protect their parents. What I can tell you for certain about trans kids, youth, is they do a lot of taking care of the people around them.

Here we see a theme we’ve heard from other affirm-only genderists: Trans youth are more mature than “cis” kids. They are extraordinarily prescient about their future; they know for certain what they will want at age 20, 30, 40.

winters-trans-kids-are-more-mature

Prominent gender therapist Diane Ehrensaft lauds her tween clients for having the wisdom and foresight to opt for adoption in the future—unlike their balking parents, whose only reason for objecting to sterilizing a 12-year-old is a selfish desire for grandchildren.

But there’s something else crucial to note about Olson-Kennedy’s comments: After initially lauding her young enbies for pursuing smaller nipple areolas, or choosing to halt their menstrual periods without sprouting a beard, she is now implying to her audience that nonbinary is only a stopover for many of these kids. They are only claiming this identity to “take care of” their parents, when what they really want is to go whole hog to a binary transition.

[3:18] “I will sacrifice my own comfort for the comfort of the people around me, who I know I’m making very uncomfortable with my gender.”

What an extraordinary assertion. Trans kids aren’t just mature beyond their years when it comes to making irreversible decisions about their bodily integrity and fertility. They also emanate Buddha-like concern for the feelings of others, especially their woefully ignorant parents. How long before we have religious sects led by trans kid gurus, like Tibetan child lamas on steroids?

And how does the claim that trans kids are precociously mature square with the accumulating evidence of a strong correlation between gender dysphoria and autism? Young people with autism are not exactly known for their self-sacrificing nature or their ability to reflect upon the feelings of others.

[3:33] And so, marking that out is really important. Because again, because expressing that [they are nonbinary] is often used as evidence that they are not trans.  “No, well they don’t want to do this. Clearly, they’re not trans.” And having that conversation, and making sure that someone isn’t taking care of someone else at their own sacrifice.

 Are they “taking care of someone else” or perhaps listening to a family member who just might have the best interests of the child at heart, more than a gender doctor who hasn’t known the kid their entire lives?

So, on the one hand, we hear that nonbinaries need treatments “to feel more comfortable,” and at the same time, we’re told that a significant number of martyr-like trans kids are “sacrificing” themselves by feigning a nonbinary identity for the comfort of their parents. Which is it?

The Guardian recently produced a mini-documentary on nonbinary milennials and their quest for comfort. Meghan Murphy dissected this bit of puffery, and took on the living nightmare of feeling uncomfortable in this article.

Well worth a look.

meghan murphy enbie tweet.jpg

 

 

 

Meet Dr. Winters: computer scientist, “empty nest mom,” & top pediatric transition expert

Some of the most vocal and vociferous proponents of early medical transition for other people’s children are late-transitioning biological fathers. (Note: While most of these individuals now call themselves “moms,” the fact that their contribution to reproduction was undeniably via biologically male gametes—aka “sperm”– cannot be simply “identified” away.)

Many of these individuals weaponize the fear that gender-defiant kids will kill themselves if not socially transitioned, puberty blocked, and moved on to cross-sex hormones and surgeries at as young an age as possible.  But there’s something hypocritical about their belief in the “transition or die” orthodoxy: Many of these MtF activists–who no doubt consider themselves “truly trans”–transitioned later in life, yet somehow managed to avoid suicide themselves, enjoying long lives as men with lucrative and productive careers (quite a few in typically male-dominated professions such as the military, technology, and finance) and the opportunity to father offspring.

Kelley Winters, PhD., is one of the most prominent trans activists agitating for medical treatment of trans-identified children. Dr. Winters is on the International Advisory Panel for WPATH, is a member of the Global Action for Trans Equality (GATE) Expert Working Group, and is a board member of the youth-transition-promoting organizations Trans Youth Family Allies  and  Gender Infinity. The TYFA bio page lists many other accomplishments:

She has presented papers on the psychiatric classification of gender diversity at annual conventions of the American Psychiatric Association, the American Psychological Association, the American Counseling Association and the Association of Women in Psychology. Her articles have appeared in a number of psychology and psychiatry journals and in two books.

The Gender Infinity website has more about the “empty nest mom.”

gender infinity

These are lofty achievements, but not unusual for a PhD.  What exactly are Dr. Winters’ credentials? Prior to transitioning, Winters, as a man, had a successful career in microelectronics design and research (mentored, as Winters says at the link, by another well-known computer expert and MtF activist, Lynn Conway, known for attempting to destroy the career of sexologist Michael Bailey, who had the audacity to write a book based on his research findings.) Winters’ PhD is in engineering and, in addition to trans-related activities, Winters is a photographer and retired computer engineer.

Kelley Winters is considered an expert on the medical transition of children, not because of any special training or demonstrated expertise in child or adolescent psychology, or a background in clinical research. Kelley Winters is a top speaker, writer, and expert on behalf of the medical transition of gender dysphoric children by virtue of the fact that Kelley Winters .… is trans.

