Layers of meaning: A Jungian analyst questions the identity model for trans-identified youth

Lisa Marchiano, LCSW, is a Jungian analyst. She blogs at (Facebook:, and can also be found on Twitter @LisaMarchiano.

Lisa’s thoughtful essay stands in stark contrast to the simplistic advice we see from self-declared gender therapists like this one. For the perspective of another therapist skeptical of the “gender affirmative” approach, see this post by Lane Anderson, a former therapist for trans-identified teens who quit her job last year due to ethical concerns.

Lisa would like to thank Miranda Yardley, ThirdWayTrans, and Carey Callahan for their contributions to this post. Though these three individuals were generous in sharing their time and expertise, the views expressed here are Lisa’s own.

Lisa is available to respond to your remarks and questions in the comments section of this post. In addition, Lisa is interested in being in contact with other therapists who share her concerns about the identity therapy model:

If there are other therapists reading this and wanting support to question or work outside of the identity model, please be in touch. Contact me privately on Facebook or Twitter, or ask this blog to put you in touch with me via email. There are lots of us out there. Let’s start talking.

by Lisa Marchiano 

As a social worker and a Jungian analyst, I have become increasingly concerned about the rush to affirm children’s and young people’s transgender self-diagnosis, and then transition them to the opposite sex. I am particularly worried about social and medical transition among teens whose transgender diagnosis arose “out of the blue,” without a significant history of early childhood dysphoria. I fear that, via their well-meaning desire to validate young people in pain, therapists are discarding basic principles of psychotherapeutic care.

My views have been informed by my work with detransitioners, as well as with parents of trans-identifying teens. I have also sought to educate myself further by listening to trans people, parents, clinicians, academics, lesbians, feminists, educators, gays, and others who are writing and speaking about gender. I believe that transition may be a viable and even necessary option for some people. I support the right of adults to choose this option with appropriate therapeutic care and support. I certainly believe that trans people deserve human rights, legal protection, humane care, and respect. However, there are potential physical and psychological dangers of transition, and we need to exercise astute clinical judgment and caution when working with young people who are seeking transition.

I have often seen trans activists and gender specialists promote “social transition” of trans-identifying youth as a positive and “fully reversible” intervention. Social transition refers to a number of steps one can take to present as the opposite sex. These might include making changes to one’s hair style, make-up, name, pronouns, and dress. One might also begin binding breasts or wearing a packer to “present” more convincingly as the opposite sex. Social transition is sometimes described as something that has few if any long-term consequences, and therefore can be recommended with minimal concerns,  even for young children. However, in some significant percentage of cases, social transition leads to medical transition. It appears likely that being conditioned to believe you are the opposite sex creates ever greater pressure to continue to present in this way. Once one has made the investment of coming out to friends and family, having teachers refer to you by a new name and pronouns, will it really be so easy to change back? Children who socially transition at a young age may have little experience living as their natal gender. How easy will it be for them to desist?

At least some of the time, each step taken toward transition creates pressure to continue. Numerous blog posts from detransitioners explore how transition made dysphoria worse, often because the young person became increasingly preoccupied with passing. This further discomfort created pressure to take more steps toward transition in order to present more convincingly as the opposite sex. To take just one example, breast binding may bring relief to some natal females who experience discomfort with their breasts, but binding in itself can be quite painful, restricting breathing and movement—thus creating an incentive to take the next step—“top surgery”/double mastectomy. I have heard one mother of a FtM young person stating that this natal female “got his lungs back” after getting a double mastectomy because he no longer needed to bind. Additionally, anecdotal evidence indicates that it is not uncommon for teens who socially transition to move on to hormones and/or surgery shortly after their 18th birthday. So it’s clear that social transition must be viewed as a treatment that carries with it a significant risk of progressing to medical transition.

Medical transition refers to a number of interventions undertaken to alter one’s body. These can include administration of hormone blockers to children and teens; administration of cross sex hormones; mastectomy; phalloplasty; hysterectomy; body masculinization; orchiectomy; vaginoplasty; facial feminization surgery; and others. All of these procedures can have permanent effects, and most of them carry significant risks. It is unusual (though not unheard of) for minors to have these surgeries. However, it is not uncommon for minors to take hormone blockers and cross sex hormones. And in 100% of the cases reported in the literature, children on puberty blockers went on to cross sex hormones. Top gender clinician Johanna Olson reports that no puberty-blocked children at her clinic in LA Children’s Hospital have ever failed to continue hormone treatment. Therefore, the claim that blockers are “100% reversible” is not accurate in practice. In fact, being on blockers appears to consolidate an investment in a cross sex identification. And although one rarely sees this “side effect” reported in the mainstream media, because gametes do not develop when an adolescent does not undergo natal puberty, hormone blockers followed by cross sex hormones results in permanent, life-long sterility 100% of the time.

Hormone blockers and cross sex hormones are being used off label (that is, they are not FDA-approved for this purpose). We have almost no knowledge about the long-term effects of taking these drugs over the course of decades, as anyone beginning transition as a young person will likely do. According to Madeline Deutsch, clinical director at University of California, San Francisco’s Center of Excellence for Transgender Health, “it scientifically makes sense that if someone is on hormones for decades, it’s highly likely that they’re going to be at higher risk [for certain health issues] than someone who started taking hormones at age 40 or 50.” Even the top pediatric gender doctors admit that there’s a dearth of good data on the long-term health outcomes of transition.

Certainly, there are risks. Cross sex hormones change bodies fairly quickly. Some of these changes are irreversible, such as a deepened voice, facial hair, and baldness for testosterone, and breast growth and, potentially, infertility for estrogen. In addition, use of cross-sex hormones carries with it potential negative side effects. Girls who take testosterone will be at increased risk for developing diabetes, cancer of the endometrium, liver damage, breast cancer, heart attack, and stroke. There may be other adverse effects of which we are not aware at this time, since long-term testosterone use in natal females is a relatively new phenomenon that has not been adequately studied.

I fear that there are young people transitioning – with the ready help of therapists, doctors, and others – who may regret these interventions and need to come to terms with permanent and in some cases drastic changes to their bodies. In fact, I know this is already happening. I have had considerable contact with the growing community of detransitioners. In many cases, the hatred for and disconnection from their bodies that these young people experienced was due to sexual trauma, internalized homophobia, or bullying. In videos and blogs, young women speak about their sadness over their lost voices and breasts. Male detransitioners mourn the loss of their testicles, the loss of their ability to orgasm, in some cases the loss of their fertility. Many have had complications from hormones such as vaginal atrophy, nerve damage, or chronic pain. You can hear some of these stories for yourself here, here, and here, among other places.

I have also spoken with many parents. Their stories are just as heartbreaking. These usually involve a teen who was anxious, depressed, socially isolated, or suffering from PTSD coming to identify as trans after internet binges on social media sites. These parents report that mental health professionals are validating the self-diagnosis of transgender after a handful of therapy sessions, without any exploration of prior mental health issues, trauma, sexual orientation, or history of gender nonconforming behavior. This clearly violates APA recommendations, which urge special caution in treating adolescents who present with sudden onset dysphoria.

All of this comes down to an essential question: When treating someone with gender dysphoria, do we do so using a mental health model, or an identity model?

An identity model is founded on the belief that we ought to be able to define our own experiences for ourselves. It proclaims that each of us has a right to assign our own meaning to our lives, our feelings, and our bodies. We get to decide who we are, and no one has authority over our self-perception. An identity model offers respect and self-determination for every person to define themselves as they would like.

An identity model has a place in psychotherapy. As people, we all self-identify aspects of our personality, values, and experiences in ways that are often very important to us. We might identify as Catholic, or as a Democrat. We might identify as an artist, an introvert, or a lesbian. As therapists, accepting and affirming our clients’ self-identification is important and empowering. As therapists, we can accept and empathize with a client’s story about his or her life experience. We can hold this story as valuable and important whether or not we objectively agree with it. As long as the client’s story does not lead to maladaptive behaviors, we do not need to challenge or attempt to discredit or disprove such a self-identification.

However, an identity model of working with transgender people goes further. An identity model stipulates that it is wrong to explore or question a client’s self-determined identity. Gender dysphoria is seen as evidence that someone is transgender, and merely wondering about underlying psychological reasons for dysphoria or alternative explanations for symptoms is seen as synonymous with denying a person’s identity. Applying our own clinical judgment to someone’s proclaimed self-diagnosis is seen as bigoted and wrong. Our role as therapists becomes limited to enthusiastic affirmation only.

In contrast, when we are working in a mental health model, we understand that clients come to us with symptoms that cause distress, and may interfere with a person’s day-to-day functioning. As therapists, we ought to be interested both in helping to alleviate or manage symptoms, as well as helping to understand the underlying cause of the symptom. If we are psychodynamically oriented, a basic assumption of our work is that every symptom has a meaning beyond its superficial presentation, and a major part of our work is to help our clients gain insight about this meaning.

In opposition to an identity model, then, the main task in mental health therapy with a client experiencing gender dysphoria would be to deeply explore the symptoms without making assumptions about what the symptoms mean. In fact, while identity therapy knows what gender dysphoria means – i.e. that the client is trans – mental health therapy will start with the assumption that we have no idea what the symptom means. We must be open to the meaning that emerges for patients as we explore their experience with them.

Seeking to understand deeply the nature, quality, and etiology of the dysphoria is not at all the same thing as denying the reality or importance of the symptom. When I explore a client’s anxiety – when did it start? What tends to trigger it? How does it feel? – I am not implying that I do not feel that the anxiety is unimportant or illusory. As we come to understand more about a client’s unique experience of a symptom, we may unwrap the meaning behind the suffering so that the problem resolves in a surprising, unexpected way. Or we may simply gain better information about the best course of treatment to alleviate the symptom for that particular person.

An identity model is not an appropriate basis on which to prescribe drastic, permanent medical intervention.

An identity model does not leave room for a therapist to exercise his or her clinical judgment. It disallows the possibility of a thorough assessment and differential diagnosis. According to the identity model, a client’s self-diagnosis is not to be questioned or explored. Therefore, alternative causes of dysphoria cannot be sought. As with many other mental health issues, the symptoms of gender dysphoria can be caused by many different things. Feeling uncomfortable with or disconnected from one’s body can go along with being on the autism spectrum; having experienced trauma; having bipolar disorder; having an eating disorder; or experiencing internalized homophobia. And sadly, it is a normal experience for teen girls, 90% of whom express dissatisfaction with their bodies.

An identity model subverts the normal diagnostic paradigm in which a patient presents with symptoms, and the clinician makes a diagnosis. In an identity model, the diagnosis is the identity. This occludes the focus on symptom resolution and management because the priority becomes affirming the identity. When symptoms are seen as validation of an identity, clinical judgment becomes irrelevant.

