Not plural-phobic: USPATH psychiatrist promotes transition for multiple personalities

Posted on December 29, 2017 by 4thwavenow

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

Note: The audio recordings linked in this post, as well as the presentation slides, were provided by an attendee at Dr. Karasic’s USPATH presentation.

Dan Karasic, MD, plays an important role in the area of transgender health care. He is clinical Professor of Psychiatry at University of California, San Francisco, and a practicing psychiatrist for the Transgender Life Care Program at Castro Mission Health Center, as well as at his faculty practice at UCSF. He is also the co-chair of the recently formed USPATH, on the Board of Directors of WPATH, and, as such, has been instrumental in the ongoing development of WPATH policies and standards.

With so much experience, as both a clinician and trans advocate, Karasic’s statements and clinical judgment carry a lot of weight. So it’s of particular interest that his presentation at a mini-symposium entitled DEVELOPMENT OF GENDER VARIATIONS: FEATURES AND FACTORS at the inaugural USPATH conference last February should focus on a topic as controversial as this: medical transition for one or more “alters” of people with multiple personalities (MPD)—also known as dissociative identity disorder (DID).

MPD/DID had its diagnostic heyday in the late 20^th century, peaking in the 1990s. The public was fascinated by the idea that one human being could comprise more than one identity or personality, and novels, films, and breathless media coverage proliferated. The disorder was thought to be the result of trauma or abuse, but has since that time been subjected to the same skeptical reassessment as the now widely debunked recovered memories and satanic abuse diagnoses (MPD/DID was, in fact, often associated with/comorbid with both).

There is something eerily familiar in this excerpt from a 1999 book by Joanne Acocella about the rise and fall of the MPD diagnosis .

Another important circumstance in Carlson’s case, as in other MPD histories, was the media. During the period of Carlson’s therapy, magazines and newspapers were retailing utterly unskeptical stories about MPD. So was the evening news. MPD experts went on TV with their patients in tow. Bennett Braun, of the nine-hour abreactions, appeared on the Chicago evening news with his star patient. At his bidding she “switched” on camera—now she was “Sarah,” now “Pete”—thus providing early training for prospective MPs in the television audience.

More important than the news were the talk shows. Phil Donahue was apparently the first talk-show host to present a program on MPD; he was followed by Sally Jessy Raphael, Larry King, Leeza Gibbons, and Oprah Winfrey. Meanwhile, celebrities were coming forward with their tales of childhood sexual abuse: Roseanne Barr, La Toya Jackson, Oprah herself. Some of them claimed to be multiples as well. Roseanne, who had unearthed twenty-one personalities within herself—Piggy, Bambi, and Fucker, among others—made the rounds. Again and again on the talk shows it was stressed that MPD was not rare; it was common, and becoming more so. “This could be someone you know,” said Sally Jessy Raphael. Oprah’s program was called “MPD: The Syndrome of the ’90s.” Today, as people are sifting through the wreckage created by the MPD movement, many therapists are blaming the media for spreading the epidemic. They are passing the buck, but still they have a point.

In the late ’90s and into the present day, a number of critical papers appeared in the clinical literature, and the verdict from many clinicians and researchers was that often cases were at least partly iatrogenic:

Although the relative paucity of data on the role of iatrogenic factors in DID renders a definitive verdict premature, several lines of evidence converge upon the conclusion that iatrogenesis plays an important, although not exclusive, role in the etiology of DID:

