What I wish the Atlantic article hadn’t censored

by Jenny Cyphers

Jenny Cyphers is a homeschooling parent. She has been writing about that experience for many years, in various online forums. Jenny has been married for 24 yrs to the father of their two children, one adult and one teenager. They all live, work, and create, in Oregon. Jenny and her teen daughter were recently interviewed for an article about gender-dysphoric youth in The Atlantic.

4thWaveNow editorial note: We are grateful for Jesse Singal’s reporting on this complex issue and appreciate that he included the seldom-heard voices of teens who desisted from a trans identity, and their parents, in his article. We are aware that in some circles, the discussions we host on our site are considered transphobic and that we, a loosely-organized group of parents writing on this site, have been defamed as a “hate group” by those on the extreme end of the activist spectrum.

As always, we encourage those interested in the issue to read as widely as possible so they may come to their own conclusions. We contend that by leaving out all mention of 4thWaveNow, The Atlantic not only failed to offer parents the alternative opinions and resources we offer, but they also contributed to an environment that, due to censorship of critical voices, continues to propagate the distorted idea that cautiousness around medical interventions for minors is inherently harmful to trans-identified people in general.


I knew, when I agreed to be interviewed for The Atlantic article “When Children Say They’re Transgender,” that some of my words might be cut, or changed in ways I didn’t intend. But Jesse Singal is a good journalist. He’s personable and honest and willing to take on some really difficult subjects. He digs deep, records, researches, cites sources and ties things together in a nuanced way. Along with editors, he carefully adds and discards words, phrases, sources, quotes, and relevant ideas that lend themselves to the overall picture of what people will read and take away from what they’ve read. That’s what good journalism is.

There are a few things about our story and the way it was presented in The Atlantic that I’d like to clarify. First and foremost, the last-minute editorial decision to unlink the essay “A Careful Step into a Field of Landmines,” I’d written for 4thWaveNow, combined with removal of all mention of the site, needs to be highlighted because in doing so, The Atlantic failed to include important resources created to help parents support their gender dysphoric and nonconforming youth. The result is an article focused on the “situation” of “trans kids” that obscures parent-led examination and support for youth to explore identity without harmful medical interventions, the consequences of which can last a lifetime.

There are more choices for families than to either support their teens’ requests for pharmaceuticals and surgery on the one hand, and disowning or otherwise invalidating their interest in exploring their identity and nonconformity on the other. The Atlantic editors’ choice to remove 4thWaveNow from the discussion in effect denied parents access to important analysis that offers a balanced and middle ground.

Delta pic

The Atlantic photo editor had to dig deep in the several photos we provided to find the pensive one they chose for their article. Here’s one my daughter likes better; she suggested it be included with this post.

Part of my agreeing to contribute to this important debate is helping to create a platform. This website is such a platform. In talking with Jesse, I was upfront about my beliefs, which in part have been informed by 4thWaveNow and the great many array of voices shared here. It isn’t a monolith. Some of us are very liberal, left-leaning people in liberal left-leaning parts of the country, doing liberal left-leaning activities. Some of us are middle-of-the road, a minority of us are conservative, some of us are doctors, therapists, professors, and teachers. Some of us have allowed full social transition to give space to figure things out while still not agreeing to medical transitioning, and some have not. Excluding mention of 4thWaveNow, a site that gets 60K hits a month, fails to tell the whole story. Why do that? Why leave out one of my main sources of information and the ways that information helped me help my child?

Two of the most important aspects of my family’s experience that are not adequately addressed in the Atlantic article, are: 1) my daughter was given a clinical diagnosis of gender dysphoria, so she was just as “truly trans” as the next kid, and 2) it was my insistence that my child wait to medically transition, not her therapist’s. My teen’s therapist, Laura Edwards-Leeper, listened to me and agreed. We were lucky. While there are some cautious, thoughtful providers, the current situation in the US is that there is also no oversight. The most vocal professionals are firmly in the affirmation camp which believes, without any long-term data to validate, that withholding hormonal interventions is tantamount to abuse.

I didn’t know, going into Delta’s first appointment, what the outcome would be. That’s how difficult this is for parents; we have no idea what the outcome will be when we have very “insistent, consistent, and persistent” children requesting immediate medical interventions. It’s a matter of luck to find a therapist who respects parents’ knowledge of their children, who takes parental concerns and insights seriously, and who are not afraid to support slow, cautious progression.

While many transgender activists argue that they understand our children better than we do, there is no evidence to support their claim. Rapid Onset Gender Dysphoria is seen primarily, although not exclusively, in natal females during puberty. It is important to understand that what separates my daughter and many of the kids of 4thWaveNow parents, is this: None of these kids experienced distress over their sexed bodies until they came into contact with the idea that there might be something wrong with them. In other words, the dysphoria is what was “rapid onset,” not necessarily their gender atypicality. These are not kids with “early-onset,” nor do they resemble later in life transitioning people who frequently claim to have always “felt like” a girl but were too afraid or oppressed by family dynamics to admit their feelings. Then, making wide sweeping projections of their own experiences, they mark our children as being in need of the help they believe they should have had. With our kids, as with the group of young people described in Lisa Littman’s survey where ROGD was first named, their dysphoria set in quickly during puberty, often after spending hours online watching/reading others discuss their distress.

Another outlandish claim (made repeatedly by some activists and “affirming” clinicians) is that we simply missed all the signs our children were suffering earlier. I can assure you that, as a homeschooling mom who spent all day every day with my daughter, she never thought she was or wanted to be a boy prior to encountering the idea from transgender kids in her social circle. In fact, between ages 9-11, she was often “misgendered” (referred to as “he” or “him”) and hated it. It saddens me that these activists experienced such awful childhoods. However, their childhoods seem to have been negatively influenced by the religious fundamentalism and/or abusiveness of their parents; their childhoods do not remotely resemble the experiences of my daughter or the many other young people experiencing ROGD whom I’ve met.

atlantic coverTeens and tweens with ROGD often meet all the clinical diagnostic criteria for transitioning. They are often “insistent, persistent, and consistent” for more than six months, or in our case, for two years. Teens with ROGD also typically meet the clinical threshold for gender dysphoria, as mine did. It’s in her medical file. That’s correct, my “never really trans kid” had a clinical diagnosis of gender dysphoria under the DSM-V. This is what we hope others understand: our kids are suffering, they hate their bodies, they want and need help. In many cases, our kids had trouble making friends, experienced some form of earlier trauma, and struggle in other important ways, completely unrelated to gender, that should not be overlooked or seen as secondary to their dysphoria.

I know, because I was in pro-transitioning parent support groups, that parents are going to “gender specialists” and demanding medical interventions for their children without thoroughly considering why their children feel the way they do. I know, because I’ve heard from parents, that some therapists will give the green light to medical pathways without addressing any mental health issues. Dr. Johanna Olson-Kennedy, who treats 900 youth at her LA clinic, is quoted in Singal’s article as saying that she “believes that therapy can be helpful for many TGNC young people, but she opposes mandating mental-health assessments for all kids seeking to transition.” As many 4thWaveNow parents and teens will tell you, this attitude denies young people the opportunity to deeply explore why they want to alter their bodies and shuts down learning about other non-medical means of managing their distress.

When I was approached to do an interview, I needed to carefully consider my motivation for doing so, and if I should agree to discuss my family’s situation at all. Ultimately, I agreed because people need to hear that there are other ways to support trans-identifying kids. Gender dysphoria is very real and it hurts. My child’s life wasn’t easy because of the intense pain of GD. I knew there had to be answers other than what I saw everywhere around me, that suggested agreeing to medical interventions was the loving and kind thing to do, and that these interventions were harmless and helpful. I agreed to be interviewed because I wanted to highlight for other parents that there are other choices: most notably, offering support (buying clothing, getting haircuts, using a new name, finding a decent therapist) while also saying “I don’t think there is anything incongruent about your body/feelings.” The Atlantic axed this part of our story, the part where parents can offer tremendous support for their children without ever setting foot in a gender clinic in search of medical interventions.

I used to be a lot more open to the idea of transitioning children, in part because I know and like many transgender people. It wasn’t until I found that in the US, girls as young as 13 are getting mastectomies, that I began to question gender affirming medicine. In the new genderist language it’s called “chest,” “top,” or “confirmation” surgery. It sounds so much nicer than a double mastectomy, almost positive and pleasant. Cutting healthy body parts off of children should not be a thing. Ever. That was the moment I decided I would never stop talking about this.

My part of the interview with Jesse Singal–although about my daughter–was really more about how to support, in general, a child going through this very difficult experience. It is challenging, if not impossible, to find places to discuss supporting teens as they explore their identity in non-medical ways. 4thWaveNow is the only US-based resource that allows this. We need to talk about how to support gender non-conforming kids; things like buying clothing from the boys’ department if you have a daughter, or buying girl clothing if you have a son. My part of the interview wasn’t aimed at kids, but at parents who really need more and better tools for helping their distressed children than the “transition or die” option. Without choices, how can people really make one? Pick one of the two? No thanks.

Someone asked me the other day why I care. Why can’t I just let people do what they want? The answer is really simple. As humans we are guided to protect our young. If our culture fails to do so, each of us have failed to protect our children. This is why there are laws against abusing children, laws preventing minors from smoking or drinking, laws to keep kids from driving, laws for educating children. We can argue against any one of those things, but the cultural “we” have agreed that this is for the good of protecting children from harm, and for promoting welfare. In the US, unlike in other countries, there are no laws or regulations about transitioning children. Until there are, this is up for debate and I’m weighing in.

The fact that so many parents are left with this narrative that there is only one right way to help a confused kid, is what drives a wedge between the parent and child, leaving children vulnerable to self-proclaimed internet “experts”, like Zinnia Jones, who are more than willing to validate their feelings, further dividing parent and child.

Look, I understand that there are some truly not-very-nice parents out there, but we should not be making policy around them. That’s the sort of thing that creates bad case law. Let’s assume that the vast majority of parents want what’s best for their children, even if they have no idea what that looks like.

I was even more puzzled about the Atlantic‘s last-minute editorial decisions when I saw thaZinnia Jones cheap puberty blockers onlinet, not only was any mention of 4thwavenow scrubbed in the final version of the article, but a statement by Jones and reference to Jones’ website were included. Jones has written multiple screeds denying the existence of the rapid-onset dysphoria in adolescent girls that more and more people (including clinicians) are noticing. Further,  Jones recommends (on Twitter) that young people secretly obtain puberty blockers online if their parents aren’t onboard.

