by Marie Verite

 In the six days since the launch of the petition urging Brown University and PLoS One to continue supporting research into the sharp increase in youth—particularly females—who seek medical intervention for gender dysphoria, over 3700 have signed and over 1060 have written comments. The initial signature goal was 1000, which was quickly surpassed in less than 12 hours; the goal has since been continuously raised. As of this writing it stands at 4000.

The signatories include many families affected by rapid onset gender dysphoria (ROGD), medical professionals, therapists, doctors, and academics. You can read them all—and sign the petition, if you have not yet—here.  A small sampler of the 1000+ comments:

— Lee Jussim – Chair Psychology Department, Rutgers University “If it’s wrong, let someone produce evidence that it is wrong. Until that time, if the research pisses some people off, who cares? Galileo and Darwin pissed people off too. Brown U should be ashamed of itself for caving to sociopolitical pressure. Science denial, anyone?”

— Richard B. Krueger – Columbia University College of Physicians and Surgeons “Brown University’s actions in its failure to support Dr. Littman’s peer reviewed research are abhorrent.” 

— Nicholas H. Wolfinger – Professor, Department of Family and Consumer Studies, University of Utah “It’s extraordinary for a dean to withdraw support for a study, especially one by an untenured researcher. This is inimical to the spirit of open inquiry. The well-being of trans youth & other sexual minorities is best served by more research, not less.”

The petition was emailed to officials at Brown and PLoS ONE editors several days ago when it reached 2000 signatures, along with a personal letter requesting a response. As of this date, no reply email or even an acknowledgement of receipt has been received.

This week, parents who launched the petition will be mailing the hard-copy petition, with its over 3700 signatories and over 1000 comments, to the Brown University and PLoS officials named at the bottom of the petition, as well as to two WPATH officials located in the United States. A response from all recipients is being requested.

In addition to petition signatories, there have been many others who’ve stepped forward to express their concerns about this assault on academic freedom and the attempted muzzling of free and open discussion regarding the surge in new cases of gender dysphoria in youth and young adults. Press coverage of the exploding controversy is increasing.

This week, the US edition of The Economist ran a piece featuring a mother who completed Dr. Littman’s survey and her daughter, now a 21-year-old desister who identified temporarily as trans and demanded medical intervention at the age of 16. The piece also covers Littman’s study and the growing controversy around it. Entitled “Why are so many teen girls appearing in gender clinics?” the article appears online and in this week’s print edition.

The Economist reports that the mother was fine with her daughter’s gender expression but drew the line at medical transition; Rachel and her mother Janette fought “for months.” In the end, Rachel desisted. The article concludes with this paragraph:

Squashing research risks injuring the health of an unknown number of troubled adolescent girls. Rachel, now 21, believes she latched on to a trans identity as a way of coping with on-off depression and being sexually abused as a child. After receiving therapy, her gender dysphoria disappeared. Had her mother affirmed her gender identity as a 16-year-old, as several gender therapists urged, Rachel would have embarked on a medical transition that she turned out not to want after all.

Despite the obvious caring and thoughtfulness demonstrated by the liberal mother and her daughter in the article, Dianne Ehrensaft, Director of Mental Health at the gender clinic associated with UC San Francisco’s Benioff Children’s Hospital and an internationally recognized gender therapist, told the Economist that Littman finding  research subjects on sites where skeptical parents like Janette congregate (such as 4thWaveNow)

“would be like recruiting from Klan or alt-right sites to demonstrate that blacks really are an inferior race.”

The Economist article is one of the first to center both the experience of a trans-identified teen who changed her mind and her mother. (Jesse Singal included such stories in his recent Atlantic story; Singal continues to undergo attacks by trans activists for what can only be described as a balanced piece on the matter of youth gender dysphoria).

There has been other prominent news coverage of the Littman controversy. Jeffrey Flier, Harvard University Higginson Professor of Physiology and Medicine at Harvard, and former Dean of Harvard Medical School, first reacted on Twitter to Brown’s removal of the press release of Littman’s’ study, and the university’s failure to support its own researcher:

A few days later, Flier penned a piece for Quillette (an online journal fast becoming one of the most respected outlets for nuanced and incisive writing), taking Brown University to task for its disgraceful treatment of Dr. Littman, an untenured professor, as well as its abdication of responsibility to defend academic freedom via its craven actions in the face of agenda-driven activists. In response, many prominent physicians have retweeted Flier’s piece, as well as Brown faculty members. In Quillette, Flier took no prisoners:

“In all my years in academia, I have never once seen a comparable reaction from a journal within days of publishing a paper that the journal already had subjected to peer review, accepted and published.”

Reactions to the Littman debacle were everywhere on Twitter (for better or worse, the cyber-public square, referred to by some as the “Agora of the 21st Century”), including  from other medical professionals, such as Nicholas Christakis, physician, writer, and researcher at Yale.

An article on Medscape on August 28, “Caring for Transgender Kids: Is Clinical Practice Outpacing the Science?” attracted comments from several physicians, most expressing serious concerns about the epidemic of young people identifying as transgender in the last few years. [Note: Some of these physicians signed and commented on the petition calling on Brown and PLoS ONE to support Dr. Littman’s work.]

Many journalists have also weighed in on Twitter, overwhelmingly in support of Littman’s work and also the petition to Brown and PLoS ONE.

Jon Kay, Canadian editor of Quillette opined on Twitter

Tonight, Kay tweeted a letter by a WPATH clinician condemning the ROGD research. Based on WPATH’s previous hostility to any and everything to do with ROGD, we should expect to be hearing more from them in the very near future.

Other coverage of the Littman controversy (recommended) includes Science magazine, Inside Higher Ed, attorney-blogger Jonathan Turley, and the Volokh Conspiracy in Reason magazine.

The intense, swift reaction to the Littman matter–and ROGD–is stunning. Ironically, the pile-on intended to suppress Littman’s work may have had the opposite effect of that desired by activists. As of this writing, Littman’s study has been viewed on the PLOS ONE website nearly 59,000 times (this count would not include, of course, additional views of the paper via email shares of PDFs, etc). Indeed, the Littman affair seems to have not only brought the question of rapid onset of gender dysphoria in adolescence, finally, into the public eye. It has also stimulated a broad group of thinkers, professionals, journalists, and clinicians to start talking about the issues, under the banner of academic freedom and the pursuit of truth over the ideological dictates of one group of activists.

It’s heartening to see that defense of these core values is not dead, after all, in the West.  We now have not just parents, but public intellectuals, physicians, and ethical clinicians speaking up who recognize what is occurring for what it is: An assault on scientific inquiry and an attempt to squelch open discussion of a phenomenon which is becoming more obvious by the day, despite every effort by the usual suspects to insist it doesn’t exist.

As of this writing, there has been no further public response from either Brown University or PLoS ONE. The last reaction we are aware of was an obsequious response by PLoS ONE on Twitter to a self-described BDSM trans sex worker who goes by the moniker “SadistHailey”/Hailey Heartless.

As we observed on our Twitter account,

by Missingdaughter

Missingdaughter is the mother of a young woman who went missing in college. The author is available to interact in the comments section of her article.

How many college students identify as genderqueer, as transgender, as something other than male or female? Short answer: we don’t know.

The Williams Institute of the UCLA School of Law tracks transgender demographics. In 2011, the Williams Institute found that 0.3% of adults identified as transgender. Another analysis from 2016, which utilized data from the CDC’s 2014 Behavioral Risk Factor Surveillance System (BRFSS), showed the number of adults identifying as transgender had risen to 0.6% of the population. What about teenagers? Yet another Williams Institute estimate in January of 2017 suggests that 0.7 percent of youth ages 13 to 17 identify as transgender. Teenagers are a difficult population to survey. Dr. Emily A. Greytek, director of research at G.L.S.E.N. thinks the numbers for teens identifying as transgender could range from 0.5% to 1.5%. Transgender is an umbrella term—this could also account for the fuzzy numbers.

For many reasons, the aforementioned data requires closer examination. For one thing, any statistic based on a generalization across a large population does not capture local variances. There is anecdotal evidence of localized clusters of transgender-identifying young people in much higher proportions than these US-wide statistics would indicate. Escalating evidence suggests an expanding social epidemic, a phenomenon being described as Rapid Onset Gender Dysphoria (ROGD).

Malcolm Gladwell argues in his book, The Tipping Point, that social epidemics germinate, emerge, and grow by specific mechanisms and for specific reasons, ultimately reaching a tipping point, the pivotal threshold at which ideas and behaviors spread uncontrollably throughout larger society. The surveys we have do not record the germination of alternative gender identities on college campuses.

The colleges themselves report only a vague sense of the numbers. In the Spring 2017 Association of American Colleges and Universities journal, a report titled “The Experiences of Incoming Transgender College Students: New Data on Gender Identity” uses data gathered from the 2015 CIRP Freshman Survey. The report follows 678 transgender students from 209 colleges and universities.

On financial matters, the report states, “transgender students receive financial aid at a higher rate than the national sample. More transgender students reported receiving Pell grants (32.8 percent versus 26.6 percent), need-based grants or scholarships (47.8 percent versus 36.6 percent), and work-study funding (35.4 percent versus 20.9 percent). More transgender students also received merit-based aid (60.7 percent versus 51.6 percent), which is especially encouraging given that the average high school academic performance of transgender students was slightly outpaced by the national average.…”

The trans-identified students have self-reported emotional health concerns: “52.1 percent of incoming transgender college students reported their emotional health as either below average or in the lowest 10 percent relative to their peers.” However, “nearly three-quarters of transgender students reported a good chance they would seek counseling (74.6 percent). One reason for this difference is that evaluation and referral by a mental health professional is typically recommended to those seeking or undergoing hormone therapy or gender confirmation procedures.”

Transgender students are a politically and socially engaged group: “Nearly half of the transgender student sample reported having engaged in some type of activism within the year prior to college entry (47.4 percent), which is more than double the percentage of students in the national sample who reported having done so (20.8 percent). Other authors have noted the tendency of transgender students to view their identity through an activist lens, describing the intersection between their gender and activist identities, and the role other identities play at the intersection.” Further, more than two-thirds of incoming transgender college students indicated they were likely to participate in protests on campus (68.7 percent), as compared to about one-third of the national sample (33.1 percent).

Nowhere in this report did it state how many students pursue a medical transition while in college. It is understandable that colleges may not be able to track shifting gender and sexual micro-identities on their campuses. Some of these identities may be a passing whim. But we don’t know anything about how many students arrive at college with a transgender identity, or who adopt a transgender identity while in college, and—more importantly—how many of these students access campus health services for cross-sex hormones or are referred to a nearby off-campus provider for life-changing hormone treatments and/or surgery referrals. Because the students are over 18, FERPA restrictions may prevent a parent from ever learning that his or her young adult child has undergone life-changing medical interventions—even if the child is still covered under the parent’s insurance plan. (True: the student is legally an adult, though not fully in brain function.) Considering the heady atmosphere of trans cheerleading on a college campus and the easy access to medical clinics, a young adult could be more likely to pursue medical transition while away at college.

As noted in the article “Are you sending or losing your teen to college?” published last year on 4thWaveNow, “if it were all just identity exploration, it would be one thing; but many college students are quickly advancing into medical treatments—often with the financial support of the university. Diagnostic testing or even basic counseling are no longer necessary, and college-bound teens have quickly figured this out. ‘Coming out’ as transgender is now treated pretty much the same as a gay or lesbian coming out, not as the gender identity disorder it was considered to be only a short time ago.”

Some students arriving at college without a previous transgender identity will adopt this label in college. How does a coming-of-age journey turn into a coming-of-transgender journey? Why would a young person without previous gender dysphoria adopt this identity? Some would term these new identities as “late harvest apples,” a term used by Diane Ehrensaft to explain unlikely transgender proclamations from older teens and young adults. There are several reasons this identity might bloom in college. One is that gender ideology on most college campuses is an entrenched dogma that manages to unite marginalized and protected identities, tribalism, theory masquerading as science, the queering of curriculum—all these ideas combined form a nebulous all-encompassing groupthink. No one dare question this gender ideology, as this theory involves a protected class of people who are highly triggered by reality.

This new identity could form during O week, which is the week for welcoming new students to a college campus. There are also welcoming queer weeks and Q week. Further, it has become the norm to announce a preferred pronoun to other students and professors, and to be instructed on pronoun etiquette so one does not make a blunder.

From O week introduction icebreakers to the classroom, it is increasingly common to make a preferred pronoun declaration and to be asked to use assorted preferred pronouns for others. The following excerpts on preferred pronoun usage are from a guide created for faculty at Central Connecticut State University:

There are also lots of gender neutral pronouns in use. Here are a few you might hear:

They, them, theirs (Xena ate their food because they were hungry.) This is is a pretty common gender-neutral pronoun…. And yes, it can in fact be used in the singular.

Ze, hir (Xena ate hir food because ze was hungry.) Ze is pronounced like “zee” can also be spelled zie or xe, and replaces she/he/they. Hir is pronounced like “here” and replaces her/hers/him/his/they/theirs.

Just my name please! (Xena ate Xena’s food because Xena was hungry) Some people prefer not to use pronouns at all, using their name as a pronoun instead.

Never, ever refer to a person as “it” or “he-she” (unless they specifically ask you to.) These are offensive slurs used against trans and gender non-conforming individuals.

Why is it important to respect people’s PGPs? You can’t always know what someone’s PGP is by looking at them.

Asking and correctly using someone’s preferred pronoun is one of the most basic ways to show your respect for their gender identity.

When someone is referred to with the wrong pronoun, it can make them feel disrespected, invalidated, dismissed, alienated, or dysphoric (or, often, all of the above.)

It is a privilege to not have to worry about which pronoun someone is going to use for you based on how they perceive your gender. If you have this privilege, yet fail to respect someone else’s gender identity, it is not only disrespectful and hurtful, but also oppressive.

You will be setting an example for your class. If you are consistent about using someone’s preferred pronouns, they will follow your example.

Many of your students will be learning about PGPs for the first time, so this will be a learning opportunity for them that they will keep forever.

Discussing and correctly using PGPs sets a tone of respect and allyship that trans and gender nonconforming students do not take for granted. It can truly make all of the difference, especially for incoming first-year students that may feel particularly vulnerable, friendless, and scared.

Do take care, faculty. It is oppressive to oppressed classes to screw up their pronouns. But it is not oppressive to you to have to learn and use preferred pronouns. Can professors be dismissive of this silliness? No, not if they wish to not be dismissed from their positions. To take one example, a recent article stated that at the University of Minnesota a new draft proposal discloses that not correctly recognizing preferred pronouns could result in “disciplinary action up to and including termination from employment and academic sanctions up to and including academic expulsion.”

Professors at many colleges are compelled to use the student’s “chosen” names, the preferred pronouns–and of course, since we are talking about legal adults, the families may have no idea this is happening with their student: “If you are made aware of a student’s LGBTQ or transgender status do not assume other professors, friends, or family are also aware of the student’s status.” CCSU recommends that faculty read Author Dean Spade’s journal article on working with transgender students. Dean Spade is a professor at the University of Seattle School of Law.

The idea that someone is defined by a gender identity will be promoted, the idea enforced, as soon as the student arrives on campus. If a student has not given gender identity much thought, she or he will now be fully immersed in declaring a gender. What is the effect on one’s identity when forced to declare a gender identity in a classroom or with the weekly RA meeting? Champlain College decided that it would be a good idea to have everyone wear a preferred pronoun button. Imagine declaring other identities on introductions, name tags, etc.: My political party is X, my sexual identity is X, though occasionally Y, my religion is X, my mixed-ethnicity includes V,W,X,Y,Z.

Sexual identities are whirred together with gender identities. It is no wonder that with so many options available that identities often do shift. Resident Advisors often receive LGBTQ training. RAs at UC San Diego are provided with a 74 page training manual on LGBTQ identities. This publication dates from 2007. If there is a more recent update, one would assume it focuses heavily on gender identities and creative sexuality labels.

Here is one item from this 2007 guide under ‘B’:

BDSM: (Bondage, Discipline/Domination, Submission/Sadism, and Masochism ) The terms ‘submission/sadism’ and ‘masochism’ refer to deriving pleasure from inflicting or receiving pain, often in a sexual context. The terms ‘bondage’ and ‘domination’ refer to playing with various power roles, in both sexual and social context. These practices are often misunderstood as abusive, but when practiced in a safe, sane, and consensual manner can be a part of healthy sex life. (Sometimes referred to as ‘leather.’)

Professors are expected to not only practice compelled pronoun speech, but also to queer the curriculum. From Vanderbilt University, we have a comprehensive guide, “Teaching Beyond the Gender Binary in the University Classroom”:

In this guide we learn the reasons some students may question the non-binary, “Clark, Rand,and Vogt (2003) observe that students may sometimes hold onto their current understanding of gender roles ‘like lifelines in class discussion’ when confronted with information that challenges their existing views.”

Instructors are encouraged to: “integrate non-conforming gender topics into courses that are seemingly unrelated to gender…Instructors might also “discuss medical diagnoses that have emerged in light of intersex patients.” Another recommendation is to “incorporate a class debate about the impact of gender labeling on the development of criteria for diagnosis, drug development and medical treatment.” Lastly, the authors suggest that “instructors might incorporate debates around the research on gender non-conforming brain structures, such as that of the female limbic nucleus neuron counts for male-to-female transsexuals. For some, the latter recommendation may seem problematic given the history of biological sexism and racism in the United States…In engineering classrooms, encouraging students to think about how existing technologies might require modification if one were to consider the needs of gender non-conforming individuals…In biology classrooms, incorporating readings about the variation of gender identity and expression when presenting about sex chromosomes.”

So we can see that gender-related ideologies and pedagogy are no longer confined to the departments of Queer Studies, Women’s Studies, Gender Studies, and the Humanities.  The college experience is queered in likely and unlikely places by professors and students alike. Some other examples include:

A professor at Northern Illinois State is concerned that masculine lesbians are viewed as women and not transgender. ‘Zir’ says that “compulsory heterogenderism, participants’ gender identities often went unrecognized, rendering their trans* identities invisible.”

“Queer Ecologies” is a course taught at Eugene Lang College. A partial course description: “Drawing from traditions as diverse as evolutionary biology, LGBTQ+ movements, feminist science studies, and environmental justice…”

If one is stumped for ideas on queering the curriculum, QuERI is a site for courses such as, “Goodgirls, Sluts and Dykes: Heteronormative Policing in Adolescent Girlhood.”

To a young ideological student, it makes sense to insert queer into the Israeli–Palestinian conflict. This honors thesis is from the department of Gender & Sexuality at Davidson College:

The Gender and Sexuality Studies Department provides you with a solid grounding in the interconnected, interdisciplinary fields of gender, sexuality, and queer studies, and engage these fields from a variety of perspectives – religious, economic, political, social, biological, psychological, historical, anthropological, artistic, and literary.

New Mexico Tech promotes non-binary awareness in STEM fields.

It is no surprise that a full immersion into gender ideology on a college campus (that is consistently reinforced) could lead a young person to embrace this identity. Yes, some students arrive to college with a genderqueer or transgender identity. Some do not. If a student adopts this identity, there is no barrier to this identity going medical. A transgender identity, a non-binary identity–both of these stated identities can receive hormones and surgeries. There is a social contagion to this identity; if many other peers are headed to the student clinic for a testosterone shot, why not?

In last year’s college piece, we documented that medical transition services were easily available on college campuses, often with just a single visit to a counselor. The 2017 Campus Pride guide listed 86 colleges that cover medical transition surgeries. Students are often covered under their parent’s insurer, and these young adults can gain access to transgender medical services. We can only assume that insurer coverage will continue to increase. If the campus student health clinic does not provide these services, the student will be sent to a nearby off-campus “informed consent” clinic. Planned Parenthood now plays a large role in transgender health services. As in, young women come to Planned Parenthood for testosterone shots. Ironic, isn’t it? Most people think of Planned Parenthood as a place to obtain birth control–not as a place to obtain an off-label drug that may render these young women sterile, not to mention the many serious and permanent side effects of this drug.

Brown University has a generous student health care plan that provides a full range of sex reassignment surgery (SRS). As stated on Brown’s counseling website: “We partner with Brown Counseling and Psychological Services (CAPS) and University Health Services to collectively provide access, without undue barriers, to medical resources on and off-campus. Brown University health insurance provides trans-inclusive coverage for therapy, hormones, and gender affirmation surgeries for students, staff, and faculty.”

Recently, Brown University has been in the news–no, not for the reason of ranking 14 in U.S. News Best National Universities. Professor Lisa Littman of Brown University recently published a study on ROGD, or Rapid Onset Gender Dysphoria. Her study was posted on the university’s news feed and then quickly taken down when students and other activists protested. A petition was created to support academic freedom and scientific inquiry. Dr. Littman’s study created a wake beyond the research community.

Does this university have conflicts of interest between supporting faculty research, scientific integrity, appeasing activist students and outside political groups–possibly conflicts with competing interests of faculty? Dr. Michelle Forcier is a professor at The Warren Alpert Medical School at Brown University. Dr. Forcier is passionate about transgender medical care: “Should we let them die when we have medicine for diabetes?” she said. “And we’re really talking about the same level of intervention. When gender non-conforming, transgender kids and adults are not supported (and) are stigmatized, then they can’t be healthy.”

Many colleges provide cross-sex hormones for their students. Here is some budgeting advice from Tufts University Health Care:

We recommend that Testosterone be obtained from pharmacies that have special expertise—Health Service commonly works with New Era Pharmacy in Portland Oregon which ships directly to you. At New Era, a 10 ml bottle of Testosterone lasts for 9 months or more depending on your dose, and costs $65 out of pocket, which is much cheaper than using your insurance. Prescriptions for needles and syringes will also be needed. Our nurses will work with you to help you learn to administer your injections. We will also provide you with a small sharps container for safe needle disposal.

Whether through the student health plan, the parent’s medical insurance (unbeknownst to the parents), or with some creative patch funding (as in one of the thousands of accounts on Go Fund Me by young women seeking “top surgery”), college students are a vulnerable population to the social contagion and permanent medical harm of a phenomenon being termed, ROGD or Rapid Onset Gender Dysphoria.

In fall 2018, “The number of students projected to attend American colleges and universities is 19.9 million...Females are expected to account for the majority of college and university students in fall 2018: about 11.2 million females will attend in fall 2018. We don’t know the exact number of college students who are identifying as genderqueer or transgender. Colleges aren’t tracking these students. Let’s choose 1% as a number in the middle, approximating from various surveys.

What could this mean for these young women? This could translate into potentially 100K young women put on a pathway to receiving a mastectomy. No one is tracking these numbers.

Colleges must reveal how many students they refer to transgender medical health services on-campus or off-campus. Colleges and universities have an ethical responsibility to state how many students are receiving cross-sex hormones and even mastectomies due to the colleges affirming and encouraging these interventions, and sending these students to providers that are more than willing to chop off their breasts.

What will become of these young students, their futures? Many, with encouragement from peers and counselors, will estrange themselves from their families.

We will hear from some families, like this one, in a future article:

“the phone call from my daughter in the deepening voice, the phone call to the college dean of students who told me ‘sometimes children do not have the same moral compass as their parents,’ the visit to the same office where they threatened to call security on me, the generic text my husband and I received from our daughter cutting us out of her life”…

Sasha Ayad, M. Ed., LPC, is a Licensed Professional Counselor who works in private practice with teens and young adults who struggle with gender issues. We interviewed Sasha via email for this post.

She uses an exploration-based approach to seek out underlying issues and help her teen clients move towards self-awareness, resilience, and long-term well being. She also conducts occasional consultations for parents whose teens present with rapid onset gender dysphoria (ROGD).

In a monthly newsletter, Sasha’s reflects on interesting psychological material, and relates it back to the phenomenon of a sudden presentation of gender dysphoria in adolescence. She also offers advice for parents as they guide and support their gender-questioning teen. Readers can sign up here to receive the newsletter and Sasha’s PDF on how to search for gender-critical therapists in unlikely places.

Sasha has a full caseload and long waiting list, so is unable to take on new clients. However, Sasha offers a subscription-based Patreon account with videos designed to help parents engage in trusting and productive dialogue with their rapid-onset teen.

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

Tell us something about your background, training, and work as a therapist.

In undergraduate school, I studied psychology and history. My graduate program was focused in counseling psychology, or the clinical practice of therapy. I’ve worked in the field of behavioral therapy and mental health in Houston, Texas since 2005, and in a counseling capacity since 2008. I spent many years working with young children on the autism spectrum through applied behavioral therapy. In the field of domestic and sexual violence, I worked as an individual and group therapist with women and children. I also developed and ran the first counseling program at a state-supported residential facility for adults with intellectual disabilities and concurrent mental illness. In recent years, I worked as a school counselor for underserved populations at a top-ranking charter school.

I am now working in my private practice full-time, based here in Houston. Most of my work is conducted online, and I see teen and young adult clients from all over the country and internationally. I specialize in working with adolescents who are struggling with gender and most of my clients are female. I also conduct occasional consults for families who have children presenting with Rapid Onset Gender Dysphoria, and create content for my monthly newsletter and video series.

I am a Licensed Professional Counselor (LPC) in Texas, and I hold a master’s degree in Education.

What specifically sparked your interest in working with adolescents and adults who have gender identity issues?

My interest in this population developed and grew organically out of my own desire to better understand the growing phenomenon. When I was a young graduate student, my understanding of this issue was limited and I was only marginally familiar with the conventional, textbook examples of childhood gender dysphoria: a person, who from a very young age, is completely convinced their body is the “wrong sex.” In these cases, the wrong body self-concept develops, seemingly, independent of societal norms and environmental influences. I used to think, “what a strange and troubling experience: to really believe you have the wrong sexed body.”

Even back then, I did hold skepticism about this narrative, with its heavy reliance on gender-atypical preferences and behaviors supplying the “evidence” that the child is actually in the “wrong body,” and therefore needs to socially and medically transition. Around 2012 I began more deeply investigating this idea of gender identity purely out of personal interest and professional curiosity. Keep in mind, this was before the huge boom of trans-identified kids in the years to come. I started to wonder how socialization and gender-norms may play a role in the idea of the “wrong body.” I also questioned the underlying suppositions of “gender identity”: that one’s “correct” biological sex or “authentic self” is always correlated with feelings of congruence between mind, spirit, and body (i.e. innate gender identity).

As time went on, I eventually discovered the work and writings of detransitioned people. I read about how quickly they were “affirmed” and shuttled towards a path of medical intervention, circumventing any opportunity for deep psychological exploration or self-knowledge. I became very disturbed by what seemed to be a failure of mental health practitioners, who were responsible for their care, to look at these young people as whole and complex individuals. Were many in our field simply blind to the myriad factors, both social and subconscious, that might interact and build up the idea of being “trapped in the wrong sexed body?” I grew quite baffled that therapists were treating gender identity without any of the thoughtfulness, intuition, or even clinical curiosity typically afforded to other presenting problems – not to mention the care historically mandated by our psychological ethical standards. And looking at the sheer number of young girls suddenly adopting a trans identity around puberty, it became obvious that something tremendously important and peculiar was happening.

I eventually stumbled upon this brilliant podcast interview with Lisa Marchiano, and my jaw dropped to hear another professional bravely speaking her mind and echoing some of the same fears I held. I reached out to her immediately and soon got connected with your work at 4thWaveNow, Transgender Trend, and many other fantastic resources.

Then in 2015, as a school counselor, I was required to take part in a training on “Supporting Trans and Gender-Diverse Youth.” To my disappointment (but not my surprise) the presenter completely failed to put forth a nuanced, thoughtful analysis, and even skirted issues when I brought them up during the training. I arranged several meetings with my manager at the time, the head of the counseling program – my goal was to educate her about the wider phenomenon and some of the less obvious problems with the training we were receiving. She graciously and thoughtfully listened to my concerns but admitted that there was so much she didn’t understand about the changes in the LGBTQAI movement, and she felt it was important to continue developing our counseling program according to the gender ideology advocates. I believe gender ideology proponents deliberately use “newspeak” and made-up language to confuse professionals into a state of self-doubt and subsequent willingness to dismiss their own intuition and clinical knowledge. And that’s exactly what I think happened to my manager, who is an incredibly brilliant, experienced, and competent social worker.

At that point I decided I would no longer take part in organizations that are committed to this belief system, with no real openness to other ways of looking at gender dysphoria. Further, some of these organizations promote this one-sided view unquestioningly to their mental health staff and the children they claim to serve. I also realized there is a scarcity of therapists working with these children in a manner that is not unconditionally affirmative. Other therapists seemed to avoid or block any type of gender and sexuality exploration, which is also harmful to the client. So, I decided to build the kind of therapy practice I thought was lacking for trans-identified youth. I started my practice part-time in 2016 and have been working independently in private practice full-time since July 2017.

Do you have a personal interest in this issue? Do you have relatives or friends who are affected by the current wave of transgender identifying children and adolescents?

Not until recently. A few years ago, when I worked as a middle school counselor, there was one child who was especially memorable; I spent much time with her, both as my counseling client and during extracurricular activities during my three years at the school.

She stood out from her peers in multiple ways. Despite having many brilliant and creative peers, she excelled in so many disparate domains, being a fantastic sketch artist, dancer, writer, and academic learner. She had impeccable grades in every subject and treated her peers with kindness and fairness. She created logos and t-shirt designs for clubs and school events, and played leadership roles in many campus groups: anime, drama, orchestra, art, and more. I have several beautiful pieces of art that she’s created for me over the years, mostly portraits of female characters, reminiscent of Japanese-style manga. Her appearance was also creatively inspired: she cycled through various hair-cuts, styles, and colors, and expressed her own personal fashion sense (and progressive political leanings) through graphic jewelry and buttons on her messenger bag. I always praised her for carving out her own sense of style and individuality.

She identified as bisexual at the time, and she was a great student-leader in my GSA club, showing initiative and often taking responsibility for large portions of our meetings. I was always careful in how we navigated conversations about gender and gender identity and she seemed to be well-grounded in her own unique expression of female identity. She was never particularly feminine, especially as a seventh grader, when there is immense social pressure to look a certain way. She always had lot of friends, was overall quite happy, and she was just one of those kids I never thought I’d have to worry about. I imagined her starting a graphic design company one day, or maybe being a video game software engineer. Really, her options are limitless.

I found out recently that she has come out as trans, and that she wants to transfer to a different school so she can start her new life as a “trans boy.” In my hours and hours of being with her, she never expressed thoughts of gender dysphoria, though I do remember that once she drew a picture of a pensive “non-binary” character and “their” girlfriend.

It feels like our best and brightest, our most creative and unique girls, are being sucked up into this vortex of confusion. The kids I meet in private practice are first introduced to me in the midst of their gender struggle, but it’s quite profound to have known someone before the identity-change, when they were happy and full of life. To think that she’s now disconnecting from her female self is very unsettling. It seems that her parents have fully accepted the wrong-body explanation and claim to have “always known she was a boy.”

How would you describe your therapeutic approach?

I’m pretty explicit with my teen clients regarding what to expect in therapy, because I believe truth, honesty, and trust are foundational aspects of any successful relationship, counseling included. I tell them something like this: “I’m different from ‘gender therapists’ you might have read about online because I won’t just meet with you one or two times then write you a letter for endocrinology. I believe my job is to help you explore who you are on a much deeper level. First I’ll spend a lot of time just asking questions and listening so I can try to understand what’s going on in your mind, heart, and body. Then we will work together to figure out what your problems are and how to solve them. That will require me to be really honest about what I see and for you to be really honest too, and sometimes counseling can be hard for those reasons. We also work together to really face your pain and see if it has something important to teach you about yourself. We can also look for ways to loosen the grip that pain has over your life so that you can find more confidence and purpose.”

As for the specifics, my approach is highly tailored to the constitution, mindset, resilience, age, and maturity of each client. I always start with trust and initial bonding, which can be hard with some clients who understand gender affirmation as a prerequisite to feelings of trust and safety. With more open clients, who are less defensive and more conversationally or intellectually predisposed, we might discuss the philosophy of gender identity and I give them space to sort through any doubts they might bring to the table. With other clients, who are in a more sensitive or fragile place, I may approach their identity indirectly, focusing instead on the underlying pain that is somehow finding relief in this new self-concept. I also like to pragmatically examine how taking on a trans identity will play out regarding a client’s self-confidence, their ability to exist in the world, how they relate to family, friends, and so on. Sometimes I have to start somewhere very basic, like assessing if the teen even understands what the words “male” and “female” mean, if they know anything about sexuality (age-appropriate understanding), or what they know about their own bodies.

The ideas that influenced my perspective at this point are quite eclectic and not restricted to the field of psychology. I draw from Acceptance and Commitment Therapy, behaviorism, social psychology, anthropology, history, and Taoism. More recently, I’m returning to a deeper exploration of psychoanalysis and Jungian analysis, which I find to be tremendously useful in making both micro- and macro- interpretations of what’s happening with my clients.

I also work closely with parents while respecting the confidentiality of the teen client. Having calls with my caseload parents every six weeks or so has proven to be incredibly important to the therapeutic progress of the teen client. Speaking with teens often gives me insights into ways that parents can deepen their relationship with their teen and to engage in more effective communication with them.

I’ve had very good feedback from my teen clients regarding their feelings of safety in session and ability to express themselves. I often hear that teens feel a great amount of pressure from others to “pick a label” and that our sessions are nice because they can explore gender without it needing to be so concrete.

Are you able to work across state lines, or must your clients be in the state of Texas?

Unlike clinical psychologists, LPCs can see clients in other states and outside the country, though I practice based on the regulations in the state of Texas. I make this clear in my initial consent conversations and documentation with new clients.

How has your your practice been going so far? Have you received any hateful or angry pushback? If so, how have you handled that?

Interestingly, I have not received too much negative pushback, but I don’t believe it will stay that way for long. I’ve seen a few people on Twitter make false claims about me, and some trolls have left unsavory comments on my blog posts. But these instances have not impacted my practice or my clients, as far as I can tell. When I speak with people about my practice face-to-face, I am typically met with far more inquiry and curiosity than hateful responses. Online though, people seem to respond with a great deal of assumptions, accelerated vitriol, and regurgitated one-liners from the trans advocacy playbook. There’s a huge difference between how my work is viewed online by trolls and in person by real people.

That being said, I have been blocked on social media by a few real-life acquaintances, which was eye opening for me. These people know nothing about the “trans kids” phenomenon, but they are the types who automatically adopt what they perceive as the correct liberal position and jump on the bandwagon without really thinking deeply about the issue at hand. Being treated this way by others on the left of the political spectrum has helped me to question many of my own long-held beliefs. I’ve wondered, “if people like me could be so blindly wrong about this, what have I been blindly wrong about?” It’s been one of the most intellectually stimulating and freeing experiences of my life to actually question my own deeply-held ideas with this much curiosity and openness.

Do you believe there is such a thing as a “truly transgender” child or adolescent? Why or why not?

It’s hard to answer a question when the terms of each word haven’t even been defined well. There’s no definition for “transgender” that isn’t completely circular in logic. Perhaps a better question is, “are there some children for whom the benefit of social and medical transition outweighs the risks”? Or maybe, “are there some children who, in order to live vital meaningful lives, must live in the gender role of the opposite sex”? To cover all my bases, let me include a question the gender therapist might ask too: “if a child is threatening to kill themselves, isn’t it better to support their transition?”

