Gender dysphoria and gifted children

by Lisa Marchiano

Lisa Marchiano, LCSW, is a psychotherapist and certified Jungian analyst. She blogs on parenting at Big Picture Parenting, and on Jungian topics at You can also find her at PSYCHED Magazine and @LisaMarchiano on Twitter. Lisa has contributed previously to 4thWaveNow (see “The Stories We Tell,”  “Layers of Meaning” and “Suicidality in trans-identified youth”).

Lisa is available to interact in the comments section of this post.

Rates of gender dysphoria in children and young people have increased dramatically in a short period of time. There is some evidence that significant numbers of those who experience dysphoria are gifted.

Since 2016, I have been consulting with families with teens or young adults who identify as transgender. Nearly all of these parents report that their child is bright or advanced, and a significant majority have shared that their transgender-identifying child was formally assessed as gifted. Four of these families report children who tested in the profoundly gifted range (verbal and/or full scale scores >150).

An investigator who presented as-yet unpublished research at the Society for Adolescent Health and Medicine conference this year described a population of adolescents and young adults presenting with a rapid onset of gender dysphoria (an abrupt onset of symptoms with no history of childhood gender dysphoria). Of the described population of 221 AYAs, nearly half (49.5%) had been formally diagnosed as academically gifted, 4.5% had a learning disability, 9.6% were both gifted and learning disabled, and 36.2% were neither.

This is a curious correlation. Could it be that gifted young people are more likely to experience dysphoria? Or is it rather that parents of gifted children are more likely to seek out my services or respond to surveys? My best guess is that it may be a little of both.


Possible Reasons for Increased Incidence of Gender Dysphoria Among the Gifted

  • Correlation with Autism Spectrum Disorders

Among those with Asperger’s, there is a higher proportion of giftedness than in the general population, and there are many overlapping traits between Asperger’s individuals and gifted individuals. This is especially true for the exceptionally or profoundly gifted. It has been suggested that as many as 7% of people with Asperger’s syndrome are gifted, compared with 2% of the general population who are gifted.

Those working with gender dysphoric youth have remarked on the significant proportion of those seeking treatment who carry a diagnosis of ASD. A 2010 Dutch study found that the incidence of ASD among children referred to a gender identity clinic was ten times higher than in the general population. At the UK’s only gender identity clinic for children, a full 50% of the children referred are on the autism spectrum.

A 2017 survey of 211 detransitioned women found that 15% were on the autism spectrum. This is 29 times higher than the rate of autism among females in the general population. Many of the survey responders felt that their autism contributed to their belief that they were transgender. For example:

I would absolutely not be trans if it were not for my autism spectrum features, which caused me to be grouped with boys in my youth because I was a “little professor” who lacked the ability to perform socially and emotionally in the way girls are supposed to.


I think autism had something to do with my childhood difficulties relating to other girls and understanding/performing femininity. Traits like difficulty socialising, extreme focus on very specific interests etc seemed more acceptable once I framed myself as a boy.

  • Gender Atypical Preferences Among the Gifted

Research has shown that gifted children are more likely to exhibit gender atypical preferences. Gifted boys and girls may have wide and varying interests that do not conform to gender stereotypes. It is this author’s observation that most teens who self-diagnose as transgender do so on the basis of gender stereotypes. Liking video games rather than nail polish is interpreted as evidence that one is a boy, and so on.

  • Awareness of Difference; Bullying

Gifted children often have particular social needs and struggles. Even at a young age, gifted kids can have a sense of being different from everyone else without understanding the reasons for this difference. Feelings of isolation and loneliness can result. These feelings can be especially intense for profoundly gifted kids, or for kids who are both gifted and learning disabled (twice-exceptional). Because the experience of the gifted child can be so qualitatively different from those of his or her peers, gifted children may struggle with social isolation.

It seems plausible that some of the gifted transgender-identifying teens whose parents I have consulted with have come to understand themselves as trans, in part, as a way of explaining their pervasive sense of difference. “I was never like the other kids. I always knew I was different, I just didn’t know why.”

Being different can also bring with it negative social attention, including bullying. The blogger, detransitioner, and PhD psychology student ThirdWayTrans has shared his story on his blog. Diagnosed as profoundly gifted and radically accelerated in certain subjects, ThirdWayTrans found himself to be the victim of violent bullying throughout much of his childhood. He transitioned at 19 and lived as a woman for 20 years before coming to the realization that his gender dysphoria and desire to transition were linked to the traumatic bullying he experienced.