Unfortunately, many therapists, and others invested in the transgender narrative, seem to be heavily influenced by activists like Zack Ford, an opinion writer for the website Think Progress who, in response to Singal’s article, enunciates the activist-notion that parental concern and insight is irrelevant to the discussion. He writes,

“Whether a parent doubts the legitimacy of a child’s transition has zero relevance to whether transitioning is best for their child. Humoring this doubt is exactly what makes the story so harmful.”

Read that quote again. Read it several times to see just how dismissive it is of parents, the very people transgender and gender non-conforming kids rely on for support. You know–the people who would be signing the informed consent paperwork at the doctor’s office, agreeing to allow doctors to prescribe permanent, sometimes sterilizing, experimental off-label use of medications, and body-altering irreversible surgeries.

The collective, cultural “we” cannot dismiss parents as trivial when we are discussing our children, whom we will protect with our lives. This protective mechanism is the prime role of parents and an important part of being human and all the moral and ethical things that come with it. This is not a divide between liberal and conservative. There are too many divisions in this world, and this country, as it is. This is about whether “we” have an ethical imperative to protect our children. Yes, we need to listen to kids. We also need to listen to parents who are not interested in stifling their children’s interests or gender presentation, but who also know their children better than any therapist ever will.

 

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“Intellectual no-platforming”: Ken Zucker pushes back on the latest attempt to discredit desistance-persistence research

by Marie Verite and Brie Jontry

Dr. Kenneth Zucker, recognized as one of the world’s top experts in childhood gender dysphoria, penned the following paper (released today).

Zucker, K. J. (2018). The myth of persistence: Response to “A Critical Commentary on Follow-Up Studies and “Desistance” Theories about Transgender and Gender Non-Conforming Children” by Temple Newhook et al. (2018). International Journal of Transgenderism. https://doi.org/10.1080/15532739.2018.1468293

Dr. Zucker has offered to provide a PDF of the full-text article if readers contact him via email.


Multiple trans-activist journalists and “affirmative” gender clinicians have (rather successfully) propagated the meme that desistance from a trans identity is a “myth”; that Zucker (former director of the Toronto clinic), Thomas Steensma, Peggy Cohen-Kettenis (of the Amsterdam team which pioneered the use of puberty blockers for gender-dysphoric children), and others have wrongly conflated merely gender nonconforming children with “true trans” kids. Therefore, their entire body of research is essentially worthless. These critics have gone further, accusing some clinicians (like Zucker) of forcing harmful reparative therapy on “trans kids.”

Dr. Zucker’s detailed rebuttal to the Temple-Newhook et al article is well worth reading in its entirety.  Be forewarned: The paper is densely argued and referenced, such that understanding it requires a decent working knowledge of the clinical literature on childhood gender dysphoria, the nuances/changes in the DSM diagnostic classifications (e.g., DSM-IV “gender identity disorder” vs. DSM-V “gender dysphoria”), as well as the trans-activist reactions to all of the above.

In a series of tweets today, Dr. Zucker emphasized one of the key points in his paper.

 “…that pre-pubertal gender social transition is itself a psychosocial treatment, which Temple-Newhook et al ignore.”

The context for this tweet can be found on page 7 of Dr. Zucker’s article:

Thus, I would hypothesize that when more follow-up data of children who socially transition prior to puberty become available, the persistence rate will be extremely high. This is not a value judgment – it is simply an empirical prediction. Just like Temple Newhook et al. (2018) argue that some of the children in the four follow-up studies included those who may have received treatment “to lower the odds” of persistence, I would argue that parents who support, implement, or encourage a gender social transition (and clinicians who recommend one) are implementing a psychosocial treatment that will increase the odds of long-term persistence.

And later, on page 10:

Temple Newhook et al. (2018) go on to state that “It is important to acknowledge that discouraging social transition [with reference to the Dutch team’s putative therapeutic approach] is itself an intervention with the potential to impact research findings…” Fair enough. But Temple Newhook et al. (2018) curiously suppress the inverse: encouraging social transition is itself an intervention with the potential to impact findings. I find this omission astonishing.

An astonishing omission, indeed.

As regular readers of this website will know, most parents in the 4thWaveNow community are particularly concerned about the recent increase in teens (particularly females) presenting to gender clinics, with a sudden onset of gender dysphoria around the age of puberty.

Although the characteristics and clinical course of early-onset gender dysphoria (the primary population discussed in Zucker’s paper) are different from that of adolescent-onset, an underlying question pertains to both: Does “affirmative” treatment increase the likelihood that a cross-sex identification will persist?

We must point out here that trans activists consider it “transphobic” for anyone to believe that a child’s desistance from trans-identification would be preferable to persistence. (In fact, this accusation is leveled by Temple Newhook et al in their paper, in so many words. This helps to explain why so many trans activists object to the very idea of studying persistence vs. desistance in the first place.)  Yet, we find it mystifying that a preference for desistance is even controversial.  Surely, if a child can find peace in his or her unaltered body–and happily avoid becoming a sterilized medical patient dependent for life on drugs and surgeries–that is a positive outcome. To leverage an analogy popular with trans activists, many say that “gender affirming” medical treatment is analogous to treatment for children with life-threatening cancers. Yet who would not feel happy for the cancer patient who goes into remission, thus avoiding the ravages of chemo and radiation?

Furthermore, is it not possible to support young people in their gender atypicality,  while at the same time encouraging bodily acceptance?

Central to this discussion is the trans-activist conflation of psychotherapeutic methods with conversion therapy.  Zucker addresses this problem head-on on page 9:

Now, of course, it would not come as a surprise if Temple Newhook et al. (2018) took umbrage at the mere idea of a treatment arm designed to reduce a child’s gender dysphoria via psychotherapeutic methods. They might, for example, offer up the following from the seventh edition of the Standards of Care:

Treatment aimed at trying to change a person’s gender identity…to become more congruent with sex assigned at birth has been attempted in the past without success (Gelder & Marks, 1969; Greenson, 1964)….Such treatment is no longer considered ethical.” (Coleman et al., 2011, p. 175)

Yet, on the very same page of the Standards, one finds the following: “Psychotherapy should focus on reducing a child’s…distress related to the gender dysphoria…” (p. 175) or “Mental health professionals…. should give ample room for clients to explore different options for gender expression” (p. 175). The lack of internal consistency between the first statement and the second and third statements is rather astonishing.

“Reducing a child’s…distress related to the gender dysphoria” should be the primary goal of all treatment methods. Quite a few 4thWaveNow parents have observed that upon social transition, their children’s dysphoria actually increased. This is another aspect related to the different populations (early-onset vs. adolescent rapid-onset) that needs to be clarified but still remains unknown. Dr. Zucker explains that he “prefers the following summary statements about therapeutics with regard to children with gender dysphoria”:

Different clinical approaches have been advocated for childhood gender discordance….There have been no randomized controlled trials of any treatment….the proposed benefits of treatment to eliminate gender discordance…must be carefully weighed against… possible deleterious effects. (American Academy of Child and Adolescent Psychiatry, 2012, pp. 968–969)

Very few studies have systematically researched any given mode of intervention with respect to an outcome variable in GID and no studies have systematically com- pared results of different interventions….In light of the limited empirical evidence and disagreements…among experts in the field…recommendations supported by the available literature are largely limited to the areas [reviewed] and would be in the form of general suggestions and cautions… (Byne et al., 2012, p. 772)

…because no approach to working with [transgender and gender nonconforming] children has been adequately, empirically validated, consensus does not exist regarding best practice with pre-pubertal children. Lack of consensus about the preferred approach to treatment may be due, in part, to divergent ideas regarding what constitutes optimal treatment outcomes… (American Psychological Association, 2015, p. 842)

Here at 4thWaveNow, we have repeatedly stated that we seek to support—not “eliminate”–our children’s “gender discordance” although we resist the idea that gender atypicality is a sign of bodily incongruence. More than anything, 4thWaveNow parents seek to help our children minimize the discomfort that accompanies their nonconformity to gender norms. Since many of our children only experienced dysphoria upon reaching puberty, we call for (much) more evidence that social and medical transition are better at alleviating dysphoria than psychotherapeutic methods.

And as Dr. Zucker has made clear via his life’s work (and in this paper), the jury is still very much out on that question–despite the many attempts by trans activists to deplatform those who study the matter of persistence and desistance.

zucker intellectual no platforming

 

The project of a lifetime: A therapist’s letter to a trans-identified teen

Therapist and Jungian analyst Lisa Marchiano received the following email recently. She and the writer of the email agreed that Lisa would address the author’s questions in a public forum, and the author kindly agreed to allow the email to accompany Lisa’s response.

Lisa can be found on Twitter at @LisaMarchiano. She blogs at theJungSoul.com

Please note that this post is intended for educational purposes only and is not meant to replace professional advice.


Email from a trans-identified teen:

Hello. I’m almost 16 years old and recently I have been reading some of your writing on “Rapid Onset Gender Dysphoria.” Currently I identify as transgender and have for almost 2 years, but as a chronic over-thinker, I like to expose myself to viewpoints and ideas that are different from my own. If my parents knew what ROGD was, they would probably argue that I am in that category. I came out to them about a year ago and I hadn’t shown any gender dysphoria in early childhood. To them, it probably seemed a little “out of the blue,” though I had known for a year before that, had begun to transition (cutting my hair and buying from the men’s section), and had been questioning since puberty. I don’t have any mental or physical health problems, and I have a wide social circle of friends, none of whom are transgender or homosexual (though one of my friends is asexual, and my girlfriend is bisexual). I’m almost positive that I’m transgender, but your writing got me thinking and I have a few questions for you.

If what I am experiencing is ROGD, and simply a coping mechanism for something else, what signs could I look for in myself to figure that out? You talked a lot about the parent’s side of the equation, but what can I, as a trans teen do to ensure that I’m not “tricking” myself into believing this?

When do you believe a trans identity is valid? I certainly don’t disagree with you that there are many teenagers in my generation that are “becoming” trans because it is trendy, having no symptoms of gender dysphoria (I know a person like this). But do you think that trans people need to meet certain criteria to be considered trans and be considered for medical transition? If so, what criteria? Do you believe that gender dysphoria can present itself at puberty?

Thank you for reading and hopefully replying. I really appreciate your time.


