No questions permitted: Thoughts from a mother whose son transitioned

This comment was submitted by a reader today. Thank you.

Thank you for your blog, which makes me feel sane again. It’s so hard to escape from a world policed along very narrow, and in my view, very dangerous lines.

I am the mother of a young adult who decided two years ago, in the wake of a series of traumatic events, that he is female. He is being supported by two gender doctors who, he says, have ‘diagnosed him as transsexual’. This ‘diagnosis’ is merely an echo of his own interpretation of his own narrative. They say that he is transsexual because he says that he is transsexual. Yet, he hears this diagnosis as confirmation of his own belief that he must transition to survive.

His belief in the absolute necessity of transitioning is based, I believe, on the trans narratives that he has encountered on the internet.

By contrast, when his adolescent sister developed an eating disorder and then self-harmed,  she was supported to challenge her beliefs, support which allowed her – after a long two years – to recover. Only a belief that you are the sex that you were not born to is unchallengeable, lest you be charged with bigotry.

For my part, I have become increasingly convinced that gender dysphoria is a maladaptive coping strategy, prompted by very real distress, but not necessarily stress focused around gender. Yet our culture, which for the last century, has been obsessed with gender, cannot see the distress underlying these claims.

I think that the supposed parallel between gender transitioning and homosexuality is particularly unhelpful and misleading. Both narratives share a story of coming out, and of liberation from prejudice. But both are not necessarily the same.

Gay culture, despite – or because of — the suffering and persecution homosexuals have often faced,  revels in humour, which rests on lifting taboos and telling the truth. But trans culture is humour aversive, maybe because humour threatens to crack the fragile identities, uncovering a truth which cannot be spoken, a truth which threatens to launch the self into terrifying chaos. I think it is for this reason that trans culture cannot countenance questioning or debate.

A reminder about my comment policy

On the sidebar to the right of my blog posts, you will find the following:

The purpose of this blog is to give voice to an alternative to the dominant trans-activist and medical paradigm currently being touted by the media. I give preference to commenters who are also gender-critical, though respectful questions and comments countering this view will be considered. Please feel free to comment on older posts. This will often stimulate new discussion.

Some bloggers see their sites as a place for brawling, free-for-all commenting with no holds barred.

This blog is not that sort of place.

The Internet is bristling with cat fights about transgenderism (and yeah, I do consider it an “ism), about feminism, and increasingly, about the growing trend to medicalize “gender nonconformity” in children, teens, and young adults. If what you’re after is a place to castigate and shame the people who’ve found a voice here, look elsewhere. I moderate all comments. My primary goal is to provide a place where left-leaning people who are critical of the dominant transgender paradigm–especially as it pertains to young people–can have their say.

Does that mean I won’t consider publishing views counter to my own? No, but it does mean I’m not interested in hateful vitriol aimed at parents and family members who are supporting each other, and their kids, in finding an alternative to the trans narrative.

If you want to see your comment published here and join the discussion, be constructive. You don’t have to agree with everything you read here, but I’m not interested in providing a platform for finger wagging, holier-than-thou transactivists. Nor will I put out the welcome mat for the tiresome scolds who have nothing better to do than try to convince us they know our kids better than the intelligent and caring parents who form a community in these pages.

I make no guarantees to anyone that a particular comment will be posted. But if you’re a parent, family member, ally, or friend looking for an alternative to the galloping trans-kid meme, you’ve come to the right place. Welcome.

Exiles in their own flesh: A psychotherapist speaks

This is a guest post submitted by Lane Anderson (a pseudonym), a practicing psychotherapist who has worked extensively with “trans teens” and their families. She shares with us her clinical insights into her clients, adolescent psychology, and the impact of the transgender phenomenon on our society as a whole.

If there are other mental health providers reading this post, please consider guest posting or responding in the comments section below the article. See this earlier post featuring Dr. David Schwartz for another critical perspective from a psychotherapist.

I am extremely grateful to Lane and Dr. Schwartz for speaking up. Time is of the essence, since the American Psychological Association recently released new guidelines which will make it even more difficult for clinicians to step forward.

