Wanting to protect my daughter’s health does not make me a bigot

By Susan Nagel

Susan Nagel is the mom of a 17-year-old girl who identifies as transgender. Nagel wrote this essay as a way to educate people who assume she is transphobic because she is unsupportive of her daughter’s desire to medically transition. She hopes others may find this essay helpful if they are trying to educate friends, family members, teachers, doctors, therapists, or journalists. Nagel is using a pseudonym to protect the identity of her daughter, and is available to interact in the comments section of this post.

A PDF version of this article is available here.


About a year ago my then 16-year–old daughter told us she believes she is transgender. Soon after, she began begging to take testosterone, to wear a breast binder, to have others call her by male pronouns, and to legally change her name. Nothing about her childhood prepared us for this; she always had stereotypically feminine interests and tastes. She loved stuffed animals, preferred skirts over pants for school, chose bright pink paint for her room, and experimented with makeup and curling her hair. When she was little. I joked that I had to add a pink load to laundry day in addition to lights and darks. Over the course of a month or two after coming out, she changed from a generally cheerful person to a morose one who spent hours crying and who told me to hide the knives.

Before I go further, I think you should know the lens through which I view things. I am a liberal, and I fully support equal access to housing, employment, education, and healthcare for all marginalized people, including transgender people. I do not think being transgender is immoral or that gender diversity is disturbing. Still after spending many sleepless nights researching the transgender movement, I have come to be very afraid for my daughter. My fears are about the rush to turn physically healthy teenage girls and young women into permanent medical patients and to do so before their brains are fully developed and with almost no oversight by mental health professionals.

bigot circleI encounter many well-meaning people who believe the transgender movement is simply a civil rights movement. They do not understand my concerns and assume I am ignorant or a bigot. I think it is because most people’s knowledge of the transgender movement is limited to mass media accounts focusing on discrimination against transgender people or on an individual’s struggle to be true to his or her self. Below are some things I wish people understood about how the transgender movement is impacting the health of children and young people along with some questions I would like people to ponder.

  1. Few children who experience gender dysphoria grow up to be transgender.

Gender dysphoria, a feeling of discomfort or distress with a person’s own biological sex, is a temporary issue for a sizeable majority of the children who experience it. Studies show that only between 6% and 27% of children who experience gender dysphoria will grow up to be transgender.  These statistics do not come from a conservative source. They are from the World Professional Association for Transgender Health Standards of Care.

  1. The drug regimen used to treat pre-pubescent children with gender dysphoria causes permanent sterility.

Some parents whose young children experience gender dysphoria place their children on drugs called puberty blockers to stop the onset of puberty. The rationale: postponing puberty will give a child time to decide which gender the child is. If the child later decides to transition, the child will more easily pass as a member of the opposite sex because the normal development of secondary sex characteristics was blocked. If the child decides not to transition, the child stops the puberty blockers, and normal puberty occurs.  Those wishing to complete medical transition, must follow puberty blockers with the hormones of the opposite sex. When puberty blockers are followed by cross sex hormones, the child never undergoes puberty for his/her birth sex and will be unable to produce viable ova or sperm as an adult.

Sterility is not the only problem caused by the typical treatment route of puberty blockers plus cross-sex hormones . The drugs being used to block puberty are being used off-label; i.e. they have not been approved for this use by the Food and Drug Administration. According to Eli Coleman, a psychologist who heads the human-sexuality program at the University of Minnesota Medical School quoted in The New Yorker, “We still don’t know the subtle or potential long-term effects (of puberty blockers) on brain function or bone development. Many people recognize it’s not a benign treatment.”

Puberty blockers have been used for a number of years to treat precocious puberty and to allow short kids more time to grow.  The FDA is currently conducting a review of nervous system and psychiatric events as well as deadly seizures among pediatric patients using GnRH agonists including one of the most common puberty blockers, Lupron. Over 10,000 adverse event reports in relation to Lupron usage have been filed with the FDA.  According to Kaiser Health News, “…thousands of women have joined Facebook groups or internet forums in recent years claiming that Lupron ruined their lives or left them crippled.”  Complaints include osteoporosis, degenerative disk disease, and deteriorating joints.

My questions are: How can it possibly be ethical to sterilize children before they are old enough to give informed consent? If your child had a medical condition with a 73 to 94 percent chance of remitting without treatment, would you agree to experimental therapies with known serious side effects? What parent can predict whether his/her child will prefer to be fertile or to pass as the opposite sex as an adult?

3. Not every person who medically transitions stays transitioned.

Although trans activists claim otherwise, it is not uncommon for transgender people who have transitioned, medically and/or socially (social transition includes adopting the dress, hairstyles, names, and pronouns of the opposite sex) to eventually change their minds and detransition. For example, a 2016 survey on detransitioning that was posted online for only 10 days collected over 200 responses from detransitioned women. Blogs and videos of detransitioners are easy to find online.

  1. There is little research on the safety of the long-term use of cross-sex hormones for the purposes of sexual transition.

Using testosterone for the purposes of sexual transition is an off-label use of the drug. One observational study of the immediate impact of testosterone treatment on females transitioning to male showed that testosterone impaired mitochondrial function and created a state of oxidative stress in the subjects’ white blood cells.  Oxidative stress is associated with neurodegenerative diseases, gene mutations, cancers, heart and blood disorders, and inflammatory diseases among other pathologies. Research on the long-term effects of using testosterone for transition is sparse.  Given the effect testosterone has on the white blood cells of women, it seems reckless to me to prescribe this drug without further studies of its long-term effects.