When I was a child I experienced trauma issues with bullying. When I was young I was physically the slowest boy but also very intellectually advanced like a child prodigy. By fourth grade I was going to the high school to take high school math, and on the other hand I was the weakest. So I was singled out for being a kind of super nerd. This didn’t make me popular at all. It made me popular with the adults actually but not my peers. So I suffered a lot of bullying and violence. It peaked in middle school where every day I would have some sort of violence directed at me.

When I was a child I started to have this fantasy of being a girl, because it meant I could be safe and not suffer from this violence due to being at the bottom of the male hierarchy. I could also be more soft. I used to cry a lot and that was also something that was not seen as good for a boy. I could be free of all of that and also still be intellectual because everyone was saying that girls can be smart too.

ThirdWayTrans notes that as an adult, he understood intellectually that it was okay for men to be vulnerable and “feminine,”  but that his internalized child perspective made it feel unsafe for him to let go of his trans identity.

  • Existential Questioning

Questioning one’s gender may go along with a predisposition to question one’s place in the world. Gifted children tend to question traditions critically, and to challenge things that others take for granted. Thinking about one’s identity may come more naturally to gifted kids.

  • Perfectionism and Anxiety

Gifted children may suffer from anxiety and perfectionism. Anxiety disorders were also well-represented among the comorbid issues reported in the detransitioners survey mentioned previously. It has been suggested by some that adopting a transgender identity may in some cases be an anxiety management strategy. I am familiar with one young man with dysphoria who is both gifted and learning disabled. His preoccupation with gender waxes and wanes, but is predictably worse during exam periods, when he tends to fall behind and become overwhelmed. The feelings of dysphoria seem to allow him to distract himself from his feelings of intense anxiety and insecurity, while alleviating some of the academic pressure. When he is suffering from increased distress over gender dysphoria, his teachers and parents are more focused on his mental well-being, and they place fewer demands on him.


Currently there is very little data on long-term outcomes for gender dysphoric youth. To date, there is only one study that examines outcomes for those who pursued medical transition as minors. The study followed 55 individuals who pursued medical transition as minors, and showed that at one year post operation, study subjects evidenced positive outcomes according to several measures of mental health. However, it is important to note that the individuals followed in this study were carefully chosen, screened, and followed according to a strict protocol. All of those in the study had histories of lifelong gender dysphoria. It is a big leap to generalize these findings to teens exhibiting sudden onset gender dysphoria, and who may receive minimal assessment and counseling before starting hormones or undertaking other interventions.

I am aware of young people transitioning whose families report a decrease in symptoms and an improvement in academic and vocational functioning post transition. However, in my experience, this is the exception rather than the rule. Of course, families seeking my assistance are doing so mostly because of poor outcomes, so I hardly see a representative sample. Nevertheless, certain patterns have emerged through my work with parents.

Most parents with whom I have consulted have teenage children with rapid onset gender dysphoria. (In other words, their child did not exhibit any dysphoria until adolescence.) Most parents supported a social transition, allowing their child to change names, pronouns, gender presentation, etc., but drew the line at medical intervention (hormones and surgery) until adulthood. Most of the parents I have worked with noted one or more of the following changes subsequent to their child’s social transition: worsening gender dysphoria as the child became increasingly preoccupied with passing; decreased academic or vocational functioning – declining grades, etc.; increased social isolation as child spent more time on transgender internet sites, or spent time exclusively with transgender friends; worsening overall mental health evidenced by increased anxiety, self-harming behaviors, and/or depression; constriction of interests as the young person ceased to pursue pastimes and activities that had once been important to him or her; and worsening family relationships, including increased tension and anger between parent and child.

I have also known of gifted young people who desisted from a transgender identity. These young people had parents who were loving, engaged, and supportive, but who assisted them in questioning their belief that they were the opposite sex. Though the sample size is small, those who desisted from identifying as trans appeared to benefit from improved family relationships, increased social and academic engagement, and overall better mental health than during the period of transgender identification.


Currently, there is very little research into long-term outcomes for gender dysphoric young people. My observations indicate that a disproportionate number of those families seeking consultation with me have a transgender-identifying teen who is also gifted. There are many possible reasons for this confluence. Assessment and treatment for gender dysphoria in teens should take into account the various motivations that might influence a young person to self-diagnose as transgender. Families should be encouraged to support their child in ways that feel most appropriate to them, taking into account that a one-size-fits-all treatment for gender dysphoria is likely not suitable at this time. Further research is needed into causes and treatments.