(a) The number of patients with diagnosed DID has increased dramatically over the past several decades (Elzinga et al., 1998); (b) the number of alters per DID case has increased over the same time period (North et al., 1993), although the number of alters at the time of initial diagnosis appears to have remained constant (Ross, Norton, & Wozney, 1989); (c) both of these increases coincide with dramatically increased therapist awareness of the diagnostic features of DID (Fahy, 1988); (d) a large proportion or majority of DID patients show few or no clear-cut signs of this condition, including multiple identity enactments, prior to therapy (Kluft, 1984); (e) mainstream treatment practices for DID patients appear to verbally reinforce patients’ displays of multiplicity and often encourage patients to establish further contact with alters (Ross, 1997); (f) the number of alters per DID case tends to increase over the course of DID-oriented therapy (Piper, 1997); (g) therapists who use hypnosis appear to have more DID patients in their caseloads than do therapists who do not use hypnosis (Powell & Gee, in press); (h) the majority of DID diagnoses derive from a relatively small number of therapists (Mai, 1995); and (i) laboratory studies demonstrate that nonclinical participants provided with appropriate cues can successfully reproduce many of the overt features of DID (Spanos et al., 1985). Given the high rates of preexisting mental conditions among DID patients (Spanos, 1996), however, it seems likely that iatrogenic factors do not typically create DID in vacua but instead operate in many cases on a preexisting substrate of psychopathology, such as BPD.

As the authors of this article attest, some patients diagnosed with MPD got worse instead of better as they underwent treatment, and not a few came to realize that their deepening troubles were at least partly the result of the misguided efforts of their psychotherapists. Some high-profile cases ended up in court, like this suit brought by Pat Burgus, who settled for $10.6 million against her psychiatrist, Bennett Braun. Burgus had once believed she had 300 different “alters,” and she “recovered” memories under hypnosis that she had eaten human flesh and–among many other horrors–sexually abused her two sons. She blamed her therapist for convincing her these memories and personalities were real.

Before her ordeal was over, Pat would develop 300 personalities, attempt suicide twice, cut ties with her family in Iowa, and go to court to regain custody of her children. She would spend more than two years in the hospital; her children would spend three. And her insurance company would pay $3 million for a treatment regimen that today seems utterly fantastic….

… Since 1993, more than 100 patients nationwide have sued therapists over treatment for MPD, which was diagnosed in explosive numbers throughout the eighties. “In many of these cases, we see a situation in which the poor training and instability of the therapist, coupled with the vulnerability of the patient, creates a situation fraught with the potential for a folie à deux”—that is, a delusion shared by therapist and patient, says R. Christopher Barden, a lawyer and psychologist who served on the Burgus legal team.

MPD/DID remains today a controversial diagnosis. In a 2004 review paper, “The Persistence of Folly: Critical Examination of DID. Part II. The Defence and Decline of Multiple Personality or DID,” authors Piper and Mersky, make the crucial points bluntly.

Concerns about the validity of MPD/DID raised by skeptics in the psych literature seem to coalesce around the following: only a small group of therapists have been involved in diagnosing it; the condition often worsens and more identities/personalities arise after treatment has commenced; and its close association with the widely debunked notion of “recovered memories” of childhood abuse further undermines its validity.

Given the precarious legitimacy of the MPD/DID diagnosis, it seems clear that–if it’s going to be made at all–it should be done with extreme caution and, above all, with an awareness of the potential for iatrogenic conditions that might exacerbate it—most importantly, the influence of the treating clinician.

Yet MPD/DID is apparently very much alive in WPATH circles. Returning to Dr. Karasic’s presentation about “trans plurals” at USPATH, he offered several case studies, all of which involved medical transition of all or some of the “alters”:

In the case of this 20-year-old “AMAB,” as seems to be typical with gender affirmative practitioners, medical transition is reported as curative (or at least palliative) for a host of other problems apart from gender dysphoria; in this instance, the patient’s Bipolar Disorder 2 and Alcohol Use Disorder were “treated simultaneously” with the T-blocker spironolactone and cross-sex estrogen. The patient “did well,” and the 7 alters (including 3 in “co-conciousness,” 2 agender, 1 female) seem to have reached consensus about gender surgery later on–presumably the requested “genital nullification” .

Then there is the 27-year-old who identifies as a genderqueer “system.” Diagnosed with autism in childhood, this “AMAB” with a primary “front” female alter, has undergone hormone therapy and presently has 85 “headmates” that include alters, tulpas, and fictives.

Headmates, tulpas, “fronting,” co-consciousness: Dr. Karasic seems well versed in the insider jargon used by the trans plural community.

“So I’ve had several patients who identify as trans and plural

…and I guess I had a reputation as a psychiatrist who was not plural phobic.”