Below are just a few items from a consent form that girls and women wishing to take testosterone must sign:

  • “I understand that it is not known exactly what the effects of testosterone are on fertility…,”
  • “I understand that brain structures are affected by testosterone and estrogen. The long term effects of changing the levels of one’s natal estrogen through the use of testosterone therapy have not been scientifically studied and are impossible to predict. These effects may be beneficial, damaging, or both.”
  • “I have been informed that using testosterone may increase my risk of developing diabetes in the future because of changes in my ovaries.”
  • “I understand that the endometrium (lining of the uterus) is able to turn testosterone into estrogen and may increase the risk of cancer of the endometrium.”
  • “I understand fatty tissue in the breasts and body is able to turn excess testosterone into estrogen, which may increase my risk of breast cancer and decrease or impede the desired effects of testosterone therapy.”
  • “I have been informed that testosterone may lead to liver inflammation and damage. I have been informed that I will be monitored for liver problems before starting testosterone therapy and periodically during therapy.”

My daughter sees nothing scary about this list. She is a teenager, and teenagers believe they are invincible. She reassures me that she would receive the treatments from a doctor, so in her mind, nothing could go wrong. She lacks the life experience that has taught me all medical treatments entail risks and side effects, many drugs are withdrawn from the market when they are later found unsafe, some medical professionals are motivated by profit, and that doctors make mistakes.  In the study of detransitioned women mentioned above, the average age of transition was 17, and the average age of detransition was 22. I suspect the timing of detransition had something to do with young women reaching sufficient maturity to calculate risks versus benefits.

In addition to the health risks, testosterone causes irreversible cosmetic changes. Male pattern baldness, facial hair, and a deepened voice follow transmen who detransition to reclaim womanhood.

I am shocked by how readily some friends accept the idea of using synthetic hormones for the purpose of transitioning teenagers. Some of these people avoid drinking milk from cows treated with bovine growth hormone and avoid eating inorganic vegetables or food tainted by genetically modified organisms. If teenagers ingest risky chemicals for politically correct reasons, is the harm is somehow reduced? 

  1. A thorough evaluation and therapy from a mental health professional are not required before a young adult medically transitions.

Several people have told me not to worry that my daughter might transition unnecessarily because a person must have a thorough evaluation by a therapist to assure he/she is truly transgender before receiving medical treatments. That may have been universally true at one time, but unfortunately it is no longer the case.  In the survey of detransitioned women mentioned above, 117 of the surveyed women had medically transitioned. Only 41 (35%) of those women had received any therapy beforehand. The vast majority (68%) felt they had not received adequate counseling and accurate information about transition before transitioning.

Some trans advocates say evaluation by a therapist should not be required for medical transition because they say being transgender is not a mental illness. Consequently, there has been a move toward informed-consent clinics. Under this scenario, any adult claiming to be transgender is allowed to receive medical transition treatments with a letter from a therapist stating they have been informed of the risks involved in transition and are capable of giving consent.

The website of RECLAIM, a St. Paul, Minnesota mental-health center for transgender youth ages 13 through 25, explains that the informed-consent process may take as little as two sessions to 10 or more. It also explains that the resulting letter to medical providers “…does not involve the evaluation of readiness…” for medical transition by the therapist. Call me old-fashioned, but I think most 18-year-olds could benefit from an evaluation of readiness.

The website of a St. Paul therapist specializing in gender issues, Bystrom Counseling and Consultation, tells potential clients that a number of Minnesota physicians “…are now comfortable prescribing hormones without written documentation of completion of (the) Global Review of risks and benefits from a therapist.” The website goes on to list the medical clinics most often accessed for this purpose.

University of Michigan Professor of Social Work Kathleen Levinstein wrote about her autistic daughter’s medical transition for 4thWaveNow. Her daughter was a special-education student, who as an adult, qualifies for disability payments and is not capable of managing her own finances. She functions at such a level, that her mother had to explain to her that women who take testosterone do not grow penises. The day after her 18th birthday, the daughter‘s gender therapist approved a double mastectomy for the daughter after only two sessions together. The daughter began testosterone treatments several months later. The daughter who also suffers from Crohn’s Disease has been hospitalized three times due to adverse reactions to the hormone.

If transgender people are not ill, doesn’t that make their treatments elective and therefore ineligible for insurance coverage? If transgender people are ill, don’t they deserve a thorough evaluation and a diagnosis before undergoing medical treatments? 

  1. When children and teens experience gender dysphoria, they are often allowed to diagnose themselves as transgender.

Parents who convince a child to seek therapy before pursuing transition should know that many mental-health professionals especially those calling themselves gender therapists use an identity approach to treating gender dysphoria, also called the gender affirmative approach. Lisa Marchiano, a Philadelphia social worker, wrote an essay contrasting the identity model of therapy to the traditional mental-health model. Under the identity model, gender dysphoria can mean only one thing: that someone is transgender. Therapists are not allowed to use their own clinical judgement to analyze whether there might be other reasons people are feeling uncomfortable with their bodies. Marchiano states, “Our role as therapists becomes limited to enthusiastic affirmation only.”

I witnessed the prevalence of this model in my own search for a therapist to help my daughter. I interviewed approximately ten therapists by phone before finding one who understood that teenagers experiment with identities and that teenagers’ beliefs about who they are may change over time, something that used to be common sense and common knowledge.

In contrast to the gender-identity model of therapy, Marchiano says the mental-health model sees gender dysphoria as a symptom. The therapist’s job is to help the client “…explore the symptoms without making assumptions about what the symptoms mean. In fact, while identity therapy knows what gender dysphoria means – i.e. that the client is trans – mental health therapy will start with the assumption that we have no idea what the symptom means. We must be open to the meaning that emerges for patients as we explore their experience with them.”

What besides being transgender could cause gender dysphoria? In a letter to the American Psychological Association, Marchiano says the survey of detransitioned women in addition to the online writings and videos of detransitioners indicate “…that many who underwent transition feel that they were doing so as a maladaptive coping mechanism to deal with trauma, anxiety, social difficulties, or other issues. The majority of detransitioners speaking out online now identify as lesbian, and many of them feel that internalized homophobia played a part in their believing that they were men.”

As a woman, I fully understand the impulse to transition to stay safe and sane in a misogynistic world. But please, let’s not view women attaining better camouflage through transition as progressive. Progress occurs when women no longer feel a need to hide.