Becoming whole: Could integrative medicine heal the mind-body split in gender dysphoria?

by worriedmom

Worried mom lives in the Northeast, and is the mother of several children. She works in the nonprofit area, and is a voracious reader and writer in the area of gender identity politics. She is available to interact in the comments section of this post.

Imagine this world: A child is sad, depressed, and struggling with uncomfortable, odd, or scary feelings about his or her body. Maybe a little socially awkward, maybe a lot. Worried about the fact that his or her interests don’t seem to fit in well with peers’. Maybe being mocked or bullied, because s/he doesn’t “act like” the other kids. Perhaps that child is having trouble making friends, or is even having intrusive thoughts that make it challenging to succeed at school, athletics or social life. Maybe that child has started puberty, and is concerned or ashamed about the physical changes in his or her body, and the way other people are reacting to those changes. The changes might not feel so good, even be quite unwelcome. The child’s body is perfectly healthy; the mind–not so much.

In this world, our child can go someplace where people know that there’s a solid and extensively documented connection between the mind and the body. In this place, treating the child involves taking into account the physical, social, psychological, community, environmental, and spiritual realities of the child’s life. Here:

  • The patient and practitioner are partners in the healing process.
  • All factors that influence health, wellness and disease are taken into consideration, including body, mind, spirit and community.
  • Providers use all healing sciences to facilitate the body’s innate healing response.
  • Effective interventions that are natural and less invasive are used whenever possible.
  • Good medicine is based in good science. It is inquiry-driven and open to new paradigms.
  • Alongside the concept of treatment, the broader concepts of health promotion and the prevention of illness are paramount.
  • The care is personalized to best address the individual’s unique conditions, needs and circumstances. Practitioners of integrative medicine exemplify its principles and commit themselves to self-exploration and self-development.

integrative medicine circle

Our child receives sensitive, understanding care, to help navigate through a hard time in life. His or her feelings are taken seriously (which isn’t always the same thing as literally). S/he will learn techniques such as meditation, guided imagery, and deep breathing to help cope with discomfort. Our child may have the chance to learn yoga, or T’ai Chi, qi gong, healing touch, and other movement therapies such as the Alexander technique. S/he may try out massage, biofeedback, acupuncture, or hypnotherapy. Non-western therapies, such as Chinese medicine or Ayurveda, are a possibility.

The medical care our child receives is coordinated with other therapies to help him or her feel comfortable, accepted, and confident. Perhaps our child will receive social skills training, with peers, or have the chance to interact with a specially-trained service animal. Maybe someone at this special place will work with our child using art therapy, music therapy, dance therapy or even horticultural therapy.

When all is said and done, our child is healed, calm and well, without ever breaking the skin! S/he is prepared to face the challenges of teenage and adult life, understanding that “feelings aren’t facts,” and equipped with techniques, ideas and support to help manage those unpleasant or unhelpful thoughts should they recur.

What is this place you ask? Well, it’s only the hottest trend in medicine these days. Call it integrative medicine, holistic, alternative, or complementary… whatever you call it, this approach to healing has taken the Western medical world by storm. World-renowned treatment centers have formed integrative medicine units – Memorial Sloan-Kettering, the international cancer center, is one of them. The Mayo Clinic is another. Many integrative medicine centers are affiliated with major teaching hospitals or medical schools. Over 40% of U.S. hospitals now offer at least some integrative medicine techniques to their patients.

The foundation of integrative medicine is the recognition that there is a profound, and not yet completely understood, connection between the human mind and the human body. That this connection exists is no longer open to question – otherwise, no drug trial would control for the placebo effect! Beyond this, research has shown that humans can, indeed, use their minds to control or change the way their bodies feel. These techniques provide a powerful way for people to actively participate in their own health care, and to promote recovery and healing for themselves.

not just the disease

While the jury is still out on the efficacy of some “CAM” practices (CAM being the term of art for “complementary and alternative healthcare and medical practices”), what is not in dispute is CAM’s rising popularity and acceptance among the general population. Far from being a “fringe” or counter-culture phenomenon, in certain patient populations, CAM use has been as high as 90%, and has been estimated at 38% for the United States as a whole.