I am a licensed psychotherapist. I’m writing this post on my last day at a teen health clinic, where I’ve seen patients and their families for nearly a decade.

In the past year especially, it’s become increasingly clear to me that I cannot uphold the primary value of my profession, to do no harm, without also seriously jeopardizing my standing in the professional community.  It’s a terrible and unfortunate conflict of interest. I’ve lost much sleep over the fact that, for a significant portion of my clients and their parents, I am unable to provide what they profess to come to me seeking: sound clinical judgment. Increasingly, providing such judgment puts me at risk of violating the emergent trans narrative which–seemingly overnight and without any explanation or push-back of which I am aware–has usurped the traditional mental health narrative.

When I am suddenly and without warning discouraged from exploring the underlying causes and conditions of certain of my patients’ distress (as I was trained to do), and instead forced to put my professional stamp of approval upon a prefab, one-size-fits-all narrative intended to explain the complexity of my patient’s troubles, I feel confused.  It’s as if I am being held hostage. No longer encouraged or permitted to question, consider or discuss the full spectrum of my patient’s mental health concerns, it has occurred to me that I am being used, my meager professional authority commandeered to legitimize a new narrative I may or may not wish to corroborate.

It’s been perilous to simply admit to not fully understanding it all–let alone disagree with the trans narrative.  There was no training or teaching. I was just suddenly told that some of my patients thought they were trapped in the wrong body and that was that.

After much soul searching, I felt I had no choice but to remove myself from this crippling work setting. Being told to exercise my clinical judgment with some clients, while ignoring it with others, made me feel like a fraud.

Throughout my career, I have come to my work with these thoughts in mind: that life is complex, that people are complex. But in one way or another, most people tend to balk at that kind of ambiguity. I try to assist people in flexing a little, try to help them find ways to manage life’s gray areas, and the occasional distress that comes from simply being conscious. But at the end of the day, I couldn’t deny it was a little weird for me to go on believing I could effectively teach others to be less rigid, more free people facing their lives head on, when I myself, their humble guide, was being exploited, tongue-tied by a new party line.

There are so many complex forces, from many different realms, coming into play with this trans wave.  Most people are completely unaware of these intersecting interests.

Unfortunately the culture war has done a number on the concept of critical thinking.  I have considered myself liberal my entire adult life, and I still am. But for a long time I couldn’t find anyone questioning this trans explosion who wasn’t on the far right. It made me feel like only conservatives were allowed to think, to consider this issue, but ultimately their thoughts were rendered meaningless due to their branding by the culture war. It’s essential that left-leaning people model critical thinking for the masses in this regard.

It’s important to link people like us together, who have been silenced, so we can resume contact with our critical thinking skills and reduce our growing sense of self doubt.  Divide and conquer is best accomplished through silencing, through calling into question those who speak out. There is so much of this attached to the trans movement. Even just wondering about a profound concept such as transgender is  labeled transphobic. What I think has happened is that people are now phobic about their own gut responses to life. We are being systematically separated from our own intuition. This is fatal for a civilization, I think. Not that our intuition always tells the truth with a capital T, but it is a critical piece of who we are. Without it, we remain profoundly directionless, and more susceptible to coercion of all types.

What frightens me most about the trans movement is that the establishment has gotten involved and is leading it. I think that’s really weird. Clearly they are benefiting from it financially. So sad. It disturbs me to see how giddy my former medical director is to be part of this growing craze. We used to treat kids with mental health problems, but now it’s all about validating their emergent and shifting identities.  As professionals, if we don’t loudly prioritize their identities as being the most important thing about them (and identities do shift constantly in kids and teens), we risk coming across as unsupportive and even immoral. Identity development has always been a teen task, but in the past it wasn’t necessarily supposed to become a lifestyle, or colonize the entirety of your existence.

Our world is in a profound state of flux. We can’t begin to comprehend what the Internet has done to how we see ourselves. People are looking for ways to belong, ways to understand who they are in place and in time. They are looking to reduce the anxiety that comes when too much change happens all at once. I try and look at trans folks as people who are seeking to answer the new questions that have emerged in this early 21st century.  I have been trying to find a way to understand their urges to detach from their bodies, to undo that feeling of exile they experience in their own flesh.  We all want to get back to ourselves; it is our duty to reconnect with those weighty parts that inevitably sink to the depths of us, the parts too heavy to remain on the surface of our lives.

