Children and Gender Roles

This post comes from Rene Jax, author. Her book “Don’t Get on the Plane” can be purchased at Barnes and Noble.

“Children are like sponges.” As their bodies and minds grow, every day brings new stimulus, situations, emotions, and physical abilities. And whilst their bodies are growing at an exponential rate, their minds are too. And as their mind’s capacity for understanding increases, they become more socially aware and responsive.

Today, the typical Western family is under tremendous financial, political and social stresses that in turn, makes its way into the upbringing of our children. Parents arguably have less influence over children than in the past, while social media, pop music culture and movies are more influential than ever. It is out of this growing technological and social change that the new fad of gender confusion en masse has sprung. Aspects of our culture are encouraging children to become confused about gender.

I was one of those children. I was a male, born into a family in crisis. My father was a drunk who left us when I was six years old. My mother was mentally ill. By the age of ten, I thought myself to be a girl trapped in a boy’s body. I was cross dressing by the time I was twelve. I began living as a woman full-time when I was eighteen, and had a sex change at thirty-five. Yet as I lay on Dr. Stanley Biber’s surgical table in Trinidad, Colorado, I never knew what was the cause of my confusion. None of the six doctors I had previously gone to before the surgery had a clue as to the cause.  Doctor’s still don’t. Transsexualism, and gender dysphoria have been studied for a half century. But there has not been any hard- scientifically based research project into the cause of this condition. NOT ONE!

In Dr. Robert J. Stoller’s introduction to his 1974 book on transsexualism, “The Transsexual Experiment” he glibly writes: “As a psychiatric illness, transsexualism is insignificant in that the pressures for understanding and cure are minimal – except from the patients. Happily for researchers, it is more important theoretically, than in its impingement upon society. Those who are transsexual are neither infections nor otherwise dangerous; they do not inflict bodily or psychological harm on others.”

This very attitude exists within parts of the medical community today. Yet, there are dangerous medical and social activists who are promoting and supporting children’s social role confusion as a medical diagnosis and niche industry. They do this to prop up their own social agendas, while at the same time, damning the children they force onto puberty blockers and sex changes to a life of being social pariahs.

Let’s start by dropping these antiquated and dangerous labels. We do this by understanding that when Dr. Harry Benjamin coined the word, Gender, it was an attempt to describe social role variances that he saw in his cross sex identity confused patients. Gender was simply meant as a category, not a thing. Since Benjamin, Gender has become a factual part of identity, and as such is now promoted as being fluid. Let’s stop all of this insanity! First off, “Gender” is a concept that has never been proven to be a real, physical reality. So, drop it and never use it again to describe a person’s social role. The same goes for “Transsexuality” This is another concept used as a label for cross sex identity confusion, but carries with it medical certainty that does not exist.

Humans are born with one of two sexes. PERIOD. The survival of our race is fully, 100% dependent upon males wanting to mate with females and vice-versa.  We know this has been the case for over a million years. If our understanding of our selves/social roles were at all fluid, (as promoted by the LGBT medical activists) then we as a species would never have survived for more than a generation or two. But it is! Knowing that as a male, I am driven to mate with a female… is built into our DNA. Our families and our societies are all built on this biological drive. Variances are so rare as to only represent about 1% of the total population.

Humans have a sex. And our sex determines our hormones, our family and social roles, and our sexual appetites. It determines our propensity towards activities and physical and emotional reactions to stimulus.   Any confusion, or desire and or feelings of being “trapped” in the wrong body are a variance of not of our DNA but of the world the child is born into.  When our children express feelings that they are not the same as their body’s sex, the first-place parents need to look for answers is not in a pill bottle for puberty blockers. They need to closely examine their parenting, their own marriage dynamics and how what the children are being taught about their role in the family and larger family structures. They must be honest about how they as parents, and their other siblings are interacting with the confused child. Remember… “Children are sponges”?

Care should be taken when choosing a therapist. There is an old expression, a baker only sees other bake shops on the street, and a banker only sees other banks. If you go to a “gender” doctor, they only have one tool on their belt, and your child will soon end up on puberty blockers.

The few studies on this issue indicate that the majority (95%) of children who show cross sex identity confusion early in life, grow out of it. The odds are in the child’s, and in the family’s favor that it will all work out fine without medical intervention. Seeing a good pediatrician will just give you another bit of information to aid in making decisions.

After dealing with cross sex identity confusion for over fifty years, I am now convinced that taking hormones, living in the opposite sex role, plastic surgery and sex changes are not the way to go. Letting our children live in the opposite sex role is emotionally damaging and only causes more difficulty and social confusion for the child. Cross sex living is not and never will be a viable lifestyle.

You can read my book on this, “DON’T GET ON THE PLANE” which details the history, the doctors and the medical malpractice behind this condition. Sold on Amazon under Rene Jax.

The Difference a Diagnosis Makes

Sunmum lives in the UK with her husband. Two of her children have at times identified as non-binary/trans.

This year’s European Professional Association for Transgender Health (EPATH 17) conference included a presentation on ‘Misdiagnosing Gender Dysphoria in Adolescents: 5 Case Studies’:


Five adolescents ages 13-15 all presenting with Gender Dysphoria were misdiagnosed by other clinicians (as Borderline Personality Disorder, Autism, Schizophrenia, or Bipolar Disorder). This study reviews their case histories and how Gender Dysphoria went undiagnosed until it was clinically accessed and the importance of differential diagnosis has with patient outcomes.

That interested me, because it was relevant to the differential diagnoses offered to two of my kids.

Diagnosis, in the area of mental health, is complex and controversial.  Diagnosis determines the allocation of resources in public health systems, and it enables access to therapies. It also materially affects the outcome for patients. David Bathory’s presentation to EPATH 17 uses ‘DSM V criteria and ICD11 criteria for Gender Dsyphoria’. (Let’s be kind: typos happen). DSM V is ‘the standard classification of mental disorders used by mental health professionals in the United States’ and it determines the diagnosis for gender dysphoria in adolescents and adults:

In adolescents and adults gender dysphoria diagnosis involves a difference between one’s experienced/expressed gender and assigned gender, and significant distress or problems functioning. It lasts at least six months and is shown by at least two of the following:

  1. A marked incongruence between one’s experienced/expressed gender and primary and/or secondary sex characteristics
  2. A strong desire to be rid of one’s primary and/or secondary sex characteristics
  3. A strong desire for the primary and/or secondary sex characteristics of the other gender
  4. A strong desire to be of the other gender
  5. A strong desire to be treated as the other gender
  6. A strong conviction that one has the typical feelings and reactions of the other gender

As the words I have italicised indicate, ‘gender dysphoria’ is diagnosed through experiences, desires, and convictions relating to ‘the typical feelings and reactions of the other gender’. The clinician must understand the patient’s subjective experience in relation to a perception of gender typicality.