After discussing several cases of successful medical transition of alter identities, Karasic reported on an online survey of 250 self-identified “trans and plural” subjects conducted by three self-described members of the trans plural community, over a one-month period. From the data gathered, there seems to have been a plethora of different alter types reported by survey respondents.

Did these alters include “furries,” an audience member wanted to know?

Q: “…What are “damiens?” [sic] The other thing is, were all the alters human, or were there some alters that took on another form?

Karasic: …I think there are people who have alters that take different forms. And I have had somebody with a wolf, you know, and sometimes fictional characters who might not be human, who can become a headmate, basically.

Q: Separate from furries? We’re not talking about furries..

Karasic: No, no no, this doesn’t have anything to do with that. This is just different people’s identities, but there are people who may have within this a system with headmates. There can be kind of a variety of …headmates.

Last August, 6 months after the USPATH symposium, Dr. Karasic discussed his experiences with transitioning multiple personalities in a thread on the public WPATH Facebook page.

Dr. Karasic does acknowledge here the importance of mental health care for people with multiple issues, but per the informed consent model that Dr. Karasic subscribes to (evidenced by his many public statements, as well as the fact that his trans health clinics operate on the informed consent model), comorbid mental health problems are not seen as a barrier to medical transition instituted before treating other comorbid issues.

In the era before informed consent became the preferred approach , particularly in the United States, clinicians were often reluctant to initiate hormonal or surgical intervention in patients with comorbid, severe mental health issues. But in the age of gender affirmation, withholding medical transition is seen as restrictive—even immoral– “gatekeeping”—even if one runs the risk of one alter ego disagreeing with medical treatment and suing the provider in court for “violating the rights of one or more personalities“, as a commenter on the same thread hypothesized.

Taking this a step further, might one trans-plural headmate sue not only the surgeon or gender therapist, but one of the other headmates for forcing medical transition (or not) on the others?

Time will tell if the spectacular court cases brought by aggrieved clients who were diagnosed with DID/MPD in the 1990s will play out in a similar fashion within the labyrinthine world of trans plurals.

Meanwhile, the reader may find the concluding paragraphs of the previously cited Piper and Mersky paper relevant when weighing the plight of “trans plurals” and the clinical approach taken by at least one prominent WPATH clinician:

Wherever we look—whether at the posttraumatic model; at theories of repression; at the epidemiologic uncertainties and aggrandizements of the disorder; at the persistent proliferation of personalities; at the elusive data that attempt to sustain the claims of exceptional abuse; at the bland presentation of breathtaking assumptions such as cross-sex, cross-species, or cross-ethnic alters; or at the impossibility of proving almost any of the basic claims of the disorder—we encounter propositions that appear to be founded on beliefs and not on facts or logic. That such beliefs could prosper in a society or a discipline represents an embarrassing weakness of the academic and professional establishment of psychiatry.

Perhaps the closest example of another culture-bound movement that resembles the modern DID–MPD movement occurred in the late 19th and early 20th centuries, when mediums and spiritist practices were popular. Hacking notes that “multiple personality has long had close links with spiritism and reincarnation. Some alters, it has been thought, may be spirits who find a home in a multiple; mediums may be multiples who are hosts to spirits” (79, p 48). Much of the best turn-of-the-century English-language research on multiple personality was published by the London- or Boston-based societies for psychical research. However, After 30-odd years of high times around the turn of the century, mediumship, spiritism and psychical research went into radical decline. A zone of deviancy that was hospitable to multiple personality severely contracted (79, p 48).

When it becomes suspect to recommend MPD as part of psychiatric evaluation or treatment, the condition is diagnosed less frequently. For example, Pope and colleagues (80,81) and others (82) have shown that North American psychiatrists and psychologists are abandoning the notion of MPD–DID as an acceptable diagnosis. In these circumstances, we expect that the condition will revive momentarily and die several times before it finally ceases to be a ripple on the surface of the psychiatric universe. In the end, it is likely to become about as credible as spirits are today. Having attempted to rationally analyze the claims of MPD–DID, we trust that we have shown sufficient evidence to predict a steep decline in the condition’s status over the next 10 years and a gradual fall into near oblivion thereafter.