From what I can see, the age-old human task to reclaim that which has gone missing appears to be manifesting with great prominence in the trans community. The problem is this: we all look for shortcuts to finding the lost treasure. It’s human nature to resist the long and serpentine journey to our own sense of personal truth. In our fear, in our self doubt, we calculate the risk and often decide it is preferable to be shown what another person–a “helping professional” or an activist–bills as a sure thing, a direct path to what we sense we lack. We all, on some level, hold a childlike fantasy that someone else has figured it out and can provide us a direct map to ourselves. And that’s what the trans narrative does. It promises to guide the follower to their essential, authentic self.  But this, unfortunately, doesn’t happen, because the essential self, whatever that is, is not created from another’s road map, but can only be comprised of the trails we forge ourselves.

What saddens me the most is the way children are being trained to think their parents do not love them if mom and dad don’t jump aboard the trans train. To me, this is a brutal aspect of a near-dictatorship being foisted on everyone. The kids are too young to see that there are no other people who will have their backs, throughout life with lasting devotion, in the unique way their families will. They think these new friends they’ve made online understand them perfectly. And in believing this unquestioningly, they find themselves lulled by the frictionless experience delivered most powerfully by group think.

Of course, I’m describing the pull of all cults; that deep human desire to be known through and through and through.The cult experience seeks to end the frustration that naturally comes when we mature and begin to see ourselves as separate beings. In our separateness, we must do the hard work of truly learning to know another. Group think reduces the fear that comes when we are unsure if we will be located by another, when we remain unable to locate ourselves.

Cults and closed narratives neutralize and tame what we see as the unknown. I think somebody needs to put a refresher out there on the cult mindset and group think.  People seem to have forgotten that we are all very easily influenced by each other. Carl Elliot wrote about this in relation to body dysmorphic disorder (people wanting to amputate their own limbs because they disidentify with them) in the Atlantic, “A new way to be mad.”

One common trait I’ve noticed in nearly all the trans kids I’ve met has been their profound sense of being different, and too alone. They often have had little success with making friends, or what I would call contact with “the other.”  Because of their psychic isolation, they are prime targets for group think narratives. But in addition to looking for a way to belong, they are also craving protection and the stamp of legitimacy, perhaps because they feel a profound lack of it.

Now that the government and medical communities are involved in the creation of who trans folks are, this class of individuals have finally found their safe havens. Now, rather than being merely invisible and awkward, they have been transformed into veritable leaders of a revolution. Now, rather than cower in the shadows, they have commandeered the narratives of others into a similar dark and brooding place where they once were. The tables, as they lived and viewed them, have now turned.

It’s got to be dizzying for these formerly “ugly ducklings” to find themselves at the center of a flock of swans. To become a part of the movement, to finally be seen and found as whole, alive, and most importantly, wanted, all they have to do is renounce the very bodies in which they feel they have been imprisoned. In doing so, the promised payoff is very big, for they have finally found a way to render mute all those who once discounted and disbelieved them. Through silencing others who threaten them, they have unearthed a means of silencing their own self hate. Rather than being afraid of themselves, they make others fear what they have become.

Psychologically these interpersonal tactics would once upon a time have been categorized as immature, “primitive” defenses erected by an undifferentiated self that cannot see the self or others as whole creatures.  But as I witness it in my own practice, this is the basic thinking underlying the psychology of the trans narrative. In her recent blog post, “My Disservice to My Transgender Patients,” Dr. Kathy Mandigo talks about feeling threatened by some of her MTF patients.  Many of the trans kids I’ve worked with will joke about how they and their friends are dictators, “masters of the universe!” I find that clinically significant. This is something toddlers do when they are first discovering they are separate from their rulers (parents). Rather than fear the parent, they seek to control the parent, exert their will on the parent and co-opt the parent’s power as their own. In doing this they hide from view their terror at facing their own powerlessness.  Ideally, the child will gradually outgrow this urge to control, will gradually relinquish the dictatorial need to create safety through controlling the external realm. When that happens,  we say it is a sign of maturity. As our own sense of agency grows, we are better able to forfeit the habit of controlling others. We also begin to feel guilt at the idea of controlling others, as we begin to see them as separate from us, 3D human beings instead of mere props on our psychic stage.

