The Lost Generation Strikes Back

Posted on May 5, 2017 by 4thwavenow

by Worriedmom

Dateline: New York, New York, May 6, 2027

When you look back at it, what’s most striking is how it seemed like nothing much was happening…and then it happened all at once. Like watching a thunderstorm roll in over the prairie: the sky strobes with flashes of far-off lightning and the thunder is a barely audible rumble, the clouds mass slowly, the wind picks up bit by bit, but it seems hundreds of miles away; until suddenly it’s right on top of you and pouring down like there’s no tomorrow.

Was it the emergence of PUFF (Parents United For Fairness), the nationwide group of outraged soccer dads and softball moms, who finally rose up as one to demand that girls be included in sports, once every team at every school became comprised exclusively of males and transwomen? Or was it in 2020, when 57% of all gold medals awarded at the Olympics in women’s events were given to biological men?

Or was it the simultaneous, highly publicized nationwide demonstrations aimed at the Human Rights Campaign, GLAAD, Lambda Legal and the National Center for Lesbian Rights, by mobs of furious gays and lesbians, chanting “no gay eugenics” and demanding their movement back? Was it the Oprah episode featuring 15 de-transitioned adults, which made #HowCouldYouDoThisToMeMom the third fastest trending hashtag in Twitter history? Many thought the death blow came with the sex abuse scandals. Interpol had been on the trail of “transition porn” for years, and when the Boston Globe blew the lid off in 2023, many thought the writing was on the wall.

But even though all this helped lead to the eventual fall of the once all-powerful “pediatric T lobby,” the day the movement died was when the trial lawyers smelled blood in the water.

The first rumblings came when the hospitals started spinning off their gender clinics into separate corporations and classifying clinic workers as independent contractors. Medical schools and teaching hospitals started trying to put as much daylight as possible between their own organizations and the gender crew. Pediatric gender doctors began setting up contingency plans for a hasty exit from the practice and quietly moving assets abroad. Insurance companies, faced by skyrocketing costs associated with transition, were by then doubly rocked by the realization that transition would only be the starting point for years of expensive treatments for chronic illnesses brought on by those same pricey procedures and drugs.

Managers of “gender clinics” belatedly realized that it might have been better to impose a distinction between transgender political advocacy and medical advice. They started cracking down on therapists and doctors who made policy and pursued professional vendettas on Twitter and Facebook, but thanks to the Wayback Machine, it was a case of too little, too late. It took a while to weed out the clinicians who advertised primarily on Tumblr and other youth-oriented platforms, although all of that evidence came in handy later on in courtrooms across the United States. (To this day, the Trial Lawyers of America sends the “Testpocalypse” doctor a bouquet of roses for his birthday.)

By this point, all 50 states had passed legislation that permitted “gender confirmation surgery” and cross-hormone treatment for children as young as six. But by 2021, the first wave began to emerge of frightened, sick, and miserable adults. Few of these individuals were counted or helped by the then-ubiquitous gender clinics, and even though their stories were suppressed by every mainstream and QT media outlet, new underground story-telling techniques started to connect them to each other. The most prominent voice among them was Brayden, a rising star on the once-popular Trans Channel who had begun his transition at age 7 months. By then the permanently disabled victim of years of unproven drug therapies and repeated (and unsuccessful) surgeries, all of which were televised, Brayden became a crusader for the “lost generation,” as the legions of victims began to call themselves. Telegenic and appealing, before he passed away Brayden became the “face” of the movement, and achieved what thousands of previous victims could not: attracting sympathetic news coverage from the many outlets that had once been under the sway of the all-powerful T lobby.

Eventually the stories of the lost generation reached the ears of people who had a tremendous financial interest in seeing to it that they received justice, or at least compensation. The first lawsuits were launched. How could we forget that moment in 2022 when, right after he filed the first of what became dozens of lawsuits, a key plaintiff’s class-action attorney was interviewed on the steps of the Southern District of New York: “Dude, we brought the cigarette industry down. You really think this is going to be hard?”

Although there were several tricky legal problems that had to be resolved first, the plaintiff’s bar sat up and took notice when in 2025 a Texas jury delivered the first successful $10,000,000 verdict for “wrongful transition.”

The verdict was later reduced on appeal, but not until discovery had revealed the astronomically high expenses that would be entailed in providing lifetime care for a young person suffering from fragile bones, peeling and broken teeth, severe mood disorder, cardiovascular disease, and, of course, sterility. It developed that “informed consent” was anything but, since nobody involved with that documentation actually had any idea of what was being consented to. Although practitioners had hoped this paperwork would shield them from liability, one of the earliest cases in the area established that neither minors nor their parents could provide informed consent to unknown, and unknowable, medical consequences. The courts also generally affirmed that patients couldn’t “waive” their care providers’ gross negligence: who knew?

After that, it was off to the races, legally speaking. Everybody left standing got sued (although by then, most of the top “pediatric gender specialists” had re-located or made themselves judgment-proof). Insurance companies were the first to crumble: faced with virtually unlimited future expenses, they imposed a blanket denial of coverage for any “gender therapies” for under-age 18 patients. R.I.C.O. (the Racketeer Influenced and Corrupt Organizations Act) proved a remarkably flexible tool for pursuing groups of affiliated health care providers, surgeons, counselors, drug makers, and the advocates who had encouraged and developed a steady stream of patients.

The NIH finally got into the game when in 2025, it began to finance large-scale studies of young people who had received GnRH agonists at a young age, followed by cross-sex hormones. Unfortunately, there was no shortage of damaged and ill subjects. At the congressional hearings that started later that year, government “watchdogs” were faced with angry speeches in the form of questions. What congress-people from both sides of the aisle urgently wanted to know was why the FDA had permitted human experimentation on, and sterilization of, children, in violation not only of medical ethics but the Geneva Conventions. There was no good answer.

Many of the “transgender reforms” were reversed as quickly as they’d been enacted. For instance, the mandatory “Might You Be Trans? No, Think About It … Really, Might You Be?” psychological screening test administered at the start of the school year for all pupils in all grades was abruptly discontinued. Hormone-suppressing drugs and cross-sex hormones were pulled from the shelves of school infirmaries everywhere. Congress amended Title IX again, and sports authorities everywhere agreed to pretend that the period from 2015-2027 “just didn’t happen.”

Few of these developments healed the victims. However, a portion of the immense liability pay-outs were eventually directed to the establishment of a nationwide fund, from which disbursements could be made to qualified plaintiffs.

As might be expected, no word was ever heard from most in the press. There was a limited amount of soul-searching in academia (Pediatric Transition and Satanic Panic: Did We Really Get It Wrong Again? was one of the most-downloaded papers on PubMed in 2028) but by and large, the majority of the most vocal trans-proponents in the press simply “moved on,” and wished everyone else would, too.

By far the most enduring impact of the rise and fall of trans-mania, as it came to be called, will be its impact on the culture wars. The line between “conservatives” and “liberals” became increasingly blurred, as people on both sides began, first, to realize that they indeed had a common interest and, second, that they could work together effectively despite their differences. People who had once regarded each other with horror and fear learned that they could advocate for the same outcome, and that joining forces made their voices stronger and more credible. The respect, tolerance and cooperation that pervaded the “trans lib” movement eventually affected social issues beyond trans-mania: working together, it was not difficult to find solutions to other social justice issues that took into account and respected personal rights and religious freedoms. Life became much easier when one side did not have to lose so the other side could win. At last, the war over Planned Parenthood was ended when representatives of all viewpoints were able to hammer out compromises that satisfied all (okay, most) concerns.

Once the culture wars were finally settled, people of all political persuasions realized the tremendous amounts of energy and time that had been wasted in fighting them, and turned, at last, to solving larger and more systemic problems. Environmental, educational, economic and social problems became much more susceptible to solution once ideology was out of the picture and the goodwill of both sides was assumed.

Even with all these positive changes, I still mourn the victims, and their faces and stories will haunt me forever. But at least I can sleep at night, knowing that I did what I could, when I could do it.

How about you?

Worriedmom is a mother of four (allegedly) adult children, who lives in the Northeastern part of the United States. She practiced law for many years and now works in the non-profit area. She is available to interact in the comments section of this post.

Graphics by Lily Maynard

A “sinister mental trap”: One man’s journey back to himself

Posted on April 22, 2017 by 4thwavenow

183

Potentilla is a detransitioned male who spends his days farming, making gardens, practicing herbalism, and reading Carl Jung. He is interested in history, human nature, and the occult, and greatly enjoys giggling with strangers, the utter improbability of life, taking long walks, and making music with friends. He is available to interact in the comments section of this post. Potentilla can also be reached at potentillacinquefoil@gmail.com, where he is happy to discuss these issues privately with concerned parents and people contemplating transition or detransition.

by Potentilla

I was born male and lived for the first five or so years of my life totally OK with that. As I got older and was taught postmodernism, white guilt and misandry, I started to hate my male body and wanted my maleness to be destroyed. I became suicidal and practiced self harm, including towards my genitals. I wanted to magically turn into a girl, and thus be redeemed.

Growing up, it was hard for me to conform to the norms of American masculinity. Part of this is that my dad is a reflective and empathetic man, and so my natural model is someone who himself doesn’t necessarily conform to gender norms. Nevertheless, I was ok with my body until maybe the age of 19, when I realized I’m attracted to other men and am both a “bottom” and somewhat swishy. Around 20 I had multiple crises; I moved to a gay hippie commune, I broke up with my first serious boyfriend, I did too many drugs, became homeless, and had several very confusing sexual relationships with women.

Slowly I came to believe that I was a repressed woman. It is a testament to my credulity that I could honestly assess my own life situation, and yet come to that conclusion. But that is exactly what happened. Trans let me explain away all my problems with a new and compelling narrative. This promise held enormous emotional appeal. At the time, I was living in a trans/genderqueer space where there was a cult-like atmosphere in regard to transitioning. Being trans made you an insider and conferred upon you sympathy, respect, and resources. Being merely gay was frowned upon.

For the past 10 years ago or so, I’ve “lived as a woman.” For the first 8 years of that, I was on cross sex hormones, when I began to use herbs to manage my health. I had an orchiectomy about 7 years ago. After my surgery, every punk house was open for me to live in. I had become a protected class.

Even though I didn’t pass as a natal female, being trans made my life easier to navigate socially. People seem much more comfortable with a somewhat feminine man becoming a transwoman than a somewhat feminine male owning his maleness. It is fascinating that this is the case, that it was and is scarier for me not to pretend I’m a woman.

So, I had some very compelling reasons to transition, those being:

unprocessed trauma concerning my gender
poor mental health and poor reality testing
social pressure
social rewards
a postmodern ideology that rewards transition

I believe that the trans movement has qualities that make it very similar to a cult. I became trans for the very same reason that people join cults; and similarly to those who escape cults, I’ve found profound healing in my slow path towards detransition.

Now, almost ten years later, it is clear that I am not a woman. In fact, it is obvious that I am still very much a male, but now with breasts and mutilated genitalia. That is an uncomfortable position to be in; not only was I mistaken; everyone knows it. But his uncomfortable reality is still preferable to the intense self-delusion and narcissism that I lived in and with for many years.

The Curse of Trans

While there is a certain temptation to accept all of this as personal failings; while there are certainly many ways that I have been weak and unstable, it doesn’t feel particularly genuine to try to explain my immersion into trans as solely a personal choice and experience. To understand trans sensu lato means understanding the ways it resembles a cult. I transitioned only after heavy indoctrination into genderist ideology. Most pertinent was the pernicious “cis” and “trans” dichotomy.

I believe this binary ideology to be a very profound curse to susceptible individuals. “Cis” is defined as someone who is okay with their body as it is, while “trans” means someone who isn’t okay with their gendered body, regardless if they physically transition or not. Given this definition, most people have at certain points of their lives been functionally trans. This is usually especially pronounced at puberty, and it is horrifyingly predictable that we’re now seeing a trend of trans children, given the intersection of pubescent dysphoria and genderist ideology.