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

Posted on August 4, 2017 by 4thwavenow

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

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

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

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

According to Dr. Olson-Kennedy,

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Well worth a look.

“I just gave him the language”: Top gender doc uses pop tart analogy to persuade 8-year-old girl she’s really a boy

Posted on July 23, 2017 by 4thwavenow

We’ve heard it over and over, ad nauseum, from gender doctors, trans activists, and their enablers:

Follow the child’s lead.
We don’t tell kids they’re trans. The child tells us!
You can’t “make a child trans.”
Just listen to the child.

OK, then. Just listen to this 4-minute excerpt from top pediatric gender doctor Johanna Olson-Kennedy, MD and decide whether the 8-year-old in question arrived at the conclusion that she’s a boy all by her lonesome.

Olson-Kennedy is the Medical Director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles, the largest transgender youth clinic in the US. She delivered these remarks at the inaugural USPATH conference in Los Angeles this past February, as part of a symposium entitled “OUTSIDE OF THE BINARY – CARE FOR NON-BINARY ADOLESCENTS AND YOUNG ADULTS.”

The first four minutes of the audio are transcribed in this post. However, readers are strongly encouraged to listen to the whole clip themselves. Timestamps are in square brackets [].

Olson-Kennedy starts with background on the case:

An 8-year-old kid comes into my practice, and this is the story with this kid: Assigned female at birth, 8 years old, was completely presenting male whatever that means—short haircut, boy’s clothes–but what was happening, is, this kid went to a very religious school and in the girls’ bathroom which is where this kid was going. People are like, “why is there a boy in the girl’s bathroom? That’s a real problem.” And so this kid was like, so that’s not super working for me, so I think that I wanna maybe enroll in school as a boy. This kid had come up with this entirely on their own.

When the kid came in, mom was like, “oh we don’t know what to do, so please help us” and so we started talking about it and what was interesting is that …you know some kids come in and they have great clarity and great articulation [sic] about their gender. They are just endorsing it, “this is who I am, and yes there’s gender confusion but it’s all of you who are confused,” so there are those kids. So this kid had not really organized or thought about all these different possibilities.

Girl likes short hair and comfortable clothes: check. Kid goes to a religious school, where people aren’t comfortable with gender nonconformity: check. Parent (who we can guess is conservative, given her kid was enrolled in a “very” religious school) takes daughter to a “gender clinic,” thereby signaling to the kid that something is wrong with you, you need a doctor: check. Said doctor believes her role is to help the kid “organize” about gender “possibilities”: check.

[1:55] You know the mom had shared this whole history, and said, when the kid was 3, the kid said, “Could you stroll me back up to God so I can come back down as a boy” and the kid’s like,” Ah, I didn’t say that.” You know, 8-year-olds, [2:09] so I’m like, “I don’t think your mom made that up, that’s crazy.”

Hang on a damn minute. Genderists always want to have it both ways, and here we have another example. When a parent like one of us on 4thWaveNow says to a gender doctor, “No, my kid never said anything about wanting to be the opposite sex until a binge on social media at age 13,” the gender doc tells us we just weren’t listening. “Listen to the child. Follow the child’s lead.” But because this mom reports that her kid said God made a mistake at age 3, and the 8-year-old denies having said it, the mom in this case has to be right.

In other words: We should “just listen” to what a parent claims a child said at age 3, but openly dismiss what the more mature child says herself at age 8.

[2:10]: So at one point, I said to the kid, “so do you think that you’re a girl or a boy? And this kid was like…I could just see, there was, like, this confusion on the kid’s face. Like, “actually I never really thought about that.” And so this kid said, “well, I’m a girl, ’cause I have this body”

The kid was brought to a doctor at 8 years old because she likes short hair and “boy’s clothes” and she has gotten flak from the school about it. What is this child going to say? This is a doctor, in a clinic, in a hospital; an adult authority figure, encouraging her to question her own already-voiced sense of reality.