Before determining that a young person ought to undergo drastic treatments that may permanently alter their bodies and lead to permanent sterilization, a thorough assessment should be conducted that explores all potential factors contributing to the dysphoria. Unfortunately, because exploration of gender dysphoria is construed by some to be tantamount to “conversion therapy,” this kind of extensive assessment is frequently not performed. Though data is sparse, I personally have had contact with dozens of young people and/or their families who received a transgender diagnosis and a prescription for hormones after one to three appointments with a therapist.  According to this survey of more than 200 detransitioned women, 65% of those who transitioned received no therapy at all, either because they were referred for treatment at their first visit, transitioned through an informed consent clinic, or bought hormones through unofficial sources. (The median age for beginning transition in this survey was 17.) Only 6% of respondents felt they had received adequate counseling about transition. In fact, according to the ideology of gender identity, thorough assessment is seen as inappropriate “gatekeeping.”

An identity model does not allow us to rule out cases of transgenderism where social contagion might be at play. It appears quite likely that the striking increase in trans-identifying teens in recent years is due at least in part to social contagion. There has been a sudden sharp rise in the number of children and teens presenting at gender clinics. The first transgender youth clinic opened in Boston in 2007. Since then, 40 other clinics that cater exclusively to children have opened. Inexplicably, the ratio of natal males to natal females has flipped sharply, with many more natal female teens now presenting. Many of these young people have been presenting with dysphoria “out of the blue” as teens or tweens after extensive social media use without ever having expressed any gender variance before. This now-common presentation was virtually unheard of even a handful of years ago. Thousands of home-made videos on sites such as YouTube chronicle the gender transitions of teenagers. These teens show off their new-found muscles or facial hair. The Tumblr blog Fuck Yeah FTMs  features photo after photo of young FtMs celebrating the changes wrought by testosterone. “I finally have freedom!” posters boast under photographs of their scarred chests post mastectomy. “I’m no longer pre-T!” boasts another under a video of someone injecting testosterone. Almost all of these posters are under 25 years of age. According to Jen Jack Gieseking, a New York academic and researcher who was interviewed by BBC Radio 4 last May, “There really isn’t a trans person I’ve met under the age of 30 who hasn’t been on Tumblr.” There are multiple credible online reports of whole friend groups coming out together as trans.

But correlation isn’t causation. As this brilliant blog post explores, the contagion factor only speaks to the particular way that young people choose to deal with distress. It isn’t that the internet is “causing” the rise in transgenderism. It’s that many young people – particularly young females – are feeling alienated from their bodies due to trauma, porn culture, societal standards of beauty, oppressive gender roles, sexism, homophobia, and so forth. Self-diagnosing as transgender becomes an attractive way to deal with the alienation because it is so validated and even lionized in the culture and the mainstream media. For therapists, an identity therapy model does not allow us to acknowledge the role of social contagion, though contagion has been well-documented in contributing to suicide clusters and other behaviors.

An identity therapy model encourages us not to put safeguards in place to prevent young people from undertaking treatments they may later regret. According to an identity model, self-diagnosis as trans should never be questioned. To do so implies a lack of support and even bigotry. Therefore, the clinician must not stand in the way of transition to the person’s “authentic self.” Because of this, an increasing number of minors are going on hormones and even undergoing surgery that will permanently alter their bodies. Even 18 is probably too young to make such major medical decisions. In cases where the 18-year-old is making medical decisions based on a social transition that she or he began years earlier, it is possibly even more likely that that young person has not carefully considered the consequence of transition. Top gender doctors are hoping to see the recommended age for “bottom surgery” lowered.

In sharp contrast, it’s not easy for non-trans patients to be sterilized before adulthood. For instance, in Massachusetts, a patient must be at least 21 years of age to qualify for sterilizing surgeries under the state’s public health scheme. When such a surgery is undertaken, patients are carefully counseled and must sign a form stating that they understand the permanent nature of the procedure, and that they do not wish to bear or father children. Patients must then wait a minimum of 30 days after signing the form before having the surgery. This procedure has been put in place because surgical sterilization has been shown to come with a high incidence of regret. Why are there not similar safeguards in place for those transgender identifying young people wishing to amputate healthy organs and/or sterilize themselves?

There is a wealth of research about cognitive and emotional development in adolescence. The upshot of it is that teens and young adults are more likely to act impulsively, are unable to assess risks well, and are more emotionally reactive. It is partly for these reasons that we do not allow teens to drink, get tattoos, or use tanning beds without adult consent.

An identity model does not allow us to examine the homophobia that drives some – possibly many — transitions. According to extensive research on desistance, a significant majority of children who identify as the opposite sex will not continue to do so into adulthood. The majority of those who desist will come to identify as lesbian or gay. “Feminine” boys are actually many times more likely to grow up to be gay men rather than transgender women. The same is true for “masculine” girls. Many lesbian bloggers (such as this one and and this one) are very concerned that the current trend to transition young people is disproportionately hurting lesbians and gays, and their fears appear to be well founded. This conservative Christian Texas mother was bothered by her son’s “flamboyant, feminine” behavior. Rather than accepting her son’s gender-defiant presentation, she has decided he is transgender. She now has a very pretty, gender conforming “daughter.”

There is widespread concern in the lesbian community that many young would-be lesbian or bisexual women are finding it easier to become “straight men” due to internalized homophobia. In this article, fourteen-year-old Mason describes how he knew he was transgender. “I’ve always known something was up about how I felt about myself,” says Mason, who as Madelyn had refused to wear pink, or to dress in stereotypically feminine attire. “I thought I was gay or bisexual or something.” In years past, Madelyn most likely would have grown up to be a lesbian or bisexual woman. To paraphrase psychiatrist Ray Blanchard, surely it’s preferable to have an outcome of a reasonably well adjusted lesbian woman, rather than someone who identifies as a trans man who has had many irreversible surgeries and a lifetime of drugs.

An identity model makes us unable to tease out other mental health concerns that may be impacting the desire to transition. There is considerable research that points to a high likelihood of co-occurring disorders in young people who wish to transition. For example, this study from 2015 noted that “severe psychopathology preceding onset of gender dysphoria was common. Autism spectrum problems were very common.” In this study, 68% of the population had first had contact with psychiatric service for reasons other than gender dysphoria. Thirteen percent were being treated for psychotic symptoms.

This study from 2004 found high rates of “comorbidity” in those with gender dysphoria, and noted that this was often not taken into consideration when treatment planning for these patients. “Results: Twenty-nine percent of the patients had no current or lifetime Axis I disorder; 39% fulfilled the criteria for current and 71% for current and/or lifetime Axis I diagnosis. Forty-two percent of the patients were diagnosed with one or more personality disorders. Conclusions: Lifetime psychiatric comorbidity in GID patients is high, and this should be taken into account in the assessment and treatment planning of GID patients.”

This 2015 study found a link between gender dysphoria and dissociative symptoms secondary to trauma. According to this blogger, trauma and dissociation were a big part of her desire to transition. This was also true for this blogger here. Similar stories from detransitioners with histories of unaddressed trauma abound.

An identity model does not allow us to take into account reports from parents or previous therapists who may not agree with the patient’s self-diagnosis. I have received dozens of distraught emails from parents trying in vain to get gender therapists to listen to them when they share information about their child’s mental health history that ought to be taken into consideration while assessing and treating gender dysphoria. While I cannot share the contents of these emails without violating people’s privacy, I can point to quite a few places online where frustrated parents have shared similar stories. For example, this social work professor states that the gender therapist did not review her daughter’s special education records or speak with the previous therapist before recommending hormones and surgery for this young autistic teen.

Parents I have had contact with have told me about their child having a history of anxiety, panic attacks, depression, trauma, loss, bipolar disorder, anorexia, cutting, borderline personality disorder, and psychosis. In these cases, as soon as the young person brought up their transgender self-diagnosis, the focus of the therapy shifted to this alone. The parents’ fears, concerns, and information about past treatments were disregarded as obstructionist and transphobic. I am not alleging that this is happening in every case. However, it certainly is happening with some degree of regularity.

An identity model does not allow us to question the incoherence of gender identity ideology. While gender dysphoria appears to be a meaningful diagnostic term that describes a set of symptoms – namely intense discomfort with one’s sexed body – it does not follow from this that one is “trapped in the wrong body,” has a “female” or “male” brain, or even a “gender identity” that doesn’t match one’s body. Though the concept of gender identity is currently being enshrined into law, the truth is that we have no meaningful definition of the term. (For an excellent analysis of the incoherence of the term, take a look at Rebecca Reilly Cooper’s work.) When a trans-identified person is asked how they know they are transgender, they are usually unable to answer the questions without reference to sex role stereotypes. For example, a physician who prescribed cross sex hormones to a 12-year-old natal female stated that the child had “never worn a dress.” This was offered as evidence of the child’s being “truly trans,” and therefore needing these hormones. I would strenuously argue that one’s clothing preferences should not be a reason to permanently sterilize a child.

It doesn’t make sense to say that one’s sex organs don’t matter, but then assert a primary, essential difference based on a sexed brain. Sexed brains do not exist. It is absurd to posit that one’s chromosomal sex, genitals, and entire reproductive system are meaningless and irrelevant or a social construct, and then assert that a subjective feeling of being the opposite gender is determinative. There is no robust science behind the notion of gender identity. Journalists have been quick to report on studies that seem to prove brain differences among those who are transgender. However, as the sexology researcher James Cantor has pointed out, these studies actually seem to be documenting brain differences among those who are homosexual.

If you want to see a review of some of the literature out there in support of a biological basis for gender dysphoria, this blog post does a good job. There are some solid studies that seem to indicate that genetics or pre-natal hormone exposure may play some role in the development of gender dysphoria. That isn’t really surprising. Pretty much every diagnosis in the DSM – from depression, to anorexia, to borderline personality disorder – has some genetic component. Gender dysphoria is real. As with other mental health diagnoses, its causes are likely complex and involve genetic, biological, environmental, and psychological factors. But it doesn’t follow from any of this that the sufferer has an inborn “gender identity” that ought to supersede any consideration of one’s objective biological sex. Body dysmorphic disorder is associated with brain differences and appears to have a genetic component, and yet the biological component of the condition does not dictate that we understand the patient’s suffering to reflect objective reality.

Transgender activists assert that “gender is between the ears, not between the legs.” However, this is an ideological, faith-based statement that cannot be scientifically validated. What is “between our ears” — meaning our inner experience of ourselves as a gendered person — is purely subjective. Within this context, asserting that one is transgender is an unfalsifiable statement of belief. In reality, feeling like the other sex does not in any way mean that you are the other sex. Identity is an important aspect of one’s experience. We get to define ourselves subjectively, and I would argue that full-fledged adults ought to be able to modify their bodies in accordance with their sense of themselves. However, subjective identity should not dictate a necessity for medical treatment of any kind, especially body-altering treatments with highly significant side effect profiles for minors or young people

An identity model does not allow us to consider treatment outcomes critically. The research on outcomes post transition is mixed at best. It is well-known that one study showed that 41% of transgender people had experienced suicidal ideation or self harm. It is less well-known that the study gives no indication whether the attempt was before or after receiving transition care. Several large studies show astonishingly high rates of suicide among transgender people who have medically transitioned (see here and here). It has been argued that suicide rates continue to be high after transition due to societal prejudice. While this likely is true some of the time, post-transition transsexuals are more likely to “pass” as the target gender, and therefore ought to be less subject to discrimination. Given the undeniably high rates of suicide in post-transition transsexuals, it is disingenuous to claim that transition is a panacea that will prevent suicide.