According to the Academy of Integrative Health and Medicine:

HCAHPS (Hospital Consumer Assessment of Healthcare Providers and Systems) scores are higher when patients receive integrative services. In one study, 76.2% of patients who received integrative services for pain in the hospital felt their pain was improved as a result of the integrative therapy. [Source] Health-related quality of life was significantly improved for patients who received integrative care. Treatments were also found to reduce blood pressure, decrease anxiety and pain, and increase patient satisfaction in thoracic surgery patients. Additional studies have corroborated the observation of reduced pain and anxiety in inpatients receiving integrative care.

In addition to its use in fields such as pre- and post-surgical and cancer care, integrative medicine is increasingly used to help patients manage or cope with such chronic medical conditions as diabetes, arthritis, Crohn’s disease (and other IBDs), asthma, allergies, hypertension, headache, insomnia, and back pain, as well as psychiatric maladies such as anxiety, depression, phobias and PTSD.

People who practice in this field do not argue that integrative medicine is the cure for all ills:

Using synthetic drugs and surgery to treat health conditions was known just a few decades ago as, simply, “medicine.” Today, this system is increasingly being termed “conventional medicine.” This is the kind of medicine most Americans still encounter in hospitals and clinics. Often both expensive and invasive, it is also very good at some things; for example, handling emergency conditions such as massive injury or a life-threatening stroke. Dr. [Andrew] Weil is unstinting in his appreciation for conventional medicine’s strengths. “If I were hit by a bus,” he says, “I’d want to be taken immediately to a high-tech emergency room.” Some conventional medicine is scientifically validated, some is not.

A 2010 review of the medical, corporate and payer literature showed that:

to start, immediate and significant health benefits and cost savings could be realized throughout our healthcare system by utilizing three integrative strategies: (1) integrative lifestyle change programs for those with chronic disease, (2) integrative interventions for people experiencing depression, and (3) integrative preventive strategies to support wellness in all populations.

boy trapped in girl bodyWe’ve certainly gone quite a while in this post without mentioning the word “transgender,” but the implications for the application of integrative medicine in this area should be crystal clear. If folks are literally or even metaphysically “born in the wrong body,” or if dysphoria is primarily caused by an incongruence between one’s physical sex and one’s gender (“what’s between the ears doesn’t match what’s between the legs”), then dysphoria would appear to be a mind/body problem of the first order.

In fact, it would seem that the transgender phenomenon is the prototypical example of a mind/body disconnect – because in the case of dysphoria, all involved acknowledge that the body in question is perfectly healthy. Something seems to be amiss in the way that the body and the mind are connected, or in the way the mind thinks of or perceives the body. So, what’s the application of integrative medicine principles to the problem of dysphoria? Wouldn’t it seem like the two are a natural fit, and that dysphoria would be the perfect arena in which to use these techniques, which are now in the medical mainstream?

You would think that, but you would be wrong.

Suppose, as is all too common nowadays, that our child’s feelings of distress and discomfort are interpreted by a parent, pediatrician, teacher, or other well-meaning professional, as the harbinger of an incongruence between the child’s sexed body and his or her brain. Let’s visit a few pediatric gender clinics (there are more than 40 such clinics in the United States alone) and see what’s on offer for our confused and hurting child.

At the Boston Children’s Hospital Gender Management Service clinic (GeMS), one of the oldest pediatric gender clinics in the U.S., the course is clear. The child meets with a clinical social worker whose job it is to “make sure that you fully understand our protocol.” The child is referred to a therapist who will need to work with the child for a minimum of three months (gosh, a whole three months to decide on something that will completely dominate the rest of your life!). Next is an appointment with a GeMS psychologist for a specialized “gender-related consultation” and then… it’s off to the races with the pediatric endocrinologist.

The Seattle Children’s Hospital Gender Clinic provides pubertal blockers, cross-sex hormones and “mental health support and readiness discussion.” The shiny new gender clinic at Yale New Haven Hospital offers “puberty blockers,” “cross-hormone therapies” and “mental health services” focusing on “readiness.” Not to worry, of course, since “male to female” surgery may be obtained for those over 18 through Yale Urology. Here’s another one: the Lurie Children’s Hospital of Chicago Gender Development Services department “provides medical consultation, medical intervention (e.g., cross sex and pubertal delaying hormones) and health research with gender non-conforming youth across the developmental spectrum of pediatrics and adolescence.” Oh, and here’s another one: Cincinnati Children’s Hospital’s Adolescent and Transition Medicine Department (note “Transition” is right there in the title of the department) provides “puberty blockers, gender-affirming hormones, menstrual suppression and referrals for therapy, psychiatry, psychology, pediatric endocrinology, pediatric gynecology, nutrition and other services as needed.” The University of Florida’s Youth Gender Program provides “consultation, psychotherapy, psychiatric medication management and assessment of medical readiness for cross-sex hormone therapy.”