My answers for adults would look very different, but let me rephrase these questions a bit and answer them for kids.

1. “Are there some children for whom the benefits of social and medical transition outweigh the risks”?

If by “risk” we mean body discomfort or feelings of incongruence, then trying to prevent that risk is the wrong aim to strive for. Discomfort and biological limitations are ubiquitous and necessary teaching tools that have been a part of human existence throughout history, and felt particularly acutely in adolescence. The struggle between budding aspects of femininity and masculinity, independence and safety, social cohesion and isolation, assertiveness and passivity, and every other fundamental human developmental endeavor requires us to grapple with our own pain and limitations. Without that struggle we don’t develop resilience, we don’t learn about ourselves, and we don’t learn anything about living in the real world as it is, materially or socially.

That being said, it may be that classic cases of absolute insistence on being the opposite sex from the age a child could walk and talk are a different story. Of the hundreds of families I’ve talked to, only a few of them have kids whose gender dysphoria started in early childhood. Perhaps those families are more comfortable with transitioning their children, so they don’t contact me as much. Since I’ve not really worked with those kids, I don’t feel I’m qualified to prescribe their best treatment.

2. “Are there some children who, in order to live vital meaningful lives, must live in the gender role of the opposite sex?”

A “good life” doesn’t come from never experiencing discomfort, or conversely from always being perfectly comfortable, which I addressed in the previous question. But perhaps someone assumes that a girl who prefers or expresses strong masculinity would do better living “as a boy”? Are certain traits or behaviors literally incompatible with being a girl in society, or a man in society? Well, what does this say about our capacity to broaden independence and make room for personal preferences? And if someone does take on non-conformist roles, should they not also develop the personal resilience and emotional fortitude to stand firm in their own presentation with strength and individuality? I think there’s something inherently flawed about expecting all of society to completely abandon every aspect of our historically stable gender roles and it’s also flawed to say there’s no room for individuals to choose how to express themselves on the spectrum of femininity and masculinity.

3. “If a child is threatening to kill themselves, isn’t it better to support their transition?”
If a child is threatening to kill themselves, we should take a huge pause and think of the big picture. Since when do emotionally unstable, demanding children get to use threats to dictate decisions as important as fertility and surgery? Furthermore, if a child is that disturbed or troubled, then they are clearly in no position to make good choices about their long-term well being. The use of this threat by transgender-affirmation advocates is incredibly manipulative and has no precedent whatsoever in the field of psychology. I’ve worked with dozens of young people who are actively struggling with self harm and making suicidal statements (whether related to gender identity or not). These behaviors can serve many functions, not the least of which are expressing psychic pain, gaining attention and care from adults, or trying to manipulate people in power into making a concession of some sort. Children who haven’t developed the emotional or relational tools for self-soothing will use any means necessary to express pain and gain what they are seeking. I don’t mean to deride a child’s methods; she’s doing the best with what she has at the time. But these are reflections we must take very seriously as clinicians. So giving into these types of threats does far more harm than good for the child. We need to instead, conduct thorough risk assessments, create conscientious collaborative plans with the child and their family, and work through underlying issues if we really care about their safety and well-being (as therapists have always done with suicidal ideation).

In the current atmosphere, professionals who question the current “affirmative” approach to therapy for trans-identified kids may be risking their careers. Do you think the concern is overblown?

This is a touchy area so I want to start by saying that I can understand the pressures therapists feel from their institutions to make politically favorable choices and statements. Many clinicians also have their own family to be responsible for and feel financial pressures to not “rock the boat.” However, we have all taken vows of high ethical standards and going along with the affirmative approach undermines our professional moral duties.

Personally, as I’ve considered this question, I find myself asking: what’s the point of having a career based on helping others if you have to lie every day about harm that’s being done? And what does the collective and cumulative impact of lying and silence about this issue amount to in the long run?

Honestly, I don’t know what is going to happen in the next five, ten, or twenty years. In recent times whenever skeptical, intelligent, and nuanced articles about transitioning children appear, there’s often a dangerously aggressive and thoughtless effort to dismiss and diminish such arguments. The way things are going, I would not be surprised if things “get worse before they get better.” That being said, I am not worried about the work I’m doing because I believe it to be the right thing to do. Standing up for good always involves a risk and personal responsibility, a burden which I feel deeply committed to shoulder.

I strongly encourage other clinicians to speak the truth and be honest about what they are seeing, because complicit silence only makes more room for absurdity and confusion.

What will it take for more therapists to come out publicly in offering alternatives to the transgender-affirming approach to therapy?

Individuals listening to their gut, questioning actively, educating themselves, and finally, acting with honesty and courage. Because when I talk with people one-on-one, there’s a deep intrinsic knowing that we have spiraled out of control when it comes to transitioning kids, but people are afraid to even think deeply about it, question anything, seek out knowledge, or speak up.

The APA has issued “guidelines” for the treatment of what they term TGNC clients (transgender gender nonconforming). Though not binding, these guidelines are nevertheless considered “best practice.” Do you agree with them? If not, how does an APA member go about recommending changes to them?

I am not an APA member, since I am an LPC (Licensed Professional Counselor), and not a clinical psychologist. However, the APA is a powerful organization and their guidelines are looked to as aspirational principles which have significant impact on how therapy is informed and practiced. I disagree with the guidelines and believe they violate some of the most basic ethical standards, including beneficence, avoidance of maleficence, fidelity and responsibility. I believe the infiltration of political ideology into non-political organizations is the main confounding element in the organization’s ability to adhere to these professional values.

Regarding TGNC, some trans activists have essentially co-opted gender nonconformity under the “trans umbrella.” Who does that leave? No one is 100% “conforming” when it comes typical gender expression. As you know we at 4thWaveNow support such gender atypicality in our kids, but we strongly resist the notion that this means they are somehow “transgender.”

I agree – even trying to amalgamate “gender non-conforming” people into some semblance of a group is an impossible task since, like you said, no one is 100% “conforming.” We all exhibit traits of masculinity and femininity, and it’s absurd to try and find some line that constitutes “cis” and “trans” – according to some of the definitions of those terms floating around.

What are your views on the possible influences of parenting dynamics on children identifying as transgender?

It’s becoming harder and harder for parents to keep their children safe from questionable ideologies, since they have infiltrated our medical and educational institutions. But I do recommend some possible means by which parents can safeguard their kids:

1. Due diligence in being aware of the types of ideas being taught at your child’s school: from early elementary all the way up to university. I know that’s a daunting task!
2. Do what you can to monitor your child’s internet use and actively talk with them about some of the ideas they come across. Engage your child and really listen: let them share their thoughts, use that time to gather information and establish safety around certain touchy topics. Then engage them in thoughtful, critical, and deep analysis (in an age-appropriate and thoughtful manner). As a side note, I never imagined myself to be someone recommending an invasion of your child’s privacy; I’ve always been quite open-minded. But spending too much time online has proven to have very dangerous potential, so the long-respected parental role of boundary-setting and limit creation is crucial here. Monitor their internet use to get a sense of what material they are viewing frequently. This will help you gauge what you need to attend to. In general, the more you can keep them offline, engaged in real-life 3D activities, the better. Go outside together, leave your phones at home, go for hikes, take them fishing, and just generally reestablish a connection to the natural world.
3. Help them regulate their eating and sleeping cycles, which play a crucial role in mood and depression. Sometimes kids stay awake, staring at a screen all night, filling their mind with anxiety-producing garbage. Set their bed-times, take their phones away overnight, and make sure they eat regularly and get plenty of physical exercise and real-life play and social interaction.
4. Have a clear sense of your own family’s values and moral direction. What do you believe in? What ultimately guides your decisions, behaviors, beliefs, etc? Give them a strong foundation based on your own belief system. Model what you want them to learn. Don’t be dogmatic, but help them make connections to what is true and supports their long term well-being. Even if they explore other ideas in their teenage years, having a loving stable foundation gives them something to come back to or build upon.
5. Don’t obsess over gender, but also don’t try to pretend it’s completely irrelevant. Set boundaries around any kind of physical manipulation or medical intervention. Binding breasts is a physical manipulation which can be harmful in the long run. Hormones and surgery should be off the table. But don’t get hung up on haircuts or clothing.
6. Don’t argue with your child about whether or not they are “actually trans.” Don’t bother thinking back about their childhood, wracking your brain for “signs” of being different or non-conforming. A more pragmatic framing is to think about the real discomfort they are having, and ways to deal with it that don’t require completely transforming into a new person; this is why reducing the time your kids are on the Internet is so important. In my clinical experience, most rapid-onset dysphoric kids didn’t feel any gender incongruence until they learned what it was from social media sites. That being said, take the time to really listen to the gripes they have with the “girl role.” They likely have some very poignant observations and ideas to share.
7. Don’t be afraid of emotions (your own or your child’s) in conversations with your teen. I’m not sure if this is a cultural thing, but I’m sometimes surprised by how afraid parents are that they might upset their child. I come from a family and culture in which open expression of emotions is ubiquitous and I have found it can be very healing when done carefully. Being honest about what you think is incredibly important, and deep emotional talks with your child are going to get turbulent – and that’s ok. It’s necessary to tell your children the truth, disagree, and show your own vulnerability. Go ahead and lovingly explain why you don’t agree with their thinking. They need to hear the truth, because they aren’t going to hear it from friends or the internet.

by Emily Williams

Emily is a 20-year old college junior at a selective liberal arts university in the US. She is using a pseudonym for obvious reasons. As her time permits, Emily is available to interact in the comments section of her article. All respectful commenters welcome, as always, but if you’re also a college/university student, we’d especially like to hear from you.

I have always been empathetic and sensitive to suffering. From a young age, I remember worrying about families who lost their health insurance, the exploitation of women, and the huge discrepancies of wealth in the world. So when I first heard stories about transgender teens, I was very troubled.

I got my Instagram account when I started high school six years ago. That’s when I started learning about the transgender community. I stumbled across their images without even trying. Most were young, 14 or 15, and laid a tragic narrative of being sickeningly confined to breasts and intolerant parents. Many of these internet strangers used the Instagram platform to connect with other trans youth, share their progress and unhealthy coping mechanisms, and discuss their comorbid mental health issues, such as anxiety, depression, and the fallout from sexual abuse. I did not interact with their posts, but read them out of curiosity and an attempt to understand.

That same year, I met my first real-life transgender person — the first of many. When I started high school, she went by her given name, Ingrid. She had buzzed hair, long winged eyeliner, combat boots, and lots of mini skirts. Clearly aiming to be different and cool. She was a senior, and spent most of her time painting in the art studio. Her look did not change throughout the year, but her name and pronouns did — at some point I began to hear people referring to someone named Diego. Before Diego/Ingrid graduated, s/he gave a presentation on “the transgender experience,” at which s/he defined what it feels like to have gender dysphoria, cited the suicide rate of trans people, and, most memorably, taught us trans etiquette: how to refer to trans people, use pronouns, and to never assume another person’s gender.

Throughout the rest of high school I came across this phenomenon several more times. Many more people I knew by association came out as trans. I heard more and more about trans people in the media (including celebrities like Laverne Cox and Caitlin Jenner), and began to hear LGBT or LGBTQ thrown around a bit more in a political context. I remained empathetic towards those who came out as trans, and tried to remember the politically correct language as best I could, often at the cost of what I had learned to be grammatically correct in my AP English Language class. While I still did not really understand how being or feeling transgender could work, I did not hear anyone else questioning it and felt I could not without offending or being insensitive.

But I was not ready for the culture shock of university, a small, selective liberal arts college. On the first day of orientation after moving into my new dorm, we had a floor meeting in which we introduced ourselves by name, location, fun fact, and preferred pronouns. “Remember, you cannot assume ANYONE’S gender identity!”  I felt silly having to tell a room of 40+ people that I prefer she/her pronouns, yet many people, at least five or six, who looked obviously male or female announced that they preferred the opposite pronouns. No one flinched or stuttered or acted like this activity was superfluous–though one international student asked me later, privately, why we had to do that. One person even announced that “some days” she would prefer to be called she, but other days would be going by he. Everyone nodded along, as if, of course, this makes sense.

By one month into my freshman year, the number of trans people I knew personally or by association was growing steadily. The school is small enough that even if you don’t know someone by name, you’ve probably seen them around. There were many boys wearing eyeliner but those were boys. There were girls wearing eyeliner that were also boys. Boys with small beards that were actually girls. And everything in between. One of my roommates started dating a “cis-passing” trans boy. Someone I met at the beginning of the year whose name was Tim would now like me to relearn that name as Rebecca. Someone else who started school with hair to her waist cut it all off and became Andrew. If you can’t determine gender by someone’s appearance, why have gender at all? Why not just call each other by our biology, whether we are happy with it or not, if only for consistency and clarity’s sake? I was trying to be empathetic but it was not easy, and confusing at best. No one said anything skeptical, and neither did I.

Two months into my freshman year, the signs on the bathrooms in an academic building were changed. Rather than being marked for men/women, both bathrooms were now “multi-stall.” The only indication that one was for men was the small print “with urinals,” vs “without urinals.” …

It seemed that most of the students who were suddenly transitioning were biological females who were smart but socially awkward. They revealed their identities as trans men, usually through a haircut and new wardrobe, followed by a Facebook post alerting associates to a name and pronoun change. They would soon take to social media, student forums, and classroom discussions to rant about “cis privilege,” how oppressed they are because they get stared at by strangers, how they want to assault people who misgender them, and how in love with their “queer” identities they are.

A few weeks ago, a research paper was published suggesting that the recent increase in transgender identification among young people is the result of social contagion. This seems obvious to me. Yet officials at Brown University censored this paper. I shouldn’t be surprised. This is a topic that we can’t discuss on my college campus, either.

There is no doubt in my mind that there is a social contagion among college students. At my school, it is trendy to be transgender, and to people who feel like they don’t fit in, particularly with other people of their biological sex, choosing to transition to the opposite sex, and become a member of the opposite sex, may certainly seem like a more viable option than continuing to feel rejected while trying to fit in. But a lot of this culture surrounding trans teens and college students is aggressively narcissistic and cutesy — selfies captioned “i love being nonbinary,” “you’re gay no matter who you date,” and “baby’s first binder!” At best these random, new identities are invented to fit an aesthetic. At worst they are aggressively anti “straight white men,” apparently the worst species on earth and the ones responsible for all hardship, as they threaten professors and other students who dare to hint at an observation that doesn’t sound affirmative of transgender identities.

Within the past year, my second year at this college, I have had girlfriends who had to share a room with a biological male who decided, within the year, to change his name to Valerie. My two friends felt bad for Val, who was clearly socially awkward, had very low self confidence, and was always asking for their approval, (“do you think I look pretty?”). When they said yes of course, to validate Val, Val would reply with “I don’t think so.”

The odd part is that when we apply for housing we are able to select sex segregated or non-gender-based housing. If you select sex segregated as a female, you are paired with females, but if you select non-gender-based housing, you are paired with other people who selected non-gender-based housing, regardless of gender. These two girl friends of mine signed up for sex segregated housing, expecting to be roommates with only other females. Val signed up for non-gendered housing, yet it seems they did not have anyone to pair Val with, and thus decided it would be better to pair a biological male with two girls than two boys.

This is concerning for me, as a feminist. There is a reason why sex-segregated housing exists, and it is not for sexist reasons. Many, even most, women and college-aged girls are not comfortable sharing a room with a man they have never met. While sexual assault can happen in a number of circumstances, forcing women to room with men seems an easy way to increase the possibility. It has been important, historically, that women have spaces that are not open to men, for their own safety.

Similarly, this past year, on the “trans day of visibility,” all of the bathroom signs throughout school were replaced with paper signs that made all of the bathrooms gender neutral. This was done by the campus LGBT club, in order to make straight people get “what it feels like to decide which bathroom to use as a trans person.” I doubt this was accurate though, because I was still caught trying to decide which bathroom would not have men in it. I opted for the bathroom I remembered had been the women’s room, as did most women. One of my directionally challenged girl friends forgot which one it was and picked the men’s. She was immediately embarrassed and confused and went to hunt for the single stall a couple floors up. If our bathrooms were more European-style bathrooms, with floor to ceiling private doors, I would probably mind very little. However, these are cheap stalls that come up to your knees, and in the men’s room of course the urinals are open to all to see. One girl shared with me that she walked into the “women’s” gender neutral bathroom to find one of our younger male professors. She was overwhelmed and went to a different bathroom. She admitted to feeling bad, as she gets the point of gender neutral bathrooms and believes that trans people should be able to use any bathroom, but she just couldn’t bring herself to pee in front of our professor. Understandably.

What has been even more upsetting is to see is how quickly these new identities are accompanied by medical changes. I know several young women who were able to easily access testosterone soon after deciding they were trans. I know four who have had mastectomies. One is currently raising funds for her breast removal as part of  a GoFundMe campaign.

While I have tried my best, and initially succeeded, in believing the narratives of the transgender experience, it struck me at college that this phenomenon is so widespread, so political, and so trendy, that I am now completely dubious. I am not allowed to speak honestly and openly on this subject without being defamed as a conservative, a transphobe, intolerant, and anti-feminist. As someone who is not trans, I am not allowed to think or talk about trans issues unless I am agreeing with a trans person. Because I can’t know what it’s like to feel born in the wrong body.

At the present time, I now know about 30 trans people personally, and another 20 by name. Given that I attend such a small school, this is a very high percentage. Even the RA of my freshman year floor, who introduced herself two years ago with she/her pronouns, now goes by he/him and identifies as a boy.

This issue became personal when my childhood friend announced she is transgender, We played with Barbies and dressed as Disney princesses when we were young. We talked about our crushes on boys, and experimented with makeup and fashion when we were teens. I can’t believe that she really thinks she is a man. She plans to medically transition. I am scared for her.  But I am afraid to say anything.

I find it biologically and statistically improbable that all of these people, born at around the same time, were actually “born in the wrong body.” I find it strange that they think they need hormones and surgery that will sterilize them permanently. What seems obvious to me is that they are uncomfortable with their bodies, suffer from other issues like anxiety and depression,  and see the attention and attractiveness of transition as a way out.

What I don’t understand is why all of my friends act like this is normal. Am I really the only one who has concerns? Or is everyone as scared as I am to say something?

Anyone who is paying attention knows the US holds the dubious distinction of being the world’s incubator for the “gender affirmative” approach. This treatment pathway–increasingly, the only pathway available in the United States–frequently consists of:

• full social transition for children, starting as young as toddlerhood;
• cross-sex hormones and even “top” and “bottom” surgeries for young teens, some of whom showed no childhood gender discomfort and only announced a trans identity in adolescence; and
• affirmation of a child’s trans identity at any age, regardless of other possible causative/related factors (such as autism, social contagion, or same-sex attraction). Some of the more fervent US clinicians eschew careful psychological assessment before they prescribe full social and/or medical transition, asserting that such thorough evaluation is unnecessarily onerous or “triggering” to the young patient.

The American Academy of Pediatrics recently released a policy statement  which essentially rubber-stamps the affirmative approach. (While the Academy itself has tens of thousands of members, a recent article pointed out that the policy document was the work of a very small, activist-inspired subgroup). The AAP document creates the impression that affirmative treatment is a matter of settled clinical consensus.

Nothing could be further from the truth.

The AAP policy has a number of glaring flaws. To take just one example, it omits a significant body of research evidence that is inconvenient to the AAP’s affirmation-only doctrine. Worse: the research the AAP document does cite ironically substantiates the very “watchful waiting” approach dismissed by the AAP. The truth is, this more cautious approach is the most commonly used and evidence-based treatment for childhood gender dysphoria recognized by clinicians around the world.

There’s a lot more to pick apart in the AAP’s policy statement, and James Cantor, PhD., a Toronto-based sexologist, researcher, and clinical psychologist, did just that today. His long (but worth it) fact-checking article is required reading for anyone interested in the topic of pediatric transition.

Please read and share Dr. Cantor’s piece widely. You can read the whole thing here.

by Michael Biggs

Michael Biggs is Associate Professor of Sociology at the University of Oxford and Fellow of St Cross College. He researches social movements and collective protest.

Pediatrics just published an article showing that trans-identified children are substantially more likely to report attempted suicide than the general adolescent population. When the results are examined closely, however, we find that the risk extends to kids who identify as lesbian, gay, or bisexual. Emphasis on the exceptional fragility of trans adolescents overlooks the importance of sexual orientation. Indeed, my analysis suggests that gender-nonconforming girls are the most vulnerable, whether they consider themselves to be transgender, bisexual, or lesbian.

Previous evidence on suicide attempts among trans-identified youth has been methodologically flawed, even ignoring the most egregious examples. First, surveys have recruited respondents haphazardly—rather than sampling from a population. Second, respondents have not been asked for their sex, but only for their gender identity. In the United Kingdom, Stonewall’s School Report was marred on both counts.

Toomey, Syvertsen, and Shramko (2018)’s article in Pediatrics provides the first rigorous study of self-reported suicide attempts. They use data on 121,000 adolescents aged from 11 to 19, who were surveyed at schools across the United States. The findings, as reported by LGBTQ magazine The Advocate, are dramatic:

Bear in mind that asking respondents whether they have ever attempted suicide will elicit an overestimate of the actual rate; we know from other studies that more probing questions are needed to distinguish genuine attempts to end life. Therefore we should interpret ‘attempted suicide’ broadly, to include all self-harming behaviors, including those not intended to result in death.

When the original article is examined closely, the results are more complicated than the headline suggests. The authors statistically analyze all the risk factors for attempted suicide, including sex and gender identity, sexual orientation, age, race, and parental education. Surprisingly, perhaps, the biggest single risk factor is actually sexual orientation.

The authors are publishing a companion article on sexual orientation. Until that becomes available, it is possible to estimate (from their Table 2) how the risk of attempted suicide varied according to different combinations of gender identity and sexual orientation—after adjusting for other characteristics like age and race.

The calculation is straightforward for heterosexual, lesbian, gay, and bisexual teens who were not trans-identified. (For simplicity the intermediate categories of ‘mostly heterosexual’ and ‘mostly lesbian or gay’ are omitted.) For each transgender category, I calculate the risk averaged across the observed distribution (from Table 1) of sexual orientations within the category. A caveat is that the these estimates have considerable margin of error because they derive from small numbers: 202 identified as male-to-female, 175 as female-to-male, and 344 as not exclusively male or female (‘nonbinary’ for short). A further 1,052 adolescents were not sure of their gender.

The graph above shows the estimated odds of a student reporting attempted suicide, compared to heterosexual boys. As the Advocate emphasized, teens who identified as female-to-male transgender had the highest risk of attempted suicide; the odds were four times higher than for heterosexual boys. What went unnoticed is that the risk was just as high for bisexual girls.

The next highest rates (triple the odds compared to heterosexual boys) were for bisexual boys, lesbian girls and for kids who identified as nonbinary. The latter’s sex was not recorded, but the majority are likely to be female; other survey evidence suggests that two-thirds of trans-identified adolescents are female (Eisenberg et al. 2017).

The next highest rates (roughly double the odds for heterosexual boys) were for gay boys, for male-to-female transgender kids, and for kids who were unsure of their gender identity (whose sex was not recorded). Finally, heterosexual girls had a significantly higher risk than heterosexual boys.

Stephanie Davies-Arai and Nic Williams’ critique of Stonewall’s School Report suggested that “[t]he ‘transgender’ category may just serve to cover up the scale of suicide attempts and self-harm rates of girls and young women.” Their conjecture is vindicated by this survey evidence from the United States. Over two thirds of the girls who identified as boys were sexually attracted to females (inferred from the proportion calling themselves heterosexual or bisexual), and so arguably are most similar to lesbian and bisexual girls. In sum, then, gender-nonconforming females were the group most likely to report attempted suicide, regardless of whether they identified as male or nonbinary—or as bisexual or lesbian.

The letter from the parents’ Gender Critical forum (discussed and reproduced below) is also an online petition. To tell the American Academy of Pediatrics that kids deserve more careful assessment and cautious treatment than the affirmation approach recommended by the AAP, you can sign the petition here.

A group of parents from the 1000+-member Gender Critical Support forum (gendercriticalresources.com) launched a communications campaign this week in response to the recent policy statement about medical treatment for trans-identified children issued by the American Academy of Pediatricians (AAP). Members of the Gender Critical parents’ forum assert that affirmation therapy is a potentially harmful approach, and detail their perspective in the letter they are sending to the AAP Executive Committee, Board Members, Ethics Committee, and to doctors who will speak at the organization’s annual conference in Florida, November 2-6, 2018.

In an email, representatives of the Gender Critical parent forum told 4thWaveNow:

We parents know first-hand the results of the affirmation approach because many of our teens have been subject to it. Many of our children were offered prescriptions after one or two doctor visits, or they were given a referral to a gender clinic to consult about transition after no attempt was made to explore other reasons for the sudden transgender claim.

In many areas of the United States, it’s no longer considered a matter of commonsense to question a sudden announcement of being “born in the wrong body” in adolescence (with no previous signs), especially when preceded by or concurrent with anxiety, depression, autism, and/or questioning of sexual orientation. This affirm-only approach is outside the mainstream of international practice. We’ve outlined five problems with the fundamentals of the AAP’s policy statement in our letter to them.

The letter from the parents’ Gender Critical forum is also an online petition, reproduced in its entirety below. To tell the AAP that kids deserve more careful assessment and cautious treatment than the affirmation approach recommended by the AAP, you can sign the petition here.

4thWaveNow responded briefly to the AAP policy statement in this earlier post. Readers may also be interested in a critique of the AAP’s policy statement written by James Cantor, PhD., available at this link.

Dear American Academy of Pediatrics (AAP):

We need you and our children need you. There is a great and growing disservice that needs your attention, scientific curiosity, critical thinking, clinical experience, and compassion.

We have serious concerns about the AAP’s Policy Statement “Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents” (Rafferty et al., 2018). While we believe that AAP’s intention behind this position statement is to protect the health of today’s gender-diverse youth (children through young adults), we are deeply concerned that the clinicians using affirmation therapy are inadvertently inflicting physical and psychological harm.

We are members of a rapidly growing online community of over 1,100 parents of transgender-identifying youth who need your help. We have no unifying political affiliation. We empathize with mature transgender-identifying people who deserve respect. We need to stop the harm to our children.

It is our concern that the AAP’s Policy Statement will continue, and possibly worsen, the harm brought to many children by the recent radical changes to treatment guidelines for transgender-identifying youth. Over the past decade, there has been an exponential rise of predominantly adolescent girls who are suddenly declaring themselves trans after the onset of puberty and who have no previous history of gender dysphoria (GD). Historically, GD showed at a much earlier age and has been exceedingly more common in boys. A recent groundbreaking study of an emergent late-onset, predominantly female trans-identifying patient population, finds significant parallels with the phenomenon of eating disorders, and includes social contagion as a key factor (Littman, 2018). The drastic increase in trans-identification and the switch to the predominant adolescent girl patient has prompted the United Kingdom (UK) Government to launch an investigation over concern that the 4400% increase in the last decade could be due to a social phenomenon (Rayner, 2018).

There is great harm being done to girls and some boys by medicalizing their gender non-conforming (GNC) behavior based on gender stereotypes, homosexuality, and/or underlying mental health issues that have led to trans-identification. The medicalization with gonadotropin releasing hormone (GnRH) agonists is highly experimental and comes with serious long-term consequences for bone health, potentially for neurological health, and as sterilizes the child when followed by cross-sex hormones. The harms of sex-aligned hormones (e.g., testosterone given to natal males) are well-known, include significant cardiovascular disease, and are increasingly exposed in lawsuits for non-transgender adults. Astonishingly, cross-sex hormones are given to the opposite sex in trans-identifying adolescents who are expected to be treated for their full lives and have permanent effects. The harms of surgeries are self-evident and irreversible, which is problematic for youth who change their minds.

The justification for non-FDA–approved medicines and surgeries is that the youth will commit suicide if these drastic measures aren’t taken (although this is not acknowledged in the AAP’s statement). There is no clinical data that supports that medical transition prevents suicide. Contrarily, long-term studies (>10 years) demonstrate increases in suicide rate, psychiatric hospitalization, and lower quality of life after sex reassignment surgery in adults (Dhejne et al., 2011; Simonsen et al., 2016; Kuhn et al., 2009).

Most transgender youth in the US who were reported in the news as having completed suicide were affirmed by social transition; thus, disproving that affirmation prevents suicide completion. The Williams Institute California GNC study reported that the percentage of teens identifying as either highly GNC or as androgynous has increased to nearly 30% and that neither group statistically differ from non-GNC teens in rates of lifetime suicide thoughts and attempts (Wilson, 2017). Furthermore, the risk of suicide in transgender-identifying youth is comparable or even less than that of youth who are non-heterosexual but who are not trans (CDC 2018, page 24, col 2, para 5), who have eating disorders (Smith, 2018), or who are referred to youth mental health services in the UK (GIDS, 2018) and yet, the “transition or die” mantra pervades as if transition is the only option.

We ask that you (1) consider our knowledge-based concerns presented as a scientific rebuttal to five main points made in the AAP position statement, (2) query AAP and other pediatricians anonymously to understand broader views, (3) conduct a more inclusive scientific debate with GD experts critical of affirmation therapy (e.g., gdworkinggroup.org) and (4) retract the AAP statement pending your inquiry. Please consider this letter a call to lead the way in exploring alternative non-invasive, non-harmful treatments. Your AAP oversight over the smaller subcommittee of “trans experts” is urgently needed.

1. THE PROBLEM OF DIAGNOSIS
   

Rafferty et al. state “transgender identities and diverse gender expressions do not constitute a mental disorder.” (p 4) and “Some youth who identify as TGD also experience gender dysphoria, …” (p 3)

If transgender-identification is not a mental disorder, what is it? Is it a medical condition? If so, how is it diagnosed? How can the TGD “condition” be both a mental health disorder for “some youth” and not for others but both are treated the same way?

These questions are never answered directly by Rafferty et al. or other “trans experts,” as well as the American Psychological Association (APA) and the World Professional Association for Transgender Health (WPATH) because the answer is simply that the youth just needs to proclaim that they are transgender – it is purely self-diagnosed.

If “being transgender or gender diverse” isn’t a mental disorder or a medical condition, why are youth treated with the life-altering, non-FDA-approved drugs (experimental GnRH agonists are used for years and hormone therapies are used for a lifetime) and irreversible, serial cosmetic surgeries in an attempt to achieve a scientifically impossible goal?

We have experienced doctors giving prescriptions without adequate mental health consideration and after only 1-2 visits.

Summary: Diagnosis is the youth’s self-diagnosis. The life-altering medical treatments offered do not match the diagnostic process or the clinical evaluation standards of medicinal or surgical safety and efficacy.

2. THE PROBLEM OF MENTAL HEALTH & TRANS-IDENTIFICATION: “CHICKEN & THE EGG”

Rafferty et al. acknowledge that trans-identifying youth have “high rates of depression, anxiety, eating disorders, self-harm, and suicide” (p 3) and that “If a mental health issue exists, it most often stems from stigma and negative experiences rather than being intrinsic to the child” (p 4)

The view that trans-IDing youth have mental health problems because of their incongruity with their natal sex is a widespread assumption among “trans experts.” Another valid hypothesis is that mental health issues cause the person to trans-identify. Normal adolescent challenges coupled with the recent unfortunate declines in adolescent mental health (e.g., increases in anxiety, depression, self-harm, and suicide), the social media and iPhone explosion (Twenge et al., 2017), and the plethora of platforms targeting youth with transgender promotion are a recipe for adolescent trans-identification.

The role that mental health plays in a sudden proclamation of transgender status is discussed in a peer-reviewed scientific study that only begins to investigate the social influences on trans-identifying youth and reveals the emergence of rapidnset gender dysphoria (ROGD; Littman, 2018).

Physicians, GD experts and clinicians have been critical of the rush to affirm an adolescent’s trans-identification, especially where no history of GD exists. Some of these professionals are part of the Pediatric and Adolescent Gender Dysphoria Working Group (gdworkinggroup.org), but many, including several AAP pediatricians are not voicing their concern in public for fear of career reprisal (Kearns, 2018).

Trans-identification offers a way out of the misery of poor mental health, misogyny, loneliness, and hatred of oneself. It offers a completely new identity (i.e., it’s identity suicide with the advantage of being reborn). Trans-identification provides body alteration, commands authority figures to alter their language and behavior, comes with a fight for social justice, and provides a sense of belonging. Can you see this ultimate recipe for disaster? We see it playing out in our homes every day and it is torture that this is therapist- and pediatrician-sanctioned and encouraged.

Summary: We have experienced that providers (pediatricians, psychologists, etc.) do not explore, or only superficially inquire about, on-going or historical mental health, trauma experiences, or any potential causes of trans-identification before affirming the child’s self-diagnosis and proceeding with medical treatment, which is consistent with Dr. Littman’s study. We have also experienced that our children are using transgender-identification as a maladaptive coping mechanism as discussed in Dr. Littmans’s study. This idea is also supported in the context of anorexia nervosa and demonstrates similar adolescent clinical presentation profiles and social contagion aspects with the modern additional factor of pervasive social media exposure to transgender promotion.

3. THE PROBLEM OF IGNORING DESISTANCE & DETRANSITION

Rafferty et al. state “…children who are prepubertal and assert an identity of TGD know their gender as clearly and as consistently as their developmentally equivalent peers who identify as cisgender…” (p 4)

Eleven scientific studies indicate that transgender-identification is transient in most youth as demonstrated by desistance from transition and/or ceasing trans-identification after puberty (Cantor 2017). The dismissal of all 11 of these studies by Rafferty et al. is not scientifically validated by two citations consisting of opinion statements written by pro-affirmation extremists (Ehrensaft, 2018; Olson, 2016) who decide to throw out all the data that was astonishingly reproducible. All 11 studies demonstrate 60-90% of prepubertal children desist and further detailed scientific discussion has refuted criticisms of this unanimity of research findings (Zucker, 2018). In fact, two of the three references cited by Rafferty et al. that are used erroneously to cite support for affirmation therapy (see below under “the problem of not applying clinical science”), state that fewer than 20% of children persist in their transgender identity following puberty. In addition to the clinical data, desistance and detransition occur regularly as evidenced by verified published anecdotal accounts in several publications, all in 2018 alone (Anderson, 2018; Brunskell-Evans, 2018; Hope, 2018; Singal, 2018; Sullivan, 2018).

Several GC forum members are parents of desisters. Some of our children recognize that their trans-identification was part of a maladaptive coping mechanism. One girl desister says she was “ridiculously shy and incredibly awkward” and states that “I became depressed and I hated myself. I hated everything about me: my body, the way my voice sounded, my awkward personality, my face. Everything. I began questioning why I felt so awkward in my body and why I hated myself. I started questioning my gender. Not before long, I was 100% sure that I was actually a boy.” Many of our children have comorbid mental health issues and many watched some of the top 100 YouTube transgender celebrity vloggers in admiration just prior to their trans-identification.

Our families have experienced tremendous and unnecessary suffering brought on by irresponsible transgender promotion and iatrogenic therapy and there are thousands more who are trans-identifying for the same wrong reasons and yet they are 100% convinced of their self-diagnosis as well as their therapists, teachers, doctors, and some parents who accept their self-diagnosis as recommended by APA, WPATH, and now, AAP.