Lisa Marchiano’s response:

Thank you for writing me such a thoughtful email, and for your willingness to take the answer here in this public forum. First of all, it goes without saying that this letter can’t take the place of therapy. I can’t diagnose from afar. I am, after all, just a stranger on the internet, and this is just my opinion. I believe it is an informed opinion, but it can’t take the place of discussing important issues face to face with someone who knows you well. Looking at these issues with a qualified therapist who can help you ponder your feelings in an open-ended way without prematurely foreclosing exploration can be very helpful. In addition, I hope you might feel comfortable someday discussing this with your parents. There may be a lot they don’t understand, but it is likely that there is no one on the planet who is more steadfastly on your team than they.

As a Jungian, I see psychological health in terms of a movement toward wholeness. Over the course of our lives, we hopefully integrate more and more aspects of ourselves, including parts that may be “feminine,” and parts that may be “masculine.” This life-long growth process means that we become larger and more complex as we become conscious of more aspects of ourselves. I do not believe that it makes sense to think in terms of identity, as this implies a single, fixed “truth” about ourselves – an endpoint that can be decisively known. Rather, I believe we continue to grow and change throughout our lives.

There is no robust evidence for innate gender identity. Our sense of gender appears to be an emergent property that arises out of a complex interplay between our bodies, our minds, and the social world. Though there is almost certainly a biological component to gender dysphoria, it is also likely shaped by our life history. The way we experience ourselves in terms of gender – that is as more or less male or female or both – is shaped by our family, our wider social network including friends and teachers, and the culture, including advertising, YouTube and other social media. Traumatic experiences, such as the loss of someone close, parental divorce, or emotional, physical or sexual abuse can also affect our experience of our gender.

Can gender dysphoria present for the first time at puberty? Clearly, many young people feel dysphoric at adolescence. Nearly all natal females feel discomfort with their bodies at puberty. I wonder if the question you are asking is whether dysphoria at adolescence but not before means that one shouldn’t identify as trans as a result. I think the answer to that is complicated, and I can’t really answer that for you. Again, this would be something to explore with a therapist who could really get to know your unique situation. Let me just say that based upon my reading of the medical literature, dysphoria presenting for the first time at puberty used to be unusual (but not unheard of) until recently.

Rapid onset gender dysphoria appears to be a relatively new phenomenon, and we don’t understand much about it yet. It appears as though the typical presentation of an ROGD teen involves considerable social influence, either online or by peers, as well as psychiatric comorbidities and/or vulnerabilities. Based on anecdotal reports, many ROGD teens first decide they are trans after reading on the internet. There is very little research on this, but the little there is seems to point to a different outcome for those with ROGD traits (no dysphoria in childhood, higher rates of psychiatric comorbidity, social influence) vs those with the more typical presentation of GD. And outcomes matter, because at the end of the day, we want all people to do as well as possible.

People often come to therapy to explore difficult decisions. I’m going to share a little bit about how I help someone explore their options. If you were to find a therapist to have this discussion with, here are some of the things the two of you might consider together.

There is a difference between what we feel, and what we choose to do about those feelings. I have a passionate conviction that all feelings are valid and important. We should be encouraged to feel them, to take them seriously, to honor them, and to be curious about them. We can take our feelings seriously and acknowledge them as valid without that acknowledgement meaning that we need to take a particular course of action as a result of them. For example – if we are very angry at someone, our feelings of anger are valid and deserve to be felt. What we do about that anger – whether we lash out at the person, for example – is another question entirely. When considering what to do about feelings, I am always interested in whether a given course of action is adaptive or maladaptive.

Let me explain more of what I mean by that. When someone comes to me with a question or a problem, I find it very helpful to examine the issue through the lens of pragmatism. I am interested in identifying what works for this particular person. This means that I ask us to set aside – at least for a moment – judgments based on values, morals, or ideology, and just explore whether a given response works.

What do I mean by “works?” In some sense, we all get to define that for ourselves, and one person’s definition might vary greatly from someone else’s. But we need some firm ground to stand on, so I do have a general answer – something works if it helps you to “do your life.” Freud famously said that the cornerstones of a mentally healthy life are the ability to love and to work, and I think that’s a great place to start. To have a life that is fulfilling, we generally need work that we find meaningful, as well as abiding relationships, at least some of which are truly intimate. I would add a third category to these two: . we can consider that a life strategy works if it is protective of our physical health – or at least not inimical to it. In sum, something works and is adaptive if it doesn’t interfere with our ability to work, to love, and to maintain our health.

Whether identifying as transgender for any individual is adaptive of maladaptive will depend on the person’s particular situation. If we are a natal female who has an inner experience of maleness (and I, in fact, believe that all females have masculine traits, and that our experience of the male side of ourselves can be very important psychologically), then identifying as male could be very liberating, exciting, and growth promoting. It could very well enable someone to engage productively in work and relationships. In this case, a transgender identity would be adaptive.

There could also be cases when identifying as transgender may not be adaptive. Whether it is or not will likely depend in part on how we understand what it means to identify as trans. For example, if part of identifying as transgender means that we need to be perceived as male when we are female bodied, we are putting ourselves in a vulnerable position, as we are giving others power over our sense of ourselves. We can’t control how others see us. Positioning ourselves so that we only feel okay when others perceive and validate us as we want to be perceived, rather than focusing on developing self-acceptance and resilience in the face of slights or rejections, is a decision that may promote worse mental health. This in turn could make it more difficult for us to concentrate at work or school. It might cause us to withdraw from friendships or other important relationships. If this were the case, we might say that our trans identification was proving to be maladaptive.

Furthermore, if identifying as transgender means that we understand ourselves to be literally male when our bodies are female, we may experience cognitive dissonance. Cognitive dissonance refers to the inner tension that we feel when important beliefs are contradicted by evidence. It can be quite uncomfortable. Psychologists have studied those whose strong beliefs are challenged by material evidence. (The theory of cognitive dissonance was developed by a psychologist studying a doomsday cult, and what happened to cult members’ beliefs when the world did not in fact end as their leader had predicted.) They note that we have a tendency to “double down” on our false beliefs in order to resolve the internal tension. Our beliefs become more extreme, and we work even harder internally to justify or reconcile with the challenged belief. (This isn’t just true of cult members. It’s true of every one of us.)

Those who identify as transgender can suffer from pangs of cognitive dissonance. This can often make the dysphoria worse. I have heard many stories from desisters and detransitioners that identifying as transgender made them feel worse, because they then had to deal with a constant tension around the fact that their body looked and acted differently than how they thought it should. This can invite obsessive, perseverative thinking, which can be draining and cause increased distress and anxiety. Adopting a belief that contradicts material reality can be a recipe for unhappiness, as we will likely feel the need to strive to become the thing we are not. This is part of the reason many wisdom traditions and psychotherapy schools direct us to cultivate acceptance of those things we cannot change.

The blogger ladyantitheist articulates the above sentiment eloquently in her post about her trans identification and desistance from it:

One of the biggest problems I think with being transgender is it comes out of an unhappiness, and that the impossibility of the accepted solution amplifies the unhappiness. Having short hair doesn’t give you an Adam’s apple, testosterone injections won’t change your bone structure, a phalloplasty won’t let you produce sperm. The closer you get to the real thing, the further the gap between you and being a real male grows. Freeing yourself from the task of climbing a mountain whose peak can never be summited is your only chance of ever actually being happy. I eventually stopped looking for validation as something I would never be, and started the process of loving myself.

If identifying as transgender amplifies our unhappiness with our bodies, if it causes us to perseverate on features of our bodies which we don’t like, then I would say that doing so is probably not adaptive.

There’s one other major conversation to have when considering whether identifying as transgender works, and that is the matter of maintaining our physical health. If identifying as transgender means that we feel compelled to engage in activities that could cause long-term harm to our body, then it may be maladaptive. Binding can result in collapsed lungs, compressed ribs, and back problems, and some report that they continue to suffer ill effects even after they are no longer binding. Mastectomies remove healthy tissue and can result in painful scarring. Testosterone will result in vaginal atrophy and may damage fertility. It can negatively affect one’s lipid profile, bone density, and liver function. It may increase one’s risk of heart attack and diabetes. There are currently 6,000 cases pending in litigation against drug manufacturers having to do with male bodied people who took testosterone, and experienced blood clots, heart attacks, stroke, and sudden death. Phalloplasty is known to have a high complication rate, and these can be serious and debilitating in some circumstances. If a basic measure of whether something “works” is if it helps us to protect and maintain physical well-being, it would appear that medical transition may not do so in many cases.

Could medical transition ever be adaptive? Yes, I think so. There are trans adults who feel that their capacity to love and work has been enhanced by transition. I suspect that those who benefit from transition have had a good process in which they explored their gender; addressed any underlying issues; and had realistic expectations for the outcomes of transition. Since transition compromises physical health, it is important to carefully consider such a step, and be certain that the benefits will outweigh the considerable known and unknown risks.

I would like to offer another rule of thumb when considering whether a particular life strategy is adaptive or maladaptive. All things being equal, it is better to preserve options and maintain flexibility. This is especially true when we are in the first half of life. When in doubt, leave options open. One of my concerns about medical transition for young people is that it shuts down future options. Having a mastectomy will permanently remove the option of nursing. Taking testosterone may render us infertile. Even if we think we never want to become a parent, there is still a value in protecting the future possibility of doing so. And fertility is not the only option to protect. If a person has taken on a significant transition to another gender expression and then has serious questions about it, they may be faced with even more serious challenges than they had before. Freedom of expression may be seriously, and in some cases, profoundly restricted or limited. Transition does have the potential to seriously limit additional life choices.

We really are all works in progress. Our sense of ourselves will continue to change and shift throughout our lives. It may be tempting to strive for certainty in tumultuous times, but I’d be wary of any urgency. You do actually have time on your side. By staying curious – as you clearly are – and trying out different things, you will gather more and better information in order to help you decide what works for you. One of the helpful things about a pragmatic framework for evaluating life strategies is that it leaves room for things to change. Most strategies don’t work forever. For any decision we make, we can ask ourselves, is this working? And then a few months later, is this still working? If the strategy is benefiting us in living our fullest life more than it is hampering us, we know to continue pursuing it. And if the day comes where we realize the balance of the equation has tipped so that the strategy is more costly than beneficial, then we can abandon it. We need not limit ourselves according to rigid beliefs about what is right or wrong.

elephant-blindmenWhile I was working on this letter, I was reading a novel called The Nix by Nathan Hill. The novel is in part the story of a woman named Faye, and it follows her throughout her life as she tries to discover who she truly is. Toward the end of the book, the author makes some comments about how we understand ourselves that I thought were very wise. I’ll let him have the last word.