Celeb ftmsA short note on the term “readiness.” It’s interesting and perhaps unintentionally revealing that this word shows up on so many pediatric gender clinics’ websites in connection with gender counseling, rather than other terms that could be used such as “suitability,” or even “screening.” “Readiness” connotes a certain inevitability about the transition process – for instance, an educational psychologist assesses a child’s “readiness” for school. The question is not if a child will go to school, of course, but when.

Although I’ll admit I haven’t reviewed the websites of every single one of the 40 U.S. pediatric gender clinics, so far I haven’t seen any that are incorporating integrative medicine techniques and principles. What seems clear is that pediatric gender clinics do not view their mission, in any sense, to include assisting their patients in resolving dysphoric feelings short of medical intervention, much less engaging in discernment or decision-making as to whether medical transition is appropriate in any given case. In fact, as we know, the primary approach to the treatment of dysphoria in the United States has shifted away from the much-maligned “gatekeeping” of the past, to an “affirmative” model. What this means in practice is that the patient (or the patient’s parents) dictate the terms of engagement; if you’re going to a “transition” clinic, guess what you’re going to get?

And although much lip service is given to the idea that a child is on a “gender journey,” it’s pretty clear from the gender clinics’ websites that this journey has only one expected destination. Most of the gender clinics’ websites contain cheerful, if not glowing, testimonials to the happiness that lies ahead for their successfully transitioned patients (“Never a Prince, Always a Princess” “Becoming Lucy,” and of course, “Born in the Wrong Body”).

The Gender and Sex Development Program, housed at the Lurie Children’s Hospital of Chicago, is especially upbeat about the amazing future in store for their pediatric transition patients, with links to a documentary entitled “Growing Up Trans,” testimonials from grateful parents and thankful teens, and multiple links to news stories with titles like “Trans Teen in Chicago: From Surviving to Thriving,” and “When Boys Wear Dresses: What Does it Mean?” (hint: the correct answer isn’t “nothing”).

gender spectrumIn fairness, it’s possible that the mental health assistance pediatric gender clinics promise their young patients could include helping children and families decide whether medical transition is the optimal outcome. It’s impossible to know whether psychiatric care given by a therapist who is professionally affiliated with a transition clinic would still be unbiased about the subject. But anecdotal evidence certainly suggests that “gender therapists” are personally and professionally invested in the transition narrative to the exclusion of all other therapeutic approaches.

Moreover, one of the primary activist goals of the transgender lobby is insuring that young patients do not have access to integrative medicine, CAMS, or to any other treatment modality, besides “gender affirmation” (i.e. medical transition for all who seek it). “Conversion therapy” bills, which prohibit therapists and other professionals from adopting any other treatment approach for pediatric gender dysphoria other than gender affirmation, have already been passed in seven states and many cities, and federal legislation that arguably would enshrine “gender affirmation” as the sole acceptable treatment has been proposed in the current Congress. (Even legislation which confuses the issue would also confuse would-be caregivers and create a chilling effect.) A new lobbying group, 50 Bills 50 States, has been formed to push for anti-conversion therapy laws to be passed in all states that do not currently have them.

One point on which all sides in this debate can agree is that gender dysphoria represents a radical “disconnect” between the mind and the body. But there is another, fundamental, “disconnect” at work here, too. We know, and have known for millennia, that there are many ways to address mind/body dysfunction that do not entail wholesale alteration of the body, which can succeed in healing and strengthening the mind. Integrative medicine blends the best of these techniques with Western medicine to obtain the healthiest outcome for the patient, yet those involved with pediatric transition appear resolutely blinded–if not hostile–to any potential application in their own field… willfully “disconnected” from current medical thinking and practice.

In fact, if the activists get their way, the “healing place” envisioned for our child at the beginning of this article will not only remain imaginary, but will be outlawed throughout the United States. Parents–indeed, all people who care about children–should be very, very worried.

Adrift on the River Trans

by missingdaughter

missingdaughter is the mother of a daughter who went missing in college; she disappeared into a “safe place.”

 Endless Identities

What happens when there are no limits to how we define ourselves?

What is real? It used to be obvious.

People become lost seeking identities.