Summary: Desistance is the most common outcome among children. Persistence of the exponentially increased population of predominantly natal female, late-onset GD adolescents (including those newly identified as having ROGD) has not been studied. Today, youth are affirmed and either receive treatment or wait until they can get treatment, thus ensuring that they will be more likely to persist. Mistaken medical affirmation leading to detransition occurs regularly.

4. THE PROBLEM OF TRANSGENDER-IDENTIFICATION ETIOLOGY

Rafferty et al. state “gender identity evolves as an interplay of biology, development, socialization, and culture…” (p 4)

Three of these factors in determining if a youth will trans-identify can be summarized as the effect of the environment on the youth’s cognitive processes during development. This is exactly as we have experienced; these social factors are the dominant factors, and not biology. Evidence for social contagion is emerging in the literature (Littman, 2018) and is consistent with our experiences. By immersing themselves in trendy transgender-indoctrinating videos recommended when they open YouTube or when their friend groups decide they are transgender together in clusters, they become myopically fixated on transition.

When the natural developmental pubertal processes are artificially ceased by treatment with GnRH agonists, this negates the adolescent’s natural ability to desist from gender confusion. The majority of gender dysphoric youth desist after puberty, thus, stopping these profoundly important integrated developmental processes of neurochemistry and physiology can prolong persistence of GD. This is demonstrated by gender clinics admission that approximately 100% of children on GnRH agonists continue onto cross-sex hormones (Olson, 2018). It is also demonstrated in a study conducted at the Gender Identity Development Service (GIDS) where “persistence was strongly correlated with the commencement of physical interventions such as the hypothalamic blocker (t=.395, p=.007) and no patient within the sample desisted after having started on the hypothalamic blocker. [In contrast,] 90.3% of young people who did not commence the blocker desisted. For the children who commenced the blocker, feeling happier and more confident with their gender identity was a dominant theme that emerged during the semi-structured interviews at 6 months. However, the quantitative outcomes for these children at 1 years’ time suggest that they also continue to report an increase in internalising problems and body dissatisfaction, especially natal girls. [emphasis added]” as presented at a WPATH symposium (Carmichael, 2016).

As for the biological underpinnings of transgenderism, we know that it is not purely genetic as demonstrated by only 28% concordance in monozygotic twins and we know little else. Neuroimaging studies provide no unifying observations. The few MRI studies that show a minor difference in neuroanatomical substructures, gray matter volume, or cortical thickness are overtly flawed by the use of subjects who have been living daily life as a transgender individual (years of neuroplasticity at play), many have been using cross-sex hormones resulting in a myriad of neuroendocrine and potential neuroplastic changes, and most egregiously, cannot possibly rule out the probability that these small differences are due to personality differences such as the tendency to engage in behavior that is stereotypically associated with the opposite sex (gender non-conforming [GNC]) or such as homosexuality.

Most kids who desist grow up to be gay (Wallien et al., 2008). Are we converting “gays” to “straights”? Perhaps extremes on both sides of the political spectrum have motivations to accept or even encourage their child to trans-identify. Far-right parents may be embarrassed by GNC behavior and homosexuality and far-left parents may be eager to embrace the latest civil rights movement.

We are accepting of our kids’ GNC behavior and/or homosexuality. We don’t accept that their bodies are wrong and need to match gender stereotypes or become heterosexual.

Summary: There are several factors and individual trajectories leading a youth to trans-identify with the most dominant factors being environmental. The “trans experts” have ignored all environmental factors, attempted to over-emphasize any biological components, failed to tease-apart GNC behaviors or homosexuality from any minor biological basis of transgender identification, and focused solely on the false position that the youth is infallible in their self-diagnosis despite conclusive clinical evidence that children diagnose themselves incorrectly 60-90% of the time.

5. THE PROBLEM OF NOT APPLYING CLINICAL SCIENCE

Rafferty et al. states “There is a limited but growing body of evidence that suggests that using an integrated affirmative model results in young people having fewer mental health concerns whether they ultimately identify as transgender.” (p 4)

Two of the three references provided to support this statement contain no data and do not reference clinical data supporting this claim (Edwards-Leeper, 2012; Menvielle, 2012). One reference is a parent survey with inclusion criteria of parents who were seeking affirmation therapy and therefore biased in their ratings of affirmation therapy (Hill et al., 2010). Numerous other flaws include that some surveys were completed at baseline before affirmative care was administered and that the sample was unrepresentative of the study populations used for comparison in terms of social class and an unusually high adoption rate (52%). All these flaws and more have been eloquently discussed in Singh et al., 2011.

Rafferty et al.’s “growing body of evidence” turns out to be an erroneous, unsupported claim. The use of citations to support affirmation therapy were fact-checked by Clinical Psychologist James Cantor (Cantor, 2018). His critical commentary reveals how the citations actually demonstrate that the most common outcome of GD is desistance, the watchful waiting approach (not affirmation) is the approach recommended by most experts and institutions, and the citations used to claim that therapists opposed to affirmation therapy are engaged in conversion therapy have nothing to do with GD because they are studies on homosexuality (not GD). There are no comparative clinical studies between (1) affirmation therapy, which includes consideration or engagement in affirmative pharmaceutical therapies and serial cosmetic surgeries and (2) other non-affirmation therapies that exclude medicalization (but it can be reserved it as a last resort for the distant future).

This grave scientific error is repeated in the on-going National Institute of Health (NIH) study where there is no comparative or control group and only affirmation therapy is tested in clinic-registered youth (Olson, 2015). An example of an appropriate comparative therapy group would include one that was holistically treated for underlying mental health issues, engaged in regular physical activity that is enjoyable to the youth, assisted with building strong social connections, and supported by loving families who do not affirm that the youth is in the wrong body and instead only ask the youth to be open to all the possible reasons why they feel that way. “Watchful waiting” approach could be enhanced by exploring and resolving the youth’s underlying mental health issues and improving psychosocial skills, mind-body connection (i.e., engaging in physical activity), and family dynamics.

There is no mention of evaluating efficacy of affirmation therapy by Rafferty et al. Even the cited scientific publications do not evaluate efficacy of affirmative medical treatments and only offer speculation. Where is the data? Data need to show unequivocally that youth will benefit over the course of their lives from the experimental therapies.

The serious safety risks of GnRH agonists and cross-sex hormones (used alone or in combination) include cardiovascular events (venous thromboembolic disease, myocardial infarction and death), bone growth inhibition, psychological (e.g., aggression), sterilization, sexual dysfunction and potential neurological risks; all of which are scarcely mentioned in the position statement. No studies exist on the effects of these pharmaceuticals on children treated over five years and cross-sex hormones are intended for lifelong use. Long-term (>10 years) studies have demonstrated that medical transition leads to worsening of mental health and worsening of physical outcomes (Dhejne et al., 2011; Simonsen et al., 2016; Kuhn et al., 2009).

Herein lies another error in the ongoing NIH study (Olson, 2015) in that outcomes for efficacy and safety need to span past 10 years to justify the lifelong intention to medicate these youth; however, the study duration is only listed for 5 years. The idea of a honeymoon period post transition followed by a period of a return to worse mental health is supported by experienced psychiatrist, Dr. Roberto D’Angelo, who works with teen and adult trans-identifying people and their families. He has seen “that difficulties can resurface many years later and often these are the original difficulties that the person hoped transitioning would address”(gdworkinggroup.org). In contrast, Dr. Johanna Olson, one of the NIH authors, belittles the tragedy of regret by saying, “And here’s the other thing about chest surgery: If you want breasts at a later point in your life, you can go and get them” (Robbins, J, 2018).

We have used several supportive but non-affirming strategies and some of us have seen our children desist. Many of the strategies we’ve tried are reflected in the caring guidance offered by two clinical professionals, Lisa Marchiano and Sasha Ayad, who consider the full context of the youth’s experience, history, and parental input (Marchiano, 2017; Toward a more nuanced exploration, 2018).

Summary: With no clinical data and a flawed ongoing NIH study, how can the medical transition of youth who would normally desist be justified? Modern non-affirming strategies need to be evaluated.

CONCLUSION

After you consider our concerns and engage in critical evaluation, can you stand by this position statement? How about other AAP pediatricians (those outside the committee who authored this statement) – do they stand by it? We request that you investigate their attitudes and observations by surveying them – anonymously so they aren’t targeted for non-compliance with the forces of transactivism. We request that you stand by the AAP’s commitment to be “Dedicated to the health of all children” and retract this position statement while you conduct an inquiry.

If you have any doubt as to why we are anonymous, you need to look no further than Rafferty et al.’s recommendation to consider legal “support” in cases where parents do not comply with subjecting their children to experimental therapies (p 8).

Similarly, pediatricians and therapists remain silent or anonymous after witnessing the slander of those using non-affirmation approaches as demonstrated by world-renowned GD expert, Dr. Kenneth Zucker (Singal, 2016), and his long-awaited vindication (CAMH, 2018; The Canadian Press, 2018).

Please read our enclosed GC forum letter (also available at https://gendercriticalresources.com) with our four proposals and more support for our position (including further discussion on transgender suicide) with many more references that couldn’t be included here.

Copies of this letter and the enclosed have been sent to the media.

We sincerely thank you for your consideration,

Parents of trans-identifying youth

REFERENCES (note: all links were accessed October 2018)

CAMH Apology. (n.d.). Retrieved from https://www.camh.ca/en/camh-news-and-stories/camh-apology

Cantor, J (2017) How many transgender kids grow up to stay trans? PsyPost https://www.psypost.org/2017/12/many-transgender-kids-grow-stay-trans-50499.

Cantor, J (2018) American Academy of Pediatrics policy and trans- kids:Fact-checking. (n.d.). Retrieved from http://www.sexologytoday.org/2018/10/american-academy-of-pediatrics-policy.html

Carmichael, P et al. (2016) Gender Dysphoria in Younger Children: Support and Care in an Evolving Context (n.d.). WPATH Symposium. Retrieved from http://wpath2016.conferencespot.org/62620-wpathv2-1.3138789/t001-1.3140111/f009a-1.3140266/0706-000523-1.3140268

Center for Disease Control (CDC) (2018) MMWR Surveill Summ 2018;67(No. 8) Retrieved from https://www.cdc.gov/healthyyouth/data/yrbs/pdf/2017/ss6708.pdf

Dhejne, C. et al. (2011) Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PloS one, 6(2), e16885.

Edwards-Leeper, L & Spack N (2012) Psychological Evaluation and Medical Treatment of Transgender Youth in an Interdisciplinary “Gender Management Service” (GeMS) in a Major Pediatric Center, Journal of Homosexuality, 59:3, 321-336.

Ehrensaft, D et al. (2018) Prepubertal social gender transitions: What we know; what we can learn—A view from a gender affirmative lens. International Journal of Transgenderism, 1-18.

Gender Identity Service (GIDS) (2018) Our response in full to the ITV series Butterfly Retrieved from http://gids.nhs.uk/news-events/2018-10-15/our-response-full-itv-series-butterfly

Hill, D et al. (2010) An affirmative intervention for families with gender variant children: Parental ratings of child mental health and gender. Journal of sex & marital therapy, 36(1), 6-23.

Hope, L (2018) Is changing gender the new anorexia? We investigate if transgenderism has become a coping mechanism for teens. The Sun. Retrieved from https://www.thesun.co.uk/fabulous/7362652/changing-gender-new-anorexia/amp/?__twitter_impression=true

Kearns, M (2018) Don’t Let Transgender Activists Politicize Child Health Care. National Review. Retrieved from https://www.nationalreview.com/2018/10/dont-let-transgender-activists-politicize-child-health-care/

Kuhn, A et al. (2009) Quality of life 15 years after sex reassignment surgery for transsexualism. Fertil Steril. 92:1685–9.

Littman, L (2018) Rapid-onset gender dysphoria in adolescents and young adults: A study of parental reports. PloS one 13(8): e0202330. https://doi.org/10.1371/journal.pone.0202330.

Marchiano, L (2017) Guidance for Parents of Teens with Rapid Onset Gender Dysphoria. Retrieved from https://inspiredteentherapy.com/guidance-parents-teens-rapid-onset-gender-dysphoria/.

Menvielle, E (2012) A comprehensive program for children with gender variant behaviors and gender identity disorders. Journal of Homosexuality, 59(3), 357-368.

Olson, J et al. (2015) The Impact of Early Medical Treatment in Transgender Youth. Retrieved from http://grantome.com/grant/NIH/R01-HD082554-01A1 Accessed October 2018.

Olson, J (2017) Deciding when to treat a youth for gender re-assignment. https://www.kidsinthehouse.com/teenager/sexuality/transgender/deciding-when-to-treat-a-youth-for-gender-re-assignment

Olson, K (2016) Prepubescent transgender children: What we do and do not know. Journal of the American Academy of Child & Adolescent Psychiatry, 55(3), 155-156.

Rafferty, J & Committee on psychosocial aspects of child and family health (2018) Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics, e20182162.

Rayner, G (2018) Minister orders inquiry into 4,000 per cent rise in children wanting to change sex. Retrieved from https://www.telegraph.co.uk/politics/2018/09/16/minister-orders-inquiry-4000-per-cent-rise-children-wanting/

Robbins, J (2018) U.S. Doctors Are Performing Mastectomies On Healthy 13-Year-Old Girls. Retrieved from https://thefederalist.com/2018/09/12/u-s-doctors-performing-double-mastectomies-healthy-13-year-old-girls/

Singal, J (2016) How the Fight Over Transgender Kids Got a Leading Sex Researcher Fired. New York Magazine. https://www.thecut.com/2016/02/fight-over-trans-kids-got-a-researcher-fired.html

Singh, D et al. (2011) Commentary on “An Affirmative Intervention for Families with Gender Variant Children: Parental Ratings of Child Mental Health and Gender” by Hill, Menvielle, Sica, and Johnson (2010). Journal of Sex & Marital Therapy,37(2), 151-157. doi:10.1080/0092623x.2011.547362

Simonsen, R et al. (2016) Long-term follow-up of individuals undergoing sex reassignment surgery: Psychiatric morbidity and mortality. Nordic journal of psychiatry, 70(4), 241-247.

Smith, A et al. (2018) Eating disorders and suicidality: what we know, what we don’t know, and suggestions for future research. Current opinion in psychology, 22, 63-67.

The Canadian Press (2018) CAMH reaches settlement with former head of gender identity clinic. CBC News Retrieved from https://www.cbc.ca/news/canada/toronto/camh-settlement-former-head-gender-identity-clinic-1.4854015

Toward a more nuanced exploration: An interview with Sasha Ayad. (2018) Retrieved from https://4thwavenow.com/2018/09/20/toward-a-more-nuanced-exploration-an-interview-with-sasha-ayad/

Twenge, J (2017) Are Smartphones Ruining a Generation? The Atlantic https://www.theatlantic.com/magazine/archive/2017/09/has-the-smartphone-destroyed-a-generation/534198/

Wallien, M. & Cohen-Kettenis, P (2008) Psychosexual outcome of gender-dysphoric children. Journal of the American Academy of Child & Adolescent Psychiatry, 47(12), 1413-1423.

Wilson, B et al. (2017) Characteristics and Mental Health of Gender Nonconforming Adolescents in California: Findings from the 2015–2016 California Health Interview Survey. The Williams Institute and UCLA Health Center for Health Policy Research

Zucker, K (2018) The myth of persistence: Response to “A critical commentary on follow-up studies and ‘desistance’ theories about transgender and gender non-conforming children” by Temple Newhook et al. (2018), International Journal of Transgenderism, 19:2, 231-245.

UPDATE

WordPress/Automattic, which hosts the 4thWaveNow website, has now sanitized the post below by redacting the name of the individual Gallus Mag describes in her statement. This is censorship. We are currently exploring our options and way forward. Please bear with us.

4thWaveNow reached out to Gallus Mag of GenderTrender after WordPress dumped the site yesterday. In her most recent post, Gallus Mag  broke the full story of a Canadian MTF trans activist who has launched “human rights” complaints against a group of women’s salon workers who were unwilling to touch and wax male genitalia. GallusMag revealed other details about the activist’s prior social media activities, some of which pertained to underage girls.

GenderTrender’s importance as a groundbreaking investigative reporting outlet covering the excesses of transgender activism cannot be overstated. The site has also served as an incubator and launching pad for many other bloggers and writers; 4thWaveNow’s founder counts herself among them.

The loss of GenderTrender is a huge blow. It is also the latest casualty in a growing clash between, on one side, a loose coalition of feminists, parents, gay and lesbian people, detransitioners, free speech advocates, clinicians, and other supporters; and on the other side, a collection of extremist transgender advocates who will tolerate no dissent from anyone, from any quarter.

Gallus Mag’s statement follows.

Today Gallus Mag informed us that her statement, published in our previous post, has been retroactively edited. Specifically, someone at WordPress/Automattic redacted the name of the Canadian individual who–as Gallus Mag described in her statement–has brought a Human Rights Tribunal action against sixteen working class estheticians who did not want to wax the individual’s scrotum and testicles. This individual’s name was replaced by “[redacted]” in the four places it appeared in the original GenderTrender statement. This was a surprise to us, since we have done no editing to the statement, which we published, unchanged, exactly as sent to us by Gallus Mag.

Interestingly, the “deadnames” of Caitlyn Jenner (Bruce Jenner) and Donna Perry (Douglas Perry) were NOT redacted. This would seem to indicate that the new policy put in place by WordPress/Automattic only applies to the Canadian trans activist Gallus Mag named in her statement. This is very interesting, given that the individual’s human rights tribunal case is in Canada, and both 4thWaveNow and the (currently suspended) GenderTrender sites are located in the United States.

Below is how the post containing the GenderTrender statement now appears.

We are now considering our options, which include moving our site to a new platform. We intend to reproduce Gallus Mag’s statement again, in full, as soon as possible. Stay tuned.

UPDATE: 4thWaveNow reached out to WordPress support, asking for an explanation. In an email response from an employee named Clark with the title “Community Guardian,” he stated an email had been sent to us several days ago; we did locate the email in our spam folder after hearing from Clark. The most pertinent information [emphasis added by us here, in bold]:

We received a report regarding the publication of private/personal information on your blog. Specifically:

https://4thwavenow.com/2018/11/17/wordpress-dumps-gendertrender-gallus-mag-responds/

(The malicious publication of private details related to gender identity, including former names.)

Publishing this type of content is forbidden by our Terms of Service, and we’ve hidden this content from public view.

Please desist from publishing content that violates our private information policy.

Can you please explain how there was a “privacy violation”? The name you redacted was used PUBLICLY by the individual in question, across social media, including LinkedIn, Facebook, Twitter, and elsewhere, It is not a “former” name. It is the individual’s legal name.

Also, this is the first I’ve heard that WordPress can go into a post and actually make manual edits to text. Is that what occurred here?

Thanks for your attention.

by Brie Jontry

 Brie Jontry is public spokesperson for 4thWaveNow and the mother of a teen who temporarily believed she was a trans boy. Brie can be found on Twitter at @bjontry.

We appear to be living in an age of heightened ideological dualism and false dichotomies. Nowhere is this more obvious than if you’re the parent of a gender-engrossed young person, and you’re desperate for objective information about how to best support your loved one. But parents who turn to the Internet to learn about the seemingly sudden distress that’s gripped their children are likely to find only one response: “affirmation.”

What does “affirmation” mean in this context? If you thought it meant affirming (as in acknowledging the reality of) a child’s distress and other assorted negative feelings surrounding their expected adherence to sex-rooted gender norms, you’d be mistaken. Increasingly, affirmation means confirming a child’s belief that there is something incongruent between their body and their mind and the belief that their body is afflicted by a kind of birth defect that only appears around puberty. To hear many trans advocates and certain clinicians tell it, the natural development of a sexed body is traumatic, dangerous, and possibly even deadly.

Like just about every other social and political issue currently being debated, the approach to helping kids uncomfortable in their born bodies could be drawn on a spectrum with a wide field of grey between the two opposing ends: blanket affirmation of born-in-the wrong-body rhetoric on one side, and wholesale invalidation of a young person’s feelings and beliefs on the other.

I want to encourage all those concerned with this issue to take a deep breath and try their hardest to assume positive intent on behalf of all parents struggling to help their children. Claims of “child abuse” from both sides against obviously caring parents need to stop. A little empathy will go a long way toward encouraging more productive and meaningful conversations. Most parents, regardless of where they stand on the affirm-or-not spectrum, want the same thing: healthy, actualized, contented children.

For my part, I want to widen the scope of what it means to offer “affirmation” and encourage those who are skeptical of medical interventions to embrace validating their children’s discomfort. At the same time, I want to encourage those researching and caring for dysphoric youth to recognize that a large percentage of parents are already doing that: affirming their children’s distress, fully in support of their gender atypicality, and also, when needed, seeking out specialized mental health care for underlying issues prior to agreeing to hormonal and surgical interventions.

When my now teen daughter was four years old, I happened upon a philosophy of parenting that at once sounded both ludicrous and wonderful. “Radical unschooling,” I read, was practiced by parenting according to principles, not rules, and by nourishing a rich relationship built on trust between parent and child. I decided to forgo punishments in favor of seeing my child’s behavior as communication, which at that age, was often grounded in an unmet need or frustration. I prioritized not only supporting her interests, no matter how odd (road kill), or silly (The Wiggles), or redundant (The Wiggles), but also tried my hardest to understand what was interesting about the things my daughter chose to pursue.

Unschooling is often misunderstood as being “child-led.” It isn’t. According to Pam Sorooshian, one of my parenting and unschooling mentors:

The term, “child-led learning,” does emphasize something very important – that the child is the learner! I couldn’t agree more. However, it also disregards the significant role played by the parent in helping and supporting and, yes, quite often taking the lead, in the investigation and exploration of the world that is unschooling.

So when my 11-year-old daughter revealed to me that she thought she was a boy inside, I approached the news from the framework of partnered exploration. I supported her by listening, by learning about her interest, by doing research she couldn’t do for herself, by talking to others and talking about all kinds of things with others while she was near, by finding specialists who could help, and also by asking:

Why…?

Where do you think that comes from?

What does that mean to you?

How else could this be different?

What can I do?

I had always (already) accepted my kind, curious, creative, quirky, stereotype-bending child. There was never a second when I considered not walking beside her as she struggled with feeling wrong in her developing body. As she sorted through trauma and grief and went through the stages of forming her unique identity, our parental support was critical to keeping her safe.

I told her I would love her no matter what and help her however I could and that I would always have her back. I told her I didn’t care who she loved, how she dressed, or what name she chose to use.

I told her I didn’t think she was really a boy but I understood she wanted to be one. I told her I wasn’t convinced there was enough evidence that hormonal interventions would serve her well long-term.

I asked her what boys could do that she couldn’t? Why being a boy would be better? I listened. I affirmed her distress, her confusion, and her desire as valid emotions. I empathized as much as I could. I helped her find ways to feel stronger, to BE stronger, to feel safer, more secure, and better able to manage discomfort and ambiguity. Because I had spent her childhood up to this point prioritizing our relationship and not my position of authority, she trusted me to help her get what she wanted, which was to feel better about herself and her place in the world. I was lucky in one way: My child was still young enough that we both had the luxury of ample time to work on this together (unlike some rapid-onset older teens and their parents).

The vast majority of parents who read and contribute to 4thwavenow may not be radical unschoolers, but they still unconditionally love and accept their children. In fact, it is precisely because they unconditionally love and accept their children that they want more than anything to help them find ways to be at peace with themselves. No parent is perfect; all of us make mistakes, get frustrated, say or do the wrong thing at times. But despite (or even because of) our blunders, we can grow along with our children. We can model empathy, open-minded curiosity, a willingness to apologize when we get it wrong, and acceptance of ambiguity. In other words, we can and we do model a different kind of affirmation.

This article is a long read, and includes detailed analysis of several research studies. Interested readers may want to review the bibliography and familiarize themselves with the relevant studies in order to engage most meaningfully with this post.

As with all articles and comments on 4thWaveNow, the views expressed by the author in this piece are his own.

by Hacsi Horváth, MA, PgCert (Sheffield)

I am an adjunct Lecturer in the Department of Epidemiology and Biostatistics at the University of California, San Francisco (UCSF). I’m an expert in clinical epidemiology, particularly in systematic review methods, epidemiologic bias and evidence quality assessment. As a researcher at UCSF, I managed the Cochrane HIV/AIDS Group for over a decade and on several occasions served as a consultant to the World Health Organization (WHO) in their HIV guideline development processes.

For about 13 years, I also masqueraded “as a woman,” taking medical measures which suggest, shall we say, that I was completely committed to that lifestyle. Most men would have recoiled from this, but in my estrogen-drug-soaked stupor it seemed like a good idea. In 2013 I stopped taking estrogen for health reasons and very rapidly came back to my senses. I ceased all effort to convey the impression that I was a woman and carried on with life.

At 12, I believed I would grow up to be a woman. I was mistaken.

As you may imagine, I have a lot of anger at transgenderism and its enablers, as well as an “inward bruise” (as Melville called it). I am not a happy camper. I have been badly harmed. However–as a father myself–I am far angrier that thousands of young people are being irreversibly altered and sterilized as they are inducted into a drug-dependent and medically-maimed lifestyle. I’m furious that women and girls are being steamrolled by trans activists into accepting any man who claims to be a woman in sex-segregated changing rooms, prisons, shelters, women’s sports, and elsewhere. If any man can simply announce that he’s a woman, then what is a woman?

My strong feelings often show through in what I write. On Twitter, in blogs and elsewhere online, I have often taken a very strident, confrontational tone. I have offended many with my refusal to utter words that I consider to be unsubstantiated, politically motivated jargon, along with my unrepentant “misgendering,” among other sins. In contrast, in real life, I try to get along with everyone and tend to be diplomatic with people whose views conflict with mine. I’m somewhat reclusive and generally not very keen to blast other people with peremptory critique.

1. Prologue

Where gender dysphoria (GD) is discussed, “suicide risk” and “transphobia” may lurk nearby, especially when the topic concerns adolescents and young adults (AYA). Why is this so? In this article, I will demonstrate that activists have created the false impression that the risk of suicide in adolescents and young adults (AYA) with GD (AYA-GD) is unique and unparalleled, that AYA-GD suicides are common and that “transphobia” is the main cause of such suicides. I will show why the shockingly high suicide attempt rates they commonly cite are not credible. I will also show evidence that AYA-GD suicide attempt rates are likely similar to those of other populations with similar risk factors. While these rates are higher than in the general population, they are much lower than they are touted to be in transgender activist propaganda.

Finally, I will look at the statistics for completed suicide in AYA-GD, before closing with some observations about losses to follow-up in studies looking into outcomes in people with GD, some years after their trans-related surgeries.

GD is a poorly-defined syndrome comprising one or more mental health problems, commonly including anxiety or depression, among others. It includes a “strong desire” to “be” the opposite sex, or at least to perform its stereotypes. At minimum, patients may have come to believe that they are utterly unsuited to fulfil the stereotypic roles and gestures socially prescribed for their actual sex, even if they have had tremendous lifelong success in doing so, and even though they are quite free to ignore such stereotypes. Gender dysphoria’s concomitant cognitive bias may keep the patient from ever getting better. The reason they may never recover from it is that this cognitive bias tells them this mental illness is really “mental wellness” (Levine 2018). They typically only visit doctors and psychotherapists who are willing (or even eager) to “affirm” their opinion that they are somehow inhabiting the wrong body. They are steered with increasing ease into a transgender trajectory and the mysteries of “transition.” Costume change, with or without cosmetic surgery, is an ineffective means of changing sex. Indeed, changing sex is impossible. “Transition” is thus mostly concerned with personality expression and receiving (in my view) unnecessary medical care. It can begin almost at a moment’s notice. In the US, self-diagnosed adolescent and adult GD patients may even receive prescriptions for cross-sex synthetic hormone drugs on the day of their first clinical visit.

Until recently, having GD and “being trans” were considered synonymous. This belief has shifted somewhat, as the phenomenon of “non-binary” people emerged. Also, it’s apparently no longer necessary even to have GD to be considered transgender. In San Francisco, if you want to be “trans,” they will “rubber-stamp” you and you’ll have your genitals inverted (or your breasts will be gone) in no time.

I don’t believe GD reflects any kind of problem or glitch in the human body. Here’s what I suggest, in broad strokes, is going on with adolescents and adults:

• Heterosexual males (the vast majority of men with GD) have autogynephilia.
• Homosexual males with GD enjoy “femininity” and mistakenly believe this means they are “trans” or even women.
• Females with GD have internalized misogyny and/or internalized homophobia.

In my opinion—which is based upon extensive research, as well as my own 13-year-long experience in pretending to be a woman–GD is only superficially concerned with one’s sex. It’s more a disturbance of identity, of mistaking the signifier for the signified. Patients have whatever mental illnesses they may have, or that develop while in the ruminations and hypomanic states that typically precede “coming out as trans.” I propose that GD is a moody, brooding syndrome that accompanies these mental illnesses. People with GD have cultivated an idealized vision of themselves as the opposite sex. At a critical point of rumination, after the patient has sufficiently disparaged his or her actual life and idealized life as the opposite sex, he or she realizes that body parts of the opposite sex may be obtained through the services of doctors (Raymond 1979, Billings 1982). Actually transforming into the opposite sex starts to seem feasible. The self-conception “splits” in two, and idealization becomes identity. Having negated any value in their actual male or female presence in the world, and now feeling themselves to actually be the self-generated persona, patients perseveratively ask themselves, “what’s stopping me?” “Feasibility” seems to trigger the split. Here begins the acute phase of GD.

Patients become obsessed with “transition.” To the same extent that they can be energized by the belief that they are making “progress,” as their bodies morph via the hormone drugs and shop clerks address them by their preferred honorifics (i.e. Miss or Ma’am for the males, Sir for the females), they can also feel destroyed by any little delay or perceived setback—including being “misgendered” or identified by others as their actual sex. Nothing else matters but “transition.” The apparent certainty of these patients, as well as their zeal to continue, is seen by “affirmative care” doctors as evidence of “being trans.”

Gender is a hierarchal framework that stratifies and categorizes “masculine” and “feminine” attributes and behaviors. In the context of transgenderism, it is also a convenient rhetorical device to elide the problem of sexed bodies and to label oneself as endorsing one or the other sets of sex role stereotypes. Earlier articulations of GD as “gender identity disorder” made more sense, but it seems that most people understood it to mean “having an opposite-sex gender identity.” I would suggest that it may more accurately be understood as simply an identity disorder, a disordered or disturbed identity, with a fixation on gender.

I agree with the late French psychoanalyst Colette Chiland when she said: “Transsexuals stage everything in the theatre of the body, and nothing in that of the psyche” (Chiland 2003). It is true that persons in the driven, obsessed stages of gender dysphoria can seemingly think of nothing except transition. No-one dreams of asking them to slow down, to seek psychotherapy, perhaps even find a way through this work to prevent transition, which can be costly on so many levels. It would be like standing in the way of a bolting, bucking horse. The fact that people with gender dysphoria are like this is a sign that something is wrong, yet they are not impeded at all.

But doctors are doctors and patients are patients. These surgeries and lifelong hormonal drug regimens didn’t used to be given out like crackerjack prizes. Virtually no research has been done in psychotherapeutic methods to alleviate the symptoms of gender dysphoria, prevent it, or get rid of it altogether. The entire literature comprises a couple of dozen case reports and small case series, some promising, nearly all from before 1990, and all using archaic methods. Based primarily on the pronouncement of Harry Benjamin, the “godfather” of transsexualism, that psychotherapy with these patients was a waste of time, the medical profession increasingly found ways to justify surgical and hormonal transition as the standard of care (Billings 1982). I will get back to this near the end of the article.

The biggest risk factor for continued large increases in GD may be the normalization of what has become common practice: that people with a variety of problems in life, or even just confusion, should be able to self-diagnose as trans, be celebrated and congratulated as such, and then turned into permanent patients. In North America and the United Kingdom, and perhaps in other settings, even children’s schools seem to operate as factory farms for transgenderism, with a pseudoscientific curriculum that disseminates transgender ideology.

“Affirmative” harms

There are three main models for treating children and adolescents who seem to have GD (Byne 2012, Costa 2016, Ristori 2016). The most sensible one helps kids to become more comfortable with who they are in material reality (Byne 2012, Costa 2016, Ristori 2016).

Another at first glance appears neutral about the question of whether the child should have a normal life or become a transsexual and therefore a permanent patient. Children subject to this strategy are often given drugs to block their puberty (Byne 2012, Costa 2016, Ristori 2016). Ostensibly, this is done to “give them time to decide,” but while deciding (and emulating the opposite sex) they surely become more deeply invested in rocketing further down that road.

The most hazardous approach of all is “affirmative care” (Byne 2012, Costa 2016, Ristori 2016), which is mainly seen in North America. According to this model, young people and adults who keenly desire to emulate opposite sex stereotypes, or perhaps show an indication that they might someday be homosexuals, are assured that they definitely “are trans,” and that it is essential to help them transition immediately (Byne 2012, Costa 2016, Ristori 2016). This model even encourages toddlers to “socially transition,” with boys being indoctrinated into stereotypic femininity and “girlhood,” and girls into masculinity and “boyhood.” Yet social transition has been shown to be predictive of persistence of GD (Ristori 2016). This means that even though young children nearly always desist from believing they are the opposite sex, socially transitioned kids are much more likely to begin puberty-blocking drugs at age 8 or 9, and then carry on with the rest of the complex medicalized transition process. If parents make any objection or refuse to “affirm” their child’s plan, they are shamed and belittled as “transphobes.” In some instances, parents can even be prosecuted and have their children taken away by the government.

Under the affirmative model, adolescents and adults are generally enabled to pursue medical interventions right away, seldom being told by their doctors “no, you are making a mistake.”

In this article, when I speak of trans activism, trans ideology and the like, I am referring especially to the “affirmative care” model. The old “gatekeeping” of patients with gender identity problems, which was developed in the 1950s to keep these often mentally unstable persons from rushing into irreversible, experimental interventions, is a ghost of what it once was. In cities like San Francisco, it has essentially been replaced by “informed consent” – which in practice translates to “on demand.”

Proponents of affirmative care have dealt the deathblow to what little gatekeeping that remains. Their activities could well be described as marketing and recruitment for “being trans.” Patients of any age need only say they think they are really the opposite sex, or wish they were, and affirmative care clinicians are happy to get busy, scheduling surgeries and prescribing lifelong drug regimens. They seem to see themselves as affirmative pioneers, especially those who work tirelessly to provide medical interventions to more and more children and teens, thus creating an iatrogenic illusion from which the kids may never emerge.  A few examples follow.

Dr. Johanna Olson-Kennedy of Children’s Hospital Los Angeles is a prominent affirmative care physician. Earlier this year at a gender conference, she described radical mastectomy outcomes in gender-confused girls as young as age 13. She doubled-down on this affront to Hippocrates by suggesting that if teen girls later regretted the loss of their breasts, they could “go and get” new breasts, suggesting that breast implants would make them as good as new. There has been a tremendous surge over the past decade in girls and young women presenting to gender clinics (Zucker 2017, Littman 2018), and Olson-Kennedy says she has personally ushered more than 1100 of them into the medicalized trans lifestyle. In a 2018 paper, she recommends referring girls for this “top surgery” first, and only afterwards prescribing testosterone – thus removing the option for what might have been a little more time to think through this irreversible decision (Olson-Kennedy, 2018).