In the story of the blind men and the elephant, what’s usually ignored is the fact that each man’s description was correct. What Faye won’t understand and may never understand is that there is not one true self hidden by many false ones. Rather, there is one true self hidden by many true ones. Yes, she is the meek and shy and industrious student. Yes, she is the panicky and frightened child. Yes, she is the bold and impulsive seductress. Yes, she is the wife, the mother. And many other things as well. Her belief that only one of these is true obscures the larger truth, which was ultimately the problem with the blind men and the elephant. It wasn’t that they were blind – it’s that they stopped too quickly, and so never knew there was a larger truth to grasp…. Seeing ourselves clearly is the project of a lifetime.

 

Detransitioned man blasts “transworld”

Angus is the pseudonym of a mostly-retired clinical epidemiologist on the faculty of a major health sciences university. We asked Angus to provide a short bio, and this is what he wrote:

“Angus is in his late 50s now, but back in his 40th year of life, his arrogance and folly led him to think it was fine to transgress, wear the dress, and pretend to be a “woman.” He did this for 13 long years, taking the synthetic estrogen drug every day, self-absorbed and entirely content. He was so convinced that he would carry on as a fake “lady” until the day he died, he decided to have some surgery. Not the more drastic option, it’s true, but most men would do anything to avoid the one he got. Quite unexpectedly one morning Angus snapped out of his transfugue trance state and felt compelled to examine his life. He rapidly ceased his masquerading and mimicry and re-engaged with material reality. He has the blog at autogynephiliatruth.wordpress.com but hasn’t put anything up there for a while. Angus can sometimes be observed causing trouble on Twitter @iforgetalready.”

As with all articles submitted by our contributors, the opinions expressed by the author are his own. He is interacting in the comments section of his post under the moniker “Awesome Cat.”


by Angus

The trans industry must concede that rapid onset gender dysphoria is a social contagion and they must cease recruiting efforts among young people.

Girls and young women increasingly make the claim in recent years to have “gender dysphoria,” an inversion of the male-dominant pattern that has been observed over many decades. More than just flipping the chart, this represents a major surge in the rate at which women are inducted into the illusory realm of TransWorld. The trans industry’s nonsensical position is that practically all “cis” people are potentially “trans,” but it’s impossible to know for sure whether anyone is a man, a woman, or some innovation unless they tell you. Even then, you may need to ask again tomorrow.

Clinicians have struggled to explain why there has been such an appalling growth in adolescent “gender dysphoria,” especially in girls and women.  One possible explanation, recognized as far back as 2010 and 2012, is the impact of social expectations, including the Internet, on the development of a transgender identity.

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And even further back, in 1999, WPATH (formerly called the Harry Benjamin International Gender Dysphoria Association) advised clinicians to proceed with caution when treating adolescents because of the changeability of “gender identity.”

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Then, in 2016, a physician named Lisa Littman conducted a study which, in part, investigated whether social contagion could be a contributing cause; in other words, perhaps some kids caught up in this mix do not really have a long-standing discomfort with their sex. It’s possible for many that the trap door could open below their feet, and within a short time, they’d be injecting testosterone. That’s truly how they roll with “affirmative transcare.”

Trans activists raged over the anticipatory invalidation they already felt with this story, as it dramatically undermined their alibi of “born this way” innocence. They seek transrecruits among children and youth, and at least in the USA, have an alarming interest in giving kids hormone drugs and surgeries at the earliest possible ages. Along with academic and clinician running dogs and other personnel getting paid in the trans industry’s multifarious dimensions, they worried that the mainstream public might see through transvested interests of its pseudoscience. They tried to kill this story with fire. Their efforts only made the story better known.***

Let me just say that I don’t believe that anyone on Earth is “transgender,” “transsexual,” trans-anything except perhaps transvestite, because that term is specific to clothes (Latin vestīre). In English the word just means crossdresser, which is accurate in a simplistic way. Nor is anyone “cis.” Evolution would not allow development of a heritable trait cluster or quasi-sub-species in which a woman or man in good physical health would have an insatiable obsessed yearning to mimic the sociocultural sex stereotypes (i.e. “gender”) for appearance and mannerisms of the opposite sex. There is no way that little Johnny likes to play with dolls or that little Jenny likes to play with trucks because as “trans kids,” they are on the spear point of an ancient evolutionary process that manifests at a certain prevalence in a given population. Had there been such genetic innovation back when we roamed the savannahs, folks with those characteristics would have all died out pretty quickly due to the lack of skilled plastic surgeons and endocrinologists. After all, along with voice coaches, such professionals are the only ones who can deliver “the basic health care they need to survive.” Our illustrious forebears in the painted caves would not have been pleased with the maladaptive meltdown and tantrum behaviour that would have emerged in proto-trans people in response to rampant “misgendering,” and excess mortality due to other people declining to play along would have been high. In real life, simpler explanations are more likely to be true, and there are far more compelling approaches to exploring the question of why women and men with healthy bodies might get it into their minds that they are really the opposite sex.

It should be pretty obvious that the “transition” one hears too much about is also a bogus mind-game. No-one “transitions” to anything except a likely-shortened lifestyle with lots more trips to the doctor, massive surgeries, aftercare; complications (some quite filthy), surgical revisions, risk of cardiovascular trouble; and lifelong drugs. Men may look forward to practicing fake voices & mincing walks, incessant “dilation” of the pseudo-“vagina” seeping void space created through flaying & inverting their genitals, heightened risk of multiple sclerosis and still being 100% male. Women may anticipate the potential for luxuriant back hair growth and being rather shocked that after mastectomies and having the organs of their reproductive systems ripped out, they are still as female as the day is long. Also, a greater risk of kidney failure, even if they are vegans.

Men and women who bought into the transprop and believe its lies have paid with their bodily integrity, and many times with their health. They are victims of it themselves, and I wish healing and wholeness for them. In the moment, however, many contribute to transgenderism’s harms.

For nearly 100 years, since doctors began misleading confused men and women to believe that this might be an option, vastly more males than females have desperately demanded to go under the knife and “change sex.” Such “change” is only illusion, but many men and women have fixated on that fraudulent goal in the vain hope to escape the miseries and melodrama of their own real lives. It is thus a matter of tremendous public health concern, indeed it’s a public health emergency, that over the course of a few years the rate of young women and girls who newly claim to be trans has gone through the roof. Doctors in Amsterdam and Toronto reported in 2015 that in their clinics there were now more females than males getting transbees in their bonnets. These women and girls had never previously shown profound dissatisfaction with being female; their “gender dysphoria” seemed to be new. Investigators used their Discussion to propose that among other reasons why women now greatly outpaced men, perhaps more secretly trans heterosexual women were now hopping on board the transwagon. Alternatively, maybe this decade’s grossly overblown propagandizing of all things trans has resulted in an Exodus of silently-suffering transfolk, women and men both, from “cisnormative” agony; women lead the way, enjoying their female privilege, as many already owned a few pairs of blue jeans or had short hair.

Newcomers to the trans industry, Helsinki then piped up to say that in their first two years running a child transing center they were stunned to find that 41 of 46 (87%) of adolescents were girls. Inconveniently for trans industry bigwigs, the Finns continued. It seems that 35/47 (75%) of these youth were already in treatment for serious psychiatric comorbidity unrelated to “gender”; and 12/47 (26%) were on the autism spectrum. The ratio of females to males, autism prevalence and levels of comorbid psychopathology were far higher than had ever previously been reported. Investigators were flummoxed by all of this, pointing out the ways that it contradicted the lying official translore, and could propose no solid explanations; least of all for the massive overrepresentation of girls.

Reports from the United Kingdom of huge spikes in the rate of child referrals to transing centers also show far more girls than ever before. The most recent of these papers from the UK suggests that from 2009-2016, the average year-on-year increase in referrals for children under age 12 was “only” 48.6% for boys, while it was 92.7% for girls; in adolescents the corresponding rates were 54.9% and 88.6%.

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Naturally, the new transcenario posed a problem for TransHQ. Most industry clinicians maintained the party line, more or less saying “gee, we didn’t know there were so many transkids.” When two of the more notorious pediatric trans industry doctors were asked about the startlingly high proportions of girls, Johanna Olson-Kennedy seemed taken aback but then acknowledged that it was true, before uttering a few more incoherent half-thoughts. Joshua Safer seemed evasive and glassy-eyed as he answered in terms of both sexes.

None of the researchers reporting this outbreak of “girlpower denied” was apparently able to imagine a possibility that would require coloring outside the lines of the trans cult’s hijacked rainbow; an answer that was much more likely to be true than their mouthfuls of bloated transjargon.

In 2016, however, Dr. Lisa Littman (now at Brown University in Rhode Island, USA) published a summary description of her survey undertaken with parents of youth purporting to have “gender dysphoria.” Results of her survey suggested something pretty obvious: This new type of rapid-onset gender dysphoria (ROGD) is a whole different animal than the usual kind observed in adolescents. It was really sort of a youth craze, exacerbated via social contagion through the influence of peer groups and shady characters who promote trans ideology and recruit adolescents aboard the transwagon. Psychotherapist Lisa Marchiano also wrote eloquently on ROGD in several articles, including this piece from the perspective of Jungian psychology.

Littman

The discussion of ROGD came upon trans activists unawares, but as the story continued to gain traction, the transmachine hotly blew up its transmissions, spewing towering tizzies of refutation, torrid pseudoscientific tirades, aggrieved attacks on academic integrity. Many trans industry academics and clinicians who have desperately tried for years to show that “gender identity” is innate now faced the possibility that the public would begin to catch on: “Innate gender identity” was complete garbage. Ice cold embarrassment and waves of sweaty invalidation flew from the ridgetops of their enormous brows. Social media was also transflamed with outrage, scorn, popcorn and flipped wigs.

But what can these trans cult & industry personnel and enablers really say in their dizzy diatribes? They raged against ROGD, called it a “hoax diagnosis,” scoffed at the study design and impugned Dr. Littman’s academic integrity. Yet they knew full well that the entirety of the “affirmative model of care” for people confused about what sex they are has much flimsier underpinnings, in addition to cherry-picking, confirmation bias, same-team replication & review, in-house “bioethicists” and financial or other conflicts of interest. What can they say, when reports from around the world confirm not only an explosion in the rate of children and adolescents getting hooked into TransWorld, but a reversal of the old familiar sex ratio? What can they say when there is in real life no “trans”?