Studies show most children no longer feel gender dysphoria as adults. It is easy to find examples of people detransitioning. So why do gender therapists assume that every instance of gender dysphoria indicates that a person is transgender? We used to require people to have advanced degrees and licenses to make mental-health diagnoses. Why are we, in effect, allowing children and teenagers to diagnose themselves?  

  1. There is no persuasive evidence that gender transition reduces suicidality in children with gender dysphoria.

One of the scariest things a parent in my position encounters is the widely reported increased risk of suicide among transgender people. Many people believe transition is the only way to prevent suicides among transgender youth. A common sentiment is, “Would you rather have a dead daughter or a live son?” I encourage anyone with this concern to read a recent essay by Michael Bailey and Ray Blanchard. Their key take-away is, “There is no persuasive evidence that gender transition reduces gender dysphoric children’s likelihood of killing themselves. The idea that mental health problems–including suicidality–are caused by gender dysphoria rather than the other way around (i.e., mental health and personality issues cause a vulnerability to experience gender dysphoria) is currently popular and politically correct. It is, however, unproven and as likely to be false as true.” There are, in fact, some studies that show higher suicide rates for transgender people who have transitioned compared to those who have not.

While there is no proof that transition reduces suicidality, teenagers are coached by others on sites such as reddit and Tumblr about how to use suicide threats as a bargaining chip.  In one of the more chilling reddit exchanges reposted on the website Transgender Reality, an 18-year-old whose father is concerned about the wisdom of hormone therapy is asked by a commenter, “Are you ready to talk to him (the father) about the possibility of suicide? Or do you want to couch it more gently, and say you ‘can’t go on living like this’ etc.?” In another post, a 14-year-old is told, “…communicate to your parents that this is not optional. It is either this or depression, isolation, suicide.” Finally, a 13-year-old is told to tell his parents, “If you don’t help me like you need to as the parents who made me, I’ll wind up bitter, miserable or dead.”

  1. Some psychologists and mental health professionals believe teenage girls and young women are experiencing a new type of gender dysphoria caught from peers and through exposure to the concept online.

aitken-sex-ratio-graphUp until about 7 years ago, more boys than girls presented with gender dysphoria at gender clinics in western countries. Around 2010, the number of girls started to exceed the number of boys and began to increase significantly. Many girls experiencing gender dysphoria in the past decade have a different profile than they did in earlier years. In the past, girls with gender dysphoria began expressing discomfort with feminine clothes, interests and toys during preschool. Most would eventually become comfortable with their biological sex while dysphoria would persist into adulthood for some. Now many girls are first experiencing gender dysphoria suddenly in adolescence. Some researchers are calling this phenomenon rapid onset gender dysphoria (ROGD) and theorize it may be a kind of social contagion spread among friends and through the internet.

A 2016 survey of 164 parents of transgender adolescents and young adults demonstrates the current contagious nature of gender dysphoria among young women. Eighty-five percent of the parents surveyed had transgender youth who were biologically female with an average age of 15. In the general population, less than one percent of young adults would be expected to be transgender, however, many of the parents in this survey said that multiple members of their child’s pre-existing friend group were also declaring themselves transgender. To be exact, 50 percent of a youth’s pre-existing friend group became transgender in close to 40 percent of the friend groups described in the study. The average number of friends becoming transgender was 3.5.

Psychologists Ray Blanchard and Michael Bailey recently reported that young people with ROGD (primarily girls) falsely come to believe that all their problems are due gender dysphoria. Girls with ROGD often become obsessed with the idea of transition, and their mental health and social relationships deteriorate. The subculture surrounding ROGD includes attributes found in cults including an “… expectation of absolute ideological agreement …and encouragement to cut off ties with family and friends…” who do not agree with them.” Since ROGD is “…based on a false belief acquired through social means,” Bailey and Blanchard believe transition will not help youth with this condition. They pull no punches: “If knowledge is power, then lack of knowledge is malpractice. The ignorance of some leading gender clinicians regarding all scientific aspects of gender dysphoria is scandalous.”

My own daughter’s experience of gender dysphoria matches the description of ROGD closely. She first began experiencing gender dysphoria as a teenager. Four member of her pre-existing friend group also began identifying as transgender in their teens. Because I have expressed doubts about her transgender identity and voiced opposition to medical transition, she refuses to talk to me about those subjects much as a cult member refuses to listen to anything that contradicts his/her beliefs. Her mental health and relationships with family have suffered.

  1. Many people stand to gain financially by the boom in children, teens and young adults seeking medical transition.

Quite an industry has built up around the treatment of transgender people. In 2007, there was one transgender clinic that served children in the United States; now there are 40 . Transgender people who medically transition become permanent medical patients. To maintain their transitions, they must take hormones and have regular blood tests for the rest of their lives. Puberty blockers, hormone treatments, blood tests, genital electrolysis, facial electrolysis, laser body hair reduction, breast augmentation, facial feminization surgery, orchiectomies, vaginoplasties, colovaginoplasties, metoidioplasties, phalloplasties, and double mastectomies are some of the expensive treatments that may be pursued by transgender people.

Additional treatments may be needed to address complications resulting from medical transition treatments. The Truth About Transition Tumblr blog has compiled posts by female to male transitioners who have experienced difficulties. One trans man posts a video about multiple doctor visits he made recently to correct his testosterone levels and stop bleeding, leading him to 1) increase his testosterone dosage, 2) start taking progesterone, and 3) to go on Lupron, usually used as a puberty blocker. Another young trans man expresses his weariness anticipating his 20th transition-related surgery. The latest surgery is a third attempt to treat an abscess that developed during his surgical pursuit of a penis.

Revenue from testosterone sales has increased dramatically in recent years. Testosterone sales generated $2.4 billion in revenue in the United States in 2013. The projection for 2018 sales is $3.8 billion, a 58 percent increase.  While testosterone is used for purposes other than sexual transition, the increase in revenue correlates with the proliferation of gender clinics.