At the Kaiser-Permanente Medical Center in Oakland, California, surgeons have removed healthy breast tissue from gender-confused girls as young as age 12.

Psychologist Dr. Diane Ehrensaft of University of California, San Francisco (UCSF) is keen for toddlers and small kids to begin a “social transition” and likely continue along the path to medical transition (Ristori 2016). As mentioned above, children and adolescents no longer need to have GD; all are welcome to begin transition. At a symposium earlier this year, UCSF paediatrician Dr. Ilana Sherer told of feeling “challenged” when “lots and lots of kids” presented to her gender clinic without feeling any gender dysphoria. The “challenge” to which she alludes is that insurance companies (rightly) require evidence that these kids are receiving psychological support before the company agrees to cover the trans-related medical interventions they seek. Sherer spoke of the solution to this problem. After a brief meeting with a child, Ehrensaft (as Sherer describes it) essentially “rubber-stamps” the youth’s paperwork so that insurance companies will pay. In other words, she is approving services for patients who not meet diagnostic criteria and indeed do not have any distress. A question comes to mind: are health insurance companies and/or the health care fraud division at the US Department of Health and Human Services aware of this practice?  It seems likely that if they knew, they would feel quite “challenged” to let it just go on.

Cross-sex hormone drugs have a drastic effect on the body and carry serious health risks. Notwithstanding this, UCSF’s guidelines suggest that almost anyone is qualified to prescribe a lifelong regimen of the drugs – even physician assistants, naturopathic providers (!) and nurse midwives. It is unclear why the MTF author of these guidelines, Dr. Madeline Deutsch, who trained as an emergency room physician, thought this would be wise. A healthy endocrine system’s ecological balance can easily be thrown into chaos – which is what happens when one takes cross-sex hormones anyway.

So, these are some of the better known members of the clinician crowd I am speaking about most directly in this article. Their approach is not the global standard – its recklessness seems clear to most people outside North America – but they are certainly marketing it aggressively.

2. Weaponizing our instinct to protect the vulnerable

Few things in life break our hearts more than to learn of a young person’s death, especially by suicide. We can’t help but have an emotional response to such news. The trans industry – comprising the activists, academics, healthcare providers, clinics, and pharmaceutical companies that benefit from transgender ideology, financially or otherwise – understands this well. The spectre of suicide in AYA-GD is a key component of trans activism. Not merely a talking point, it is a truncheon that activists and trans industry clinicians, other industry partners and virtue-signalling “allies” wield to force full compliance with their demands. To prevent trans suicides, the trans industry requires nothing less than a world that is utterly purged of transphobia.

Well, what is transphobia? Is it, as activists insist, a type of “hatred” that people who are not confused about the sex to which they belong (“cis,” in industry jargon) aim at the oppressed, still emerging masses of women and men, boys and girls who were “born in the wrong body”? No, of course not. Criticizing transgender ideology has nothing to do with hate and everything to do with mammalian evolution over the past 200 million years, the scientific method and common sense.

Then is it really homophobia, perhaps? Yes, in some cases it might be, because (in my view) no one is actually “trans.” Gay men and lesbians who take the transgender path are still essentially gay men and lesbians. But transphobia is much, much more than this.

“That’s transphobic.”

In real terms, transphobia could be defined as anything that an ordinary person does, says or even believes that “invalidates” transgenderism and its core principles, or invalidates any belief of a person claiming to be trans. In other words, factually stating that men cannot become women, nor can women become men, has a high probability of increasing GD in any trans persons within earshot. It would be considered transphobic. When a “trans woman” is made to feel that it is inappropriate for him to be in the women’s restroom or changing room, he feels tremendously dysphoric and “invalidated.” Similarly, to “misgender” a trans person – to accurately refer to a male with masculine pronouns, or a female with feminine ones (“gender” does, after all, exist in the grammar of many languages) – can send dysphoria through the roof, as validation plummets. People need to feel validated! But validating a lie so they might feel better for a minute is not helpful. Trans activists insist that misgendering is an “act of violence” that “literally kills” – meaning that being addressed with the wrong pronoun might drive them to suicide.

A common meme on social media.

Why do many clinicians and other educated people go along with this nonsense? The trans activists insist on “validation” in everything they do or say, without objection. Objections or disagreement are transphobic. Any utterance or action that increases GD for anyone is transphobic. Unwillingness of society or any individual to accommodate any desire of men or women claiming to be trans is transphobic. Mirrors are transphobic. Biology is transphobic. Reality is transphobic.

Lifesavers

In contrast, every type of medical or social intervention for the supposed benefit of people with GD, especially youth, is described as “life-saving.” The refrain of “life-saving” echoes everywhere in the discourse around this topic. This has been a key strategy in convincing people that major surgeries are a “medical necessity” – “the basic healthcare they need to survive.” According to the trans industry and its friends, spikes in GD due to transphobia seem to lead almost automatically to AYA-GD wanting to end their lives. It is as if they are always on a ledge, ready to jump. This incessant repetition of purported suicide risk is like a strange new variation of Munchausen syndrome by proxy, wherewith trans activist adults and some clinicians effectively threaten suicide on behalf of the young people. They do this to socially-engineer, manipulate and intimidate non-industry doctors, politicians, community leaders and families of AYA-GD. They are well aware of the emotional responses they will get with this rhetoric. Meanwhile, experts in suicide prevention have always recommended against strongly emphasizing suicide risk in a given population.

On a related tangent, clinicians in the earlier days of proper gatekeeping often reported that their male trans patients commonly used manipulative suicide threats to get more rapid approval for hormone drugs and genital de-masculinization surgery (Burchard 1965, Pauly 1965, Limentani 1979, among others).

Most parents and other reasonable adults would easily reject the notion that healthy adolescents urgently need hormonal and/or surgical intervention so that they can be their “authentic selves.” It doesn’t make any sense. They’re healthy; and until a few weeks or months ago she was just an ordinary girl, he just an ordinary boy. However, activists and industry clinicians mess with everyone’s sense of reality by insisting that without such “care,” there’s a fair chance these suddenly troubled youth will commit suicide. Parents and policy makers alike are thus terrorized into going along with trans ideology, and the general public begins to believe it’s true.

Suicidal behaviour is learned (Strosahl 2006). The degree to which AYA-GD have internalized the notion that they may not live long is disturbing: Most seem to have taken on board not only that they are abnormal, hated by the “cis” world, but that they are also expected to kill themselves. On a mobile phone app called Whisper, thousands of AYA-GD create these “posters” in which they briefly express what’s on their minds, and people respond. It’s tragic and alarming that many of these young people are apparently in such deep distress, especially when the reasons for this distress are not true. They have been manipulated into a cultish belief system.

On the other hand, suicidality is so ingrained in their consciousness that they almost seem to threaten suicide as a way of saying hello, to establish commonalities.

Surveys of attempted suicide rates

How serious are these young people? It may indeed be true that AYA-GD attempt suicide at higher rates than most other AYA, but these rates are not uniquely high, as I will soon show. They are also likely lower than the shockingly high estimates frequently broadcast through trans activism. Completed suicides in AYA-GD are rare, and estimates of suicide attempt rates do not translate into rates for completed suicide. There are around 100 to 200 suicide attempts for every completed suicide in adolescents (Sarchiapone 2016). Suicide attempts may vary greatly in both the seriousness of the effort and the lethality of the method used (Liotta 2015). “Cutting” or other forms of non-suicidal self-injury may be construed as suicide attempts. Suicidal ideation is even further removed from completed suicide.

I’m now going to critically appraise the most commonly cited surveys of suicide attempt rates in AYA-GD and other relevant populations, and then we’ll look at some of better quality.  Fair warning: The following sections delve into research methodology to an extent some readers may have difficulty following. I would suggest reading the cited studies (if you haven’t already) for context and to aid in understanding the points I’ll be making.

Surveys in AYA-GD & adults with GD. Several surveys have tried to quantify the rate of attempted suicide in adults or adolescents with GD. In general, one can say that the flimsier the survey methods used, the more likely the estimates will not reflect reality in the population being studied. Many have heard about survey results suggesting that over 40% of adults (Haas 2014, James 2015) or adolescents (Toomey 2018) who identify as transgender have attempted suicide at some point in life. There is good reason to mistrust the accuracy of these claims, as two surveys in adults (Haas 2014, James 2015) were inherently at high risk of bias due to their design; the other in adolescents (Toomey 2018) for a similar reason, as well as a high risk of bias due to extreme looseness in survey data collection. Non-probability convenience samples, such as those used in the above surveys, are not appropriate to use when trying to quantify an outcome (such as suicide attempts) in a given population (Gideon 2018). It is a rather haphazard means of data collection.

Unfortunately for the researchers conducting these surveys, their use of convenience samples pretty much guaranteed that their estimates would be far off the mark. Citing estimates from such surveys, let alone hyping them, is inappropriate (Gideon 2012). They each needed a sample that was representative of the populations in question, and to obtain that they would have needed to use probability sampling methods. These are more complex to implement. Even so, it is unclear why they didn’t do so, especially in the case of the National Transgender Discrimination Survey (Grant 2011), which was analyzed by the Williams Institute (Haas 2014), and the US Transgender Survey (James 2015). Judging by their very lengthy and glossy published reports, these projects seemed to have more than sufficient resources to do their surveys correctly.

The latter survey (James 2015) seems to have had an identity crisis in terms of its sampling methods. The document claims in two places to have used convenience sampling and in one place to have used purposive sampling. Purposive sampling is typically used in qualitative research when a comprehensive, “saturated” understanding is desired. Researchers seek informants who have abundant experience and expertise. This method has an intentional selection bias. In describing its supposed “purposive sampling” method, the document lists “direct outreach” (by which was meant convenience sampling) and then several methods for network sampling.

Network sampling is commonly used in HIV research in developed countries to reach “hidden” or stigmatized populations, such as injection drug users. In countries where it is illegal for men to wear women’s clothing & accoutrements, let’s say in Uganda, HIV prevention researchers will commonly use respondent-driven sampling, snowball sampling and other network sampling methods to find such men. Doing this in the United States in 2014 would likely have resulted in responses from injection drug users or people with serious mental illness who were also transvestites. That may be fine if the survey’s goal is to collect data from people with big problems in their lives, but it is not appropriate for obtaining representative data from the population of interest (Heckathorn 2017). In any case, the vast majority of US Transgender Survey data were definitely collected through convenience sampling, such as advertising on various websites and other simplistic efforts. It was not a purposive sample. Any data collected through their alleged network sampling methods would likely have made their findings even less representative of the US population who believe themselves to be transgender.

This is not to say that convenience sampling is always bad. No indeed – there are certainly appropriate uses for convenience samples. Researchers may use convenience samples when they wish to make a rapid, exploratory assessment of a new or changing phenomenon, such as rapid onset gender dysphoria (ROGD) and other epidemic outbreaks. Data can be collected more quickly than when probability-based methods are used, and can then inform the development of more rigorous research, which may (or may not) replicate the initial findings. Convenience samples are fine to use if researchers wish to describe and even quantify the characteristics of the sample itself. They are not fine if the goal is to extrapolate from the sample to describe or especially to quantify characteristics of the overall population (Heckathorn 2017).

A closer look at the recent paper by Toomey et al (2018). Some may object that the study by Toomey and colleagues did not use a convenience sample. At first glance, it may not seem so. Indeed, with the large overall sample size mentioned prominently in the abstract, it may have the appearance of a rigorous study. However, even Toomey acknowledges that the sample was unlikely to be a representative one.

Consider what transpired prior to the authors’ obtaining survey data for more than 120,000 adolescents from a Minnesota-based organization called “Search Institute.” Over a period of three years (2012-2015), the company had sold its do-it-yourself survey services to an unknown number of school districts in various regions of the US (not reported, but said to be “national in scope”). After the Search Institute provided a complicated instruction book to officials from each district, the schools were on their own in administering the surveys. Schools could decide for themselves who would be in charge of administering the survey, whether it be the school principal, math teacher, bus driver, football coach or someone else.

Students completed the surveys online. The company received the survey data from each school, analysed it, and sent reports of these analyses back to the districts.

For the school districts, a well-conducted survey that reached all or nearly all of the district’s students, as a census would do, could potentially provide very good data. It’s rather different when you conduct a secondary analysis, as Toomey and colleagues have done, of aggregated data from the unknown number of school districts. Even if every student in every one of these districts was reached, the data mean very little at the national or international level. The sample has very little if any generalizability to the broader population. In fact, after the data are pooled, these data no longer have particular relevance to any of the individual school districts. At this point these are just some mixed data that happened conveniently to be available. They are not representative of anything except that collection of districts, en banc. This would still be all right if, for example, these specific school districts were exactly all the school districts in a given region, and you were only interested in responses from youth in that specific region – but this is not the case.

There are indications in the article that things may not have gone so well with these surveys. For example, Toomey reports overall 12-month suicide attempt data for all survey respondents at 14.1%. He suggests that this figure is “consistent with” the 12-month suicide attempt rate in the US Centers for Disease Control and Prevention’s (CDC) 2015 Youth Risk Behavior Surveillance System (YRBSS) survey finding of 8.6%. Inexplicably, Toomey also throws in CDC’s estimate for “made a plan to attempt suicide” of 14.6%. Making a plan is not the same as actually attempting suicide. An estimate of 14.1% is not consistent with an estimate of 8.6%. It’s an overestimation by close to 40%. If we are paying attention, we see this discrepancy as a sign that the Search Institute’s aggregated survey data are not even relevant to the general population of youth.

Following this, it is time to figure out just who is being surveyed. Recall that the article’s title is “Transgender Adolescent Suicide Behavior.” This reader was surprised and somewhat impressed to read that data from “N = 120 617 adolescents” was used to achieve [their] objectives. Surely the aggregated survey data didn’t include that many trans youth. Indeed, they only looked closely at data from a few hundred such youth, a tiny subset of that much larger number. Why prominently mention the overall number when the analysis is only about those who say they are trans? It might have been appropriate to mention the larger number, as long as they also reported there the number of respondents whose data they examined.

Toomey and colleagues set themselves up for additional failure by including responses from kids who did not even claim to be trans. The fact that survey data came from youth as young as age 11, unlikely to have become fluent in trans ideology quite yet, compounds the problem of trans being some kind of an umbrella, a cookie, a unicorn or whatever else one wants it to be.

Table: Self-description of trans-identified respondents in Toomey 2018

So, the big 120,000+ number reported in the abstract was a sleight-of-hand manoeuvre for the reader in a hurry — cooked up to convey the false impression that this was a seriously large pool of data. It was actually quite small. I say again, we have no evidence that anyone in the world “is transgender” – born with some essential or innate gender identity that is “incongruent” with their biological sex. Even if “being trans” in any essential way were as real as paint, these researchers have data from fewer than 400 adolescents, along with a few hundred kids who claim to be “non-binary” and another thousand or so who have no idea what they’re supposed to say.

Next, Toomey and colleagues report that suicidal behaviour history was assessed with just one question: “Have you ever tried to kill yourself?” The question is direct, but experts in designing surveys for assessing suicidality suggest that overestimates are less likely if respondents are asked several times, in different ways (Strosahl 2006, Horn 2016).

Contrary to the assurances of Toomey and colleagues (2018), detailed methods for this survey were not available on the Search Institute website. Some cursory characteristics were provided, but these were on the order of advertising. A “user guide,” intended for the use of school personnel conducting the survey, highlighted the difficulties that school administrators, teachers and other staff might have in preparing for and administering this survey. They are encouraged to take a National Institutes of Health online training in ethical conduct of research with human subjects. They are told that a “census” survey method would be best to use, but are immediately given instruction in estimating necessary sample sizes and in methods for conducting systematic random sampling. It is unlikely that most of these school districts had staff on hand who were up to the task of conducting the survey with competence. The truth is we have no idea what happened in those schools or how faithful they were in following the user guide. The Search Institute organization left school districts to their own devices. With a Search Institute employee as a co-author, Toomey and colleagues (2018) may have known more detail about the schools and how data were collected, but they do not report it.

Finally, Toomey and colleagues (2018) calculate adjusted odds ratios to estimate probabilities of suicide attempt by demographic characteristics and “gender identity.” They needn’t have gone to the trouble. It gives their analysis a simulation of gravitas, but given the “convenient,” admittedly non-representative data, there’s no reason to believe that these estimates are anywhere close to accurate.

Better quality surveys of AYA-GD. Interestingly, in addition to analysing data from the survey reported by Haas and colleagues (2014), the Williams Institute at University of California, Los Angeles, also conducted one that was much more rigorous (Wilson 2017). This organization was contracted with the state of California in 2015-2016 to survey a sample of adolescents in the state. They were required to use much stronger methods than had been used in the other surveys or their other implausible analyses. For example, instead of asking respondents who happened to be nearby to fill out surveys online, they used trained interviewers who spoke over the telephone directly with each adolescent. Among other aspects, this enabled them to clarify any potential misunderstandings. Unlike the other surveys, questions about suicide attempt history in the California Health Interview Survey (CHIS) were asked in several nuanced variations, reducing the potential for an overestimate (Strosahl 2006, Stone 2016). Also, in contrast to the other surveys which used convenience samples and were not intended to be representative of the population (Haas 2014, James 2015, Toomey 2018), this survey was intended to be representative of California’s adolescent population (Wilson 2017).

The CHIS did not explore GD or whether students considered themselves to be trans, but it did explore degrees of gender nonconformity. I realize that these are not the same. In our current epidemic of ROGD (Littman 2018), I would suggest that data from students whose personality & style expression is strongly at variance to that of their respective sex stereotypes might serve as a proxy for data from students who considered themselves to be trans. If a boy today endorses that he is “very feminine” or a girl that she is “very masculine,” I’d bet a dollar that these kids believe they are trans.

Only 3% of adolescents ages 12-17 who thought their peers regarded them as “very masculine” (if girls) or “very feminine” (if boys), categorized as “highly gender non-conforming” by investigators, reported having attempted suicide. This rate was statistically similar (i.e. not different) to the 2% rate reported by peers who felt other students considered them to be “gender conforming” (Wilson 2017). Considering that no one yet has adequately defined “trans” and that GD’s diagnostic criteria are similarly hazy, the survey with stronger methods may provide a more accurate picture of AYA-GD attempted suicides than the ones with weaker methods. It’s a bit unclear, as “highly gender nonconforming” youth are not necessarily the same as youth with GD – though one would expect youth with GD to be highly gender nonconforming.

On the other hand, it is rather telling that the file name of the Williams Institute report actually includes the phrase “transgender teens.” I’m pretty sure this is what they meant by “highly gender nonconforming.”

A parallel survey conducted by the same team in California in adults ages 18-70, who were explicitly asked if they considered themselves to be transgender, found that 22% reported suicide attempts (Herman 2017). The authors do not comment on their institute’s previous finding of nearly double that proportion in trans adults across the US as a whole (Haas 2014).

In any case, the Williams Institute’s “highly gender nonconforming” adolescent estimate of 3% is lower than that of the CDC’s well-conducted YRBSS survey of high school students (of any level of gender conformity) across the US.  In 2017, the survey found that 7.4% reported ever having attempted suicide, down from 2015’s estimate of 8.6%, mentioned above.

Lowry and colleagues (2018) conducted a secondary analysis of CDC 2015 YRBSS data, focusing on students in two urban California school districts and one in Florida (n=6,082). As with the Williams Institute survey, investigators explored gender nonconformity, not GD or “trans” status. They found that 23.5% of urban high school girls who felt peers considered them to be “somewhat masculine” reported a suicide attempt in the preceding 12 months. Investigators did not report separately the proportions of girls who said they were seen to be “very” or “mostly” masculine, because there were fewer than 30 responses for each. Instead, they pooled data for these with the “somewhat” masculine responses. In this composite category, 20.5% of girls had attempted suicide in the preceding year. However, this was not statistically associated with their gender nonconformity (adjusted prevalence ratio [APR] 1.60; 95% confidence interval [CI] 0.81 to 3.16). Gender nonconformity was not associated with suicide attempts in any of the other female “masculinity” categories.

In “very feminine” urban boys, 14.7% reported suicide attempts, compared to 17.7% and 26.4% respectively in boys who thought they were perceived to be mostly or somewhat feminine. In somewhat, mostly and very masculine boys, suicide attempts were reported by 6.1%, 3.4% and 4.6%, respectively. In “equally masculine and feminine” boys, 9.3% reported suicide attempts. However, researchers could not directly associate these rates with gender nonconformity in any of the somewhat, very or mostly categories.  In other words, several factors besides being highly gender nonconforming likely played a role in the suicide attempts of somewhat, mostly and very feminine boys.

There are other adolescent populations besides trans youth whose lives commonly include significant challenges. Suicide attempt rates in these populations are similar to those in “highly gender nonconforming youth” that we have seen with the better quality surveys. We already know that adolescents and adults with GD tend to have much higher psychiatric comorbidity than the general population (Hepp 2005, Duišin 2014, Heylens 2014, Connolly 2016, Reisner 2016, Wise 2016, Alastanos 2017, among the more recent references). Indeed, before making such clinical observations put one at risk of breaking the law (or at least being banned from Twitter), numerous clinicians observed that the personalities and behaviors of their patients with “gender identity” problems were often consistent with those of people with borderline personality disorder (Hoenig 1974, Levine 1981, Meyer 1982, Lothstein 1984), a condition with higher suicidality than the general population.

Rates of clinically significant psychopathology in youth referred to gender clinics are similar to those of youth referred for non-gender reasons to mental health clinics (Kaltiala-Heino 2018). We also know that many are gay or lesbian. Many also have experienced bullying. Let’s look at what well-conducted surveys sampling these other populations more specifically have found.

Survey in youth with mental illness. Around 96% of adolescents in the US who attempt suicide meet lifetime criteria for at least one mental illness (Nock 2013). The most prevalent DSM-IV disorders found in youth attempting suicide included major depressive disorder, eating disorders, attention-deficit/hyperactivity disorder, conduct disorder and intermittent explosive disorder (Nock 2013). Personality disorders are seldom assessed.

Husky and colleagues (2012) with the US National Co-morbidity Survey conducted computer-assisted face-to-face interviews with more than 10,000 adolescents ages 13-18. In youth with any psychiatric condition (n=2,341), 6.8% had attempted suicide in the preceding 12 months. In youth diagnosed with mood disorders (n=1,021), 14.4% had made an attempt in the preceding year. The proportions respectively for substance use disorders, anxiety disorders and disruptive behaviour disorders were 8.3%, 6.0% and 11.7%. Numbers were small (n=76) for youth with eating disorders, but 26.9% had attempted suicide in the preceding 12 months (adjusted odds ratio 11.40, 95% CI 3.18 to 40.87).

Survey in sexual minority youth. Sexual minority adolescent (i.e., lesbian, gay and bisexual) populations face similar challenges to trans-identified adolescents. Indeed, there is very significant overlap of the populations, as many trans youth identify (or formerly identified) as lesbian or gay.

Stone and colleagues (2014) analysed CDC YRBSS data from five US metropolitan regions for the years 2001-2009, with the objective to identify suicide risk factors in sexual minority youth. They aggregated data and stratified those for youth who declared their sexual orientation to be heterosexual, lesbian, gay male, bisexual or unsure. Investigators do not report the overall denominator of adolescents surveyed, but 20,545 reported ever having attempted suicide. Summary data for reported suicide attempts, stratified by sexual orientation, are presented in the table below.

Table: Prevalence of sexual minority youth suicide attempt and medically serious suicide attempt, five US cities, 2001-2009

These 2001-2009 estimates seem somewhat higher than estimates using composite data from the 2017 round of the YRBSS, showing that in students self-describing as lesbian, gay or bisexual, 23.7% (95% CI 19.4 to 28.5) of girls and 18.3% (95% CI 11.5 to 27.9) of boys had attempted suicide in the preceding 12 months, with an overall estimate of 23.0% (95% CI 18.6 to 28.0) (CDC 2018). This suggests that suicide attempts may be declining in this population. Medically serious suicide attempts were reported by 7.5% (95% CI 5.7 to 9.8) of lesbian, gay or bisexual youth (CDC 2018).

Survey in youth who have been bullied. Messias and colleagues (2014) analysed data from the CDC’s 2011 YRBSS to determine the impact of bullying on suicidal behaviour in adolescents. In youth who reported any bullying victimization, either school bullying or cyber-bullying (n=3429), 24.7% reported ever having attempted suicide in the preceding 12 months. In youth who reported both school bullying and cyber-bullying (n=1,122), 21.1% reported a suicide attempt (Messias 2014).

How well can we believe any of this evidence? Finally, in regard to the evidence from all of these surveys, it’s important to remember that according to the global standard GRADE approach to assessing the quality (certainty) of scientific evidence, even the population-based surveys using relatively strong methods would contribute only very low-quality evidence. I have not given it a full analysis, which would require a systematic review to be done, but that’s my quick informal assessment. Very low-quality means that the true proportions could still be quite different from these estimates. In the surveys with weaker methods, well, let’s just say they don’t inspire much confidence.

3. Completed suicides

If transphobia were really driving large numbers of AYA-GD to suicide, we would need to get a handle on what those numbers might be. Let’s try.

Wikipedia’s “List of LGBT-related Suicides” lists 11 names of people deemed trans. The first trans name listed is that of a man who died in 2009. Next is the suicide of troubled teen, Joshua “Leelah” Alcorn of Ohio, USA, in December 2014. His death was heavily exploited by trans activists  and the mass media covered the tragedy quite intensively for several weeks. There were even death threats made to Alcorn’s parents. According to the Wikipedia suicide list, eight additional AYA-GD took their lives in the five months following Alcorn’s death. Although this Wikipedia page has been edited dozens of times since mid-2015, no additional “trans” names have been added to the list since then.

By no means am I suggesting that anything is proven by this, or that anything on Wikipedia should even be believed. I do want to point out that if it were true that large numbers of AYA-GD were dying at their own hand, that list would likely be a great deal longer. The other thing I want to highlight is the apparent contagion of Alcorn’s suicide to several other AYA-GD. Around 5% of all youth suicide can be attributed in part to discussion and media coverage of other suicides (Kennebeck 2018).

People don’t kill themselves for just one reason, like feeling worried about the future (the main theme of Alcorn’s suicide note). It’s a complex behaviour that may have several factors contributing to the decision. The most prominent of these are mood disorders and other types of mental illness (Gili 2019). Others include “all or nothing” thinking, substance abuse, a family history of suicide and feelings of hopelessness. Another important contributing factor is exposure to other suicides (Strosahl 2006) and news and discussion about suicides.

Real conditions. It is certain that suicide remains a serious problem in AYA, with or without GD. Overall, suicide is the third leading cause of death in AYA ages 15-24 in the United States. However, we must consider this statement in context. Relatively few young people die from cardiovascular disease, cancer and many other illnesses that contribute to mortality in older age strata. The two leading causes of death in AYA ages 15-24 in the US are accidents (unintentional injuries) and homicide (CDC 2018). Between 1999 and 2016, a total of 80,866 AYA in the US committed suicide, of whom 14,051 (17%) were female (CDC 2018). There is a significant disparity between the sexes in this proportion, which may be due to males using more lethal means (CDC 2014). Females more frequently report suicidal ideation and suicide attempts than do males (Nowotny 2015). In AYA of both sexes ages 15-24 in the 1999-2016 period, the overall rate of completed suicide was around 10.6 per 100,000 suicides (CDC 2018). Corresponding to their proportions, rates for females and males respectively ages 15-24 were 3.8 and 17.1 per 100,000 suicides across the 1999-2016 period (CDC 2018).

Paradox. Let’s look for a moment back to 1950, when gender roles, sex-specific dress codes, laws regulating sexuality and other aspects of social control were much more rigidly “enforced.” The suicide rate for AYA in the US was much lower than it is now. For both sexes, it was only 4.5 suicides per 100,000 AYA. As is usual, the rate for boys was higher than that of girls, 6.5 vs. 2.6. From that year, through our society’s sturm und drang of the ‘60s and ‘70s, AYA suicides trended upward, reaching a peak in 1994 with a combined rate of 13.6. The overall trend declined slightly and then was more or less flat until 2011, when it began again to climb.

A problem emerges. Why have rates of completed suicide in AYA increased in recent years, during an era when public awareness of transgenderism and GD has increased dramatically? Not just “awareness” – by 2018, organizations and individual people make bizarrely intense efforts to seem the most supportive “trans ally.” Other populations with elevated suicide rates include people with mood disorders or other mental illness (Nock 2013) and people who are sexually attracted to others of the same sex (Hottes 2016). These populations would likely also have experienced the earlier times with much greater distress than they would today. If the trans industry’s logic were consistent, they would also have had higher rates of suicide. Were young people more psychologically stable and resilient in the old days than they are now?

Taking that trans logic a step further, why don’t we see epidemics of suicide in populations that really have to deal with systemic bias? Are AYA-GD frequently pulled over by the police, frisked and hassled more than other AYA? Are they followed around in grocery stores and department stores more than other AYA? On rainy or sunny days, are their waving hands regularly ignored by taxicab drivers with empty cars, who then stop to pick up other AYA?

Although AYA-GD are relatively few in number, so too are the numbers of AYA completed suicides. If society now cranks out transphobia at lower levels than before, and if it were true that transphobia-induced dysphoria leads to suicide in AYA-GD, we would have expected to see very high rates of completed suicide in earlier decades. We should have seen these rates decline, if only a little. However, after warbling up and down for a few decades, they went up.

The relationship of “regret” to study attrition and possibly to suicide

Before finishing this article, I want to point out something explicitly. Long-term follow-up studies have shown that completed suicide rates in people who received trans hormones and surgeries, and supposedly “transitioned,” are in fact much higher than in the general population (Asscheman 2011, Dhejne 2011, among others). Few follow-up studies assess “regret” in their study populations. Those that do assess regret may also have very narrow criteria for defining “regret,” or will follow-up after too short a time for patients to realize their regret. No-one really knows the right interval, but assessments of regret after three or five years are of limited value. Regret should still be assessed at such intervals, but those rates may not indicate the proportion of patients with regret at 10 or 15 years, particularly if there is high loss to follow-up. Loss to follow-up is generally judged to be high when it exceeds 20% (Higgins 2011).

Investigators often report very low regret rates. Consider that the feelings of regret one might experience in this context may be very deep and complex. It may seem pointless to change one’s paperwork or to inform the doctor. At the same time, many of these studies have exceptionally high losses to follow-up; either they can’t find these patients or they get no responses from them. On a personal level, I can tell you that I had zero interest in explaining my situation to anyone, and I never wanted to see a doctor again. Paperwork was the last thing on my mind. I only wanted to melt into the Earth.  Although I “detransitioned” (i.e. ceased trying to make people think I was a woman), it’s important to bear in mind that “regret” and “detransition” are not synonymous. A person may experience profound regret but not feel prepared to “detransition,” a very intense, emotionally painful and often frightening process.

And where did all those “lost” people go? They need medication for the rest of their lives. Are the ones in Wiepjes 2018, for example, lost somewhere in the Netherlands? How does that happen in a high-tech society? Other areas of medicine at least try to keep good patient follow-up, even in countries with few resources. I just wanted to suggest that some of these “lost” may in fact have expressed “regret” through intentionally losing their lives. Some may have quietly “detransitioned,” but those not taking testosterone or estrogen would be living in increasingly poor health. Others may have continued in their “transsexual” status –but regretting what they had done.  There has been no peer-reviewed research into this – only happy stories about “tiny” regret rates. It is remarkable that individual stories in YouTube videos, blogs and books, as well as newspaper articles and other journalistic accounts, provide the best available evidence about regret.

Zucker and colleagues (2016) usefully examine the report of Dhejne and colleagues (2014), in which “regret” data for Sweden are reported in patients receiving “sex re-assignment surgery” (SRS) between 1960 and 2010. This paper suggests a regret rate of 2.2%, based on a very narrow criterion: formal application to the government to restore their original sex designation. Zucker and colleagues (2016) note that with a median follow-up of eight years, more recent regret may not yet have emerged, and then draw from Dhejne’s earlier (2011) paper on health, suicidality and criminality outcomes in the Swedish transsexual population to show why a 2.2% regret rate is likely a gross underestimate. Zucker and colleagues (2016) point out that while 10 of 666 (1.5%) of patients receiving SRS between 1972 and 2010 made formal regret applications, 10 of 324 (3.1%) who received SRS between 1973 and 2003 had killed themselves (Dhejne 2011, Zucker 2016). Another 29 of 324 (8.9%) receiving SRS in that period had made documented suicide attempts (Dhejne 2011, Zucker 2016). They further suggest that if another 29 persons who did not meet Sweden’s criteria for transsexual surgery.

If anyone wishes to suggest that this was all in the transphobic bad old days, I would remind them of the title of Hoenig’s 1977 paper: “The legal position of the transsexual: mostly unsatisfactory outside Sweden” (Hoenig 1977). In other words, Sweden had a very liberal and accepting society.

What’s clear is that there is currently a strange desire in the ideology and culture of transgenderism to ruthlessly extirpate any evidence that contradicts the official narrative of “born this way.” The fact is that people with gender dysphoria really do have quite serious mental health issues that for the most part are either ignored or celebrated. The existence of “regret” and detransition is a huge thorn in their side, a threat to their “validity.” This may be the reason that few studies bother to assess regret; or even keep good track of their patients, as is done in other areas of medicine that commonly maintain patients in long-term chronic disease care. It’s not right to ignore evidence of suicides or imply that those lost to follow-up are probably just living happily ever after.  This is how researchers can create the impression that regret rates are low. Some investigators assess regret after too short an interval, such as the “less than one year” (and possibly as little as two weeks) to five years for radical mastectomy in young women age 13-25, reported in Olson-Kennedy 2018. But is Dhejne’s 2.2% really a low proportion? If you were keen to skydive, and you learned that 2.2% of parachutes didn’t open – would you jump?

Table: Losses to follow-up (Partial, incomplete list of studies)

Table: Reported regret and criteria for regret (Partial, incomplete list of studies)

4. Conclusion

In summary, the high estimates commonly bandied about by trans activists and the mass media in regard to suicide and suicide attempts in AYA-GD are likely much too high. Completed suicide and suicide attempt rates in the AYA-GD population may vary significantly by region and socio-economic context. In my opinion, however, they are likely to remain consistent (in a given setting) with those of other populations of which they are also constituents — sexual minority AYA populations, AYA who experience bullying and AYA living with other mental health problems. The trans industry’s insistence and hype that AYA-GD are constantly on the brink of transphobia-related suicide at rates that far exceed those of other highly relevant populations is a shameful social engineering strategy to keep society’s focus preferentially on transgenderism–perhaps to cast themselves as visionary pioneers in the field. I don’t think it will turn out that way for the clinicians: history will not absolve them.

As I mentioned earlier in this article, there have been no rigorous studies conducted (ever) of any psychological intervention to help AYA-GD (or anyone) to cope effectively with their GD and thereby become more comfortable in their bodies. I’m working on another paper on this topic, because it is very deep and rich and there is much to cover, but here are some preliminary thoughts.