While this study showed positive outcomes for early transition, there were only 55 subjects included. Perhaps more importantly, they were last assessed at one-year post sex reassignment surgery. In the survey of detransitioned women, the average length of transition was four years. It seems possible that some of the 55 individuals followed in the first study might go on to have regrets if they were followed for longer. Worryingly, one of the 70 individuals invited to participate in the study was unable to do so because the person died as a result of postsurgical necrotizing fasciitis after undergoing vaginoplasty.

While the media is full of stories of young people becoming happier and more confident after being allowed to transition, there is some evidence that this is not always the case. In addition to the research that documents high suicide rates post transition, I am aware of anecdotal evidence of continued or even increased anxiety and depression, social isolation, psychiatric hospitalization, and poor academic outcomes for those who have transitioned.

An identity model does not allow us to explore other options for dealing with dysphoria. Transition – social and medical — is currently the only treatment commonly prescribed for gender dysphoria. If what we are treating is an acute discomfort with one’s body, it would seem reasonable to offer a range of different treatments before prescribing transition, including anti-depressants, talk therapy, and emotion-regulation skills to help patients manage their distress. However, none of these treatments is routinely prescribed for gender dysphoria. In the survey of 200 detransitioned women, some significant percentage of them stated that they found alternative ways of dealing with dysphoria other than transition. Detransitioner and therapist in training Carey Callahan offers several specific techniques that she has found helpful on her blog. Clinicians and researchers ought to be mining these experiences to find other effective treatments for dysphoria in addition to transition.


An identity model makes some questionable assumptions about the nature of identity and our ability to know ourselves. An identity model is predicated on the notion that identity is immutable, essential, and knowable. This is not my experience of human nature. Identities are useful for approximating something about ourselves. They are constructs that allow us to talk about our experience. But they are not absolute truths, and they rarely say something about our most essential, mysterious, and ultimately unknowable essence. To quote Whitman, “do I contradict myself? Very well, then, I contradict myself. I am large. I contain multitudes.” I have had the good fortune to contradict myself many times in my life – contradict myself on things that at one time felt utterly essential and absolutely true. I believe this is a universal human experience, and yet another reason why making permanent changes to one’s body at a young age ought to be approached with extreme caution.

An identity model makes it impossible for us to acknowledge or discuss the varied reasons why a person might want to transition. The desire to transition likely has many varied causes. Seeing all transitions as an expression of innate gender identity obscures the very real differences between one person’s situation and another, making it impossible to assess and treat people in an individualized way. A late transitioning MtT autogynephile has an experience of gender dysphoria that is vastly different than that of a fifteen-year old lesbian, and the former’s experience ought not in any way to dictate how we understand or treat the latter.

An identity model creates a false dichotomy between affirmation and bigotry. According to the current narrative, the only supportive response to a teen who has self-identified as transgender is to affirm this identity and begin transition immediately. Any other response is quickly labeled transphobic. In reality, there is a huge range between assisting a child in transitioning immediately and affirming that they are and in fact always have been the opposite sex, and denigrating or shaming them for their desire to transition or coercively trying to get them to conform to rigid gender expectations. Parents can communicate their unconditional love and support. Parents can offer solace and warmth as the child struggles with distressing feelings. Parents can seek legitimate psychotherapeutic help to offer space for the young person to explore and understand the desire to transition. Teenagers often develop strong beliefs about what they must do or have, and it is well known that these beliefs and demands are not always sound or rational. Never before have parents of teens been told that they have to accede to the demands of their teenager or risk doing irreparable harm. Parents of teens have always had to step in and set loving limits on behavior that may not be in the young person’s long-term best interest. When dealing with a child who has diagnosed themselves as transgender, parents can do what parents of teenagers always do – set sensible limits and help a child to reflect on the potential consequences of his or her actions. Parents can assure the child of their ongoing love and acceptance if he or she does eventually decide, as a full-fledged adult, to transition.

An identity model offers an inferior kind of therapy to those who identify as transgender. As the blogger Third Way Trans has pointed out, “if someone is a member of a dominant class they receive regular psychotherapy but if they aren’t they receive a special kind of social justice therapy.” Those who come into treatment with gender dysphoria are not given the opportunity to explore deeply their experience, but instead have their self-diagnoses affirmed. There are people who will need to live as the opposite sex in order to have the happiest, fullest life possible. These individuals may need to consider taking hormones or having surgery. Surely these people deserve to have a place to explore these consequential decisions without prejudice in favor of a specific outcome so that a process of careful discernment can take place. If therapists are only cheerleaders for transition, how can someone in this situation get help to make the best decision?

I believe we should offer clients with gender dysphoria high quality mental health therapy. In a guest post on this blog, a woman who considered transitioning several times during her life shared a moment from her own therapy that proved important to her.

“When I started therapy in my early twenties, I revealed to my therapist that I had been raped at 18. It had been four years and I had never told anyone. In the process of uncovering that rape and telling her about it, I stated, during a session, that I wanted to become a man. She nodded, she said she understood, and that it was something we could explore, but in the meantime, we really needed to talk about the rape. I appreciated her approach. She wasn’t directive, judgmental, or reactive, she simply stated it was something to keep talking about, but encouraged me to focus on my experience of being raped and other traumas.”

In providing high quality mental health therapy to all patients, we would communicate unconditional positive regard to our gender dysphoric patients, just as we would with anyone else, and as the therapist in this blog post did. We would greet their announcement that they feel as though they may need to transition with acceptance and curiosity, communicating that we are willing to go there with them, to explore this desire in all of its intricacy, without prematurely coming to a fixed notion of what is right for our patient. We would see the person in front of us in all of their miraculous complexity, and not just as a “gender identity.”

As therapists, we have been trained in assessment. We have been trained to wonder about layers of meaning that may not be visible at first glance. We have been trained in how to recognize and work with trauma. We have been trained to help out clients explore their labyrinthine inner lives. When clients come to me wondering whether to end a relationship with a boyfriend or change careers, we typically spend months considering all of the different facets of such a decision. Don’t we owe at least as considered a process to someone contemplating making permanent changes to his or her body, especially when that person is a teen or young adult?

92 thoughts on “Layers of meaning: A Jungian analyst questions the identity model for trans-identified youth

  1. This is just beautiful:
    In providing high quality mental health therapy to all patients, we would communicate unconditional positive regard to our gender dysphoric patients, just as we would with anyone else, and as the therapist in this blog post did. We would greet their announcement that they feel as though they may need to transition with acceptance and curiosity, communicating that we are willing to go there with them, to explore this desire in all of its intricacy, without prematurely coming to a fixed notion of what is right for our patient. We would see the person in front of us in all of their miraculous complexity, and not just as a “gender identity.”
    Thank you so much for this post!

    Liked by 3 people

  2. Thank you very much for this post. I wholeheartedly agree with you that the mental health model is the appropriate approach.

    I wish to comment on this: “Parents can assure the child of their ongoing love and acceptance if he or she does eventually decide, as a full-fledged adult, to transition.”

    I wonder at what age does one become a “full-fledged adult”? legally it is 18.

    My daughter purposely said nothing to me until after her 18th birthday….I had to piece things together to see bits & pieces of how she had confided to others earlier, but only by months, not years. This was a rapid onset decision to transition….to her it became her explanation for why she didn’t feel like a girl, why she felt differently, why her brain worked differently. It became a very impulsive obsession with her. Don’t dare question her decision. Normal teen behavior…perhaps.

    But as I review in my mind her childhood and more recent behavior, I wonder if perhaps she is “on the spectrum” but has remained undiagnosed. Apparently only recently is it being realized how females on the spectrum can remain undiagnosed as children and remain so for years. Some women are being diagnosed in middle age.

    “Autism spectrum problems were very common” was noted in the 2015 study from Finland you mention above.

    I think part of wondering why so many more females are showing up at gender clinics will need to explore how autism, specifically high-functioning autism (fka Aspergers), can be missed in females. We need greater attention to improvement of autism diagnostic tools that include the different ways it can show up in females.

    Perhaps having an autism diagnosis will provide an explanation for these girls as to why they feel differently, and it can provide them with a group of other females who feel and act like they do…without having to transition to avoid dresses and makeup.

    So, in the case of these girls, whatever they decide to do as “full-fledged adults” will still be under a mental health model that provides for an ability to ask why they feel the way they do. Perhaps they are “on the spectrum”….let’s take the time, dear young adult, to learn more about what that means and see if it might help explain – and relieve – the feelings of dysphoria.

    Liked by 4 people

    • Thanks for raising this. To be clear, I do not think that 18 constitutes being a full-fledged adult. I am familiar with detransitioners who transitioned in their late twenties who felt that their transition was poorly considered and very much regret the permanent changes they made to their bodies. At what age is someone capable of making a mature decision about permanent medical intervention? I don’t know what the magic number might be, but it seems as though someone ought to be out in the world working and having relationships for some time before he or she can assess the impact transition might have and whether the changes are worth the losses and risks.

      Liked by 1 person

    • Just before my daughter told us she was “a guy”, like your daughter after she was 18, I had come to the conclusion that she was on the autistic spectrum, which explained some of her anxiety, her non- conformity with typical feminine appearance. I am hoping this is taken into consideration when she is assessed for gender dysphoria.


      • Do not depend on it and do not assume they do not see it as separate issue. These kids lose their humanity in eyes of proponents of Trans cause. ask directly their policy and practice. No therapy better than bad therapy

        Liked by 1 person

      • There’s perhaps work you’ve done here in the therapeutic community, offering an alternative approach to blind acceptance of the desire to transition? There’s obviously a few of us out here who think the same way, and just as as clearly an interest from families. Therapy by Skype could be an option?


    • Can anyone recommend a thorough psychologists in the northern NJ 07421 area. We were seeing one that didn’t even look at anything else but gender identity. I’m looking for someone to look into underlying problems. As I’ve stated before I do believe some people are born inside the wrong body, and usually they show signs of that early on. I also believe that this is a psychological problem in some teenagers. My daughter FTM talks about all the kids in school that think they are transgender and how annoying it is. Right there tells me it seems to be trending for some teens. If anyone can give me any advice it would be greatly appreciated. Thank You


      • I wish I had a name for you, but I don’t. Looking for someone who is a psychoanalyst is not a bad place to start, but you must interview carefully. Older therapists are likely to be more circumspect.


      • Patty,
        NJ bans conversion therapy which makes it difficult to find a therapist to address underlying issues. Would you consider traveling about an hour into NY state? If so I could give you the name of the Psychotherapist my daughter has been seeing.


      • Weathering the storm: I was just looking for clarification on conversion therapy. I too am from NJ, I looked into this and what I read is that the you cannot council someone who is homosexual and try to convert them to heterosexual. Also, it protects children under 18 who feel they are the opposite sex (you can’t provide them therapy so that they change their mind to their biological sex) am I correct? Now, my son is 20 (he has not transitioned) he is not homosexual. He will be going to a therapist next week, that I have chosen (I don’t know how that will go). I do not believe I am asking for conversion therapy, just looking for the therapist to see if there are any underlying issues that need to be addressed. I would appreciate any advice or clarification on the conversion therapy. Thank you.