[2:34] Right? This is how this kid had learned to talk about their gender…that it’s based on their body.

“Had learned?” Is Olson-Kennedy actually telling her audience that a little girl demonstrating her understanding of biological reality is something that was erroneously imparted, as opposed to the doublethink-newspeak indoctrination Olson-Kennedy is about to peddle?

[2:40] And I said, “oh, so …and I completely made this up on the spot, by the way, but …I said, “Do you ever eat pop tarts?” And the kid was like, oh, of course. And I said, “well you know how they come in that foil packet?” Yes. “Well, what if there was a strawberry pop tart in a foil packet, in a box that said ‘Cinnamon Pop Tarts.’? Is it a strawberry pop tart, or a cinnamon pop tart?”

Your body is just a wrapper, a piece of foil to be discarded (more like: pumped full of hormones, sterilized and eventually surgically reconfigured) so the “real” self can be revealed.

[3:00] The kid’s like, “Duh! A strawberry pop tart.” And I was like, “so…”

At this point [3:09], there is a staged pause and we hear the audience laugh loudly and knowingly.

[3:12] And the kid turned to the mom and said, “I think I’m a boy and the girl’s covering me up.”

[3:17] Audible murmurs and “wows” from Olson-Kennedy’s rapt audience

pop tarts Johanna Olson-Kennedy is not a developmental psychologist. Of course, it doesn’t take a PhD, an MD, or even a high school diploma to know that children as young as eight still believe in Santa Claus; that they can transform themselves into animals or super heroes; have not learned to distinguish fact from fantasy. (Then again, developmental psychologists like Diane Ehrensaft are jettisoning decades of knowledge about child development as they hop aboard the trans-kid bandwagon, so there’s that.)

And the best thing was that the mom was like, [squeals] and she goes and gives the kid a big hug and it was an amazing experience. But I worry about when we say things like “I am a” vs “I wish I were” because I think there are so many things that contextually happen for people in around the way they understand and language [sic] gender.

Here we go again with having-her-cake-and-eating-it-too. Olson here is referring to the trans-activist talking point that a kid who claims they ARE the opposite sex is truly trans (vs one who just says they “wish” they were); it is claimed (without evidence) as a surefire diagnostic indicator. But Olson is having it both ways: Because this kid did not fit that particular trans-activist talking point, it must be dumpstered (or put another way, the goalpost must be moved).

Regarding the evidently overjoyed mom, an aside: “Progressive” doctors/activists show no shame, none at all, when using religious conservatives as mascots for their trans kid cause. Take Kimberly Shappley, a conservative Christian mother from Texas, who initially (by her own admission) tried to spank and shame her effeminate toddler son into behaving “like a boy”. Shappley finally showed love and acceptance when the child essentially gave in and announced he must be a girl at age 4. Shappley is now a celebrated activist, who is trotted out by the transgender press, Slate, and the Huffington Post as a model parent of a “trans” kindergartner.

Back to Johanna Olson-Kennedy and her 8-year-old client:

[3:41] So, I don’t think I made this kid a boy.”

Again, a dramatic pause for appreciative laughter. No, Johanna, you didn’t “make this kid a boy.” You made her believe she is a boy, authority figure that you are.

I don’t THINK so.

More laughter.

[3:44] I mean, and if I did, and I’m wrong, then I’m totally gonna come to this conference and tell people that I was wrong. I will.

That probably won’t be necessary. You did a bang-up job teaching a young child that she can change her sex, that her defiance of gender norms means she’s not a girl, so desistance is unlikely at this point. We’re on the road to blockers, cross sex hormones, and sterilization. The whole enchilada.

Of course, Dr. Olson-Kennedy could study whether leading questions and kid-friendly analogies have any impact on persistence of a trans identity, using some of the taxpayer money she got from the NIH, but it doesn’t appear to be a particularly urgent research question for her at the mo.

[3:58] But I think giving this kid the language to talk about his gender was really important.

“Important” would be one word for it.

And actually, it did not make him a boy, it gave him language to understand his gender.