As one of the most frequent commenters on the WPATH Facebook public group page, Winters’ commentary and opinions are almost always deferred to by the MDs, therapists, and other gender specialists in the group. Winters expends a lot of verbiage claiming that the top experts in the field of gender dysphoria have it all wrong in their decades of peer-reviewed research demonstrating that the vast majority of gender dysphoric kids desist from a trans identity.

Winters is most active on WPATH threads addressing the treatment of trans-identified children and teens—typically arguing, as yesterday, for less gate-keeping and more widespread availability of hormones and “corrective” surgeries for minors under the age of 18.

Winters corrective surgery for minors

Kelley Winters, PhD. in computer engineering, thinks there is “no basis in evidence” that teens ought to wait to make permanent life-changing decisions (aka “corrective” surgery). They can’t get a tattoo or use a tanning bed, but they sure as heck should be entrusted to undergo major surgery and sterilizing drug treatments. According to Winters, any reasoned suggestion that minors might lack the cognitive wherewithal to make such decisions is “purely political.”

Winters does raise one good point in that comment. Puberty-blocked kids do feel, rightfully, that they are left behind in prepubescence while their non-trans peers go through puberty and begin to explore themselves as sexual beings.  Gender doctors have created an iatrogenic problem, with an iatrogenic solution. The problem: Block puberty, thus freezing the kid in arrested childhood while their peers move on, making them naturally impatient for puberty themselves. The solution? Dose them with sterilizing cross-sex hormones and major surgeries as young as 12 or 14 years of age.

As does occasionally happen in the WPATH echo chamber, a commenter in the thread raises the question of whether youth are fully equipped to understand the magnitude of the decision they’re making.

 I am a little concerned about glossing over some of the sticky issues, though. .. For example, part of the socialization experience many youth experience can involve severe pressures to conform (including penalties for not conforming). Some unknown number of youth might be conflicted about genital reconstruction, or not want it at all, and yet be ill-equipped to resist these pressures. There is precious little support for gender-non-conforming girls or boys, or women or men, and even less for people who refuse that binary altogether. Can we spend as much energy on supporting people (youth and adults) who are in that middle or “other” ground as we do helping them move towards our culture’s comfort zones? Is it always a disaster to be different? I also wonder, should we be concerned about decisions affecting reproductive capacity? Many youth may have little awareness that as adults they may desire not only to raise children but also to play a specific role in genetic parenting. What discussions or support would need to take place in order for a youth to make an informed choice about a surgery that would limit reproductive capacity? (I never wanted children “of my own” either as a child or as an adult. But I know any number of people for whom this was a strong desire acquired in adulthood.)

The commenter makes some excellent points about supporting gender-defiant kids in general, as well as pointing out the fact that many young people have no clue what it means to choose to be infertile.  But Kelley Winters, PhD. in computer engineering, isn’t particularly worried about the maturity of trans kids. In fact, in Dr. Winters’ professional estimation, trans kids are more mature than their “cis” counterparts, endowed with the rather unusual adolescent ability to predict how they’re going to feel 20 or 30 years down the road:

Winters trans kids are more mature

“Virtually all of the trans youth I’ve been honored to know were remarkably conversant and thoughtful beyond their years on their own reproductive decisions.”In what universe are the judgments and assertions of 14- or 16-year-olds predictive of their future judgments and opinions? Young teens don’t get to vote, drink, marry, sign a contract (except, apparently, the one giving their “informed consent” to medical transition),  even get a tattoo—but by virtue of thinking they are the opposite sex, they are “mature beyond their years” when it comes to deciding on major surgery and chemical sterilization?

In the same comment,  Winters, who managed to live into adulthood to father biological kids, plays the suicide card, aka “better sterile than dead”:

Winters suicide

The specter of suicide (misused as always) is usually the conversation stopper, and this thread is no exception. But one point of interest here is how Winters started the thread– with a discussion about the trans reality TV star, 15-year-old Jazz Jennings, who has been on a testosterone-blocking implant and cross-sex hormones since at least age 14. Anyone who has recently watched TLC’s “I am Jazz” is aware that medical transition has not prevented this teen (by Jazz’s own admission—in episode 2, season 2) from feeling suicidally depressed, socially isolated, and in need of antidepressants (themselves known to carry a risk of increased suicidality in adolescence)—as well as a yearning for “the classical boobs you see on TV.”

I’ll ask the question I’ve asked before: Why are trans activists like Kelley Winters—particularly adults who transitioned later in life and are themselves parents (and grandparents in some cases)–so very interested in promoting early medical transition of other people’s children? Winters, like others who survived to transition as adults after passing on their genes, isn’t just agitating for the rights of transgender adults in housing, employment, or (even) bathroom access. They devote most of their advocacy to the medical transition of young people.