There is absolutely no good reason why gender dysphoria has essentially been excluded from 15 years of research in new “transdiagnostic” approaches to treating people with depression and anxiety disorders. It is outrageous that no trials have been done of cognitive behavioural therapy, dialectical behavioural therapy, mindfulness therapy and other new approaches to reduce rumination, cognitive bias generation and other maladaptive coping that may be prodromal to or concurrent with the emergence of GD; as well as to treat patients currently experiencing the condition. GD is not sui generis, unique, super-special! It is well within the spectrum of conditions efficaciously treated with transdiagnostic approaches. It is as though the “transition” promoters of mainstream transgenderism had some kind of a racket going on.

Again, there has not been even one study that tested psychological interventions to alleviate GD symptoms, much less any of the new ones. Why not? Because Harry Benjamin declared it to be a “useless undertaking”! Sure, it may have been “hard to treat” using the arcane psychoanalytic or Kleinian object relations methods that used to be popular, but trans industry “hormones and surgery” dogma has kept anyone from testing the new methods. When simple remedies are untried, it is not preferable to healthy but confused patients on lifelong drug regimens and offer them drastic surgeries that do not accomplish what patients hope they will do and are often accompanied by significant complications.

If it is possible to help people with GD to cope with, and perhaps even recover from GD, using an inexpensive approach that is feasible to implement anywhere, this would surely be better than the extreme and lifelong medical interventions currently presented as the only alternative to a life of misery (or a life lost to suicide).

This piece is already long; I will more thoroughly explore the topic of alternative approaches to gender dysphoria in a future article.

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by Carrie-Anne Brownian

Carrie-Anne is a thirtysomething historical novelist, historian, and lover of many things from bygone eras (except for the sexism, racism, and homophobia). She can be found at Welcome to My Magick Theatre, where she primarily blogs about writing, historical topics, names, silent and early sound cinema, and classic rock and pop; and at Onomastics Outside the Box, where she blogs about names and naming-related issues. Her only “child,” an 18-year-old spider plant named Kalanit, has thankfully never had any issues with her gender identity!

Carrie-Anne has written two other pieces for 4thWaveNow: “The boy with no penis” (about the case of David Reimer) and “Transing the dead,” a companion piece to this article.

She can be found on Twitter @Anyechka

As trans activists have demonstrated many a time, propagating their ideology takes precedence over accurately representing history. They have a long track record of posthumously declaring famously gender-defiant people (many of them LGB)  to be trans, despite a complete lack of evidence (from either primary or secondary sources) to support such an extraordinary claim. Many have also declared old works of literature about LGB people, and women who posed as men to live freer lives and have more opportunities, to be part of a trans canon. Seeing as the modern-day trans umbrella is so broad and vague, trans activists feel confident in including anyone who wasn’t or isn’t one million percent a collection of rigid stereotypes.

Enter the latest trend in this misrepresentation of history: Genderqueering the dead.

In December, Katie Byford, a photographer, filmmaker, and poet, started a Twitter thread about nineteenth century female photographers, such as Eveleen Myers, Emma Barton, Constance Fox Talbot, Minna Keene, and Clementina Hawarden. After this wonderful celebration of female pioneers in photography, Ms. Byford made another thread, this one holding up Claude Cahun, Marianne Breslauer, Florence Henri, and Annemarie Schwarzenbach as “transfemale,” “genderqueer,” “trans,” and “queer.”

These lesbians were referred to with “they” pronouns, in spite of never having claimed to be anything but women, and no other evidence pointing to a trans identity. Like many other lesbians and gender-defiant women throughout history, they had short hair, wore stereotypical men’s clothes, and shunned the role of dainty little ladies immersed in all things domestic and stereotypically feminine.

Before these women’s true stories are presented, let’s look at the history of the term “genderqueer,” and the concept of claiming to be neither male nor female.

According to anthropologist April Scarlette Callis, in “Bisexual, pansexual, queer: Non-binary identities and the sexual borderlands,” people only began “identifying” as homosexual in the nineteenth century, when sexuality was medicalized in the wake of modern scientific developments and the decreased influence of religion. She quotes George Chauncey, a Yale history professor, as saying that gender roles, not sexual partners, were used to determine sexual orientation in the early twentieth century. E.g., only butch lesbians and effeminate gay men had labels attached to themselves, not lesbians and gay men who had less gender-defiant style and behavior. Only in the mid-twentieth century were people officially labeled homosexual or heterosexual.

The first recorded use of the word “genderqueer” is in an article from August 1995 by Riki Anne Wilchins, published in In Your Face: Political Activism Against Gender Oppression. Ms. Wilchins used this word to describe those with unnamed or complex gender expressions. In her 1997 autobiography, Read My Lips: Sexual Subversion and the End of Gender, she identified herself as genderqueer.

In June 2001, in The Village Voice, E.J. Graff used the word in “My Trans Problem,” in which she pondered whether trans people belong in the LGB movement:

“Many of us who are homoqueer, or queer in our sexual desires, are also at least a little genderqueer—more butch or sissy than we’re supposed to be…For lesbians as well, genderqueer (a masculine woman) has at times trumped homoqueer (a woman who has sex with a woman) as the defining stigmata…As many gender-passable homos win a place at the Thanksgiving table, our genderqueered sibs are still beaten, fired, harassed, and murdered not for the sex they have but for the sex they appear to be.”

Also in 2001, “GenderQueer Revolution” and “United Genders of the Universe” were founded to fill a perceived gap in the representation and celebration of people who considered themselves neither male nor female. In 2002, the term went mainstream with the publication of GenderQueer: Voices from Beyond the Sexual Binary, a collection of thirty-eight essays edited by Joan Nestle, Clare Howell, and Riki Anne Wilchins. Ever since, usage of the term and identification with the concept have been steadily rising.

While Ms. Wilchins may have had sincere intentions and a specific identity in mind when she coined the word, as had those who were early adapters of the concept, the explosion of identity politics, queer theory, and postmodernism over the past 5–10 years have rendered it as meaningless and catch-all as “queer.” Today, many consider “genderqueer” an umbrella term which includes identities such as “non-binary,” “demigender,” “trigender,” “bigender,” “agender,” “neutrois,” and “pangender.” Some people involved in identity politics even consider the word offensive and archaic nowadays, and have supplanted it with “non-binary.”

Marcel Moore and Claude Cahun, Self-Portraits Reflected in a Mirror, ca. 1920, Jersey Heritage Collections.

Thus, this concept didn’t exist when the abovementioned female photographers were alive. Claude Cahun, the first cited, was born as Lucie Renée Mathilde Schwob in 1894, and adopted the unisex name Claude sometime between 1917 and 1919. She experimented with several different surnames before settling on Cahun. Historically, it’s hardly been uncommon for lesbians to adopt male names, but this did not mean they were trans men or “genderqueer.”

In 1909, at age fifteen, she met seventeen-year-old Suzanne Alberte Malherbe, who later adopted her own new name, Marcel Moore. They quickly became friends, creative partners, and lesbian partners. In 1917, Moore’s widowed mother married Cahun’s divorced father, making them stepsisters. Their creative partnership may have diverted attention from their lesbian relationship. Both were active in the anti-Nazi resistance movement on the island of Jersey during World War II, and were imprisoned and sentenced to death after being discovered. They were saved by the island’s 1945 liberation (“Acting Out: Claude Cahun and Marcel Moore,” Tirza True Latimer).

Claude Cahun Jersey Heritage Collection

Cahun described Moore as l’autre moi (the other me), and they remained partnered until Cahun’s death in 1954. After Moore’s 1972 suicide, she was buried next to her lifelong partner at St. Brelade’s Church on the island of Jersey. Over the course of their lifetimes, neither claimed to be anything but women; they were gender-defiant lesbians.

The second photographer to be posthumously genderqueered was Florence Henri, born in 1893. Though she was a very prolific, well-known avant-garde photographer in her heyday, her name is largely unknown today. “Meet Florence Henri, The Under-Acknowledged Queen Of Surrealist Photography,” a Huffington Post article by Priscilla Frank, claims she “toyed with gender binaries, using her personal appearance to emphasize the performative nature of gender.”

Florence Henri © Centre Pompidou, Paris

Henri’s 1928 self-portrait is cited as an example of this, because it features herself “dolled up almost as if in drag” (i.e., short hair and a so-called man’s shirt), and two silver balls reflected against a mirror, “equivocal symbols of both testicles and breasts.” Posthumously identifying Henri as “genderqueer” on account of this is a huge stretch. She was bisexual and at times adopted a tomboyish, androgynous style. She never claimed to be anything but female!

Marianne Breslauer Estate/Fotostiftung Schweiz, 2009

The third and fourth photographers cited, Marianne Breslauer and Annemarie Schwarzenbach, were close friends, though not romantic partners. While Schwarzenbach was a lesbian (who entered into a lavender marriage of convenience with bisexual Achille-Claude Clarac in 1935), Breslauer appears to have been heterosexual. Breslauer was born in 1909, and rose to become one of the leading photographers of the Weimar Republic. Her anti-fascist activism and Jewish background eventually drove her out of her native Germany. After World War II, she and her husband became art dealers (“Beautiful Tomboys of the 1930s”).

Schwarzenbach was born in 1908, and dressed and acted “like a boy” from a very young age. She also adopted the name Fritz. Neither of her parents ever forced her to adopt a more stereotypically feminine role. Her own mother was also bisexual, and had a long-running affair with opera singer Emmy Krüger, as well as other women, which her father raised no objections to (“Swiss writer’s life was stranger than fiction,” Isobel Leybold-Johnson).

Annemarie Schwarzenbach, © Marianne Feilchenfeldt-Breslauer

Throughout her life, Schwarzenbach continued dressing and behaving “like a man,” and exclusively had relationships with other women. Many times, she was mistaken for a man. Her attempted suicide, not her personal style, caused a much greater scandal among her family and their conservative circle. Breslauer described her as “neither a man nor a woman, but an angel, an archangel.” She travelled all over Europe and Asia as a prolific photographer and journalist, and tragically died from a bicycle accident at age thirty-four (“Beautiful Tomboys of the 1930s”).

On a related note, LGBTQ Nation and Ha’Aretz recently reported the discovery of alleged trans or “third gender” burials in a 3,000-year-old grave in Hansalu, Iran. This ancient city was almost continuously inhabited from the sixth millennium BCE till the third century of the Common Era. Among its claims to fame are the Golden Bowl of Hansalu and the Hansalu lovers, two male skeletons who seem to be embracing. The city was violently sacked and burnt around 800 CE, possibly by Urartians, which froze one of its layers in time, much like the eruption of Mount Vesuvius did to Pompeii. Thus, researchers have found a wealth of incredibly well-preserved artifacts, buildings, and skeletons (“Iran’s Pompeii: Astounding story of a massacre buried for millennia,” Catherine Brahic).

Biologically female skeletons were typically found with jewelry, needles, and garment pins, while biologically male skeletons were usually found with weapons, metal vessels, and armor. Simply because 20% of skeletons were discovered with objects associated with the opposite sex, or a mixture of objects, art historian Megan Cifarelli has presented this as evidence of “non-binary individuals” and “a third gender.”

Predictably, the Ha’Aretz article goes on to appropriate and misunderstand known “third genders,” such as India’s hijra and the Two-Spirits found in various Native American cultures. The evidence of such social categories doesn’t negate the reality of being male or female, nor does it have anything to do with post-modernist, queer, trans activist theory. On the contrary, they’re based upon a sex binary. People who don’t fit into either role find a place in these “third genders,” and thus are freed from the expectation of heterosexual marriage and sex, childbearing, having to wear certain clothes, accepting certain social and familial roles, and so forth. Most importantly, everyone around these people understands they’re still the biological sex they were born as.

Native Americans have repeatedly asked people to stop claiming to be Two-Spirit when they haven’t any Native American blood. Not only does this appropriate their culture, it doesn’t take into account how diverse Native American culture is. Not all tribes had/have Two-Spirits. For example, the Iroquois, who kept a much more extensive documentation of their people’s history and daily lives than many other tribes, never recorded Two-Spirits among their ranks. The Apache likewise have no records of them, though they were kind and respectful to Two-Spirits from other tribes (ibid).

Both the Apache and Iroquois had very egalitarian societies, in different ways. Apache adults typically had sex-segregated roles, but children were raised to do things associated with both sexes. Because their tribe was almost constantly at war with other tribes, it was essential to know how to do basic life tasks (e.g., sewing, cooking, hunting, construction) in the event of a sex imbalance either at home or in the trenches. Meanwhile, Iroquois women enjoyed great amounts of political power and authority. Hence, there was no need for Two-Spirits (ibid.).

One tribe that does have Two-Spirits is the Lakota Sioux. Their record of such a category extends as far back as their written history. They also had extremely sex-segregated roles from a very early age, and permitted polygyny. Lakota Two-Spirits were always men, never women. Men who didn’t conform to their tribe’s rigid rules about “proper” behavior were put in the camp with women and children, which didn’t enjoy as high a quality of life or social standing as the men’s camp (ibid.).

Another tribe with Two-Spirits, the Dene of Alberta, Canada, historically treated their women horribly. To give just one example, Dene women were forced to go hungry, if their husbands dictated it, during famines and food shortages. They were among the most mistreated, oppressed women among all North American tribes. Thus, the evidence makes it clear that progressive tribes had no need for Two-Spirits, while ones with the harshest, most rigidly-enforced sex roles required this social category as a way to deal with gay and gender-defiant men. In spite of not being regarded as “real men,” they still had the social power to opt out of manhood. Women weren’t allowed to opt out of womanhood. And again, none of these Two-Spirit men ever claimed to be women, nor were they seen as such (ibid.).

To get back to the topic of the grave, it seems more logical to conclude that the presence of stereotypically male or female objects with the opposite sex is evidence of gender-defiant individuals, possibly lesbians and gay men. If there were indeed a “third gender” in this society, it had nothing to do with modern-day views on the subject. It just goes to show that society may have had great acceptance towards non-conformity, so much so they buried these people with said objects. There also may have been other reasons they were buried with those objects; e.g., a soldier wanting to mend his uniform, both men’s and women’s clothes using garment pins, or women passing themselves off as men to fight in a war or rise to a more prominent social position.

The most recent paleoanthropological evidence reveals that our Neanderthal cousins had a very egalitarian society, with women as well as men hunting dangerous game face-to-face and taking equal part in all aspects of their daily lives, far more so than our own direct ancestors in the Homo sapiens sapiens line (The Neanderthals Rediscovered: How Modern Science Is Rewriting Their Story, Dimitra Papagianni and Michael A. Morse). Does that mean Neanderthals were all “genderqueer” themselves?

By declaring all these people “genderqueer,” part of a “third gender,” and automatically under the trans umbrella, young people who are gender-defiant themselves are being done a grave disservice. When they see no role models from history, in whichever field they may be passionate about (art, photography, music, writing, acting, science, medicine, mathematics, etc.), in addition to a dearth of gender-defiant examples in their own real lives or modern society, they’ll be more likely to believe they must be trans or “genderqueer” themselves. There are almost no available counterexamples to convince them otherwise — to help them see that it’s very possible to be a perfectly normal, happy woman or man who doesn’t behave like a walking, talking stereotype.

Youth in previous generations, not all that long ago, had high-profile gender-bending examples like Annie Lennox, Boy George, David Bowie, Grace Jones, Prince, Marlene Dietrich, and just about everyone with a New Romantic style in the Eighties. Today, however, young people are being sent the message that preferring short hair, trousers, boxer underwear, button-down shirts, and no makeup; or pink, makeup, long hair, stereotypically feminine clothing, and jewelry, means they must be trans or “genderqueer,” instead of simply a normal  tomboyish, effeminate, or androgynous person.

Calling strong, proud women and lesbians “genderqueer” and using “they” pronouns erases, insults, and demeans who they truly were, in addition to doing a disservice to today’s young women. Respect for the dead is a common value across cultures and eras, and this is a painful example of the exact opposite.

by GNC-centric

GNC-centric is a detransitioned dysphoric lesbian. She lived as a trans man for most of her teen years in Canada. For many of those years she attended book readings and lectures on gender and LGBT events, and studied queer ideology. She now uses social media to speak critically about the harms she witnessed and experienced as a member of the transgender community. 

She can be found on Twitter @gnc-centric

Foreword

Many readers may be familiar with Morgan Page as the creator of the Planned Parenthood Toronto workshop “Overcoming the Cotton Ceiling: Breaking Down Sexual Barriers for Queer Trans Women” in 2012. I never heard about this before meeting gender critical feminists after leaving the trans community, years later. I honestly don’t remember anything like that topic coming up while I was in the youth group, although it may have.

I am writing this years after my experience, so there isn’t a ton of detail. I am avoiding using any names, save for Morgan Page, the leader of the youth group I attended. I am using “she” pronouns for Morgan since that is what I used when I knew her; to do otherwise feels disingenuous. This specific group (Trans Youth Toronto) doesn’t exist anymore, although The 519 in Toronto now has other groups for trans youth. Morgan Page no longer works there.

I first met Morgan Page in 2012 at a conference for Gay-Straight Alliances from high schools in the greater Toronto area. Though I’ve since detransitioned, I identified as trans at that time, but I didn’t know any trans people in real life, only online. Morgan was a super nice, friendly person and invited me to the youth group she ran at The 519 in Toronto (LGBT Community Centre). Most of the time, the Trans Youth Group attendees were majority MTFs and “nonbinary” (NB) males. There was an upper age limit (somewhere between 21-25) but it was a pretty small group, usually fewer than 10 people; so when people aged out they just stuck around. I guess others learned that the age limit wasn’t being enforced because more and more older (30-40 year old) MTFs started to join.

I remember one day, there were three MTFs over 40 who were hitting on the teen FTMs, very explicitly. It was obviously making us uncomfortable, but almost no one ever said anything, only changed the topic or tried to engage them in a conversation away from us. The only time I remember them being asked to leave was when Morgan was away and the group was led by an FTM substitute.

The 519 LGBT Community Centre, Toronto

It was very common for the group to discuss the logistics of sex before and after SRS, kinky sex, and erotic fanfiction. I remember Morgan asking the three teens in the room, including me, if we were comfortable talking about this, but obviously we weren’t going to say no now that the conversation had already been started by these older people. I know of at least three FTMs who entered into relationships with older MTFs while in this group, all of which seemed very unhealthy to me. To me, FTMs under 18 dating or sleeping with (usually kinky) MTFs over 20 seemed very sexually exploitative. Healthy boundaries between adults and minors were foreign to this group, much like in the greater queer and trans community.

Morgan didn’t present herself as someone to emulate, but as someone to share her trans experiences with us. She spoke of her time as a teen prostitute, her SRS, her art, her writing, and her connections in the queer community. I think most of the teens saw her as someone to just give us advice and support, since she could recommend which clinics or doctors to see to start HRT and tell you what you needed to say to doctors so they’d sign off on SRS. She’d talk about what to expect after SRS. She knew the MTF side personally, but she also was intimate with a fair number of trans men so she told us about the FTM side too. At the time, to me, she seemed like the magic key to accessing all the medical transition resources I wanted. This was a trans support group, so one might assume this was normal—and it may have been for such a gathering—but in retrospect, I find elements of this concerning.

Unsurprisingly, most of the teens seemed to be there without their parents’ knowledge (as I was), but there was unquestioning support for all of them to medically transition as soon as they wanted. There was one male nonbinary who complained about how they had to perform more femininity in order for their doctor to get them a prescription for estrogen. To us in the group, this doctor was evil for trying to deny our friend what they needed. Looking back now, the only thing that made this person “trans” was their clothing and nail polish. They made no attempt to pass as female, so I understand why a doctor might have been hesitant.

One of the most memorable experiences I had there was when I was 16 and had brought my 15-year-old non-trans female friend with me. We were hanging out, talking about the usual stuff, when Morgan mentioned she was going to be a judge at the Porn Awards that night and invited my friend and I to go with her for free. We said no—I knew right away I would probably see penises, and that would make my dysphoria worse. At that point in my life I had only seen porn once, and since then had only talked to porn actors and cam girls in the queer/trans community online. I honestly thought it was all empowering and fun. Still, my gut reaction was “no,” thank god.

Morgan’s personal life would often come up. This wasn’t a problem in and of itself, but I believe it normalized some harmful behaviour for us younger people. She would talk about when she was a teen and had a 30 year old boyfriend, then one of the teen FTMs would chime in how they had an adult boyfriend. She would talk about the drugs she did as a teen—weed, coke, poppers, etc; people would chime in about doing drugs in high school. She would talk about her time as a prostitute/sex worker, and others would accept this as a normal part of most MTFs’ lives. It’s one thing to be open about these topics so teens can discuss them without fear or shame, but another to present them as typical behaviour for trans people.

Usually, these things came up because someone other than Morgan started in on the topic. I don’t think she had any negative intentions, but most of the young people there had never been exposed to these things, and because of her, our first received message was that these were positive and mostly-harmless choices.

When I was 16, I started seeing a counselor for my family situation, my mental health, failing in school, and to help with my trans identification. This was the first time in my life I had met someone who really wanted to help me with my crippling social anxiety. I expected to learn coping techniques, not only for my anxiety but also for my dysphoria. She never gave me any advice for handling dysphoria directly. In one of my last sessions with her, I mentioned maybe using some of the techniques used by people with Body Dysmorphic Disorder. My counselor, a lesbian with an FTM partner, seemed surprised by this idea. Much like Morgan’s group, she didn’t attempt to tackle dysphoria, but merely took it as a sign that I needed HRT as soon as possible.

I was one of very few people in that group who got help for my mental health. This is horrifying considering how many of us openly talked about being suicidal and self-harming. It was a given that all the members of this group had struggled with depression and anxiety at some point. A lot of us had also experienced trauma, and many of us had ADHD or were on the autism spectrum. For some reason, none of this was ever discussed as seriously as other topics.

As mentioned previously, Morgan Page was the creator of the Planned Parenthood Toronto workshop “Overcoming the Cotton Ceiling: Breaking Down Sexual Barriers for Queer Trans Women” in 2012. And although I had never heard about this until after leaving the trans community, years later, those of us in Morgan’s youth group definitely identified as members of our chosen sex class, which is the cornerstone of the Cotton Ceiling movement: that sex-based attraction can be reclassified as gender-based attraction.

The only context in which lesbians were ever discussed was in regards to “trans lesbians”. Most of the MTFs & male NBs there would lecture the few FTMs and female NBs about our “masculine/male privilege,” explaining to us that they experienced “transmisogyny” and therefore we needed to know when to be quiet and listen. These beliefs and attitudes were essential in the aforementioned relationships between FTMs and older MTFs in the group. I remember one time I was discussing how I didn’t pass somewhere and was treated like a woman and called “dyke”, but they insisted it was just transphobia, and that I could no longer experience misogyny now that I identified as male. The idea that I might be a lesbian or that I might have experienced lesbophobia never came up. Isn’t this the perfect group mindset to facilitate abuse? Is this really the right dynamic for teens trying to discuss their trans issues, family, school, and mental health problems?

In conclusion, I believe that Morgan treated us like adults when we were only teens. She expressed unwavering support for anyone to transition regardless of their history, age, family situation, trauma, etc. The group viewed most therapists as “gatekeepers,” so she advised teens to find doctors who practiced Informed Consent. This means that many of the teens in that group started HRT without seeing anyone for their mental health first, after signing what amounted to a non-liability waiver. Strangely enough, we almost never talked about post-op complications nor the long-term negative effects of HRT, a lack of concern for which is sadly the norm in the trans community. She spoke about sex, drugs, porn, and kink as if it were a normal part of our lives because we were trans.

Honestly, my friends and I thought we might find help for our dysphoria, help understanding how trans identities and sexual orientation intersect, and yes, how to get HRT & SRS. Dysphoric and gender-nonconforming kids and teens need support groups that help address their everyday problems, without automatically being labeled as trans. In retrospect, that group was a breeding ground for predators and narcissistic trans males, with trans females discouraged from pointing this out on account of their “masc privilege”. At the end of the day, I think the members of the group internalized the prioritizing of MTFs and the silencing of FTMs, a mindset that now permeates almost all of the LGBT community.

by Inga Berenson

It was a hot summer morning. I was nine or ten, riding my pony from our farmhouse toward the barn where my father was working. This was the first time I had gone riding since a string of bad falls had caused me to lose my nerve, but I loved riding, and was determined to be back in the saddle.

So far, things were going well. The gravel road between our house and the barn was about a mile long, and I was halfway there. My usually cantankerous little mare was being perfectly docile, but I was approaching the house of a quirky neighbor who kept a menagerie of animals – donkeys, zebras, buffalo, and a gaggle of dogs that barked at every passing car. I was mostly worried about the dogs and how my pony would handle the barking – it sometimes made her nervous, but there was no dog in sight as I rode past the house.

I was thinking I was home-free until I heard a commotion from the paddock across from the neighbor’s house. I looked around and saw a giant draft horse push through a dilapidated wire fence and come galloping toward me, neighing and grunting in what I later understood to be equine lust. In an instant he was beside us, rearing and pawing his great, hairy hooves in the air near my face. I thought that was the end of me and my pony.

Then all of a sudden I heard my mother’s voice. I looked around and found her running toward us, yelling and hurling gravel at the big horse. She distracted him just long enough for me to hop off. My pony raced off into the safety of some low-hanging trees, and the neighbor came running out of his house to capture his oversized horse.

As I stood there, weak-kneed from my near-death experience, I saw my mother’s car parked a few yards down the road, the driver’s-side door still open, and I knew what had happened. She had been worried about me, so she had followed from a distance, just to be sure I made it okay.

Illustration by Chiara (Twitter: @chiaracanaan)

I’ve been thinking about that story a lot lately. It was about four years ago that my daughter first told me she thought she might be trans. I believe her story is a classic example of social contagion, since she had never expressed any discomfort with her sexed body until she got Tumblr and DeviantArt accounts and began spending all her time on her phone. Since then, I have felt a bit like my mother, standing in the middle of the road, hurling gravel, trying to protect my daughter from an ideology that has sought to convince her that she was born in the wrong body.

I am fortunate. Unlike some of my friends with kids who became convinced they were trans, I feel reasonably confident that my daughter will not medically transition. She desisted from a social transition more than a year ago, and she told me recently that she no longer identifies as trans. However, she still has many friends in the gender-queer community, and I know we’re not out of the woods. When she turns 18 in a few months, she may exercise her right as a legal adult to start medical transition, and there won’t be anything I can do to dissuade her. This worries me greatly. So, as a matter of self-preservation as much as anything, I’ve been asking myself, what if she does transition? How will I cope?

The short answer is I don’t know, but I certainly won’t disown her or ask her to leave my home. In fact, of all the many gender-critical parents I know who have trans-identified children, I know absolutely no one who has disowned their child or kicked them out of the house. I’m sure it must happen, but I don’t know any. Of course, all parents say things they regret – especially during the highly charged arguments with teens who are demanding immediate medical interventions. In one such argument, one of my best friends even told her then-trans-identified daughter to get out, but she immediately regretted it, took it back, apologized, and asked her daughter to stay (which she did). I also know at least three mothers who have lost contact with their trans-identified children, but in those cases, the kids themselves severed the relationship, not the parents. In fact, the mothers continue to try to reconnect with their children, despite being repeatedly rebuffed.

Although I know I won’t disown or reject my daughter, I also know that I won’t affirm her decision to transition. It’s not really that I’m deciding not to; I simply cannot bring myself to do it. It would be dishonest for me to call her my son when I don’t believe she’s male. Plus, I don’t think it’s helpful for me to allow my daughter to dictate how I define words like “male” and “female.” Does this mean I love my child less than the mothers who affirm their children?

Since I cannot occupy the mind of any of these other mothers, I guess I’ll never know. But I do know that my love for my child is so deep and strong that the idea that she has been misled to believe that her body is wrong depresses me to no end. I am angry — bitterly, bitterly angry that this ideology has taken up almost four years of her life so far and god only know how many more years it may take.

Maybe the reason some parents affirm their children’s transgender claims and some parents question them lies in the parents’ own experiences of puberty. When my daughter felt embarrassed about shopping for bras at 13, I was not surprised because I remembered that feeling vividly. I hated it. I hated knowing that people could see my developing breasts and the outline of the bra straps under my shirt. I especially hated the very feminine bras – the ones with lots of lace and little pink bows where the cups joined in the middle. They made me feel vulnerable and exposed and miserable.  I also know I got over it – for the most part, anyway.

Trans activists claim that the number of trans-identifying people has increased so rapidly not because there are more trans people today than in the past but because society has become more accepting and they are no longer afraid to come out. But if this were the case, why are the greatest increases occurring in the population of female teens? Why aren’t middle-aged women like me queuing up for hormones now that we can come out? To me, the answer is clear. Women like me had a chance to come to terms with our bodies and accept ourselves as we are. My daughter didn’t have that chance because an insidious ideology was waiting in the wings to convince her that her feelings about her body meant that it was wrong.

But maybe the mothers who readily affirm their children’s trans self-diagnoses didn’t have this experience at puberty. Maybe they were lucky enough to sail smoothly and happily from childhood through puberty, unambiguously pleased to watch their bodies go from child to woman – so, when their children expressed unhappiness about their developing bodies, they were genuinely puzzled and could only agree their kids must have been born in the wrong body.

Whatever the reason for the difference between those parents and me, I resent the fact that the mainstream media will tell their stories, but they won’t tell mine. I resent the fact that my daughter looks at those parents and wishes I could be like them — because I never can be.

If my daughter does eventually decide to take hormones or undergo surgery to medically transition, the only way I could fully support it is if I had clear scientific evidence that she had a condition requiring such an invasive treatment. If there were a definitive medical test – a brain scan, for example – that proved my child’s distress arose from an incongruence between her brain and the rest of her body that could only be alleviated by transition, I think I could go along with it. But there is no such test because individual brains don’t break down neatly into pink and blue categories. Sexually dimorphic brain features are subject to averages just like other physical characteristics. In general, men are taller than women, but if you plot their height on a bell curve, you will see lots of overlap between the sexes. You’ll also see outliers on the “tails” of the bell curve—6’4’ women, and 5’1” men. This is true with psychological and neurological traits, too. Also, trans activists justify their born-in-the-wrong-body claims by pointing to a few studies which indicate that the brains of trans-identified people are more similar in some respects to the opposite sex than their natal sex. But these studies do not control for many factors, including sexual orientation, and we know already that people who are same-sex-attracted have some brain features more similar to the opposite sex.

Without tools to reliably predict who will benefit from transition, I simply cannot support medical interventions for young people whose brains have not fully matured (generally understood to be around age 25). I want desperately for my daughter to accept her body and to avoid the irreversible changes and the many health risks that are inherent in medical transition. But she will soon be 18 years old, and she will have the power to transition no matter what I want – even though she is still at least seven years away from brain maturity. There’s a real chance that she could. Would that be the end of the world?

No, I know that it wouldn’t. As worried as I am about this outcome and as fixated as I’ve been on preventing it for four years, I do have to remind myself that her transitioning would not be the worst thing that could happen. Plus, I will still be able to hold onto the hope that she will detransition before the hormones can cause too much damage to her long-term health. Every day it seems that I read about a new detransitioner. More and more young people are saying enough is enough. They are reclaiming their bodies and their lives, and I find their stories inspiring.

A few days ago I watched a video in which four young women, who formerly identified as trans, answer questions about their experience and share their insights. Their video gave me hope for a couple of reasons. First, they acknowledge the role that social contagion plays in driving the huge increase in kids (especially girls) who are identifying as trans today. It takes real courage to speak up and share stories that contradict the popular understanding of why people transition. These stories not only challenge the narrative of why people transition; they also show that, for many young people, transition does not make their lives better.

But another reason that video gave me hope is that I can see these girls are all okay. In fact, they’re better than okay. They are strong and smart, and they are living with purpose and a sense of future. They reminded me that transition – even medical transition — is not the end of the world. Three of the girls were on hormones for more than a year. Their voices are changed, but they are healthy and well, and that’s a beautiful thing.

Detransitioners have been giving hope to me and other parents for many years, but the relationship between the groups has been difficult at times. Some detransitioners have understandably resented how parents sometimes try to use their stories as cautionary tales to warn their kids about the dangers of medical transition. A big part of the problem is the language people sometimes use when talking about medical transition. For example, referring to the bodies of detransitioners as “mutilated,” their voices as “broken,” or their stories as “heart-breaking” has not been helpful.

One of the most powerful and positive messages of the gender-critical movement is that no one is born in the wrong body. Gender-critical parents like me are constantly trying to encourage our kids to accept their bodies just as they are. Yet I believe we need to extend that same acceptance to all bodies – even bodies post transition. To feel good about themselves and their lives, all people need to be able to accept themselves physically and mentally, and words like “mutilated” don’t help them do that.

Online, the interactions between detransitioners and parents has also been a little rocky at times because parents sometimes overstep boundaries that detransitioners need to be healthy. Parents often reach out to detransitioners for help with their personal situations – to seek parenting advice and guidance. But most detransitioners who speak out publicly are quite young; they don’t have children and they aren’t parenting experts, nor is it fair to saddle them with the responsibility of helping us. They’re dealing with their own issues, are often most focused on helping each other, and they don’t (and can’t be expected to) understand the situation and struggles of parents. What’s more, many have written or vlogged about their own, often fraught, relationships with their own parents, so when other parents reach out to them, they can feel “triggered” by being reminded of their own family relationships. These young people are still maturing and processing what their transition and detransition mean to them. They need time and space to be able to do that, and desperate appeals from parents they’ve never met, for help with kids they don’t know, could interfere with that process.

Also, detransitioners are not a monolithic group. Not everyone who detransitions regrets transitioning. Deciding that transition is not right for you and regretting transition are not necessarily the same thing. Detransitioners who do not regret their transition naturally resent it when people use their stories to make a case against medical transition.

At the same time, those detransitioners who are willing to speak out about the harms of transitioning and the power of reidentifying with your birth sex can be powerful allies in the fight to raise awareness about the regressiveness of gender ideology and potential harms to other young people – whether we’re trying to raise this awareness in the culture at large or just in our own homes. I hope my daughter will listen to the stories of some of these detransitioners and decide to first try some other strategies for becoming comfortable in her natural body.

If, however, she does eventually transition, I hope she can be honest with herself about it and accept that she can never be male – however much she may be able to look like one. I follow several gender-critical trans women on Twitter. Although they have sought medical intervention for palliative reasons, they acknowledge they are male and support sex-based protections for women. They don’t demand that the world repeat the mantra that trans women are women. They have a healthier outlook on the world and a healthier sense of self because they aren’t trying to change anyone’s perception of material reality (like male and female).  I appreciate the courage they are showing. Their stance as gender critical has cut them off from the support of the larger trans community, which regards them as heretics and traitors. And it must be noted that they’re not universally accepted among women who are gender critical, some of whom regard them with suspicion.

Of course, my daughter may never come to recognize the bill of goods she’s been sold. She may transition, remain transitioned, and remain committed to an ideology I find regressive. If that’s the case, it will be my life’s task to love her and support her in spite of these things. But that doesn’t mean I will ever abandon my own sense of reality, because doing so would be inauthentic, and parents should not have to subordinate their own authenticity to their children’s quest for it.

What I can do is look after her, help her financially to achieve non-transition-related goals, cook her favorite foods, hold her hand when she’s feeling down. I can even go out of my way to avoid gendered language so as not to provoke or upset her, but I simply cannot utter beliefs I don’t hold. Our relationship needs to be based on mutual respect. I must respect her autonomy, but she must also respect mine.