When I encountered this false dichotomy, naturally I put myself on the side of “trans” because I have a long history of hating my gendered body. Once I accepted this as true, I was locked into the certain path of claiming I was a woman. This led to faith-based beliefs that “gender is innate” and “I am a woman,” which in turn led to the blind faith that “hormone replacement therapy will solve my problems” and “I’ll be so much happier after I’m castrated and no longer male.” This was compounded by the widespread belief that transgender feelings grow worse with time and inevitably lead to insanity or suicide if there is not medical intervention.

And away I went, my mind totally taken with genderist ideology, with full faith that transitioning was the only way to save my life.

This is why I consider “trans” to be a curse. I imagine the evil trans witch standing over the gender-nonconforming children lost in the woods, reassuring them that “cis people are comfortable with their bodies and trans people aren’t. I can help you become at home in your own body” as the children follow her deeper into the woods to be transformed. What the children don’t realize is that they must pay for this with a piece of the glowing, golden ball that is in their hearts. Later, only a few become disillusioned and decide to retrieve the piece of their heart that they lost. They wander alone hither and thither in the dark woods for many years to find the sacred springs where they wash off their deception, fear and helplessness, and find that the golden ball never actually left. They are still themselves, only disfigured and disoriented by the deal they made with the evil witch. But they are finally able to leave the dark forest and again become part of the human family.

I’m open to the idea that some individuals need to transition to live their authentic selves. There may very well be folks who genuinely and beautifully find themselves in transition. That being said, though, I believe it is inevitable that these stories of self-discovery through sex change, no matter how true they are or beneficial to the individual, contribute to the destructive myth of the trans/cis binary. I don’t want to generalize too much from my own experience, but I also strongly believe that transition does profound harm, even when it does help. People have the right to transition, but I also believe that the entire gender identity movement has become unfathomably destructive, especially to gender nonconforming young people who, for the most part, would almost certainly otherwise be homosexuals. There are areas of subtlety which I’m not sure how to explore in this regard, and they are beyond the scope of this essay.

Sense of Self

During the time I believed I was a woman, I enjoyed every step of transition, because it gave me an identity. I didn’t know who I was and a transgender narrative gave me a handle to understand myself. Rather than needing to take care of the wounded parts of my self, I created an entirely new persona, and I played that part every moment of every day.

This worked as a great solution for a time; I did a good job playing that part, rather than living as my authentic self, and was thus shielded from the vicissitudes of the world. This is of course textbook narcissism, which makes me wonder if trans is as much a cult of narcissism as a cult of gender.

With time however, my authentic self was nonetheless nurtured by my experiences and I began to become more genuine. This transformation had three parts:

1) Leaving the Trans Cult

After a nasty breakup, I left a queer land project and LGBT community where postmodern Marxist ideology was very dominant. I constantly self-censored to fit in with the group. My own political leanings tend towards Burkean conservatism, so I was more or less lying to myself and others. I attended mandatory sensitivity training which had the feel of a political indoctrination meeting. Almost every day, I ritualistically confessed my guilt as a white person in conversation with my peers, and they did the same with me. Over time I began to feel an actual intense guilt. And with that, I began to wake up to the fact that this sort of politic was bad for my mental health.

So after my nasty breakup, I left this queer community and got a live-in job at a farm. My coworkers there were much more free thinking, and I began to find it easier to think for myself. That year I worked 55-hour weeks and read about 60 books (including Spengler, Odum’s Ecology textbook, Marcus Aurelius, Homer, and more). This study, and the new milieu with new friends, allowed me the opportunity to learn that I’m strong and capable living on my own, and my worldview was massively expanded.

2) Going off Hormones

About 9 months after leaving the trans cult, I stopped taking hormones, and began taking herbs, and studying them, to maintain my health instead. I could pursue a passion that connects me to my inner self while showing me that I’m not dependent on maintaining a trans identity to meet my own health needs.

I’ve also developed skills which have helped many other people. In turn, I saw people valuing me for something deeper than my identity. I am very passionate about plants and have been my entire life. I am also open and spiritual in my psychological orientation. This makes the study and practice of herbalism deeply rewarding to my authentic self, and helped me become strong enough to escape from living mostly out of my trans identity.

3) Detransition

After leaving the queer land projects, I fell into several other social milieus where thoughts were heavily policed. By this point I had already stopped believing in the idea of transition, but kept up appearances for social benefit–and that social benefit was huge. Certain people would hire me because I was perceived as trans. I could find places to live with queer folks largely on account of my identity. Living in these environments, which were well stocked with self-appointed thought police, was bad for me, and I began contemplating leaving. Near the end of this time I developed debilitating chemical sensitivities, and decided my best bet was to live with my parents for a time. At that point, the entire trans narrative dissolved, and just as quickly, my chemical sensitivities became very easily manageable.

Some Closing Thoughts

Over the years, I’ve known dozens of trans people. Most had reasons that were less convincing than my own for transition, and as we’ve seen, my own justifications were rather feeble. This leads me to believe that, by and large, trans is a disingenuous ideology that is a current mass hysteria. It is also clearly something of an unintentional eugenics program against gender nonconforming folk. The entire enterprise makes me feel sick. It has become trendy to commit oneself to lifelong hormone therapy and surgical mutilation. I was not able to correctly appraise the situation at the time I became trans and deeply regret the decision now.

Going a little deeper, trans is profoundly sexist and actually creates less diversity in expression. I went from an authentic, studious, awkward, somewhat feminine man to performing full time as a trans woman. Eventually my authentic self reasserted itself, and now I’m slowly moving towards more integration. The trans narrative does much more than merely normalize mental illness; it creates mental illness. I would have never transitioned if I hadn’t been wounded by postmodernism and then given an escape hatch in trans. The narrative made me crazy just as much as my own predisposition made me vulnerable to it.

My sense is that no one wants to hear the voices of detransitioners until it is too late. My sincere hope is that some people who are considering transition, as well as parents with “trans” children, might read my essay and choose a brighter path than that of transition. Please learn from my mistakes and consider other options. Most dysmorphia goes away with time. The entire trans narrative is a sinister mental trap which is profoundly harmful. There are infinitely better ways to deal with the universal experiences of dissatisfaction and desire to be someone else.

“In the absence of solid evidence”: “Innovators” and “thought leaders” promote under-18 transition

Posted on December 11, 2016 by 4thwavenow

112

by Overwhelmed

The University of San Francisco runs one of the most prestigious and well respected programs for “trans kids” in the United States. Their publication, “Health considerations for gender non-conforming children and transgender adolescents,” written by Johanna Olson-Kennedy, MD, Stephen M. Rosenthal, MD, Jennifer Hastings, MD and Linda Wesp, MSN, consists of detailed guidelines on treatment for gender dysphoric youth. It appears to be written for providers, not laypeople, with specific recommendations for GnRH analogues and hormones—when to start, options for delivery (e.g. injection, patches, gel), dosages, needle gauge sizes, and lab tests for monitoring. Other areas are addressed too, including the induction of amenorrhea in natal females and the importance of discussing infertility. Towards the end of the protocol, there is a section about genital and chest surgeries.

The authors state that current standards of care recommend waiting until patients are 18 years old for genital surgeries. But regardless of this advice, they advocate for underage surgeries in certain cases:

Both the Endocrine Society Guidelines and the World Professional Association of Transgender Health (WPATH) Standards of Care version 7.0 recommend deferring genital surgery for both transmasculine and transfeminine youth until the age of 18 years. As youth are transitioning at increasingly younger ages, genital surgery is being performed on a case-by-case basis more frequently in minors.

One of the authors of the UCSF document, Dr. Johanna Olson, has frequently argued for relaxing the over-18 guidelines on genital surgery, including earlier this year on the WPATH Facebook page.

Here’s what the UCSF guidelines have to say about “chest” surgeries aka mastectomies:

While increasing numbers of insurance companies are covering the cost of male chest reconstruction, there are often arbitrary barriers to surgery citing that youth need to be at least 18 years of age prior to undergoing this procedure. Providers should participate in appeal processes so that patients can undergo chest surgery. There are currently no available data that report the positive impact of male chest reconstruction in minors, although a study is underway now.

Gender doctors don’t have the data to back up the double mastectomies and chest contouring they are performing on minor children. But regardless, providers are instructed to recommend health insurance coverage for the procedure—including intervening in appeals processes.

Throughout the guidelines, there are a number of times it is admitted that the science of pediatric medical transition is lacking in data:

“While sparse data exist regarding the impact of puberty suppression and gender-affirming hormones administered during adolescence, there have been promising results from the Netherlands indicating that this approach in adolescents results in improved quality of life and diminished gender dysphoria.”

“While there still exists uncertainty as to which GNC children will continue into adolescence and adulthood with transgender identities and/or gender dysphoria and which will not, it is been noted in prior studies that increased intensity of gender dysphoria is a predictor of a future transgender identity.”

“While data are sparse, preliminary results from the Netherlands indicate that behavioral problems and general psychological functioning improve while youth (age 12 and older) are undergoing puberty suppression.”

“While clinically becoming increasingly common, the impact of GnRH analogues administered to transgender youth in early puberty and <12 years of age has not been published.”

“No consensus exists on the length of time GnRH analogues should continue after youth begin gender-affirming hormones.”

However, regardless of these caveats, the protocol comes across as very thorough. Eighteen different sources are cited for justification. The authors appear to be knowledgeable and capable.

But at the very end, there is this disclaimer:

ucsf-disclaimer

And there you have it. We are relying on the “expert opinions of innovators and thought leaders” in a field that is in its infancy. “In the absence of solid evidence,” children are being given earlier and earlier irreversible medical interventions based on best guesses about the future.

As the guidelines note, though, studies are indeed underway. Olson and other gender specialists have received a $5.7-million NIH grant to study children and teens who are currently undergoing medical transition. But importantly, these studies aren’t recruiting a control group of untreated trans-identified children, and they are only set to run for 5 years. While any information is better than none when it comes to this modern experiment on youth, the long-term medical and psychological outcomes for the people who were subjected to irreversible medical interventions in their youth will remain a mystery for decades to come.

Could social transition increase persistence rates in “trans” kids?

Posted on November 28, 2016 by 4thwavenow

The trend of “socially transitioning” children as young as 2 or 3 years old to endorse the notion they are “born in the wrong body” is a very new phenomenon. But to read about it in the press, you’d think this was a settled area of clinical practice, with proven results and few doubts about its efficacy.

It is no such thing.

In a 2011 journal article, Dutch clinician-researchers who first pioneered the use of puberty blockers cautioned that early social transitions can be difficult to reverse:

As for the clinical management in children before the age of 10, we suggest a cautious attitude towards the moment of transitioning. Given our findings that some girls, who were almost (but not even entirely) living as boys in their childhood years, experienced great trouble when they wanted to return to the female gender role, we believe that parents and caregivers should fully realize the unpredictability of their child’s psychosexual outcome. They may help the child to handle their gender variance in a supportive way, but without taking social steps long before puberty, which are hard to reverse.

Even the Endocrine Society, which actively promotes puberty blockers and cross-sex hormones for pubescent children, counseled against social transition in its practice guideline:

As recently as last year, a 17-clinic qualitative study reported on doubts some clinicans have about aspects of “affirmative” treatments for children:

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

But among many clinicians and activists, social transition (which usually leads to puberty blocking and then to cross sex hormones) is now being actively promoted as completely harmless and “fully reversible.” Not only that: it is being shamelessly peddled as the only way to prevent suicide amongst children and teenagers.

What evidence do we have for these assertions? There is no historical record of desperately dysphoric “trans children” who demanded sex change lest they commit suicide. The constant media and activist drumbeat that very young children must be socially transitioned ASAP; must be called by the correct pronouns; must have their “wrong bodies” fixed prior to the “wrong puberty”– or they will kill themselves–is the most irresponsible thing the mass media and medical profession could possibly do. It is a form of emotional blackmail which has terrorized countless parents into handing their kids over to gender clinics and activist-run “charities” for transition to the opposite sex. And the media, by running breathless stories implying that the only way to support gender-defiant and gender dysphoric children is to “transition” them, may be contributing to suicide contagion, a phenomenon that has been well known for decades.

As far as evidence that social transition is “reversible,” which of these children is actually “reversing”? Certainly, the ones who have continued on to puberty blockers are not:

Imagine the pressures on any of the myriad trans-kid YouTube stars, or the children who are the subjects of the too-many-to-count fawning media portrayals we see in every major newspaper and magazine. Can a Jazz Jennings really change course?