      • Hi Patty – I just came upon your post from a few months ago. How are things going with your daughter now? If you still haven’t found a mental health professional to work with her, I am accepting new clients online starting mid-January. Feel free to look at my site, read my blog posts, and let me know if you think working together would be a good fit.


  3. This post highlights the “Alice in Wonderland” feeling so many of us get when confronted with Team Trans “in person.” Everything that Ms. Marchiano learned during her professional education and substantial experience is thrown out the window. The therapeutic models and understandings that apply in every other situation for some magical reason don’t apply here. Where once professionals (and parents) could be trusted to develop good judgment and then use it, now the world is turned upside down and none of the old understandings apply. Why? Oops, that’s transphobia!

    So my younger daughter started college this year, and tells me that at least two of her former high school classmates are now sharing dorm rooms with people of the opposite biological sex. On the grounds that said room-mates are trans. What could possibly go wrong?

    In any other time or place, the vast majority of parents would quickly stand up and demand a change, because most parents know from experience that this is a really bad idea. I know I certainly would (still). But again – experience means nothing, up is down, black is white, and reality is what we say it is, nothing more. Yikes.

    Liked by 3 people

  4. So, how to circulate this to every major newspaper in the country and get reporters whose beat is teens, teen phenomena, teen health, high school, etc., to actually cover this? I’m glad we’re all here and we are reading this, but I am so frustrated that it is so incredibly hard to get any mainstream publication to do a serious piece on this and to feature some of these critical points, or to do interviews along these lines. The only pieces that come out that question the ubiquity of the trans narrative about teens and transition are from very conservative outlets such as Breitbart News Agency or The National Review, and this only feeds the contention and subsequent dismissal that anyone who is trying to raise awareness about a social contagion factor to the transtrend, and that this might be seriously and permanently harming some teens, is simply a closed-off and bigoted right-winger. This is not a right/left issue. This is a children’s health issue that crosses all backgrounds and political scales. This blog from Lisa Marchiano makes so many excellent common-sense and insightful points. I’m just worried that a blog that “falls in the woods,” as it were and is only heard by us, misses having the impact in terms of awareness and change that mainstream coverage could catalyze. How many parents and kids out there have drunk the Kool-Aid because there are no other sources of information available to them? For any of us who have friends at various news outlets, please let’s forward this to them. This has got to circulate more widely. Thank you, Lisa for putting this all together so sensibly and with such integrity.

    Liked by 7 people

      • So Important! I’ve been a lefty all my life – and all the members of the family are too. BUt since I’m the only one who questions the trans agenda and the transition of our relative whose story matches the one told in this article – was a happy child doing mostly sex-typical stuff with a few exceptions (never big on jewelry or makeup – but I went without makeup most of my 20s). So now I feel like they think I’ve turned right-wing. They certainly don’t listen to me – even though I have had the medical experience of taking testosterone for a medical problem (which resolved once the reason for my 0 T level was discovered and addressed). The facts that the package insert named potentially irreversible changes (voice, head & body hair, for example) and that one possible side effect, “really really feeling like a guy” was not included are waived off because I was taking T “for a different reason”>


    • I agree. But I do believe that slowly, people may come to their senses. Every time I have a conversation with a thoughtful, logical person, they start to notice the inconsistencies, and sometimes downright dangerous assumptions in transgender ideology. When you critically deconstruct gender, people eventually realize it’s actually far more freeing to question gender itself rather than shuffling people back and forth from one gender to another.

      These teens are also deeply disembodied and require a skilled practitioner to help them work on the dissociation and somatic aspects of dysphoria. It’s sad that therapists are tackling dysphoria with more dismebodying “treatments”


  5. I’m a therapist. The British Association of Counselling and Psychotherapy (BACP), which is the largest UK organisation representing professional counsellors, recently devoted a lot of space in its monthly journal to working with trans clients. None of the writing (including an editorial) challenged, questioned or was even curious as to ~why~ someone might have body dysphoria – as above, it seemed that the only non-bigoted response should be one of unthinking acceptance. There is, understandably, an expectation in the therapy community that counsellors/therapists should be able to accept, welcome and celebrate working with a great diversity of clients. I believe that the fear of being seen ~not~ to be doing this is getting in the way of thinking about how we are working with young people who chose to transition. To be honest, I am, to my regret, far too wary of the potential effect on my professional reputation to openly challenge the journal’s stance. I don’t know where we go from here.

    Liked by 2 people

    • And this is why I am struggling so much with my child. Trying to find a therapist in the UK who is not going to just accept what the child says and push the hormones etc or one that has any clue about what the underlying causes might be seems impossible…. I would be most grateful for one.


      • You could try finding a clinical psychologist (i.e. highly qualified and professionally regulated) who speacialises in adolescent mental health. i.e. who would also be helping children suffering from anorexia and other difficulties. See them by yourself first to check they will explore with your child everything that might be
        going on, and not see the gender difficulties in isolation. Best of luck to you.


      • I would suggest going private, and interview them first. If cost is an issue, many do sliding scales, and/or you can have fortnightly sessions instead of weekly. Take into account that most therapists in the UK (but not all), in order to get work, have no choice but to belong to one of the organisations signed up to this “memorandum of understanding” against conversion therapy, which quite rightly prohibits conversion therapy for LGB but also means that when it comes to gender, only the gender-affirmative approach is allowed. I have heard that Jungian therapists are more likely to see things differently.


  6. A beautiful, well-researched, well-rounded piece, drawing on mature therapeutic experience. This would be a beneficial article for new therapists as part of clinical training. I do disagree about medical transition being desirable for any reason, mainly because this only takes into account individual satisfaction and does not take into account the social harm caused by replacing sex with identity. Readers of gender-critical blogs are only too aware of the immense harm being done to those who are NOT gender dysphoric by the current treatment model. This is another area where gender dysphoria is treated differently. In other diagnoses, we factor social harm into the equation when we explore treatment possibilities.

    Liked by 4 people

  7. Thank you so much for this. It perfectly encapsulated how my husband and I are feeling about our daughter’s out of the blue revelation that she is trans and how we want to approach it in her individual and our family therapy. I sent a link to your blog post to our new family therapist just so she would know what page we were on because I couldn’t have articulated our position in response to this declaration better. We love our child and ultimately she will decide what to do as an adult, but we feel compelled to be honest that while we absolutely believe she is currently experiencing this dysphoria, that our knowledge of her over the past 13+ years tells us that her truth is not that she needs to be a boy to be happy or at peace, but is something deeper that has also caused her to engage in self-harm and eating disordered behavior. And it is because we don’t want to abandon parts of her that transition would try and erase that makes us unready at present to use male pronouns or a male name. Not sure where we will end up on those, currently I am trying to just avoid names and pronouns altogether. Anyway just a big, big thanks for so clearly articulating how I feel. And I for one appreciate the nuance, because I do not think that transition is wrong for all people with gender dysphoria, and I do think that people who are currently or have already transitioned deserve nothing but compassion and support for what is a really difficult thing to do.

    Liked by 3 people

  8. Lisa, you are a brave and compassionate woman. I hope the professional blowback does not become punitive and unsustainable.

    my 18 year old has begun pushing for medical transition. Spouse and I have told her we cannot support it financially. We have told her we will always love her but that the risks are too substantial for us to feel morally OK about doing this on her behalf. Obviously when she is self supporting with her own financial resources, that is different. She is very angry right now. But at least she is allowing me to raise points of thought as rationally as possible. My heart aches for her as she has another psych diagnosis and a difficult early life history. We have told her that she owes it to herself to explore the source of her feelings and possible life trauma responses before making permanent and risky physical choices. We have told her that we will support work with a more general analyst but that the gender clinics only do one thing: facilitate transition

    We live in one of the states that’s passed a conversion therapy law which complicates matters. Can you speak a little more about the Jungian model and whether you think this is a reasonable place to start seeking a therapist who’d be willing to use a general mental health framework vs an identity framework? I am afraid we are not going to be able to find any help along these lines. Even if I do, kid might flat out refuse to go. What she wants is a quick fix along the lines of the fuckyeahFTM video model. I’m afraid my kid is going to be yet another casualty of this insanity, and that any leverage we apply to slow it down is going to do permanent damage to the loving and trusting relationship we have been struggling to build with her over many difficult years.


    • I agree. Lisa is both brave and compassionate, and her post did such a good job of articulating the many reasons to question the standard transgender narrative.

      And my heart goes out to you, Puzzled. I believe you handled your daughter’s request well. You were loving, but you took a principled stand. It’s such a difficult thing to do — to face the anger and disappointment of our children on these issues.

      Right now my 14-year-old is angry and hurt simply because I expressed reservations about her conclusion that she is transgender. “Don’t you believe this is real?” she asked me.

      And just as Losingsleep did with her daughter, I assured her that I know she’s experiencing dysphoria but I’m not convinced that transition is the only or even the best way for managing the dysphoria. I reminded her of some trauma and emotional distress that she experienced shortly before the dysphoria began, and I stressed my belief that she needs to examine those feelings carefully before undertaking transition.

      Unfortunately, she has already socially transitioned at school, and she has just started seeing a gender therapist (at her insistence), so I’m not sure how much leverage I have.

      I did, however, send her Lisa’s blog post, and she said she would read it. We’ll see if she can open her mind to the possibility that there is another way.

      Puzzled and Losingsleep, I wish you both the best as you try to help your kids through this difficult period. Even after losing a beloved mother, father and brother, I never experienced anguish like this until my daughter told me she wanted to be a boy.

      Liked by 1 person

      • BornSkeptical I feel so much for you. It hurts so much to see my daughter feel that I have abandoned and rejected her because I don’t think she is a boy. Especially because she is quite depressed right now and is in a really fragile state emotionally. Like you, I have also experienced a lot of loss in my life, and lost my father when I was about my daughter’s age. That loss sent me into a depressive episode, but I came out of it so much more resilient and with a better understanding that I did in fact want to live and had things to live for. As a result I have these kind of crazy fleeting thoughts lately where I hope that something really bad will happen to me (a cancer diagnosis or a terrible car accident) in the hopes that it will give my child something outside herself to be sad about. I know that makes no sense, but right now the world feels very upside down as my proud feminist ballerina daughter insists that she is a boy.

        Liked by 1 person

      • my sdvice is insist on your right to address her as your daughter, the anger will subside it takes too much energy. There is much of the toddler in this teens and as such giving in to demands does not help them grow to maturity,


    • I am curious about how you far you are going in not providing financial support. My child is still a young teenager so these issues are still years away, but I find myself wondering if I would need to cut her off our medical insurance at 18 and if that would even help. I believe that because our insurance comes from public employment, that it covers medical transition. I just can’t imagine cutting her off like that, especially as she will still be in high school when she turns 18. We could refuse to pay for college, but that also seems hard to imagine putting in practice. Anyway I am asking you because I can imagine that this is really incredibly hard for you and I am wondering what steps you are and are not taking.