Unfortunately some people have a hard time making this shift. They get stuck or addicted to manipulating their external environment, and will continue to create inner safety through the constant and relentless work of controlling others.

Last week in a team meeting, our medical director said he was meeting with a girl who identifies as FTM to discuss top surgery and testosterone treatment.  Apparently, according to the director,  the girl’s mom is slowing down the process of transition.  Bad mom, right? The director added that the girl’s mom told her that 9 out of 9 of her daughter’s friends also identify as FTM.

At this point I couldn’t hold my tongue any longer. I said, “Can we not be honest and see that we are dealing with a trend?” Of course, everyone else  at the table was mute.  Considering I’m leaving my post, I felt bold enough to say that I found it infuriating we couldn’t discuss this topic clinically. More silent colleagues (except their eyes were wide as if they wanted me to keep talking and taking the risk for them). I said that what we were doing as a medical community was potentially very harmful, and made mention of some of the videos I’d watched featuring transmen who decided to go off testosterone.  The medical director prides himself in providing special services for those patients he deems unjustly marginalized by society. But he can’t see how the medical community has become complicit in the oppression he earnestly seeks to remedy.

A large part of the problem comes with the revolution in health care. More and more, we are giving people the power to define their own treatments. This is good in many ways, but the trans movement is using this moment, and is actively recruiting young, psychologically undefined and frightened people to push their agenda through the medical community. It’s clearly not that difficult to do. These kids are just pawns. That’s how it looks to me anyway. The trans community needs more converts so that the narrative becomes more cohesive. I’m guessing the push for this comes from a need to further cohere so they will have more members to fully cement a fragile, constructed reality.

We–people who don’t identify as trans–are the external realm that must be controlled to bring the trans community the inner peace they now lack. But they don’t get that they will never find calm or strength this way. You cannot find yourself through coercing others. You cannot extinguish your fears by turning from them. The trans community must face their own fears, face themselves and their own demons. They can’t wipe out their fear that they are not really transitioning by censoring the thoughts and expressions of others. If they believe they are trans, they shouldn’t need to spend so much effort foisting that belief on others.

The fact that they do dictate to others is to me diagnostic of their very condition. They are uncertain about who and what they are. No sin in that. That’s human.  The transgression comes in refusing to accept this uncertainty, and in sacrificing the lives and consciences of others to nullify your own self doubt.

Coming soon to a state near you? Double mastectomy for your 15-year-old, without parental consent

“Top surgery”–the removal of both breasts with subsequent “chest reconstruction” –is the holy surgical grail for many females who identify as trans male.

Once strictly a prerogative for adult females in the United States, there is a growing trend for younger “trans teens” to pursue double mastectomy as early as possible. In the United States, the age of medical consent for major medical procedures without parental involvement is typically 18 years, with a few exceptions–notably for “emancipated” or married minors, and for contraception/birth control services, which are generally available to teens at an earlier age. There are also a few states with a lower age of medical majority, Oregon being one of them (age 15).

But the push is on by trans activists to lower the age of consent for trans-identified teens to undergo general anesthesia and major surgeries (both “top” and “bottom”), and to force both private insurance policies and taxpayer-funded state health plans to cover the procedures as a medical necessity.

Going under the surgeon’s knife is always a risky business.  Apart from the questionable wisdom of colluding with a pubescent girl’s notion that she is “really a boy,” mastectomy and general anesthesia carry risks of complications.  (Interestingly, “gender dysphoria” is no longer considered a mental disorder in the DSM-5, but a normal variant in the human condition–which somehow still requires extreme medical intervention.)