Young people are systematically gaslighted in their indoctrination about all things trans. Like many adults, adolescents are usually overstimulated, sleep-deprived and eating suboptimal food; often somewhat traumatized and fragmented far away from knowing their own wholeness. Trans ideology is now presented to kids in USA schools as truth, “settled science” that helps people to “become their authentic selves,” masquerading through life as the opposite sex. But based on both my personal experience as a former “transwoman” and my ongoing research,  trans itself actually doesn’t exist, at least not in material reality. It exists only through mind-games; reversals, inversions & perversions of meaning; language-policing; and bureaucratic paperwork.

All human beings are “valid,” but transgenderism is a cultish ideology that leads to serious harms. Rich countries of the world have fallen grotesquely into error and if there is any justice, the people who promote and take advantage of the transcraze in young people someday will be held accountable.

Letter to a gender clinic: A parent’s call to action

A version of the letter contained in this post was sent by the parents of a trans-identifying daughter to the gender clinic where she received transition services. PADad, who is the young woman’s father, would like this letter to serve as a template for other parents, and encourages readers to participate in the letter-writing campaign he describes below. PADad is available to interact in the comments section of this post.

Note to 4thWaveNow readers: The letter as written by PADad has undergone lawyer review. Please see the April 10, 2018 update posted beneath the letter.


 by PADad

Like many who congregate on 4thWaveNow, we are the parents of a young person (in our case, a 20-year-old daughter) who has recently and suddenly come out as transgender. And like most here, our daughter had never exhibited any gender dysphoria as a child.

We have been doing a lot of research and planning our steps carefully. We have decided that one thing we must do is to push back against the forces in our society that are encouraging young people to take potentially harmful medications and make irreversible changes to their bodies. We want to help ensure that, before they are given access to medical interventions, young people carefully explore why they believe these changes are needed and how the changes will affect their lives in the future.

The trans activists do not outnumber those of us who are concerned about this trend, and our inactivity is putting our children at risk. Right now, many clinicians prescribe hormones and surgeries for youth with little fear of repercussion. We can change the calculus for these clinicians. We must reveal to them how many parents have the same concerns, as well as our tenacity in calling them to account. We are not going away.

To that end, I have prepared a letter that I will be sending to all of the clinicians who are involved in my daughter’s care. Because she is on our health insurance plan, we have access to her actions and payments, so we know who these people are.

I have drafted a similar letter to send to our health insurance company, putting them on notice that they are complicit in this harmful trend and urging them to change their standards for the treatments and surgeries they will allow and cover. We are also pursuing legal representation to follow up on our letters.

If insurance companies see they may be exposing themselves to liability by covering interventions that may cause more harm than good, they can play an important role in limiting the number of young people who inappropriately undertake medical intervention.

This linked site contains a comprehensive list of gender clinics in the US., organized by state and easy to search. Please consider sending your own letters to no fewer than 10 clinicians on this list, if possible, by registered mail. You may choose to use/customize our letter (below) as a template. Choose the clinics who are closest to you and perhaps add in some at random. We need to get as many out there as we can.

If some of these clinicians and facilities change their ways, others will follow. The risk of lawsuits goes up for them if they allow themselves to be singled out. That can affect the cost of their malpractice insurance. If we act together, we can make a difference.


A Parent’s Letter to a Gender Clinic

You are receiving this letter because our child is a patient at your clinic or a clinic like yours. The purpose of the letter is to make you aware of a concern that many parents, including myself, and a large and growing number of medical professionals, share about the care you are providing for our children. Some of these young people are over the age of 18 and therefore do not have to include us in their health decisions. Regardless of their age, and regardless of whether or not we are involved in discussions between you and our children, you have an obligation to do what is best for their long-term health. We do not believe this is happening.

The increasing rate at which young people, aged 11-21, are coming out as transgender cannot be explained by the fact that the broader transgender movement in western societies is removing the social stigma around coming out. The evidence is very clear at this point, and becoming clearer by the day, that what is going on with at least some of these young people, particularly young women, has elements of a social contagion.

We are including links to multiple pieces of research at the end of this letter to support our statements and to elucidate our concerns. As medical professionals, you should be aware of this research, and you have an obligation to take it seriously. At a minimum, you should be raising the bar and making selection criteria considerably more stringent before prescribing “puberty blockers,” HRT and surgeries. Because these treatments have permanent effects on patients’ bodies and minds, you should be first requiring alternatives to these treatments which are more reversible. Unless social contagion and other underlying and preexisting factors (including other mental health issues) are ruled out, it is insufficient and negligent to place undue emphasis on self-reporting from the youths themselves.

We understand that you may be under the impression that existing law provides protection against future liability for prescribing these dangerous drugs and performing these surgical interventions. We disagree. Moreover, as human beings and responsible medical professionals, you can raise the bar for treatment, reduce future regret rates, and put pressure on your peers to be better informed and to act responsibly.

Be advised that through this letter, we are putting you on notice. So far as we know, the current course of medical transgender treatment for minors has never been tested in the context of medical malpractice liability, and we do not believe that these interventions will be found to meet the standard of care for the treatment of juvenile dysphoria.

If you do not act in the best interests of all of your patients, the day may well come that you will be held accountable. We are planning for that day. Clinics and doctors will be called out by name. We will call you out by name in legal proceedings, and in social and conventional media. You should assume that, particularly given the irreversible and (at least in some cases) unwanted changes that these young people will suffer, damages can reasonably be expected to be substantial.

In addition to the risk of legal action, you should think about your place in history and your reputation. This contagion will pass, as they all do. But due to its size and impact, you should expect this social contagion to be a topic for years to come. It is already large and catastrophic enough to garner significant interest and publication in medical, social and psychological journals. I urge you to think carefully about how your clinic and your name will be mentioned in the course of this crisis, and whether you protected or ultimately harmed young people; whether you acted out of concern for youth or for your profits. You can dismiss any single case or patient as justifiable, but history will be less kind when looking at the body of your work over time.

I would encourage you to read the referenced research and clinical opinion, including the multiple links to additional published research in these articles, and familiarize yourself with it. There is sufficient information there to warrant serious soul-searching in any practitioner involved in the medical transition of minors and young adults.


Update: April 10, 2018. A few trans activists have claimed that the letter as written amounts to issuing (possibly unlawful) threats. For clarity, here are remarks by two lawyers in the 4thWaveNow community. (Caveat: This statement should not to be construed as legal advice for anyone reading this.)

Any communication, such as the letter referenced above, that states “if you engage in X behavior, Y consequences may result” could be termed, in some sense, a “threat.” The issue is not whether “threat” is the correct appellation, the issue is whether that “threat” is actionable (i.e. potentially gives rise to civil or criminal liability). Here, the answer is no.

Start with the understanding that in the United States, there is extremely wide latitude for speech. We enjoy robust First Amendment protections that give us the ability to express our opinions quite freely and widely without government interference, compared to other countries. There are allowable restrictions for such things as defamation or criminal conspiracy, as one would expect, but generally speaking, such restrictions on speech tend to be very narrowly interpreted and difficult to fall within. In the U.S., there simply is no such tort or crime as “hate speech;” our Supreme Court so ruled last summer. Moreover, “hate crimes,” or crimes motivated by animus against a particular group based on group characteristics, are a sentencing enhancement, or an additional penalty that is added on to a pre-existing crime. Other than in a few very select instances that don’t apply here, there is no such thing as a “hate crime” standing alone (an underlying crime such as assault, battery, etc. has to have been committed to give rise to the “hate crime” add-on).​

​On the “threat” point, first, as to criminal liability. A “threat” only gives rise to criminal liability when it communicates or contains, for instance, the intention to use bodily harm against the recipient, to harm the person’s property (e.g. “terroristic threats”), or to obtain financial advantage by unlawful means specified in an applicable law. An example of the latter would be extortion (“pay me X or I’ll tell your husband you are having an affair”). The “clinic letter” does none of these things, and 4thWaveNow unequivocally and strongly condemns any revision to the letter that would threaten such actions.

Second, as to civil liability. It is generally permissible to threaten to take legal action against someone in order to assert or protect one’s legal rights. Lawyers send “demand letters” (letters that outline why a party should do, or not do, some action, and the legal consequences for refusing to comply) all the time.

Moreover, it is not 4thwavenow that is making any demand in the letter; and the letter, in the form contained on the site, does not identify any recipient.

Summing it up, at the very most the “clinic letter” could be viewed as containing a non-actionable “threat” by the individual at issue (a) that legal remedies may be sought, to the extent such remedies are now, or in the future become, available and appropriate, and (b) to advocate the subject positions with, and exert public pressure upon, medical providers and insurers.


Suggested References

 “Evidence for Altered Sex Ratio in Clinic-Referred Adolescents with Gender Dysphoria,” Aitken et al, The Journal of Sexual Medicine, 2015

https://www.ncbi.nlm.nih.gov/pubmed/25612159

Analysis of article here:

https://transresearch.info/2015/09/10/evidence-for-an-altered-sex-ratio-in-clinic-referred-adolescents-with-gender-dysphoria-review/

The Canadian clinic saw nearly nearly three times as many female teens in the past 8 years as they had seen in the previous thirty. The Dutch clinic saw nearly twice as many female teens in the past 8 years as they had seen in the previous seventeen.

Rapid Onset of Gender Dysphoria in Adolescents and Young Adults: A Descriptive Study. Lisa L. Littman MPH., Journal of Adolescent Health, 2017.

http://www.jahonline.org/article/S1054-139X(16)30765-0/fulltext

Parents online are observed reporting their children experiencing a rapid onset of gender dysphoria appearing for the first time during or after puberty. They describe this development occurring in the context of being part of a peer group where one, multiple, or even all friends have developed gender dysphoria and come out as transgender during the same time frame and/or an increase in social media/internet use. The purpose of this study is to document this observation and describe the resulting presentation of gender dysphoria inconsistent with existing research.

“Medicine must do better on gender,” Margaret McCartney, British Medical Journal, 2018

https://www.bmj.com/content/360/bmj.k1312

A clear rise in referrals of children to specialist gender identity services has been seen in recent years, particularly in teens. Yet the role assigned to medicine can’t be separated from societal attitudes and abilities. The debate on gender occurs in an environment where boys are seen as being boys, and girls as girls, because of how they behave rather than their biological sex…

…Therapists are right to be concerned about overdiagnosis and overtreatment. But this concern can be perceived by parents as a barrier rather than a caring, evidence based response.