In addition to risky medical treatments, many girls and women use binders to compress their breasts and make their chests appear flatter. Binders have side effects such as back pain, shortness of breath, and rib fractures. When I Googled the term, “binder risks,” the first site that popped up was a plastic surgery clinic that does “top surgeries” for girls/women who want to transition to male. Yes, the folks who will profit by cutting off girls’ healthy breasts want to make very sure girls and their families understand the risks of binders.

What other civil rights movement has involved supporting body modifications for minors and young adults?

I have never felt so alone. People who would normally be allies for parents of a troubled child including therapists, doctors, teachers, and friends support this madness. I can only assume it is because they believe some or all of the following:

  • Only transgender people experience gender dysphoria.
  • Being transgender is always an innate and permanent condition.
  • People with gender dysphoria receive careful evaluation and therapy before being allowed to medically modify their bodies.
  • Transgender minors are not being allowed to make permanent changes to their bodies.
  • Transition-related medical treatments are well-tested and proven safe.
  • Children, youth and adults always fully understand why they are feeling dysphoric.
  • Physicians and drug companies would never experiment on children or put profit ahead of patients’ best interests.
  • Research has proven that transition prevents suicide.

 

None of it is true.

A friend told me recently that I have nothing to gain by resisting my daughter’s desire to transition. I strongly disagree. If resistance means my daughter postpones medical treatments until she can weigh the risks versus the benefits with more maturity, I gain plenty. If I can buy more time for her to discern whether her dysphoria really means she is transgender or whether something else precipitates her discomfort, I gain plenty.

I feel genuine rage toward the therapists and doctors who are complicit in the pursuit of medical transitions for kids, teenagers and young adults. You swore you would first do no harm. You should be ashamed!

If anyone working in the malpractice insurance industry happens to read this story, I have one final question specifically for you. Is it wise to cover the therapists and doctors involved in the transition of children and youth? When the lawsuits begin, I hope the settlements are breathtaking.

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Born in the right body: Introducing 4thWaveNow’s new spokesperson, mom of a teen desister

Brie Jontry is a part-time academic, and a politically liberal mom to an adventurous, wilderness-, insect-, and art-loving teen. She currently lives in the American southwest with her partner and daughter, a huge dog, three cats, and various insects who come and go.

Brie has been a member of the 4thWaveNow community for two years, since her daughter first temporarily identified as transgender. After exploring all kinds of ideas, thoughts, and feelings related to gender identity with her daughter, Brie has decided to speak publicly about her family’s experience.  In particular, Brie agreed to be our public spokesperson to counter the untruth that only religious, anti-LGB conservatives are skeptical about medical transition of gender-atypical young people.

Note: Anyone who has spent time on our site knows we are not a monolith, but a diverse group of parents with varying (though generally congruent) views.  Brie’s experiences and analysis are her own, but are on the whole in line with those of the other gender-skeptical parents in our community.

In a future article, Brie’s daughter, along with a few other teen desisters will discuss their own thoughts about identity, gender nonconformity, desistance, and more. Stay tuned.

As her time permits, Brie is available to interact in the comments section of this interview.


You are the parent of a teenage girl who temporarily believed she was trans, but changed her mind. Can you tell us something about her journey—and yours?

brie resized

Brie Jontry

A few months before my then 11-year-old said she might be transgender, she told me she didn’t want to grow up. She had just met her new pediatric endocrinologist (she has type 1 diabetes) and he told us she was in the early stages of puberty. In the car on the way home from the appointment, crying, my daughter asked me how much longer until she’d start bleeding, until her breasts would grow.

A few weeks after that appointment, Leelah Alcorn, a transgender teen in Ohio, committed suicide by walking onto a highway into the path of a tractor trailer. My daughter was gripped by Leelah’s story, by the horrific choice of death over a seemingly endless painful existence, and she agonized (for weeks) over the details in Leelah’s suicide letter. “What is transgender? Was Leelah a girl trapped in a boy’s body?” “How could her parents not see they were killing her?”

A few months later, my daughter told me she thought she might not be a girl. I asked if that meant she was really a boy and she said she thought so. I said something like, “this is a lot to think about” and asked her permission to speak to her grandfather, a psychologist, and another friend, a genetic biologist and a lesbian. She agreed and sheepishly let me know she’d already told her poppa.

I called my dad that night after she’d gone to bed. He reminded me that she’d always “been her own person” and that imagination and sensitivity could have been heightened by almost obsessively reading/thinking about Leelah Alcorn. He explained body and gender dysphoria, and drew a connection to eating disorders. “You wouldn’t help her starve herself if she thought she was too fat,” he said. “Help her just be her, in her own body, whatever that means.”

Next, I spoke to Audrey, our gay geneticist friend who reminded me of her own teen years and cautioned that she certainly would have considered transition had it been readily available. Together, we looked at the few studies we could find about hormonal suppression in adolescents and testosterone use in healthy female bodies. My friend was horrified by the lack of long-term data available for medical interventions being performed on healthy adolescent bodies. Audrey spoke to my daughter about the hormonal responses which occur in puberty, how besides development of secondary sex characteristics, pubertal hormones are needed for brain development, neural pathways, grey matter. If you “pause” that process, she told us, you’ll be stunting the very growth that will make you into the adult you. “You don’t know who you are yet,” Audrey said, “how can you know that’s not who you want to be?”

My daughter agreed to put medical transition, a process she’d been watching with envy in numerous transmasculine teen videos, on hold while we explored these ideas together.

What followed were two years of emotional upheaval and deep exploration. Family and friends agreed to stop using “girl” and worked hard to remember her requested “kid” in its place.

salt-in-the-soup.pngI pestered anyone who was willing, to talk to me about gender, adolescent development, and hormonal modulation. I talked to someone I knew in the midst of her own gender transition and to her partner. I talked to trans people, gay people, other parents of trans and GNC kids, endocrinologists, a Zohar scholar, educators, radical feminists, postmodern theorists, and child and teen psychologists, including those who designated themselves “gender specialists.” I joined large Facebook groups for parents of trans and gender non-conforming kids (and was subsequently thrown out for posting data about Lupron).