Our story: With our own daughter, we witnessed a total erasure of self. Her history, appearance, real concrete facts, our family history–obliterated. Flipping through dark rooms on the internet = gone.

Artificial identities can be created, and they have grown exponentially since the birth of the Internet. Immediate, intimate, brain-searing, stranger-advice and images all become siren calls for the disturbed who are looking for way to channel pain or explain it. But could it be that sometimes the imagery and intimacy of the Internet Siren are the cause of the identity meltdown, the disturbance?

Lila Greenfeld , a professor at Boston University, writes:

As I argue in my recent book Mind, Modernity, Madness, the reason for high concentrations of severe mental illness in the developed West lies in the very nature of Western societies. The “virus” of depression and schizophrenia, including their milder forms, is cultural in origin: the embarrassment of choices that these societies offer in terms of self-definition and personal identity leaves many of their members disoriented and adrift.

The US offers the widest scope for personal self-definition; it also leads the world in judgment-impairing disease. Unless the growing prevalence of serious psychopathology is taken seriously and addressed effectively, it is likely to become the only indicator of American leadership.

It’s not that the delusional didn’t exist before the advent of the Internet. They did. But perhaps the Internet spreads things, like a cold virus wreaking havoc on an airplane.

 Madness and Identities

An article by Carl Elliot, A New Way to Be Mad, tells of an odd disorder– the desire to be an amputee. I found this article (written in 2000) fascinating, because many of the author’s cultural observations, as well as the behaviors described, foretell of the expanding transgender movement we see today.

The phenomenon is not as rare as one might think: healthy people deliberately setting out to rid themselves of one or more of their limbs, with or without a surgeon’s help. Why do pathologies sometimes arise as if from nowhere? Can the mere description of a condition make it contagious?

Language can make a condition contagious. Language can create an identity.

But we shouldn’t be surprised when any of these people, healthy or sick, uses phrases like “becoming myself” and I was incomplete” and “the way I really am” to describe what they feel, because the language of identity and selfhood surrounds us.

The Internet magnifies the language and the message.

On the Internet, you can find a community to which you can listen or reveal yourself, and instant validation for your condition, whatever it may be.

Says one amputee in Elliot’s article, who also turns out to be transsexual.“There was a huge hole to be filled and the Internet began to fill it.”

Fifteen years after Elliot wrote his piece, there are now seemingly infinite descriptions of trans and queer identities on the Internet. Some involve role-playing. There are sexual fetishes and micro-definitions of selfhood. Yes, some are relatively tame, and simply answer queries about awkward adolescent angsts. But the intimate stranger playing the teacher-role will invariably suggest that your child has an alternative identity.

Elliot says in his Atlantic article that “Geek Love” by Katherine Dunn is an influential novel in certain psychopathology communities. Apparently, it is compelling to some to be different, to distinguish oneself from the cookie cutter masses–to be distinct, better?

I started to notice that term, Geek, coming up a lot with my daughter. I suppose it means different things to different people. She seemed to use it to define herself as intellectual—in the way that a genius might not have the best possible social skills. And then the term queer reared its head. Queer as in non-binary, different, none-of-the-above. Looking into it more, I see that the Geek and Queer world collude and collide on the college campus. To take but one of countless examples, is a site and study by a Women’s Studies/LGBT Studies Professor at The University of Maryland. Queer-geek, apparently, is a new definition of selfdom.

We live in an age of micro-identities. Micro-identities will splinter you into a gazillion tiny quarks. Do you want to live in Quarksville?

quark subatomic explosion

Could the rise of transgenderism be a transient mental illness?

Why do certain psychopathologies arise, seemingly out of nowhere, in certain societies and during certain historical periods, and then disappear just as suddenly?

In Mad Travelers/Reflections on the Reality of Transient Mental Illnesses, philosopher and historian of science Ian Hacking discusses the phenomenon of transient mental illnesses and how they arise, limited to a certain time and place, and how they spread in ecological niches.

Niches require vectors, and Hacking emphasizes four that are essential for a transient mental illness to thrive:

1) Medical. The illness should fit into a larger framework of diagnosis, a taxonomy of illness.

2) Cultural polarity The illness should be situated between two elements of contemporary culture, one romantic and the other tending to crime. What counts as crime or virtue is itself a characteristic of the larger society.

3) Observability. The disorder should be visible as a disorder, as suffering, as something to escape.

4) Release. The illness, despite the pain, provides a release that is not available elsewhere in the culture where it thrives.