Many children with gender dysphoria will grow up without reassignment surgery but will be gay or bisexual. One concern is that gender reassignment makes homosexuality “disappear”: in Iran being gay is illegal, but the rate of gender reassignment surgery is the highest in the world.

“CBC Self-Censorship Part of Frightening Gender Identity Trend,” Susan Bradley, The Post Millennial, 2018.

https://www.thepostmillennial.com/cbc-self-censorship-part-frightening-gender-identity-trend/

In my own practice, I have seen a good many young women displaying the phenomenon known as “rapid onset gender dysphoria,” or ROGD, which overwhelmingly affects girls. Typically, the ROGD teenage girls I see have, wittingly or not, begun to experience homoerotic feelings about which they are conflicted. They tend to be socially isolated, and somewhere “on the spectrum.” They may have histories of eating or self-harm disorders.

They have found companions with the same attributes on Internet sites, which diminishes such adolescents’ sadness over their social isolation, but which can also lead to foreclosure of reflective thinking about their own feelings and situation. Some of these girls are depressed, afflicted with suicidal ideation. Because of the initial euphoria they experience in finally “belonging” to a well-defined kinship group, they tend to embrace the idea of transitioning wholeheartedly as the solution to their other problems.

“Transgenderism and the Social Construction of Diagnosis,” Lisa Marchiano, Quillette, 2018.

http://quillette.com/2018/03/01/transgenderism-social-construction-diagnosis/

Activists and certain clinicians who are sympathetic to the activist movement appear to feel threatened by the idea of rapid onset gender dysphoria because the suggestion that dysphoria might be influenced by social or cultural factors undermines the notions of innateness. If dysphoria isn’t innate, justifying medical intervention becomes more complicated.

“Early Medical Treatment of Children and Adolescents with Gender Dysphoria: An Empirical Ethical Study.” Lieke et al, Journal of Adolescent Health, 2015 

https://www.ncbi.nlm.nih.gov/pubmed/26119518 

Seven themes give rise to different, and even opposing, views on treatment: (1) the (non-)availability of an explanatory model for GD; (2) the nature of GD (normal variation, social construct or [mental] illness); (3) the role of physiological puberty in developing gender identity; (4) the role of comorbidity; (5) possible physical or psychological effects of (refraining from) early medical interventions; (6) child competence and decision making authority; and (7) the role of social context how GD is perceived. Strikingly, the guidelines are debated both for being too liberal and for being too limiting. Nevertheless, many treatment teams using the guidelines are exploring the possibility of lowering the current age limits […]As long as debate remains on these seven themes and only limited long-term data are available, there will be no consensus on treatment.

“The Influence of Peers During Adolescence: Does Homophobic Name Calling by Peers Change Gender Identity” Delay et al,  Journal of Youth and Adolescence, 2017

https://link.springer.com/article/10.1007/s10964-017-0749-6

Homophobic name calling emerged as a form of peer influence that changed early adolescent gender identity, such that adolescents in this study appear to have internalized the messages they received from peers and incorporated these messages into their personal views of their own gender identity.

“The Endocrinologist’s Office—Puberty Suppression: Saving Children from a Natural Disaster?” Sahar Sadjadi,  Journal of Medical Humanities, 2013

https://pdfs.semanticscholar.org/46da/ae7559f1b49d4516b0eee5266ab24a6e739a.pdf

Currently, the health consequences of the treatment are relatively unexplored. The treatment is being implemented, however, under the pressure of the emergency of saving the child from the devastation assumed to follow the onset of puberty. 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.

The annual number of referrals to the gender dysphoria specialist team at the Astrid Lindgren Children’s Hospital in Stockholm. Referenced article in Swedish:

http://lakartidningen.se/Klinik-och-vetenskap/Klinisk-oversikt/2017/02/Kraftig-okning-av-konsdysfori-bland-barn-och-unga/

“A Different Stripe”, Renee Sullivan, Psychology Today, 2018

https://www.psychologytoday.com/articles/201803/different-stripe

It’s been four years since I reidentified as a woman. My gender dysphoria was real and often painful, but the way for me to resolve it wasn’t by becoming a man. It was by questioning and rejecting the stories society had told me about what it means to be a woman.

Some charts illustrating the steadily increasing number of natal females presenting to gender clinics, worldwide.

increase in girls Toronto amsterdam

Canada, Netherlands, UK, Finland

increase in girls sweden

Sweden

increase in girls tavistock

United Kingdom

New zealand increase in girls to gender clinic

New Zealand

increase in girls

Toronto and Amsterdam

 

 

 

An RN & mum of a trans-identified young adult on perils of off-label cross-hormones as first-line treatment for gender dysphoria

Mumtears is a registered nurse, a wife, and mum of two daughters, currently aged 23 and 20 years old. She lives with her husband of 27 years, the father of her two daughters. She says: “Because of my currently unpopular thoughts, and because of not wanting to cause harm to my family, I feel I need to remain anonymous. I also started a blog a while ago, but- frankly- I haven’t kept it up. I am not very technologically sophisticated. If you want to read what there is in my blog, you can find it at myheartandhope.wordpress.com.” She can be found on Twitter @Mumtears1 and is available to interact in the comments section of this post.


by Mumtears

I have been a registered nurse for 30 years. From childhood, I always wanted to be a nurse. I really feel like being in the nursing profession was a “calling” for me.

While going through my post-secondary studies, studying for my Bachelor of Nursing degree, I recall being taught that, in all conditions, medical and nursing treatments should always begin with the least invasive way to treat that condition. I was taught that this was best practice care for the human body.

I have had many years’ experience working in Acute Care Pediatrics at our local children’s hospital. It was there that I learned that children are not simply “little adults”. Pediatric patients require specific attention and care, due to their rapidly developing minds and bodies. Their bodies and minds function very differently from adults. Medications and treatments are all prescribed based on the child’s body weight. They also cross different developmental stages at different rates on their way to becoming adults.

For the past 7 years, I have been working at a very busy family practice, caring for all types of patients with all types of concerns, from birth to the very elderly. I work with a family physician who also specializes in transgender care and sexual health. I have seen, assessed and cared for countless adult transgender patients. They comprise a combination of male-to-transgender and female-to-transgender patients.

Almost 5 years ago, my youngest (then 16) daughter expressed to her dad and me that she “thought she should be a boy”. That was the day our family life changed in ways we never anticipated. Throughout childhood, our daughter never presented as stereotypically “masculine”. She never outwardly expressed to us any kind of discomfort. She appeared to be mostly happy. A bright spark. She loved to play outside: doodle with chalk on sidewalks, sandbox play, climb trees, ride bikes. She smiled often. She loved building with Lego, playing Polly Pockets and with tiny toy horses. She enjoyed making tiny crafts, including models of people and animals made of Sculpey clay.

She was also very academically smart, reading beginner short novels before entering Grade 1. She taught herself how to tie her shoes and how to ride a bike. With the help of her father, when she was about 8 years old, she built one amazing bicycle from two used bikes purchased at a garage sale. In Grade 4 she challenged a Math unit about fractions and passed the final exam with flying colours, even before the unit began. She was musically advanced, playing beautiful piano tunes at age six, wonderful tenor saxophone solos in junior high. We had her tested for giftedness by a school psychologist. He told us that she was “just below” the gifted category.

We parents did begin to notice some general, social discomfort in late junior high, but we assumed that this was normal teen awkwardness, which can happen during puberty, so we were not concerned about it. We were absolutely blindsided by her proclamation that she thought she would be a boy.

My older daughter never had a temper tantrum when she was a toddler. I thought it was down to good parenting. How wrong I was. When our younger daughter was born, she behaved quite differently from her sister. Different personalities, which was not surprising to us because my husband and I are also very different from each other. Our youngest daughter started having temper tantrums at 18 months of age, which lasted 4 long years. Then, it was like a light switch turned on. Suddenly she realized she could settle her emotions down by reading quietly, alone on her bed. After just over 4 years of a frequently chaotic time, our house and family seemed to be at peace again. It was lovely.

Thinking back to this time in early childhood, I thought my daughter’s gender discomfort might be a similar phase for her. I still think it might be. I pray that, with time and life experience, she will develop an acceptance and comfort about her female body, and a knowledge that being the female sex does not have to place limits on her happiness and what she can accomplish in life.

drawing-testosterone-injectionBefore daughter told us she thought she should be a boy, I had already seen and assessed countless adult transgender patients. They comprised a combination of male-to-transgender and female-to-transgender patients who ranged in age from late 20s to early 50s. I admit that I when I first started working in family practice, I was very naïve about what “transgender” means. I noticed that all of the adult transgender patients I met also had comorbid mental health issues, which had not been fully resolved and, in some cases were severe/debilitating. My professional duty was (and still is) to provide excellent, compassionate nursing care to these patients. My personality is compassionate, empathetic and caring. I learned some of the transgender lingo; for example, “top” and “bottom” surgery. I’ve administered countless testosterone injections. I’ve changed the dressing on the donor arm of a young 20-something female-to-transgender patient who had recently undergone phalloplasty surgery. And now, after I administer these injections, I’ve found myself in the staff washroom, trying to compose myself for my next patient. Watching female erasure (in particular) causes me much sadness, partly due to what is going on with my own daughter. But mostly due to the fact that I am an adult female-born woman.

As I already said—but it’s worth saying again–I was taught that, in all conditions, medical and nursing treatments should always begin with the least invasive way to treat that condition. I was also clearly taught that pediatric patients have smaller, ever changing and rapidly developing bodies and minds, and need to be treated differently from adult patients. I was taught that physical, mental, and emotional development in children is ongoing, well into the early to mid 20s. Because of my knowledge about child development, both body and mind, I don’t understand why the medication Lupron is being given to healthy-bodied children. This medication is approved for use to treat adults with advanced prostate cancer and endometriosis. In children it’s used to slow down precocious (early-onset) puberty. It’s only in the past few years that it’s being prescribed for children who have gender dysphoria. This is an off-label use for this drug and it’s being given to healthy-bodied children even though there has been no research done to determine its safety or efficacy regarding gender dysphoria.