I asked my daughter to show me some of the things she was reading and watching online which led to her realization. Together, we explored all kinds of “you might be trans if…” quizzes and “Am I trans?” posts on Reddit’s “Ask a Transgender” subreddit, various Tumblr blogs, and elsewhere. We talked a lot about stereotypes and gender roles.

At my daughter’s request, we went to the Philadelphia Trans Health Conference, where we met Jazz Jennings and ate pizza with hundreds of transgender kids and their parents. Dinner conversations between parents were clearly divided between stories of natal boys who’d “always been this way,” who “always liked pink” or sparkly princess dresses; who liked to play with dolls and wanted to wear nail polish, and born-girls who, on the cusp of puberty, often friendless, suddenly came out as “trans.” My daughter made a lot of new friends that night, some of whom now, two years later, have been on testosterone for a number of years; some have had mastectomies. Of the teens she met that evening, I’m aware of one other who has also desisted.brie pull 2Ultimately, what brought her to the realization that she is not “in the wrong body” (about two years later), were endless, ongoing conversations about sex-based norms, gender roles and expectations, misogyny, and homophobia, between her and lots of other people, mostly women. NO ONE fits neatly into any stereotype associated with their “identity.” She came to understand that her suffering wasn’t because her body was wrong; she was suffering because growing up is hard! To her, “being trans” explained a lot of her discomfort and anxiety, but she came to realize that it wasn’t actually “being trans” that caused any of it.

She came to see medical transition as physician-assisted self-harm. In a twisted way, it helped that she is already dependent on synthetic hormones for her life. She has zero choice about injecting insulin every time she eats, or when her blood glucose is too high, up to ten times a day, for the rest of her life. When her friends who’d started HRT complained about needing injections, something snapped in her. She saw the stark difference between needing pharmaceutical treatment to live (no choice) and desiring it as treatment for a feeling. Her body IS, actually, wrong. It’s verifiably broken and without synthetic hormonal supplementation numerous times a day, every day, she will die. Quickly and painfully.

She realized that her friends had healthy bodies but that their therapists, their friends online and in real life, and sometimes even their parents, were supporting them in the belief it was their bodies that were wrong because they didn’t match their personalities, their preferences, who they were supposed to love. When she realized this, she got angry. She felt tricked into believing there was something wrong with her because she didn’t want to be ogled by teen boys, or wear dresses, or because one of her favorite things was to talk about the difference between aquatic and terrestrial isopods.

So it sounds like she experienced a “rapid onset” gender dysphoria in adolescence, a phenomenon which is now only starting to be recognized.

Yes. And…no. She told me that prior to Alcorn’s suicide, that she wasn’t aware that being transgender was possible, that it even existed. Once she came into contact with the idea, it captivated her and she quickly identified her “transness” as the reason she didn’t want to go through female puberty. She wasn’t alone. Numerous girls in her various peer groups would come out as trans in the coming year.

I think it is critical to this discussion, though, to talk about all the ways she’d been “gender non-conforming” up to identifying as trans.

As liberal, progressive, feminist parents, we never put energy into making sure our daughter adhered to gender norms. As a baby, she wore all the colors and never had a head-squeezing headband to denote “girl.” I never bothered correcting strangers who thought she was a boy. I insisted she wear a dress once, to a wedding, when she was eight. She cried.

When people asked her if she was a boy or a girl, she’d bark, or meow, or roar.

brie pull 4When she was younger, her favorite toys were stuffed animals, scraps of fabric, cardboard boxes, and small plastic insect, dinosaur, and dragon figures. Then, as she got older LEGO, but never the pink sets. She played lots of imaginative games with her stuffed animals and little figurines and dump trucks; she never wanted a doll and cried once when she was four and someone gifted her one. She couldn’t understand how someone who knew her might think a Mermaid Barbie would be a welcomed present.

Her favorite stuffed animal was a crab named “Crabby” who went almost everywhere with her. When people asked if Crabby was a boy or a girl, she’d answer: “she’s a boy” or “he’s a girl” and laugh. Outside, she liked to pee standing up, like her dad, and somehow figured out how to pee farther than her best friend, a boy.

She mostly preferred “boy’s” clothing: sweatpants and shirts with insects, dragons, monsters, and dinosaurs. We let her choose her own clothing as soon as she wanted to and had no problem with her heading over to the boy’s section of stores.

These are important details because once I turned to trans-affirming websites and books (which were all I could find until I learned the phrase “gender critical”), the gender nonconforming choices she made, her preferences, some of her behaviors, could easily be read as proof that she really was a boy, that she had a “boy brain,” and perhaps, that she was exposed to too much testosterone in utero as evidenced by her relative finger length.

The acute stress she felt over her body (dysphoria) was indeed rapid-onset. However, looking back, there were many incidents which could have been interpreted as signs of an “innate gender identity” that didn’t match her sex.

Trans activists have tried to convince the public that “desistance is a myth”. Yet your daughter did indeed desist. Why do you think activists want to deny the experiences of young people like your daughter?

Because desistance justifies cautious, rational, skepticism. Desistance proves that some people think of themselves as transgender and then come to think of themselves as not trans. Desistance creates doubt.

When I say “desisters,” I’m talking about those who once thought of themselves as trans but do not currently see themselves that way. Desisters like my daughter and the other young people we know, never took steps to medically transition although they considered themselves transgender and in most cases, looked forward to medical intervention of some kind.

Desistance stories are often criticized as being about kids who were never “really trans” to begin with. Brynn Tannehill, a board member of the Trans United Fund, argues that the 84% desistance rate is inflated because it caught up a lot of gender nonconforming kids in place of “true trans” kids–so of course they desisted; they were never trans!

Here’s the thing, neither was my kid. Chances are, most of the kids of parents reading here aren’t trans.

