Response to “Fear of a Trans Planet”

This is why the viewpoints on this site matter. This is why.

BORN WRONG

(This is a response to this article; I’m reposting it here because their comment box doesn’t allow line breaks, so this way I can post a link to it for anyone else who absolutely cannot read that many words with no lines in between.)

“Where are the people who switched pronouns at 10, switched pronouns again at 25, and found the experience traumatizing? Where are the people who received unneeded medical interventions and were permanently, or temporarily, harmed?”

I transitioned FTM at 16, was on testosterone and had a double mastectomy by 17. I’m 20 now and back to understanding myself as a lesbian, like I was before I found out about transition and latched onto it as a way to “fix” body issues created by the challenges of growing up in a deeply misogynistic and lesbian-hating world. I don’t know if he’s ever planning on using the interview…

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Conversion Therapy?

When I suggest that it might be appropriate to do a thorough assessment of trans identifying youth before sending them down the road to become life-long medical patients, I am often told that such an approach would be tantamount to conversion therapy. In doing so, I would be committing the same sin that mental health providers committed for years in attempting to “cure” homosexuals of their same sex attraction. Though this may appear at first to be a valid analogy, the two things are very different.

Homosexuality is not a mental health diagnosis. Gender dysphoria is.

Tragically, it is true that for too long of a time, homosexuality was viewed as a mental health diagnosis which required treatment and cure. Today, we know this isn’t true. I have had the honor of treating a number of young people who were in the process of coming out. I offered them support as they told friends and family. Together we explored internalized homophobia. In one case, I advocated for the patient with her mother. I did not need to assess whether these patients were in fact gay or lesbian, because being gay or lesbian is not a mental health disorder, and therefore no treatment is indicated or sought. My role was merely to offer support and a place to process a variety of feelings these young people had as they came out.

Transgenderism is not a mental health diagnosis either. It is an identity that is adopted as a means of managing the acute distress that can accompany gender dysphoria. Gender dysphoria is a mental health diagnosis. Like many conditions, there can be many causes of dysphoria, and there are several possible treatments for it. Some of those with dysphoria have found relief with interventions such as somatic psychotherapy; embodiment practices such as yoga; talk therapy; and medications, especially SSRI’s. Adopting a transgender identity is one way of managing gender dysphoria. Medical transition, which can involve cross sex hormones and/or surgery is the most invasive treatment possible for gender dysphoria, and therefore should be the treatment of last resort after others have failed.

Put another way, a person presenting to a therapist with gender dysphoria is there to get treatment and relief for the discomfort he feels in his body. The patient’s self-reported distress is the presenting problem, so of course it is appropriate to assess and explore it. In the case of a gay or lesbian, society sadly assigned pathology to the fact of being same sex attracted (by pathology, I mean something like “there is a problem that needs to be fixed or addressed”). In the case of someone with gender dysphoria, it is the patient himself that is telling us that there is something wrong with him that needs to be addressed. If the symptom is same sex attraction, then that doesn’t require treatment. If the symptom is feelings of profound distress, well that does require some kind of treatment.

When someone presents to a psychotherapist with symptoms that may require invasive treatment, it is the therapist’s job first of all to do a thorough assessment in order to determine whether the patient meets the diagnostic criteria for the disorder for which he or she is seeking treatment. Appropriate support and interventions should be offered, reserving the most invasive treatment only as a last resort.

For example, many people arrive at a therapist’s office saying something like, “I’m depressed.” Depression is used colloquially to indicate that we are feeling sad, however, it also has a specific clinical meaning. If someone came to me and said they were depressed and wanted electroconvulsive therapy (ECT), sending the patient to the hospital to undergo this procedure would be reckless and inappropriate. The first thing I would do would be to ask them to describe for me their depressed feelings. At some point, I would run through the list of symptoms that indicate whether one is suffering from major depressive disorder. I would ask: How are you sleeping? How is your appetite? How is your mood? Sex drive? Weight? Do you do anything that you find pleasurable? Do you have thoughts of suicide? From these and other questions, I would begin to get a sense of whether the person qualified for a diagnosis of depression.

I would also need to know many more things before I could make a treatment recommendation. For example, is there a family history of depression? Are there other symptoms that might indicate something else is going on? Perhaps the person has an eating disorder, or is feeling depressed sometimes, but is manic at other times. All of these factors might change the intervention that would be most appropriate. I would want to know whether the person had suffered a recent loss. If their spouse had died recently, then the diagnosis of depression wouldn’t be exactly right. I would want the person to know that the deep feelings of sadness, the hopelessness, and sleeplessness would be a normal — if painful — part of the human condition.