For any other condition, major surgeries requiring general anesthesia would be seen as last resorts.  It would be considered a miracle cure to be celebrated if a 15-year-old cancer patient were able to go into remission sans surgeries and chemotherapy.

For any other condition, everyone involved in the process–the patient, their families, doctors–would be looking for the least-invasive, least extreme, least permanent treatment approach. And the very last thing they would do is lobby legislatures for less parental involvement in these life-altering decisions that affect an adolescent girl.

As I have written about previously, these activist gender organizations are already proudly and secretly handing out free breast binders to kids with “unsupportive parents.” But they aren’t stopping there. They are doing their best–and succeeding–at further eroding the involvement of a child’s most trusted adults in permanent medical decisions.

Let’s take a closer look at Oregon, where, in 2014, TransActive Gender Center successfully lobbied the state legislature to include transgender hormones and surgeries for children on the tax-payer funded Oregon Health Plan (OHP), which is Oregon’s version of Medicaid for low income people. (There is not enough room in this post to cover the many medically necessary procedures that are not covered under the OHP.)

And TransActive just had another victory. Only a few days ago,  it was instrumental in ensuring there is NO lower age limit for “transgender surgeries” WITH parental consent. This means that a parent can decide (because let’s be very clear: when it comes to an 11 or 12 year old or even younger, it is the PARENT who is making the executive decision) to allow their young child to have even her ovaries and uterus surgically removed. Here we see Jenn Burleton, executive director of TransActive, celebrating on Burleton’s public Facebook page:

Burleton age of consent cropped

In the comments, supporters are jubilant. Only one injects a note of caution:

It’s good but I hope these parents and kids have the benefit of LOTS of counseling

In response, Devin Kit Crosland (scroll down for profile), a female-to-male trans-identified individual who heads up TransActive’s “In a Bind” free breast binder program for minors, helpfully points out that, in Oregon, kids age 14 and up can already get transgender counseling, without interference from “parents who aren’t supportive or aren’t educated on the issues.”:

Crosland gloats about 14 year olds and counseling cropped

On its public Facebook page, Transactive crows about the ways it has helped to make it that much easier for a young girl who wants to remove her breasts:

Transactive gloats about changes to OHP

We’re down to one referral letter (instead of two) for both cross-sex hormones and “top surgery,” on the taxpayer-funded Oregon Health Plan. What’s next on TransActive’s agenda? No letter at all? An online, on-demand dispensary for testosterone, and same-day, walk-in clinics for double mastectomies? No lower age limit for “gender affirming” surgeries without parental consent?

TransActive is aptly named. These are activists, and they want to make sure girls in other US states–your daughter, too–can get these surgeries without the pesky interference of any “unsupportive” mom or dad.

The same Facebook victory thread on Jenn Burleton’s public page shows supporters asking how they can change the laws in their own states. Burleton makes it clear that TransActive isn’t just some Oregon-focused local organization. No, Burleton wants to move this agenda forward across the nation:

Burleton pushing agenda

For those interested, TransActive Gender Center will share the testimony we prepared for adding and protecting this coverage in Oregon with anyone working on securing or interested in securing the same or similar coverage in their state. PLEASE… do not pursue this dialogue on Facebook!

Send an email to

So what are the gender nonconforming young people supposed to do while they’re waiting for the taxpayers in their state to pony up for their breasts to be removed? After all, these surgeries are expensive. In most states, unlike Oregon, health plans still consider “top surgeries” elective and not medically necessary.

The Internet is abuzz with ideas and resources. The site aggregates lists of “top surgeons” and self-funding ideas. Many people set up online charities for themselves, asking complete strangers on the Internet to donate to their cause. All the fundraising sites I found were fully publicly accessible, with not a few run by teens under age 18. A Google search for “top surgery gofundme” results in 1900 hits. The tag “top surgery FTM” turns up plenty of results on Tumblr. And a search of the GoFundMe site itself with keywords “top surgery” currently turns up 455 people looking for donors–with several of the potential surgery patients under the age of 18. Parents are even getting in on the act, putting up online fundraising sites for their kids, evidently even for young people with developmental disabilities.