Now the DSM carries authority. It is ‘the product of more than 10 years of effort by hundreds of international experts in all aspects of mental health. Their dedication and hard work have yielded an authoritative volume that defines and classifies mental disorders in order to improve diagnoses, treatment, and research.’  These are the boxes into which clinicians place the many and varied manifestations of human distress. But these boxes, these labels, also change. Since DSM V was issued in 2013, it has been repeatedly updated.

From age 13 to 19, my daughter explored the gamut of female teenage problems, testing her poor mother to the limit, and accumulating diagnoses as if her ambition was to try out the whole of the The Diagnostic and Statistical Manual of Mental Disorders (DSM–5), or in her case, since we are based in the UK, the ICD-10 (the International Statistical Classification of Diseases and Related Health Problems).  I was curious, then, to know how the presenter, David Bathory, knew that ‘gender dysphoria’ was the correct diagnosis.

  1. Eating disorder

It started when my daughter was 13 with an eating disorder, a diagnosis which carries a strong association with suicidality. According to a 2014 study ‘rates of mortality, and specifically rates of suicide, are undeniably high in ED populations, as are the rates of self-harm’. Approximately ‘one-third of women with a diagnosis of BN [Bulimia Nervosa] ‘have had at least one suicide attempt.’ The GP responded quickly and referred her to a specialist NHS eating disorder unit where she had individual therapy. It was described as an ‘atypical eating disorder’ because she was not underweight (though bulimic, and obsessed). I was surprised that she had insisted on going to the doctor. I wondered whether there wasn’t an element of social contagion since her best friend at school had a serious eating disorder and had received in-patient treatment.  A teacher at her single sex school confided that over 50% of the girls in her year had eating disorders. Therapy seemed to work: the therapist explained that eating disorders arise in a large proportion of people after dieting since diets themselves  trigger eating disorders. She was given an eating plan and encouraged to eat small, sensible regular meals. She got better.

  1. Mood disorder

But then in her GCSE year, aged 15, she started to self harm and to talk to her therapist about suicidal feelings and intentions. There were symptoms that sounded like psychosis. She thought she had schizophrenia and though her therapist was unconvinced, there was a plan to take her in for observation after her exams finished. In the meantime, she was diagnosed with a mood disorder and offered CBT. But shortly after her first session she made a serious suicide attempt and spent a week in hospital.

  1. Personality disorder

She was then admitted as a psychiatric in-patient and was reassessed. The diagnosis this time was borderline personality disorder, a diagnosis defined by suicidality:

Suicidality is a defining feature of borderline personality disorder (BPD). It is also the feature that creates the most anxiety among those who treat patients with this disorder. It is rare to find patients with BPD who have never shown any suicidal behavior. As described in criterion 5 in DSM-IV-TR,1 these patients are characterized by “recurrent suicidal behavior, gestures, or threats, or self-mutilating behavior.” Suicidal ideas and threats are ubiquitous, and most patients make multiple suicide attempts.2 Suicidality in patients with BPD is chronic and can continue for extended periods (months to years).3,4

 She was immensely relieved that her unhappiness had a cause and a label. At last she was being taken seriously. But I thought that the diagnosis seemed to make her worse: she went online, researched BPD and quickly completed the set of symptoms: self-harm, screaming, staying at home and refusing to go to school. It’s a tough diagnosis for the parent as well: BPD (a quick google confirms) is associated with parental neglect and sexual abuse. I thought that the stigmatizing label completed her self-loathing. But the diagnosis did give her access to Dialectical Behaviour Therapy, and after a first failed attempt to engage with the programme, and another few months seeing a psychiatrist with no empathy to whom she refused to talk, she entered a programme which made absolute sense to me, a programme based on self-acceptance and the desire for change. Dialectical Behaviour Therapy was created by Marsha Linehan, a therapist who herself suffered from extreme suicidality as a young person. In one study, its efficacy was tested on:

‘One hundred one clinically referred women with recent suicidal and self-injurious behaviors meeting DSM-IV criteria, matched to condition on age, suicide attempt history, negative prognostic indication, and number of lifetime intentional self-injuries and psychiatric hospitalizations’

Despite resisting the best efforts of the endlessly patient therapists, she was offered skills to teach self-acceptance, coping skills for strong emotions. The six month parent and carer psycho-education course seemed eminently sensible, teaching me skills that everyone needs: meditation and mindfulness, tree hugging, supporting children with strong emotions, what self harm means. Best of all, I discovered that the other parents were both desperate and likeable. We were not the unsupportive monster parents that the diagnosis seemed to suggest. The only thing that I could fault in the programme – perhaps inevitable with mental health professionals who see young people at their very lowest – was a lack of ambition. They didn’t seem to expect much of my daughter.

  1. Gender dysphoria

Returning from her individual therapy one day, my daughter dropped in at the local sports shop and bought herself two sports bras that were clearly much too small for her. She had left school after GCSEs, signed out of Facebook, stopped seeing her loyal friends and now, a whole year later, was staying in her room and studying Youtube. When I commented that the sports bras looked a bit uncomfortable, she explained that she was Gender Non-Binary. I didn’t take this seriously: as far as I could see, we are all gender non-binary, though those sports bras did look uncomfortable. I could see that her self-esteem was at a low point, and she had given up all exercise and social life, so I didn’t say anything about it or comment on this new label.

  1. Autism

Around this time, she decided she was autistic. She particularly liked She started rocking back and forth at the table (behavior I learned to call ‘stimming’). Her therapist suspected that quite a few of the BPD kids she was seeing might really be autistic and put her down for an autism assessment. The appointment took some time and in the meantime, she had become a great deal better and the BPD diagnosis had been removed. Her self harm had stopped and she was noticeably calmer.

The autism service offered an extremely thorough and lengthy diagnostic procedure. Half a day with my daughter followed by a three-hour structured telephone interview with me focusing on her behavior at age 3-4 and around 10.  At the end of this she was told that she wasn’t autistic but probably did have Borderline Personality Disorder.

Almost immediately she became worse: she had wanted the autism diagnosis (which did not seem stigmatizing to her) and as soon as the personality disorder diagnosis was re-imposed, she immediately became unstable and miserable. The impact of a diagnostic label on her sense of self was dramatic.

  1. Recovery

What cured her, in the end, was an Access course: a wonderful teacher believed in her and encouraged her to apply to university. That summer, on a particularly hot day, I suggested we should see if we could find her something more comfortable to wear. She agreed and gender non-binary joined the dustbin of discarded identities. At university tutors thought she was a brilliant: now she simply has an ‘artistic temperament’ and is friends with other odd girls who love their course and want to spend time reading in the library.

Diagnosis and its discontents

How then do we know which is the right diagnosis? How do we know (in the cases presented to EPATH) that ‘Borderline Personality Disorder, Autism, Schizophrenia, or Bipolar Disorder’ were the wrong diagnoses?