None of the children who have been identified as “truly transgender” by clinicians like Norman Spack and Johanna Olson are going to get the chance to find out if they would have been just as happy not being socially transitioned. We won’t learn in any systematic way whether social transition and media validation could be creating persistence in children who might otherwise have grown up without medical and psychiatric tampering. We can’t know, because researchers aren’t studying them; they don’t have control groups of children who claim to be the opposite sex but who are not socially transitioned and subsequently puberty blocked.

What is a truly transgender child? According to activists and some clinicians, the key trait (along with being generally “gender nonconforming” and preferring the clothes, activities, and appearance more typical of the opposite sex) is that these children are more “persistent, consistent, and insistent” in saying they are the opposite sex (vs simply wanting to be, or wishing they were).

But what is the meaning of “persistent, consistent, and insistent” with children who have only been on the planet a short time, as are the many toddlers, preschoolers, and grade schoolers now being labeled as “trans kids”? Especially when a rather large percentage of these children also exhibit traits of autism—a disorder known to be characterized by rigid thinking, gender nonconformity, and obsessive/restricted patterns of behaviors?

Activists don’t seem troubled by any of this, nor by the decades of research showing most dysphoric children desist and grow up to be lesbian or gay adults.

The recent study most often cited by trans activists is one by Kristina Olson at the University of Washington, which essentially proved that children who preferred the activities and appearance of the opposite sex weren’t just pretending; they really meant what they said! (Why would anyone question that?)

But even Dr. Olson, whose confirmation-bias-riddled study includes no control group of non-socially transitioned children, admits that no one can know the outcome for this new generation of experimental patients.

These kids are, by any measure, guinea pigs being subjected to social engineering and then (in most cases) experimental medical procedures, the results of which won’t be known for decades. Researchers like Kristina Olson are fully aware of this, but they think it’s worth the cost of some regrets, some detransitions. Because hey–it’s science.

A commenter on the above article aptly points out the elephant in the room:

Fortunately, there is reliable data from other clinician-researchers which suggest a more cautious approach is still in order. We have a 2012 study by Devita Singh, which demonstrated that a very high proportion of kids—some 88%–happily desisted from a trans identification as adults. It’s worth noting that several of these children were “persistent, insistent and consistent” in their formerly intense gender dysphoria.

Dr. Singh shared her views about early transition in a recent, unusually balanced article in The Walrus magazine:

Singh is frustrated that, despite the findings of her study and others like it, there’s now more pressure than ever for doctors and families to affirm a young child’s stated gender. She doesn’t recommend immediate affirmation and instead suggests an approach that involves neither affirming nor denying, but starting with an exploration of how very young children are feeling. Affirmation, she argues, should be a last resort.

These days there can be a high price to pay for treating gender affirmation as a last resort. Dr. Ken Zucker, a renowned gender dysphoria expert, has approved puberty blockers and cross-sex hormones for many adolescents. Nevertheless, he recognizes that children often change their minds, and takes a careful approach in his clinical practice. For this heresy, he was hounded from his position at CAMH in Toronto by trans activists hellbent on preventing any kind of therapy for dysphoric kids besides “affirmation.”

But Dr. Zucker is still actively publishing, having co-authored several scholarly journal articles in 2016 alone, and he continues to work with families and young people in his private practice.

In an age when too many believe that children, no matter how young, should be affirmed in their gender identities with no further investigation, clinicians like Zucker are very much needed. Desistance, despite trans activist protestations to the contrary, is a real thing. It’s just not as newsworthy as the latest trans kindergartener coming out story.

This places a heavy burden on parents who aren’t sure who their children are, or who don’t accept the notion that a 5-year-old, even an insistent and strong-willed one, has a set identity in the same way adults do. The current politics leave them behind, because their stories don’t fit neatly into the binary in which trans identities are either accepted or rejected, full stop. There’s no natural political grouping for parents of desisters, because desisting isn’t an identity-politics lodestone in the way persisting is. “We’re quieter,” said Amanda of parents of kids whose gender dysphoria desists. “There are a bunch of us scattered around, and we’re not acting collectively.” As Merry put it, “I feel like sometimes there’s no middle ground. You’re either trans or you’re not, and you can’t be this kid who is just kind of exploring.”

Layers of meaning: A Jungian analyst questions the identity model for trans-identified youth

Posted on September 25, 2016 by 4thwavenow

Lisa Marchiano, LCSW, is a Jungian analyst. She blogs at theJungSoul.com (Facebook: https://m.facebook.com/thejungsoul), and can also be found on Twitter @LisaMarchiano.

Lisa’s thoughtful essay stands in stark contrast to the simplistic advice we see from self-declared gender therapists like this one. For the perspective of another therapist skeptical of the “gender affirmative” approach, see this post by Lane Anderson, a former therapist for trans-identified teens who quit her job last year due to ethical concerns.

Lisa would like to thank Miranda Yardley, ThirdWayTrans, and Carey Callahan for their contributions to this post. Though these three individuals were generous in sharing their time and expertise, the views expressed here are Lisa’s own.

Lisa is available to respond to your remarks and questions in the comments section of this post. In addition, Lisa is interested in being in contact with other therapists who share her concerns about the identity therapy model:

If there are other therapists reading this and wanting support to question or work outside of the identity model, please be in touch. Contact me privately on Facebook or Twitter, or ask this blog to put you in touch with me via email. There are lots of us out there. Let’s start talking.

by Lisa Marchiano

As a social worker and a Jungian analyst, I have become increasingly concerned about the rush to affirm children’s and young people’s transgender self-diagnosis, and then transition them to the opposite sex. I am particularly worried about social and medical transition among teens whose transgender diagnosis arose “out of the blue,” without a significant history of early childhood dysphoria. I fear that, via their well-meaning desire to validate young people in pain, therapists are discarding basic principles of psychotherapeutic care.

My views have been informed by my work with detransitioners, as well as with parents of trans-identifying teens. I have also sought to educate myself further by listening to trans people, parents, clinicians, academics, lesbians, feminists, educators, gays, and others who are writing and speaking about gender. I believe that transition may be a viable and even necessary option for some people. I support the right of adults to choose this option with appropriate therapeutic care and support. I certainly believe that trans people deserve human rights, legal protection, humane care, and respect. However, there are potential physical and psychological dangers of transition, and we need to exercise astute clinical judgment and caution when working with young people who are seeking transition.

I have often seen trans activists and gender specialists promote “social transition” of trans-identifying youth as a positive and “fully reversible” intervention. Social transition refers to a number of steps one can take to present as the opposite sex. These might include making changes to one’s hair style, make-up, name, pronouns, and dress. One might also begin binding breasts or wearing a packer to “present” more convincingly as the opposite sex. Social transition is sometimes described as something that has few if any long-term consequences, and therefore can be recommended with minimal concerns, even for young children. However, in some significant percentage of cases, social transition leads to medical transition. It appears likely that being conditioned to believe you are the opposite sex creates ever greater pressure to continue to present in this way. Once one has made the investment of coming out to friends and family, having teachers refer to you by a new name and pronouns, will it really be so easy to change back? Children who socially transition at a young age may have little experience living as their natal gender. How easy will it be for them to desist?

At least some of the time, each step taken toward transition creates pressure to continue. Numerous blog posts from detransitioners explore how transition made dysphoria worse, often because the young person became increasingly preoccupied with passing. This further discomfort created pressure to take more steps toward transition in order to present more convincingly as the opposite sex. To take just one example, breast binding may bring relief to some natal females who experience discomfort with their breasts, but binding in itself can be quite painful, restricting breathing and movement—thus creating an incentive to take the next step—“top surgery”/double mastectomy. I have heard one mother of a FtM young person stating that this natal female “got his lungs back” after getting a double mastectomy because he no longer needed to bind. Additionally, anecdotal evidence indicates that it is not uncommon for teens who socially transition to move on to hormones and/or surgery shortly after their 18th birthday. So it’s clear that social transition must be viewed as a treatment that carries with it a significant risk of progressing to medical transition.

Medical transition refers to a number of interventions undertaken to alter one’s body. These can include administration of hormone blockers to children and teens; administration of cross sex hormones; mastectomy; phalloplasty; hysterectomy; body masculinization; orchiectomy; vaginoplasty; facial feminization surgery; and others. All of these procedures can have permanent effects, and most of them carry significant risks. It is unusual (though not unheard of) for minors to have these surgeries. However, it is not uncommon for minors to take hormone blockers and cross sex hormones. And in 100% of the cases reported in the literature, children on puberty blockers went on to cross sex hormones. Top gender clinician Johanna Olson reports that no puberty-blocked children at her clinic in LA Children’s Hospital have ever failed to continue hormone treatment. Therefore, the claim that blockers are “100% reversible” is not accurate in practice. In fact, being on blockers appears to consolidate an investment in a cross sex identification. And although one rarely sees this “side effect” reported in the mainstream media, because gametes do not develop when an adolescent does not undergo natal puberty, hormone blockers followed by cross sex hormones results in permanent, life-long sterility 100% of the time.

Hormone blockers and cross sex hormones are being used off label (that is, they are not FDA-approved for this purpose). We have almost no knowledge about the long-term effects of taking these drugs over the course of decades, as anyone beginning transition as a young person will likely do. According to Madeline Deutsch, clinical director at University of California, San Francisco’s Center of Excellence for Transgender Health, “it scientifically makes sense that if someone is on hormones for decades, it’s highly likely that they’re going to be at higher risk [for certain health issues] than someone who started taking hormones at age 40 or 50.” Even the top pediatric gender doctors admit that there’s a dearth of good data on the long-term health outcomes of transition.

Certainly, there are risks. Cross sex hormones change bodies fairly quickly. Some of these changes are irreversible, such as a deepened voice, facial hair, and baldness for testosterone, and breast growth and, potentially, infertility for estrogen. In addition, use of cross-sex hormones carries with it potential negative side effects. Girls who take testosterone will be at increased risk for developing diabetes, cancer of the endometrium, liver damage, breast cancer, heart attack, and stroke. There may be other adverse effects of which we are not aware at this time, since long-term testosterone use in natal females is a relatively new phenomenon that has not been adequately studied.

I fear that there are young people transitioning – with the ready help of therapists, doctors, and others – who may regret these interventions and need to come to terms with permanent and in some cases drastic changes to their bodies. In fact, I know this is already happening. I have had considerable contact with the growing community of detransitioners. In many cases, the hatred for and disconnection from their bodies that these young people experienced was due to sexual trauma, internalized homophobia, or bullying. In videos and blogs, young women speak about their sadness over their lost voices and breasts. Male detransitioners mourn the loss of their testicles, the loss of their ability to orgasm, in some cases the loss of their fertility. Many have had complications from hormones such as vaginal atrophy, nerve damage, or chronic pain. You can hear some of these stories for yourself here, here, and here, among other places.

I have also spoken with many parents. Their stories are just as heartbreaking. These usually involve a teen who was anxious, depressed, socially isolated, or suffering from PTSD coming to identify as trans after internet binges on social media sites. These parents report that mental health professionals are validating the self-diagnosis of transgender after a handful of therapy sessions, without any exploration of prior mental health issues, trauma, sexual orientation, or history of gender nonconforming behavior. This clearly violates APA recommendations, which urge special caution in treating adolescents who present with sudden onset dysphoria.

All of this comes down to an essential question: When treating someone with gender dysphoria, do we do so using a mental health model, or an identity model?

An identity model is founded on the belief that we ought to be able to define our own experiences for ourselves. It proclaims that each of us has a right to assign our own meaning to our lives, our feelings, and our bodies. We get to decide who we are, and no one has authority over our self-perception. An identity model offers respect and self-determination for every person to define themselves as they would like.

An identity model has a place in psychotherapy. As people, we all self-identify aspects of our personality, values, and experiences in ways that are often very important to us. We might identify as Catholic, or as a Democrat. We might identify as an artist, an introvert, or a lesbian. As therapists, accepting and affirming our clients’ self-identification is important and empowering. As therapists, we can accept and empathize with a client’s story about his or her life experience. We can hold this story as valuable and important whether or not we objectively agree with it. As long as the client’s story does not lead to maladaptive behaviors, we do not need to challenge or attempt to discredit or disprove such a self-identification.