Also, I want my daughter to understand that it’s ok for other people (even her parents!) to disagree with her and hold different views; that doesn’t mean we don’t love her. Far from it. I want my daughter to be strong and resilient enough to face the reality that life will be full of other people who disagree with her for any number of reasons. I’d rather she learn resilience than fragility that is triggered whenever she encounters disagreement or disapproval from others.

I feel such a sense of solidarity with the other gender-critical moms I’ve met here on 4thWaveNow, on Twitter, and in real life because they’ve seen what I have seen – that this ideology has made our children less resilient, it has alienated them from their families, their former friends, and, worst of all, their own bodies. Most of us have watched as our children went from well-adjusted kids to teens preoccupied with online worlds, feeling oppressed and seeking medical transition.

For our efforts to call attention to the regressive nature of the ideology, we have been called “bigots,” “transphobes,” even “Nazis.” So-called gender therapists gaslight us and pretend to know our children better than we do. And some journalists, blind to their sexism, have dismissed us (in one case, as merely a “bunch of mothers”), despite the advanced degrees and professional careers many of us hold, not to mention the voluminous research we have done to educate ourselves about this particular subject.

And, yes, we have made mistakes. We are certainly not perfect. There are so many things I have said to my daughter that I wish I could unsay or at least say differently. There are so many times when my strong emotional reaction to things she was telling me created a barrier and shut down communication between us. Of course, she has said things that hurt me too, but as her mother and the adult in the relationship, I rightfully bear a larger share of the burden to try to make things right between us.

I can’t change the past, of course. What’s done is done. But I do know this: My mother has been dead for more than 20 years, but I think about her every day. She was far from a perfect parent, but she loved me fiercely. The love she gave me in the first 30 years of my life still sustains me today. I know that now, in a way I didn’t fully understand when I was younger.

I don’t know what the future holds for my daughter. My fervent hope is that she will reject the idea that she needs to change who she is, but whether or not she does, I hope one day she will look back on my resistance to her transition as the act of love that it is. I hope that her knowledge and memory of the fierceness of my love will sustain her, as my mother’s sustains me.

Interview by Grace Williams

In this interview with Chiara, one of the co-founders of the Pique Resilience Project (PRP), and her mother, Denise (aka “Marie Verite”), the founder of 4thWaveNow, the two women tell the story of Chiara’s temporary trans identification and how this inspired the creation of 4thWaveNow. They talk about what life was like for both mother and daughter during the teenage years when Chiara believed she was a man, and Chiara describes the influences that eventually led to her desistance.

For several years now, 4thWaveNow has been administered and edited by a small, dedicated group of parents; it’s no longer a one-woman show. In the meantime, Chiara has gone her own way, recently joining forces with three other detransitioned women — Dagny, Helena, and Jesse — to launch the Pique Resilience Project. The purpose of PRP is to offer support to the growing number of young people who have realized that transition was a mistake for them, as well as to young people who are questioning their gender identity but have not yet transitioned. PRP has so far released two videos (here and here) and a podcast. Chiara was also interviewed by Benjamin Boyce about her experiences with trans identification and desistance on Feb. 21, 2019.

Chiara and Denise were previously interviewed (using the pseudonyms Rachel and Janette) for an article by Charlotte McCann in the Sept. 1, 2018, issue of The Economist,
 “Why are so many teenage girls appearing in gender clinics?”

Grace Williams conducted this interview with Chiara and Denise via email. “I am one of the thousands of parents who have benefited greatly from 4thWaveNow,” says Grace, “and I’m deeply grateful to Chiara and the other young women of the Pique Resilience Project for their work to help young people like my daughter.”

Chiara, I’ve watched the videos you and the other women of the Pique Resilience Project have made and I’ve been really impressed with how articulate you all are. This is something new: a group of detransitioned/desisted women starting a YouTube channel. Can you tell us a bit about what inspired you to do this and how things are going so far?

I was put in contact with Dagny, Helena, and Jesse a few months ago, and we had our first meetup in January. The initial goal was to create an ongoing multimedia project, focused mainly on raising awareness. All four of us have unique experiences and are committed to sharing those in the hopes of informing others about the dangers of automatic gender affirmation and the influences of social media. We also dive in to other factors that fuel dysphoria, and the importance of exploring those before embarking on medical transition.

We’ve had incredible, overwhelmingly positive feedback so far, as well as a ton of opportunities that have arisen for us to expand our platform. Several parents and young people who are questioning their gender have contacted us for advice, and I personally have helped two so far in the process of self-reflecting and moving toward desisting. I’m very excited about the future for us and this project.

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Denise, what are your thoughts about PRP?

Chiara has always done things her own way. She’s tough and intelligent, so in one sense I’m not surprised that she could pull off something this important. And at the same time, what she and the other three women of PRP have created far surpasses what I could ever have imagined five years ago. Their message is one of strength and hope—not only for their primary audience, young people who are questioning their gender, but for parents whose daughters and sons have pursued and/or desisted from a trans identity. Not every young person will desist or detransition, but these women show and tell what that can be like. By joining together as a group, the PRP women are offering an alternative vision that we haven’t seen in quite this way previously (although there have been some really inspiring detransitioners who’ve been writing and vlogging about their experiences for several years now). I really think their insights and experiences will help many people in the years to come—and that includes not only those who detransition/desist and their families, but also others who continue to live as trans-identified people.

Obviously, it’s been a long and sometimes difficult road for both of you, starting with Chiara’s initial announcement that she was trans in late 2014. Let’s jump into that story, starting from the beginning. First, how did Chiara tell you she thought she was trans?

Chiara told me she was trans soon after her 17^th birthday, in a text message consisting solely of a link to an online informed consent clinic that would prescribe testosterone for minors, with parental permission. Medical transition was her goal from the get-go, and pretty much out of the blue. She had never previously said one word about feeling “wrong” as a girl—in fact, quite the opposite. I had thought for quite some time that she was likely a lesbian (which I fully supported), but there had never been any indication that she despised her body or wished she were the opposite sex.

But we had just watched the TV series “Transparent” together, and good liberal that I’ve always been, my initial reaction was “maybe she IS trans.” If she had not abruptly and immediately expressed such an intense interest in testosterone and top surgery, I might not have embarked on a research mission which in rather short order resulted in alarm bells—primarily because I learned the effects of T are mostly irreversible, and I well remembered my own dead-certainties at age 17 that turned out to be mistaken when I got older. Her constant demand for hormones (and later “can I at least have top surgery”?), coupled with my phone calls to some gender therapists, all of whom in so many words told me if she said she was trans, then she was, intensified my skepticism.

When I asked one of the gender therapists how we could know she was trans as opposed to lesbian, she said, “Oh, it is very rare for a trans man to actually be a lesbian. Very, very rare.” Then there was the (very nice) FTM therapist who, when I mentioned Chiara had not had a full-on relationship yet, said, “A lot of trans teens just skip that step” and added “he’d” be welcome at the next trans teen support group that week. I actually did schedule an appointment with this therapist, as well as signed her up for the group, until my crash online course in all things trans made me think better of it and cancel. Not long after, Chiara and I together found a therapist who used a mental-health (vs. “affirmative”) model and agreed to work with Chiara without enabling medical transition.

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Chiara, why do you think you came to believe you were transgender? What forces were acting on you?

At the time, I of course believed that I was “a man trapped in a woman’s body,” and that I would truly not survive if I was not allowed to transition. (I wasn’t constantly or seriously suicidal, though I had ideation at times—it was more that I saw no future for myself as female; the only option in my mind was living as male. Additionally, suicide rates by trans-identified kids are misrepresented and used to threaten and manipulate people into “validating” identities without question.) In hindsight, however, I was struggling to deal with trauma, internalized homophobia, and social isolation. I was at a vulnerable place, and not all that happy being a girl, so I latched onto a trans identity almost as soon as I first heard about it online.

Was there a lot of talk about suicide online? If so, did that influence you in any way?

There was a large amount, the most notable being the case of Leelah Alcorn, an MtF teenager who committed suicide in 2014. Her death affected me, along with many others, as it was sensationalized and widely held up as a warning to parents: “This is what happens when you don’t let your kid transition.” This mantra continues to be repeated online and everywhere, and perpetuates the idea that suicide is the “only way out” for kids whose parents will not accept their gender identity—this is a false statement that should under no circumstance be peddled to impressionable young people.

What made you feel unhappy about being a girl?

I was dealing with trauma, which caused me to want to escape my body. This, in addition to my resistance to accepting my same-sex attraction, resulted in a rejection of being female.

How did your dysphoria manifest itself? What “triggered” it for you?

It came on in the span of a couple months, but was still a fairly gradual process. The main triggers were my increased usage of social media, which facilitated my exposure to trans ideology and activism, as well as my social isolation and beginning to learn about and come to terms with past trauma. My dysphoria caused me to adopt an appearance that was as masculine as possible—I cut my hair short, wore men’s clothes, bound my chest, and packed off and on for over a year. I even used the men’s bathrooms in public, and felt good about myself when I passed successfully.

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Denise, as every parent knows who has experienced something similar, hearing your daughter suddenly declare she is transgender and tell you she needs hormones immediately is very stressful. How did you cope?

Starting the website—which was initially a cry into the wilderness, just hoping to find and speak to other parents who were skeptical of their teen’s desire to embark on medical transition—was crucial in helping me to cope with the situation. I suspect there would have been more arguments and difficult times between Chiara and me if I had not had the outlet of writing and finding others online who were in the same boat.

Pretty much all my “in real life” friends at the time were lifelong liberals/lefties like me, who saw (as I had) everything to do with trans activism as purely and simply the next civil rights movement; they hadn’t had a reason to look into some of the more controversial aspects because their lives hadn’t been touched by the issue. So, for the most part, I couldn’t talk to them openly about what was happening in my family.

This was, of course, a very difficult time for Chiara as well. She wanted desperately to transition. Did you make any concessions to her at the time?

I did. At her request, I bought boxer shorts, “men’s” clothing, “men’s” dress shoes, and repeatedly paid for very short haircuts. I was happy to do this, in part, because being “gender nonconforming” in clothing, hairstyles, etc. doesn’t mean a person is actually the opposite sex. I was well aware, however, that these outward expressions of gender meant to Chiara that she was a man (at the time). I drew the line at hormones or surgery, and I didn’t purchase the binder she asked for. (Whether she ever got a binder herself from one of the websites that offer them free, I don’t know.)

What were conversations between you like at the time?

We pretty much had a communication breakdown. Once we were a few months into it, I began to realize that I needed to say as little as possible, because after all, in just a few months, this was all going to be out of my hands (she was 17). Also, parental lectures—or even attempts at meaningful conversation—were becoming counterproductive (that can be true for any parent and teen in conflict, trans-identified or not!). When I did say something, I tried hard to be succinct, instead of going on and on. I would say things like: “You’re a strong, gender-nonconforming young woman. That doesn’t mean you are literally a man. In fact, you could be a role model for other young women in the same boat.” At the time, this all seemed to fall on deaf ears.

Like many parents in this predicament seem to do, I found and looked up to young, detransitioned women who were writing on Tumblr. I thought they somehow had “the answer.” I now know they don’t, and many—if not most—don’t appreciate parents reaching out for help. Nevertheless, I was fortunate to be able to meet two detransitioners I’d discovered online in person when I attended the Michigan Women’s Music Festival in 2015. They were kind enough to reach out to Chiara (with her and their permission) and I remain grateful to them for their generosity.

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Chiara, what turned things around for you? Was there anything that you read or heard that suddenly helped you realize not only that transition was not right for you but that gender identity as a concept was suspect?

At 17, as soon as I graduated high school, I moved to Florida for nine months for an internship on a horse farm. We had very little internet access, and spent most of each day performing physical labor, so I was forced to focus on something apart from trans ideology. Being disconnected from social media, specifically Tumblr and YouTube, allowed me to slowly begin rediscovering myself and my interests and by the time I returned home, I had matured (emotionally, physically, and mentally) enough to return to these social media sites with a critical eye. I found radical feminist blogs, the messages of which resonated with me, and gradually moved away from my trans identity with the support of this new community.

What appealed to you about the radical feminist blogs? What were they saying that resonated with you?

Radical feminism, being focused on women’s issues and liberation, was a breath of fresh air for me in many ways. The people writing about it online were fiercely protective of women and passionate about enacting change. The main points that appealed to me were their acceptance and celebration of lesbian and bisexual women, and their tendency to think critically and question problematic narratives—specifically prostitution, pornography, and, of course, transgenderism. They opened my eyes to the glaring issues behind trans activism (puberty blockers, misogyny, homophobia, women’s loss of rights, etc.), which allowed me to finally realize that I wanted nothing to do with the movement, and the best way for me to fight it was to simply exist as myself and stand up for other women. I definitely do not agree with every aspect of the ideology, but I believe it is the one of the only movements that truly cares about helping women.

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Denise, are you a radical feminist?

I like to think of myself as a “rational” feminist. Some of the tenets of radical feminism seem more ideological than logical—for example, the notion that humans are essentially “blank slates,” with all gendered behaviors being only social constructs. But there is a large body of replicated, cross-cultural scientific evidence that there is a biological basis to typical sex differences, and even some typical gendered behaviors, many of which are rooted in evolutionary selective pressures. Again, we’re talking about averages; individuals should never be assumed to be average. Being gender-atypical doesn’t mean anyone’s brain is mistakenly stuck in the wrong body. Historically, some of the more interesting, accomplished humans have been atypical for their sex. And, importantly, many—though not all—gender-atypical kids grow up to be lesbian, gay, or bisexual adults. This has long been well understood, though in the last few years, the trans movement has obscured this knowledge. There is a very real (even if unintended) risk that proto-LGB kids will be unnecessarily medicalized before they are old enough to realize and accept their sexuality. We already see many detransitioned lesbians who themselves say their difficulty accepting their sexual orientation contributed to their transient trans identification. (Of the essays I’ve written, I am perhaps most proud of the one I wrote on this subject, “The surgical suite: Modern-day closet for today’s teen lesbian”).

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Chiara, you mentioned that internalized homophobia played a role in your belief that you were trans. Why were you more comfortable identifying as a trans man than a lesbian?

In many ways, it felt easier for me to exist as a gender-conforming, “typical” man, as opposed to a gay, gender-nonconforming woman. As I mentioned in my recent interview, I think a lot of my desire to transition was based on a fantasy version of myself as a man—I was convinced that all discrimination against me would disappear as soon as I became a straight man. I also believe that our society is still largely heteronormative and somewhat homophobic, and gay people are often subjected to judgement, hate crimes, and insults. This is something many young people begin realizing in their teenage years, and it is understandably tempting to want to escape those experiences.

Did you talk to a therapist about your questions about gender identity? Did you find the therapy helpful or counterproductive?

I have been in and out of therapy for many years. It was incredibly helpful for me in many regards, and I strongly believe it should be utilized to determine factors contributing to dysphoria, before medical transition is permitted. The two long-term therapists I’ve had in the last few years have allowed me the space to explore mental health, come to terms with past events, and build the skills necessary to advance my life in the direction that I want. I hope that therapists will begin to educate themselves on both sides of gender ideology, and use this knowledge to encourage critical thinking in anyone who may be questioning a trans identity.

What were the things you think your mom got right in parenting you during the period when you identified as trans, and what do you think she got wrong? What could she have done better?

I am grateful that she never allowed medical transition, as I am sure I would have regretted it. I also appreciate that she put me in contact with a couple of detransitioned women, as well as paying for therapy for me to discuss issues behind my dysphoria.

But there were times in which I felt that my privacy was invaded, and this made it difficult for me to trust her intentions. I also had my phone taken away. While I understand that she truly felt that was for the best, I do not believe that trying to cut me off from the internet was helpful—I had multiple other ways to access it without my phone anyway, so this only caused resentment and anger on my end. I do understand that this was a very stressful time for her, but I believe that she could have been more careful about how she phrased several things, and stepped back to look at how some of her actions would impact me in the future.

Teens and their parents often have a hard time communicating with each other, even when the trans issue isn’t on the table. Were the arguments you had with your mom around this subject always counterproductive, or did she occasionally say things that stuck with you and helped you (eventually) see things differently? Conversely, do you think your mom was eventually able to understand some of what you were going through and trying to tell her?

At the time, most of our arguments did nothing to change my mind or outlook. At that point in my life, I was reluctant to change my opinions and take advice, especially from my mother. I can look back now and agree with a lot of what she expressed to me, and I do think that some things she said stuck with me and helped me to open my mind to the idea that transition was not the right path for me. I believe that she did eventually understand a lot of what I was feeling, but it was an unfamiliar topic to her at first.

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Denise, do you have any regrets? Were there any things that you wished you had done differently?

I do have regrets about how I handled some things. I was not (and am not) a perfect parent, and I think the increased stress we both experienced during that time damaged our relationship. We’d been very close pre-puberty, but along with the other garden-variety issues that arise for parents and teens weathering adolescence, the trans issue turned the stress-volume up to max. One night, when Chiara was screaming about how awful I was not to approve medical intervention, I screamed back that she should just leave. I immediately wished I hadn’t said it. She didn’t leave, and I never took any steps to kick her out, but I know how much that must have hurt and probably still does. I’ve apologized, but I still wish I could take it back because I never meant it.

Monitoring and restricting her social media and (temporarily) confiscating her phone are things I feel more conflicted about. At the time, it seemed to me that she was being inducted into a cult: the obsessive nature of her wanting “the two Ts” (testosterone and top surgery), scripted language, and a seeming refusal to examine or explore what might be underlying this (as well as a general refusal to talk to me about much of anything) resulted in my feeling desperate to know what was going on inside her, and to try to keep her safe in any way I could. Besides the rumination on being trans 24-7, her grades had dropped from As and Bs to Ds and Fs, she nearly dropped out of high school, she had drifted away from all the friends who had previously been important to her, and totally abandoned all her hobbies and interests.

In an ideal world, I would not have invaded her privacy, and I know from my own teen years how such actions feel like a huge betrayal of trust. Something similar happened to me when I myself was 17. I discovered one day that my dad had searched my closet and confiscated a baggie of marijuana I had hidden beside a diary. I still remember the burning outrage. I confronted my father and for many years could not forgive him. Now, of course, I can understand how worried he was about me and the choices I’d been making. But whether what he did was justified, or whether my similar actions with Chiara were justified? I’m not sure.

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Chiara, on the PRP website, you, Dagny, Helena, and Jesse state plainly that you all experienced rapid-onset gender dysphoria (ROGD) as described in the paper published by Dr. Lisa Littman last year, but trans activists have tried to dismiss and discredit Dr. Littman’s research, claiming it is based entirely on the claims of bigoted, transphobic parents. Why do you believe that you experienced ROGD? How would you respond to Dr. Littman’s critics?

I believe that ROGD is a very real phenomenon, because I, myself, and many others only began experiencing dysphoria around our teenage years, seemingly in response to significant changes or struggles. I did not begin to have dysphoria until I was a young teenager, and had no desire to transition until I began hearing about others doing so. I became obsessed with the idea that I was a man, and completely fixated on medical transition as the only viable option for me. Since I can look back now and understand that I would not have been happy long-term with that decision, I am very confident in Littman’s study, and believe that discrediting it as “transphobia” is wildly irresponsible. I find it very strange that trans activists see any inkling of criticism as a direct, “violent” attack.

You mentioned that you had no desire to transition until you heard about others doing so. Did your dysphoria increase the more you learned about gender identity and transition?

Absolutely. The more information I consumed on the topic, the more adamant I was that transition was right for me. Other people’s hormonal and surgical results appealed to me at the time, and I desperately wanted that for myself. It was a vicious circle: the more I watched, the more my dysphoria grew, and the more my dysphoria grew, the more I needed to “escape” in the form of this addictive media.

Why do you think so many young people—especially girls—have come to see themselves as transgender?

In many ways, it is incredibly difficult and often painful to exist as a woman in society. Dealing with harassment and strict gender roles is a daily ordeal, and media often portrays us as infantile, sexualized, and unconditionally available to men. Women are targets of assault and murder simply because of their sex—the idea of escaping that, which transitioning to male promises to provide, is very attractive.

What do you think it will take to wake people up to the harm that’s being done in the name of gender ideology?

Honestly, I think this is already starting to happen. The response to our project alone has been big (over 20K video views in the first two weeks) and overwhelmingly positive, which gives me hope that more and more people are beginning to realize the negative effects of this movement. Also, many of the young people who transitioned when the movement was beginning to really take hold a few years ago are now detransitioning, and their voices are growing in number. I am grateful to be part of a project to raise them up, because I believe those experiences are very important and should be shared in order to educate others.

Trans activists claim that only a tiny percentage of people who transition regret their transitions. Do you think the number is this low?

No, I believe that the percentage is actually fairly high. People claim that less than 3% of trans people detransition, but since detransitioners are routinely silenced and discounted, I am hesitant to accept that number as accurate. Also, this estimate generally fails to account for people who desist–that is, abandon a trans identity before taking hormones or undergoing surgery.

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Denise, do you agree?

Yes. And with organizations like Gender Spectrum promulgating immediate affirmation of youth trans identities, we’re likely to see more in the future. Plus, many who detransition don’t return to their gender therapists/MDs, nor are they being systematically tracked otherwise. And regardless of how many detransitioners there are, they matter. Their voices matter. And it shouldn’t be seen as “transphobic” or even controversial to ask that we try—as a society, as parents, as clinicians, even as trans activists—to minimize the number of people who will later feel they were harmed by believing they were trans; particularly people who were irreversibly harmed by medical intervention they later come to regret.

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Chiara, what would you say to the activists and legislators who are pushing for legislation that would make it illegal for therapists to encourage clients to explore why they feel they must transition?

I think that would be blatant malpractice. The job of a therapist is to help people overcome issues and develop the best life possible, and transition is not always the right way forward. This would also prevent therapists from digging into deeper issues behind dysphoria. If this law were to go into effect, if would only increase the number of young people who would later detransition.

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Denise, why have you decided to “come out” now?

After Chiara and her compatriots launched Pique Resilience, I realized we were in a new phase—both as mother and daughter, as well as in the greater effort to raise awareness about the complex issues to do with youth transition. Until now, it was of utmost importance to me to protect Chiara’s identity and privacy, so very little information about her was ever included in anything I wrote. Her courage in bringing her story to light has inspired me to step forward as well. There’s nothing to be ashamed of, anyway. Many families have had very similar experiences to our own, and the more of us who are able to speak publicly about our lives, the better.

I suspect detractors might claim the only reason Chiara desisted is because of something I’ve done or said to somehow cajole her into doing it; that she’ll “retransition” in the future. Or maybe: 4thWaveNow is the master puppeteer pulling the strings of the Pique Resilience Project. But Chiara is an adult, supporting herself, living on her own, making her own decisions. And I’m pretty sure the other three women in PRP are also very much their own persons! As far as our family situation, I feel quite certain that if Chiara had decided to pursue transition (and she told me she absolutely planned to, as recently as age 18), she’d have gone ahead with it. Then I’d be in the position of coming to terms with that decision, which I know I would have. She’s my child. I’ll love her no matter what she does, whether I agree with it or not.

Trans activists have worked very hard to deny the experiences and observations of families impacted by an abrupt onset of gender dysphoria. Just a couple of days ago, trans activist and writer Julia Serano penned a long Medium article, as well as a tweet thread, in which she paints ROGD as some sort of coordinated, grand conspiracy cooked up by bigoted parents and backwards clinicians. It’s strange that activists like Serano (along with many others) refuse to believe there could be some young people (the majority of them female) who identify as trans due to social contagion and other issues (which Chiara and the other women of Pique Resilience Project have eloquently talked about in their videos and social media postings). Why can’t Serano et al understand that people are talking about their own lived experiences? The fact is, if there’s any mutual effort on the part of those of us who’ve experienced or observed ROGD, it’s simply a “grand conspiracy” to tell the truth.

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Chiara, what would you say to trans activists who might claim your mother has brainwashed you into believing that you’re not trans? (They tend to say that about any parent whose kid desisted.)

Parents are often demonized, called “abusive,” and beaten down by trans activists if they dare to question whether transition is right for their child. Parents are generally not in the habit of brainwashing their children—rather, most want to protect and support them. Asking your child to think critically and consider other factors at play is not abusive, it’s just parenting. Further, I am an adult fully capable of making my own decisions and formulating my own opinions. My decision to desist was mostly due to my own experiences and research, not a result of my mother forcing an ideology.

When did you first learn that your mom was the founder of 4thWaveNow?

Just a few months ago, not long after we started Pique Resilience, and years after I desisted. I was very surprised, mainly because I had no idea that my mom was running a blog at all, let alone one of this size. I completely respect and support all the work that has gone into it; it’s become one of the largest and most-visited sites providing an alternate viewpoint, and I’m grateful for the support it gives to both young people and their parents.

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Denise, do you have anything to say to those who criticize parents when they do not immediately affirm their children’s belief that they are transgender?

One of the most pernicious things trans activists and some gender clinicians do is try to drive a wedge between young trans-identified people and their families. While there are certainly abusive parents, the vast majority of us who have serious reservations about the medicalization of our gender-atypical youth do love and care about our kids and only want the best for them. We do our best, given our own personalities and weaknesses (as well as our strengths). While the time during which Chiara believed she was trans was very difficult for us and brought out the worst in us both, I’m very grateful we have moved toward healing the rifts between us, though we have further to go. Above all, I’m very glad that Chiara and the other three intrepid women of the Pique Resilience Project have started their own effort to help young people like them.

When it comes to how this increase in young (mostly) women who believe they’re men will ultimately play out, no one knows; it’s going to unfold over the next few years and decades. But I can say this: the future of the movement to raise awareness about this issue does not belong to 4thWaveNow, or parents. It belongs to resilient young women like Chiara and her friends and colleagues. They are the ones who will make the world a better place for their generation and the next generation of gender-atypical young people to come.

by Helena

Helena is a 20-year-old woman who identified first as nonbinary, and later as a transgender man, from 2013 through 2018. In 2016, she began medical transition by taking testosterone, and detransitioned two years later. Helena was an avid Tumblr user during the time she thought she was trans. In retrospect she can see the profound influence the social media platform had on her life and the development of her trans identity —  and the impact it continues to have on many young people. In this article, Helena dissects Tumblr as a platform, explaining to the uninitiated that its very structure lends itself to the self-referential ruminations of troubled teens–teens attempting to navigate and find their place in the identity-besotted cyber-culture that has all but replaced in-person interactions in the 21st century.

This piece will be the first of three that analyze aspects of Tumblr Helena has observed as detrimental to the massive numbers of youth who call the site their virtual home. She can be found on Twitter @lacroicsz and is a member of the Pique Resilience Project. Helena is available to interact in the comments section of this post.

We’ve all read Lord of the Flies, right? A bunch of tween boys get stranded on an island and all of their deepest, most repressed urges surface as they desperately attempt to organize and manage the tiny preteen society they’ve found themselves in. The novel ends in bloodshed, as the author theorizes that the immaturity, communication breakdown, and decision making difficulties one would find in a group of adolescent boys would create a chamber of destruction. How would it have ended differently, some have asked, if the story was one of a stranded group of girls? What would happen if every troubled, isolated, self-loathing, depressed, and emotionally overwrought teenage girl in the world wound up alone on an island?

Tumblr. Tumblr would happen.

Tumblr: you either love it, hate it, or have no clue what it is. Tumblr is the microblogging platform that has given birth to some of the most intensely devoted fan bases online, with over 456 million registered accounts as of 2019. While known widely for fandom-related art, writing, and discussion, there is another, darker aspect of Tumblr that requires a better acquaintance with online communities to understand. In many corners of the internet, Tumblr is known as the core of a certain brand of leftist ideology, not-so-affectionately dubbed the “Social Justice Warriors.” It is these “SJWs” that have taken the site from a platform for fan content to a highly influential ideological powerhouse.

However, an analysis of Tumblr as simply a bunch of “crazy SJWs” does not do the site justice. To understand Tumblr and its influence in youth mental health, culture and politics, you must realize that Tumblr is not simply a site some people visit to share their opinions or look at pictures. You must stop viewing it as merely a website, but as more of a dimension: it has its own social rules, hierarchies, ideologies, and interconnected communities. As a site where millions of people, mainly teenage girls cut off from the outside world, maintain constant daily connection, it has developed into a true culture–the mammoth hub of alternative teenage lifestyle.

Most people are aware of the new challenges our increasingly online culture presents to us. The internet has given rise to a slew of new concerns about psychological impacts, particularly pertaining to previously nonexistent and more covert forms of predatory or manipulative behavior. Tumblr is, of course, just one website out of many that raises these concerns, so why does Tumblr specifically matter? It matters because Tumblr, to millions of its users, is not simply a social media platform. It is their world, the place where these teens make their deepest friendships, express their most vulnerable selves, and begin to develop their own identities. It is also the world from which a surprising amount of our modern-day social justice ideology emerges.

The internet is the 21st century town square, and it is no secret that the discourse that takes place on it is at the forefront of every aspect of our society and politics, Twitter being perhaps the most notable example. On Tumblr, there is a running joke that “Twitter is everything Tumblr was three years ago;”  in other words, whatever social justice topic is fashionable on Twitter at any given time has long since been beaten dead on Tumblr. As someone who spent 2011 to 2016 on Tumblr, and 2016 to 2019 on Twitter, I can confirm this as true–the discourse we see on the liberal sides of Twitter would have been seen on Tumblr three years ago.

Recursive antiterf virtue signaling

When I check up on some of the current Twitter topics (such as queer theory) on Tumblr in 2019, the conversations are far more intricate and removed from reality than they are currently on Twitter. As time progresses, the seriously confused debates and ideas cooking within the Tumblr echo chamber find their way to other platforms and push those user bases in the same direction. This is scary because, unlike Tumblr, Twitter is taken very seriously. Citizens can converse with politicians, celebrities, and influencers in a way that was never possible before, and activists can reach a spectrum of people who would have otherwise never listened to them. Now, when I think about the kind of ideologies I subscribed to as a teenager on Tumblr, and as I see them being played out on Twitter and in the real world years later, it deeply concerns me. My concern about this trend is exacerbated even further when I realize that most people do not understand the planet from which many aspects of online activism emerge. And this lack of understanding is shared by a wide demographic, including professionals, parents, and confused Leftists and Liberals blindsided by the turn activism has taken in the last half decade.

Now, before I begin the first installment of this adventure through the space-Tumblr continuum, I must issue a disclaimer: I am no expert in psychology, sociology, or social media. Research into the complexities of social media and the various platforms’ effects on human communication and mental health is a growing field, with new empirical studies emerging rapidly. My observations as a former daily user of Tumblr are purely that: my observations. This being said, I have insight into the site that gives me an advantage over those who may be curious from the outside, experts or not. When I look back on my time spent on Tumblr, I am overwhelmed by the many malignant qualities I see reflected in my own actions and beliefs, and those of the site’s current and former user base. After mulling it over (and spending way too much time scouring the site for visible patterns of dysfunctional behavior), I have identified three crucial aspects that make Tumblr the problem it is, the first of which I’ll discuss in this article.

#1 Tumblr is designed in a way that fundamentally enables extreme groupthink, manipulation of information, destructive interactions, and distorted ways of thinking.

Information on Tumblr is shared in two main ways: posts and reblogs. Posts are content that users share on their Tumblr blogs. Posts can take the form of text, imagery, quotes, links, audio, or video. Reblogs are posts that users share that originally appeared on the blogs of other Tumblr users. If you are familiar with Twitter, the concept of “tweets” and “retweets” is a good comparison. When a user reblogs a post, they have the option to add a comment that will appear below the original post’s text. Other users may reblog the content further, each time adding their own comments. Eventually, you may have a long comment chain emerging from a single reblog.

Above is an example of Tumblr’s reblog and caption system at work. At the top is the original post, and the bottom two comments are the comments that existed on the version of this post at the time the person who reblogged the chain onto my dashboard chose to reblog it. There may be countless other versions of this post that others are reblogging, with different captions added onto it, all under the same original post. All the interactions, including likes, reblogs, captions, and replies that exist for this post can be seen by clicking the “notes” indicator on the bottom left hand side.

Innocuous as this may seem from the screenshot above, it is this very feature of Tumblr that I find to be one of the most problematic. On posts that are more emotionally or politically charged, it’s not uncommon for users to reblog full blown arguments that, by the last visible caption in that particular version of the post, arrive at a conclusion, often reflecting the beliefs of their established social circle. This prevents the reader from ingesting the point the original poster was trying to make and coming to their own logical conclusion, because they have a certain version of a back and forth dialogue laid out for them, often expressed in a very intense and polarized way that makes the final conclusion seem more correct simply because of the way the argument is framed. Unless one has the self awareness to check the full amalgamation of comments in the notes section and attempt to decipher the jumbled mess of heated additions to the post, one isn’t going to get every side of the argument. Unbeknownst to the reader, there could be yet another comment after the “conclusion” that could completely flip their view on the topic once again.

After months, or years of developing opinions and a worldview through spoon-fed arguments that disengage the mind from processing the information at hand autonomously, critical thinking skills can take a serious hit. When one listens to a live debate or has an engaging conversation with another human being, information can be shared back and forth, enabling all parties present to grow from the debate, learn from each other, sharpen their critical thinking skills, and refine their own arguments and world views. On Tumblr, this necessary form of communication and intellectual development is often lost to this new sort of “factory farmed” way of forming opinions and debate (or lack thereof), resulting in highly opinionated youth who have never actually thought about what they believe and why they believe it. I once passionately held beliefs that I believed were my own, but when I tried to describe them in my own words, I would often arrive at a sort of mental barrier. As my peers and I exchanged scripted rationalizations, we were unable to connect the dots between the intellectual blind spots in our own minds.

As users read through the captions on a contentious post, especially if they are unfamiliar with the topic, it’s not uncommon for their opinions on the matter to flip back and forth with every comment they read as they go down the post. The reader then eventually arrives at the stern conclusion, which they are likely to adopt as their own. Readers may also feel pressure to agree with the dominant opinion in that particular snippet of the conversation, as the person framed as being “wrong” or the “loser” typically is indicated to be bigoted or stupid, often receiving backlash or public humiliation based on the particular version of the post a certain circle of users is reblogging.

When you try to navigate the world of Tumblr posts, the task of separating fact from fiction is herculean. A major part of the online experience for people with better critical-thinking skills is the constant effort to contextualize and cross-check events, claims, and sources. Children and teens often do not have these skills just yet, and it seems that Tumblr’s developers have failed to compensate for this at all. Sites like Facebook have claimed to take a stand against “fake news” while many users on Twitter and other sites encourage others to refrain from knee-jerk reactions to “news,” and to cross-check claims before letting the starving Rottweiler of outrage out of its kennel. Tumblr, however, has neither the self-aware user base to encourage such attitudes, nor a team of developers who seem to care about whether or not the confusion of Tumblr users is affecting their mental health, let alone influencing international public discourse.

Users can also interact more interpersonally in the form of “asks” (direct messages that can be answered either publicly or privately and have the option to be sent anonymously), as well as instant messaging via the Tumblr chat function. “Asks” will appear in the inbox, and are more often than not a variety of different types of messages as opposed to actual questions. The option for anonymity has allowed for this feature to be used as the primary method of bullying or harassment, as well as, interestingly enough, a method for users to send themselves messages, often hateful, to gain sympathy or manipulate discourse happening within their social circle.