Medical “gofundmes” are nothing new in the US, where plenty of people are still uninsured or underinsured. People needing cancer treatments or surgeries have been funding themselves through bake sales and online fundraisers for quite some time. And while, as I noted earlier, being “transgender” is now no longer considered  a psychological disorder, it is a non-disorder which requires extreme medical treatments, so it’s natural that people are hitting the interwebs to raise cash.

And what about the “top surgeons” who do the work? Space does not allow a full review in this post of the hundreds of top surgeon sites popping up all over the web, but it’s obvious this is a growing and lucrative business. To take just one example, Dr. Hope Sherie has a display ad that appears all over, with her own page on that site promoting herself as

Highest Level of Top Surgery Care on the East Coast

Dr. Sherie, along with the other surgeons featured on, posts before-and-after photos, including several showing the results of years of breast binding vs. the post-surgical results. She also helpfully lets us know that she’ll be at the Gender Odyssey conference, a pow-wow for transgender activists, medical providers, trans people, and their families that meets yearly and begins this Friday, August 21, in Seattle, WA.

A look at the advertisers on the home page for the conference shows several plastic surgeons, as well as some organizations–like the Center For Lesbian Rights–that might not be staying exactly true to their original mission, if you think about it; but that’s a subject for a future post.

gender odyssey

I want to close this post by addressing a few sincere questions to the transactivists and medical/psych providers who might have landed on this page.

I expect that most, if not all, of you feel you are doing the right thing for these girls. You are not monsters. But I have to wonder: do you ever engage in any soul searching? Do you ever ask yourselves, “Am I doing the right thing?” Is your sleep ever troubled by the suspicion that at least some of these young women will regret the permanent changes you have allowed them to make to themselves?

Many of the parents who write to me are losing a lot of sleep. They are constantly searching their own consciences, wanting only to do right by the children they have known for so many years. They know their children far better than you do. It seems to me that every adult who is involved in the weighty business of encouraging other people’s children to pursue a path of medical transition ought to just stop. Think.

It’s not enough that some of you are going to study these kids in the future. What of the people who may be irrevocably damaged by the treatments being administered right now?

Is this work you are doing something you will regret someday? Will you go to your grave confident you have “done no harm?”  You have the future of our precious children in your hands. Respect us–both parents and our kids–enough to honestly ask yourself: AM I doing the right thing?

Self harming as survival, not suicidal intent, in dysphoric young women

There is an interesting new comment up on the Guardian piece about the mother with the mentally fragile daughter who wants to transition. In fact, there are many good comments that have been posted since I blogged about the article the other day. The commenter–a woman who has been to hell and back–provides excellent advice to parents of girls who are engaging in self harm.

I have suffered mental health issues since I was a child and my self harm began aged 11, I continued in secret till my twenties.

If I could share one thing with you, it would be this; self harm didn’t mean I was trying to kill myself. It allowed me to survive. It allowed me to moderate and purge very strong emotions that I couldn’t put into words. I come from a dysfunctional home where no one taught me how to talk about my emotions or that I was allowed. It gave me back a sense of control over my own life, I belonged to myself, I wasn’t at the mercy of adults who abused me. It had an addictive physiological response, the rush and the soothing pain killing adrenal response. It was survival. It wasn’t a cry for help, for attention or to punish family.

Your daughter won’t be in a place to stop self harming until she has a viable alternative set of skills, identifying her feelings, being able to communicate, bring heard, building self esteem, feeling belonging. Those skills take time to build and she needs a professional to do it with.

Most of all, she needs a Mum to witness where she is right now. Not a Mum who wants to fix her (natural as that feels) or a a mum who will analyse what she says and tell her what means. Listen to her with kindness, non judgment, let her voice her feelings. Feeling like you are alienated from your body is painful, listen to it and witness it. That doesn’t mean you have to endorse a gender reassignment. But listen. Whether she means she wants to be a man, it is telling you something about how she sees herself.

You can make it through this. I got into therapy, off meds, I stopped self harming and at 31, I am a happy healthy woman. At 25, I had endured 5 hospital admissions and was crashing out of the psychiatric system. I was giving up hope. What changed that was being listened to and loved by people who focused on what was valuable about me, not what was wrong.