However, an identity model of working with transgender people goes further. An identity model stipulates that it is wrong to explore or question a client’s self-determined identity. Gender dysphoria is seen as evidence that someone is transgender, and merely wondering about underlying psychological reasons for dysphoria or alternative explanations for symptoms is seen as synonymous with denying a person’s identity. Applying our own clinical judgment to someone’s proclaimed self-diagnosis is seen as bigoted and wrong. Our role as therapists becomes limited to enthusiastic affirmation only.

In contrast, when we are working in a mental health model, we understand that clients come to us with symptoms that cause distress, and may interfere with a person’s day-to-day functioning. As therapists, we ought to be interested both in helping to alleviate or manage symptoms, as well as helping to understand the underlying cause of the symptom. If we are psychodynamically oriented, a basic assumption of our work is that every symptom has a meaning beyond its superficial presentation, and a major part of our work is to help our clients gain insight about this meaning.

In opposition to an identity model, then, the main task in mental health therapy with a client experiencing gender dysphoria would be to deeply 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.

Seeking to understand deeply the nature, quality, and etiology of the dysphoria is not at all the same thing as denying the reality or importance of the symptom. When I explore a client’s anxiety – when did it start? What tends to trigger it? How does it feel? – I am not implying that I do not feel that the anxiety is unimportant or illusory. As we come to understand more about a client’s unique experience of a symptom, we may unwrap the meaning behind the suffering so that the problem resolves in a surprising, unexpected way. Or we may simply gain better information about the best course of treatment to alleviate the symptom for that particular person.

An identity model is not an appropriate basis on which to prescribe drastic, permanent medical intervention.

An identity model does not leave room for a therapist to exercise his or her clinical judgment. It disallows the possibility of a thorough assessment and differential diagnosis. According to the identity model, a client’s self-diagnosis is not to be questioned or explored. Therefore, alternative causes of dysphoria cannot be sought. As with many other mental health issues, the symptoms of gender dysphoria can be caused by many different things. Feeling uncomfortable with or disconnected from one’s body can go along with being on the autism spectrum; having experienced trauma; having bipolar disorder; having an eating disorder; or experiencing internalized homophobia. And sadly, it is a normal experience for teen girls, 90% of whom express dissatisfaction with their bodies.

An identity model subverts the normal diagnostic paradigm in which a patient presents with symptoms, and the clinician makes a diagnosis. In an identity model, the diagnosis is the identity. This occludes the focus on symptom resolution and management because the priority becomes affirming the identity. When symptoms are seen as validation of an identity, clinical judgment becomes irrelevant.

Before determining that a young person ought to undergo drastic treatments that may permanently alter their bodies and lead to permanent sterilization, a thorough assessment should be conducted that explores all potential factors contributing to the dysphoria. Unfortunately, because exploration of gender dysphoria is construed by some to be tantamount to “conversion therapy,” this kind of extensive assessment is frequently not performed. Though data is sparse, I personally have had contact with dozens of young people and/or their families who received a transgender diagnosis and a prescription for hormones after one to three appointments with a therapist. According to this survey of more than 200 detransitioned women, 65% of those who transitioned received no therapy at all, either because they were referred for treatment at their first visit, transitioned through an informed consent clinic, or bought hormones through unofficial sources. (The median age for beginning transition in this survey was 17.) Only 6% of respondents felt they had received adequate counseling about transition. In fact, according to the ideology of gender identity, thorough assessment is seen as inappropriate “gatekeeping.”

An identity model does not allow us to rule out cases of transgenderism where social contagion might be at play. It appears quite likely that the striking increase in trans-identifying teens in recent years is due at least in part to social contagion. There has been a sudden sharp rise in the number of children and teens presenting at gender clinics. The first transgender youth clinic opened in Boston in 2007. Since then, 40 other clinics that cater exclusively to children have opened. Inexplicably, the ratio of natal males to natal females has flipped sharply, with many more natal female teens now presenting. Many of these young people have been presenting with dysphoria “out of the blue” as teens or tweens after extensive social media use without ever having expressed any gender variance before. This now-common presentation was virtually unheard of even a handful of years ago. Thousands of home-made videos on sites such as YouTube chronicle the gender transitions of teenagers. These teens show off their new-found muscles or facial hair. The Tumblr blog Fuck Yeah FTMs features photo after photo of young FtMs celebrating the changes wrought by testosterone. “I finally have freedom!” posters boast under photographs of their scarred chests post mastectomy. “I’m no longer pre-T!” boasts another under a video of someone injecting testosterone. Almost all of these posters are under 25 years of age. According to Jen Jack Gieseking, a New York academic and researcher who was interviewed by BBC Radio 4 last May, “There really isn’t a trans person I’ve met under the age of 30 who hasn’t been on Tumblr.” There are multiple credible online reports of whole friend groups coming out together as trans.

But correlation isn’t causation. As this brilliant blog post explores, the contagion factor only speaks to the particular way that young people choose to deal with distress. It isn’t that the internet is “causing” the rise in transgenderism. It’s that many young people – particularly young females – are feeling alienated from their bodies due to trauma, porn culture, societal standards of beauty, oppressive gender roles, sexism, homophobia, and so forth. Self-diagnosing as transgender becomes an attractive way to deal with the alienation because it is so validated and even lionized in the culture and the mainstream media. For therapists, an identity therapy model does not allow us to acknowledge the role of social contagion, though contagion has been well-documented in contributing to suicide clusters and other behaviors.

An identity therapy model encourages us not to put safeguards in place to prevent young people from undertaking treatments they may later regret. According to an identity model, self-diagnosis as trans should never be questioned. To do so implies a lack of support and even bigotry. Therefore, the clinician must not stand in the way of transition to the person’s “authentic self.” Because of this, an increasing number of minors are going on hormones and even undergoing surgery that will permanently alter their bodies. Even 18 is probably too young to make such major medical decisions. In cases where the 18-year-old is making medical decisions based on a social transition that she or he began years earlier, it is possibly even more likely that that young person has not carefully considered the consequence of transition. Top gender doctors are hoping to see the recommended age for “bottom surgery” lowered.

In sharp contrast, it’s not easy for non-trans patients to be sterilized before adulthood. For instance, in Massachusetts, a patient must be at least 21 years of age to qualify for sterilizing surgeries under the state’s public health scheme. When such a surgery is undertaken, patients are carefully counseled and must sign a form stating that they understand the permanent nature of the procedure, and that they do not wish to bear or father children. Patients must then wait a minimum of 30 days after signing the form before having the surgery. This procedure has been put in place because surgical sterilization has been shown to come with a high incidence of regret. Why are there not similar safeguards in place for those transgender identifying young people wishing to amputate healthy organs and/or sterilize themselves?

There is a wealth of research about cognitive and emotional development in adolescence. The upshot of it is that teens and young adults are more likely to act impulsively, are unable to assess risks well, and are more emotionally reactive. It is partly for these reasons that we do not allow teens to drink, get tattoos, or use tanning beds without adult consent.

An identity model does not allow us to examine the homophobia that drives some – possibly many — transitions. According to extensive research on desistance, a significant majority of children who identify as the opposite sex will not continue to do so into adulthood. The majority of those who desist will come to identify as lesbian or gay. “Feminine” boys are actually many times more likely to grow up to be gay men rather than transgender women. The same is true for “masculine” girls. Many lesbian bloggers (such as this one and and this one) are very concerned that the current trend to transition young people is disproportionately hurting lesbians and gays, and their fears appear to be well founded. This conservative Christian Texas mother was bothered by her son’s “flamboyant, feminine” behavior. Rather than accepting her son’s gender-defiant presentation, she has decided he is transgender. She now has a very pretty, gender conforming “daughter.”

There is widespread concern in the lesbian community that many young would-be lesbian or bisexual women are finding it easier to become “straight men” due to internalized homophobia. In this article, fourteen-year-old Mason describes how he knew he was transgender. “I’ve always known something was up about how I felt about myself,” says Mason, who as Madelyn had refused to wear pink, or to dress in stereotypically feminine attire. “I thought I was gay or bisexual or something.” In years past, Madelyn most likely would have grown up to be a lesbian or bisexual woman. To paraphrase psychiatrist Ray Blanchard, surely it’s preferable to have an outcome of a reasonably well adjusted lesbian woman, rather than someone who identifies as a trans man who has had many irreversible surgeries and a lifetime of drugs.

An identity model makes us unable to tease out other mental health concerns that may be impacting the desire to transition. There is considerable research that points to a high likelihood of co-occurring disorders in young people who wish to transition. For example, this study from 2015 noted that “severe psychopathology preceding onset of gender dysphoria was common. Autism spectrum problems were very common.” In this study, 68% of the population had first had contact with psychiatric service for reasons other than gender dysphoria. Thirteen percent were being treated for psychotic symptoms.

This study from 2004 found high rates of “comorbidity” in those with gender dysphoria, and noted that this was often not taken into consideration when treatment planning for these patients. “Results: Twenty-nine percent of the patients had no current or lifetime Axis I disorder; 39% fulfilled the criteria for current and 71% for current and/or lifetime Axis I diagnosis. Forty-two percent of the patients were diagnosed with one or more personality disorders. Conclusions: Lifetime psychiatric comorbidity in GID patients is high, and this should be taken into account in the assessment and treatment planning of GID patients.”

This 2015 study found a link between gender dysphoria and dissociative symptoms secondary to trauma. According to this blogger, trauma and dissociation were a big part of her desire to transition. This was also true for this blogger here. Similar stories from detransitioners with histories of unaddressed trauma abound.

An identity model does not allow us to take into account reports from parents or previous therapists who may not agree with the patient’s self-diagnosis. I have received dozens of distraught emails from parents trying in vain to get gender therapists to listen to them when they share information about their child’s mental health history that ought to be taken into consideration while assessing and treating gender dysphoria. While I cannot share the contents of these emails without violating people’s privacy, I can point to quite a few places online where frustrated parents have shared similar stories. For example, this social work professor states that the gender therapist did not review her daughter’s special education records or speak with the previous therapist before recommending hormones and surgery for this young autistic teen.

Parents I have had contact with have told me about their child having a history of anxiety, panic attacks, depression, trauma, loss, bipolar disorder, anorexia, cutting, borderline personality disorder, and psychosis. In these cases, as soon as the young person brought up their transgender self-diagnosis, the focus of the therapy shifted to this alone. The parents’ fears, concerns, and information about past treatments were disregarded as obstructionist and transphobic. I am not alleging that this is happening in every case. However, it certainly is happening with some degree of regularity.

An identity model does not allow us to question the incoherence of gender identity ideology. While gender dysphoria appears to be a meaningful diagnostic term that describes a set of symptoms – namely intense discomfort with one’s sexed body – it does not follow from this that one is “trapped in the wrong body,” has a “female” or “male” brain, or even a “gender identity” that doesn’t match one’s body. Though the concept of gender identity is currently being enshrined into law, the truth is that we have no meaningful definition of the term. (For an excellent analysis of the incoherence of the term, take a look at Rebecca Reilly Cooper’s work.) When a trans-identified person is asked how they know they are transgender, they are usually unable to answer the questions without reference to sex role stereotypes. For example, a physician who prescribed cross sex hormones to a 12-year-old natal female stated that the child had “never worn a dress.” This was offered as evidence of the child’s being “truly trans,” and therefore needing these hormones. I would strenuously argue that one’s clothing preferences should not be a reason to permanently sterilize a child.

It doesn’t make sense to say that one’s sex organs don’t matter, but then assert a primary, essential difference based on a sexed brain. Sexed brains do not exist. It is absurd to posit that one’s chromosomal sex, genitals, and entire reproductive system are meaningless and irrelevant or a social construct, and then assert that a subjective feeling of being the opposite gender is determinative. There is no robust science behind the notion of gender identity. Journalists have been quick to report on studies that seem to prove brain differences among those who are transgender. However, as the sexology researcher James Cantor has pointed out, these studies actually seem to be documenting brain differences among those who are homosexual.