Before deciding upon any treatment, therefore, I would need to confirm the diagnosis, to complete a differential diagnosis to rule out other causes, and to ascertain the severity and duration of the illness.

Depression can be serious. Ninety percent of those who kill themselves have depression or another mental health disorder. It is appropriate to take depression very seriously. It is considered best practice to begin treatment with those interventions whose adverse effects are least serious and permanent. For example, most of the first line medications for depression such as SSRI’s tend to be well tolerated and have mostly non-serious side effects. Talk therapy can be effective in treating depression and generally does not have adverse side effects. Some people do not respond well to these medications or therapy, however. In these cases, doctors may prescribe a variety of medications, some of which carry more risks.

For those patients who have debilitating depression and severe suicidality, and who have failed every other treatment, psychiatrists will often prescribe “shock therapy,” or ECT. ECT can be very effective, but it is considered a treatment of last resort since it can result in permanent memory loss. Most people with depression will avoid ECT as long as they can. Most patients are not even considered for ECT until they have failed out of every other treatment.

Back to gender dysphoria. Someone arriving at a therapist’s office seeking medical transition is there because he or she is suffering from a mental health diagnosis known as gender dysphoria. Just as in the case of depression, a good therapist ought to do a thorough evaluation to confirm the diagnosis; complete a differential diagnosis to understand what other mental health issues might be going on; and get a sense of the severity and duration of the dysphoria. Only then ought a treatment plan be devised. As is the case for depression — or any other physical or mental health issue, for that matter — the least invasive treatment with the fewest long-term side effects ought to be tried first. Indeed, insurance companies often require that  mental health and substance abuse patients “fail out” of lower levels of care before they will pay for more expensive, extensive treatments.

Gender dysphoric young people ought first to be offered therapy and perhaps anti-depressants. Not to “cure” them of being trans, but to address the distress for which they are seeking treatment — in this case, gender dysphoria. Such therapy might include support and exploration. Only if the young person fails all other treatments ought drugs which induce permanent changes and carry a high risk of adverse side effects to be prescribed.

Part of the confusion around the matter of “conversion therapy” with trans identified youth is that many do not see medical transition as a treatment for a mental health disorder. They view transgenderism as a normal variant of human experience. This may in fact be the case. However, according to this view, those seeking medical transition are therefore choosing to undergo a medical procedure without a medical indication. This is certainly something that we have a place for in our culture. We allow adults to modify their bodies with cosmetic surgery. To have breast implants, face lifts, etc, we do not require a mental health diagnosis or any kind of psychological assessment. Adults are free to do as they wish with their own bodies, and we consider such procedures ethical as long as patients have been fully informed of the risks.

It may be that as a society, we evolve to think of medical transition in the same way that we currently think of cosmetic surgery. In this case, it is not a treatment for a mental health diagnosis. No assessment and diagnosis would need to be made. It would become just like any other fact about a person in therapy — something that could be explored and discussed if the patient wished.

However, if medical transition is not a treatment for a mental health diagnosis and is therefore non-medically necessary, then it should not be performed on children and young people. Ever.

Currently, medical transition is considered to be a treatment for a mental health disorder. Advocates are lobbying for policies that will require insurance companies to cover transition costs because these are deemed to be medically necessary. When treating a mental health disorder, it is always appropriate to do a full assessment and to offer those treatments that are least invasive.

To imply that therapists who complete a thorough assessment of a young person presenting with gender dysphoria are somehow not practicing appropriately is fallacious. In fact, omitting such an assessment and rushing to affirm a transgender identity is not competent or ethical.

 

 

 

 

A Lesbian Psychologist Speaks Out

By Saye Bennett
I am a lesbian, and I am a psychologist.

Those two facts have been inextricably linked in my mind as I have observed, with increasing dismay, both the mental health community and the medical community unquestioningly accept the current transgender trend as fact. 