Let’s assume for the moment that there is such a thing as “true trans.” What does that mean? Let’s say there is at least minimal proof that gender identity is innate and biological (there isn’t). Let’s pretend that we have long-term data showing that medical intervention in adolescent development is beneficial to those who don’t fit easily into gendered expectations and norms and to those who suffer from dysphoria.

Now, let’s say that all the previous gender-atypical behavior my daughter exhibited growing up was resultant from a biological abnormality.

So what?

So what if she sits on the far end of the bell-curve’s tail of female behaviors and preferences? How does that make her “other?” Why does that mean she’s in need of medical intervention to “correct” something deeply amiss?

Why can’t she and all other outliers be supported as they are without needing to be fixed? Have we learned nothing from the historical horror show of medical interventions enacted on children with differences in sexual development (“intersex”)? Why does being an outlier mean that she’s “really a boy?” instead of simply, that she’s different than the female norm?

Desistance as a likely possibility gives rise to the “wait-and-see” approach, which according to some “affirmative” gender professionals, is just as dangerous to kids as insisting they’re not trans. This horrifies me, that cautious “wait and see” approaches are discouraged when there is zero evidence that socially and medically transitioning children and teens is beneficial, apart from (parent reported) immediate gratification and short-term validation.

The affirmation model used widely in the US is actually highly controversial. In the UK, a doctor is under investigation for providing cross-sex hormones to children as young as 12—a situation being normalized at pediatric gender clinics in the US.  Under-18 surgeries take place in the US, while they are prohibited in the UK—and even Thailand, once known as a go-to place for underage procedures.  US “affirmative” clinicians behave as if the debate on child transition is over, even though leading researchers at 17 worldwide locations cautioned in a 2015 journal article that “in actual practice, no consensus exists whether to use these early medical interventions.”

brie pull 3And still, WPATH argues in favor of lowering age limits for medical and hormonal treatment and easing access to transgender medicine. In the US, some pediatric gender practitioners and their advocates act as if this course of treatment is settled science. It isn’t. Even the gender specialists in the Netherlands who pioneered the use of puberty blockers in “trans kids”  caution against socially transitioning younger children, because kids who don’t socially transition seem to mostly work it all out by themselves, and some socially transitioned youth who changed their minds found it very difficult to desist later.

Desistance stories also add weight to recommendations for cautious approaches that focus on first treating underlying mental health issues. That’s problematic in a climate where trans activists want to completely depathologize transgenderism. I know a lot of families whose children currently think they’re trans. In almost every instance, there are prior mental health diagnoses or family experiences of trauma.

Parents like you—many of whom are contributors on 4thWaveNow—are castigated as “transphobes” or (at best) “unsupportive.” What do you say to these charges?

Supporting children in desiring and procuring plastic surgery, synthetic hormonal suppression and supplementation is not healthy, supportive, enlightened, or progressive.

Authentic selves do not require surgical and hormonal treatment unless there is underlying pathology, like for my daughter’s autoimmune condition which requires daily hormonal supplementation.  Medical transition should be a last resort for those whose suffering cannot be ameliorated otherwise.

Becoming a life-long medical patient is not liberating; it is enslaving. Being critical and cautious is not hatred, it’s being a good parent.

Gender dysphoria is real and it causes real suffering. My daughter was in deep, profound, pain.

After initial hesitation, I knew my child was not “born into the wrong body” and that as her parent, I would be doing more long-term good (and also less long-term harm) by offering her the time and tools she needed to see herself as whole, capable, and “authentic” as she was instead of affirming that there was something wrong with her.

I think that the most supportive thing we can offer our children is to take apart all our preconceived ideas about gender and identity alongside them. I was told by parents of trans kids and gender therapists that the only expert on my child’s gender identity was my child and that asking “why?” “what does that mean?” “How did you arrive at that conclusion?” “Who are your sources?” and a thousand other questions which would lead down a thousand other rabbit holes, was transphobic, unsupportive, and harmful to her well being.

They weren’t. Those are exactly the questions that helped her make sense of herself, helped her feel whole instead of in need of corrective treatment, helped her be resilient in the face of disappointment and learn to manage both real and perceived limitations.

The stories we’ve been telling aren’t enough. They don’t go far enough. Deep enough. They’re too easy. The answer isn’t a pill or plastic surgery. How many children were prescribed Ritalin simply because their bodies couldn’t stay still? I mean, come on. An entire industry has risen up around trans kids. Careers are being made, not just in the medical field but in education, policy, fashion, the media, all because normal, developmentally appropriate childhood behaviors have been repackaged as (often homophobic) pathologies. We’ve seen this before.

Being “trans” is too easy. It’s an identity picked off a shelf and inside the packaging, there’s a list of other necessary components one must procure before reaching authentic selfhood. “Being trans” to girls like my daughter is like a quest in a video game with each “affirming’ “medical procedure acquired is an “epic win” bringing you one step closer to having all your problems solved. Except no video game exists that suppresses development or leads to the removal of healthy body parts. Being trans isn’t a video game, it’s real life. Real, painful, confusing, life and being trans was the defining aspect not only of identity but also the root of all her suffering.

I supported my child in her journey. What I didn’t do was accept the first and easiest answer. I helped my daughter know that disagreement or unacceptance of any gendered norm was more than okay. I fully supported what my generation quaintly called ‘gender bending” in all ways, but I didn’t agree to let her subject herself to significant bodily harm in an attempt to treat her dysphoria. From the very first announcement, I let her know that she could cut her hair however she wanted, wear whatever clothing she wanted, and use whatever name she chose.

I supported her in her discomfort, to the best of my ability, and I also let her know that discomfort and confusion are legitimate aspects of a meaningful, deeply explored life.

 There are two rationales given for the urgent need to medically transition young people: the risk of suicide, and “passing” better as the opposite sex if puberty is blocked. Do you think these reasons are valid, and if not, why?