      Just fyi, I read our state’s anti-conversion therapy law and I don’t think that anything that was in this post would violate it — the law in CA provides:
      (b) (1) “Sexual orientation change efforts” means any practices by mental health providers that seek to change an individual’s sexual orientation. This includes efforts to change behaviors or gender expressions, or to eliminate or reduce sexual or romantic attractions or feelings toward individuals of the same sex.
      (2) “Sexual orientation change efforts” does not include psychotherapies that: (A) provide acceptance, support, and understanding of clients or the facilitation of clients’ coping, social support, and identity exploration and development, including sexual orientation-neutral interventions to prevent or address unlawful conduct or unsafe sexual practices; and (B) do not seek to change sexual orientation.

      I don’t see how what Lisa describes here is either seeking to change behaviors or gender expression, and it does seem like to it is identity exploration and development:
      “In providing high quality mental health therapy to all patients, we would communicate unconditional positive regard to our gender dysphoric patients, just as we would with anyone else, and as the therapist in this blog post did. We would greet their announcement that they feel as though they may need to transition with acceptance and curiosity, communicating that we are willing to go there with them, to explore this desire in all of its intricacy, without prematurely coming to a fixed notion of what is right for our patient. We would see the person in front of us in all of their miraculous complexity, and not just as a “gender identity.”

      That said, I feel for the mental health professionals who are trying to help my child deal with a litany of issues and who would not want to be subject to a complaint under this statute…But as I said above I sent this to our family therapist hoping that it might help.


      • losingsleep, our insurance does not cover transition services so that’s not a determination I have to make. yet. if the feds keep going the way they are going, i expect it will be illegal for insurers to exclude this pretty soon. on the other hand, it’s expensive and they will press hard for evidence that it’s effective treatment, so maybe a big challenge would be a good thing.

        at this point for us it would be totally out of pocket. testosterone is not expensive but we’d have to pay a gender clinic, which she is demanding. not going there. i will continue to urge more general counseling (and try to find someone. like I said, not too optimistic there.).

        Our kid does not have income of a job so she has no resources besides us. For now. That could change soon. And then …. she is of age, we can’t stop her if she has her own money. Other than threatening to cut off her college money. And i don’t think i could do it as long as she attends classes and maintains her grades and adequate progress. trans or no trans, the kid has to make a living.

        Right now she is very angry, but i’d rather have that than some other reactions she might have. We continue to reach out and assure her of our love and support, even though she denies these things have any value unless we do what she wants right NOW.

        And yeah bornskeptical, it is a whole new level of grief. I think partly because the outside world offers sympathy for death-in-the-family situations but only derision and admonition and scare tactics for parents in this situation. It’s no wonder a lot of us have started to feel we are going crazy. And i have other ill family members in need of support so I’m about to lose it, honestly.

        It’s no wonder parents give in.


    • Hi puzzled. I do think a Jungian analyst would be a fairly safe bet, though nothing can be guaranteed. As with other psychoanalytic schools, the starting point for Jungians is that EVERY presenting issue likely has a symbolic component. You don’t stop at the manifest content that someone brings in. You always assume there is more underneath. “It’s not about what it’s about.” That is a basic premise in all depth schools.

      There are some specific things about a Jungian approach in particular that could be very healing to someone struggling with gender. One hundred years ago, Jung stated that every woman has an inner masculine component, and every man has an inner feminine component. Developing these contrasexual aspects of ourselves are part of living a full life, according to Jung. (Simplifying greatly, here.)

      A Jungian approach concerns itself most of all with meaning, so it is fundamentally optimistic. In contrast, I find transgenderism essentially nihilistic.

      Here is a link to find a Jungian analyst:

      However, it is worth clarifying that no therapist can do anything with someone who doesn’t want to be there, or who hasn’t bought into the process. Many Jungians don’t work with teens. Even if they do, if your teen is bought into this narrative and you expect the therapist to set them straight and change their mind, that almost certainly won’t work. The kid has to want to go, and be open to what they are going to hear.

      I think that removing a child from social media/peers/the internet may be more effective than changing therapists (unless the kid wants to change therapists too). Filling their time with other activities that don’t have anything with trans peers; gently but persistently challenging the incoherent ideas of transgenderism; spending unplugged, fun time together as a family doing anything that has nothing to do with gender. All of these might be helpful in pulling a kid back from the ledge. Of course, it depends on how far down the road a kid is.

      I’m so sorry that I don’t have more promising answers. I hope something I have written helps.


  9. Thank you for your replies, everyone.

    Losingsleep, I too have had desperately sad thoughts–where I’ve halfway hoped for something terrible to happen to me — not so much as a means to the end of getting my daughter to think about something other than gender, but just because I have been so depressed I didn’t want to live anymore. I’m on a new antidepressant now, which is helping me cope better, but it remains hard.

    I spend almost all of my free time now trying to educate myself on this topic. I feel like I’m trying to wrest my child out of the jaws of something awful.

    Punkworked, you make a good point. I think we have to steel ourselves against the anger of our children and go ahead and present the counterarguments they don’t want to hear.

    Liked by 1 person

    • If there were a way to check out of all this without abandoning people who need and rely on me, I would do that. Because I’m sick of this. I don’t see much possibility of good things in the future, and if it’s not going to get better, I would just as soon not be around. But I would never do that to all the people in my life who rely on me. Including the one who currently hates me.

      Lisa, thanks for your comments. My kid is not currently seeing a therapist so it wouldn’t be a matter of changing, but I agree that she would have to be willing. I don’t expect her to be talked out of anything. I only expect her to spend some time exploring the roots of these strong feelings that she has.

      In the past we have done some of the other things you suggest. I think that’s what has helped us keep the peace for as long as we have. But she is away at college, and I no longer have control over her Internet habits or many other things. She has always been a very black-and-white thinker, so the idea that there could be some traumatic root of the things she is feeling is a hard sell with her. She just would prefer to believe that the brain sex theory is the reason she is the way she is.

      I can only continue to try to reach out and love and communicate as clearly as I know how, and try to persuade her to think a little deeper and more long-term.

      Liked by 1 person

      • (((Puzzled)))…

        Many of the other parents here, as well as myself, can feel your pain. The adult child who brought me here is, thank goodness, in a bit of a lull at the moment over the trans issue. I don’t know where she’ll go in the future with it but for now I detect a very small chink of light between the door of her closed mind, and the world where reality resides. One thing that has been tremendously helpful is that she has left behind the bubble of college and the enormous pressure that the trans ideology exerts on those in it. The needs to find a better job and to fully support herself seem to have introduced a certain sanity into the process that wasn’t there before.

        I don’t know how far along in college your daughter might be, where she is, or what her peer group has to say. My hope would be that if you can just eke her through her college years without her deciding (for instance) to amputate her breasts, things still have a chance to turn out okay. You do recognize, which I know contributes to your despair, that you have very little influence over her at this point, other than financial. And I get it that you may not want to withdraw that support, I won’t judge you for that.

        I will also share with you some learning that I have about another adult child of mine, who seems to have gone off track pretty much permanently. That is, at some point, we have to “let go and let God” and “detach with love.” I know that sounds banal but if there really truly is nothing you can do, then you have to concede it and move on to changing the things you can change, namely yourself. It is like, if you keep banging your head against a wall, that will ultimately not affect the wall at all but it will sure do a number on your head! There is a huge amount of grief that any parent (meaning you and me) feels at seeing a child make disastrous, horrible choices, one after the other. It would be so great to think we can love them out of their mistakes but really, not so much.

        Hang in there!


      • I so relate to all the parents here and just want to add my voice to the conversation. Our 15 year old daughter announced to us that she “is” transgender, about 6 weeks ago. I found this website about 4 weeks ago. What a godsend. I’ve spent all my free time reading about transgenderism and have come to the same conclusions as you all. I am experiencing a mix of sadness, anxiety and absolute rage at the current state of the medical community and society at large for the lack of critical thinking that not only is not going on, but is actually TABOO regarding this issue. Let me add, that like most of you here, I’m a liberal-minded person who supports equal rights for all people. Like a previous poster said, I don’t see our point of view ever reaching mainstream thought. It’s too late. The only thing we can do is keep the lines of communication open with our kids, keep our relationships with our kids strong and share what we know with them. We can hold out the hope that our kids will see the truth for themselves. That’s all we can really do.

        And to the author of this post–absolutely brilliantly written. You hit on all the points that need to be discussed in an intelligent, coherent way. Thank you so much.

        P.S. Ha! One more thing I wanted to add– I find it fascinating that SO many of us have daughters who have the same psychological issues:anxiety, depression, cutting, eating disorders, and Asperger’s. My daughter has all of the above, but was never tested or diagnosed with Asperger’s. My husband and I have said for YEARS that we think our daughter either has Asperger’s or at the least some Asperger’s traits. Every time I’ve brought it up to a therapist, I’m told she wouldn’t get a diagnosis because she makes eye contact!

        Liked by 2 people

      • For worriedmom — thanks, just now seeing this. Absolutely true re the acceptance. Once you’ve done everything that can be done, you have to somehow let go and move on. It’s just hard for a parent and … if you knew what we’ve already been through with this kid, way before the gender stuff, since she came into our lives in an already-damaged state? You’d know how hard it is to get out of the mode of trying to remedy these things. We have been fighting for this kid’s mental health for a LOT of years, including times when she was damaging property and trying to hurt us. And it kills me that just as we were emerging from so many years of some of that stuff, which was agonizing in and of itself, and really building a loving and trusting relationship, this notion has to come along and blow it all to smithereens.

        A secondary area of pain is that it’s so fricking socially isolating for a parent who’s “unsupportive” of early transing. I’ve lived in liberal/progressive world all my adult life and I can see the look in many of my friends’ eyes when I try to talk about the situation with them — like I’ve instantly transformed from a good person into an unreasonable “phobe” who’s inevitably going to damage my kid. I can see the criticism there even as they struggle to say something comforting (usually along the lines of “can’t you send her to an LGBTQ support group?”). I had one of them suggest we attend the Gender Spectrum conference. They’re all trying to help, but they have NO idea what’s going on out here. Enough of that and you just stop sharing, and then lie awake at night second (third/fourth/umpteenth) guessing what you’re doing. Maybe there is an inherent biological cause? Maybe we’re all misguided and will deeply regret not getting on board right away? Maybe this really would solve all my kid’s problems? maybe maybe maybe

        Lord. I need Prozac. Or something.


      • puzzled, both of your responses here speak to me and my own situation. My daughter has such severe mental health issues which are only now, after years of trying to help her, and being thwarted because she insists everything revolve around a trans-identity, are being addressed. And the lost time and money and goodwill are taking their toll.

        My kid ISN’T headed for college or a normal life — she’s on a fast-track out of our home because we simply cannot cope with her and help her within our family. She requires specialized treatment from people who are trained to deal with someone with her mental health issues. Trying and absorbing her violence and manipulation for years and then being forced to try and protect her from what I know (transition) which would only magnify her problems? Took any remaining fight out of us.

        It’s a very lonely situation to have a severely mentally ill child. It gets even lonelier when you can’t talk about the complicating factor which stands in the way of getting your kid the help she needs.

        May all of us and our children find some resolution and peace.