I’ll give them the benefit of the doubt. They likely are convinced (or have convinced themselves) that this is the best thing to do for kids who say they want to be the opposite sex. Adult MtF transitioners who are also biological fathers, like Kelley Winters (and like this person I engaged on Twitter last month) believe that, in hindsight, if given the opportunity themselves in childhood, they’d have chosen medical transition with all that would have entailed–including, evidently, foregoing parenthood. How do they explain this to their own kids, I wonder?

But maybe–instead of promoting suicide contagion and the idea that a healthy young person’s body can be “wrong”–trans activists like Kelley Winters would be better off expending their energies on self-reflection; on the glaring fact that they themselves lived into adulthood without the need of a surgeon’s knife, an endocrinologist’s needle–or prepubescent sterilization.

Minor surgery? Top US gender doc agitates to lower age for genital surgery

Dr. Johanna Olson-Kennedy of LA Children’s Hospital is one of the better known “gender specialists” in the United States. She has achieved notoriety amongst gender critics for her controversial advocacy of early cross-sex hormone treatment and “social transition” of young children.

Her latest efforts to push the envelope on child transition are on display in a post she made two days ago on the public WPATH Facebook page, wherein she lobbies for the next WPATH Standards of Care (SOC 8) to support lowering the age of consent for “bottom” surgery (officially recommended to be 18 or older in the WPATH SOC 7).

To date, Olson’s post has garnered 52 “likes,” with plenty of enthusiastic responses. Only one clinician has raised a shadow of doubt.

What does Dr. Olson-Kennedy want? Nothing more than for immature preadolescents to be allowed to undergo–with full insurance coverage–major genital surgeries so they can impersonate the opposite sex at an earlier age.

Olson orig post

Because of the upside-down activist-driven reality we live in today, rather than helping gender dysphoric young people come to terms with their healthy young bodies, Dr. Olson-Kennedy and her colleagues socially transition children to believe they are the opposite sex.  By “affirming” a child’s (by definition, childish)  idea that they are born in the “wrong” body, pediatric transgenderists like Olson-Kennedy condition the child to reject and even abhor their “wrong” body, thereby making natural puberty an enemy to be “blocked” at its onset—in the example Olson-Kennedy cites in her post, as early as age 11. Everyone in the child’s life is “supportive” and “affirming” of the fiction that one’s sex can be changed, so it’s not surprising that 100% (the figure cited most often by these gender specialists) of socially transitioned, puberty-blocked children desperately want to move on to full medical transition (and into the waiting arms of surgeons and endocrinologists). Carving up, sterilizing, and drugging a child’s body is becoming more and more normalized.

It’s worth noting that the WPATH Facebook page is not only frequented by doctors and psychologists. Comment threads are often dominated by trans activists, whose views are typically received as expert opinion. One such activist is trans woman Kelley Winters, a PhD. in electrical engineering who has presented to WPATH and is deferred to as an authority on matters of pediatric transition. Winters is not the only one; typically these individuals have no training in medicine or child psychology, with their only claim to authority on pushing for mutilating surgeries and hormones for other people’s children being their own transgenderism and conviction that turning other people’s children into lifelong medical patients is the right thing to do.

Winters and Olson

So Olson-Kennedy and others have created a medical condition that can only be treated by massive infusions of cross-sex hormones and surgeries. The children are blocked early, and now we have a self-fulfilling prophecy. Of course these “girls” are not going to want to stop feminizing hormones. Of course they feel their lives have been “put on hold,” and they are all going to want “functioning vaginas.” The gender specialists have quite successfully crafted a situation where these young people will long for a surgically-engineered body as young as possible. How could they not want that? And how difficult would it be to desist from these longings once the train has started down that road, with all their friends, their families, and a prostrate media cheering them on?

Just to establish (and for my regular readers, review) a few simple facts:

  • “Bottom” surgery aside, puberty blockers followed by cross sex hormones results in guaranteed lifelong sterility. This is a fact that is never disputed by any specialist, but which is downplayed and seldom mentioned by anyone. Sterilization of children in any other context would be considered a human rights abuse, not a social justice triumph.
  • There is no research or clinical evidence that gender identity is innate. On the contrary: There is decades of research showing that gender identity is a matter of identification with gender stereotypes and parental modeling. It is impossible to find a story about a “trans child” that does not include anecdotes about these children preferring typical gender-stereotyped activities, clothing, and hairstyles of the opposite sex.
  • Frontal lobe development—in particular,  sound judgment, the capacity to understand and care about future consequences, and impulse control—is not complete until the mid-20s.
  • Young brains are highly plastic. It is patently obvious that the very act of “socially transitioning” young children to believe they are “born in the wrong body”  conditions them to continue on to full medical transition, with all the attendant risks and consequences.

Olson-Kennedy’s thread is ongoing, with many enthusiastic commenters and supporters. I encourage readers to see for themselves and then inform others about what the leading lights of pediatric transition are doing and saying. This is the future for gender nonconforming children and preteens, and the public deserves to know.