Major life moves made from a place of fear and lack of choice are rarely successful. Kids don’t kill themselves because they’re trans. Suicidality needs to be treated as a dysfunctional response to unhappiness, not as a symptom of being trans. Anxiety needs to be treated as anxiety and not as a symptom of being trans. Depression needs to be treated as depression and not as a symptom of being trans. And suicide should not be used as a strategy to manipulate vulnerable parents desperate for “expert” advice or to prime kids to take their own lives. Stop already. That stuff’s contagious.

Most of the parents who’ve agreed to support medical transition for their children and the various gender “experts” I’ve talked to over the past few years argue that children who transition young will pass easier. That’s a problem, because prioritizing “passing,” like much of the surrounding ideology, actually reinforces binary perceptions of gender by suggesting there is only one way to be/to look like a man or a woman. I know gorgeous women with broad shoulders. I know handsome men who can’t grow a beard. So what? The effects of testosterone on a natal female are rapid, and some, like the growth of facial hair, male pattern balding, and changes to one’s voice are irreversible. Besides, it’s recommended that natal females taking testosterone for more than a few years have a full hysterectomy to minimize increased risks of some cancers. Therefore, early transition does not limit later medicalization. Sometimes, it even increases the need for more intensive and painful procedures later.  I think it would be far healthier for those who are gender-atypical and for society to get rid of the idea of “passing” completely.

Until recently, the only critics of pediatric transition seemed to be people primarily from the conservative right.  They tend to conflate transgenderism with gay rights, and are opposed to both. What is your own political affiliation and viewpoint?

Oh, I’m left-of-left. Another reason I want to speak out is because most opposition to trans advocacy comes from the conservative right and IS deeply entrenched in sexist and homophobic beliefs.

Most on the left are too afraid to speak out for fear they’ll be labeled as transphobes, bigots, TERFs, bio essentialists, and just plain old shitty, hateful, shallow-minded people.

Sigh.

Look, if an adult decides after careful and hopefully well researched, in-depth exploration into why they want to undertake surgery and/or HRT, and they fully understand–to the extent it is possible to understand given the lack of long-term data—what their medical choices could mean 5, 10, 40 years down the line, I believe they should be free to make whatever medical choices they and their support team believe to be best. I think insurance policies or better yet, a national health insurance policy (I can dream), should pay for all services related to transgender care.

I believe trans people should be protected against discrimination in education, healthcare, employment, and housing. I want trans people to feel safe walking down the street. I want them to be safe walking down the street.

What do you hope to achieve as public spokesperson for parents of trans-identified young people?

I want to make the conversation larger; I want it to go deeper; I want the medical community to keep their ‘corrective treatments’ away from our children’s bodies. It’s not okay to offer them life-long patienthood without first giving them tools and support to explore the “why?” the “what next?” and a myriad of other possibilities and conclusions.

Currently, the only voices in the discussion are those involved with the industry that’s risen up surrounding transgender medicine. I want to take the discussion beyond the self-declared “experts” who are making entire careers off of the notion that it’s possible to be born into the wrong body.

Many advocates of medical transition for youth claim that there are “true trans” kids who are very different from merely “gender nonconforming” youth. Do you agree?

No. I think almost every human on earth is gender non-conforming in some ways. I was listening to Georgia Warnke recently. She’s largely responsible for getting the medical community to stop performing surgeries on young intersex children, and she helped people learn to be more comfortable with ambiguity in sex and gender presentation. She cautions that we don’t want identities to “go imperial,” a phrase she borrows from Kwame Anthony Appiah who writes that some identities “risk becoming the obsessive focus, the be-all and end-all, of the lives of those who identify with them,” and they “lead people to forget that their individual identities are complex and multifarious.” I’m concerned that’s what’s happening with many of our youth.

Their lives are boring, they’re isolated, the earth is dying, the economy is dying, their families are disintegrating, they’re carrying so much. I can’t imagine a more difficult age to come into ‘ideological’ adulthood than this one. I think a great many young people identifying as trans are doing so because it’s the only life-shaking, meaning-bringing area of their lives they have any control over. Being trans is an answer, a solution, and a meaningful marginal identity during a time in history when being a member of an “oppressed class” also begets greater social currency in some circles.

We’ve given them surfaces. Reflections of reflections of copies. The Mirror Stage mirrored and misidentified. A rose wet with Photoshop dew on a handheld screen that’s the first thing they touch when they wake up and the last thing they touch before they go to sleep. We parents didn’t realize what was happening. We couldn’t predict how digital lives would bleed into reality, that we’d need to clarify what we mean when we say the word “cloud.” Another mom going through this says, “online worlds seep into life like too much salt in a soup.” Curated personas, best friends you’ve never smelled or touched, avatars brought to life.  The Junior Oxford Dictionary removed the words “acorn, ash, buttercup, dandelion, fern, ivy, nectar, pasture and willow” to make room for: “blog, broadband, celebrity, chat-room, mp3 player and voicemail.”

Huge, meaningful and exciting swaths of our kids’ lives have played out in digital worlds while their material worlds have become smaller, more isolated, and disconnected. In many cases, our kids were already disassociated from their bodies, even before they became aware of trans identities. Running, jumping, dancing, wrestling, all these things happen primarily in controlled spaces now. The only remaining place for many young people to gather away from adult-controlled, contrived, and protected spaces, are digital worlds. It follows, in this climate, that “authentic selves” might also be technologically-mediated products to consume. My god, talk about planned obsolescence. This is planned obsolescence of the body from the moment of its birth and our kids are early test subjects in transhumanism. For real. No tinfoil hat needed. Google “postgender.”

No. I don’t believe that there’s such a thing as “true trans.” I believe we’re all mosaics of hormonal, skeletal, emotional, personal, etc. traits and that identity is being commodified in dangerous ways.

Your daughter is only 14. The “affirmative” clinicians will say, see? She just wasn’t really trans. No one can be “made” to be trans, so your daughter just figured out she wasn’t. No harm done.