      • Katiesan —

        Yes. So hard. I’m sorry to hear your daughter’s still battling all the stuff that is preventing her from clear thinking. Sometimes you just can’t live with a person like that no matter how much you love them. Sending you solidarity. P


  10. Puzzled, Love mydaughter – Same here – surely we can’t all be wrong about our lovely quirky daughters, who think in black and white. I have recently seen a clinical psychologist (to help me work out where to go from here). Her thoughts were that this is about identity, and control, not dysphoria. Try and get her to think about, and concentrate on discussing, her other identities – sports, hobbies, career, study. Try and make sure that her other mental health needs are being treated (although my daughter doesn’t really respond to talking therapies, anti-depressants have worked well though). Make it very clear to her what your boundaries are – in our case that we don’t want her to do anything irreversible until she is 25, at which point we will wholeheartedly support what she needs to do. Our daughter has been seeing a psychiatrist, and even though she is now 18, we wrote to him setting out all of our concerns/thoughts (i.e. absolutely no sign of ever wanting to be a boy before this year) so that they were on her medical record going forward, also made sure there was a record that we thought she had autistic traits. This is in the hope that all this is taken into consideration.

    Btw we were also told our daughter couldn’t have Aspergers as she made eye contact. Have you looked at a blog called “musings of an aspie?”. I tried to get my daughter to have a look and see how similar she is to this – but she declared it irrelevant as she is not a woman 😦

    Liked by 1 person

    • Off on a tangent here, but as a therapist who’s worked with many young women with Aspergers/Aspergers traits, and as the mother of a teenage girls with a diagnosis of Aspergers, the “eye contact” thing drives me crazy! It’s absolute nonsense that it should preclude a diagnosis of Aspergers, ~especially~ for girls. Grrrrrrr. I’m so sorry that you and the commenters above have met with such poorly informed professionals.

      Liked by 2 people

    • Scared Mum, I think you’ve raised an important point – this being about identity and control. For some reason, a lot of today’s youth culture conflates identity and control. But, in reality, most things about our identities are things we cannot control – when we were born (Greatest Generation, Baby Boomer, Baby Buster, Gen X, Gen Y, Millennial) nationality, race, height, and … sex! There’s little of our identities that IS under our control. Even if you get a degree in biology, if no one hires you for a job in that field, people would find it weird if you called yourself a biologist while working in a clothing store (most people would identify you as a clerk)

      Notice how the MTTs always say that giving trans their own toilets, changing rooms, locker rooms, isn’t good enough – not letting them into existing women’s toilets, etc., is “undermining muh identity!!!” (Same when someone isn’t on board with making English less clear with all the made up pronouns or calling individuals “they/them”)

      Most of our “identity” (or “identifying characteristics”) are things that Others See About Us – height, weight, age, race, and … sex. How this meme of “identity” being something each person constructs de novo caught on is baffling to me.

      As for the Aspergers in girls issue – there is debate about whether the symptoms in girls are different from symptoms in boys. Also, Not Ever Aspergers/Autistic Person Has Every Symptom!

      As for eye contact – I have always found eye contact uncomfortable, especially with strangers. During training for a sales job, I learned a trick – look at the tip of the person’s ear. The person will Think you’re giving eye contact. So I would say someone claiming to observe eye contact is not the measure. I would ask the child to discuss eye contact. And maybe you could seek a second opinion about Autism spectrum. There are some good Autism tests on the internet that could be shared with an evaluator.


  11. Excellent article. I am going to veer off topic slightly but only as I don’t know where else to post this #peaktrans experience. At a cafe saw a “mom” arrive for a mommy-and-me play group with a toddler. The mom was roughly 6’2″, mini dress, accessories, long shaved legs.. and a prominent jaw and five o clock shadow. Mom left the tot with the others and went into the bathroom.. to shave. Came back applying aftershave. Then went on chatting. Ok on the one hand, if the other moms accept this person as a fellow mom, and he/she is happy.. what do I care? However I couldn’t help a feeling of sadness that this guy couldn’t just lovingly embrace himself as an “effeminate” man.. why did he have to colonize female physical and social space? And all the good tolerant liberal moms (of which I would count myself) have to accept him as one of them.
    – I’m a parent to young girls at risk of indoctrination (one is gender non-conforming). And relative of FTM teen.


    • Melani, ”However I couldn’t help a feeling of sadness that this guy couldn’t just lovingly embrace himself as an “effeminate” man.. why did he have to colonize female physical and social space? And all the good tolerant liberal moms (of which I would count myself) have to accept him as one of them.”

      Assuming that this man was the biological father of the toddler at the play group, then I doubt that he is an ”effeminate” man. If he is still shaving and hasn’t had laser treatment to his facial hair then it’s probably because he isn’t always presenting to the world as his female alter ego. Why did he shave at the play group and not at home? Maybe ”daddy” became ”mummy” after he had left home? He gets a big thrill out of colonizing female space, by being one of the ”Mums”. It’s a heaven sent opportunity for an autogynephile. He takes the the tolerance of liberal mothers as acceptance, and even worse, he uses his own child to shield himself from negative reactions.

      I may be wrong, but my experience with one of these men leads me to suspect his motives.


    • ..and as of right on cue, today after school one of my daughters comes home w the new vocab word, transgender. Learned from teacher at school.


  12. If there are other therapists reading this and wanting support to question or work outside of the identity model, please be in touch. Contact me privately on Facebook or Twitter, or ask this blog to put you in touch with me via email. There are lots of us out there. Let’s start talking.

    Liked by 1 person

  13. I would like your thoughts on another aspect of the current trans scene that struck me forcibly when I started looking into this–the hate filled and violent rhetoric (mostly from MtF) that fills so many Internet sites and is directed at anyone who dares to raise any kind of questions. It is not always just speech; this also extends to actions as the recent headline “Transgender athlete tries to murder athletic chief” attests to. How does this fit into the view you develop here?


    • I’m speaking for myself here (I’m sure 4thwavenow has her own opinion).

      I am appalled by the pretty much everything the trans activists demand:
      – change our language (not just the ridiculous made up pronouns, but using “they/them”when referring to individuals),
      – act like changing biological sex is possible
      – treat people who are clearly one biological sex like they are the other sex (failure to notice the person wants to be treated as opposite of their biological sex or a slip of the tongue like using the person’s given name – charmingly referred to as “deadnaming” – being met with vitriol and claims that this was an intentional act of “undermining my identity”)
      -actually re-rigidifying sex-associated styles, toy options, and behaviors that our society has spent decades loosening
      – taking as given the claim that every single kid who is “gender nonconforming” is a high risk of suicide if transition is not begun forthwith, and frightening parents in an attempt to extort compliance with the trans agenda
      – turning women’s rest rooms, locker rooms & shelter spaces into free-for-alls (Interestingly, not only do MTTs want to use women’s rooms, but FTTs are in no hurry to use the men’s room)
      – refusing the concept of 3rd option (which negates the “I just need to pee” argument – some even admit that using the women’s room is about their “identity” being validated by the rest of us)
      -accept as given that questioning whether this might not be the right choice for a particular individual is tantamount to pushing every trans person alive towards self-destruction
      – accept as true (despite evidence to the contrary) that being trans puts a person at high risk of being murdered because our society hates these people so very much (while conflating us questioning with us hating)

      But what makes me really question whether society should go along, on top of the demands that we all ignore reality is the vicious way we are treated by trans activists. “You hurt my feelings by X (“misgendering, deadnaming, not using my current favorite made-up pronoun) SO F U!!!” There is a complete lack of a concept of give-and-take, no attempt to help the rest of us understand, only to demand that we act in certain ways, reasons be damned. And our motives are assumed to be hurtful, and no amount of explaining will erase that assumption – explaining or questioning only gets more shouting, cussing and insults.

      Trans activists are basically demanding that we remake our society in a way that aligns with their ideals and a way that does not align with physical reality and they are being absolute bullies about it.

      Liked by 1 person

  14. Pingback: PODCAST: The trouble with transing kids

  15. My beautiful and formerly very feminine daughter decided she was a guy in her mid-twenties. She had been seeing a therapist for various anxiety and other issues. She had a history of cutting and some kind of sexual abuse she would never tell me about. She was making good progress with this therapist, but then got fixated on this trans thing and the her therapist did not give in, she went to find another one who would accept her narrative. I mourn the loss of that treasured relationship. I am miserable and also furious that I am being bullied and required not just to accept this transition, but also to agree that it is true and also agree that it has always been true. I know that this is wrong. I never enforced any kind of gender expression with my kids and my ex-duaghter was more typically feminine than I have ever been. One thing I have noticed it that the most common words transitions use to describe their experience are “fun” and “exciting”. This sounds more like the words used for extreme sports than for relief obtained from treatment of a medical condition.


  16. Thanks so much for this excellent article.

    I would add:

    an identity model leads to silencing and erasing detransitioned women and men. It makes it impossible to talk about people who had gender dysphoria reconciling with their biological identity. Instead they must be confused – either they were never transgender or they are transgender and are just in denial.

    Liked by 3 people

  17. My husband and I were run over by the trans train 5 days ago. We are completely bewildered that our 200lb 6’5″ 17 year old son has self diagnosed himself as really being a girl. Say what?! He is very intelligent, but we have always suspected Aspergers. He never agreed for us to have him tested for this though. There was no indication what so ever that he was anything other than a boy. He never asked for girlie things, never acted girlie, etc. Now he has labeled himself trans on college apps and he goes by a female name at school. We are beside ourselves but willing to fight for our son. Every time I see a pic of him I get weepy but I won’t let society win. We are in the process of contacting a psychologist to get him tested for Aspergers which we now think he will agree to. We are also making an appt with a psychiatrist to address depression, anxiety and ADHD through meds. We think he could also be bipolar. We always knew something wasn’t right but it definitely had nothing to do with being trans. We will get our son back. Thankfully where I live there is not a law yet that makes conversion therapy illegal.


    • I am so sorry to hear that you are going through this. You are right to question fast track transition. You are right to want to address underlying mental health issues first. Please vet any psychologists or psychiatrists very carefully. Many of them have bought into the “born in the wrong body” narrative without giving it much thought. These professionals can do a lot of harm in a short amount of time with an impressionable young person.


    • Rebecca, we are in a similar situation but our daughter is 18, so use the time you have while your son is 17 to get all your concerns on his medical record. Effective treatment for anxiety and depression sounds like the priority. Our daughter we also think has autistic traits but this does mean that she doesn’t really engage with talking therapies welll, and is extremely stubborn, and literal, so having a rational conversation is almost impossible. And right now we are grateful that ADs have addressed her depression and helped with anxiety. I did read that these things can take a long time – months and years – to resolve, so don’t expect miracles. And there are people for whom changing gender is the best way forward, so that is one possible outcome. The psychiatrist my daughter saw advised us to stay neutral but make sure your child knows unequivocally that you love him irrespective of what happens. The psychologist I am seeing (I am still really struggling with this several months on) says to make it very clear to our daughter that no one should make irreversible decisions (on anything) before they are 25, in the hope that this will act as a brake at the back of their mind on any impetuous decisions. Also to try and focus his attention on other identities your son has – as a student, a sportsperson, other hobbies
      etc, It’s a really tough one, wishing you well, -and hoping this insanity somehow comes to an end.