Hacking writes of “the fugue,” a transient mental illness first named and observed in late 19th century France. It was considered a dissociative disorder, and arose in young men expressly by their excessive/obsessive wandering—and resulted in the loss of self and memory. The first identified patient with this newly-termed illness was named Albert.

Albert and his doctors establish, in a hyperbolic way, the possibility of the fugue as a diagnosis. Everything I am about to describe could be fantasy. Everything could be what in the trade is called “Folie à deux”, half madness, half folly, produced by the interaction of the doctor and the patient.

Hacking writes about how this new diagnosis took flight; a disorder that had barely been described was now considered commonplace. “Mad Travelers” also talks about anorexia as a transient mental illness:

The suffering is manifest, but are we talking about behavior that is produced by stereotypes of female beauty, combined with a way of rebelling against parents, or are we talking about a “real mental disorder”?

Could we not be talking about the epidemic of transgender here?

Changing Souls

In another work, Rewriting the Soul Multiple Personality and The Science of Memory, Ian Hacking writes of semantic contagion:

When we think of an action as of a certain kind, our mind runs to other acts of that kind. Thus, classifying an act in a new way may lead us on to others.

How do we form our identities? Hacking’s observation applies to many ideas and the identities that flower from these ideas. We all know that pornography is widely available on the Internet. I had previously considered pornography as something that some men got hooked on; something that would be natural for a teenage boy to click on. But I think the viewing of pornography is more common in girls than many parents would like to think. There is a realm of queer pornography–queer, as a steppingstone to transgender. The pornography of the dark internet is brain-warping, soul-warping. Call it identity-warping if you’d rather.

One thing that some pornography does is to disseminate new modes of action, new descriptions, verbal or visual.

What we have seen with our daughter seems to be a dissociative disorder—a total disconnection from and loss of self.  Hacking’s books are both about dissociative disorders, or what used to be called hysteria. Can one not think of mass hysteria when we see so many young people declaring themselves “trans”?

When Hacking writes of transient mental illnesses reinforced by the psych community, he includes the epidemics of fugue in 19th century Europe (young men wandering the continent with no memories), as well as the multiple personality disorder explosion in America of the 1970s-1980s.

In the New Yorker issue April 3rd, 2017, Rachel Aviv writes in “The Apathetic” about a mysterious illness affecting refugee children in Sweden. Some of these children whose families were denied asylum have fallen into a coma– a cultural response? a transient mental illness? that expresses their pain. One child, Georgi, describes the experience of being trapped in a glass box—dreamlike—until slowly he realized that the glass wasn’t really there. “The glass wasn’t real. And now—now I understand that it wasn’t real at all. But, at that time, it was very difficult, because every move could kill you, I was living there.”

Transgenderism has found its ecological niche in Western culture, here and now. I first thought of the college campus and high school campus as possible ecological niches, until I realized that the trans condition has metastasized and is now found widely across the Western world. To be clear, Western world means societies that affirm transgenderism, promote it, give it special protected status, and naturally pay for all the treatments to become a different person.

Hacking describes what he terms the “looping effect”: people become aware of how they are being classified, which then results in the person altering their behavior and self-conceptions in response to their classification.

Classifying a phenomenon as a medical condition amplifies and colludes with broader cultural forces to create the condition. Susceptible young people who think they have this “condition of trans” are being fast-forwarded into medical treatment–permanent, harmful, devastating treatments that maim the individual, the family, and the wider society. We now have a transient mental illness mating with a social theory (gender theory was invented in the 1970s as an offshoot of feminist theory) to produce a mutant: a perfectly fine, healthy young man or woman mutilated to resemble the opposite. It is dehumanizing.

Contagious Desire

Ian Hacking uses the term “semantic contagion” to describe the way in which publicly identifying and describing a condition creates the means by which that condition spreads. He says it is possible for people to reinterpret their past in light of a new conceptual category.

Speaking of semantics, my references to transgenderism reflect the “new transgenderism” and not the old. I do not refer to the very young being gender-confused—persistently genderconfused. I refer to a movement that muddles sexuality and gender and opens the gender-revolving door to any who enter, as in, choose thy gender and medicalize it and surgicalize it.

There is much re-writing of history among the young adults proclaiming transgender. Hacking, in Rewriting the Soul, addresses memoro politics:

The doctrine that memory should be thought of as a narrative is an aspect of memoro politics. We constitute our souls by making up our lives, that is, by weaving stories about our past, by what we call memories.