If you want to see a review of some of the literature out there in support of a biological basis for gender dysphoria, this blog post does a good job. There are some solid studies that seem to indicate that genetics or pre-natal hormone exposure may play some role in the development of gender dysphoria. That isn’t really surprising. Pretty much every diagnosis in the DSM – from depression, to anorexia, to borderline personality disorder – has some genetic component. Gender dysphoria is real. As with other mental health diagnoses, its causes are likely complex and involve genetic, biological, environmental, and psychological factors. But it doesn’t follow from any of this that the sufferer has an inborn “gender identity” that ought to supersede any consideration of one’s objective biological sex. Body dysmorphic disorder is associated with brain differences and appears to have a genetic component, and yet the biological component of the condition does not dictate that we understand the patient’s suffering to reflect objective reality.

Transgender activists assert that “gender is between the ears, not between the legs.” However, this is an ideological, faith-based statement that cannot be scientifically validated. What is “between our ears” — meaning our inner experience of ourselves as a gendered person — is purely subjective. Within this context, asserting that one is transgender is an unfalsifiable statement of belief. In reality, feeling like the other sex does not in any way mean that you are the other sex. Identity is an important aspect of one’s experience. We get to define ourselves subjectively, and I would argue that full-fledged adults ought to be able to modify their bodies in accordance with their sense of themselves. However, subjective identity should not dictate a necessity for medical treatment of any kind, especially body-altering treatments with highly significant side effect profiles for minors or young people

An identity model does not allow us to consider treatment outcomes critically. The research on outcomes post transition is mixed at best. It is well-known that one study showed that 41% of transgender people had experienced suicidal ideation or self harm. It is less well-known that the study gives no indication whether the attempt was before or after receiving transition care. Several large studies show astonishingly high rates of suicide among transgender people who have medically transitioned (see here and here). It has been argued that suicide rates continue to be high after transition due to societal prejudice. While this likely is true some of the time, post-transition transsexuals are more likely to “pass” as the target gender, and therefore ought to be less subject to discrimination. Given the undeniably high rates of suicide in post-transition transsexuals, it is disingenuous to claim that transition is a panacea that will prevent suicide.

While this study showed positive outcomes for early transition, there were only 55 subjects included. Perhaps more importantly, they were last assessed at one-year post sex reassignment surgery. In the survey of detransitioned women, the average length of transition was four years. It seems possible that some of the 55 individuals followed in the first study might go on to have regrets if they were followed for longer. Worryingly, one of the 70 individuals invited to participate in the study was unable to do so because the person died as a result of postsurgical necrotizing fasciitis after undergoing vaginoplasty.

While the media is full of stories of young people becoming happier and more confident after being allowed to transition, there is some evidence that this is not always the case. In addition to the research that documents high suicide rates post transition, I am aware of anecdotal evidence of continued or even increased anxiety and depression, social isolation, psychiatric hospitalization, and poor academic outcomes for those who have transitioned.

An identity model does not allow us to explore other options for dealing with dysphoria. Transition – social and medical — is currently the only treatment commonly prescribed for gender dysphoria. If what we are treating is an acute discomfort with one’s body, it would seem reasonable to offer a range of different treatments before prescribing transition, including anti-depressants, talk therapy, and emotion-regulation skills to help patients manage their distress. However, none of these treatments is routinely prescribed for gender dysphoria. In the survey of 200 detransitioned women, some significant percentage of them stated that they found alternative ways of dealing with dysphoria other than transition. Detransitioner and therapist in training Carey Callahan offers several specific techniques that she has found helpful on her blog. Clinicians and researchers ought to be mining these experiences to find other effective treatments for dysphoria in addition to transition.

An identity model makes some questionable assumptions about the nature of identity and our ability to know ourselves. An identity model is predicated on the notion that identity is immutable, essential, and knowable. This is not my experience of human nature. Identities are useful for approximating something about ourselves. They are constructs that allow us to talk about our experience. But they are not absolute truths, and they rarely say something about our most essential, mysterious, and ultimately unknowable essence. To quote Whitman, “do I contradict myself? Very well, then, I contradict myself. I am large. I contain multitudes.” I have had the good fortune to contradict myself many times in my life – contradict myself on things that at one time felt utterly essential and absolutely true. I believe this is a universal human experience, and yet another reason why making permanent changes to one’s body at a young age ought to be approached with extreme caution.

An identity model makes it impossible for us to acknowledge or discuss the varied reasons why a person might want to transition. The desire to transition likely has many varied causes. Seeing all transitions as an expression of innate gender identity obscures the very real differences between one person’s situation and another, making it impossible to assess and treat people in an individualized way. A late transitioning MtT autogynephile has an experience of gender dysphoria that is vastly different than that of a fifteen-year old lesbian, and the former’s experience ought not in any way to dictate how we understand or treat the latter.

An identity model creates a false dichotomy between affirmation and bigotry. According to the current narrative, the only supportive response to a teen who has self-identified as transgender is to affirm this identity and begin transition immediately. Any other response is quickly labeled transphobic. In reality, there is a huge range between assisting a child in transitioning immediately and affirming that they are and in fact always have been the opposite sex, and denigrating or shaming them for their desire to transition or coercively trying to get them to conform to rigid gender expectations. Parents can communicate their unconditional love and support. Parents can offer solace and warmth as the child struggles with distressing feelings. Parents can seek legitimate psychotherapeutic help to offer space for the young person to explore and understand the desire to transition. Teenagers often develop strong beliefs about what they must do or have, and it is well known that these beliefs and demands are not always sound or rational. Never before have parents of teens been told that they have to accede to the demands of their teenager or risk doing irreparable harm. Parents of teens have always had to step in and set loving limits on behavior that may not be in the young person’s long-term best interest. When dealing with a child who has diagnosed themselves as transgender, parents can do what parents of teenagers always do – set sensible limits and help a child to reflect on the potential consequences of his or her actions. Parents can assure the child of their ongoing love and acceptance if he or she does eventually decide, as a full-fledged adult, to transition.

An identity model offers an inferior kind of therapy to those who identify as transgender. As the blogger Third Way Trans has pointed out, “if someone is a member of a dominant class they receive regular psychotherapy but if they aren’t they receive a special kind of social justice therapy.” Those who come into treatment with gender dysphoria are not given the opportunity to explore deeply their experience, but instead have their self-diagnoses affirmed. There are people who will need to live as the opposite sex in order to have the happiest, fullest life possible. These individuals may need to consider taking hormones or having surgery. Surely these people deserve to have a place to explore these consequential decisions without prejudice in favor of a specific outcome so that a process of careful discernment can take place. If therapists are only cheerleaders for transition, how can someone in this situation get help to make the best decision?

I believe we should offer clients with gender dysphoria high quality mental health therapy. In a guest post on this blog, a woman who considered transitioning several times during her life shared a moment from her own therapy that proved important to her.

“When I started therapy in my early twenties, I revealed to my therapist that I had been raped at 18. It had been four years and I had never told anyone. In the process of uncovering that rape and telling her about it, I stated, during a session, that I wanted to become a man. She nodded, she said she understood, and that it was something we could explore, but in the meantime, we really needed to talk about the rape. I appreciated her approach. She wasn’t directive, judgmental, or reactive, she simply stated it was something to keep talking about, but encouraged me to focus on my experience of being raped and other traumas.”

In providing high quality mental health therapy to all patients, we would communicate unconditional positive regard to our gender dysphoric patients, just as we would with anyone else, and as the therapist in this blog post did. We would greet their announcement that they feel as though they may need to transition with acceptance and curiosity, communicating that we are willing to go there with them, to explore this desire in all of its intricacy, without prematurely coming to a fixed notion of what is right for our patient. We would see the person in front of us in all of their miraculous complexity, and not just as a “gender identity.”

As therapists, we have been trained in assessment. We have been trained to wonder about layers of meaning that may not be visible at first glance. We have been trained in how to recognize and work with trauma. We have been trained to help out clients explore their labyrinthine inner lives. When clients come to me wondering whether to end a relationship with a boyfriend or change careers, we typically spend months considering all of the different facets of such a decision. Don’t we owe at least as considered a process to someone contemplating making permanent changes to his or her body, especially when that person is a teen or young adult?

Announcing a new online survey for detransitioned women

Posted on August 16, 2016 by 4thwavenow

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

A real live 22-year-old detransitioned woman

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

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

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

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

Please share this survey widely

Trans United Fund plays suicide & race cards to emotionally blackmail the balking masses

Posted on May 28, 2016 by 4thwavenow

A key trans-activist political tactic is to accuse pediatric transition skeptics of “hating” trans kids. Nothing could be further from the truth. Far from hating gender-defiant young people who have been labeled transgender by the important adults in their lives, our interest is in protecting them from drastic medical interventions. Many who contribute to 4thWaveNow are parents of such children and teens. If anyone is doing the “hating” it is the trans activists, who vilify parents like us and our supporters.

Why do I bring up the hate angle? Because the rationale given by the new political action committee Trans United Fund (TUF) for their slick new video featuring trans kids and their parents is to counter the “hate” being aimed at these kids. In announcing TUF’s professionally produced 2:20 minute infomercial, the trans-activist lobby GLAAD (whose Board Chair is Jennifer Boylan, an MtoF activist) had this to say:

In light of the recent rise of anti-LGBT bills nationwide, Trans United has released a new ad entitled “Meet My Child” that humanizes transgender people.

Implicit in this wording, of course, is that opponents of sterilizing and drugging children are engaged in a dehumanization campaign.

The video, above all, glorifies parents who simply go along with their child’s proclamations that they are, or want to be, the opposite sex. [Calling all child development experts of yesteryear: Teach us about concrete thinking as a developmental stage.]

We see children who look to be about 7 or 8, and others who appear to be middle school age—all of them “presenting” as the opposite sex by way of dress, hairstyle, and toy-and-play-activity stereotypes.

Quiz: Can you tell the “trans boy” from the “trans girls”?

Long multicolored tresses = ?

Basketball..hint, hint

Do they even make blue dollhouses?

So much for transgenderism being about “challenging the binary” and “breaking gender molds.”

The images of happy trans kids and their parents are juxtaposed against a TV-clip cameo of a bloviating Ted Cruz, US Senator and former GOP presidential candidate, a far-right conservative. The message to liberals is clear: You’re just like the Tea Partiers if you don’t buy what Trans United is selling.

At 1:43, we are reminded (as we are in daily media stories):

This is a lie—or more charitably, a distortion. Like most such cynical distortions, it is derived from something true. The 41% figure comes from the oft-cited Williams Institute survey, whose authors themselves note that this (yes, unacceptably high) suicidality rate includes not just trans-identified but also gender nonconforming adults who have ever had thoughts of self harm. It is not an actual suicide “attempt” rate. Moreover, and most importantly, the survey found that people who have sought and/or received medical transition services have a HIGHER RATE of self harm and suicidality.

My bringing up the Williams Institute survey does not indicate a callous attitude towards high self-harm rates in trans-identified people. In fact, all gender nonconforming people (which includes many gay, lesbian, and bisexual people who have never identified as transgender) have a higher rate of suicidal thoughts and self harm. My purpose in bringing up the 41% statistic is to shed light on the cynical use of self harming rates to bludgeon parents and others into thinking that pediatric transition is the cure for despair.

(For more detail on the Williams Institute survey and the origin of the 41% figure, please read this whole post.)

Directly after the 41% appears on screen, we see the tearful mother of a trans girl saying, between sobs, “She’s my heart. I don’t want to lose her.”

The media experts at Trans United know exactly what they are doing. The death of a child is the most devastating possibility imaginable to any loving parent, with suicide almost beyond contemplation. No parent would face the suicide of their child without blaming themselves.

So, this is checkmate. Game, set, match:

Gender defiant kids–no matter how old they are–are the opposite sex if they say they are. Period.
Trans kids are cute and innocent—like all children.
If you don’t accept that these kids are actually the opposite sex, you will cause them to kill themselves.
If you don’t accept that these kids are actually the opposite sex, you are a hateful bigot—just like Ted Cruz.
Having any doubts or questions about the actions of adult transgender people is tantamount to hating children and their loving parents.
Don’t be a transphobe! [Note to liberals: You might even be a racist transphobe, because the video includes non-white parents and kids. More on that in a minute.]

In this recent MetroWeekly story showcasing TUF and its propaganda video, the mother of a 5-year old trans girl tells us this:

My daughter Ariel is only five years old. She is beautiful and perfect, just the way god made her. She is also trans,” Fajardo said. “Like many little girls, she loves Elsa and Barbie and dresses.

Apparently the child was trans while still an in-arms baby

As is always the case, when talking about their children, parents of young trans kids always refer to gender stereotyped play, clothing, and behaviors, and Fajardo is no exception. (How many adult gay and lesbians today could testify to their love of the activities and lifestyle of the opposite sex?). And lest we forget: Parents who have allowed their young kids to decide “who they are” will mean, in many cases, a lifetime of hormones, surgeries, and almost certainly, if they follow the path of other children who have been socially transitioned and moved on to puberty blockers—permanent sterilization via cross-sex hormones.

The TUF professionals who created the inaugural ad seem to have made a point of using ethnically diverse people in their infomercial. It is the African American mother who delivers the nightmare implicit warning that any parent who doesn’t transition their young child will be directly responsible for their suicide:

“She’s my heart. I don’t want to lose her.”

Making sure liberal skeptics (like me) know it’s not just white people who have trans kids appeals to our commitment to support people of color. But while it’s politically incorrect to bring it up, there is evidence that people from some communities tend to have more traditional, rigid ideas about homosexuality. If a parent is averse to the idea of (for example) an “effeminate” son who might grow up to be homosexual, it’s not much of a stretch to think that parent might find some modicum of relief in thinking their child has a condition which can be cured by modern medicine; maybe even turn the child straight.

Pew poll on attitudes towards same-sex marriage

But regardless of whether ethnicity or culture is a factor in homophobia or parental support for transitioning children, Trans United Fund is using children to promote an agenda. Even with the sound turned off, the imagery in the TUF ad peddles the message that people are transgender from birth (for which there is no evidence—if anything, the peer-reviewed evidence runs counter to this), playing neatly into the trans activist assertion that children who claim the opposite sex in childhood are definitely going to grow up to believe they are trans as adults.

Trans United Fund launched with a splash in April, and even though this first expensive piece of propaganda takes aim at a Republican (Ted Cruz), they say they will accept money from whoever wants to pony up the funds.

Hayden Mora, a founding member of the Trans United Fund (TUF), says that the newly launched PAC will take support wherever it can be found.

“Our vision and our goal is to have a conversation with anyone who is serious about supporting the trans community and supporting trans people,” he told The Daily Beast. “That includes Democrats, Republicans, Independents, and everyone else on the political spectrum.”

TUF is not alone. There is plenty of money and power behind the trans lobby, and many of these organizations work in coalition, with interlocking board members and staff. Hayden Mora , a transgender man and TUF spokesperson, is also the Director of Strategic Relations at the Human Rights Campaign (HRC), another deep-pocketed trans activist organization.

Other national advocacy groups focused on transgender issues include the National Center for Transgender Equality (NCTE), which has long coordinated with federal, state, and local governments on various policy issues. The American Civil Liberties Union (ACLU) and Lambda Legal have both been influential in the fight over North Carolina’s recent anti-transgender legislation.

TUF’s lead story today focuses on the pressure the group is bringing to bear on Hilary Clinton; they want her to take a firm position on the “bathroom wars” currently being waged between the US Government and balking states via a flurry of competing lawsuits.

As always and everywhere, money talks. We will likely be seeing and hearing a lot more from Trans United Fund in the months and years to come.

Gender Critical Dad is fed up with the bucketloads of doublespeak

Posted on May 3, 2016 by 4thwavenow

Gender Critical Dad is a brand new blog by the father of a teenage girl who—after coming out as a lesbian at age 14–has now decided she is in fact a trans man. They live in the United Kingdom.

As far as we know, this is the first skeptical blog created by the father of a self-identified trans teen. Click on over and check out his blog. He’s already got several interesting posts up, from the perspective of a “stroppy bugger” (his term).

Gender Critical Dad is available to respond to questions in the comments section of this post.

What inspired you to create your own blog, as a “gender-critical” dad? Did you find other gender-critical blogs or resources that helped motivate you to start your own?

I think it was several things: A displacement activity, to find some use for the anger and restlessness that ran round and round my mind since I realised the danger that my daughter was in; a catharsis, a chance to tell my story, make some sort of sense of it, get a reality check. Was I a horrible person for not “supporting them on their brave journey”? The blog is a place where I can get things out without burdening friends and my partner.

Hopefully my story will encourage others—maybe especially fathers–who are going through the same thing and let them know that the things they perceive and how they feel, are valid and real.

The current predominant narrative of trans kids is very much one of brave kids finding their true selves, supported by loving friends and a family who courageously struggle to come to terms with this brave new world.

I, as well as other parents are telling a more real narrative that features anxious, confused kids, scared of the adult sexuality portrayed in an ever more pornified world and feeling unbearably cramped by the tightening gender roles, desperately looking for an alternative. That scary world includes people encouraging them to identify as trans, sometimes mistaken but well meaning, sometimes for sinister motives. It includes organisations which have infiltrated academia, the NHS [UK National Health Service], and education. It includes a cult with all the manipulative features we would recognise from Scientology or the Moonies.

GC Dad

I’ve used the name “Gender Critical Dad” because it was the most accurate name I could think of. I hope it is taken as a mark of respect to the subReddits with that name and the important work done by radical feminists that I depended on to make sense of my feelings about the transgender dogma.

I have no wish to claim any ownership of the term gender critical. I am using it because it is catchy and memorable, and it will hopefully help me get my story out to other people being hit by transgender. If more people think about wider gender critical ideas and take a more respectful look at radical feminism, that’s fantastic.

4thWaveNow has been an enormous influence, showing me that other people have stories similar to mine, and also demonstrating how telling those stories can give comfort, strength and support to other people. I am also inspired by https://youthtranscriticalprofessionals.org/ and https://rebeccarc.com/ for providing a very sane, calm and well-reasoned critique of transgender.

Have your views about your daughter’s transition evolved since she first announced she was a trans man?

Yes, before I hit Peak Trans, my image of a transgendered person was Hayley Cropper from Coronation Street, a quite dignified person, who had taken a well thought out decision and just wanted to carry on with life as a woman.

The reality I discovered was very different, a world of aggressive men using trans as an excuse to invade women’s spaces and get a kick out of intimidating them. An ideology that, while claiming to be liberating people from assigned gender, actually re-enforces gender roles and then tells vulnerable young people that the only way out is to mutilate themselves, start a life time of drug dependence and nurture an obsession with appearance and other people’s perceptions, claiming it as victimhood.

We were glad to see your new site, since so few fathers seem to be weighing in publicly about the transgender youth trend. Most of the contributors to 4thWaveNow are mothers. Why do you think that is? Is there a reason why dads would hesitate to make their views known?

I think most men, especially those on the left side of the political spectrum, are scared of being seen as intolerant and bigoted. It’s a very “Emperor’s New Clothes” situation. I think most men have no problem with gay men or lesbians, but really don’t believe in the reality of a gender identity separate from biological sex and would find the logic of genderist dogma farcical. The idea of someone, straight faced, explaining that trans women can have a female penis, but are just as much women as biological women would be met with the derision it deserves by the majority of men.

These men might be sympathetic to Hayley Cropper, but also have an understanding of what autogynephilia is, even if they have never heard the word. If they were exposed to the wild west of queer theory and gender identity politics they would find it both ridiculous and sinister.

The difference between what they feel and what they see everyone else express, is a massive source of cognitive dissonance and very difficult to make sense of.

A lot of dads are understandably, desperate to keep some sort of relationship going with their kids and partners, and they may be unaware that other people are experiencing the same feelings so go along with the trans narrative. Many may not be able to cope with the difficult feelings caused by the cognitive dissonance and end up estranged from their children and partners.

4thWaveNow has a couple of posts focusing on Jay Stewart and the organization Gendered Intelligence in the UK. What has been your experience with Gendered Intelligence?

I initially assumed they were some sort of gay and lesbian or feminist support group. What I found from looking up their web site and from https://youthtranscriticalprofessionals.org/ was they are both a trans cult, a trans pressure group and an increasingly lucrative business.

I went to some meetings that were open to parents. I found a small group of young people, all looking younger than their age, some anxious parents and two strapping blokes who looked like parody transvestites from “Little Britain.” It was a deeply creepy experience and I realised just how perfect a set-up it was for grooming vulnerable young people and setting up dependencies that could be exploited the day they turned 18.

To be honest I only read anything from them to get an idea of what they are doing that directly affects my daughter, I really do not need to wind myself up. The more I see of them, the more they remind me of Scientology, but they are stealing young people’s healthy bodies, not just gullible rich people’s money.

You have written that your daughter originally came out to you as a lesbian, but now says she is a trans man. Obviously you are skeptical of this switch. How does your daughter explain it to you? Why do you doubt it? Does she know about your doubts?

Communication on the topic is difficult at best. It always ends up in rows [UK English for “arguments”] which I do not handle well, so I tend to avoid the subject, so a lot of what I think about this may be supposition.

She says that she has never felt happy as a girl and that once she came out to friends and teachers, she has never been happier. She tells us that everyone else accepts her new gender and she passes effortlessly. We know from personal experience that this is untrue. It also sounds just like so many stories on the Gendered Intelligence website or any other pro-trans site.

I’ve known a lot of lesbians from a previous job I had, and they were all wonderful, open and friendly people. My daughter seemed to be developing into a very stylish lesbian before the trans thing started. But now she’s withdrawn, ashamed of her body and obsessed with her appearance.

She knows exactly how I feel, but as I said, I don’t handle rows well.

How are you handling the transition? Do you use “preferred pronouns,” and have you purchased a binder?

I’m determined to not be an enabler, so I will not use preferred pronouns, but otherwise I try to keep my opinions to myself, not always successfully. If I try to discuss it, we will end up rowing and I will push her further into the cult.

Somehow she got hold of a binder. I pretend not to notice when she wears it.

Did your daughter show any signs of being gender dysphoric as a young girl?

This question is impossible to answer without either accepting or confronting a lot of the assumptions behind the trans ideology. I’m a stroppy bugger so here we go.

If you look up the symptoms of gender dysphoria on the NHS (http://www.nhs.uk/Conditions/Gender-dysphoria/Pages/Symptoms.aspx), you get a list that includes:

disliking or refusing to wear clothes that are typically worn by their sex and wanting to wear clothes typically worn by the opposite sex
disliking or refusing to take part in activities and games that are typically associated with their sex, and wanting to take part in activities and games typically associated with the opposite sex
preferring to play with children of the opposite biological sex

…all of which is just sexist bollocks. Most people would display these “symptoms” at some time in their lives.

Next in the list of GD symptoms we have:

feeling extreme distress at the physical changes of puberty

I grew up a boy, I was late to puberty and not at all happy about that. I can understand why puberty is a bigger challenge for girls, who might well have learned about puberty blockers from the internet. So this too must catch a lot of people.

disliking or refusing to pass urine as other members of their biological sex usually do – for example, a boy may want to sit down to pass urine and a girl may want to stand up.

My brother went through a stage of sitting to pee; he had somehow got the idea that that was why women lived longer.

insisting or hoping their genitals will change – for example, a boy may say he wants to be rid of his penis, and a girl may want to grow a penis.

As a late developer, I was convinced I was under-endowed. How would I have reacted if offered the chance of being a special snowflake who would grow into a beautiful lady?

So we are left with:

insisting they’re of the opposite sex

Girls get a shit deal, since they have to live up to ridiculous beauty standards. Boys watch enormous amounts of porn and that influences the pressures they put on young women. Aspects of puberty that my generation accepted or even celebrated, like pubic and underarm hair, are now deemed repulsive. Young women are expected to be a ridiculous hybrid of constantly available sex toy, pure maiden and pre-pubescent little girl. As I have discovered, post-trans, lesbianism as a distinct, respected culture and role model has disappeared–to now be a category on You-Porn or a pretense of autogynephilia.

Is it any wonder that a lot of young women these days see no alternative to trans?

Kids are weird. That’s just what they do, so just let them be weird kids for a while. Don’t call it either a mental illness or some mismatch between their bodies and a mythical gender fairy that can be cured by surgery, a lifetime of hormones and bucket-loads of doublespeak.

So when you get right down to it, asking whether my daughter ever showed signs of gender dysphoria is a really stupid question. The only answer is “probably no more than you”.

If my daughter lives life for a while as a woman, lesbian or straight, actually has relationships and then comes back to me as an adult and says that she would be happier as a man, then I would think very hard about it and try to understand.

Do you know other parents “in real life” (vs. online) who share your gender-critical views?

No, although I have ‘come out’ to some close old friends and colleagues. Once I’ve explained the reality of what trans is, they seem to accept my version.

How does your partner (your daughter’s mum) feel about all of this? Do your views differ?

My partner agrees with me and shares my views on gender identity, but is much better at navigating the thin line between enabling the delusion and losing communication, so can still to some degree communicate with our daughter. Still, my partner often ends up being told by our daughter how terrible we are. She really has been a rock; at times I have been close to crumbling and she has always been there for me.

Are you observing other teen girls in the UK who are also transitioning to male?

I see some around town. It’s heart-breaking, these young women, who could be beautiful and confident, who could be enjoying the freedom of youth and all the chances to explore themselves and the world. But now heads down, huddled, painfully self-conscious, anxious, making pathetic attempts to pass, but I’m sure, that at some level they know that people are only pretending to believe it.

How does your daughter’s school handle her transition?

They encouraged and colluded with it without telling us. They gave her a new name badge and use preferred pronouns. One teacher seemed quite proud of how she had supported our ‘special lovely’ daughter. Yes I’m furious about that, but can’t bring it up without outing and alienating her. Someone might be getting a present of Sheila Jeffreys’ Gender Hurts book at the end of term.

How can we support what you’re doing?

Keep doing what you are doing. Let people know that there is another story and that the gender identity dogma is a lie.

I’d love to see us get organised and start acting collectively, but I know that will be very hard, with everyone needing to protect their and their kids’ privacy.

We need to reach out and let people know that there is dissent and that the dissenters are not horrible people. We need to separate rejection of the trans ideology from homophobia and let people know that there is no scientific validity to gender identity and that there are other ways of tackling gender dysphoria.

I’m sure there is a story here that a good investigative journalist could really run with. It reaches from grubby little men in girls changing rooms, through to some very powerful people, all the time trapping and exploiting young people. I haven’t a clue how to get that story out.

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

Posted on April 21, 2016 by 4thwavenow

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

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

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

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

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

What services did TransActive provide or recommend?

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Do No Harm: An interview with the founder of Youth Trans Critical Professionals

Posted on April 5, 2016 by 4thwavenow

A new organization has formed for therapists, social workers, medical doctors, educators, and other professionals concerned about the rise in transgender diagnoses among children, adolescents, and young adults. Youth Trans Critical Professionals was founded by a psychotherapist and a university professor just a few short weeks ago. The organization has a website (already publishing thought-provoking pieces from professionals), a Facebook page, a Twitter account, and many followers. If you are a professional skeptical of the transgender youth trend, please visit the website and consider contributing to the effort. Your anonymity will be protected at your request.

4thWaveNow recently interviewed one of the founders of Youth Trans Critical Professionals. She is available to respond to your questions and remarks in the comments section below this post.

Why did you start this organization for professionals skeptical of the trans-kid trend? What is your personal interest in this matter?

I’m going to start by saying something that I will probably say several times. Our main concern is with medical intervention in children and young people that leaves their bodies permanently altered and/or sterilized. We don’t have a moral issue with people identifying as transgender, and believe that those who do should be protected from discrimination like any other minority. However, the medical treatments for children who identify as transgender are risky, not approved by the FDA, and permanent. With any other condition, we would be bending over backwards to find other ways to support these children without resorting to major medical intervention, and would turn to puberty blockers, cross-sex hormones, and surgery in only the rarest and most extreme cases. It is very disturbing to the originators of youthtranscriticalprofessionals.org that these treatments, whose long term effects are not well-studied, are being offered very casually for a condition which isn’t even clearly defined.

I have a private practice where I work mostly with adults, although from time to time, I do see adolescents. I first became aware of this issue because parents were coming in describing kids struggling with gender identity. I started to notice a pattern: an anxious, depressed, or socially awkward kid who spent a lot of time on social media would announce that he or she was “trans,” often requesting access to cross-sex hormones shortly after this announcement. Every one of the mothers in my practice who reported this behavior was incredibly supportive of her child. These moms may have shared feelings of confusion or concern with me, but their initial reaction toward their child was always acceptance.

The first time I heard this story, I didn’t make much of it. It sounded like normal teenage experimentation to me, and I admired the mom’s openness to accepting her child. However, as I saw more of these cases – and I saw the cases progress to the point where the child was demanding medical intervention – I became concerned and wanted to learn more.

What I found once I started looking was that more and more young people are identifying as trans, often after bingeing on social media. For some reason that I can’t quite fathom, there is a tremendous feeling of excitement around this issue among many adults. I found out that administrators at private schools were boasting about “several kids transitioning” at their school. I heard this from more than one school while I was researching this. They shared this as evidence, I think, of how truly progressive and accepting their school is. However, I find it really odd that no one blinks an eye when four kids are transitioning in a grade of sixty kids. Given how rare transsexualism is believed to be, doesn’t that alone ring a warning bell?

The more I learned, the more disturbed I became. Where were the critical voices? Where were the adults familiar with child development speaking out for young people who are in danger of being swept along on a current that may carry them towards sterility before they have even finished high school?

I was shocked to realize that many of my fellow therapists appear to have uncritically bought into the narrative about trans children that goes something like this: 1.) gender identity is a legitimate thing. You cannot question it without being bigoted. 2.) Children know their own gender identity. 3.) If you do not immediately and uncritically affirm a child’s professed gender identity, you will be doing that child grave harm, and may even induce suicidal behavior, 4.) The best and only treatment for a child who professes to have gender dysphoria or claims to have a gender identity other than that associated with his or her sexed body is transition – social, medical, or both. It doesn’t matter whether that child has comorbid mental health issues such as anxiety, depression, trauma, autism, substance abuse or bipolar disorder. 5.) Once a child has professed his or her gender identity, the adults around that child should follow his or her lead, providing whatever treatment and accommodations are requested by that child.

There is nothing about the narrative outlined above that is beyond controversy and shouldn’t be open to questioning. The construct of gender identity is poorly defined and lacks coherence. It surely shouldn’t be the basis for subjecting our kids to irrevocable body changes and sterilization. Assuming that children have some mysterious knowing about their gender identity seems like poor practice. Children are often very sure of things at one moment in time and believe something completely different a week, a month, or a year later. Child development is a fluid process. Refraining from immediately affirming a child’s gender identity brings with it no documented harm. The oft-quoted figure about suicide among transgender youth is a misuse of statistics. Many children (and adults, for that matter) feel significant distress about an aspect of their body or identity. Usually, therapists explore many ways to support a person facing this kind of discomfort. Sometimes medication can bring relief. Sometimes, exploration brings a new understanding. Sometimes, discomfort must be borne as we come to terms with a difficult or disappointing reality. Why the rush to change the body? Permanently?! Of course we as adults should be putting the brakes on a process that is leading toward permanent sterilization. Of course we should. Where were the other professionals who also believed this?

There is such a dearth of professional voices calling for restraint and caution in turning to medical intervention. Pediatricians, social workers, psychologists – most professional groups state that we must affirm a child’s gender identity. While we appreciate the intention here to be supportive of gender non-conforming kids, it seems the greater value ought to be protecting children from unnecessary medical procedures that often result in sterility; a central aim of youthtranscriticalprofessionals.org is to raise awareness of this.

Yes. Where are the child and developmental psychologists on all of this? Much of what transgender activists promote seems to fly in the face of what we know about child and adolescent developmental psychology. It has been understood for decades that young children confuse fantasy with reality; that adolescents try on and shed different identities; that children are conditioned by what they experience; that a child or adolescent’s sense of self is anything but rigid. Have you heard from any skeptical child psychs, and what will it take for some of them to start speaking out?

So far, I haven’t heard from any, but I imagine we will. You are right, and you phrase the issues very clearly. Kids do try on different identities. And we as adults don’t do them any service by privileging gender identity as some special, separate category. There is nothing innate or special or sacred about gender.

And kids have very strong feelings about what they want, and they often confuse things they want with things they need. It is so incredibly difficult to watch out child be in psychic pain. It can send us flying into action as we try to make their suffering stop. But part of our job as a parent is to use our discernment as the adult who knows them best to learn when to listen to the manifest story they are telling us about themselves, and when to listen to a deeper story underneath that.

I was talking recently with a friend who has a daughter in college. She was telling me about the awful, awful time she went through when he daughter was 13. The girl was obsessed with getting an iPhone. She cried nightly about how terrible it was for her not to have one, how it was damaging her social life and making her isolated and depressed. She was visibly distraught over this issue being any reasoning. She begged for it literally as if her life depended on it.

Thinking of this issue with trans kids, I said to her, “At least you knew that she wasn’t going to come to any grave harm if you didn’t give her an iPhone.”

My friend surprised me by saying that at the time, she felt confused about whether she was doing great harm to her daughter by not giving her a phone. “Between the peer pressure and the advertising, I was almost convinced that I was doing her grave psychological damage.” Imagine how hard it would be to stand up to a teen’s desperate demands for hormones if you had mental health professionals telling you that you were damaging your child by withholding them!

I suppose the point is that just because our kids want something very, very badly doesn’t mean that we have to capitulate or surrender our adult judgment. Teenagers don’t have a fully developed prefrontal cortex. We can’t abdicate our responsibility as their parent to say no when what they fervently desire may be harmful for them, or at least may have consequences they aren’t capable of fully appreciating.

Do you believe there are truly transgender children? Are they different from the teens who claim to be trans because of social contagion?

What a complicated question! Let me break it into a couple of parts.

First of all, there is no question that there has been a huge increase in kids identifying as trans. Much of this increase is certainly due to social contagion. Kids are getting exposed to this on social media, where they are taught that “if they are asking whether they are trans, they probably are.” Look, most teenagers go through a period of feeling intensely uncomfortable in their own bodies. I think that for many of these kids, this is an expression of that discomfort. Forty years ago, maybe more kids developed eating disorders. Twenty years ago, they were cutting. This is the current way to express that nearly universal adolescent discomfort. We all need to feel that we fit in, and that we stand out. Identifying as trans hits both of those criteria big time. You go to school and announce you are now Joe instead of Jo, and let people know you want to be referred to by a different pronoun, and in many schools, you are met with excited acclimation from peers. You are different in an exciting, trendy way. At the same time, you can feel a part of the other kids who are also embracing different gender identities. It must be very heady.

So I do believe that there is a huge social contagion piece, and this is one of the things that I don’t hear other people talking about much. This matters a great deal, because it has probably happened that some anxious, socially awkward kid has come out as trans as a way of gaining acceptance and belonging, and has gotten so much support and affirmation that she has continued down the road to take hormones. In short order, she had permanently altered her body – a deepened voice, facial hair, baldness, increased risk for certain diseases – and maybe this wasn’t for her, really? Or not for her forever? But now this person has to live with those consequences forever. Testosterone and other cross-sex hormones are not tattoos that carry trivial risks, or can at least be hidden easily. This ought not to be a life-style or fashion decision, and for some kids at least, I am convinced it is. I realize this is an incredibly unpopular stance, but this is what I am seeing from my little perch.

Of course, there are those who identified significant distress with the sex of their body before transgenderism became a cause celebre. I have read the stories about two-year-olds who ask why God made a mistake. Some of these stories are pretty compelling. I am not an expert in this area, and when I read these stories, my strongest reaction is that I am grateful I have never had to be the person responsible for making a decision about such a case. I’m not at all sure what the right thing to do is, but I will say that I could imagine that transitioning might be right in some cases.

There is an Atlantic article about this from 2008 that I found very interesting. It profiled several of these kids who are “persistent, insistent, and consistent” starting at an early age. Some of the Canadian kids were treated by Dr. Kenneth Zucker. The article describes some of the things involved in the treatment such as “taking all the girl toys away.” I admit that made me cringe. Really?! Who would want to do that to their child? However, at the time the article was written, Chris, the child in question, had grown up to be a gay, effeminate man who had a healthy, intervention-free body.

My understanding is that when Zucker’s team assessed a gender dysphoric child, they closely examined the family system, considering carefully different dynamics that were in play, and then crafting an individualized treatment plan that might involve several different kinds of interventions. I believe that enforcing gendered toys was something that was done in some cases, but was accompanied by other therapeutic interventions that took into account the whole family dynamic. The ultimate aim was to help the child feel comfortable identifying with his or her natal sex.

The article also followed an American child who had been affirmed early, and had begun to live as a girl. And it made reference to the social media star Jazz Jennings, who was profiled by Barbara Walters. I found the reaction of the Canadian parents to this practice of early affirmation very compelling, so let me quote from that part of the article. (The bolding is my own.)

The week before I arrived in Toronto, the Barbara Walters special about Jazz had been re-aired, and both sets of parents had seen it. “I was aghast,” said John’s mother. “It really affected us to see this poor little peanut, and her parents just going to the teacher and saying ‘He is a “she” now.’ Why would you assume a 4-year-old would understand the ramifications of that?”

“We were shocked,” Chris’s father said. “They gave up on their kid too early. Regardless of our beliefs and our values, you look at Chris, and you look at these kids, and they have to go through a sex-change operation and they’ll never look right and they’ll never have a normal life. Look at Chris’s chance for a happy, decent life, and look at theirs. Seeing those kids, it just broke our hearts.”

So I think, if I had a little boy who insisted he were a girl, and I could do this terrible thing of enforcing gendered play, or I could do this terrible thing of altering his body and destroying his ability to have his own children, which would I pick? If I knew I would have a healthy, happy, whole gay man at the end of it, if I had a reasonably good guarantee that would be the outcome, I would much rather pack away the Barbies. The personal and social difficulties of back-tracking on a childhood or adolescence spent transitioning will inevitably be immense. If a child has been transitioned from a young age how will they know, or be able to begin to articulate, that a mistake has been made? At a recent at Cambridge University seminar entitled ‘Gender Non-Conforming Children: Treatment Dilemmas In Puberty Suppression‘ it was stated that 100% of children on puberty blockers go on to transition; it’s clear there is absolutely no going back on medical intervention.

In any case, those of us who started youthtranscriticalprofessionals.org would argue that transition is always an option into adulthood. I am familiar with the view that when someone transitions as a child, they have a better chance of “passing” in adulthood, but given the very real risk of later regret, I think we might decide that medical transition is a choice to be made by full-fledged adults only.

How do you answer charges that you are promoting harmful reparative therapy on trans youth? How is this different from trying to turn gay kids straight?

Well, I’m not sure I believe that we should try to “talk kids out” of believing that they are trans, first of all. If a fourteen year old kid came into my office and said, “I’m pretty sure I’m gay,” or “I am gay,” I would say, “Tell me about that! What is that like for you? How long have you known? What lead you to first wonder about your sexual orientation? What is hard for you about knowing this? What kind of support do you need?”

If a fourteen year old kid came into my office and said, “I think I am trans,” or “I am trans,” I would ask similar questions: “Tell me more about that? What does that mean to you? Help me understand your internal experience that leads you to know yourself as trans? What kind of support would be helpful in addressing this? When did you first start to wonder?”

The purpose is both cases would be to do the thing that therapy is meant to do – to explore our experience so that we can understand it more deeply.

There are a couple of differences. First, while I would be interested in hearing from the gay child about his particular way of experiencing his gayness, we all have a pretty clear idea of what that means. A gay boy experiences sexual attraction to other boys, and not so much with girls.

The notion of gender identity, however, is much less clear. If a boy of fourteen were to tell me he is really a girl, I would want to know about that experience. What does that mean? In what way do you experience this inner sense of femaleness? How does this experience manifest for you? What are the different ways of understanding this experience? Is it a consistent experience, or is it subject to variation? How does this experience influence your understanding of yourself?

Sexual orientation and gender identity are actually quite different and these differences justify different approaches. Sexual orientation has shown itself to be quite stable. Most gays and lesbians knew from very early on that something was different. These feelings aren’t dysphoric, although they may cause distress because of homophobia. It isn’t dysphoria, it is just an awareness of who you are. It isn’t a sense of being wrong, or in the wrong body. And it doesn’t tend to change. These feelings are generally stable throughout the life span.

This isn’t the case for gender dysphoric kids. We know that a majority of them will naturally desist. Unlike sexual orientation, gender identification does tend to change for the large majority of dysphoric kids.

The other major difference – and this is the heart of the artichoke – is intervention. Gays and lesbians are not seeking intervention. They just want to love whom they love. My hypothetical gay boy client and I would be free to discuss and explore his experience of being gay and his coming out process without any high stakes medical decisions hanging over our heads. If I knew that my hypothetical trans patient would not have access to medical intervention until she was, say, 25 years old, she and I could spend our therapeutic hours exploring her experience as a trans woman, and I could offer support for the difficulties involved in being different in this way.

My goal for therapy with a trans kid would be to provide a warm, judgment free space in which they could explore their gender identity and what it means for them without a rush to medical intervention. I wouldn’t aim to convert. No. But I wouldn’t want to close in on this being the final answer, since I know that so many gender dysphoric kids will desist of their own accord.

I would hope that no one would ever be shamed or persecuted or made to feel unworthy or respect and love because of these feelings. I would argue that there is another approach in between rejection and affirmation, and possibly the word for that would be acceptance. I accept you as you are. I support you. I am curious about what you are going through. I want to hear more about your experience. And I accept that your sense of your own identity might change, and I will accept you then as well. But in any case, I would hope to delay medical intervention until the person was at least 25 years old.

Maybe the last thing to say about this is the most controversial. It isn’t really clear what exactly “gender identity” even means. It appears to refer to a subjective inner state, but when pressed, those who identify as trans will often resort to gender stereotypes in describing their discomfort. Forgive me, but I am not going to want to send any person down a conveyor belt toward permanent mutilation and sterilization over a self-diagnosis of an inner state.

Gender is a social construct. If gender is the problem, why on earth change the body? Is seems obvious that the right thing to do is to change or even abolish the construct altogether. Changing the body to fit the social constructs we have around gender only serves to further entrench the constructs we are trying to escape – and these are socially, not biologically constructed; there is no evidence that gender identity is innate.

What is your vision for Youth Trans Critical Professionals? What do you ultimately hope to achieve?

Initially, we are hoping to solicit posts from 100 professionals writing on the trans child trend from how they see it. By doing this we aim to assemble the first collection of voices of Youth Trans Critical Professionals to evidence our mutual concern. There is a meeting being planned, and we are also discussing the possibility of co-authoring a book. Ideally, we would like to help move the needle on this conversation, hopefully resulting in clearer standards of care that protect gender dysphoric and nonconforming young people from unnecessary medical intervention and permanent sterilization.

How can a group of anonymous professionals make a difference? Without a public face and voice, who will believe you are who you say you are?

Anonymity certainly limits our credibility at this point. Many of us are contending with constraints of professional institutions which broker no dissenting views. It is our hope to speak out publicly once there are more of us. In the meantime, I hope that we will be judged by how we write and think. I believe that people that read the site will know that we are striving to do this in order to protect children from unnecessary medical procedures and permanent sterilization, not out of hatred or bigotry. In addition, some professionals working with us are also friends and relations of children and young people identifying as trans and need to remain anonymous to protect their loved one’s privacy.

In the few weeks the site has been live, have you heard from other professionals who want to be on-board?

The site has been up for less than two weeks, and it has already been viewed over 2,000 times. The overwhelming majority of the comments have been positive. (I have not deleted any comments, if that tells you anything. One person wrote a critical comment, which I approved.) And yes, professionals are reaching out and asking how they can be involved not just from professions allied to medicine, but teachers, youth workers, practitioners of law, artists and writers and so on.

How can parents find therapists and other medical providers who will resist the current trend to diagnose kids as trans? There are no public directories, while there are tons of published resource lists of “gender specialists.”

What a good idea! Perhaps we could gather the names of such providers and maintain a directory. This would be a great resource because families are telling us they reluctant to access services because they do not trust service providers to tread a sensitive line between gender confusion and medical intervention.

As a therapist, how would you suggest a parent deal with a child insisting they are trans? The current trend seems to be “affirming” the child’s identity, no matter how old the child is.

Well, this is another complicated question. Obviously, we always want to communicate love and acceptance of our children. We can accept and affirm our child and respect their struggles and personhood without necessarily affirming a professed identity.

Part of what makes this a thorny problem is that there is no neutral stance. If we affirm the kid’s gender identity, we likely tip the scales in favor of a trans identity. If we look for other ways to express our support and empathy for our child, we likely tip the scales the other way. Given that even doing nothing is not a neutral intervention, we have to ask a difficult question. Is desistance a better outcome? If we had to choose which way to tip things, what is the right way? For me, it is clear that, all things being equal, desistance is a better outcome because it avoids invasive medical procedures and sterilization. Whenever a young person is engaged in keeping the conversation about their trans identity open, they may feel comfortable deferring medical intervention which will have the side effects of irreversible sterilization – at least this puts growing maturity on their side.

There is also the very critical issue of social contagion. I believe that many kids identifying as trans for the first time as teens – and perhaps many younger kids as well – have “picked this up” from social media. Parents are not infallible, but we are likely the best judges of whether our kid is truly suffering from deep-seated gender dysphoria, of whether the gender issue is a way to express other issues.

If a parent has a teen who comes out as trans, I would be interested in knowing the following:

Has the child been anxious, depressed, or struggling socially?
Does the child have other mental health issues, such as PTSD, substance use, or bipolar disorder?
Has the child been spending a lot of time on social media? What sites? How much time?
Are the child’s peers (or desired peers) coming out as trans as well?
Did the announcement come “out of the blue,” without prior indication that the young person has ever struggled with their gender or identity before?

If the answers to these questions are pretty much “yes,” I would actually suggest that the parent state firmly and clearly that they do not support their child’s transition. I realize this is heresy. I would, as David Schwartz suggests, stop talking about gender. Anxious and depressed teenagers may learn that they can get a rise and a reaction out of adults when they mention gender. Addressing only the gender dysphoria instead of the underlying issues does these kids a huge disservice.

We know that social media sites like Tumblr and Reddit are fertile ground for social contagion and that many children start talking trans following immersion in these worlds. We know it’s easier said than done, but disconnecting them from the internet, especially social media, does give space for developing more self-reliant thinking. For some families it may be possible to remove a young person from their environment completely. Three months spent in nature away from screens, or overseas, or volunteering in a challenging environment may serve as a “hard reset,” allowing them to focus on something other than themselves. (After all, gender dysphoria is in essence very solipsistic.) Of course not all families have the networks or necessary resources to broker new horizons for their child in these ways. Parents are telling us it is extremely difficult to work out the best ways to support their child. But we are gaining increased confidence that saying ‘no’ to your child’s trans aspirations can inspire your child’s confidence for reflection. All parents try to keep their children away from dangerous trends sweeping youth culture and the trans trend requires the same vigilance.

I do believe that parents can have an impact. Letting a kid know that you don’t buy the gender identity drama, stating plainly that you love them as they are, but you don’t want to see them destroy their health and sterility can have an impact. They might roll their eyes, but I believe they hear you. At least if they ever look back in regret and despair they will know that you tried to protect them.

How can we support you?

If you know a lawyer, doctor, therapist, academic, nurse, teacher, guidance counselor or other professional who deals with young people and questions this trend and is thoughtful, please send them to our website! We are hoping to solicit 100 professionals to post on the site over the next few months. They can reach us from the site, and can send us material to post – anonymously if they wish.

Send parents, trans youth and their allies to the site too. Our aim is to cohere strength amongst and between us to bring serious, committed and critical attention to the dangers of trans orthodoxy.

4thWaveNow

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

Tag Archives: transgender children