    • I was very surprised, during my tenure as a leader of the national “support” group for parents of LGBT people, exactly how many parents came in with kids “on the spectrum” who wanted to transition. The parents were doubly gutted, because their child was already facing difficulties due to psychological factors, and then layering the “trans thing” on top of it – well I could certainly understand why some parents couldn’t stop crying. One of the things that made me eventually step down from leadership was that I *could not* assure parents that it “would all turn out okay” the same way I could for parents of LGB kids. I know anecdotes don’t = evidence but there did seem to be a significant overlap that should be investigated before we go any further.

      Liked by 1 person

      • Thank you. I was unaware of that. I only just ran across this site. I am so very grateful for it. Everything else just touts trans mania. My son saw his therapist last night. We had been in contact with her about getting my son tested for ASD as well as in to see a psychiatrist about meds. She relayed this info to him as though it was coming from her. She seems to be with us which is so awesome. He is willing to try meds and be tested even though he thinks we are “well meaning intolerant old fools”.


  18. You (The author) live in my area, we have a friend in common that has her LCSW & is in private practice, and I would be very interested in speaking with you about your views. You need to know that:
    *I am trans.
    *I am a social worker.
    *I believe some people ARE born in the wrong body; I was one.
    *I’ve had years of therapy and did my homework to make sure I was indeed transgender. (I am-happily so).
    *I also strongly believe that I am on the autism spectrum, though never formally diagnosed.
    *I believe that the ‘Informed Consent’ and WPATH ‘Standards of Care’ models are both faulty.
    *I interned at an ‘Informed Consent’ clinic and was shut down the three times I raised concerns to my supervisor about the person I conducted a trans intake on; two still haunt me years later.
    *I believe no one under the age of 25 should be allowed to medically transition, and only with the blessing of a COMPETENT therapist that has been seeing them for a minimum of one year; this needs to be on a case by case basis though because no two people are the same (i.e. Did their research vs did none, age, education level, hx of trauma, etc.)

    Liked by 1 person

  19. Hi A Noun. I very much look forward to being in touch. While I don’t believe that anyone is literally “born in the wrong body,” I do believe that, for a small number of people, transition may be necessary to live one’s best life. I don’t think we really understand why yet. Otherwise, I imagine we are on the same page.


  20. As a Jungian Analyst who is also trained in WPATH standards of care I find this to be full if misleading information born out on ignorance as well as trans phobia. My hope for anyone who is looking for gender affirming Jungian Analysts to not let this post lead you to believe that all analysts share the same view. I find this sort of information contributes to shaming.

    My hope for you and others on this thread is that you go back and really study thiis,


    • Hi Dr. Loomis. As a colleague, I would enthusiastically look forward to engaging with you on this topic. Even if we don’t agree, I imagine there is room for a fruitful discussion. There is much in Jungian thought that would allow us to relate to gender dysphoria creatively.

      Given this, I am disappointed that you expressed your disagreement with me by utilizing the standard tactics of the transgender activists — you stood back and accused me of transphobia. I find that this is usually intended to be a silencing tactic rather than an opening to dialogue. Exactly what was transphobic about what I wrote? Where did I say anything hateful or intolerant? You mention also that my “information contributes to shaming.” In what way? Did I not make a plea that we expand how we think about gender dysphoria to be more encompassing and accepting of a wider range of possibilities around how we understand this? Rather than being shaming, I am advocating for us being more accepting, would you not agree?

      You suggested that I “need to really study this.” Well, I have. The piece shared here was written only after speaking with and reading the writings of detransitioners, trans people, and the leading researchers in this field. I have read every major research article I could get my hands on, and many of them are linked above. There is no scientific basis for innate gender identity. There is no evidence that transition reduces suicidality. If you think you have evidence that supports either of those assertions, please share it here.

      You accuse me of being ignorant, phobic, and poorly informed, yet you offer no cogent argument against any of the points that I have raised. While my piece is ladened with links to articles and research, you offer nothing of the kind, but dismiss what I am saying with the thought-stopping platitude “transphobic.”

      Finally, Dr. Loomis, I need to say that I have in my hand as I am writing this the 2016 members list of the International Association of Analytical Psychology. This is a complete list of each and every certified Jungian Analyst in the world, and I cannot find you on that list. It is a serious matter to misrepresent your professional qualifications. I hope I have merely misunderstood your claim somehow.

      Liked by 2 people

    • T. Loomis, it is blatantly obvious that the author needs (a Lot) more exposure to trans-identified folks, as well as a thorough and honest look at her ignorance. I don’t know that she is trans-phobic as much as she is just grossly misinformed, ignorant, and reaching for answers for the very small number of trans-folks who decide, for whatever reasons, to transition back.
      It also would have been helpful if the author had shared how many trans-folks she has had exposure to. Never having heard of her until this article, and knowing everyone’s name who regularly works with my community in this area, my guess would be very few.

      To the author: Your opinion that people are not born in the wrong body is dangerous.
      My advice to you… attend trans conferences for a MINIMUM of five years, interact with (many) trans folks, research scholarly articles, especially those written by trans-folks, contact health clinics across the country that work with trans folks, attend WPATH conferences, connect with your peers who are in the trenches working with trans folks… in other words, do your homework and THEN form an opinion. Please.


      • How about this? People inside the echo chamber (that would be you) ought to realize not everyone agrees with you. People who doubted lobotomies were in the minority in their time. Were they wrong?

        This blog was deliberately established as a place for people who wanted to think outside the box–i.e. the echo chamber you’re peddling here. How about you do some serious homework on exactly why 4thWaveNow came to be–especially considering we are largely a group of left-leaning, LGB-positive parents and friends who watched our happy kids morph into miserable trans-identified teens in a context of massive social contagion.

        If you really cared as much about ALL kids as much as you claim, you’d welcome a few therapists, like Lisa Marchiano, who aren’t just drinking the Kool-Aid; who are using their clinical judgment to consider alternative treatments.

        You said: “To the author: Your opinion that people are not born in the wrong body is dangerous.”

        This pretty much sums up the activist stance: Questioning an IDEA–because that’s all it is, an idea–is “dangerous.” Prove that there is any actual evidence for “born in the wrong body”–historically or medically. Do people wish they could be the opposite sex? Of course. Are there people who believe they ARE the opposite sex? Yes. But beliefs and wishes don’t constitute an actual reality that the only thing “right” in the body-mind is those beliefs and wishes. A Jungian therapist is in a good position to question such notions and even help a young person choose a course that doesn’t involve scalpels, injections, and intense hatred of the body.

        Here’s a thought. Spend some time reading the writings of detransitioned people and others who have desisted from a trans identity. There are several linked in the blog roll on the home page of this blog.

        Liked by 2 people

  21. That’s a pretty amazing comment there, RIP Robert. I, too, am a professional (not in the psychiatric field, however) and when my colleagues and I disagree about a professional question, the automatic response isn’t “educate yourself until you come to my way of thinking.” My response to a point of disagreement is typically something like, “why do you believe this?” and “what evidence backs up your approach” and “have you considered factors X, Y and Z” … rather than telling someone who disagrees with me that s/he is “grossly misinformed” and “ignorant” just because s/he disagrees with me.

    At the very least, I’d point out where I thought the other person was incorrect. Using specifics. Illuminating the points at to which I though the other person was ill-informed.

    Otherwise, you know, it’s all sound and light. There’s no basis for discussion or working it out, it’s just name-calling: “you’re wrong because I say you are.” Doesn’t do much for the rest of us, to be honest.

    Liked by 1 person

  22. Let’s see if the author approves this reply since she didn’t my last one.
    To 4thwavenow:
    1. Don’t assume you know anything about me.
    2. I dislike kids, so I don’t care about ANY of them; what I care about are blatantly ignorant people with privilege and power pushing Their bigotry onto others and professing to know what’s good for someone else.
    3. What happened to people having agency over their own lives?? Oh that’s right, children are considered property.
    4. Aren’t parents supposed to love their child unconditionally? Or is it unconditional as long as they agree with their parents views and values?
    5. We all self-identify as many things, (blog owner for instance), so what is the harm in allowing a child to say he’s a boy or a girl, and supporting them whether you agree or not?
    6. Which came first, dysphoria or mental health issues, and what if they feed off of each other?
    6b. What if the mental health issue has nothing to do with the dysphoria? Hmm.
    7. If a child does not get at home what he or she needs to thrive, he or she Will look for it elsewhere.
    8. The author of this particular post has some good points, and I agree with her on a few things. She and I will disagree on other things and that is ok.
    9. Some of the comments made me physically ill. I truly hope y’all find some empathy for those who are different than you. The world would be a boring place if we all thought the same.
    10. It’s easy to hide behind your computer while making judgments and lashing out; I suggest you pause and count to ten before you hit Send next time.


    • Please read the description under the “About” section. This blog exists as a forum for an alternative view and approach to pediatric gender dysphoria. The fact that you “dislike children” and that you call a reasoned response to your comment “lashing out” tells us this is probably not the forum for you. Agreeing to disagree is fine. Calling the well informed participants here “ignorant” or “bigoted” is not. Your enumerated comments and questions also lead us to ask you to read the hundreds of pages on this blog, which contain links to research as well as personal accounts, before you consider submitting another comment. We are not required to publish any particular comments. Publishing this second one of yours was a courtesy that may or may not be offered again.

      Liked by 1 person

    • Here are my responses to your points, in case anyone wants to read them:
      1) I don’t know anything about you. Don’t assume you know anything about my child. Believe it or not, I know her better than strangers on the Internet, her teachers, her friends, and her doctors.
      2) You don’t like kids or care about what is best for them. That’s fine. Please don’t profess to know what is best for my child. Believe me, parents like me who dare to question the trans agenda have no power. We have to fight tooth and nail to prevent the medical industry from drugging the hell out of our kids.
      3) Why do you care? You don’t like kids, right? I’m sure your parents let you do exactly what you wanted when you wanted, even when it could cause you great physical harm. I don’t buy booze and drugs for my teen even though she might want them, because I’m her parent and I’m supposed to look out for her.
      4) See my response to #3. Loving unconditionally has nothing to do with allowing kids to become lifelong medical patients. It’s not about agreeing or disagreeing with lifestyle choices. It is about causing irreparable physical damage to her healthy body.
      5) The harm is in becoming a lifelong medical patient, destroying the endocrine system, having major surgeries that are totally unnecessary for a healthy body.
      6) They may feed off of each other. It can be difficult to determine which came first. Why is it a problem to try to unravel ALL issues before medical transition? Wouldn’t a good treatment plan for all of the issues pre-transition only help the person, whether they transition or not?
      7) I agree. One of the things that children/teens DON’T need is parents who let them do whatever they want and give in to every demand the child has. Children need to feel protected by their parents. I know plenty of kids who get into trouble with the law, use drugs, skip school, etc because their parents have no rules. No matter what my child decides to do regarding transition as an adult, I will pick up the phone when she calls and I will come running when she needs me.
      8) I don’t think any of us here expect total agreement on all points. I think our hope is for an understanding that each child/teen is different, and each should get the treatment that is best for them.
      9) This has nothing to do with having empathy for those who are different from me. It makes me physically ill thinking about my daughter becoming a lifelong medical patient. I imagine it is similar to what parents of chronically ill children go through in some ways. I know that the worry over my child’s long term health has taken a physical toll on me. I have the medical bills to prove it.
      10) I could say the same for you. Call it lashing out or whatever you want, I will do whatever it takes to protect my kid from people who want to destroy her life.