And we know that puberty blockers lead in most cases to cross-sex hormones. Why is the current first-line treatment for gender dysphoria in young, healthy bodies off-label, unstudied cross-hormone prescriptions? Young adult females can go into a family doctor’s office, state “I’m transgender”, and be handed a Rx for Androgel. This is what happened with my daughter, over a year ago. She never filled that particular prescription. However, last week she notified her father and me that she plans to start taking testosterone. She’s in a lengthy queue to be seen by our city’s gender specialist/psychiatrist and is impatient. She gave us no concrete reasons for wanting to start taking testosterone. She demonstrates little outward discomfort when she is in our home or when interacting with extended family.

She had one visit with the same family doctor who gave her the previous Androgel Rx. She told us that he told her what side effects could occur (while reading from a computer screen). She told us that he did not discuss reproductive planning with her, and that he gave her no written information about any of the side effects. She told us that he gave her the prescription and some bloodwork requisitions. This family doctor did not take a multidisciplinary team approach; he acted on his own. He did not refer her to an endocrinologist to check her hormone levels. He did not send her to any mental health professional, who could have assessed her for the source of her discomfort and possibly provided her with other less-invasive treatment options, such as cognitive behavioural therapy. How is the way in which this family doctor gave my daughter this off-label cross-hormone prescription medically ethical? In my province, family physicians can be the primary prescriber of cross-hormones. While using a multidisciplinary approach might be a good practice, it is not mandated. I’m currently trying to find answers via our provincial and national medical associations. The answers I’m looking for aren’t forthcoming.

I know that in no other medical or other health-related case would something like this happen, with regard to the prescription of off-label medications. I’d like to give you another home-based, common-sense example: Young adult child says to parent: “I have a really bad headache.” Think about this. Would it make any sense for the parent’s first response to be, “Your dad has some leftover oxycodone from his recent surgery, which he no longer needs to take- here, have some!”? Of course not. What would make medical/practical sense would be to first check that the young adult isn’t dehydrated. It is known that dehydration can cause headaches. “Try drinking some water and see if you feel better”. That would be the least invasive thing to try at first. If drinking water didn’t help the headache and if the young adult child had no know allergies or health conditions, it would be appropriate to next offer them acetaminophen, dosed per the package instructions. It is known that acetaminophen is a very effective analgesic, with a low incidence of side effects. If the headache persisted, perhaps it would be appropriate to then try a non-steroidal anti-inflammatory, such as Advil. There might be some inflammation in the neck or jaw muscles, causing the headache, which, if reduced, could relieve the headache. It is known that Advil is a mostly safe anti-inflammatory medication, with low potential side effects.

Recently I attended a Medical Education Session, which was held at a recent clinic retreat. The session was about low testosterone levels in adult males and testosterone replacement therapy. What I learned is, that for male bodied patients, the recommendation is that if the testosterone bloodwork result is low, it is important to clearly understand the patients’ symptoms concerns and general health. If the patient’s symptoms are low and the patient is not concerned, then giving the patient a prescription for testosterone is not advised. This is because there are also many side effects that can happen from taking testosterone, which can cause negative symptoms/concerns for the patient–especially if these male-bodied patients also have other health concerns. I learned that this is appropriate safe medical care for male-bodied patients.

I’ve done my own learning about testosterone. The pharmacy companies’ printed drug information about testosterone products states that this medication should not be given to women. It has never been studied in female bodies. Also, there are no long-term studies which indicate safety or a positive result for females who take this medication. Physicians are prescribing it “off label”.

I have been trying to learn as much as I can about gender dysphoria and its treatment. I have read many studies, documents, medical association websites, etc., and continue to do so.

When I learned about the newly recognized “rapid onset gender dysphoria”, I realized that much of its description matched what we were/are witnessing in our youngest daughter. Currently there is little known regarding care or treatments for young people presenting with rapid onset gender dysphoria. And few physicians are even aware of this phenomenon. There has been a dramatic increase, over a short period of time, in the number of teens and young adults who are seeking care for being transgender. And the demographic for which sex is declaring transgender has also changed. There are now more natal females than males with this concern.

With all that I have learned about rapid onset gender dysphoria and current treatments for it, I have more questions: Why are these off-label testosterone prescriptions being given to young healthy-bodied female patients as a first-line treatment for gender dysphoria? Especially since it is known that testosterone causes permanent body changes in female bodies, making it an invasive and irreversible treatment. Why are physicians prescribing these off-label cross-hormones without doing further assessments to ensure that this is the best treatment for their patients? I believe these are reasonable questions to ask. I believe these are prudent questions to consider. It is not transphobic to ask these questions. Many parents are asking questions like these. If you’re a parent wanting to learn more and connect with other parents, you can check out: https://gendercriticalresources.com/Support/index.php


Afterword:

I have recently learned that my daughter has likely started her testosterone prescription already. I found the receipt for it in her room at home, for low dose Androgel, from a pharmacy our family never uses, so I know that she has purchased it. She is currently living away for university, in a city which is a 2-hour drive from our home, studying in an arts program there. She has never told any of our close extended family anything about her gender dysphoria. We all live in the same city and see each other fairly frequently. Our older daughter (a graduate with a degree in Cultural Anthropology) knows and supports her sister’s claims, but that is all.

androgelOur younger daughter had the opportunity over Christmas (two Christmas dinners actually), to tell anyone in her extended family about her plan to start testosterone. She hasn’t said anything to any of them. Nothing about her gender dysphoria. I’m sure that it will be upsetting to many of them. My daughter and I text back and forth. We text about her activities (theatre, parkour). About her classes (she studies hard and gets excellent grades). About her saxophone practice (she recently was accepted into the university’s wind orchestra). I am proud of the person she is. I see so much potential for her to become an amazing woman and I am sad that she wishes to erase her female body. Frankly, I believe that “gender” is a crap concept, which is why I don’t discuss this with her. Ever since she first told us her thoughts, we have been clear in telling her our concerns. It’s up to her to think about what we have told her. We hope that she will undergo some work to understand the source of her discomfort, but we know that the decision will be hers to make. She tells us that she loves us. We have clearly told her that we love her and always will. We financially help support her post-secondary education. We want her to have many good job opportunities. We want her to have a good life and be happy and healthy. I dread her voice changing. I dread seeing her beautiful face change. And I find myself wondering if she actually needs to go through all of this, in order for her to “find herself” and come out the other side. The birth name we gave our youngest daughter means “strong”. I thought this would serve her well. We continue to use her birth name because we have not given up hope. As parents, we were never prepared for any of this. And as a registered nurse, I am very disturbed by all of it.

Baptised in Fire: A relieved desister’s story

by Sam

Sam (not her real name), 22, identified as trans between the ages of 16-19. A relieved desister, she enjoys tidying, writing, and watching the weather. She lives in the United Kingdom. Sam can be found on Twitter @rainiest_day and is available to interact in the comments section of her article.

Sam joins several other desisters on 4thWaveNow who, along with their parents, have shared their experiences of rapid onset of gender dysphoria (ROGD) in adolescence.


I was not a trans child. I was a gender-conforming little girl, as far as children are ever completely gender-conforming.  I liked pretty clothes but I also jumped in the occasional mud-pit. I didn’t play with Lego very much, because I wasn’t particularly good at it, but who cares? Not I. I felt no discomfort with being a girl. I felt little discomfort with anything, really; I was a bossy, blunt, stubborn little girl with very important opinions about everything.

I was not overjoyed about puberty. I don’t think I’m alone in that! Bras–miserably restrictive. Periods–horrible. Men followed me home from school even when I was twelve and thirteen; I in my uniform was not a very pretty child, but that didn’t seem to be the point. I didn’t like high school because I didn’t understand how I was supposed to act. Being overtly smart, because I was, made people dislike me, so I tried being stupider, but even then, I was still doing it all wrong. I thought I wasn’t on the same wavelength as everyone else, which, of course, is what loads of people feel like. But I didn’t know that. My relationship with my parents wasn’t perfect, but it was good, and we all got on.

When I was in my teens, I got into a disaster of a relationship with a girl. I was no longer in control of myself, of my body, of when I slept and when I ate and where I could be when. Things got very difficult. As the situation became increasingly unhealthy, over a very short space of time I became deeply dysphoric. Suddenly I loathed my female body and its nauseating shapes and its catastrophic frailties with a vehemence I had never known before. I stood in the bathroom and knew I needed to wash but I couldn’t take off my shirt, I couldn’t, because of what was underneath it, so I went out foul. I lost a lot of weight–partly from stress and partly to prove I could still control one aspect of my body. The new flatness of my chest only relieved me, it felt good like nothing else in my life felt good. As my legs got scrawny and the line of my figure straighter I felt only relief. I dressed only in masculine clothing, chopped my hair very short, felt like it made me tough, mean, safe. I still remember the exact moment a man said, “Excuse me, mate” to me as he passed me. It felt so much better than being hit on, even if nothing felt very good anymore.

God, everything hurt. I was desperate, unspeakably desperate to be in control of my own body, in the middle of a situation in which I wasn’t. I wanted to be strong, but I wanted even more to disappear. I wanted everyone in the world to go away. If my body was different, I knew I would have power, to walk away, to STOP IT.

I knew a little about what this was that I was feeling, I’d looked it up online –oh, I’m trans.  I tried to tell my girlfriend that I was trans, that I wasn’t a girl. She carried on as if I had said nothing, wouldn’t humour me by using my new name. I was stung, confused. A friend gave me a binder. I got thinner. I was “he”, or maybe “they”, yes, that was nice, like a cool drink of water; just anyone not called “she”. The “she” I was walking around in felt disgusting to me. “She” was all wrong. Skinny male me, pleasantly mistaken for a boy, felt like a port in the storm, if still not enough. I wanted control, control, of my body, of my life, but not to be me as I had been, because whoever that was far away, getting further away all the time, waiting for all of this to be over. I wanted like hell to be everything I wasn’t, and I didn’t know that other people felt that way too, not just transgender, but apocalyptic, so I was all alone.

The relationship ended. I was in a bad way. I’d made a Tumblr blog, looking, really, for a space that I could have to myself to vent, and I found myself on it a lot more. There is good stuff on that website. But the nasty stuff is so easy to find and so hard to wriggle free of if you’re like I was: lonely, miserable, hollow, and utterly lost, uneasy about everything, because now that she was gone I wasn’t quite so sure about being a boy, but I knew very definitely I couldn’t be a girl. Everything was still all wrong.