Well the occasion gives us a clue: at a conference on transgender health, we are going to discover that transgender is the relevant explanatory term.  The autism service showed the rare ability NOT to diagnose its own specialism but all the other services applied the label they were formed to dispense: eating disorder was the diagnosis of the eating disorder service, mood disorder of the mood disorder service, BPD of the DBT service. Family therapy (which also helped us) assumes that the answer lies in the family. As our GP said to me: ‘That’s the danger of the specialist service: you send a patient with an advanced facial cancer to the irritable bowel service and all they can see is the irritable bowel’. The university tutor diagnosed her as a hardworking student.

Diagnosis, of course, has its critics. Speaking in 2013 just before the release of DSM-5, consultant clinical psychologist Lucy Johnstone offered a fundamental challenge to the use of diagnostic labels, arguing that it is ‘unhelpful to see mental health issues as illnesses with biological causes’. According to Johnstone ‘there is now overwhelming evidence that people break down as a result of a complex mix of social and psychological circumstances – bereavement and loss, poverty and discrimination, trauma and abuse’.

As a parent, I know that ‘a complex mix of social and psychological circumstances’ can sound all too much like ‘the family’. But my daughter’s recovery shows that – with good support – even protracted and disabling mental illness can enable a new understanding. Although we want to shield our children from pain, ‘dysphoria’ – unhappiness – is part of the human condition.

Mental illness certainly exists and it is devastating. It is only when we acknowledge that mental illness exists that we can challenge the stigma it carries. To claim that gender dysphoria is not a pathology is to succumb to this stigma, not to challenge it.

As Lucy Johnstone says, ‘people break down’. But the labels we apply are only ever pragmatic categories formed to allow access to therapy. And these labels can themselves do harm, becoming an identity for the person to whom they are applied. Within the DBT service, therapists reminded the young people that they were not the illness. Despite the horrible term ‘personality disorder’ there was not something irretrievably wrong with their inner, unchangeable selves. They were suffering through patterns of feeling and behaviour which they could change. They learned coping strategies, ways of self-soothing, of understanding and labelling their feelings. They were taught that self-harm and suicidality are not the only ways of responding to pain. They were taught to accept their bodies, to focus instead on what they could do, what they could achieve.

And if diagnosis is fundamentally dangerous, it is never more so than when it is self-diagnosis by Google, echoed by medical professionals who dispense irreversible physical interventions for feelings and beliefs. I still shake with horror at what might have happened if my daughter had said the word ‘gender’ to the GP. I know what would have happened because my son, perhaps envying her the intensive focus of parents and professionals, did just that.

For this reason, I can’t accept the premise of virtually all discussion of teenage gender dysphoria: that physical treatments are mandatory because of the risk of suicide. Every diagnosis my daughter received was associated with suicide, from eating disorder, to mood disorder, to BPD. I know the overwhelming fear experienced by parents, a fear that stops you sleeping, from which you are never free.  But in the case of my daughter, suicidality itself was the problem, a response to pain that she could learn to replace by other safer techniques.

Suicide is not uniquely associated with gender dysphoria. Nor is dysphoria uniquely or strikingly associated with gender. In the end, we are simply talking about unhappiness, manifested in the varied forms created by the culture in which we live. For my daughter, the most powerful cure came from literature which showed her that pain is universal, and that consciousness is an intense experience. She recovered when she was valued for what she could do with her brain.




Staring The Future In The Face: How Many Of Us Will Be Left?

What kind of world will the child trans trend lead to?

Marcus Gregory

“So we allow as many as thirty per cent of the female embryos to develop normally. The others get a dose of male sex-hormone every twenty-four metres for the rest of the course. Result: they’re decanted as freemartins structurally quite normal (except that they do have the slightest tendency to grow beards), but sterile. Guaranteed sterile.”

 Aldous Huxley, Brave New World

Throughout the developed English-speaking world, gender nonconforming boys and girls are now routinely coerced into transgender identities. Cross-gender play, clothing and claimed identity in children is seen through a lens of the child being transgender, with the favored route being to sexually transition the child. The trend is activist-driven, and not based on anything like science: Miranda Yardley, Stephanie Davies-Arai, and Stephen Levin have written recent articles discussing the fundamental flaws in these ideas.

What I want to discuss is the long term impact on gay and lesbian populations of widespread, early child transition, which we can expect from changing guidelines for transition. Many gender nonconforming boys and girls would grow up to be gay and lesbian if left alone. Widespread transitioning of children, based on diagnostic criteria for gender dysphoria that include gender nonconforming behavior, should target children who would have otherwise become normal homosexual or bisexual adults. But most children also don’t end up homosexual. Can we make any predictions about this new world?

Clues from childhood research

To understand where the trans trend might go in future, we can use recent psychology research from Melissa Hines’ group at Cambridge University. Her graduate student Gu Li examined a database of 4,500 UK children whose gender-typical play behavior was tracked in early childhood. The childrens’ behavior was assessed on a scale called the Preschools Activities Inventory or PSAI: on this scale, 0 corresponds to most feminine, 100 to most masculine. At 15, the children were asked, via anonymous computer interview, about their sexual experiences and preference. Li found very strong evidence children who were homosexual or bisexual in adolescence tended be gender nonconforming, much more often than children who reported being heterosexual.

Compared to heterosexual adolescent girls, lesbian girls were 12–19 times as likely to display extreme levels of gender nonconforming behavior at ages 3.50 and 4.75 years; compared to heterosexual adolescent boys, gay boys were 20–26 times as likely to display extreme levels of gender nonconforming behavior at ages 3.50 and 4.75 years.

Some of these sexuality-related differences in gendered play behavior were almost certainly biological, as there is widespread encouragement for nearly all kids to conform to gender roles. That’s also in line with the knowledge that girls with a condition called CAH, who are exposed to more testosterone in the womb, tend to be more masculine in play and preferences.

While being gender nonconforming, as measured on the PSAI scale, isn’t the same thing as a diagnosis of gender dysphoria, there is a strong connection. Transgender education in UK schools tells children they have “pink and blue brains”, and that children with gender-atypical behavior are transgender. In Australia, under the “anti-bullying” Safe Schools initiative, young children are taught “for about 4% of people their gender may not align with the sex they were assigned at birth”, with an intense focus on “affirming” gender nonconformity as being transgender. When children who are forming a sense they are boys or girls are constantly told being gender nonconforming means they are transgender, they will probably go along with it.

Worldwide, the large, recent increase in such referrals supports the idea cultural factors are making nonconforming kids into “trans kids”. For example, referrals to the Tavistock, the only gender identity clinic in the UK that deals with minors, have gone from 96 six years ago, to over 2000 this year. In the US, there are now nearly 100 child gender identity clinics. And in Australia, an “epidemic in transgender children” has been noted in the wake of the Safe Schools program. The tactics used by trans ideologues to promote this ideology to children and punish dissent seem cultish, if not totalitarian. If transgender ideas about children become fully accepted, referrals to gender clinics should become very common for gender nonconforming children.

Screen Shot 2017-05-20 at 3.55.12 PM
Tweets reporting the Australian Safe Schools program’s impact on children in Victoria (“Vic”) presented at a conservative conference.

Moreover, Li’s paper supports a connection between nonconformity and dysphoria (emphasis mine):

Another line of evidence […] comes from clinically referred children, many of whom demonstrate extreme cross-gender behavior that partially or fully meets the diagnostic criteria for gender dysphoria/gender identity disorder [in the DSM]

A future scenario: who will transition?

Let’s consider a “Brave New World” future where socially transitioning nonconforming children by age 5 becomes commonplace. A critical question is how many children will continue to a medical transition. This should not be a small fraction, for the following reasons. First, we should expect social transitioning “locks in” kids: they can form a sense of identity as the opposite sex. Second, there will be a significant barrier for a socially transitioned boy to change his mind, since peers and adults will have invested in his transgender identity and stepping away may cause embarrassment.

Social transition also sets up the expectation the child will go to the “next step”: puberty blockers, HRT and then sex reassignment surgery. This is becoming easier, younger: new WPATH guidelines lower the age hormones can be used, and some within WPATH are proposing there should be no lower age limit for surgery. We might expect socially transitioned gay and lesbian kids are less likely to socially de-transition than straight kids, due to opposite-sex attraction being more socially approved. Li reported:

The current study found that not only levels of gender nonconformity, but also change in gender-typed behavior across the preschool years related significantly to later sexual orientation, especially in boys. When heterosexual individuals, who comprised the majority of participants, increasingly conformed to respective gender norms, nonheterosexual individuals appeared to conform less, or became more nonconforming, over time.

Still, using Li’s study, we can say something about the impact of transitioning many young children in our “Brave New World” scenario. This generation would otherwise make up the young gay and lesbian population in 15-20 years, the late 2030s. Li provides the proportions of children who are effeminate boys and masculine girls at age 4.75, broken down by their PSAI gendered behavior score, and by their sexual orientation at age 15.

Admittedly, there aren’t many 15-year-olds who report being gay and lesbian in this study: 24 gay boys and 16 lesbian girls. That means there’s a lot of uncertainty, and only rough estimates are possible. It might well be some more of those adolescents will eventually realize they are gay or lesbian.  It’s also harder to look at the impact on children who say they are bisexual at 15, since detailed figures on their behavior weren’t supplied.

To assess the impact of common childhood transition, we assume in this future scenario, children are transitioned who are markedly gender nonconforming. Imagine all boys with PSAI scores below a certain number, and all girls scoring over a certain number, will end up transitioned. Using Li’s paper above, I’ve graphed the proportions of gay and straight boys who’d be transitioned, if this happened to all boys with PSAI scores below a certain point.

If 5-year-old boys with PSAI scores under 45 or so (more effeminate) are socially transitioned, this would affect about 15% of gay boys and perhaps 1% of straight boys. But because only 1.1% of boys in this sample declared they were gay at age 15, we expect many boys who weren’t claiming to be gay by this age would be transitioned, too.

Using child PSAI score distributions in Li’s Table 4, I’ve also plotted the percentage of transitioned boys who would be gay or bisexual against the percentage of all boys who would transition in this scenario. Even if the most gender nonconforming 0.2% of boys are transitioned, much less than current estimates of the US trans population, about 75% of those transitioned boys will say they are heterosexual by 15.

A somewhat different picture emerges for girls, as transitioning gender nonconforming girls with a PSAI score above 55, would transition 25% of all girls who could go on to be lesbian at age 15, but about 1% of all other girls. That is: girls who go on to be lesbians are relatively more gender nonconforming than boys who go on to be gay.

Finally, I’ve plotted the percentage of transitioned girls who would be lesbian or bisexual as a function of the percentage of all girls who are transitioned. For this, I used child PSAI score distributions from Li’s Table 3, although the number of lesbian or bisexual girls here was quite small. Transitioning the most gender nonconforming 0.3% of girls at age 5 would result in about 30% of transitioned girls being lesbian or bisexual. This would decline to under 20% if transition hit 0.8% of all girls.

Brave new world: social impacts of wide transition

In our society that devalues those who don’t meet stereotypic gender expectations, modern medicine offers a route back to conformity by way of transition, which many parents, children and teens are only too happy to take. This “Brave New World” future where most gender nonconforming children are coerced into sterilizing, body-altering “treatment” might seem dystopian, and close to Iran-style gay conversion. But due to trans activism and changing medical and educational practice, it’s undoubtedly starting to happen, and we can try to assess the impact on the lesbian, gay and bisexual population.

However, what the data above shows is many young children who are gender nonconforming, and thus at high risk of being transitioned, are not necessarily going to be homosexual. This might be surprising, but James Barrett, the head of the UK’s Charing Cross Gender Identity clinic, wrote a paper showing some boys referred to gender clinics are heterosexual: of ten feminine boys, only one became transsexual and four became heterosexual. This is also in line with 4thWaveNow’s recent articles on the Tumblr community, showing many male-attracted teen girls identifying as “trans gay men”.

The pediatric trans trend appears to represent a fundamental break from previous concepts about who goes on to transition. Instead, making child transition normal may have a broader effect on children and teens, especially girls, and well beyond those who are very nonconforming. Up to 5 percent of girls in certain schools, or in one survey even up to 12 percent of young people, appear to place themselves on the trans spectrum.

A social trend of prepubescent transition would go with transition of gay, lesbian, and nonconforming teens being commonplace. Another uncertainty is whether sexually aware, latent autogynephilic male teenagers might transition. Miranda Yardley has written about this recently. We should not understate the impact of a potential cultural fixation where teenage boys think enjoying gender-bending pornography means they are transgender. Ironically, in a worst-case where many children go on to medically transition, these factors could have the most serious impact on lesbians while potentially giving a large increase in the “trans lesbian” population. By the 2030s, the typical young “lesbian” could be male.

In this analysis, I’ve explored the consequences of putting young gender nonconforming children down a medicalized path. The impact of this alone would be the erasure  unnecessary risky medicalization, sterilization and destruction of their gay/lesbian identity  of about 1 in 4 of those lesbians who know their identities in adolescence, and 1 in 6 such gay men. To be sure, it often takes gay and lesbian people significantly longer to come out, even to ourselves. But at every step through childhood, the presence of transgender as a possible identity to take on, acts as a kind of sink, that traps gay and lesbian kids. And, it seems, a surprising number who would be straight, but are gender nonconforming.

Marcus is a gay scientist. He tweets @LogicalMarcus

Technical note: For the proportion of children transitioned vs PSAI cutoff plots, I extracted the PSAI score distributions broken down by sexual orientation of age 4.75 children from Figure 1 of Li, Kung and Hines. For the proportion of children transitioned who are homosexual or bisexual vs total transitioned plots, I calculated this from the means and standard deviations of the 3-group intercepts of Tables 3 and 4 for age 4.75, assuming normal distributions and the same proportions of sexual orientations as their reported numbers. To check a normal distribution assumption wasn’t misleading, these plots showed broad agreement with similar plots calculated from the detailed distributions of Figure 1 for homosexuals and heterosexuals only.

Transgender Kids: Are We Doing More Harm Than Good?

by Todd A. Whitworth

Before we start I’d like to disclose a little about myself to inform you the reader that I am not coming to this subject void of experience. I am a female to male transexual man. I started my transition in 1993 by changing my name and gender pronouns. I took a year before I began the physical part of my transition in 1994 with hormone replacement therapy, I was 21. I remain glad that I made the choice to transition, and that I took the time I did to explore that it was not just a phase.

The movement to support children transitioning from one gender to the other may be causing more harm than good. For the purpose of this piece, I am asserting that there are two genders male and female. Transitioning from one gender to the other is a long, expensive, and invasive process. It involves hormone replacement therapies for the rest of one’s life and several expensive surgeries which may or may not yield the result the individual wants. No amount of hormone therapy and surgical intervention is going to change biological reality. This is not a choice to enter into lightly and it’s highly suspect that a child has the maturity and cognitive ability to truly make an informed decision. A person’s brain is in development up to the age of 25. Perhaps we should wait before helping our children to transition.

No one is totally happy with who they are, and right now trans is trendy being comfortable in your the sex you are born into and corresponding gender role, is not. Cisgender, a word I’ve come to detest, is a term used for individuals who are not trans. It gets continually used as a bullying tactic to shame kids who are ok with their biological sex and the gender that matches their sex. I am a trans person, and I do not advocate for anyone to be made to feel ashamed for being happy with who they are.

We, humans, are social animals. We start to learn how to navigate in society when we are kids. We yearn for acceptance and understanding, we want to fit in. This makes sense because at one point in our history, to not fit in, to be socially ostracized, to be thrown out of the village, meant certain death.  Of course, kids want to fit in and be accepted it’s natural, and being ostracized, feels awful.

Something to remember we are dealing with children. Kids go through phases, just because your little boy puts on a dress one day, does not make him a girl. Say your little girl likes rough and tumble play and sports over dolls? It doesn’t make her a boy. Hormones sterilize and surgery is very expensive. Once puberty starts the body begins to change and hormones start to surge the child may become more comfortable with their biology. Maybe your kid is transgender, maybe they aren’t, before becoming their biggest cheerleader for transition maybe let nature take its course and see what happens. Gender dysphoria, formerly Gender Identity Disorder is a mental health diagnosis, and it’s not that common as gender advocates would have you believe. Don’t take my word for it, look up Gender Dysphoria in the current DSM V[1]. Gender dysphoria is persistent, pervasive, and causes ongoing distress. It meets the criterion for a mental health diagnosis, not a phase.

In summary, kids are not adults, and they need our care and guidance. They are immature, impulsive, and try on lots of different identities in an attempt to fit in. One of those identities may be transgender. I am not arguing that Gender dysphoria won’t present in childhood, it may. I am arguing for pause before fully diving into super advocacy mode. I am not a parent, but I do know that most parents want to do the best for their children to protect them, support them, and stand by their decisions to help them thrive and grow. That being said, it is also the job of the parents to help their children by keeping them safe from harm, including decisions they may not be ready to make yet.










[1] The Diagnostic And Statistical Manual of Mental Disorders is meant to be used by mental health professionals not laypeople.

Careful Assessment is Not Happening

This recent article highlights a phenomenon that many concerned about the teen trans trend are seeing regularly – the extensive screening that many in the public believe happens before a young person is referred for hormones or surgery isn’t happening. According to the article, the parents called several therapists looking for someone who could help their newly gender dysphoric daughter explore and manage these feelings.

“Every therapist we spoke with – and we spoke with quite a few – told us that if a teen says they are trans, then they are, and the parents’ job is to affirm and help them transition. There was no therapist who would say to Abby, ‘This is not my experience of you.’  No therapist was interested in exploring the possibility that something other than being born into the wrong body could be operating here.”

Very similar accounts can be found on the blog 4thwavenow.

Like many who read this blog, I phoned gender therapists during the weeks after her announcement that she was trans. Without even meeting my child in the flesh, all four of these therapists talked to me like this trans thing was a done deal. I wrote about one of those conversations here. One very friendly therapist, who identifies as FTM and whose website stressed “his” commitment to “informed consent,” assured me that there was no need for my daughter to first experience a sexual or romantic relationship before deciding whether she was trans. “Most of the young people just skip that step now,” the therapist said.

When I speak of my concern about this trend to those unfamiliar with this issue, one of the predictable responses is that my fears must be misplaced because extensive therapy is required before any treatment can begin. There is no need to worry that a young person might undertake permanent, drastic alterations to his or her body, because anyone who doesn’t really need this treatment will be identified by professionals.

Unfortunately, this is not always the case.

This article in Slate describes the shift away from gatekeeping to informed consent. Even gender clinics that focus on children and youth such as Mazzoni operate under an informed consent model. If the child or teen declares themselves trans and consents to treatment along with the parents, that is all that is needed for treatment.


Here is an example of a consent form of testosterone therapy.

One of the most striking findings of the detransitioner survey conducted by Cari Stella is that 65% of those who medically transitioned had no therapy at all.  The pattern appears to be the same in the US and the UK. Screening is minimal to non-existent. The model is affirmation and informed consent. If you say you need this treatment, your healthcare provider will not stand in your way.

A Reddit user posted about their experience at a gender clinic. This user was approximately 19 years old when they sought treatment. This user was pleased with the lack of gatekeeping they experienced.

Dr. Timmins was unconcerned about the patient’s history of self-harm, and was careful not to question the patient’s motivation. From this account, it does not appear that Dr. Timmins explored the patient’s mental health history very deeply.

He did offer the helpful suggestion of freezing eggs, since testosterone can affect fertility. One would think that, given the acknowledged reality of severe side effects of treatment, it would be advisable to assess and counsel more carefully, but this account clearly indicates that did not happen.

Instead, Dr. Timmins had other advice:

The doctor recommends getting lots of visible tattoos, to make sure the patient isn’t mistaken for a 12 year old boy.  Stay away from the arm, though. You might need that skin for phalloplasty.

Taking a look at some of the poster’s other comments elsewhere on Reddit, we learn that they have a history of sexual trauma, abuse, depersonalization and derealization, dissociation, substance abuse, and self-harm.

It would seem to make sense that a history of any one of these issues might make a health care provider want to assess and counsel thoroughly to make sure that the desire to transition was not a maladaptive coping mechanism. But these kinds of considerations don’t seem to apply in transgender medicine.

In the US, Dr. Johanna Olson Kennedy is one of the leading pediatricians working with trans identified youth. She is explicitly against any kind of gatekeeping, as she made clear recently on the WPATH Facebook page.

I would point out that gatekeeping for serious medical intervention is indicated not because trans people are mentally ill, but because it is standard practice in medicine to evaluate the appropriateness of any treatment before prescribing it, especially if that treatment has a potential for adverse consequences. Any parent knows that a child’s self-diagnosis of an ear infection is unlikely to result in a prescription for antibiotics. Responsible physicians will take the time to examine the patient to see if such treatment is really indicated. Wouldn’t this seem even more necessary when the treatments are associated with serious side effects such as loss of fertility or liver damage?

Dr. Olson Kennedy appears unconcerned about potential regrets. For those who change their minds later, bodily changes and possible sterility will have all been part of their “gender journey.”

Which brings me to my final point. Our Reddit poster contends that they are happier now that they are taking testosterone, and that they are certain this is the right course. Even if one transitions for the “wrong” reason, where is the harm? If this is a treatment pathway that really helps some people, why shouldn’t we make it available to them?

Because we have no idea what the long-term effects of being on cross sex hormones will be. Because we have sufficient reason to be concerned that there could be serious adverse effects. Because if someone transitions as a maladaptive way of coping with trauma, the time spent transitioning may be time lost to healing. Because there are certainly ways of addressing dysphoria that are less risky. 

For those of you coming to this issue for the first time, it simply isn’t the case that young people are being carefully evaluated before being put on medications that are being used off-label and have not been studied for their safety long-term.

A Letter to the APA

Psychotherapist Lisa Marchiano sent the following letter to the APA in support of Justine Kreher of For  months, Justine has been tirelessly sending letters to LGBT organizations on this topic.

Lisa blogs on parenting at and blogs on Jungian topics at She can be found on Twitter at @LisaMarchiano.

March 6, 2017

Dear Members of APA Division 44:

I am writing this letter in support of my colleague Justine Kreher of (Her letter can be found here.) I am a licensed clinical social worker and Jungian analyst who has consulted with dozens of families who have a transgender identified teen. My experience with these families has shown me that parents want to protect their child from drastic and potentially harmful medical intervention that may not be necessary.

I have many concerns about the role of psychologists and other mental health professionals in affirming a young person’s self-diagnosis as transgender, and encouraging immediate social and/or medical transition. For the sake of brevity, I will focus on the following four areas:

Potential Harm to Gay, Lesbian, and Bi Children

I am aware of the APA’s position on sexual orientation conversion therapy (i.e. therapy intended to ‘convert’ gay individuals into heterosexual individuals). The first strong position came out in 1997: and then a stronger position later:

The APA has taken an unequivocal stance against conversion therapy. Gender reassignment evaluation and treatment, without strong guidelines and oversight in place, amounts to the same outcome as conversion therapy – implementing a treatment for a problem that hasn’t been scientifically established to exist, with the intent of creating a change that hasn’t been proven to be therapeutic (or is only therapeutic in some cases). I encourage the APA to take a strong position against pediatric transition practiced without careful oversight.

There is plenty of anecdotal evidence reported by clinicians who see families with gender nonforming children that parents are uncomfortable with the thought of having a gay or lesbian child. Many of these parents feel more comfortable having a transgender child. One example appeared in this article in The Atlantic.

Catherine Tuerk, who runs the support group for parents in Washington, D.C., started out as an advocate for gay rights after her son came out, in his 20s. She has a theory about why some parents have become so comfortable with the transgender label:

“Parents have told me it’s almost easier to tell others, ‘My kid was born in the wrong body,’ rather than explaining that he might be gay, which is in the back of everyone’s mind. When people think about being gay, they think about sex—and thinking about sex and kids is taboo.”

In the recent BBC documentary “Transgender Children: Who Knows Best?” Dr. Ken Zucker shared that he had had families say of their trans kids, “Well, at least they’re not gay.”

Kimberly Shappley, whose transgender daughter was featured in the March, 2017 HBO special Vice was clearly disturbed by the thought that her little boy was exhibiting pre-gay behavior. The following quote is from this news article.

“I am a devout and conservative Christian and an ordained minister,” she said and explained that she tried to force Kai into being a boy when she was a toddler. “I knew my kid was different before the age of 2,” Shappley said. “My child was very feminine, flamboyant and dramatic. No matter how I tried to punish, reshape or discipline her, she continued being very feminine.”

In this news article, Shappley admits that friends and family were questioning whether Kai was gay before Shappley allowed her child to transition. Says Shappley:

“I was very concerned, because at the time I was leading a small ministry at my church and teaching Bible study, and here I have this kid who people in my family were flat asking me if this kid was gay.”

While Shappley’s story may be an especially clear cut case where a parent appears to be more comfortable having a gender conforming “straight” trans child than a gay or lesbian child, tales such as this are not uncommon.

Keeping this in mind, consider the recent longitudinal study that found high rates of gender nonconforming behavior among gays and lesbian in early childhood.

Abstract. Lesbian and gay individuals have been reported to show more interest in other-sex, and/or less interest in same-sex, toys, playmates, and activities in childhood than heterosexual counterparts. Yet, most of the relevant evidence comes from retrospective studies or from prospective studies of clinically-referred, extremely gender nonconforming children. In addition, findings are mixed regarding the relationship between childhood gender-typed behavior and the later sexual orientation spectrum from exclusively heterosexual to exclusively lesbian/gay. The current study drew a sample (2,428 girls and 2,169 boys) from a population-based longitudinal study, and found that the levels of gender-typed behavior at ages 3.50 and 4.75 years, although less so at age 2.50 years, significantly and consistently predicted adolescents’ sexual orientation at age 15 years, both when sexual orientation was conceptualized as two groups or as a spectrum. In addition, within-individual change in gender-typed behavior during the preschool years significantly related to adolescent sexual orientation, especially in boys. These results suggest that the factors contributing to the link between childhood gender-typed behavior and sexual orientation emerge during early development. Some of those factors are likely to be nonsocial, because nonheterosexual individuals appear to diverge from gender norms regardless of social encouragement to conform to gender roles.

Given the high rates of gender nonconforming behavior in gay and lesbian children; the high desistance rates of gender dysphoria; that as yet there is no reliable way to determine which dysphoric kids will desist and grow up to be well-adjusted lesbian, gay, or bi adults; given that puberty blockers followed by cross sex hormones lead to permanent sterility 100% of the time, it is crucial that careful clinical guidelines be developed that will help to prevent gay and lesbian children being lead down a path that leads to permanent sterilization and other medicalized intervention. Since the APA has taken a strong stand against conversion therapy, the organization should also speak out against what is in practice a form of medical gay conversion therapy.

Lack of Evidence Regarding Outcomes

Currently, the evidence related to transition outcomes is relatively poor. In June of 2016, the Centers for Medicare and Medicaid Services (CMS) denied coverage for gender reassignment surgery after a year-long review determined that there was not sufficient evidence that these treatments were therapeutic. From the report:

Based on a thorough review of the clinical evidence available at this time, there is not enough evidence to determine whether gender reassignment surgery improves health outcomes for Medicare beneficiaries with gender dysphoria. There were conflicting (inconsistent) study results – of the best designed studies, some reported benefits while others reported harms.

The overwhelming majority of the evidence about transition was derived from studies done on adult transitioners. There are only a few studies that look at outcomes among those who transitioned prior to age 18. De Vries et al. noted positive outcomes among pediatric transitioners. However, the sample size of 55 was relatively small. In addition, it seems worth pointing out that the original group being studied consisted of 70 young people. One of these was not included in the study because the individual died from postsurgical necrotizing fasciitis after vaginoplasty. In addition, these young people were assessed for the final time at approximately one year post surgery.

In contrast, consider the study conducted by a young female detransitioner. Though not peer reviewed research, this study offers one of the few glimpses into the experience of those who transitioned and then went on to re-identify as female. (Honestly, I find it sad and telling that the only research being done on this growing group is being conducted by the young women themselves.) Cari Stella’s study was open for two weeks. During that time, more than 200 detransitioned women responded. The results are enlightening. Most chose to detransition because they found other ways to deal with their dysphoria. While participants in the De Vries study were assessed for a final time at least one year post operation, the women who answered Cari’s survey reported that the average time they spent transitioning was four years. It seems possible that some individuals in the De Vries study may become less happy over time with their outcome.

It is also important to point out that those individuals in the De Vries study were carefully screened, assessed, and followed. In today’s climate of immediate affirmation, young people are receiving hormones after only a handful of therapy sessions. This of course may make it more likely that they may come to regret these interventions. From Cari’s survey:

117 of the individuals surveyed had medically transitioned. Of these, only 41 received therapy beforehand. The average length of counseling for those who did attend was 9 months, with a median and mode of 3, minimum of 1, and a maximum of 60. I’d like to have something cool to say here, but I’m honestly just stunned at the fact that 65% of these women had no therapy at all before transition.

Cari’s findings corroborate what I am hearing from parents and seeing online. With good intentions, gender therapists are quickly affirming a trans teen’s self-diagnosed identity. However, this may mean that other factors get overlooked.

Cari’s survey and the writings and videos of detransitioners around the web make it clear that many who underwent transition feel that they were doing so as a maladaptive coping mechanism to deal with trauma, anxiety, social difficulties, or other issues. The majority of detransitioners speaking out online now identify as lesbian, and many of them feel that internalized homophobia played a part in their believing that they were men. Many express having been harmed by their transition, and some refer to it as “medically assisted self-harm.” Here is just one excerpt from the writings of a detransitioner discussing how she was harmed by transition:

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 absolutely am traumatized by what happened to me, and I’m not the only one. I’m a part of support networks for women who stopped transition that have over 100 members, and that’s just the individuals who have gone looking for others with this experience and found us. I’ve met more than a dozen of these ladies in person at different times… we’re definitely real.

Plenty of others who transition, whether they continue or not, live with complicated feelings about what happened. Not all of us name those experiences the same way, search for community to process that pain, or ever “go public” to any degree. This is trauma.

Hormone therapy really wasn’t that safe, in my experience. I remember being 17 and watching my pediatric endocrinologist literally Google dosing information right in front of me. Didn’t inspire confidence. The doctors controlling my HRT had no idea what they were doing, at least with patients like me. They were all just as confused about how to treat me medically as they were about how to interact with me as a human being. When I was on testosterone and taking Adderal for ADD, I got heart palpitations, chest pain, and shortness of breath. I didn’t tell anyone because I didn’t want to have to choose between a psych med that was making a huge difference in my ability to function in the workplace and hormone therapy, and I didn’t want to acknowledge that what I was doing was dangerous.

Early in my transition, I went through menopause. This caused vaginal atrophy and drip incontinence that has persisted for years. I piss myself slowly all day now; it’s really not cute or fun. I refused to acknowledge it was connected to the HRT-caused vaginal atrophy that immediately preceded its onset until months after going off testosterone. Yeah, I signed a paper saying I knew that could happen. I also thought this treatment was my only hope for coping with the intense feelings of alienation/disgust with my femaleness. I was wrong. Transition didn’t help. It did harm, harm that I now have to learn how to live with on top of all the shit I thought transition would fix.

Practice norms in this area are alarmingly based more on activist agendas than evidence. Take for example Diane Ehrensaft, PhD. She is a thought leader in pediatric transition, and the Director of Mental Health and founding member of the Child and Adolescent Gender Center at UCSF. She has written and published widely, and is often cited as an expert. She writes about helping children find their “true gender self,” and states that the clinician needs to go through a careful process to differentiate between the persisters, desisters, and the genderfluid – or the “apples,” “oranges,” and “fruit salad,” as she names them. However, she cites almost no research to help us understand how she makes these determinations. As stated earlier, we do not currently have criteria that can definitively identify which children will persist. In this short video clip, Ehrensaft reveals her casual disregard for the fact that the treatment path towards which she leads families will permanently sterilize the child.

Social Contagion

Until recently, the evidence for social contagion among transgender identified teens was strong, but anecdotal. For example, a therapist wrote a blog post in which she described whole friend groups coming out together. Fortunately, there is some research currently being conducted that is attempting to document social contagion among transgender identified teens.

This transgender trend looks strikingly like other social contagions to which adolescents are known to be prone. There is considerable research on suicide contagion among teenagers. There is also a great deal of research on social contagion in eating disorders. To take just one example, Paxton et al. demonstrated that a teen girl’s use of extreme weight-loss behaviors is closely linked with whether her friends use them. From the study:

This study explored friendship variables in relation to body image, dietary restraint, extreme weight-loss behaviors (EWLBs), and binge eating in adolescent girls. From 523 girls, 79 friendship cliques were identified using social network analysis. Participants completed questionnaires that assessed body image concerns, eating, friendship relations, and psychological, family, and media variables. Similarity was greater for within than for between friendship cliques for body image concerns, dietary restraint, and EWLBs, but not for binge eating. Cliques high in body image concerns and dieting manifested these concerns in ways consistent with a high weight/shape-preoccupied subculture. Friendship attitudes contributed significantly to the prediction of individual body image concern and eating behaviors. Use of EWLBs by friends predicted an individual’s own level of use.

Paxton, S. J., Schutz, H. K., Wertheim, E. H., & Muir, S. L. (1999). Friendship clique and peer influences on body image concerns, dietary restraint, extreme weight-loss behaviors, and binge eating in adolescent girls. Journal of Abnormal Psychology,108(2), 255-266. doi:10.1037//0021-843x.108.2.255

Social contagion among teens is a rich area of literature for which many examples could be cited. This 2014 study found that teens who adopt an “alternative” identity such as “emo” or “Goth” were more likely to self-harm. This was true even after controlling for other factors. The authors point out that engaging in self-harm aids in reinforcing group identity among teens.

It is likely that we do not yet fully understand the enormously powerful role that social media can play in spreading social contagion. Many transgender identified teens report extensive time online on social media sites such as Reddit or Tumblr. On YouTube, there are tens of thousands of videos made by trans young people, documenting their transitions in a way that valorizes taking testosterone and estrogen, or getting a double mastectomy.

Consider this account from a young man found here:

So you have all these young men who don’t understand their sexuality, watching sissy porn. Eventually they are going try and find out what it all means.

This is where the trans ideology plays its part. The trans narrative sucks these confused young men like myself in with all the “answers.” You see many confused fetishists posting in places like reddit/asktransgender asking if they are trans. Whatever their questions are, the usual reply from these places is something like “if you could press a magic button that would give you a female body would you press it? If you thought about it, then you may be trans, because a “straight” guy wouldn’t hesitate for a moment.” They try to equate the masochistic thrill with a desire to be a woman. And once you fall for that they have you.

They create a very intricate web of bullshit that is very hard to see out of once inside. It is very cult like. Any non-kool-aid drinking source of information is deemed “transphobic.” Any therapist that doesn’t tow the line is a “gate keeper.”

Lastly, in discussing teen transgender identification and social contagion, it is crucial to keep in mind that teens are presenting with gender dysphoria in a way that was exceedingly rare even a short time ago. Until recently, most cases of pediatric gender dysphoria began in early childhood. With the onset of puberty, most children desisted, but some persisted into late adolescence. Research confirmed that cases of gender dysphoria that began in early childhood and persisted into late adolescence were extremely unlikely to resolve. In these cases, it made sense to assist the young person in transitioning. Now what we are seeing is significant numbers of young people coming out as transgender in adolescence (the most common age appears to be 14 or 15) without having had any prior history of gender dysphoria or even gender nonconforming behavior in many cases.

The major studies on using puberty blockers had very strict criteria of early onset of gender dysphoria and life-long gender dysphoria. Specifically- the studies did not include kids who had no gender issues in childhood and had the onset of gender dysphoria happening as a teen. It is quite an overreach to apply those studies to defend treatment for kids who have an out-of-the-blue onset of GD as a teen (often in the context of mental illness or social struggle) as if they are exactly the same thing. This rapid onset gender dysphoria appears to be an entirely new clinical presentation that may well indicate significant social contagion.

 Misuse of Suicide Statistics

In nearly every media article that discusses transgender children, a mention is made of high rates of self-harm and attempted suicide. Gender therapists often cite suicide statistics in attempting to convince parents to affirm their child’s trans identity and allow them to transition. The Williams Institute found that 41% of transgender people reported having made a suicide attempt at some point, and this statistic is frequently cited. The study’s authors admit that, because of the way the survey was conducted, the 41% number may be somewhat inflated. Taking this into consideration, we see that suicidality among transgender teens appears to be roughly similar in incidence to suicidality among gay and lesbian teens.

Most relevant to the discussion here is the complete lack of evidence that transition alleviates suicidality. The Williams Study, for example, does not indicate when the attempts took place – whether before or after transition. In fact, it may be the case that suicidality is higher among those who have transitioned.

Studies such as this one found that suicide rates were higher for those who transitioned. From the study:

“Those who have medically transitioned (45%) and surgically transitioned (43%) have higher rates of attempted suicide than those who have not (34% and 39% respectively).”

A long-term follow up study conducted in Sweden and published in 2011 found that suicide rates were significantly higher for those who had transitioned.

“Persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population.”

A 2015 suicide cluster of transgender teens in San Diego included three adolescents who had been fully supported in transitioning by their families.

It bears repeating: There is no evidence that transition reduces suicidality among transgender teens. Suicidal young people ought to be treated for suicidality, not given body altering drugs. Nevertheless, gender therapists continue to use the threat of suicide to convince parents to allow their children to undertake irreversible medical interventions of dubious therapeutic benefit.

Thank you for taking the time to read my letter. I hope you will give the issues I have raised here careful thought.

Lisa Marchiano, LSCW, NCPsyA

Interview with a Detransitioned MtF

This post is an interview with a 26 year old former MtF. 
1.) First, could you tell me about your experience of dysphoria? I have the impression that this is probably experienced very differently by different people, so I am curious about the nuance of your individual experience. How did it feel? How did you know it was gender dysphoria? When did it start? Was it continuous? Or did it come and go? Anything you can share that would help me understand what that feeling was like.
I was depressed and suicidal in 2013. I saw someone in the counselling office of my college once a week on the recommendation of a doctor. I had recently broken up with a young woman I had lived with shortly, and the counselling focused on my repeated failing relationships with women including my mother. I blamed my incompatibility with the women in my life on the idea that there was a fundamental misunderstanding between us since I was actually a girl in a boy’s body. As in, how could I have successful mother-son or boyfriend-girlfriend relationships if I’m actually not a son or a boyfriend? That made perfect sense to me at the time.
2.) How did you learn about the term transgender?
I learned about the term transgender on the internet. I looked at a lot of trans stuff but I’m not very social online so I didn’t ask any questions or start any dialogue with members of the community I’d soon be sort of part of.
3.) How did you decide to transition?
I have been and still am embarrassingly narcissistic and obsessed with my identity. The first thing I changed was my name since I had already wanted to for the hell of it. My legal name is ironically a unisex name: Taylor. Ashley is another unisex name, which I chose as to ‘gently’ transition in the workplace and other real life situations. I didn’t show up one morning in drag. If I did it right it should’ve been a ~6 month morph into a somewhat female-looking creature.
4.) Tell me about your experience with the medical community. Did you seek therapy as you were deciding to transition? Were you offered alternative treatments for the feelings of dysphoria? What kind of assessment was done before hormones were prescribed?
I went to a walk-in clinic in my trans gear and said I wanted to see this doctor I knew of in town that prescribed hormone replacement therapy for people who identify as transgender. The doctor asked me less than a dozen questions and said okay. A week later I had a similarly short conversation with an incredibly suspicious endocrinologist who got me on estrogen the same day and I was off to the races. Less than an hour of face-to-face time with any sort of medical practitioner before I got my long-term hormone prescription.
I was 23 years  old.
5.)  What was it like to go on estrogen? Did it help? How so?
Estrogen was actually great. I admit I fucking love placebos, but I think the estrogen really made me super relaxed and calm. I felt happier and more optimistic despite still going through the weirdness of public transitioning, specifically at work.
6.)What was your experience being transgender? Did it help the dysphoria? Did you feel better overall? Worse? In what ways?
Transitioning made me happy in the sense that I felt I was changing parts of myself I didn’t like, but it made me even more obsessed with gender roles which were what I was supposed to be rejecting.
7.) Tell me about your detransition process?
I stopped taking the pills and stopped shaving. The doctor called once after I missed my next appointment, then never again. Then basically read nothing but radical feminist twitter for a while.
8.) What advice would you give to a young person considering transition?
Do not do it. Hating your body is a part of having a body. You can either live with it or not. If you change it you’ll still hate it even if you can tolerate it. You’ll brainwash yourself if you haven’t let others yet. It’s a cult based on sexual fetishism and pseudoscience. You’ll do something stupid or lose all of the people in your life then in 2030 when this whole thing is over you’ll never be the best version of yourself you could’ve been.