  23. Probably not worth the time to engage (too much) but this second response is just so… oh… whimsical!

    Point 1 – fair enough. Over the internet nobody can really know anything about anybody, though.
    Point 2 – gosh, that’s interesting. Doesn’t like children so doesn’t care about them. Except….
    Point 3 – in view of Point 2, why care whether or not children are given agency?
    Point 4 – in view of Point 2, why care whether or not parents love their children unconditionally?
    Point 5 – if “we all self-identify as many things,” what makes sex special?
    Point 6 – if the implication is, the dysphoria caused the mental health issue, then say so. I’m not aware that’s backed up by any research or sound psychiatric logic, though. I also don’t see anything in this question that would justify not treating mental illness, or chalking up every symptom to dysphoria.
    Point 6b – is that supposed to be telling? Again, I don’t see how that demonstrates that trying to unravel the source of an individual’s distress, prior to buying into a trans “answer,” is a bad thing.
    Point 7 – hopefully not from “helpful adult trans” people, but I guess you never know. Also, see Point 2 (again).
    Point 8 – agreed.
    Point 9 – you might like to read some of the hundreds of posts on this site from parents who love their children deeply and fiercely, and who are frightened and furious at the “transgender lobby” for encouraging their children to do lasting damage to themselves in the name of ideology. Perhaps some empathy might come from the “trans side” as well.
    Point 10 – the dialogue on this site is civil, restrained, and well-informed. We are well aware that we’re swimming against the cultural tide, but we believe our children are worth it.


  24. I don’t know what parts of the country/world y’all are in, but where I live there are two very different mentalities concerning children medically transitioning, and I’m only going to focus on the medical aspect. In the city, professionals are definitely ‘gung-ho’, whereas in the suburbs they seem to be more cautious–in my experience and a generalization. The issue then becomes the consumer (parents) seeking out another professional.
    I wholeheartedly agree that parents need to do what’s best for their child and I honestly commend you on questioning whether lifelong hormone therapy is what’s best. I won’t speak on surgeries because that’s a whole other messy issue.

    As I wrote to someone just yesterday…
    ‘How many more children will want to kill themselves, cut off their penises, mourn the days of being shirtless like other boys because now they’re going through female puberty, feel like a freak of nature, live years and years of a lie because their family and friends are not supportive? How many more are we going to lose because they stood in front of an oncoming train at 17yo and then get the final slap because his parents put his female name and pronouns in his obit? How many before we get it right?’ And…
    ‘I agree about the ethicality about 1-2 visits to a therapist is questionable at best. Like you know, we have no idea about the long term affects of hormone therapy (as one example)… how much of that is our fault as a society, constantly telling girls, through various methods consciously and not, that being female is equal to ‘less than’? Without getting into politics, the pres elect is a prime example of shaming women because they’re women, and god help them if they’re not considered ‘attractive’. Ok so I went into politics a little bit.
    One of the many answerable questions I have is would the suicide ideation, depression, etc. be there if they did NOT transition? It’s like the chicken or the egg question. I’ve met young people who’s depression etc was relieved after medically transitioning and I’ve met some who struggle with it even after and I mean teenagers/young adult.
    Now children…. sigh. I think the trans train is going too far—in SOME instances, and are right on track with others. Again it all comes down to case by case and a wait and see. We have ‘standards of care’ in place for a reason and yet some professionals don’t follow them as (I think) they should.
    I met with one teenager who was completely ignorant, had done no research except watching YouTube videos with his mother. THEY decided the teen was trans; mom paid for the teen’s top surgery and was going to remortgage the home to pay for phallo. I felt sick. I could do or say nothing because I was at an ‘informed consent’ agency. I wanted to scream for the teen and the mother to get into family therapy immediately. I said as much to my supervisor who shut me down and called me a gatekeeper as if it were a bad thing.

    So no, I don’t like kids, but I care that they be allowed to express themselves (NON-medically), IF in fact they’re trans. I am a HUGE advocate for living as the assigned sex before medically transitioning for many reasons.

    The internet is a blessing and a curse; (I grew up without it.). It helps us to find others who are like us, but it also can influence us negatively too, especially when we’re trying to find how we fit.

    I see your side and I see the other side too. I am so tired of hearing about yet another suicide of a trans teen, or a trans person because the parents disowned them, the family disowned them and they were thrown out like yesterday’s trash. I also can’t imagine what it’s like to be a full-time parent.

    Now some of the comments are not civil (pronoun rant for instance), but the majority of them are written out of true concern and I get that. What is the harm in using male pronouns for your *daughter while *he tries on this hat? It doesn’t harm anyone and it shows support. Is it really any more crazy than any other phase a child goes through? (Not being sarcastic here.)

    My childhood is not open for discussion unless you want to talk about being repeatedly sexually, physically, and emotionally molested, then put into foster care where all of that continued. Am I trans because of that? Nope; I was trans before that and I am still trans after that.

    Words hurt. How we say words matter. I was triggered by some of the things written; I apologize for that.
    Again, I see both sides and I cannot tell you how frustrating it is because I am reminded on a daily basis just how short and fragile life is. I work in hospice and I often wonder how much we worry about will matter in the end.

    By the way, Robert Eads died because the medical professonals in his southern community refused to treat his curable cancer out of prejudice. A documentary titled ‘Southern Comfort’ shows the last days of his life.
    The medical profession can, and does, refuse to treat trans folks. I have a DNR/DNI/DNH in place because of that.

    I don’t care if you don’t publish this, blog owner; this was written to you. (From my echo chamber)


  25. Lisa, hi, a client of mine asked me to reach out to you. She spoke with you. I left you a private message on your Facebook page. Thanks for all that you do. Dwan Reed, LCSW, PhD candidate


  26. Hello Lisa,

    Thank you for sharing this piece! First for context; I’m a transwoman who now believes that I made an incalculable mistake in transitioning and, as such, I applaud your honest appraisal of the situation.

    My story is as such: at about the age of 5 I was distraught to learn I wouldn’t turn into a girl, at 8 I was doing my best to harm my genitals so I could never reproduce and at 10 I was deeply saddened that my body was not going through female puberty. At 19 I came out as gay, 20 I began crossdressing. This fits the classic transsexual narrative to be sure, and as such it was very easy for me to find a therapist and psychologist who consented to hormones and three months later bottom surgery. I was 22 years old.

    To be fair transitioning opened up parts of my self which had remained obscure. For the first time in my life I felt comfortable in my body, I was indescribably happy for the first 6 months or so and my life had a charmed and meaningful feeling. I became spiritual, interested in the occult and began to apply myself with discipline to life in ways that yielded, and still yield, good results

    Seven years later I question my choices. I come from an irreligious, liberal background. Third wave feminism was a part of my elementary school education. Upon reflection it is apparent that a huge part of my inculcation revolved around postmodernist and marxist assumptions. Namely, that categories and narratives are relative and thus stripped of numinous meaning and that being male made me complicit in the class guilt of maleness. As I’ve meditated on this understanding for many years it has become clear to me that my desire to transition was most probably caused by enormous guilt for my “privilege”. Trans was, at least in my case, something of a release valve for the intolerable pressures of social justice levelled against a young white male. It allowed me to use post modernist logic to absolve myself of this horrible guilt, the fundamentally marxist class guilt which was present from elementary school on up.. Transitioning provided an easier way out than challenging the tenets of the post modern marxism that has infected the political left in the United States. I thank the grace of God that even after transitioning I have the integrity to question these institutions.

    To acknowledge now, much older psychologically, that I’ve mutilated my body as a form of capitulation to a repugnant and hateful ideology fills me with a sense of sickness in the pit of my belly. Of course I wouldn’t make the same choices now. And I don’t have a coherent way of understanding my sexed self. Legally I’m a woman. Physically I’m a eunuch. It feels like defeat to, now after my prior choices, claim maleness. This is a spiritually degrading predicament. The most succinct way I can phrase this is that I have betrayed myself; the younger, reckless, impulsive, radical, and unreflective me betrayed the older more reflective and conservative person I have become. I’m not sure how to calculate the enormity of this loss to my present self.

    So again thank you for writing this piece! It takes bravery to stand up to the social justice warrior narrative and even more so to present your perspective in such a nuanced, compassionate and open hearted way.

    Liked by 3 people

    • Wow, coyote girl. Thank you for sharing your experience. That took a lot of guts. I hope typing that out helps you to heal in some small way. I think that with the significant increase in the number of children and young adults transitioning we will see more and more adults in your position.
      If you haven’t already, I suggest you check out the thirdwaytrans blog. TWT has put together a group for detransitioned males. You might find some support from people with similar experiences there.

      Liked by 2 people

    • Coyote Girl, thank you for your kind comment on my post, and for sharing your story with such honesty and vulnerability. It is indeed a sickening feeling to realize we have betrayed ourselves, and the cost of your betrayal is significant. Betraying ourselves and then learning to come to terms with and make meaning of our self-betrayals is a part of the human condition, however. I remember Jungian analyst Jim Hollis saying, “We all kill our children every day,” by which he meant that we all betray ourselves. It sounds as though you are in the belly of the beast now. Real suffering. From the way you are engaging your suffering, I believe you are on the road to making meaning of it.

      I would be very happy to speak with you. I hope you will get in touch. You can email me at

      Liked by 2 people

    • Dear Coyote —

      Sending you peace, light, and strength. New life emerges from dark places. You will find the story that ultimately makes sense to you, in time — whether this is re-identification as a guy or something less binary (but not “woman”). Processing what is past is the first step in imagining a future. (Easy to say, but … yeah.)

      I’d second TheMom’s recommendation of TWT and also the blog. Joel, who writes it, is formerly female-identified and now working toward a social work degree and is active in advocating better treatment of people who are moving away from trans identification — from medical issues to psycho/spiritual ones. He is a compassionate person to correspond with.

      Nat at also does very interesting work writing about issues similar to those that you are grappling with.

      Thank you for bringing us your thoughts and perspective.

      Liked by 2 people

  27. Pingback: Lisa Marchiano on the trouble with transing kids

  28. I need help locating a psychologist who will not jump to my daughter transitioning to be happy. I wrote a long comment describing my situation and lost it when I had to log in to the site. The condensed version is she’s been in therapy for what we thought was for anxiety and an eating disorder for 18 months but for 13 or 14 of those months it’s been about her self diagnosis of gender dysphoria. We didn’t hear about it till a month ago. My child’s behaviors before and still are a contradiction to what I’ve read about these kids who feel this way, but she insists this is how she feels. She’s been referred to by her male chosen name and male pronouns in therapy and at school within a small group of friends within the Gay Straight Alliance that she’s a part of and her school councilor (who is the adult leader of the GSA). If anyone can help me with any info or recommendations I’d greatly appreciate it. Her current therapist is just accepting and giving her homework to find male centric activities that she finds appealing. We’re in the Tampa to Orlando area of Florida. I’m feeling very helpless and betrayed by a system meant to help my child but seems to making things worse.


  29. Pingback: Barbara Kay: Parents face scorn for worrying about letting their children change genders | National Post

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