As a psychologist, the most urgent and obvious concern I have about this uncritical acceptance of the transgender trend is our ethical mandate to “Do No Harm”. How can we, in good conscience, happily send our clients down a long and dangerous path of cross-sex hormones and invasive surgeries? (If you don’t think there are dangers in these interventions, please take the time to research very thoroughly, making sure to scratch beneath the shiny surface veneer of the relentlessly positive trans propaganda).  
Our goal as mental health professionals should be to empower our clients to become their healthiest, best, authentic selves. 
To believe that a client’s true self can only be achieved by changing everything true about herself is ludicrous.   
And yet that is exactly what the mental health and medical communities are wholeheartedly endorsing.
The current political climate is increasingly limiting professionals’ choices in this matter, and is now even squelching our right to speak out with questions and concerns. 
Questioning is now deemed hate speech, and refusal to simply automatically submit to client demands is now deemed unprofessional and “transphobic”. 
When it comes to the transgender trend, differential diagnosis is forbidden, yet how can professionals adequately diagnose or recommend treatment without getting the full picture?  
Instead of blindly accepting our client’s diagnosis of herself, we should be doing what we do for ALL clients, which is to actually find out what is going on that led the client to this point.
There are many factors that may need to be considered when a client reports she is transgender, including, but not limited to: sexual orientation (more on this below); trauma; general body image; eating disorders; medical history; autism spectrum disorder; mood issues; anxiety; family relationships; and social dynamics (including social contagion). In other words, a thorough assessment of all relevant factors and a comprehensive background history are needed to get a full picture.  
The mention of sexual orientation leads me to my next point, because, as I mentioned above, the transgender trend concerns me greatly in my professional role, but it affects me even more saliently as a lesbian.
As a lesbian, I can say with firsthand knowledge that lesbians often do not meet society’s stereotypical notions of “femininity”. Even though I am a so-called “feminine-presenting” lesbian myself, there are still significant differences in how I process and approach the world in comparison to my heterosexual cohorts.  
Therefore, because lesbians often do not fit into society’s narrow definition of alleged “appropriate” femaleness, I have been witnessing many lesbians being ensnared into the trap of thinking that they must be transgender.
Because lesbians often don’t see others like ourselves in the world around us, we often feel we are different than other females. This is likely to be even more true during childhood and adolescence, before we have the independence and the means to get out and explore the world.   
Many lesbians have interest in activities, peers, toys, items, hobbies, colors, clothes, books, movies, TV shows, games, etc. that do not fit into society’s narrow view of “stereotypical femininity”.
So if a female reports she “does not identify with/as”, nor feel similar to, other females, it does NOT mean she is “really a male”, it just means that she is a different, unique, and equally valid, type of female.  
Similarly, if a female reports that she likes sports, or the color blue, or wearing pants all the time, or wants to play with trucks instead of dolls, (etc.), it does NOT mean she is “really a male”, it just means she carries her femaleness in a way that is different from society’s rigid expectations.  
Females who do not fit into the traditional “feminine” stereotype do NOT need hormone blockers or cross-sex hormones; they do NOT need to “socially transition”; and they do NOT need unnecessary surgeries.  
Female bodies are not the problem here…society’s expectations are the problem.
There is no “right way” nor “wrong way” to be female. 
What girls/women who carry female differently do need is unconditional acceptance and support, in order to become comfortable navigating being different in a critical and rigid society. 
Mental health and medical professionals owe it to our clients to think critically about all information being presented to us. 
We owe it to our clients to delve deeply to find the truth, and to always strive to “Do No Harm”.  
Bottom line, we owe it to our clients to critically question an ideology which is based on John Money’s already discredited gender identity theory; and which is also based on stringent, faulty notions of what it means to be a female. 
**Note: The focus of this post is based on females, so that is the term used for simplicity and clarity. However, please note that the same general principles would be relevant for males who do not fit the stereotypical notions of “masculinity”.

“I Thought I Was Trans. Really I Was Just Scared of Being a Woman.”

Posted from Reddit with the author’s permission.

Over a decade ago, I came to the conclusion I was transgender after coming across a FTM message board.
I was a tomboy as a child, dressed in boy clothes handed down from my mum’s friends, begged for short hair, sweltered in trousers rather than dresses at school (girls could wear dresses or trousers, boys could wear shorts or trousers), spent my time catching bugs, climbing trees, etc. My parents were fine with it all.

Things changed from 11 or so. Gradually my boobs grew and periods started. My 70 year old martial arts teacher groomed and molested me, my mum bullied me about wearing a bra because boys would see my boobs jiggle and that would be INAPPROPRIATE, the girls at school wanted to know what size I was, the boys at school would make lewd comments or sometimes try for a grope.
My peers were all suddenly into clothes and make up and I was meant to be as well! I was touched up by men in their 40s when I sat next to them on the bus. I was no older than 13/14! I had to be careful to conceal my soiled sanitary towels in case my dad saw them when he opened the bin, as that would be INAPPROPRIATE! I was so conscious of how my body was judged, I stopped swimming. I love swimming and live on an island and still haven’t swum in years because I feel so self conscious of my body. My friend and I used to race out to touch a moored boat first and participate in events swimming from one bay to another, I’d probably struggle to doggy paddle in a pool now.
I hated my breasts. I hated my periods. I blamed them for the way I was being treated as a girl, instead of blaming the people who felt that the way to treat a girl was to restrict them and humiliate them and use them. I was a more nervous, less confident person at 15/16 than I was at 9/10. I buzzcut my hair and gave up on trying to be happy being “girly” with feminine clothes and makeup and started wearing unisex/men’s clothing, hoping it would also stop men sexually harassing me. The shit I got from people was horrible, and guys at school just thought it was “funny” to harass me now because of course they wouldn’t actually fuck me.
When I found an FTM message board I thought it all made sense – I was supposed to be a man! Men don’t get harassed for daring to leave the fucking house! Men don’t have to wear make up and shave their legs religiously! I started making plans to run away from home (conservative area, not the best healthcare for out of the norm problems) and start transitioning, though thankfully I never put them into action. I came across radical feminism and realised that I had been traumatised by my treatment by men and patriarchal society, not my breasts and periods.

From a Concerned GP

GPs are concerned by the increased demands on us to prescribe potential dangerous lifelong hormonal treatment and advice on disfiguring surgical procedures to our otherwise healthy patients who chose to identify in increasing numbers as “trans” patients. It is deeply disturbing that the trans activist community seems to be manipulating the NHS into providing these harmful treatments, and stating that these are “life-saving” approaches, without questioning the issue of gender as a socially constructed system or the gleeful involvement of drug companies and unscrupulous surgeons willing to do this disfiguring surgery.
As a doctor, this possibly homophobic , misogynistic and conservative approach to gender identity is deeply disturbing. Young, possibly gay children, or children who show any degree of deviation from societal norms of gender behavior, or who have any commonly found body dysmorphic ideas are being encouraged to transition rather than being allowed explore other ways of being with who they are or of playing with natural fantasies prevalent at that age. This is deeply disturbing and contrary to the principle of “first do no harm”

“Four Words Sheryl Never Said”

Cari is a 22 year old detransitioning woman wrote this earlier post for this blog. She recently created these powerful posters, which she has been kind enough to allow me to post here. Cari blogs about her experience at guideonragingstars.tumblr.com, where these posters first appeared. 

“These posters are in reference to my therapist at TransActive Gender Center, Sheryl Rindel, who I saw for 3 months before being referred for hormone therapy at 17. She did not address my trauma history or other stressors in my life which contributed to the depression I blamed on being dysphoric and pre-transition, or present me with alternative ways to deal with dysphoria.”

4words14words2

4words34words4

 

Rapid Onset Gender Dysphoria Research Study: Recruiting Parents to Fill Out Survey

Below is a description and link to a research survey intended to collect information about rapid onset of gender confusion/dysphoria and social media use in teens and young adults. Sudden onset of gender dysphoric feelings in the teen years is an unusual presentation, and this researcher is looking to learn more about it. If your child or young person began experiencing gender dysphoria between the ages of 10 and 21, please consider filling out the survey. Also, please feel free to share the information below with the survey link with others you know or on social media. Thank you.

Please note: YTCP has collaborated with 4thwavenow.com and transgendertrend.com to disseminate this survey. This same material will be posted on all three sites.

Rapid onset gender dysphoria, social media, and peer groups

GCO# 16-1211-00001-01-PD
 
We have heard from many parents describing that their child had a rapid onset of gender dysphoria in the context of increasing social media use and/or being part of a peer group in which one or multiple friends has developed gender dysphoria and come out as transgender during a similar time frame. Several parents have described situations where entire friend groups became gender dysphoric. This type of presentation is atypical and has not been studied to date.  We feel that this phenomenon needs to be described and studied scientifically.
 
If your child has had sudden or rapid development of gender dysphoria beginning between the ages of 10 and 21, please consider completing the following online survey. If you have more than one child with gender dysphoria who fits the above description, please complete one survey per child.
 
This survey is completely anonymous and confidential and conducted through Survey monkey, an independent third- party. There is no way to connect your name with your responses. We do not track email or IP addresses. The survey should take 30-60 minutes. Participation in this research study is voluntary, and you may refuse or quit at any time before completing the survey.
If you know of any individuals with a similar experience who might be eligible for this survey, or any communities where there might be eligible parents, please copy and paste this recruitment notice and survey link to share.