It’s difficult to explain what the “nasty stuff” is if you haven’t spent time on there yourself, exactly how pervasive and focused the brainwashing is, how perverse and suffocating and addictive it can be. The convoluted and illogical discourse, the constant shifting of goalposts so you are always on your toes to know what can I say? What am I allowed to think? What does this word mean today? So many lies were told to me about gender, sex, oppression, people, love, health, and happiness. I didn’t get better, and neither did anyone else I spoke to, but we were assured that this way–with our made-up pronouns and our made-up genders and our self-diagnosed illnesses–was the right way. It was a real crabs-in-a-bucket mentality, where any criticism, even of downright abusive behaviour, was transphobic and/or ableist and/or racist. To suggest improving oneself, sorting out your life, was cruelty of the highest order; we were perfect as we were, they  cooed, and anyone saying otherwise hated us and everyone like us. Narcissism ruled supreme.

We copied the writing style everyone else used, and we copied what they said too. They said and then we said we were beautiful. They and then we said we were against the world, the cis world, the hateful world, the world that wasn’t ideologically pure like we were ideologically pure. Nobody suffered like us. We were martyrs, floating high above reproach and deserving, more than anyone, of every good thing in the world: comfort, other people’s money. We deserved to have every rule bent for us, because we were right and they were wrong.

I could go on, describing every argument they used to justify this attitude, but I doubt they’d work on you. A lot of us were young teens, vulnerable in some way, whether abused or ostracised from society or just weak-willed. They gave us a new self, and all the power in the world. We thought so ruthlessly, that people against us didn’t deserve to live, reasoned it out in our mad non-reason –horrible, horrible, icy, inhumanly mechanical thinking that I have never encountered anywhere else since. We didn’t think about what we said, we just repeated what we knew we were supposed to say, and really, truly thought we were expressing our own thoughts.

They told us that we could choose a gender, any gender, out of countless, that we could make up our own and they would be taken seriously; they were, but only ever by others on there. Words on Tumblr ceased to mean the same as in the real world. Words were made up. They said if we wanted to wear make-up, or pink, or feminine clothes, we had to have a label for that, and if we wanted to have short hair, and wear masculine clothes, we had to have a label for that too.

I am not even touching the language around sexual orientation, because that is a whole other article. If we liked to switch how we “presented”, we would have a label to describe that we switched, and we could also change our labels and our pronouns day-to-day to describe how we felt (FELT! That is the crux of all of this nonsense) each day. It is so, so exhausting to be constantly examining every desire, thought, inclination of your shifting, constantly changing adolescent self, trying to find a word to fit, only to question yourself again the next week, or day, or hour. We adjusted our entire sense of self once, again, again, again. Every time, distancing ourselves a bit more from the person we used to be, that we couldn’t bear to be anymore. (I think we knew the old us would be ashamed, so we hid our faces from them.)

The time I wasted! Years on this! The energy! They say “agender” means I don’t have a gender. Do I feel like that? How do I know? How can you “feel” that? They said this was freeing for us, to finally know what to call ourselves, but the boxes they said we had to choose from were so tiny we couldn’t fit, unless we had a hundred, and even then we didn’t feel satisfied. We were forcing ourselves apart into splinters until we weren’t people any more, just words, and words that didn’t mean anything.

Why on earth weren’t we happy? We were children who knew so little about the world, and we believed everything everyone on Tumblr said. They–and then we–all spoke with such perfect arrogance, like we knew everything. We knew we did. There was also an awareness we had–although never, ever voiced, even to ourselves –that if we were just a white, normal, “cis” kid, we couldn’t be part of this club. We were part of it because we were special, and we were special because we were part of the club.

I questioned nothing. I didn’t have one original thought. And I didn’t really feel a thing.

I never looked at myself and thought: girl. That wasn’t right, and what’s more, it was vile. I was something else. I knew it.

Well: my parents knew I was sad. All that I told you about above didn’t fulfil me, although I knew it had to, because I had nothing else. My misery was obvious. One day, I stopped being able to smile. I was so emotionally numb, and that frightened me. I just couldn’t make my face smile. As I spiralled deeper into the trans-cult, my parents & I had arguments over everything. I was snappy, I was mean, I was acting recklessly, I was telling them off for using language that the trans-cult said was bad, I was ignoring all of their eminently sensible and kind advice. I tried to tell them I wasn’t a girl, to use different pronouns when they referred to me.

baptised in fireWhile they weren’t angry, just bemused, and while they really did try, I never felt my parents’ efforts were good enough. It was horribly unfair of me to treat them this way when I myself was always unsure. Even when someone in the real world “validated” me, it didn’t feel as nice as it was supposed to. Why not? I didn’t know. Were they lying? Did they really get it? Why didn’t I feel happy for more than a few minutes, did it mean I was using the wrong words? I crawled back onto my online spaces for further fruitless introspection. Over time, I lost contact with virtually all my old real-life friends – I was no longer invited to anything. I must have been annoying as all hell.

One tiny event in particular– my poor parents, poor me, poor all of us– sticks in my head and makes me feel sick whenever I think of it:

I was in the car. They were driving me to a college lesson because I hadn’t got up in time, because I wasn’t sleeping. I hadn’t washed. Before I got out of the car, my mother gave me a five-pound note.

“It’s the “cheering-up Sam” fund,” she said.

I suppose it sounds silly. But it burns. I’m looking down at that five-pound-note in my hand, and it’s breaking my heart. They knew I was so sad, but what could they do? They loved me so much, but what could they do? What were they supposed to do? How could they possibly help me? I couldn’t hold a civil conversation with them. I was mad, wildly irrational. I knew I was in the wrong but my pride was searing me full of holes. I lost my temper when the conversation became stressful, I walked out of the house and wandered around, alone, sick to my stomach with anger.

I became convinced that T was what I needed. I felt sick at the thought sometimes, but other times I would feel giddily sure, so eventually I summoned up the courage and called a clinic to make an appointment to start testosterone. But before the clinic called me back, something strange happened.

My dysphoria went away. It just went! Why or where it went I can’t say. I was 19 by this time, still clinging to my “trans identity”, insistent I wasn’t “cis”, but the feeling of wrongness about the sex of my body was gone and has stayed gone since. I didn’t love my body in the slightest, but I no longer hated it and think it completely, fundamentally wrong like I had before. I struggled with my weight for a long time then and after, but I began to realise I was female.

My close brush with acquiring testosterone shook me back into my senses somewhat. I was conscious as I came back into my body that I had almost made a huge mistake. The fear of what could have been stayed with me, that as my dysphoria passed I might have been trapped in a body more foreign to me than the original, a body like a boy that my brain no longer actually needed. The irreversible changes that would have occurred weighed on my mind:  the voice no longer mine, the man-face, the dark, thick hair. So anxiously, I thought – that’s not me…

I very slowly, not quite realising it, was distancing myself from the trans-cult and its thinking.

Well, this and that happened, I struggled on, I had a few setbacks, I struggled on a bit more. I got a proper job. This was the kick in the backside, the firework up the arse that I had needed. I was busy. I was tired. I was called “she” – I was too embarrassed to ask for special pronouns. I had to wear work clothes like everyone else. I took my work seriously, but I had to listen to people chatting in such a heretical way! Saying things that I hadn’t dared to even think, for so long! Talking about men being men, and women being women, so casually using language I had forgotten I could use. At some point, I started to agree with them. The hours I worked kept me off Tumblr and Twitter. The real world beamed blinding, hot sunlight into the dark and cold and dusty parts of my world. And one day, I simply deleted all of my social media. I can’t remember why – I just knew I had to. I didn’t stay to say goodbye to anybody I knew, I just wiped it all. I have never missed it since.

My relationship with my parents recovered. It’s a lot better now than it was before, somehow. They know I’m myself– a real, human woman who knows it– again. I started tentatively using the words daughter, woman, girl, sister to describe myself in conversation. Even now when I say those words I feel them in my mouth. I worked, shopped, ate, and I was doing weird things I did before; laughing like a horse, telling off-colour jokes to make my parents snort.

I had spent a lot of time at home, and perhaps the loveliest thing is that I ended up spending much time with my mother, while I was unemployed and recovering. We talked and we argued. But we talked far more than we argued. Sometimes I fell asleep while she was talking; she has a very soothing voice. Sometimes she fell asleep while I was talking – maybe my voice is soothing too. I loved my mother before, but I didn’t know how much I could love her, because I had never tried to understand her. I wonder, if I had breezed through my teens and headed out, unhesitating, into the great beyond, would I talk to her so fondly and treat her so kindly as I do now? Every cloud.

For a long time, I was a shell of myself. But the bossy, blunt, stubborn girl wasn’t all gone. The trauma I went through took time to fade to something I could manage, but I forgave her and I forgave myself. If I met her in the street I really think I could chat with her. I go stretches of days without thinking about it for more than a few seconds. At first my views on, well, everything, flip-flopped wildly. I went to a much wider variety of websites, I read books, I learned about things happening that I had missed, or worse, things where I had believed completely untrue versions of events.

The world had been such a hostile place when everyone was supposedly out to get me, and the only safe space was my Tumblr, where people only ever told me I was right. I learned that people thought a lot of things, had a lot of opinions, and get this: that some people could think one thing I agreed with, as well as another thing I disagreed with. I had been divorced from humanity in the trans-cult, and I was shocked at the empathy I found in myself for people, shocked at all these people, walking around, all with their lives and their feelings and their hearts. The “privileged” people actually suffered; I had believed they couldn’t. There was so much more suffering than I’d known there to be, but there was also so much more goodness. Every morning I realised my horizons were broader than the morning before, only to discover by the evening there was still so much more I hadn’t the faintest clue about.

Turns out, being a woman? You can wear anything you want, and you’re still a woman. You can do what you want, and you’re still a woman. Reality never needs to be validated.

My ability to think critically returned bit by tiny bit. It took time for me to get used to asking questions, checking sources, not believing every little thing I saw or read. I had been taught to believe unquestioningly and I had to wrestle myself out of the habit. Even now, I remind myself I can have opinions and I can disagree with someone, and they can disagree with me, and it doesn’t mean I’m a bad person; it just means that people are people, and I’m a person, and I have to deal with them being people just as they deal with me, because we have a great deal more in common than not. Through it all I have had the support of my parents – we can talk now.

I’m here now. I’ve slowly, quietly rejoined the human race as a woman, knowing it a miracle, holding both the stubborn determination of my childhood and the grateful joy of my young adulthood. The old me I was once so ashamed to face is here, and we are one again, baptised in fire and back fighting.