[4:03] An unidentified audience member or co-presenter interjects: Why are we talking about this again?

Oh, how do you talk to people about…Oh and are you a medical provider? Ok, this is something I learned from being married to a mental health person.

Another unidentified participant: “Tell me more about that.”

More raucous laughter and extended applause.

But “tell me more about that” isn’t what Olson said. Even if psychologically counseling children were in her scope of practice, Olson-Kennedy didn’t use what is referred to as “active listening” with this kid. That would have meant validating the kid when she denied saying God made a mistake (why doesn’t Olson-Kennedy give any weight at all to the insight of an 8-year-old vs a 3-year-old?). If she’d been “actively listening,” Olson-Kennedy would have taken seriously the little girl’s stated understanding that she was, in fact, a girl. Instead, Olson-Kennedy “gave him the language” that she was actually a boy.

Make no mistake: This approach is what is on the ascendant when it comes to gender nonconforming children and how such kids—our kids—are being treated in the United States of America in 2017. Johanna Olson-Kennedy is one of the leading pediatric gender doctors in the US, running the largest clinic in the country. She is not some fringe figure. She is one of the recipients of a $5.7 million grant from the NIH to “study” kids like this 8-year-old (with no control groups of non-transitioned children).

Olson-Kennedy favors lowering the minimum age for genital surgeries. She is not averse to calling Child Protective Services on parents who won’t transition their kids (something she and other gender docs openly discussed at the same USPATH conference). Johanna Olson-Kennedy is a true believer in medicalizing gender nonconformity, with all the very grave repercussions stemming from that belief.

And she is not alone.

UPDATE 7/24/17: A reader sent us the following commentary in response to this piece via email today:

Olson-Kennedy appears to be unaware of the decades of research on suggestibility, which is defined as “the quality of being inclined to accept and act on the suggestions of others when false but plausible information is given.” Research psychologists have demonstrated repeatedly that children are vulnerable to suggestion when being interviewed by adults. They can be influenced by an interviewer’s status, interviewer bias, and leading and repeated questioning.

In one study, children witnessed a staged event, and were then interviewed by adults who were given incorrect information about what they children had seen. The study found that “children’s stories quickly conformed to the suggestions or beliefs of the interviewer.”

In the cited transcript, the question Olson-Kennedy first asks – “so do you think you’re a boy or a girl?” – is leading. A leading question is defined as “a question that prompts or encourages the desired answer.” To ask the question “do you think you’re a boy or a girl” is to suggest that it is possible that either is an option. Olson-Kennedy tells us that the child provided a clear answer to the question that was based on the child’s knowledge of her own biology. However, Olson-Kennedy signaled to the child that she is not satisfied with this response. She did this by repeating the question using the pop tart metaphor rather than accepting the child’s answer. A repeated question carries with it the implication that the initial answer given was not satisfactory. We must assume that the child picked up that she had given the “wrong” answer by stating that she was a girl.

Within the repeated question, Olson-Kennedy offers an alternative explanation for the child’s experience – couched in alluring, child-friendly image of sugary pop tarts. The child complies with Olson-Kennedy’s implied suggestion that she is in fact in the wrong body, and receives affirmation for this compliance in the form of breathless acclamations by both mother and the high-status doctor. By “providing the language,” Olson-Kennedy encouraged this child to conceptualize herself as having been “born in the wrong body,” complete with the imprimatur of a major medical center. The kid didn’t stand a chance.

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

Posted on February 25, 2017 by 4thwavenow

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Shriveled raisins: The bitter harvest of “affirmative” care

Posted on January 26, 2017 by 4thwavenow

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

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

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

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

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

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

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

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

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

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

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

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

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

Source: Williams Institute, 2014

So, given that

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Robert Garofolo, PBS.org:

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

4thWaveNow

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

Tag Archives: USPATH conference 2017

Not plural-phobic: USPATH psychiatrist promotes transition for multiple personalities

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

“I just gave him the language”: Top gender doc uses pop tart analogy to persuade 8-year-old girl she’s really a boy

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

Shriveled raisins: The bitter harvest of “affirmative” care