When a user makes a statement that another group considers “problematic”, it is not uncommon for that user to be absolutely obliterated with anonymous messages demanding changed behavior, apologies, or simply exercising the sender’s desire to decimate someone online. When someone is harassed like this over a heretical statement, the entire situation, along with the mental state of the user being attacked, often descends into complete chaos.

It is expected that when you are called out, you immediately and calmly apologize (flog yourself) and promise to never do whatever it is you are being called out for again. Even then, it is hard to satiate the hungry mob. People who appear too calm can be accused of not taking the situation seriously or disrespecting the feelings and concerns of those who were offended. It is always a lose-lose-lose-lose….lose… situation, and as you may have already discerned, critical thinking in this atmosphere is nearly impossible. Without the anonymity of the ask feature, and the capability for one user to send multiple messages causing an illusion of a mass attack, mole hills would not be perceived as mountains as often as they are. What is in reality more likely to be an individual perceiving your words as offensive begins to feel like you have stepped on a mine that has just decimated the peace and order of your entire community, even if it really is just one or two people sending dozens of anonymous hate messages (often including to your friends and followers) and calling enough attention to the situation that your entire social circle is pressured to stand up and persecute you for your crimes.

To a young teen who knows no better source of community, this can feel devastating. There is intense pressure to avoid critical thought and embrace toxic tribal attitudes, heavily valuing conformance with ideology over individualism and loyalty to important relationships. When someone is accused, their friends are expected to sever ties with the accused, lest they themselves be accused of supporting or conspiring with a convicted transphobe, racist, or abuser, as perceived by the community. These experiences sound crazy, and they most certainly are, but they would not be happening to the extent and in the fashion that they do on different social media sites without some of the particular features mentioned above.

If that wasn’t enough, there is a final piece of inspiring web development that makes Tumblr unique: Tumblr posts don’t have timestamps. Unlike your timeline on Twitter, Reddit, or YouTube, your Tumblr dashboard offers no way of knowing when something was posted. It could have been four hours ago or four years ago. It’s not uncommon for posts written in urgency about a certain situation, oftentimes having been previously debunked (even in the notes sometimes! Too bad 99% of the user base would never think to check. See what I mean about that being a problem?) to continue circulating years later, inspiring misinformed or unnecessary fear within readers. This lack of time context can seriously distort a person’s perception of events or political and social climate. Too many users are getting their news, partaking in a community, developing a sociopolitical ideology, and curating their own identities based on internet posts floating around in a vacuum devoid of reference to reality; not even time.

“Call-out culture,” the pervasive danger of groupthink, attitudes towards mental illness, and militant activism are all topics I will analyze in more depth as this investigation progresses in later installments. As concerned adults or Tumblr veterans, we must understand that these noxious conditions are a result of the site’s fundamental building blocks and not purely a reflection of the character of the individuals who use it. Tumblr seems to be designed for destruction, and it’s incredibly sad that one of the only places so many young people feel able to express themselves is also oriented in a way that seriously compromises their emotional and intellectual development. This online world feels like a necessity for so many young people. I myself wonder if I would have survived the most turbulent and depressed years of my young adolescence if it were not for the capacity for self expression and friendship I found on Tumblr. This is why we have to understand the many ways in which the site has gone wrong, and how these outcomes can be traced down to Tumblr’s very roots. Consider the fact that adolescent distress is being fed into a convoluted mechanism designed for distortion, and the whole thing begins to make a lot more sense.

Thank you for reading, and I look forward to sharing more of this online world with the real one. Stay tuned for Parts 2 and 3.

At 4thWaveNow we are serious about fact-checking and providing sources so that our readers can verify information for themselves.

It is well known that Susie Green of Mermaids took her child to Thailand to undergo SRS, which was carried out on the child’s sixteenth birthday. As 4thWaveNow contributor Artemisia pointed out in a post last year, this operation would not be legal in Thailand nowadays. Under the Thai laws currently in force, it is illegal to perform SRS on anyone below the age of 18, while patients aged 18 to 20 require parental consent.

It has come to our attention that there is a rumor on social media that the law was changed because the people of Thailand were shocked and revolted by Mrs Green’s action. This is completely untrue. We do not know where that story originated; we’ve attempted to correct it several times on Twitter, yet the rumor persists.

 For the benefit of those who want to know more about the real reasons for the legal changes, Artemisia has provided us with the following detailed account.

For further information on UK charity Mermaids, see this 2017 article by Artemisia, “Should Mermaids be permitted to influence UK public policy on trans kids?”

by Artemisia

Susie Green is the Chief Executive Officer of Mermaids, a UK charity noted for its advocacy for the off-label use of  gonadotropin-releasing hormone (GnRH) agonists to disrupt the normal progress of puberty in children labelled ‘trans’. Mrs Green has also indicated her support for removing age-related restrictions on surgical procedures intended to make the bodies of trans-identified people conform better, superficially, to the sex to which they wish that they belonged. At present under the National Health Service irreversible gender-related surgery is only available to patients eighteen and older. This is in accordance with international standards of care.

Recently Mrs Green tweeted her approval of a statement by a US specialist in genital surgery who argues that ‘surgery should be allowed based on competency’ — that is, ability to give informed consent to treatment — rather than ‘age of majority’.

She has already shown a strong personal commitment to this position. In 2009 she took her child, Jackie, to Thailand for a vaginoplasty: the creation by plastic surgery of an artificial vagina. Susie and Jackie have told this story a number of times in interviews with the media and also in a television documentary.

Why did Mrs Green take Jackie to Thailand? During the course of the last forty years, Thailand has built up a reputation as a place where male persons seeking feminisation surgery can have various procedures, including vaginoplasty, performed by competent surgeons for far less money than it would cost them in Europe or the United States. The development of this highly specialised trade certainly owes something to the presence of a strong indigenous tradition of males who present as female: the kathoey, often referred to as ‘ladyboys’. It is reported that many of them undergo feminisation surgeries, including vaginoplasties.

Until 2008 there were few or no legal controls over such operations. In April that year the Thai government imposed a ban on the castration of males below the age of eighteen.  According to a report in the Telegraph (a reputable London newspaper) the new law was a response to pressure from the Medical Council of Thailand, which had issued a warning about the health risks of teenage castration: damage to ‘hormone growth and physical development’. Boys as young as 11 or 12 were undergoing castration in the belief that it would help them present a more feminine appearance as they grew older. It was a preliminary to later feminisation surgeries. In that respect, its use was similar in purpose to the current use of GnRH agonists as ‘puberty blockers’.

The move to make it illegal was strongly supported by the Gay Political Group of Thailand, whose leader, Natee Teerarojjanapongs, told The Bangkok Post, “These youngsters should wait until they are mature enough to thoroughly consider the pros and cons of such an operation.” In another, later interview he said, “I got so many calls where they said they are so sorry that they did a sex change … They make a big mistake and they want to come back and be the same. But they cannot!”

The Medical Council of Thailand is a professional body that has statutory authority. In April 2009, a year after the ban on castrating under-age boys, the Council issued a new regulation: in future, ‘sex change surgery’ would be permitted only if the patient was over 18. Furthermore, patients of 18 and over who had not yet reached the age of 20 must have the permission of ‘an authorized guardian’. (In Thailand 20 is the age of majority.) This regulation was to come into force 180 days after publication in the Government Gazette. It was during this period of grace that Susie Green took Jackie to Thailand for an operation to create an artificial vagina.

There is a rumour that sometimes surfaces on Twitter that it was because of Susie Green that Thailand imposed the age limit – supposedly the authorities were so horrified at a mother bringing her sixteen-year-old for a vaginoplasty that they brought in a law to stop anyone else from doing this. There is absolutely no truth in this rumour. It is not clear who began it, and as stated above, 4thWaveNow has attempted to correct it on Twitter, with little success.

This is what actually happened: on 20^th April 2009 the Thai medical authorities announced a forthcoming ban on ‘sex change’ operations on any person under 18. The intention was to protect young people from undergoing irreversible surgeries that they might later come to regret. Jackie’s vaginoplasty was carried out on the child’s sixteenth birthday. This dates it to 16^th July: three months after the new regulation was announced and before it came into force on 29 November. In other words, the operation took place at a point when it was known that it would soon be illegal for such a drastic procedure to be performed on a patient so young.

Did Mrs Green and her advisers know that the law was about to change? It seems unlikely that Norman Spack of Boston Children’s Hospital, a well-known promoter of medical transition for teens, was unaware of the steps being taken in Thailand. Jackie was a patient of his at the time. Dr Spack has described at a TEDx event how, as an experiment (‘something a little bit innovative’), he prescribed Jackie ‘a blocking hormone’ (GnRH agonist) to block testosterone and later ‘added estrogen’ when Jackie was only 13. Following which, ‘on her 16th birthday, she went to Thailand, where they would do a genital plastic surgery.’ Helpfully, he added, ‘They will do it at 18 now.’

Two years after the operation Susie and Jackie gave an interview to the Sun newspaper, in which it was said that Jackie had become ‘one of the youngest transsexuals in the world’. A few weeks later, in a piece in The Yorkshire Evening Post, this had changed to ‘the youngest person in the world to have a sex change’, and over the course of the next two years this unverifiable claim was repeated as fact in The Daily Mirror, The Daily Mail and The Sunday Times.

It echoes a claim that was earlier made about a German teenager, Kim Petras. In February 2009, shortly before Jackie and Susie travelled to Thailand, the Telegraph reported: ‘German teenager Kim Petras has become the world’s youngest transsexual after undergoing an operation at the age of just 16.’ The story was also published in the Sun and the Daily Mail. Kim was reported as saying in an interview, “I had to wait until my 16th birthday but once that was past I was able legally to have the operation.” So when Susie Green arranged for her child’s surgery to take place on the day that Jackie turned sixteen, it meant that in future it would be Jackie who could make a plausible claim to that distinction.

In 2009 Kim Petras had begun on a modelling career and had also issued a CD. Nowadays Petras is a well-known singer-songwriter who has told the press, “I just hate the idea of using my [transgender] identity as a tool,” preferring to be known for the music. In 2011 the Sun reported that Jackie had plans to build a career ‘as an actress, model and singer’.

The following year Jackie competed in the Miss England beauty contest, reaching the final, and became the subject of a BBC documentary: Transsexual Teen, Beauty Queen. In a memorable section, Susie Green talks about her child’s operation. She reveals that because Jackie had not gone through a natural puberty (as a result of the hormone treatments prescribed by Dr Spack), the surgeon was unable to carry out a penile inversion procedure:

38:57: Susie Green (to camera). The majority of surgeons around the world do something called penile inversion where they basically use the skin from the penis to create the vagina. And she hadn’t developed through full puberty so to not put too fine a point on it there wasn’t much there to work with [starts to smile] –; sorry Jackie (she’ll hate that) [turns away from camera and convulses with laughter].

39.15: cuts to a still photo of 16-year-old Jackie on a hospital bed waiting to go into the operating theatre.

4thWaveNow postscript: As Artemisia has amply demonstrated in her article, it has never been in dispute—least of all by the Greens—that Jackie underwent SRS in Thailand at the age of 16. Interestingly, the UK Daily Mirror, in a story just last October, reported that Jackie’s surgery took place in the United States.

This is an error 4thWaveNow pointed out (as did a commenter on the article itself), but as of this writing nearly 6 months later, that error remains standing. Moreover, it seems safe to assume that the Greens are aware of the Mirror piece; apparently, neither Jackie nor Susie have required the newspaper to correct this significant error of fact.

GuessImAfab is a 22-year-old re-identified female who identified first as nonbinary, and then a transgender man, from the ages of 18-21. She lives in the United States. GuessImAfab was on testosterone for a year and a half and spent a lot of time engaged in the online trans community on multiple social media platforms. You may have seen an abridged version of this narrative on her Twitter account.

 GuessImAfab chronicles the development of her trans-identification, including being prescribed testosterone as a “nonbinary” teen. She now believes her gender therapist was negligent in not fully exploring the underlying reasons for her disidentification from her female sex. She also notes the lack of follow-up she received from the MD who prescribed T, despite her diagnosis of polycystic ovary syndrome (PCOS).

by GuessImAfab

I lived with Rapid Onset Gender Dysphoria for three years, believing wholeheartedly that I was not a girl, because the trans community told me that I didn’t have to be. ROGD is a phenomenon described by researcher and physician Lisa Littman as a type of adolescent-onset or late-onset gender dysphoria where the development of gender dysphoria is observed to begin suddenly during or after puberty in an adolescent or young adult who would not have met criteria for gender dysphoria in childhood. When I first developed what I believed at the time to be genuine gender dysphoria, Littman’s study was not on the radar, and it did not cross my path for the first time until late last year. I started to read the study, but it had been shared by someone opposing it; truthfully, as I read it and started to really resonate with it, I got panicky and just closed it and stopped reading, because I was scared to agree that I did fit the criteria. I did not re-identify and decide to detransition until later.

I want to talk about my experience with Rapid Onset Gender Dysphoria (or being transgender), to add my voice to the growing chorus of detransitioners speaking out about what we’ve been through.

I was able, with the encouragement of the transgender community and transgender ideology, to develop an unshakeable faith in an unrealistic identity.  I struggled with self-hate, was susceptible to grooming, and existed under the influence of the online trans community, which uses tactics that I believe parallel Steven Hassan’s BITE model for mind-control to stop critical thinking and encourage cognitive dissonance. Behavior control, information control, thought control, and emotional control were all factors in the development and progression of my Rapid Onset Gender Dysphoria. My behavior was fueled by an unconscious attempt to escape from being female, bisexual, and gender nonconforming in a world that pressures women to be “feminine.” I want to share how it led me to seek hormone replacement therapy, and the red flags that professionals missed or ignored in my quest.

Let’s start from the beginning: I had been a tomboy when I was young, had a crisis over my sexual orientation in middle school, and went through high school as a “regular girl”- I wasn’t especially feminine, but I also wasn’t gender nonconforming. I’d been “part of the LGBT community” (in other words, I identified as a bisexual girl and was active on Tumblr) throughout all of my high school years.

As a teenager, I often joked with my friends and on my Twitter account that I “wish I had been born a boy” because I “just didn’t get being a girl”! (Later, these tweets would reinforce my false belief that I had always been a boy.) Every time I wore a dress to school, I felt the need to announce it to all of my friends, like I was putting on a crazy costume and just didn’t want them to be shocked. I was a theater kid, and had been since I was a child, and thankfully the theater kids didn’t get picked on. I was well-liked and lucky to not have a bad high school experience. The majority of my friends, theater kids as well, were either straight girls or gay boys, nearly all of whom I crushed on at one point or another. In fact, it became a sort of running joke that I was only attracted to gay guys, because by the time I had graduated, three of the boys I had “dated” had ended things when they realized they were gay. This was another big factor later on in my ability to be fooled into believing that I could actually really be a gay boy myself and always had been. But more on that later. For now, let’s move on.

The boy I dated from the end of my senior year of high school through to the beginning of my second year of college was, in retrospect, a total jerk, but I thought I loved him. He policed what I acted and looked like to the point where I feared that if I cut or dyed my hair, he would dump me. We started to go to college parties together and I was surrounded by girls in crop tops and high-waisted skirts. I knew that I looked more attractive when I wore that too (plus liberal feminism at the time was always making sure to remind me to “be a slut! do whatever you want!”) so I had a peak of “empowered femininity” prior to the rest of this tale.

My boyfriend grew less interested in me towards the end of our relationship, I could tell. I began to panic. I just wanted to be someone that he loved, was attracted to and wanted to be with. When he ended things, I asked if there was anything at all I could do to make him change his mind. He said no, he just didn’t want me.

Over the next six months, I alternated between deep, isolating self-loathing and rebounding with my (same) ex, though I knew I shouldn’t have. I would end up sneaking out and sleeping with him every few weeks even though I was well aware that he didn’t want to get back together. To be 18, right? Months wasted with impulsive, unhealthy behavior — it didn’t allow me to grow.

During this time, I first cut my hair into a bob after years of wanting to, after weeks of agonizing, fearing I would be ugly with short hair. But when I finally did it, I didn’t feel ugly, I felt incredible. We’d broken up in the fall and I saw him periodically until the spring. November was the first time I discovered “non-binary gender identities”, and I started the research that would consume every aspect of my life for the next three years.

For a visual representation of some of my ROGD timeline, throughout this article we’ll take a look at my iPhone notes and private social media posts from that time. (Heads-up for mentions of self-harm.)

Note from September expressing the state of my mental health.

Note from November, something I wrote when I was feeling the impulse to self-harm.

list of “non-binary identities” I had discovered online in late November

draft of an email that I sent in November to the other officers of a campus feminist club

My memories of this time period are a little foggy. I was so miserable and wound up all the time, I can’t tell you exactly what I was thinking except from looking through things I’d written. I just kept reading and internalizing all of the ideas that the online trans community stressed: it didn’t matter if I hadn’t had sex dysphoria since I was a child, that was just the “mainstream trans narrative.” I could still be not-cis; that was valid. And anyway, I had never liked my large breasts or wanted anyone to know that I was busty. So maybe that had been sex dysphoria, and I just didn’t realize until I learned more. The community said so.

I was still very nervous, and hadn’t told anyone I was internalizing things I read about gender identity until I joined a club in college where I met my first “trans person” (in my opinion, another girl with ROGD, but that’s neither here nor there).

She identified as “agender” and used they/them pronouns. The meeting was the first time I ever had to do a pronoun circle. I was meeting all these people for the first time; I had a chance to start over and be a new person. So, when it came around to me, I said my pronouns were they/them.

No one questioned me. I took a deep breath. Okay, cool, so that felt fine. Maybe that meant something. When they addressed me, they used they/them pronouns. I considered how it made me feel: I didn’t mind it. I told them I was still “exploring my gender identity” and they all affirmed that and told me to take my time.

Note from February. “Genderflux” was an identity I tried on for awhile.

I continued to “research”. I got deeper into the online theory. In the spring, a little after I stopped meeting up with my ex, my friends from the club and I went to a week-long event together that was incredibly trans-positive. Pronoun stickers and all. I had been thinking about my discomfort with my female name, and they encouraged me to “try a new name” just for the event.

So I did. The name I chose was androgynous, not exclusively male, and over the week I began to introduce myself by it. It felt… cool, comfortable. I didn’t have to think about who I really was or who I had been, which all felt tied to my female name. I could create an entirely new identity for myself, and it was “valid.” The community swore that this feeling was “gender euphoria,” another sign I was on the right path.

At one point, I remember hearing someone say, “If you have questions about your gender at all, you may not be binary trans, but you’re probably not cis.” This stayed in my mind for a long time.

While I was at this event, I met a straight guy who I started to like. I told him I was non-binary, so not a girl, and he was like “Okay cool, no biggie”. We started to date about a month later, and over the next six months or so I “explored my gender identity,” with his “support.” I cut my hair into a pixie and started to wear men’s/neutral clothes more. It felt amazing, like coming home after I’d been dressing up and playing the part of a feminine girl for my previous boyfriend for so so long. I took this as more proof that I was on the right path. And my boyfriend still liked me — he said he’d like me no matter what! For a short time, I felt on top of the world.

I continued in my non-binary identity, until the fall when I transferred to living away at a new college. I started to feel stressed about my identity. I felt like no one would take me seriously as a “non-binary” person or see me as anything other than a girl; I didn’t want to be seen as a girl.

To try to sort out my confusion, I went online and looked to the trans community and to trans ideology. Was this a normal feeling?

Apparently, some non-binary people went by he/him pronouns! It didn’t mean that they were men (I had insisted to myself since the beginning that there was no way I was a man, because men were trash, and why would I want to be one of them?). Cool! I changed my pronouns to he/him.

My boyfriend was okay with it. He knew that I wasn’t male or anything, so it didn’t threaten his sexuality or masculinity. The pronoun change really amped me up though. I was living in “gender-neutral LGBTQ housing” on campus and we all put our pronouns on our dorm room doors.

A post I made on my private Instagram account when I first made the decision to change pronouns.

Every day it was a reminder.

After a few weeks, the anxiety I was experiencing because my family was unaware of my feelings and situation really started to weigh on me. But I knew they would not understand being non-binary. Once, months earlier, I’d tried to talk to them about the agender girl I knew — they were lost (and amused).

But I felt so much better in my presentation, so much more comfortable in my mannerisms, in using he/him pronouns and “being a boy” (in retrospect, it was being gender nonconforming). When I compared the contentedness I felt in my new self-expression to the distress I had been feeling when I first discovered trans ideology, I was affirmed by the online trans community into believing that the change was indication that I did have gender dysphoria. It was absolutely drilled into my head that it did not matter at all that I did not have the “typical trans narrative”. But I decided that if I had any chance of my parents accepting me and my dysphoria, I had to play it like I was a Transgender Man, because that was the narrative they knew…

…which leads us to the letter I wrote to my parents when I “came out” to them as transgender. I read over it for the first time recently since I wrote it (two and a half years ago), and to be honest, it’s legitimately embarrassing nonsense. It may be enlightening, however. If I had read this letter for the first time now, but it had been written by someone else, I would have seen how many leaps of logic there were in what I was saying, but only because I’ve gotten out of the thought-cult. I would’ve reacted in a similar way to my parents at the time. Unfortunately, my parents didn’t understand the scope of the cult-logic and how utterly mind-consuming it can be. I had also been a very secretive child, and had never really been forthright with them with regard to my feelings about myself before, so they had very little to work with. So while it’s now cringeworthy for me to read knowing that I wrote it and truly believed that I was correct, I think it’s a really stark, grim, and telling portrait of how well-meaning young women who feel “different” can be indoctrinated into believing they’re transgender.

Here it is in its full, maladaptive glory. Names have been redacted.

When I look back at the first day I came home after sending this and The Conversation I had with my parents, I feel so overwhelmed with guilt and shame. They and I both had no idea the extent to which the ideology had been hammered into my brain as irrefutable… they did their best and it ended with a screaming match and me leaving to stay at my boyfriend’s house. They had so many questions that I didn’t have answers to because of the huge gaps in logic that I had been conditioned to ignore. When they pointed them out, I became flustered and overwhelmed and felt like I was being attacked for the way I felt. I left the house after dinner, sobbing.

One of many posts on my private Instagram account from this time period, expressing how much I was struggling with day-to-day functioning.

We didn’t talk directly about it for months. I wasn’t living with them full-time at the time. Whenever I came home, we danced around the subject and they pointedly avoided referring to me by name or pronouns at all. To me, at the time this was just more of a rejection and fueled my fire to prove myself. I spent so much of my time engulfed in queer/trans theory. Because my parents hadn’t affirmed me and I’d left in a fit, all of my friends and the community were hugely affirmative following my “coming out.” Luckily (though I didn’t feel lucky at the time), I have amazing, non-bigoted parents who assured me that they loved me and wanted me to be happy; they just believed I was mistaken.

Not everything was going smoothly during this time. When I caught my boyfriend flirting with a girl, he insisted it was a mistake, that he knew I deserved better, and that it wouldn’t happen again (it would). I asked if it was because I wasn’t a girl, because I wasn’t feminine enough for him anymore, and he insisted no (it was). He was the only support I had or cared about at the time, because I felt hurt by my parents. I was terrified he would realize that he didn’t want to be with a trans guy and leave me for a pretty girl. I was up his ass constantly looking for approval that it was okay for me to be who I wanted to be. So, I forgave him.

Literally all I ever thought about was him and my gender. I lived away at school until the following spring, either holed up in my dorm room on Tumblr and Leftbook, or driving to my boyfriend’s place to hang out with him and our friends (his group of friends that I slid into). Sometimes, I crashed at my parent’s house. Every time they “dead-named” me I felt more alone. My isolation and depression were growing. I moped all the time, I skipped class, I was constantly sick.

The weekend before I moved home for the summer, I caught him flirting with yet another girl. I “forgave” him again, meaning I agreed to drop it because of my paralyzing fear of losing him, but it pushed my stress level over the edge and sent me into the worst pain I’ve ever experienced. To make matters worse, I had to have (not gender-related) surgery when I came home. I lived at home all summer, recovering from surgery, depressed, anxious, feeling misunderstood and disrespected by my parents.

I had a lot of time on my hands.

A note from the time I was living home, things the community told me were signs I had gender dysphoria as a child/adolescent/teenager.

I started watching testosterone before-and-after videos on YouTube. I began to consider what it would be like and feel like to pass to strangers as a man. It sounded… nice — certainly better than the idea of always being looked at as a failed woman for not being feminine. Another example, I thought to myself, of me experiencing “gender euphoria.”

I have ADHD and have been unmedicated my entire life. I got incredibly hyper-focused on watching these testosterone videos. They were all happy. They all looked like I wanted to look. They all talked about how being on T made them confident, self-assured, and comfortable in themselves. Many of them, though, talked about always being masculine and thinking they were lesbians. Whenever I felt doubts about being transgender, it most frequently was that I didn’t relate to this aspect of their stories. I had never thought I was a lesbian. I had been feminine in the past without it bringing me to the brink of suicide, which was what I’d believed happened to trans men as kids. So I would go back online and try to see if anyone felt the way that I did.

As it always does, trans ideology had a justification for my lack of severe distress over being feminine as a child. I think that this justification was what ‘helped’ my parents ‘understand’ as well. I was led into believing that I was a gay male, and that my attraction to men and femininity when I was young was just me expressing the fact that I was actually a gay boy. Part of the reason I was able to convince myself that I was a gay man even though I had experienced attraction to girls since I was a child was because I’m not attracted to trans women, and the community claims that if you’re not attracted to trans women, you can’t claim to be attracted to women at all, since Trans Women Are Women. I was told that most likely, because I had always been a boy, deep down I just had internalized homophobia about it, and had only thought I was attracted to girls.

My parents, seeing how depressed I had been, and having not spent much time with me during the past year while I was away, tried to see my point of view. Over the next few months, my peers provided me with more logical fallacies to get my parents to “understand” where I was coming from. Eventually, when they saw I was more comfortable being gender nonconforming than I had been being feminine, and that I wasn’t backing down, they made the switch to my new name and pronouns. I know I never convinced my parents that I was “born in the wrong body” or that I was ACTUALLY a man, although for a time I had absolutely convinced myself. The reason why they “gave in” was because they witnessed the genuine transformation and growth of my comfort in my body and self-expression. I had the wrong idea, though, about why my “dysphoria” was soothed when I socially transitioned. Every time I felt happy with the way I looked or felt, it was because for the first time in my life, I felt free to express my gender nonconformity. In retrospect, I believe that I unconsciously did not think it was possible for me to dress and act the way I wanted to without a “valid reason” — simply desiring to be a gender nonconforming woman didn’t seem possible to me. It wasn’t something I even realized I preferred until I tried it. By internalizing transgender ideology, I falsely attributed my newfound comfort in female masculinity to “proof” that I was actually a transgender man. And once I began to imagine what it would be like to be seen and treated as a man, to “pass”, it became all I could think about. I started to hate my body and my voice more and more every day. The deeper in I got, the more dysphoric I became.

Eventually, I told my parents I wanted to start testosterone.

Side-note: “What about your straight boyfriend?”, you’re thinking. “If you started testosterone, wouldn’t the masculinizing effects turn him off?” Thanks for reminding me. My boyfriend swore that all he wanted was for me to be happy, and that he would still be attracted to me no matter what because he loved me. At this point, I had been socially transitioned for almost a year and we were constantly saying that we were gay together and that we were going to get gay married one day (I Know.) and live happily ever after. But the longer I was on T, the less attracted to me he was. I could tell, which was difficult for me. I’d catch him flirting with someone else 6 more times over the course of our relationship. But I’m ahead of myself! End side-note.

My mom reached out to a coworker whose son is transgender, and she was put in touch with my gender therapist. The therapist I went to had a Master’s degree in social work and is licensed in clinical social work (LCSW). His official stance is “that the gender therapist’s and medical provider(s) role is to support the client in their gender identity, and not to be gatekeepers for medically necessary treatment.”

I was beyond thrilled when I looked into who the therapist was after I got his name. He was a trans man. Being trans gave him a bias, and I knew that going into it at the time, which was exactly what I wanted. I knew this meant I’d won– he had diagnosed my mom’s friend’s child with GD and connected him with a doctor to prescribe testosterone. He agreed with me in terms of how I believe gender identity worked, and he was a proponent of the affirmative-care model for transitioning. I just needed to convince him that I fit the role of someone who needed testosterone. I’d already mostly convinced myself, and I’ve always been a great actor (theater kid, remember?). I felt like I was set.

To be prescribed testosterone, I met with the LCSW two times over the course of about a month. We went over my general medical history. He asked me about my feelings about gender and my identity. I told him honestly that I wasn’t 100% “binary,” but I WAS sure I wanted to be on testosterone. I didn’t necessarily feel like a cis man, but I felt uncomfortable being seen as a woman. I felt sexualized, I didn’t want people knowing I had breasts, and I thought hormones would help people think I was not a woman. I explained how I felt about “being gay for men”, but that I had “no assigned sex at birth preference, so I would theoretically date a trans man”.

Now, pause. None of those things should have qualified me to be a candidate for hormone replacement therapy. All of those things should have been taken into consideration by my therapist. He could have performed a thorough assessment of my mental health, my possible history of trauma, my experiences with abuse and objectification tied to my body, as well as my experiences with sexism and homophobia as a woman. He could have continued to meet with me for more months before he decided I “passed.” He did not. He told me that there was a Primary Care Physician in his network who he’d sent other trans patients to, and referred me to her.

This doctor was incredibly endearing. She listened intently when I talked to her and she didn’t once make me feel like it was the wrong decision for me. She came across as an empathetic adult who could help and wanted to do what she agreed was best for me. I think that may be the most dangerous thing for girls with ROGD—all that “validation” from people you trust with your health. This doctor told me that on testosterone, I would experience the “three H’s” (I’d get “horny, hot, and hungry”). I would sweat a lot, get hairier, and my voice would deepen. My fat would redistribute. She did tell me that she recommended I look into freezing my eggs, as I have Polycystic Ovary Syndrome, and “you never know because there aren’t a lot of long-term testosterone studies.” I didn’t have the money, though, and kids were the last thing on my mind anyway, so I refused. She gave me a small packet to read over detailing the known effects of T. I signed a form saying that was OK with me, went for bloodwork, and when my hormone level results came back and I was approved as healthy enough, I was prescribed T a few days later and sent home. Normally, she said, she would make me come in after I picked up my prescription to have her give me the shot the first time and give me needles and syringes, but I showed her I could do it myself with a saline shot so she let me go and prescribed syringes to the pharmacy along with the testosterone.

That was nearly two years ago. I was switched from that doctor to another one a month later when she moved networks, and I met with her one time. I have not been to see that doctor since, they have not followed up with me, they have not asked me to come in to get my levels checked or to assess my health. They simply continued to refill my prescriptions through my pharmacy when I requested it on the app, until I stopped requesting it. I am 22 now, and both the doctor & therapist know I have Polycystic Ovary Syndrome.

To me, this is the reality and medical irresponsibility of informed consent. Neither the therapist or doctor were unkind or made me doubt myself. I believed this could all be true, so it was true. My perception was the only reality I knew. Why would I stop?

I had moved in with my boyfriend by the time I was able to get my appointment for T. My family, finally, was happy for me. They watched me do my first shot on Facetime and we all clapped.

That was that: I was on testosterone.

A note from a few weeks after I started T, trying to rationalize and repress my uneasiness about how easy it was for me to start hormones and how quickly I’d decided I wanted to.

Initially, I was pleased with the changes T was giving me, but my experience wasn’t as intense as a lot of people I knew. PCOS means my natural T levels are high, and I told myself that maybe I was always meant to be testosterone-dominant, I was just “in between” before, and that’s why I had felt so uncomfortable.

Seriously, the weird circular reasoning you start to do after years in this community is… beyond.

All in all, my (absolutely straight) boyfriend and I lasted 9 months after I started T before he ended things.

I moved home. Thank god, thank god, thank god for my family. I really don’t know what I would have done or how I would have fared if my family weren’t so incredibly loving, understanding, and patient with me as I healed from what I’d been through and reconciled the past three years of my life.

I consider myself VERY lucky that being gender non-conforming (a masculine female) is how I feel most happy and true to myself, and as such testosterone’s changes to my body don’t upset me too much. But that is not the case for all female people with rapid onset gender dysphoria, and I was able to access it far, far too easily.

When I reflect back over the time that I suffered with ROGD, especially the months prior to starting testosterone, I wish I could tell myself then what I know now. Transgender ideology and the toxic internet culture around it brought my life to a staggering and painful halt for three years. The professionals around me who should have screened me thoroughly and been willing to help me get to the root of my issues with my body, my expression, my gender, and myself, did not. Because of that, I will never get the chance to have a healthy relationship with the body that I had and the person who I was before T.

On a personal level, in order to move forward in my life and grow into loving myself, I feel that it is healthiest for me to accept the changes to my body and what I went through. Otherwise, I will spend far too long resenting myself and the people around me. For this reason, I don’t waste time mourning. I believe a better focus of my energy is to share my experience, empower other women to reconcile their relationships with themselves, and help those who still are being groomed into believing that the only way they can be happy is to permanently alter their bodies. There are so many suffering, deluded young people whose faith in lies are being encouraged by the medical community at large, and whose lives and bodies are being irreversibly changed because of a lack of critical understanding about what Rapid Onset Gender Dysphoria is and looks like and how severely it can impact impressionable youth.

In a follow-up post, I will get into my experience of reconciling and coming to terms with my body, my identity, womanhood, and myself, but for now I’ve covered all of the important points with regards to the development of my Rapid Onset Gender Dysphoria.

Thank you all for reading.

The government of the state of Vermont is currently accepting public comments on a proposal to remove all age limits on sex reassignment surgery (SRS) for Medicaid recipients. The full, four-page proposed rule is available on the Vermont Human Services website.

Vermont’s Department of Financial Regulation issued a press release on June 24, signaling the state’s intention to move ahead with the rule change. Governor Phil Scott “recently proposed updates to Vermont’s Health Care Administrative Rules to allow transgender youth under age 21 to undergo gender-affirming surgery through Medicaid.”

Medicaid is a federal program that provides health insurance to low-income individuals. Although minimum benefits for all states are determined by the Centers for Medicare and Medicaid Services (CMS), each state administers its own Medicaid program and decides for itself which other procedures will be covered and which will not be. (Note: Some states have adopted a different name for their Medicaid program; e.g., California’s Medi-Cal and Oregon’s Oregon Health Plan.)

The public comment period for the Vermont Medicaid policy change is open until July 17. You do not have to be a Vermont resident to submit a comment regarding this change. If this proposal sounds to you like the wrong thing for a state government to do, please take a few moments to comment. See instructions at the bottom of this article.

Why should you care about this issue? We’ll have more to say about that later in this post, but for now, here’s what Rachel Inker, who works at the Transgender Health Clinic at Community of Health Centers of Burlington, had to say when interviewed by the Burlington Free Press:

“The choice to have surgery is a personal one that should be explored in every age group.” 

Is Vermont an outlier with the proposed change to its Medicaid SRS policy? Let’s take a look.