The only reason my daughter figured out she isn’t trans is because I gave her space, time, and access to diverse people to talk to. I did not, as was advised, immediately affirm her new trans identity. Had I done so, had I said, “oh, yeah, that makes sense” she would most likely, she says, be taking testosterone now. She thanks me regularly for not believing she was a boy trapped in a girl’s body.

Related to the previous question, how do you know your daughter won’t change her mind again and realize she actually is trans? Again, the activists/affirmative clinicians will say maybe she’s just staying “in the closet” about being trans to please you.

I don’t know that my daughter won’t change her mind. How could I? What I know is that she spent the past two years interrogating her dysphoria: where it came from, what purpose it served/didn’t serve in her life; what triggered/increased/decreased its intensity. For the most part, she faced her dysphoria, anxiety, and past trauma head-on and learned ways to live in her body more comfortably.

Is she just waiting until she leaves home to come out again? Best to ask her [Note to readers: We will!] but I don’t think so. She’s angry that she wasted two years of her childhood worrying about her gender identity. She sees her non-conformity with gender roles and her non-compliance with “femininity” as aspects of her individual personality, not as pathology in need of corrective medical care. To her, and she can explain this better than I can, being “trans” means accepting that males/females can only be one way, that some aspects of identity/personality/self-essence beyond biological functions belong to only males or females. She doesn’t believe that’s true.

Do you oppose medical transition for all youth? Why or why not?

No. I believe that for some youth, pharmaceutical treatment might bring the most relief. I do not believe that surgery to remove healthy body parts should ever happen on children or adolescents.

Physically altering (and sterilizing) bodies as a “corrective measure” is nothing new. The history of medicine overflows with horrors enacted on dark skinned and disabled bodies, the bodies of women, and of homosexuals. Doctors in the Netherlands, where homosexual males used to be surgically castrated, were the first to suppress natal puberty in trans identifying children. I think that history, of medically-supported and induced harm on noncompliant bodies, is important to keep in mind when thinking about transgender medical treatment. I mentioned Ritalin earlier. But let’s remember lobotomies, cures for hysterical women, female genital mutilation. Let’s remember that puberty suppressants followed by cross-sex hormones will sterilize a body for life. Gender specialists are sterilizing and greatly increasing the risks of cancer and other debilitating medical conditions in children, many of whom would simply have grown up to be gay in earlier times.

Caution. We have to be more cautious, not open the gates wider. Puberty suppressants, cross-sex hormones, and surgery, all have life-long consequences. Shouldn’t the focus be on helping people learn to accept themselves, in all their messy, unmatched, contradicting, and possibly limiting, glory? We contain multitudes, right? Let’s contain them in the healthiest of possible bodies, with the least amount of dependency on chemical and specialized medicine.

We all want to thank you for stepping forward as public spokesperson for 4thWaveNow. As you are well aware, many parents feel they cannot go public because of the current political climate.

I want those of us who live with and care for young people investigating their gender identities to think more critically and carefully about the idea that humans can be born into “wrong bodies,” and that “authentic selves” are dependent on medical consumption. I want to push the conversation beyond “because I am trans” answers. That’s not good enough. There’s more here and we owe it to our kids and future societies to ask harder questions and to wait, patiently, for more meaningful answers.

I want to speak out because I know others can’t. The risk to one’s livelihood and to the peace of their families and communities is immense. Nothing I am saying is hateful or bigoted but questioning the dominant narratives of innate gender identity and affirmative models of treatment are dangerous moves when even philosophical questions are considered “epistemic violence” against trans people.

This is unacceptable. We cannot think rationally or make well-informed choices if half the conversation is muted. The voices of desisters are important contributions to any discussion focused on dysmorphic adolescents and kids who don’t easily conform to gender norms. I want parents to know that it’s okay to say, “hang on, lets think all this through together.”

You know, if “being trans” simply meant I am who I am who I am and it didn’t often come with a side of medical necessity, I wouldn’t be here insisting we need to talk about this stuff more thoughtfully, more thoroughly.

If sex is socially constructed, like trans advocates argue, why does anyone need to alter their sexed bodies to match their gender identities? It doesn’t make sense. Transgender medicine is being marketed to our young people under the guise that their gender-atypical behavior and/or their developmentally normal bodily discomfort is a sign of incongruity, of imbalance. Normal, healthy teen angst, the challenges of independent identity formation in adolescence, these processes have been pathologized. Instead of helping kids be resilient, many aspects that fall under “gender identity exploration” enable self-perceived and socially-inflicted oppression, hardship, isolation, and malaise.

But, too, in many ways, what’s happening with awareness about gender identities is meaningful and I’m thankful to young people for pushing the rest of us to think about what being “masculine” and “feminine” means in this day and age. Thanks to young people, many are noticing how toys are more gendered now than they were thirty years ago and lots of parents are questioning why boys can’t wear sparkles and why we tell girls to smile. This is all good stuff! But all the good stuff is coming at the cost of our children’s long-term physical and emotional health.

I’m adding our story to the mix because it offers an alternative trajectory to the one that currently dominates the press. In addition to the “courageous trans kid” who lets everyone know that she is a he, I want to highlight young people who’ve come to terms with their sexed bodies and courageously move forward in life without feeling there is something wrong with them, that they’re disabled in some way, that their bodies or other’s perceptions of them are in need of correction.

Both my daughter and I want other parents and young people to know it is possible to work through some/most/all aspects of dysphoria without removing healthy body parts or injecting off-label cancer drugs and cross-sex hormones.

I want parents to know it’s okay to ask questions, to dig deep, to be skeptical. To push your children and those who oversee their care to go beyond “just because” answers like “because that’s how I feel” or, “that’s who I am,” to deeper levels. Push through to “why?” and “what does that mean?” to “where does that feeling come from?” and bravely explore what’s uncovered. What does it mean to “feel” like a woman or a man? Why do those feelings mean healthy bodies are in need of medical intervention? I mean, really, how can it be that so many have suddenly been born “wrong?”