You can do it.

Comic relief? Or not.

For anyone who is not yet familiar with it, I recommend a stroll over to the Gender_Critical subReddit to enjoy a visit with its ever sharp and snarky denizens.  It’s primarily a collection of gender-related media stories, which the hungry subReddit piranhas attack with incisive zeal.

The moderator deirdreofthegaians has a special knack for creating snappy headlines that capture the sad absurdity of the gendered dystopia we find ourselves in today. Tonight’s selection is particularly interesting, in a brutal sort of way.  “FTM teen will just have her partner carry her babies, no big!” “MTF caught with huge cache of weapons and explosives.” “Internalized homophobia leads lesbian to identify as genderqueer after family stages intervention.”

Enjoy? Or not…

National Institutes of Health funds $5.7 million grant to study pediatric transition

This is big news. Children who have been diagnosed as “transgender,” who are currently being experimented on with hormones and surgeries, will finally be studied in (one hopes) a systematic way at several clinics across the U.S. over a 5 year period.

The good news? Someone will actually be collecting data and publishing research studies on these kids. The bad? The children are still the same guinea pigs, being treated experimentally with outcomes still to be determined.

The studies will run for 5 years, which will be enough time to yield some important information. But the real litmus test is what life will be like for these children when they grow up to be adults.  The younger children will still be adolescents when the studies end. One can only hope that the NIH will fund further longitudinal studies to follow these people–some of whom will be permanently sterilized–well into their lives as adults.

The study – which will begin enrollment in fall 2015–will include 280 transgender youth with gender dysphoria–those who are persistently distressed by the incongruity between their gender of identity and the gender they were assigned at birth. Participants will be those who seek medical intervention to align their physical bodies with their gender identity and alleviate gender dysphoria and its associated negative effects, including anxiety, depression and substance abuse.

The study will include youth from two age groups: younger children in early puberty, who will receive hormone blockers, called GnRH agonists, used to suspend the process of puberty – preventing the development of undesired secondary sex characteristics; and older adolescents, who will begin use of masculinizing or feminizing cross-sex hormones that allow them to go through the ‘right’ puberty – consistent with their gender of identification.

For the cohort in the earliest stages of puberty, the study will evaluate the impact of treatment on mental health, psychological well-being, physiologic parameters and bone health, and will document the safety of hormone blockers. In the older group, the study will document the safety of administering cross-sex hormones for phenotypic gender transition, as well as evaluate its impact on mental health, psychological well-being, and certain metabolic/physiological parameters.

Who will be conducting this NIH-funded research? The doctors who have made the biggest names for themselves in the new frontier of pediatric transgender “treatment”:

The multicenter study will be located at four academic medical centers with dedicated transgender youth clinics. The co-investigators and their institutions include:

Johanna Olson, MD, Children’s Hospital Los Angeles and the Keck School of Medicine of the University of Southern California

Stephen Rosenthal, MD, UCSF Benioff Children’s Hospital San Francisco

Robert Garofalo, MD, MPH, Ann & Robert H. Lurie Children’s Hospital of Chicago and Northwestern University Feinberg School of Medicine

Norman Spack, MD, Boston Children’s Hospital and Harvard Medical School

These doctors have a lot at stake to prove that their experimental treatments will produce positive longterm outcomes for these kids–over the lifespan. Can and will they design studies that will truly be unbiased and well controlled? Will they end the studies and treatments early if negative outcomes start piling up? Will they be motivated to apply for more funding after 5 years, or will they declare 16-year-olds who began transitioning  at 11 successes and cease following them? Will they look closely at how natal males and females differ in their response to hormones and surgeries?

Time will tell. For the children’s sake, we can only hope these doctors will use the NIH research money ethically and wisely.

But given how much these doctors have already invested in administering hormones to kids and publicly touting the unmitigated good of “transition” and “trans kids,” it’s hard to see how they can approach this research without bias. If long-term evidence ultimately shows more harm than good resulting from this, they will be seen as providers who hurt innocent children–a much bigger stigma than harming adults.