Only two states have explicitly removed minimum age limits for SRS

In our research for this article, we were unable to find an online resource that compiles information about Medicaid rules for under-18 surgeries in all 50 states. The information we provide below is based on our painstaking search of the Medicaid websites in all 50 states, as well as the websites for HRC, ACLU, and TranscendLegal, all organizations that lobby for medical transition coverage in the United States. Some of the information we found is based on a review of recent news articles on the topic.  Note: It is possible we have missed something; if we have, please provide your corrections in the comments section of this post, and please provide links for the missing or incorrect information.

In quite a few cases, the information about Medicaid coverage of SRS is buried in obscure documents that are not available via a standard search for terms like “gender dysphoria.” For example, the Oregon Health Plan (OHP) indicated it would cover medical transition beginning in 2015, but many previously active links now land on unrelated pages (e.g., https://www.oregon.gov/OHA/HPA/CSI-HERC/FactSheets/Gender-dysphoria.pdf) or are broken. A search of the list of covered services on OHP comes up empty for the keywords “gender dysphoria” and “transgender,” but a deeper investigation uncovers the full policy. It’s worth asking: Why is clear policy information about gender transition so difficult to find?

As of this writing, this is what we have found regarding SRS coverage for Medicaid recipients under the age of 18:

• Only 2 states have removed minimum age limits for SRS, New York and New Hampshire. But in contrast to the proposed Vermont rule change, the policy statements for these states seem to express reservations. For example, the New York statement contains this caveat: “Although the minimum age for Medicaid coverage of gender reassignment surgery is generally 18 years of age, the revised regulations allow for coverage for individuals under 18 in specific cases if medical necessity is demonstrated and prior approval is received.”
• In 19 states, SRS is not included in the standard Medicaid benefits for any age—that is, they do not explicitly list SRS among covered procedures. That generally means they would consider it on a case-by-case basis. It’s worth noting that this is also the policy of Medicare (the federal insurance program for adults over 65 and disabled persons), which as of 2016 declined to cover medical transition as a standard benefit because of the poor quality of research supporting it.
• Only 10 states expressly exclude SRS for any age. (See July 26, 2018, article in the Journal Sentinel.)
• The remaining 21 states (including Washington, D.C.) expressly cover SRS (see slide 10 of this document on fenwayhealth.org); Colorado, Hawaii, Nevada, and Massachusetts specify that Medicaid SRS coverage is only for adults over 18. Several others–including California and Oregon (see page 205)–indicate that  they follow the WPATH Standards of Care 7 guidelines (which specify SRS for adults only, see page 27), while others (such as Connecticut and Washington ) appear to make no explicit stipulation as to whether they cover under-18 SRS. The Connecticut policy document hedges: “Genital surgery is typically not carried out in adolescents until the adolescent has the capacity to make fully informed decisions and consent to treatment.”

WPATH SOC 7 genital surgery guideline

So even some very liberal states (like Massachusetts) only cover gender reassignment surgeries for people over 18. (Note: In some states where Medicaid will not cover genital surgeries for those under 18, it will cover mastectomies on a case-by-case basis. This is in alignment with the WPATH Standards of Care 7.)

A caveat: When it comes to medical transition coverage by Medicaid (for any age), the landscape is rapidly changing. State Medicaid offices are under increasing pressure by trans activist organizations to provide these services. For example, last year a federal judge in Wisconsin ordered the state Medicaid office to cover surgeries for two patients (FTM and MTF). A caveat is also in order when discussing the WPATH Standards of Care since certain activist clinicians are in favor of abolishing minimum-age guidelines in the upcoming SOC 8.

Why Vermont, and why now?

Vermont is a rural state with a small population. Yet, even with its small population, the NGO Outright Vermont “serves over 2,100 LGBTQ youth and their families, and nearly 5,000 educators and service providers in every county in Vermont.”

The numbers of children and young people seeking gender services in Vermont have grown rapidly in recent years. And one reason for this rapid growth may have to do with the activities of this small but very influential charity. Charity Navigator.com, which provides information about a large number of charities, lists  Outright Vermont – inexplicably – as a disaster relief organization. It was founded in 1989 for the laudable purpose of supporting lesbian, gay, and bisexual youth. However, if you look at its activities in recent years, it seems to be largely concentrated on transgender issues.

One of the ways the charity uses its funds (some of which are provided from government sources)  is to run summer camps and provide gender-identity programs to Vermont public schools. Outright Vermont has more than 60 volunteers who go into schools across the state. Because the charity fails to consider the possibility that social contagion may account for a significant portion of the increase in transgender-identifying kids, it fails to see how much it may be perpetuating the very distress it seeks to alleviate. Through its work in schools, the charity could be serving as a vector of social contagion. (To read about how efforts to raise public awareness about anorexia created a contagion among adolescent girls in Hong Kong in the mid-1990s, see the first chapter of Crazy Like Us by Ethan Watters.)

4thWaveNow has been following with great interest the ongoing news coverage about Mermaids in the UK and the large influence that charity has exerted on policy and clinical decisions at Tavistock and Portman, the NHS youth gender clinic in the UK. Charities like Outright Vermont and the larger and better-funded California organization Gender Spectrum appear to be exerting a similar influence in the United States.

What does Outright have to do with the proposed change in the Vermont Medicaid rule? According to a June 14 article in the Vermont Digger,

“Both Outright Vermont and the Community Health Centers of Burlington — the organizations that Kaplan and Inker are a part of, respectively — participated in drafting and providing feedback on the rule. According to Inker, the process began last fall, and several additional groups took part.”

Is the charity simply unaware of the increasing number of desisters and detransitioners? Surprisingly, no. The website links to a document developed by the University of Vermont that states “many children who are trans will end up identifying with their sex assigned at birth post puberty.” The document even acknowledges that “there is no way to predict which children will persist or desist as adults.”

Excerpt from U. of Vermont brochure

At the same time, the Outright Vermont website states that no age is too young for transition. How can this be? If many children desist after puberty, how can the charity justify puberty blockers, followed by cross-sex hormones? Such a protocol prevents the child from ever experiencing natural puberty, so they never have the opportunity to desist. Even social transition, often claimed to be a benign course of action, may reduce the likelihood that a child will eventually become comfortable in their natural body. (See Could social transition increase persistence rates in “trans” kids?)

Why this policy change is a bad idea

There are at least two important reasons this policy change is a bad idea. First, we know that many young people desist from a trans identity. Anyone who follows detransitioner accounts on Twitter and other social media will have noticed a rapidly increasing number of people, particularly women, who are speaking out about the negative effects transition has had on their lives. With the numbers of detransitioners increasing rapidly, how then does it make sense to pass a policy to make it even easier for young people to make irreversible changes earlier than they already can?

Another reason this policy change doesn’t make sense is the compelling evidence for social contagion. The study published last year by Dr. Lisa Littman suggests that social contagion may be a significant factor in the increase of trans-identifying young people. Many people, particularly activists, have criticized her study for only talking to parents, but she acknowledges the limitations of her study and indicates this is only preliminary research. Much more is warranted. But in the meantime, many detransitioners have begun speaking out about their own experiences, which corroborate Dr. Littman’s findings.

Although Littman’s is the first study to focus exclusively on the possibility of social contagion, other studies have suggested the role it may play. For example, this 2015 qualitative study surveyed 17 gender clinics around the world; some clinicians pointed out the influence of the Internet on the rise in youth clamoring for medical intervention:

“They [adolescents] are living in their rooms, on the Internet during night-time, and thinking about this [gender dysphoria]. Then they come to the clinic and they are convinced that this [gender dysphoria] explains all their problems and now they have to be made a boy. I think these kinds of adolescents also take the idea from the media. But of course you cannot prevent this in the current area of free information spreading.” –Psychiatrist

A better use of resources

Outright Vermont has done important work for gay, lesbian, and bi youth since its establishment in 1989. We also support its efforts to prevent bullying. No child, regardless of how they present themselves or who they’re attracted to, should be bullied. But the charity fails to see that some aspects of gender identity undermine support for GLB youth—in fact, all youth. Because of the serious, irreversible, and lifelong health effects from hormones and surgery, medical transition should be the last resort for young people experiencing discomfort with their bodies.

So instead of pushing for a policy to lower the age limit and making it easier for kids to make decisions they may come to regret, wouldn’t it make more sense for this charity to spend its resources on looking at ways, other than transition, to help girls and boys become more comfortable in their bodies without the need to become medical patients for the rest of their lives?

Outright Vermont Facebook posting 13th June 2019

Insult to injury

Perhaps the most distressing part about the Vermont proposed rule is this statement near the end of it:

“Vermont Medicaid does not cover reversal or modification of the surgeries approved under this rule.”

If incongruence between your biological sex and your perceived gender is sufficiently distressful to put you at risk of suicide, then it would work the same way in the other direction, wouldn’t it? If, after you transitioned, you then regret the effects on your body and decide you would like to return to living as your biological sex, how is it any less life-saving to provide you with those services?

If the change in policy is really driven by the desire to eliminate the distress of incongruence between biological sex and gender identity, then surely Medicaid should cover gender reassignment reversal surgeries just as willingly, right?

Vermont Medicaid won’t be alone in covering surgeries to affirm trans identities, while refusing to cover surgeries for those who detransition or otherwise come to regret the outcomes of medical interventions. Oregon also refuses to cover revisions unrelated to surgical complications.

Opens the door to prepubescent surgery

The article in the Burlington Free Press begins with the sentence, “Vermont health insurance regulators are planning to tweak Medicaid rules so transgender youth no longer have to wait until age 21 to seek gender-affirming surgery.” The word “youth” suggests adolescents. But in reality the rule opens the possibility of surgery at any age, including prepubescent children.

We can hear the objections now: “No one is proposing to give SRS to prepubescent children.” But is this strictly true? Further down in the same article, we find this very interesting quote from Dr. Rachel Inker, who runs the Transgender Health Clinic at the Community Health Centers of Burlington:

“The choice to have surgery is a personal one that should be explored in every age group.” 

Every age group?

The Swedish Pediatric Society recently published a statement [English translation] saying that “giving children the right to independently make life-changing decisions [about hormonal interventions for gender dysphoria…] lacks scientific evidence and is contrary to medical practice.”

In addition, more and more people—even among those who promote gender affirmation—acknowledge the possible ill health effects of puberty blockers like Lupron. Johanna Olson-Kennedy, director of The Center for Transyouth Health and Development at Children’s Hospital Los Angeles, the largest pediatric gender clinic in the world, has been worried for the past eight years that youth who spend too long on blockers, as per the Endocrine Society guidelines that suggest blocking in Tanner 2 and cross-sex hormones at 16, will suffer significant bone density loss. In her “Puberty Suppression: What, When, and How” presentation at the 2017 Seattle Gender Odyssey Conference, she stated:

“You need to have sex steroids for bone protection and probably a lot of other things that we are not nearly as clued in as we need to be. … For the young people in my practice, I hesitate to have people on just blockers in that age range for more than two years.”

She’s also concerned about “emotional lability [which] is really common with blockers.” In addition, she rightfully points out that,

“if you practice a model where you don’t start hormones until 16, you’re putting a 14-year-old trans boy in menopause, which you just have to understand is potentially going to be a trainwreck.” (clip of excerpted section and  audio of full presentation)

In fact, some of the clinicians who are the most aggressive in promoting early transition urge skipping blockers altogether and going straight to cross-sex hormones. Since cross-sex hormones administered before the end of puberty permanently sterilize them anyway and (in the case of natal males) prevent the development of sufficient penile tissue to create a neovagina, what’s to stop them from proceeding straight to surgery? In addition, some parents are resorting to tucking and taping their natal sons’ penises, while others are purchasing plastic penises for their natal female daughters. Earlier surgeries would eliminate the need for these interventions, so it’s not a stretch to imagine that removing minimum age limits entirely could open up the door to prepubescent surgeries.

In fact, a similar rationale is already driving down the age for “top surgery,” the euphemism for double mastectomies. To prevent the pain and harm that binders cause girls, clinicians are removing their breasts at earlier and earlier ages—sometimes as early as 12 or 13 years of age.

As one provider from Vermont says in the Burlington Free Press article, “Having young people have to wait until they were 21 just didn’t really make any sense.”

So let’s not be under any illusions here. This rule change opens the door to the government paying not only for double mastectomies for 12-year-old girls but also the removal of the penises and testicles of prepubescent boys. Can under-18 phalloplasties be far behind?

How to submit a comment on the Vermont rule

1. Go to https://secure.vermont.gov/SOS/rules/index.php. The rule, titled “Gender Affirmation Surgery for the Treatment of Gender Dysphoria,” is second on the list.
2. Click the small green button labeled “View” in the right column.
3. Scroll down to the section labeled Contact Information and click the green button labeled “Send a Comment.”
4. Complete the form.

You may also submit comments by emailing them to this account: AHS.MedicaidPolicy@Vermont.gov.

According to an email we received from the Vermont Agency of Human Services, “after the close of the public comment period on 7/17/19, comments will be reviewed and considered. When ready, the final proposed rule will be filed with the Secretary of State and the Legislative Committee on Administrative Rules (LCAR). The meeting schedule for LCAR can be found on the LCAR website. It is unknown at this time which meeting this final proposed rule would be scheduled for, but when it is filed and scheduled it will be posted on the LCAR agenda online. The rule does not take effect immediately after the LCAR hearing–an adopted rule must be filed. The timelines and procedures for filing an adopted rule are outlined at 3 V.S.A. §843.”

Carol F. is a 39-year old woman (adult human female) from a conservative area in California. She was raised in a religious environment. From ages 35 to 38, she identified as a transgender male and lived her life being perceived as such. The disconnect between her lived experience as female and how she was treated while being seen as male caused her to begin to question the trans narrative. A few months ago, Carol began to detransition, after being on testosterone for almost 4 years and undergoing a bilateral mastectomy.

Carol has spent her time since starting detransition being vocal about how the push for transition harms women and girls, particularly those who do not perform femininity in the “traditional” way. In this essay, she talks about her own transition-detransition process, as well as the often negative impact of the transgender movement on the lesbian community, spouses, and family members.

Carol can be found on Twitter @SourPatches2077

by Carol F.

My decision to detransition began when I started taking antidepressants for depression and anxiety. A month into treatment I felt like my whole world had come alive. I could feel true joy for the first time in years and I could take pleasure in everyday things. I had struggled with being very angry and agitated and often had enraged outbursts over nothing, but it had begun to be less overwhelming and I found I could manage and control my emotions.

I suddenly–and with some horror–realized that I had never needed to transition. My life didn’t feel overwhelming anymore. I could feel my emotions more clearly and sort through what had seemed before to be a complete disaster of thoughts and feelings. I started to question my motives, my perceptions, and my feelings, not only around transition but around all the life decisions I had made. I began asking myself what it would be like to live as a woman again, but I had gone so far with transitioning. How could I admit just a month into taking anti-depressants that I was wrong, how could I turn back?  No, I told myself, it couldn’t have been that simple.

We are told that being transgender is this deep-rooted thing, that it is part of our being, our core. It’s who we are, it’s our truth or truest self. I believed this when I started transition, how could this have been so flawed? How could my feelings have been so wrong? I kept these thoughts and feelings to myself and decided I would just continue living as a man, that it was too late to change this. I made my bed now I will lie in it.

I continued living my life as I had. I graduated college that spring and began working in the mental health field. I got a job working at a youth psychiatric hospital. This is when the second realization happened that made me question further being trans and trans ideology. At this hospital I saw so many young gender nonconforming girls come in claiming they were trans men. They wanted to go by male pronouns and male names. They were 13 years old, they were 15, they were 17. They all looked like little butch lesbians to me, and I felt a pang of shame and sadness. I saw myself in them. I saw their pain and fear and the abuse some had experienced. I saw the mental health issues they struggled with and how these issues left them longing for escape. They harmed themselves, they tried to end their lives, and they hurt. I wanted to reach out to them; I wanted to tell them it’s ok to be a lesbian woman. I wanted to show them a strong functioning butch woman. But how could I, when all they could see when they looked at me was a bearded man? How could I tell them what I couldn’t tell myself?

It was at this facility that I also began to work closely with men, something I had never really done before in my life. I had steered clear of being close to men in any way, although I had not realized I had done this; it was all unconscious at the time. Being considered “one of the guys” and having to play that role as much as I could left me with a deep sadness and longing for connection with women again. I knew I didn’t fit in. I hadn’t had a boyhood or been socialized as a male. I had had abuse and discrimination thrown at me just for being born a female, something they could never understand. Socialization makes up much of who we are, dictating the kind of path we are set on at birth. It has expectations and demands; it molds us and forms us in ways we are rarely aware of until you cross over to the other side in a kind of covert way. I often felt like an interloper in the male world–an alien observing private behavior and culture rarely seen by the outside world. This experience of being an intruder or imposter in the male world more than anything informed me that, yes, I was in fact a woman. There was no changing that. In a strange way this experience let me see how much of a woman I am. I had always labored under the impression that I was more male than female because of my mannerisms, likes, and way of dress. However, being on the other side with men solidified the truth that I was female and a woman through and through. My mannerisms, the way I dressed, and all the rest were just window dressing. It didn’t make me woman or a man, it was just me.

Then there were the London lesbians. There was the protest at London Pride where a handful of radical feminist lesbians stepped in front of thousands and made their voices heard. I had been following a well-known transman on social media and he had posted a story from Pink News. The headline went something like “transphobic lesbians storm the parade” or some kind of nonsense like that. I read the story but was a little annoyed because it didn’t say what they were protesting. Just that they were transphobic. I posted on social media asking others why the women had been protesting and what their message was. The response I got was basically “who knows, they are just transphobic and being hateful.” Well, I thought, maybe so but it’s always better to know the full story before making a decision to write people off. I began my internet search, and wouldn’t you know it, that led me to radical feminism. And that was the hammer that broke my illusion right open. The next several months was me and radical feminism and I heard the phrase I wish I had heard years ago, “The only thing that makes you a woman is that you are female.” A simple, to the point, and really quite obvious observation. How could I have thought otherwise? I agreed with it, but had still not taken the final step to detransition. But the push to do so began to be ever-present and its whispers grew louder every day.

My stubbornness is both a hindrance to me and my great strength. Sometimes it takes getting to the tender and protected parts of me to push me into a kind of submission, letting go of the thing I have been gripping so tightly for so long. It was the lesbian stand-up comic Hannah Gadsby who broke that grip. I saw her Netflix special, Nannette, and it hit parts of me I didn’t know were there. Her raw anger slapped me right in the face and told me something I hadn’t wanted to ever admit: Being a butch lesbian woman was fucking hard, it could be sad, it could be vicious, and it could break a woman.

When you walk through the world as a living example of everything that the world tells you is ugly and disgusting it can break you. And it had broken me. I knew, as I sat there in my room sobbing, that I had some real truths to face about myself. About my motivations for transition and the deep pain I carried with me. My internalized homophobia was something I always denied but it was damn strong and I had used it as another tool to hurt myself with. But the time had come to stop hurting myself, I knew this.

I contacted my doctor the next day and told her I wanting to quit my testosterone shots. It’s now been 4 ½ months since I last injected testosterone. I feel good and healthy. I’m on the mend and it’s wonderful.

The factors

ADHD is a very misunderstood disorder by most people. It affects almost every aspect of your life. I was not diagnosed with ADHD until I was 36, but after receiving the diagnosis it made a lot of the way my brain works finally make sense to me. I now see that ADHD played a large role in my fixation and desire to transition. People with ADHD often get hyper-focused on a particular thing. That thing becomes an obsession and we think about it nonstop for days, months, or even years. I got it in my head at 22 that I was trans and there it stayed for 15 years until medical transition had become almost completely unregulated. When I was 34, I found myself in a very mentally vulnerable place. Often when people with ADHD become mentally overwhelmed, we go back to a fixation we might have had or one we have kept with us but maybe have ignored for a while. We go to these fixations for comfort and organization, to feel better and safe again. I went back to my ideas about being a trans man and transitioning.

Looking back now, I think this was probably one of the most devastating times in my life. I had recently become a parent, which although a happy life change, is also a very stressful one. Around the same time, I lost my grandmother (who was more of a mother to me). I cut ties with my mother because I could not in good conscience allow her around my child and for this my brother and sister refused to have anything to do with me. I lost my good friend and brother-in-law to suicide. My wife literally lost her mind with grief and I felt like I was drowning. I became very depressed and wanted out of my life. I isolated myself, watching transition videos nonstop for months. I wanted to kill myself but knew what a shit move that would be to my family, so I latched onto transition as a way to feel at peace again. ADHD also affects one’s ability to reason though things thoroughly. Even though we may think about a subject nonstop we are not actually doing any kind of real analysis. It’s more like a movie that just keeps playing our favorite scene. The scene I played was one in which I was a strong man who lived a happy life.

When you are told from the age of 8 that the way you walk, talk, and act is like a boy by your mother, your schoolmates and other adults, it’s so easy to buy into the idea that you really are a man and that makes you completely normal after all.

I was raised in a very religious household where we were taught that women were put on this earth to serve men. I was not allowed to cut my hair or wear anything but long dresses, as my body was deemed immodest by default. My father had died when I was 2 in an accident and my mother had remarried into this religious atmosphere. My stepfather and mother abused me extensively from the age of 4 to 9. I learned to cope with the abuse by detaching myself from my body. I took back my power by never allowing my abusers to make me cry, I withstood the pain upon my body by disassociating. I believe this early abuse and dissociation from my body gave rise to the feelings that my body was wrong, not my own, and some kind of foreign entity—the same things people describe when talking about gender dysphoria. The sense of “wrongness” that one feels with their body.

When I was 9 my stepfather and mother divorced. I had a little more freedom to be myself and I began to express my likes and dislikes, as is normal for children to do. I wanted to play football, I liked boys’ clothing and style and I loved the idea of having short hair. My mother, although not as religiously fervent as she had been with my stepfather, was still a staunch fire-and-brimstone Christian, and very homophobic. She would become angry at me for wanting these “boy” things and punish me if I behaved “like a boy.” She ridiculed the way I walked and my mannerisms, telling me that I needed to walk and act like a girl. I had one bright spot in my childhood, and that was my paternal grandparents. They allowed me to wear boys’ clothes when I stayed with them and do my hair any way I wanted.  Of course, I had to be very careful that my mother never found out, and we all knew it.

My mother’s behavior introduced an internal hate inside myself as a gender non-conforming girl. This would later be compounded by the homophobia I faced when I came out as a lesbian. I had never given the trauma I had to go though as a young lesbian the kind of gravity it deserves. When I was 17 my mother was growing very worried because I was showing no interest in boys or men. She decided to set me up on a blind date with one of her friends’ 22-year-old son. I was sheltered and ignorant and scared of my mother, so I went out with him. She had never met the guy and had not actually seen her friend in years; they only occasionally talked on the phone. I knew within the first 5 minutes of being in the car with him that he was very dangerous and unpredictable. I could feel with everything that I was that he was fully capable of killing me. I knew I couldn’t set him off, he would use any excuse to become angry. I spent the next 30 minutes of the car ride being as polite and submissive as possible, all the while strategizing on how I could get out of this. When we got to a town I lied and told him my mother wanted me to call her and let her know we arrived and I faked exasperation with my mother’s request. I went to a payphone and called my mother. I told her I wasn’t feeling well and was coming home. I then told him that she had told me I needed to return home because her employer had called her into work due to an emergency and I had to watch my sister and brother. He was displeased, and I made every effort to ensure him of how upset I was that our night had been ruined and assured him that we would go out next week. The drive home was the longest drive I’ve ever taken. I made it home safe and for the first time ever I yelled at my mother for her stupidity in putting me in a dangerous situation.  This showed me how expendable I was as a woman if I could not adhere to the roles expected of me. I was better off dead than a dyke.

When I finally did come out as a lesbian at 19 years old, I was put through hell by most of the people most important to me in my life at the time. I lost friends, I was told I was never allowed at family gatherings because I was sick and would cause harm to the little kids. I was ridiculed and called every nasty name in the book. I was propositioned by men who were sure they could make me straight if I allowed them to have sex with me. I was told I was too pretty to be a lesbian, I was trying to be a man, I had been turned by a child molesting dyke, and the list goes on. I faced harassment in public life, mostly by men who would yell out “dyke” to me as I walked down the street or became confrontational with me if I looked at their girlfriend or god forbid smiled and said hi. I was not even safe at my job. There were men who would make jokes about raping a woman who got out of line, men who called me “spike” and “sir” to my face and refused to work with me. Men who talked openly about beating up fags or killing their sons if they were gay. It was enough to make anyone want to escape. I just wanted to live my life, I wanted to be unnoticed, but I couldn’t be. I hated this, I hated myself, and I felt like I must be the most disgusting creature in the world—that I must be wrong.

Trans explains why I’m wrong

The first time I heard the word transgender applied to women was in 2002 when I was 22 years old. It seemed as if overnight the young lesbian community had started to embrace this trans idea. Most of the butch lesbians I knew refused the label “butch” and instead said they were trans men. My wife and I were friends with several lesbian couples at the time and every butch woman in that couple now claimed to be trans. The first time I was corrected by a young butch named Lacy, she said “Oh I’m not butch, I’m really a trans man.” I had no idea what she was talking about so I asked. As I remember, she gave the simple answer, she was a man trapped in a female body. I was disgusted by this and repulsed even, but it never left my mind. I then began to ponder what it meant to be a trans man. A man who had a female body seemed to tick a lot of boxes for me. After all, I was always told I behaved like a boy. I walked like one, I acted like one, I was attracted to women. I liked men’s clothes and short hair. It started to make sense. It explained everything that was wrong with me. All the ridicule, all the abuse I had suffered through wasn’t my fault, or even the fault of the people who did it. What I suspected must be true, these people saw something in me that was wrong and broken. I latched onto the trans label very quickly and began telling friends and family that I was trans and that I wanted to transition.

However, this was 2002 and standards of care were still relatively strict compared to today. I had to see a gender specialist, live as my desired sex for at least six months, and undergo at least 6 months of therapy before being allowed to receive cross-sex hormones. I managed to find a gender specialist in my hometown and began working with her. She demanded that if I wanted hormones I needed to start living as a man, going by a male name and pronouns and being in male-only spaces. This was impossible for me. I had large breasts that could not be hidden and a curvy, obviously female body. I was also stricken with fear at the idea of going into male-only spaces. This seemed incredibly dangerous to me. I refused and decided to let go of transitioning. However, I always kept it in my mind as the explanation for why I was the way I was. I didn’t demand people recognize me as a trans man but I saw myself as such, and it brought me comfort that I was normal.  

Transition wasn’t what I thought it would be

I made the decision to start medical transition in spring 2015 at the age of 35. Older than most transitioning woman to be sure, but not unheard of. Although many teens and younger women are transitioning, there is also a large population of adult women, mostly butch lesbians, who have also transitioned in the last 5 years or so. These mostly go unnoted because we are adults and already living on the outskirts of society. A simple look at a butch-lesbian dedicated subreddit or Facebook group will show many conversations about butches transitioning. The loss is very real and is leaving devastation in its wake in the lesbian community. I’m just one of the many. Only four months after I started testosterone injections, I had top surgery, or more precisely a double mastectomy. I hit the ground running with regards to transitioning. I couldn’t seem to do it quick enough.

Detransitioners know about the honeymoon period of transition. It lasts anywhere from 6 month to 3 years, depending on the person. Two years seems to be about average. Transitioning, although it ends up not helping in the long run, does help for a while. This is what makes it so hard to explain to those who are either still trans or those who have never been in this situation, because transition did help, for a while. I felt better when I started taking testosterone. I had more energy, I was less depressed, and my mood seemed more stable. I thought this meant I had made the right choice, and even my therapist and doctors saw this as proof that hormones were good for me.

I have done a little research into testosterone use in females, and although there isn’t much out there, what I have found seems to indicate that elevated mood and energy are some of the positive effects of testosterone use. Even males who use testosterone experience this. But what made me feel good was not some spiritual lining up of my brain with the right hormones (yes, a therapist did say this to me) but a simple side effect of a drug. No different than drinking alcohol or using any other substance to ease emotional pain. Another reason transition helped was that being seen as male enabled me to walk through the world like just another person. I didn’t draw attention and I got treated better than I ever had, by my co-workers and strangers alike. I have since heard of some trans-identified females who make the decision to continue living as men, not because they actually believe they are men but because they know it’s safer and easier for them than if they were to detransition and live as woman again. I honestly can’t blame them. It was wonderful to experience the freedom and safety of moving through the world being thought of as a man, if only for 3 years.

After about 2 years on testosterone I noticed that my anxiety had started to become much worse. I discussed this with doctors and psychiatrists, but they didn’t think the testosterone could cause this effect. As time went on my anxiety became worse, to the point where I was taking an anti-anxiety medication daily. It reached a breaking point when I could no longer leave my bedroom without having a panic attack. I couldn’t drive because that triggered a panic attack as well. I really couldn’t do anything but keep myself sedated on benzos and stay in bed. This is when I hit bottom. I went to a psychiatrist and got an antidepressant called Viibryd that is also used for panic disorders­. Starting antidepressants is both mentally and physically hard. Those first 2 weeks on the medication were like hell. My brain felt like it was ripping apart and I had panic attacks that were so bad that I really did want to die so I would not have to feel them anymore. But by week 4 the side effects dissipated, and I began to feel joy, a sense of peace, calm and clearer headed.

On top of the anxiety and depression, transitioning had ended up making my dysphoria worse. Why? Because now I was worried that men would discover I didn’t have a penis when I used the male bathroom. Because I was smaller than most males. Because my voice wasn’t as deep. Because my hands & feet were smaller. Because my body shape was more feminine then male. Because the way I talked and gestured was seen as feminine. Because my chest had scars across it. Because I was soft spoken and not aggressive. Because I was raised as a girl and was never part of the boy’s club, so I didn’t know how to interact in male culture. Because every day, I stepped outside my house and was consumed with not being found out for what and who I really was: a woman. It seemed like I had switched one set of problems for another.

There were also the health side effects I was experiencing. My skin seemed to always have something wrong with it. The first year I had terrible acne, which is expected, but after that subsided, I always seemed to have some kind of rash or irritation that I hadn’t had before. My vagina was showing signs of atrophy and was painful all the time. To alleviate this, I would have needed to start taking a topical estrogen cream that you insert into your vagina. For someone with dysphoria around their genitalia, this is really the last thing you want to have to deal with. I was always aware of my female genitals because they hurt and were unhealthy. Again, not helpful if you have dysphoria around this area. I was also seeing my cholesterol climb every time I had a blood panel done, which was every six months. I knew it was a matter of time before I would need to be on medication for this. I was also starting to creep into the range of concern for diabetes. Additionally, I was quickly losing my hair and, in another year or two would likely be bald. All this happened in a span of 4 years on testosterone. I was completely healthy with thick beautiful hair before starting testosterone.

As of this writing, I have been a little over four months off testosterone. My cholesterol levels have dropped, risk for diabetes has gone down, and my hair is starting to fill in a little. The atrophy to my genitals and uterus has reversed and I am in good health. I feel happy and content. There are some things I will never get back, though. I had a double mastectomy only 4 months into transition, so my breasts are gone. I mourn this, I mourn that I will never get the chance to make peace with them like I have started doing with my sex and body. We all carry scars from life, and these are mine.

 The family suffers too

I believe it’s very important to recognize the pain transition and trans ideology can cause to the family members of the trans-identified person. The families are the forgotten victims in all this, and this is unacceptable. The trans community takes little care in the impact transition has on not only the trans person themselves, but also their family. These are some common things I heard when I began my transition.

“You are the same person you have always been”

“You will be a better person/spouse/parent because now you will be living your true self”

“Your journey is important”

If the family is upset, sad, angry or generally just confused about the transition of their family member, here are the things said to the spouse/parents/child/family member.

“This isn’t about you, it’s their journey”

“You aren’t being supportive”

“You are being transphobic”

“They have always been this person, you just didn’t know”

This is so problematic because trans ideology is, at its core, extremely self-centered sometimes even in the narcissistic range. The trans person is encouraged to view the family’s emotional state as hateful or transphobic towards them if they experience normal human emotions of sadness, loss, confusion, or anger. Trans people are not encouraged by the community to see transition as the major life-changing event that it is. Instead, it’s downplayed and given the emotional weight of a new haircut or a change of clothes. The family members are expected to say nothing but positive things and show no “negative” emotions. They are shamed into silence. Mandated to keep their feelings to themselves lest they be labeled the most horrible thing one could be called in our society right now: transphobic.

When I began transition my wife who I had been with for 15 years was devastated, and rightfully so. In the beginning she believed as I did in most of what trans ideology had to say. She really did think I was trans and she was supportive. However, her life was also being turned upside down emotionally. She had lost her brother to suicide only a year earlier, she was a new mother, and now her wife was trying to become a man.  She was scared, sad and feeling loss. She naively turned to the trans community for support during this time, trying to find other spouses of transitioning people to talk to. She thought these “support groups” would be a place for support. A place one could talk openly about the emotions they had as they went through transition with their family member. What she got instead was everyone saying how happy they were for their spouse and how exciting this all was. No negative emotions. When she started expressing her confusion, fear and anger over my transition it wasn’t long before she got the “TERF” word thrown at her. She had never heard the word before and after multiple people labeled her a TERF and eventually ran her out of the support group, she went online searching for “TERF” (as we all would if we didn’t know what something meant). She found gender critical and radical feminist information, chats and web sites. It was there she found support. I find it quite funny that it was the trans community itself that drove someone to turn into a “TERF”.

What I’m trying to show here is the very unhealthy & damaging effect trans ideology has not only on the trans-identified person but also their families. I really do believe this is cult-like, even religious behavior.  It is divorced from reality, basing everything on a belief supported by feelings and very little science. It is faith-based and you must believe. It is all or nothing, good versus evil with no room for nuance or critical analysis. I’ve seen this before, as I wrote about in the beginning of this article, because I was raised in religious extremism. Trans ideology mimics this very closely. It can capture people on the fringes of society, people with mental health issues and people in pain from trauma. It promises relief from symptoms, an answer for which people are searching.

The community positions itself as the most oppressed demographic in society, while holding the people on the outside hostage with threats of suicide and blame for murders committed against the trans community. It showers acceptance and validation on its members as long as they adhere to trans dogma. The trans people who do not adhere to the ideology are called truscum, traitors or TERFs. People such as myself who detransition are told we no longer have a right to say anything about the trans experience because we are no longer trans or never were trans to begin with. Many of us are shunned from the community — like a dirty secret. This shunning of former members is a great deterrent to detransitioning for some. For those who do detransition, we usually slink away and are never heard from again. For those who do speak out we are labeled TERFs (a label that has come to mean nothing but a person who doesn’t completely agree with trans ideology), or ridiculed for not knowing we weren’t trans. We are told that we took valuable resources away from “real” trans people and that we should be quiet and go away.

I began as a true believer, I thought I had found my answers, I thought it all made sense. I had euphoric feelings of relief and happiness when I began transition. Four and a half years later, and I am rebuilding my life from the ashes. I burned myself and my family up into a million pieces and now we have to make sense out of the disaster. I am very lucky and grateful that I have a wonderful wife who has stuck with me more than she ever should have and a son who is immensely forgiving of his mother’s flaws. I find that every day is better than the last, if only by a half step. The resilience of the human spirit is amazing to me. Never give up.