Ask a parent about their daughter who has suddenly announced that she is a “trans man” without any signs of her being gender-atypical and then you discover that many in her friend group are doing the same. Social contagion. Mass hysteria. Memoro Politics. The looping effect is magnified by the identity-seeker.

Warped Adolescence

When we are young, in our formative years, we are heavily influenced and shaped by our environment. Current brain development science tells us we are still in-process until age 26 or so. Our experiences and exposures and perceptions shape our developing character. The young person who gets sucked down the wrong tunnel of the Internet is in danger of derailing from their true selfhood. The notion of gender identity seems based on gender stereotypes. Since when are all men the same and all women the same? Of course, much of gender is based on culture but not all–so what? Duh—girls are not born loving pink.

What about sexuality? Some people are sexually fluid; some are firmly rooted in one camp from an early age. Yes, for some there is a biological, perhaps genetic influence. Others have their sexuality tweaked by obviously, experiences, but in these days much experience is virtual: viewing a screen behind a closed door—extreme stuff that creates identities, names the identities, labels the person. Again, brain-warping, soul-warping, warped.

Science and Progress

If “progressive” ideas have brought us the notion of gender destruction with the ultimate goal of body destruction, no thank you—I’ll take our original form.

Thomas S. Kuhn writes in The Structure of Scientific Revolutions that the scientific community can be guilty of linear thinking.

When a revolution (in science) repudiates a past paradigm, a scientific community simultaneously renounces, as a fit subject for professional scrutiny, most of the books and articles in which that paradigm has been embodied.

Kuhn suggests that scientific education would be better off with the model of the art museum or a library of classics, not the repudiation that can be a drastic distortion of a discipline’s past. Kuhn believed that science didn’t advance in a steady march of incremental progress; scientific insight could happen in great bursts. One interpretation of this is that ideas of years or decades earlier may be valid–or the correct theory. A discovery could burst forward in science, have a breakthrough, and the progress/idea could also rain down as a cloudburst.

It is one thing to be young and experiment with presentation. But when we medicalize and surgicalize a social movement, a transient mental illness, we cause harm to every one of us. As with Georgi, the young Swedish boy in The Apathetic, who felt trapped in a glass box, how do we break the glass and release our children trapped in the transgender glass box?

The Wide, Muddy and Turbulent River Trans

I think of the many streams of young people attracted to transgenderism. I think of a river composed of many tributaries, of a drainage of dendrites: the girl without a strong identity who goes searching, the girl who was a bit tomboyish but still happy being a girl, the teen girl who identified as lesbian until the muddling of sexual identity and gender identity pushed her over the bank, the socially awkward, those identified as being on the autism spectrum, those with serious mental illnesses that alter perception, the self-haters on the gamut spanning cutting, anorexia, transgender,  the boy who identified as gay and then took it a step further, the teens lost on identity-sucking websites, those hooked on pornography of a certain kind, the gamers and cosplayers who forget what is real, all of those young lives, each unique, each precious, all of them young men and women with their entire lives ahead of them sucked down the wide and muddy and turbulent River Trans and out to sea.


When your child re-writes history and does everything, she can to cease to exist, she re-writes your history too. There is the daughter you have known since birth. You know her. Yes, I grant that we can never truly know another. But when your child takes a 180 degree turn from herself, from her family, from all who know and love her, when she hates herself and hates you, it is a death.

We do not exist in a vacuum. We are all connected, a part of our immediate family, extended family, friends, village. When an individual is lost, the entire village will search. If we don’t, we will all become lost. Moral relativism, individual libertarianism, whatever, we say, that’s cool, I’m Ok–You’re OK, whatever you want to do—as though that person exists in a vacuum and has no connections.

When everything is okay, nothing is okay. We all lose.

The below is excerpted from

A Poem Epilogue by James Dickey (1966)

Turning Away

Variations on Estrangement


Something for a long time has gone wrong,

Got in between this you and that other one other

And now here  you must turn away.

Beyond! Beyond! Another life moves

In numbing clarity begins

By looking out the simple-minded window,

The face untimely relieved

Of living the expression of its love.



Shy, sad, adolescent separated—out

with its nerveless vision

Of sorrow, its queen-killing glare:

The gaze stands alone in the meadow

Like a king starting out on a journey

Away from all things that he knows.

It stands there  there


With the ghost’s will to see and not tell

What it sees with its nerveless vision

Of sorrow, its queen-killing glare: