Suicide or transition: The only options for gender dysphoric kids?

by J. Michael Bailey, Ph.D  and Ray Blanchard, Ph.D

This is the first in a series of articles authored by Drs. Bailey and Blanchard. As their time permits, they will be available to interact in the comments section of this post. Please note: As always on 4thWaveNow, if you disagree with the content of this article, your comments will be more likely to be published if they are delivered respectfully. Hateful or trollish comments will be deleted.

Michael Bailey is Professor of Psychology at Northwestern University. His book The Man Who Would Be Queen provides a readable scientific account of two kinds of gender dysphoria among natal males, and is available as a free download here.

Ray Blanchard received his A.B. in psychology from the University of Pennsylvania in 1967 and his Ph.D. from the University of Illinois in 1973. He was the psychologist in the Adult Gender Identity Clinic of Toronto’s Centre for Addiction and Mental Health (CAMH) from 1980–1995 and the Head of CAMH’s Clinical Sexology Services from 1995–2010.

It is increasingly common for gender dysphoric adolescents and mental health professionals to claim that transition is necessary to prevent suicide. The tragic case of Leelah Alcorn is often cited as the rallying cry: “transition or else!” Leelah (originally Joshua) was a gender dysphoric natal male who committed suicide at age 17, blaming her parents for failing to support her gender transition and forcing her into Christian reparative therapy. Subsequently, various “Leelah’s Laws” banning “conversion therapy” for gender dysphoria (among other things) have been passed or are being considered across the United States.

The suicide of one’s child is every parent’s nightmare. Given the choice for our child between gender transition and suicide, we would certainly choose transition. But the best scientific evidence suggests that gender transition is not necessary to prevent suicide.

We provide a more detailed essay below, but here’s the bottom line:

  1. Children (most commonly, adolescents) who threaten to commit suicide rarely do so, although they are more likely to kill themselves than children who do not threaten suicide.
  2. Mental health problems, including suicide, are associated with some forms of gender dysphoria. But suicide is rare even among gender dysphoric persons.
  3. There is no persuasive evidence that gender transition reduces gender dysphoric children’s likelihood of killing themselves.
  4. The idea that mental health problems–including suicidality–are caused by gender dysphoria rather than the other way around (i.e., mental health and personality issues cause a vulnerability to experience gender dysphoria) is currently popular and politically correct. It is, however, unproven and as likely to be false as true.

Suicide vs Suicidality vs Non-suicidal Self-injury

Suicide is a rare event. In the United States in 2014, about 13 out of every 100,000 persons committed suicide. Suicide was most common among middle aged white males, who accounted for about 7 out of 10 known suicides.

It is helpful to distinguish at least four different things: Completed suicide means death by suicide. Suicidality means either thinking about committing suicide or attempting suicide. Non-suicidal self-injury means injuring oneself (most often by cutting one’s skin) without intending to die. Finally, mental illness includes a variety of conditions, from depression to conduct disorder to personality disorders (such as borderline personality disorder) to schizophrenia–some of which are especially strongly associated with completed suicide and suicidality, others of which are more strongly associated with non-suicidal self-injury.

Obviously, completed suicide is what we are most worried about. Because it is so rare, however, and because it is often difficult to know about the dead person’s motivations for suicide, it has been especially difficult to study. There are fewer studies focusing on gender dysphoria and completed suicide than on gender dysphoria and either suicidality or non-suicidal self-injury. Studies of suicidality must rely on self-report (for example, someone must report that they are, or have been, thinking about committing suicide), and this complicates interpretations of results. (Maybe some people, some times, are especially likely to say they have been suicidal, even if they haven’t been.) Also there is more than one kind of gender dysphoria–we think there are three (this is a topic for another day)–and we should not expect risks to be identical for all types.

The Scientific Literature

Our aim here is not to review every available study, but to focus on the best evidence. Larger, more representative studies–and most importantly, studies of completed suicide–are most informative.

Studies of Completed Suicides

 Two large systematic studies of completed suicide and gender dysphoria have been published, one from the Netherlands, the other from Sweden. Notably, both countries are socially liberal, and both studies were conducted fairly recently (1997 and 2011). Both studies focused on patients who had been treated medically at national gender clinics. These patients all either began or completed medical gender transition, and we refer to them as “transsexuals.” (We don’t know how many of the patients there were from each of the three types we believe exist.)

The Dutch study’s suicide data were of male-to-female transsexuals (natal males transitioned to females) treated with cross-sex hormones (and many also with surgery). Of 816 male-to-female transsexuals, 13 (1.6%) completed suicide. This was 9 times higher than expected. Still, suicide was rare in the sample. The Swedish study found an even larger increase in the rate of suicide, 19 times higher among the transsexuals than among a non-transsexual control group. Still, only 10 out of 324 transsexuals (i.e., 3.1% of the group) committed suicide. Again, still rare. Note that both studies were of gender dysphoric persons who transitioned. As such, their results hardly support the curative effects of transition.

The Dutch and Swedish studies were of adults whose gender dysphoria may or may not have begun in childhood. No published study has focused only on childhood onset cases. However, psychologist Kenneth Zucker has tracked the outcome of more than 150 childhood onset cases treated at the Centre for Addiction and Mental Health into adolescence and young adulthood. He has generously shared with us (in a personal communication) his outcome data for suicide. Out of those more than 150 cases followed, only one had committed suicide. Furthermore, Dr. Zucker’s understanding (based on parent report) is that this suicide was not due to gender dysphoria, but rather to an unrelated psychiatric illness. On the one hand, one suicide out of 150 cases is more than we’d expect by chance. On the other hand, it is a rare outcome among gender dysphoric children and adults.

Studies of Suicidality and Non-suicidal Self-injury

People who commit suicide were suicidal before they did so. But most people who are suicidal do not commit suicide. “Suicidal” is necessarily a vague word, encompassing “intends to commit suicide” and “thinks about suicide,” both in a wide range of intensity. Furthermore, most studies would include as “suicidal” someone who falsely reports a past or present intention to commit suicide.

Why would anyone falsely report being suicidal? One reason is to influence the behavior of others. Saying that one is suicidal usually gets attention–sympathy, for example. It can be a way of impressing others with the seriousness of one’s feelings or needs. Although this possibility has not been directly studied, reporting suicidality may sometimes be a strategy for advancing a social cause.

According to data from the Centers for Disease Control (CDC), the rates of intentional but non-fatal self-injury peak during adolescence at about 450 per 100,000 girls and a bit fewer than 250 per 100,000 boys. These rates are much higher than the 13 per 100,000 American completed suicides per year (and remember that suicide is more common among adults than adolescents). So it is reasonable to assume that most adolescent self-injury is not intended to end one’s life. We are not suggesting that parents ignore children’s self-injury. We simply mean that self-injury often has motives besides genuinely suicidal intent.

 Not surprisingly, given the increased rates of suicide among gender dysphoric adults, suicidality (i.e., self-reported suicidal thoughts and past “suicide attempts”) is also higher among the transgendered. One recent survey statistically analyzed by the Williams Institute reported that 41% of transgender adults had ever made a suicide attempt, compared with a rate of 4.6% for controls. This survey recruited respondents using convenience sampling, however, and this may have inflated the rate of suicidal reports. Additionally, the authors of the survey included the following (admirable) disclaimer):

Data from the U.S. population at large, however, show clear demographic differences between suicide attempters and those who die by suicide. While almost 80 percent of all suicide deaths occur among males, about 75 percent of suicide attempts are made by females. Adolescents, who overall have a relatively low suicide rate of about 7 per 100,000 people, account for a substantial proportion of suicide attempts, making perhaps 100 or more attempts for every suicide death. By contrast, the elderly have a much higher suicide rate of about 15 per 100,000, but make only four attempts for every completed suicide. Although making a suicide attempt generally increases the risk of subsequent suicidal behavior, six separate studies that have followed suicide attempters for periods of five to 37 years found death by suicide to occur in 7 to 13 percent of the samples (Tidemalm et al., 2008). We do not know whether these general population patterns hold true for transgender people but in the absence of supporting data, we should be especially careful not to extrapolate findings about suicide attempts among transgender adults to imply conclusions about completed suicide in this population.

That is, importantly, the authors realize that suicidality and completed suicide are very different things, and it is suicidality that they have studied. Completed suicides in their group will be much, much lower.

Increased suicidality for gender dysphoric children was also reported by parents in a recent study by Kenneth Zucker’s research group.

A systematic review of non-suicidal self-injurious behavior in “trans people” found a higher rate, especially for trans men (i.e., natal females who have transitioned to males). The most common method mentioned was self-cutting. (Self-cutting is a common symptom of borderline personality disorder, which is also far more common among non-transgender natal females than among natal males.)

Is Transition the Answer, After All?

In a very recent study psychologist Kristina Olson reported that parents who supported their gender dysphoric children’s social transition rated them just as mentally healthy as their non-gender-dysphoric siblings. Furthermore, parents’ reports suggested that the socially transitioned gender dysphoric children were not less mentally healthy than a random sample would be expected to be.

This research falls far short of negating or explaining the findings we have reviewed above. First, it was relatively small, including only 73 gender dysphoric children. Second, families were recruited via convenience sampling, increasing the likelihood of various selection biases. For example, it is possible that especially mentally healthy families volunteer for this kind of research. Third, the assessment was a brief snapshot; we would expect socially transitioned gender dysphoric children to be faring better at that snapshot compared with children struggling with their gender dysphoria. (There is little doubt that at first, gender dysphoric children are happier if allowed to socially transition.) Young gender dysphoric children do not show that many psychological or behavior problems, aside from their gender issues. The aforementioned study by Kenneth Zucker’s research group showed that mental health problems, including suicidality, increased with age. Perhaps this won’t happen with Olson’s participants, but it’s too soon to know.

Why Is Gender Dysphoria Associated with Mental Problems, Including Suicidality?

 We don’t know.

The current conventional wisdom is that gender dysphoria creates a need for gender transition that, if frustrated, causes all the problems. That is a convenient position for pro-transition clinicians and activists. But they simply don’t know that this is true. Furthermore, both our past experience studying mental illness scientifically and specific findings related to gender dysphoria suggests the conventional wisdom is unlikely to be correct.

As an example, Leelah Alcorn’s suicide (like most suicides) was tragic, but she appears to have had problems that were not obviously caused by her gender dysphoria. She posted as Joshua (her male identity) on Tumblr:

“I’m literally such a bitch. shit happens in my life that isn’t even really that bad and all I do is complain about it to everyone around me and threaten to commit suicide and make them feel sorry for me, then they view me as sub-human and someone they have to take care of like a child. then when they don’t meet my each and every single expectation I lash out at them and make them feel like shit and like they weren’t good enough to take care of me. since I can only find imperfections in myself I try my hardest to find imperfections in everyone around me and use them as a way to one up myself and make others feel bad to make myself look better.”

Sophisticated causal analysis of mental illness and life experiences has invariably shown that things are more complex than previously assumed. For example, although depression is certainly caused by adverse life experiences, those vulnerable to depression have a tendency to generate their own stressful life experiences. So it’s not as simple as depression being caused by life experiences alone. Also, depression has a considerable genetic influence. Similarly, women with borderline personality disorder (BPD) report that they have experienced disproportionate childhood sexual abuse (CSA), and many clinicians and researchers have assumed that CSA causes BPD. But one just can’t assume the causal direction goes that way–one must eliminate alternative possibilities. Recent sophisticated studies suggest that, in fact, CSA does not cause BPD.

Research to understand the link between gender dysphoria, various mental problems (including suicidality), and completed suicides will take time. There is already plenty of reason, however, to doubt the conventional wisdom that all the trouble is caused by delaying gender transition of gender dysphoric persons. We have already mentioned the fact that transitioned adults who had been gender dysphoric (i.e., “transsexuals”) have increased rates of completed suicide. Their transition did not prevent this, evidently. Suicide (and threats to commit suicide) can be socially contagious. Thus, social contagion may play an important role in both suicidality and gender dysphoria itself. Autism is a risk factor for both gender dysphoria and suicidality. No one, to our knowledge, believes that gender dysphoria causes autism.


Parents with gender dysphoric children almost always want the best for them, but many of these parents do not immediately conclude that instant gender transition is the best solution. It serves these parents poorly to exaggerate the likelihood of their children’s suicide, or to assert that suicide or suicidality would be the parents’ fault.


Aitken, M., VanderLaan, D. P., Wasserman, L., Stojanovski, S., & Zucker, K. J. (2016). Self-harm and suicidality in children referred for gender dysphoria. Journal of the American Academy of Child & Adolescent Psychiatry55(6), 513-520.

Dhejne, C., Lichtenstein, P., Boman, M., Johansson, A. L., Långström, N., & Landén, M. (2011). Long-term follow-up of transsexual persons undergoing sex reassignment surgery: cohort study in Sweden. PloS one6(2), e16885.

Marshall, E., Claes, L., Bouman, W. P., Witcomb, G. L., & Arcelus, J. (2016). Non-suicidal self-injury and suicidality in trans people: a systematic review of the literature. International review of psychiatry28(1), 58-69.

Nock, M. K., Borges, G., Bromet, E. J., Cha, C. B., Kessler, R. C., & Lee, S. (2008). Suicide and suicidal behavior. Epidemiologic reviews30(1), 133-154.

Van Kesteren, P. J., Asscheman, H., Megens, J. A., & Gooren, L. J. (1997). Mortality and morbidity in transsexual subjects treated with cross‐sex hormones. Clinical endocrinology47(3), 337-343.

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?

The adolescent trans trend: 10 influences

The below post is written by Overwhelmed,  4thWaveNow contributor and the mother of a teen daughter who insisted she was transgender, but who subsequently changed her mind. Other parents in the same situation have shared their experiences on 4thWaveNow, and a new research study (currently recruiting) is the first to systematically examine the phenomenon of “trans trending” amongst tweens and teens.

Trans activists and gender specialists constantly assure us that puberty blockers are harmless and “fully reversible.” They claim these drugs “buy time” for a young person to decide if they really are trans. But given that social transition + puberty blockers are followed in 100% of reported cases by cross-sex hormones (see here and here),  the “buying time” assertion deserves a lot more scrutiny. If there weren’t other forces at work (like social contagion and the conditioning effect of being validated in the idea that you are “really” the opposite sex if you prefer the appearance and lifestyle of that sex), a 100% persistence rate in trans-identification simply wouldn’t be happening.

And when it comes to teens who experience onset of gender dysphoria in adolescence, parents like Overwhelmed, Penny White, and the founder of this website–who have personally observed their teens voluntarily desisting from a trans identity–are the ones who have actually bought time for their kids: precious time to realize that becoming a lifelong patient haunting the offices of endocrinologists and plastic surgeons is not the only way to live a gender-defiant life.

by Overwhelmed

Earlier this year, a Nature article reported on the May 2016 launch of a study aimed at documenting the psychological and medical impacts of delaying the puberty of trans youth:

 Funded by the US National Institutes of Health (NIH), the US $5.7-million project will be not only the largest-ever study of transgender youth, but also only the second to track the psychological effects of delaying puberty — and the first to track its medical impacts. It comes as the NIH and others have begun to spend heavily on research related to the health of transgender people, says Robert Garofalo, a paediatrician at Ann and Robert H. Lurie Children’s Hospital of Chicago, Illinois, and a leader of the study. “We seem to really be at a tipping point,” he adds.

Garofalo and his colleagues aim to recruit 280 adolescents who identify as transgender, and to follow them for at least five years. One group will receive puberty blockers at the beginning of adolescence, and another, older group will receive cross-sex hormones. Their findings could help clinicians to judge how best to help adolescents who are seeking a transition.

Despite the fact that puberty blockers–followed in nearly every case by cross-sex hormones–have been prescribed for many years for “trans kids,” this study will be the FIRST in the United States to track the impacts of medical transition on this population. It has become increasingly popular for gender doctors to start trans-identified children on puberty blockers. The rationale is to avoid the potential psychological distress and the physical development of secondary sex characteristics associated with the “wrong puberty.” Based on the constant onslaught of celebratory articles about “trans kids” in the media, the public is likely unaware that puberty blockers and cross-sex hormones are not approved by the FDA for this purpose. These drugs are being used off-label and the science isn’t settled by any means. Even the gender doctors confess there is no medical consensus.

I appreciate that the Nature piece is not just another one-sided article touting pro-transition dogma. Although the journalist failed to mention that children who pause their natal puberty, and then directly proceed to cross-sex hormones, have the not-so-insignificant consequence of permanent sterility, she did include viewpoints not often seen in the mainstream media:

 “But some scientists worry that putting off puberty in older children may disrupt bone and brain development, reducing bone density and leading to cognitive problems.”

 “Because most children who question their gender do not do so past adolescence, many psychologists discourage “socially transitioning” until the teenage years.”

The debate is so heated — and evidence so sparse — that the authors of the American Psychiatric Association’s 2013 Diagnostic and Statistical Manual of Mental Disorders (DSM-5) were unable to reach a consensus. “People are making declarations of knowledge that are their belief systems, that aren’t also backed up by empirical research,” says Jack Drescher, a psychiatrist at the William Alanson White Institute in New York City.”

 But there is one assertion in the article–touted as settled science—that raises a huge red flag:

 “But those who identify as transgender in adolescence almost always do so permanently.”

Many parents who read 4thWaveNow are VERY familiar with this assumption. When their child, out of the blue, with no prior history of gender dysphoria, claims to be transgender, most parents resort to internet searches to become more knowledgeable. They read articles like this one by Irwin Krieger, LCSW, which tells parents it’s pretty much inevitable their teen or young adult child will remain transgender:

 …I do acknowledge that most teens who have come out to parents and others as transsexual are truly transsexual so as not to give them any false sense of the likelihood of their child having a change of heart.

Parents are encouraged to just start “supporting” their child by using the correct pronouns, buying new clothes and aiding their child with social (and possibly medical) transition.

Historically (prior to the year 2000), the research data did show that many kids who consistently believed they were the opposite sex during and after puberty held onto this belief into adulthood. But in the last few years, something new has emerged: a wave of post-pubertal, self-diagnosed trans teens.  These youth may not fit the historical profile due to relatively recent influences like:

  1. The social contagion phenomenon. Many confused teens and young adults (and increasingly, tweens) seek out answers from strangers online. They say they don’t “fit in,” that they prefer clothing and activities usually associated with the opposite sex. They ask, “Does this mean I’m transgender?” The answers they receive frequently affirm they are and urge them to “Transition NOW!” Places like Tumblr, Reddit, and YouTube (MTF and FTM transition videos) are full of this “wisdom.” The blog Transgender Reality documents some of these conversations.

Sometimes it isn’t an online influence that sparks a newly realized transgender status. There are more students socially and medically transitioning in high schools and universities. On some campuses there are entire friend groups claiming to be transgender, and an impressionable child who is befriended by this group may suddenly decide he/she is trans as well.

  1. The ability to achieve an instant “special” status. There is an appeal for some to identify as transgender in order to receive extra attention or boost their social standing.

If a student announces to school administration that they’re transgender, it’s becoming taboo to question them. More schools are enacting guidelines (like this one co-authored by the National Education Association) that enable children to be treated as the opposite sex, regardless of maturity level or mental health status. And parents don’t need to be in agreement, or even informed, about these accommodations.

Additionally, some children and/or their parents may be enticed by the potential to become celebrities. After all, Jazz Jennings and Caitlyn Jenner have their own TV shows strictly based on their transgender identities.

  1. The reduction in gatekeeping. The current train of thought among gender doctors and therapists is that gender identity is innate, unchangeable, and is often realized at a very young age. If you follow this line of thinking (and assume that no one could possibly be confused or misled into believing they are transgender), then you likely feel it is unjust, and even harmful, to make a child jump through gatekeeping hoops before medical treatment.

As an example of this logic, Dr. Johanna Olson-Kennedy, the medical director of the Center for Transyouth Health and Development at Children’s Hospital in Los Angeles, was recently quoted in this article about Sam who was given puberty blockers, then began testosterone injections and had a double mastectomy all by the age of 14:

 “It is pretty well proven that people know their gender by the age of 5,” said the Center for Transyouth Health and Development’s Olson. “If we accept and believe that people know their gender by the age of 5, why not accept that trans kids know their authentic gender?”

Treating young people with gender dysphoria is critical, Olson said, as puberty increases the chances they will harm themselves.

“One of the things that puts trans kids at higher risk is this period of time when they are going through puberty,” she said. “Their body is becoming the adult or permanent version of this body they are not comfortable with.”

  1. The push for transgender identities to be seen as a normal variation of human existence (like homosexuality). It has become more common for doctors and therapists to avoid labeling people who think they are the opposite sex as having a mental disorder. An example from Jack Drescher is in this article about the World Health Organization classification system:

When ICD-11 is published, being transgender will be listed in a different part of the document, potentially under conditions related to sexual health, said Drescher, who is a New York psychiatrist and a professor of psychiatry at New York Medical College. “So they’ll be diagnoses, but they won’t be mental disorder diagnoses.”

The medical community’s process of de-stigmatizing being transgender was also reflected in the last round of updates to the Diagnostic and Statistical Manual of Mental Disorders in 2013.  The DSM, which is used by clinicians, replaced the diagnosis of “gender identity disorder” with “gender dysphoria.” The diagnostic class was also separated from sexual dysfunctions.

Identifying as transgender shares some similarities with anorexia nervosa  and body dysmorphic disorder for which treatment consists primarily of therapy and possibly medication. But the regimen for gender dysphoric patients often includes medical interventions to physically alter their bodies to better align with their feelings, making this condition treated like no other mind/body disconnect.

  1. The popularity of early social transition. It’s becoming increasingly common to socially transition prepubescent children, to encourage them to live as the gender with which they identify. In the Nature article cited above, psychologist Diane Ehrensaft (a proponent of the gender affirmative model) and transgender rights attorney Asaf Orr comment on this approach:

But encouraging children to live as the gender they identify with is an increasingly popular choice. “There’s been a real sea change,” says Diane Ehrensaft, a psychologist at UCSF. She reports seeing more prepubescent patients recently who have already transitioned socially.

Many transgender-rights activists support this model, and liken any other approach to gay-conversion therapy. “You’re telling a kid, ‘I don’t believe you’,” says Asaf Orr, staff attorney at the National Center for Lesbian Rights in San Francisco. The best strategy, he says, is “to affirm a child’s gender exploration, regardless of what the end result is going to be”.

The gender affirmative model encourages children to “explore” their gender identity through social transition. It is often stated that it’s harmless to do so since no hormones or surgeries are involved. But this doesn’t take into account that children who are treated as the opposite sex are being conditioned to continue in their belief, potentially leading to future medical interventions. Even the Dutch researchers who pioneered the use of puberty blockers to treat transgender youth, do not recommend social transitioning in prepubescent children due to the “high rate of remission.”

dutch anti social transition

6. Transactivism. There is a burgeoning group of people who are out to educate the world about the importance of accepting transgenderism. Their pleas are often presented as anti-bullying or anti-discrimination campaigns. They tend to cite high suicide rates and imply that misgendering someone or questioning their gender identity may contribute to these statistics. Many of these activists are transgender themselves and feel they are the most knowledgeable about their condition. They pass themselves off as experts. Many conduct training sessions in schools, police departments, hospitals, etc. They write books, media articles, blog posts. Host conferences. Just one activist can have considerable influence. And there are so many voices shouting this philosophy that it drowns out opposing viewpoints.

7. Framing transgender acceptance as the new civil rights movement. Personally, I was elated when the US Supreme Court declared same-sex marriage legal. But, after that triumph, organizations like the Human Rights Campaign (HRC), the American Civil Liberties Union (ACLU) and the National Center for Lesbian Rights (NCLR) seem to be focusing more intensely on the transgender rights movement.

It is admirable to oppose discrimination against transgender people in employment, housing and appropriate health care. And I very much condemn violence against them. But there needs to be a balance. It should be acknowledged that some impressionable children, teens and young adults are confused and erroneously self-diagnose as transgender. This vulnerable population needs protection from unnecessary medical interventions. But since these organizations promote the “born this way” dogma, anyone who doesn’t blindly accept and support them as the opposite sex, is called misinformed or even abusive and bigoted.

In a short period of time, the transgender rights movement has made substantial gains. There have been laws passed in the United States and Canada that could be interpreted to mean any therapy that doesn’t affirm a youth’s gender identity is illegal. US schools are being pressured to allow transgender-identifying students into opposite sex bathrooms, locker rooms, and even bedroom assignments on overnight field trips. Overall, there has been a tendency in recent guidelines, legislation and court cases to prioritize gender identity over sex.

  1. The significant growth of the gender industry. There has been a rise in demand for gender clinics, doctors, therapists, endocrinologists, surgeons (and even “packers”—penile prostheses) due to the rapid increase in gender dysphoric children.

Back in January 2016, this pro-transition Cosmopolitan article stated that the first US transgender youth clinic opened in Boston in 2007. And since then 40 more have begun catering—exclusively to children—in the United States.

Surgeons are finding their services are increasingly sought after as well. Dr. Curtis Crane (who performs mastectomies on minors) has commented on how he cannot keep up with the demand for phalloplasties, even though he keeps training more surgeons in the technique:

 Crane says he’s one of only a few surgeons in the U.S. performing a high volume of phalloplasties — a booming surgical niche fueled by an increasing number of transgender men seeking to complete their anatomical transition. Even after hiring and training two colleagues to perform the eight-hour surgery, Crane’s patients must wait a year to have it done.

I frequently come across statements from doctors and therapists saying their transgender-based business is flourishing, often with a significant backlog. Due to their expertise, these are the professionals that I wish would speak out about potential over-diagnosis and over-treatment of trans-claiming youth. You have to wonder if they truly see the massive increase in patients as a positive (“more people are finally being treated because they are better informed and there is less stigma”). Or do they see trouble on the horizon (“I’m pretending everything is peachy, but I’m really concerned this may be a disastrous medical trend”)?

  1. Selective media coverage. Many media outlets portray positive “trans kids” stories, but choose to omit information not favorable to the transgender rights movement. Usually there is no discussion of the high desistence rates, or of the significant risks associated with medical treatments. And when facts like these are not included, the public is misinformed.

US media is chock-full of pro-pediatric-transition stories, many of which have been discussed on this site. You can also click on the Transgender Trend blog links below for examples and excellent analysis of biased programming from the UK’s BBC:

  1. The silencing of skeptics. Unfortunately, it is taboo to voice concerns that children, teens and young adults may be at risk of unnecessary medical transitions. This blog is one of the ONLY places online that parents and their allies can speak out, although most choose to do so anonymously to maintain their privacy.

Unfortunately, there are some trans activists, deeply offended by anyone contradicting the transgender narrative, who work to discredit anyone who dares to express opposing viewpoints. To these activists, it is fair game to try to get someone fired from their job or to post pictures of their children with sexually explicit captions (see the Michael Bailey link). Alice Dreger, Michael Bailey and Kenneth Zucker have been recipients of this treatment.

On a positive note, I’ve heard there are a growing number of professionals—doctors, nurses, teachers, journalists—whispering their concerns to each other. But due to the current environment, they’re afraid to speak publicly. Afraid they’ll be called bigots. Afraid they’ll lose their jobs.

We are living in a time when the number of gender dysphoric children is rising exponentially with no sign of a leveling off.

Guardian increase in peds transition graph

Kids are being medically transitioned regardless of the fact that there’s no medical consensus of what the best treatment options are. No one knows the long term consequences of puberty blockers, cross-sex hormones and surgeries in this population. This may very well be a disastrous fad similar to the false memory and ritual abuse scares of the ‘80s and ‘90s. And to top it all off, there’s significant pressure not to publicly express skepticism.

Mainstream media involvement would be welcome, along with brave professionals speaking up about their concerns. It is essential that the public be informed not only of the pros, but also the cons, of transitioning children.

Instead of focusing solely on treating the burgeoning number of gender dysphoric children, professionals ought to investigate the reasons for the radical shift in this population. Why are so many presenting to gender clinics? Why are there currently so many females vs. males seeking treatment (historically it was the opposite)? Why do so many have co-morbid mental health issues—autism spectrum disorders, OCD, ADHD/ADD, depression, etc.? These are important questions in need of answers. Especially because of the often irreversible nature of medical interventions, and that the patients are children with the rest of their lives ahead of them.

Today’s children are exposed to all kinds of influences that weren’t present until relatively recently. It would make sense to now reject the statement “those who identify as transgender in adolescence almost always do so permanently.” And to re-evaluate treatment protocols so that children, teens and young adults receive the thorough mental health care they need, and avoid any unnecessary medical interventions.

Social work professor speaks out on behalf of her FtM autistic daughter

UPDATE 5/24/16: The National Review (NRO) has published an article discussing Dr. Levinstein’s post here on 4thWaveNow. It was pointed out in the comments thread on the NRO piece that Dr. Levinstein’s bio on the U Michigan-Flint site includes a statement that she is the “proud mother of a trans son.” I asked her for a response, and she submitted the following for this update.

That bio was written two years ago, prior to all my daughter’s surgeries and the ensuing and now chronic health problems resulting from testosterone, at a time when I was trying my best to be supportive of my child’s choices.

I am indeed proud of my daughter, who has been a victim in this process.

Dr. Levinstein also stated that she is happy to discuss her situation further with the press.

Dr. Kathleen “Kelly” Levinstein, PhD, LCSW, LMSW is a Professor of Social Work at the University of Michigan, Flint.  Among many other accomplishments, Dr. Levinstein was a Heilbein Scholar at the NYU School of Social Work, where she also taught, and has directed and provided clinical services for people with disabilities for many years, primarily in New York and New Jersey. A clinical and research social worker for 40 years, Dr. Levinstein describes herself as “the only out autistic PhD level social worker” in the world. Her research and advocacy work includes human and civil rights violations against the autistic community.

In this post and accompanying short interview, Dr. Levinstein tells us about the ordeal currently being experienced by her daughter who has undergone transgender medical transition. Dr. Levinstein also shares her thoughts about the current increase in young women with autism being diagnosed as transgender.

A version of Dr. Levinstein’s account will be published in an anthology entitled Female Erasure: What You Need To Know About Gender Politics’ War on Women, the Female Sex and Human Rights, Tidal Time Publishing, Fall 2016. Ruth Barrett, editor, forward by Germaine Greer.

For previous 4thWaveNow posts on the subject of autism and transgenderism, see here:

“Insistent, consistent, persistent”: Autism spectrum disorder seen as no barrier to child transition–or sterilization

Guest post: For teen girls with autistic traits — a plea for watchful waiting

New study out of Finland: Girls with gender dysphoria have many other mental health issues

by Kathleen “Kelly” Levinstein, PhD, LCSW, LMSW

My daughter, who is on the autism spectrum, as am I, is now 19 years old. She had felt (and told others) that she was a lesbian most of her life. When she was 16, she began watching a TV show called “Degrassi,” which featured an FtoM character. After a few weeks, she announced that she was not actually a butch lesbian, as she had previously said, but was in fact trans. She started attending a local PFLAG meeting, where she met many trans people, including a number of FtoM trans teenagers who were raving about a certain “gender therapist.” Although the APA recommends a minimum of one year of “gender counseling” before surgery, this gender therapist (whom I consented to, before really understanding what I was doing) gave my daughter the go-ahead to have a bilateral mastectomy after only two sessions. This gender specialist never reviewed any of the Special Ed records or spoke to my daughter’s previous therapist, who had known her for a decade. And, crucially, she never asked my daughter, “Might you be a lesbian?”

The gender therapist (whom I believe has an unholy financial alliance with the surgeon) gave my daughter (then 18 and one day) the go-ahead for the $30,000 surgery (covered for all university employees and their families where I work). My daughter is now on testosterone (which she clearly is unable to evaluate the risks and consequences of).

To give you some sense of my daughter’s level of understanding of what it means to transition, she told me recently that she believes that the testosterone “will grow her a penis.” I had to break the news to her that, although this is the mythology in the PFLAG meetings (where a number of the other young trans people are also autistic), this is not the case.

She has been taken advantage of. Healthy organs were amputated. This is insurance fraud, poor clinical practice, a violation of APA standards, unethical and unjust. It is a crime not just against women, but particularly against disabled women. So many of these young women who are “transitioning” are also autistic.

My daughter has a representative payee on her SSDI [disability] check, as it was felt that she was unable to handle her own money. This was of little concern to the gender therapist. I believe that once the therapist realized the “treatment” would be covered by the University of Michigan insurance, it was full speed ahead.

You mention that your daughter previously considered herself a lesbian, and this changed when she started watching the TV program “Degrassi.” Was that the only thing that influenced her to claim a trans identity? Was there anything else?

Other than Degrassi, the PFLAG meetings–which are now the cult of trans–sealed her fate. There were no young lesbians there. In fact, there are very few young lesbians left–they are all transitioning. If she had been able to have a lesbian relationship prior to transitioning I believe that things would have transpired differently. I attempted to get her in a support group for young lesbians when she was 12, but was informed that because of liability insurance reasons,  she was not welcome until age 18. By that time it was too late.

She had a legal name change in Dec of 2014, a bilateral mastectomy in April 2015, and started testosterone in Sept 2015.  My daughter has severe Crohn’s Disease, and currently, she is having grave reactions to the testosterone. She has been hospitalized three times now for complications.

Many professionals, as well as some autistic people themselves, have written about the fact that young people on the ASD spectrum are often “gender nonconforming” and have a less stable sense of identity. Can you speak to this regarding your daughter?

I DO believe that there is an overlap with the autistic and transgender populations.  Some studies show a higher level of testosterone in autistic human beings. For males a high enough level of testosterone converts to estrogen. This may explain the large number of autistic people of both sexes claiming that they are transgender.

In recent years, activists have agitated for disabled people to be treated as having the same “agency” to make medical decisions as non-disabled people. In fact, when anyone brings up concerns about young people with autism being questioned about their transgender identity, they are accused of “ableism.” Do you have any thoughts about this?

Yes, I agree–anyone asking for critical thinking about these issues with autistics is accused of ableism and transphobia. This is often an effective silencing tactic. I have found no allies in the autism community. Instead, there is a vilification of anyone daring to ask questions about these issues, including the evidence of MtoF physical, sexual and psychological violence against women. Women who publicly question receive death threats, threats to rape us and our children, burn us to death with gasoline, decapitate us, and so on. This all coming from people who claim they are our “sisters.”

Given that your daughter was recently hospitalized for health issues related to her use of testosterone, have you found any medical professionals who are willing to speak up about this?

I have found no health professionals willing to go on the record against this. Everyone is afraid of professional suicide and threats of violence. I am standing alone.

My daughter’s latest hospitalization has been described by doctors as due to “absorption issues.” She now has a full beard but still has her period. The testosterone is wreaking true havoc on her system.

Autistic women (again, I am one) frequently have a difficult time, sensory-wise with their periods. But rather than attempting to help us with this difficulty, our problems get labeled  “gender dysphoria” and the answer has become to remove our periods from us.

We will find out in 20 years the effects of testosterone on our young women. I am confident that it will not be a pretty picture.

Shrinking to survive: A former trans man reports on life inside queer youth culture

Max Robinson is a 20-year-old lesbian who recently detransitioned after 4 years of hormone replacement therapy. She underwent a double mastectomy at age 17, performed by plastic surgeon Curtis Crane in San Francisco. Max reports that her gender therapist wrote letters verifying the immediate medical necessity of these treatments.

Max currently works to provide direct support to developmentally disabled adults living in group homes; she detransitioned on the job in December 2015. Her novel Laika, which tells the story of the little stray dog who was sent outside Earth’s atmosphere in a Soviet satellite, is available digitally or in print here. In addition, Max and her partner collaborate on many graphic art and creative writing projects.

 Max, like many young lesbians of her generation, was led down the path to FTM “transition” as a teen, effectively short circuiting her chance to fully integrate her orientation as a same-sex attracted female.  As detailed in her account, the difficulties many young trans men face in queer communities are not widely known; and the less-than- rosy experiences of FTM teens are certainly not discussed in the many mainstream media stories which unquestioningly celebrate testosterone and surgery as welcome treatments for dysphoric girls—many of whom are same-sex attracted.

Max’s story will also appear in an upcoming anthology to be published within the year.

In the meantime, Max is available to respond to your questions and discussion in the comments section below this post.

All of us at 4thWaveNow are very grateful to Max for her courage in writing this post.

by Max Robinson

When I was 5, I led a girl rebellion. We put on capes and chased some boys in capes around. Whatever they said we couldn’t do, we did. It was mostly push-ups or holding bugs. I could hold any bug. My dad still has a picture in his office of me at a science fair, hands full of hissing cockroaches.

I hated to be told there was something I couldn’t do. In first grade, I’d go home from school all in a huff because the girls’ bathroom pass had pictures of bows on it, while the boys’ had soccer balls. My teacher wouldn’t let me choose which pass I wanted. I played soccer!

When I was in third grade, I drafted letters to the author of a children’s book series. I was bothered by the constant underlying sexism in her books about a family rescuing animals. The mom and the daughter were always secondary, sweeping or cooking in the background, while the father and son saw all the action. What troubled me most of all was that these books were written by a woman. I didn’t understand why she couldn’t create a single interesting female character.

Around the same time, my mom finally let me buy a pair of boys’ shoes. They were red and black, and I didn’t have to tie them. I wore them all the time, so often that the plastic frame of them tore through the fabric. It cut into my feet, but I didn’t tell my parents. I thought I wouldn’t get another pair. They didn’t find out until they saw the back of my ankles, torn and bleeding. When I told them why I hadn’t said anything, they got me another pair. This is my first memory of hurting myself on purpose so that I would feel better about my appearance. Later, there was tweezing, high heels, waxing, shaving, running, and trying to starve myself. In all of those, at one time or another, I was encouraged, but they really weren’t for me. I wanted to choose to hurt myself in my own way.

When I was 16, I talked my older sister into ordering me a binder, and I wore it as often I could. It hurt like hell. I insisted it didn’t. The pain made it easier to think less, which was nice, especially at school. Class was boring and I couldn’t focus, so I would always spend the whole day winding myself up with some thought obsession or another to keep busy. I would ask the teacher for bathroom breaks, and then used them to cut myself, just because I was under-stimulated and unhappy.

After school, I read Autostraddle articles and dozens of pages into the archive of FTM blogs. I was glad to see some women who looked kind of like me, saying that they had futures now. I wanted what they had, and I hated what I had. I think I was 15 or just barely 16 when I started checking this stuff out.

The longer I thought about it, the more sure I was that it was true. At first, I thought I might be genderqueer. Then, I wanted to go on testosterone for a while, but keep my breasts. Next I was sure that I wanted them gone. I would confess these changing thoughts anxiously to other trans-identifying friends online. They would reassure me that this happened to a lot of people, and that the dominant transgender narrative was oppressive.  Then I began reassuring others of this, too. We all agreed that being trans was very special and difficult.  Before, I had never felt special or that my pain mattered.

Some part of me knew I was talking myself into it. I ignored that part.

For the first time, I had a community that paid attention to me, at least online. We talked about our feelings and we listened to each other. This was my first real experience with Internet culture. I loved having friends. It wasn’t like school, where I was irritable and weird, floating between tables at lunch. People actually liked me on Tumblr. Almost all my friends were female and trans-identifying.

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I didn’t know anything. It was just so comforting to think that I was born wrong. If my body was the problem, it could be solved. Transition had clearly defined steps. Everybody chose from a set list, and when it was over, they were properly assembled.

When I renounced my connection to womanhood and what I shared with my sisters, I sealed away important parts of myself. I thought I was turning away from the hurt that came from being seen as a woman by men, but it was too late for that. That hurt has been inside my bones for years. After transition, I kept quieter than ever before. Always afraid, always afraid. Brought back into line.

Transition was supposed to fix things. That’s what I believed and that’s what doctors told my parents. I was 16 when I started hormone blockers, then testosterone. I was 17 when I had a double mastectomy.

If I didn’t look like a dyke and act like a crazy teenage girl, there would have been nothing to fix.

To fund my surgery, I started a blog where I posted print-to-order clothing and gifts, pandering to the interests of the people I saw on there. It worked pretty well. I got a bunch of money, but not quite enough. My parents used some of theirs, and my grandma helped, too. After all, this was a medically validated condition. I had been to appointments with professional after professional, all of whom agreed this was the way to go.

But it turned out to be cold comfort, removing hated body parts. Breasts marked me as a woman dressed funny. I wasn’t afraid to be anesthetized or cut open. The day of my surgery, after the doctor drew the lines of the incisions on my skin in Sharpie, I asked him where the tissue would go. He told me it would be incinerated as medical waste. I cackled. When they led me back to the operating room, I was confused. I thought there would be a silver table that I had to lie down on. I told my doctor this. He told me it wasn’t an autopsy, and laughed.

My first post-op memories don’t start until a day or two later. The pain wasn’t bad, and emptying my drains reminded me of using a menstrual cup, just with a lot more yellow stuff. It felt better than trying to live as a man with breasts. I couldn’t lift my arms to wash my own hair for a couple weeks, but seeing a flat chest was a breath of fresh air. It felt like it made sense after I had been watching my old face disappear, cheeks narrowing, beard coming in, because of testosterone. I didn’t want to be seen as a woman–as a lesbian–and I didn’t want to ask why.

Or maybe I just didn’t know who to ask. I did try. Before I started medical transition, I asked my gender therapist, a trans man, about internalized misogyny. The question was dismissed. I didn’t even really know what internalized misogyny was, but  I wanted to understand. Instead, I was assured that it probably wasn’t that. I got a letter for hormone replacement therapy, and later, for the top surgery. I was grateful.

It took years of testosterone for me to finally realize it was okay to live in my own body without it, that making this peace with myself was possible, and that I deserved that chance. I didn’t know it was okay to be a dysphoric lesbian, that I could survive this way. I was almost 20 when I stopped hormones. I had been 20 for a little while when I stopped understanding myself as a trans man.

Things changed. My mind changed.

There’s a species of rotifer (microscopic zooplankton) called Bdelloidea. A male bdelloid has never been observed. They’re all female, reproducing exclusively through parthenogenesis for millions of years. How did they survive quickly evolving parasites and rapidly changing environments without the adaptability afforded by sexual reproduction? Bdelloids shrivel up under stress. In anhydrobiosis, they’re easily carried away by the wind. For up to nine years, they’ll stay alive like this–barely living, but alive. Shrinking yourself to survive is a legitimate strategy, and sometimes it works.

After I detransitioned, I started a new job where I was known as a butch lesbian. At first, people treated me worse than when I was “passing” as male. Nobody trained me. They tried not to look at me at all. They didn’t relax until I started talking, talking like I had in high school. I made jokes and people laughed. I told them about my childhood when they told me about theirs. I did more than listen, finally. People actually liked me here, the same people who looked at me funny when I first started the job.

It had been so long since I had said anything outside my home without worrying about whether I “sounded male.” I hadn’t realized how much I had been holding back since I decided to transition. I hadn’t made new friends, except online, in years. In a couple weeks at this job, I got rides home and wedding invitations. I thought I was incapable of connecting to anyone in person, but I was just incapable of connecting to anyone as a man — because I’m not a man. I can’t pretend to be one without hiding an essential part of my nature.

I thought “woman” was wrong for me, because of how I dressed, how I related to my body, how I resented the expectations society had for me as a woman. I didn’t realize that my horror at my body could be caused by the horror of living in a world that wants to control all women.

If “being a woman” really was nothing but an identity, if I had been raised in a world where it really did just mean calling myself a woman, I never would have transitioned.  I would never have attempted to surgically and hormonally erase my femaleness. My drive to be anything but a woman was rooted in the material reality of being a woman, a material reality that cannot be identified out of. Trying to live in a fantasy where everything women have suffered for being female is null and void, even as misogyny continues to shape our lives, was valuable only in that I finally learned how incredibly valuable it was to name myself as a woman.

There is power in naming. It’s how we find each other, how we connect to our histories, how we connect to our futures. Driving us apart from each other is the easiest way to keep us from learning to recognize attempts to redefine our realities.

I didn’t know this then. I subscribed to an incredibly misogynistic set of beliefs for years. “DFAB privilege” was a common phrase in our community – “designated female at birth privilege.” It was accepted fact that being born female gave you a lifelong advantage over a male who transitioned. This included men who used transition only to mean using different pronouns on Tumblr and having an anime girl as their avatar. We believed that, as “dfabs,” we needed to shut up about our petty problems. We could never have it as hard as any “dmab women or non-binary people.” Everyone in the trans community agreed that it was our responsibility to uplift “dmab voices.” None of this seemed outrageous or strange to me; it felt pretty intuitive. Growing up under male domination is a grooming process that leaves many girls and women extremely vulnerable to manipulation.

The first experience that did make me start to feel suspicious of male transition was when I was 18 and a genderqueer-identifying man who had never pursued any kind of transition raped my best friend, a woman unacquainted with insular trans community politics. I had indirectly introduced her to this guy via mutual friends. After the rape, she told me what he did; I had been in the next room the whole night, awake, talking to someone I didn’t even like. I had no idea it was happening. When she let our mutual friends know, we both assumed they would have her back; after all, they referred to their apartment as a safe space for rape survivors. But instead, her rapist changed his pronouns on Tumblr, claimed to have schizophrenia, and then said that he couldn’t possibly have raped her, because of the power dynamics between a “cis” woman and a transwoman. He moved back to LA a few months later, without ever taking any steps towards transition. When he got there, he told his old friends he wasn’t schizophrenic or trans anymore.

Years before that, two different transwomen I knew had pressured me into sending nude photos of my breasts to them. I messaged them first, as a 16 year old, after seeing them repeatedly posting about being horny and suicidal, and how only nudes would make them feel any better. They didn’t even know who I was. To one of them, I submitted the nudes anonymously. I didn’t want to talk, I just wanted him to feel better. I thought it was my responsibility. It might still be posted somewhere, I have no idea.  Both of the transwomen who sexted with me identified as lesbians at the time and knew I was a transman. They didn’t care, as long as we were talking one-on-one.

I didn’t fully see the value in differentiating male from female until a traumatized and disabled lesbian I knew well, K, finally admitted to me that her transwoman partner M was beating her regularly.

For three years, she lived with steadily escalating physical & sexual violence, the details of which were originally included in this article but have now been removed for privacy reasons. Suffice it to say – it was an intimate portrait of what radical feminists understand as male violence.

It’s been two years since she moved in with me, away from him, and she’s still recovering from what he did to her. She had two decades of trauma before that, but nothing ever broke her like this did. Calling that relationship “lesbianism” left her stranded from the framework she desperately needed in order to contextualize her experiences as a survivor of captivity. It destroyed her ability to call herself a lesbian or a woman for a long time: if lesbians like to sleep with transwomen and were repulsed by the supposed maleness of transmen, how could she be a lesbian herself? If women are what her ex-partner M was, then she, K, must be something else entirely. The language of transition lends itself readily to abusive gaslighting that disguises and distorts women’s ability to name what is happening. What was done to her was extreme cruelty of a distinctly male variety, cruelty she was especially vulnerable to because of her lifelong history of trauma at men’s hands.

The more I started to understand that M could not have been female, the more I understood why I was. One’s actual sex matters. Running from its significance prevents you from doing anything but continuing its cycles of destruction. As soon as a transwoman said, “No, I’M not a man,” we instantly lost our ability to protect ourselves from him. Women who never transitioned in these trans circles believed their “cis privilege” rendered them man-like in their power. For those of us females (mainly lesbians) who did seek transition, we were often told that, as transmen, we were exactly as bad as any other men.

Loading the language was an incredibly powerful tool. I was a lesbian trying to save my friend from domestic violence at the hands of a man she had partnered with out of intense desperation, facing immediate homelessness as a severely mentally ill woman with limited mobility. Understanding this could have connected us to our foremothers who struggled through similar battles to protect each other from abusive men. Instead, we felt completely adrift. Other women dealing with abuse perpetrated by transwomen have described a similar sense of being in entirely uncharted territory, terrified to speak first, unable to find anyone else sharing experiences; they’re all too scared of being labeled an untouchable “trans-misogynist.”

In the 21st century, intelligent and capable adult women are having to relearn what “man” means, with fear at their backs every step of the way. We were among them, exploring radical and lesbian feminist ideology online and marveling at how decades-old works precisely described circumstances we had thought of as occurring only recently. Janice Raymond’s discussion of transexually-constructed lesbian feminists in The Transsexual Empire was startlingly relevant. She saw this coming. As lesbians, we have a rich history of theory that had been completely denied to women who came of age when K and I did. All either of us knew about Janice Raymond, until last year, was that she was evil to the core; a horrible transphobe. We believed this because we didn’t know any better.

Deprogramming took almost a year. Both of us were terrified just to read dissenting opinions. K, me, and another lesbian exited from the radical queer scene began moderating an online support group for anyone dysphoric and born female, including many who still identified as trans. When that group started, I was still one of the transmen. All of us were so incredibly relieved not to be alone. We disagreed on a lot of stuff, but we were all tired of what we saw happening to females.

When our remaining friends from the transgender community found out that we considered transwomen capable of male violence, and that we were concerned about transition’s effect on young adults, almost all of them deserted us immediately. Female trans-identifying friends who knew K’s history of homelessness and our currently rocky financial situation started talking publicly to each other about how we literally deserved to starve to death.

Losing these friends hurt enough on its own. Being cut off from them just when we had begun to see the severity of the situation within these groups was so much worse. I have a list of 20 intercommunity predators, mainly transwomen who prey on females — women or transmen. Eleven of them are one or two degrees of separation from us. So many women in our community had themselves been pressured to share nude photos, coerced into unwanted sex, or outright violently assaulted by males describing themselves as transwomen, but they still didn’t feel able to challenge the narrative they were being fed. These women, our friends, had been there with us. They saw transwoman predator after transwoman predator being named by their terrified female victims. The “call-outs” (a word used for anything from hurting someone’s feelings slightly to brutal rape) usually only happened once several victims of the same predator found each other and made sure they had friends on their side. When victims couldn’t be sure they would be supported, they didn’t come forward. The political climate made it doubly difficult to “call out” a transwoman. We were constantly being reminded that transwomen are harmed by the horrible stereotype that they’re all rapists or perverts, and we were taught that we needed to be constantly policing ourselves to avoid perpetuating this idea.

The silent victims of transwomen had good reason to keep quiet. We all saw transwomen using the language of “cissexism” and “transmisogyny” against anyone who named their behavior as harmful. Even transwomen dating other transwomen experienced abuse at their hands. In the resulting fallout, it was never clear who the true aggressor was; both of them would immediately begin using identity politics and “privilege dynamics” (i.e., someone poor can never hurt someone rich, under any circumstances, etc.) in a way that was very effective at obfuscating the truth. Our friends had been right beside us for all of this, and they still damned us for beginning to name what had enabled this wide-scale intercommunity violence.

Young lesbians in the “queer community” are known by many names: if you want to avoid scrutiny for not hooking up with transwomen, you’ve got to get creative. Some of us call ourselves queer, bisexual, or pansexual, because there’s no word for only being attracted to females, and you can’t be a lesbian if you date transmen or avoid dating transwomen. A lot of us, having been told that we can opt out of womanhood by choice, decided that we never want to be called “she” again. Young women who cling to the word “lesbian” find themselves increasingly pressured to sleep with transwomen, because—according to trans dogma–they are supposedly more vulnerable and oppressed than any “cis” lesbian.

Many transwomen seem to view dating a “cisbian” as a uniquely valuable source of gender validation. After all, lesbians only date women. There is no acknowledgement that, under some circumstances, some lesbians can be coerced into relationships that they are incapable of experiencing as anything except traumatic. I have never seen a transwoman from these circles ever express the possibility that this might be true. By all appearances, they have never considered it. Running from unpleasant truths is something that a lot of folks who transition (me included) tend to get very good at.

The insistence that lesbianism is not a strictly female experience runs so deep that transwomen, even those who only date other transwomen, often refer to themselves as “transdykes.” This includes those who are not transitioning–men who can literally only be differentiated from any other man when you ask his preferred pronouns. Many women believe that these “transdykes,” even those who have never been identifiable as anything but straight men to the outside world in any way, are more oppressed than any “cis” woman, specifically on the axis of gender. The level of gaslighting taking place here is difficult to overstate.

From the outside, now, I can finally see how ridiculous it is. Realizing this took months and months. It took us a year of exploring the feminist theory that had been forbidden to us before me or K could even call any transwoman a man without having a panic attack.

At first, when I started learning more about opposing viewpoints, I identified as a “gender-critical transman.” I knew that the transgender cause had been used in a lot of disgusting ways, but I still believed transition was the only way I could survive, and I was trying to reconcile seeing myself as transgender with believing that the vast majority of trans activism was harmful to women. During this time, I really looked up to gender-critical transwomen–transitioning males who were usually at least marginally more sympathetic and thoughtful than most men. I tried to reconcile our respective identities and our needs, as we understood them, with the needs of women as a class.

I failed. At the end of the day, I just don’t want anyone male in the bathroom with me. I don’t want them on a women’s volleyball team. I don’t want them at Curves. I don’t want them in a lesbian book club. The experience of being male is fundamentally different from the experience of being female — even if a man passes, even if a man has surgery to more closely resemble his idea of a woman. I don’t say this out of a hatred for transwomen. I say this out of love and respect for women. What we are cannot be conceived nor replicated in a man’s imagination, and it absolutely cannot be formed out of male tissue on an operating table.

The sympathy I feel for men harmed by gender, to the extent that it means I encourage male-to-female transsexualism, is in direct competition with the sympathy I feel for women harmed by gender. Everyone is entitled to make their own choices about their bodies. Everyone is also entitled to have opinions about the choices that others make about their bodies. I feel that transition is a treatment with far-reaching harmful side effects — not only for the individual receiving treatment, but for those around them.

Lesbians who see their sisters disappearing are more likely to try to erase themselves. Lesbians who are forced to welcome men into their spaces will never be able to see or understand the value of female-only space, having never actually experienced it. Transition does not cure the irreconcilability of our selves with our environments. Gendered identity crises are very real to the individuals experiencing them, myself included, but this energetic drive towards change is not best spent reforming ourselves into someone who can assimilate into the world men have built. We need to use this energy to work towards restoring balance to a sick world.

Many young lesbians (and some older lesbians caught up in a youth-oriented trans/queer culture) hold political views diametrically opposed to our collective interests. We genuinely believe some off-the-wall garbage, like that it’s wrong and evil not to be attracted to penises because of “internalized cissexism.” We have been successfully brainwashed to serve males at the expense of our own health and sanity.

I have so much empathy for other women who believed transition was their best choice. I lived that. The fact is, loving a woman does not automatically mean agreeing with her. I believe that all of us deserve better. We deserve to experience autonomous female space. We deserve the opportunity to experience our bodies as a part of nature worthy of celebration, not objects to be “reconstructed.” The energy we spend trying to run from our own bodies is better spent working to support each other.

Those of us who make it out of communities like the ones I was in often only manage to do so because of strong female (in my experience, lesbian) support networks that help us relearn how to think for ourselves without getting angry when we make mistakes in the process. I hear political opponents of the transgender movement calling it extremely cult-like and in the same breath damning the women, usually lesbians, who fall into the trap. This reinforces the learned hatred of anyone who disagrees without creating any opportunity for victims of this ideology to ask questions and explore viewpoints that—while the victims have not yet extricated themselves–genuinely feel like some kind of blasphemy to them. The pace of progress needs to be determined by the individual. Frustration with the behavior of young people in the transgender community is very understandable, but even the most righteous anger is unlikely to change minds when it’s directed at someone who has been manipulated into believing that dissenting women are literally equivalent to murderers.

The beliefs they have internalized are harmful to all women. No one is obligated to subject herself to being triggered or re-traumatized by the virulent misogyny that trans activists tend to espouse, even in the name of reaching out to a sister in crisis. Taking care of yourself has to come first. I try to stay available for conversations with questioning trans-identifying females, but I can’t always be there. I need rest, too.

As I move away from viewing myself and my body as an object to improve, I’m realizing more and more how much of my energy has been devoted to appeasing men in some way. By and large, that was a waste of time. I’m working on using my emotional energy for the benefit of myself first, and then for the benefit of other women.

While I was transitioning, I was terrified of eventually regretting it. I sure as hell didn’t let on much about my doubts, for fear of losing access to medical treatment, but I was consumed all the time with obsessive thoughts about it. I didn’t understand how I could go on living as a woman with no breasts. What man would want to fuck me? Never mind that I didn’t want to be fucked by any man; that didn’t feel like a good enough answer.

I am so incredibly grateful that I learned that there was more to being a woman. Transition was absolutely not the easiest way to learn this, but it was how I learned it. It was how I learned that I could survive without men viewing me as a piece of meat. I never shaved my legs or armpits again. I stopped tittering at their stupid jokes. I dress practically. I’m grateful that I learned it was okay to exist as I am.

For me, transition was a processing of distancing my true self from my body and my environment. Detransition has been the opposite: learning to participate earnestly in the world again. For me, this isn’t about undoing my transition. I’m not seeking any further changes like electrolysis or breast reconstruction. I am a woman, even if my body is recognizable as the body of a woman who once thought transition was the best choice available to me. My body has known tragedies, but my body is not a tragedy. When I catch myself slipping into deeply misogynistic internal tirades about the aspects of my appearance that changed during transition, I practice thought replacement. I am not a waste of a woman.

I’m so grateful for all of the incredible women I’ve connected with who are on the other side of transgender identities now. Some of them are women I met years ago, when both of us were still pursuing transition. Transition doesn’t have to be forever. If transition makes you sick inside, you don’t have to live and die with that sickness. There is community. There is processing. There is genuine healing. More and more of us are waking up, each with her own story. We question and disagree, with our enemies and with each other. We learn. Together, we are moving forward.

Tumblr snags another girl, but her therapist-mom knows a thing or two about social contagion

Below is a comment recently submitted to 4thWaveNow by (yet another) parent of a girl who discovered the trans-trend on social media. This mom just happens to also be a psychotherapist.

Update: Please see the comments section for a lively and important discussion about the state of psychotherapy for trans-identified kids–including the controversy about what is (and isn’t) “conversion therapy.”

In a time when major professional organizations representing social workers, therapists, and school counselors are fully aboard—hell, they’re steering–the trans-kid bandwagon, it’s refreshing to hear from a therapist who hasn’t drunk the Kool-Aid.

But surely there must be many others who have doubts? Given the stunning disconnect between (on the one hand) the established knowledge about child and adolescent development in both neuroscience and psychology (things like identity formation, executive function, magical thinking, and neuroplasticity, to name only a few important lines of study), and (on the other hand) the simplistic mantra “if you say you’re trans, you are!” touted by “gender specialists,” there has to be some cognitive dissonance churning the minds of thoughtful clinicians.

We’ve heard from a few of them. In Exiles in Their Own Flesh, therapist Lane Anderson wrote that her skepticism about the transgender trend, along with her commitment to professional ethics, eventually drove her to resign her post working with trans-identified adolescents. Psychoanalyst  David Schwartz was featured in a post highlighting his insightful critique of the “inflated idea” of transgenderism.  And blogger Third Way Trans, a detransitioned man/former trans woman who is a graduate student in psychology, does yeoman’s work presenting a more nuanced view of transgenderism and identity politics.

Perhaps skepticaltherapist’s words will move a few more mental health professionals to speak up on behalf of our kids? We can hope.

by skepticaltherapist

There is an episode of Star Trek: The Next Generation where the crew is introduced to a mysterious alien video game. It slowly infiltrates the minds of the crew, and Wesley Crusher and another young ensign watch as the adults around them slip into addiction. Wesley begins to sense that something is amiss, and goes to find Captain Picard. He is so relieved to find the Captain and to be able to confide in him. As Wesley leaves, we see the Captain reach into his desk with sinister sangfroid and take out a gaming device. He too has been infected. As we suspected, the game is really an insidious mind-controlling apparatus that will allow an alien race to gain control of the ship.

star trek

That is what this trans madness feels like to me. When I first began to hear this emerging in the young people around me, I felt confused. As a dyed-in-the wool liberal, I felt I should be accepting and affirming. As a therapist and long-time student of human nature, it just doesn’t make sense to me that people are “born in wrong body” except for perhaps in extremely rare cases. I believe there are “true” cases of transsexualism, but the number of those affected must be vanishingly small. Why all of a sudden did it seem to be everywhere?

When thoughtful colleagues and friends started talking matter of factly about five- and six-year-olds who were being supported and affirmed in choosing another gender, I was stunned. How could that possibly be anything other than very confusing for a young child? What was I missing? I must, I at last concluded, be getting truly old.

The alien mind control device made its way into my home about two years ago when my then eleven-year-old daughter begged me for a Tumblr account since her friends all had one. Foolishly, I consented without looking into it further. I wish I hadn’t. This trend toward all things pan/bi/non binary/gender fluid/trans, etc. has generated a huge amount of energy among kids my daughter’s age. I had been watching it with some degree of suspicion and concern. But last month the degree of my alarm grew. She started dropping provocative hints, such as asking us if she could get a buzz cut. I found some writing she had left around the house, where she wondered to herself whether she were “really a girl.” She was very excited a few weeks ago when a new friend came out as trans.

It isn’t that I am a hating ogre. I think if I really believed that my kid were profoundly unhappy in her body, that this narrative was coming from her and not from social media and the kids around her, I would be reacting very differently. I would also have a different reaction if I could convince myself that gender identity experimentation were essentially harmless. Girls want to pretend to be boys? Sure! Why not? But it is absolutely chilling to think that, these kids who are just doing what teens do, get support from the adults around them that let them get stuck in the experiment so that many of them wind up permanently changing their bodies.

For the record, this is a kid who has never had any gender nonconforming behavior at all. She has always been a girly girl. As a toddler and young child, she had several “crushes” on boys. She has always been very consistent in having fairly typical “girl” interests, with few to no “boy” interests. She has always been interested in art and dance at school. She is a little socially anxious, and that is about the only thing that makes her susceptible to this, I think. Probing further, she admitted that she has been binding, and has asked her friends at school to call her by a gender-neutral name. She also told us that she had begun researching testosterone. Luckily, her interest in this started just a few weeks ago, as best as I can tell.

After that conversation, I was a wreck. In spite of having taken a sleep aid, I woke up at four am that night, my heart pounding out of my chest. I started googling again, as I had done before, trying to find some place on the internet not infected by either the “trans is terrific” narrative, or hateful speech from the other side. Search term after search term returned similar results. “Trans peer pressure,” for example, returns article after article about how trans kids need support against bullying and peer pressure. Finally, “social contagion trans” brought me to this site.

Such a huge, huge relief. I feel like Wesley Crusher finding the one other person on board the Enterprise whose mind hasn’t been taken over.

Her current school is a wonderfully progressive and nurturing. But the school administrators all seem keen to jump on the “trans is terrific” train. They proudly proclaim to prospective parents that there are several kids transitioning in the upper school. It seems like this fact is sort of exciting to everyone, and establishes without question their all-accepting super liberal cred.

I have decided that the cult indoctrinators have had free access to her beautiful thirteen year-old-brain for two years now, and that it is time that I intervene and fight for my daughter. I am so grateful for the clarity I have found on this site. Because of this blog and the stories shared here, I am feeling cautiously optimistic that we may have been able to pull her back from this brink. We have closed her Tumblr account. My husband and I have been confronting her about thinking she is trans. We haven’t been yelling or ugly or angry. We have just been telling her what we think, how we are seeing things. Partly because of this blog, we have been able to avoid going through the, “Really? Well if you say so. That is great, I guess!” stage. Right when we got wind of this, we have just been very up front that there is something dangerous going on in society and that we will not tolerate her playing around with this. We are going to continue talking to her.

As a mother and a therapist, I have been stunned and saddened to the extent by which I feel silenced, both personally and professionally. I am afraid to discuss my concerns about my daughter with friends for fear of feeling judged and being accused of being a horrible mom who will damage my child. (Certain friends of mine have circulated petitions decrying thoughtful op-ed pieces in major newspapers that were approaching Caitlyn Jenner’s transition with some well-considered feminist questioning.) I am afraid of speaking up in professional circles about the phenomenon more generally for fear of drawing ire and misapprehension. It is so frightening to think that therapy for my daughter doesn’t feel like a safe option, since the process might be so easily hijacked just by the mention of the word “trans.”

As a therapist, I mostly work with adults. A common reason for seeking therapy is being at a place where you are wondering about leaving your marriage. When a woman (or man) comes in, they usually say something like, “I haven’t been happy in my marriage for a long time. My husband isn’t a terrible person, but I just don’t know if I can stay.” What I don’t say at that point is, “Well, if you are wondering that, it must mean that you need to leave the marriage. To stay any longer would be a terrible mistake. Here is the name of a divorce attorney.”

Ending a marriage is a huge deal. There are enormous consequences for several people, even when children aren’t involved. It isn’t a decision to be taken lightly. When a client says to me that they are thinking of leaving, I believe my job is to help create the space for them to explore this as a possibility without judgment in either direction. I want to provide complete acceptance of all of their explorations. It isn’t my job to interpret their feelings or tell them what to do. I listen. I ask questions. I reflect back what I hear. I neither rush them forward nor try to hold them back. It is a slow careful process of discernment, as it should be. There is a marriage in the balance.

I believe that open-ended non-judgmental exploration is the very essence of the therapeutic process. The current prohibition on exploring a patient’s feelings of gender dysphoria seems a perversion of this process. I would feel that I had done someone a terrible disservice by imposing an external yardstick on someone’s private decision as to whether to divorce. The potential for harm is so great! How much greater is the potential for harm when we are talking about impressionable young people electing to undergo permanent sterilization?

This is very lonely, and very frightening.


What the hell are you talking about? No. You’re a girl.

In this guest post, 25-year-old Charlie Rae (a pen name) shares her experiences living as a gender-dysphoric girl with a no-nonsense mother who didn’t for a minute subscribe to the notion that Charlie was really a boy. 

Charlie credits her mom, along with her training in martial arts and a peer group full of rough-and-tumble girls, with helping her realize who she really is.

Charlie is available to respond to comments and questions in the comments section below the post (her WordPress screen name  is artistarmy).

by Charlie Rae

I suffered from undiagnosed gender dysphoria for the first half of my life. I still often have the feeling that I am trapped in the wrong body, and that there is, somehow, another person living inside of me that my body isn’t represented by. I still try and change who I am all the time, endlessly searching for a way to look that fits who I feel like I am, but to no avail. It’s confusing, and sometimes painful, but I’ve come to see that it has more to do with society than with me as an individual.

It started as young as I can recall, in my family, where any and all activities were sex segregated: boys/men doing one thing, girls/women doing another. The older we got, the less accepting the boys were that a girl wanted to be around them all the time, and the harder it got to live in my own skin. I basically ignored my girlhood; I didn’t speak of it, and when they joked about it, I would ignore them. I didn’t want it to be a topic of conversation. I just wanted to be a boy. I thought something had gone wrong when my mom was pregnant with me.

Girls always talked a lot, about clothes and boys. They would try on outfits and go shopping. I would ask them, “aren’t you bored?” but they always said they weren’t. Once, at the beach, I tried to lie around and tan with them. “This is what you do all day?” “Here,” they said, and drew a little picture on my stomach with sunscreen. “Now you just wait until you’re tan enough to see the picture.” I thought, “I’m definitely not a girl,” and went back to playing pickle, and football, and getting dirty.

When I was in elementary school, the sex-segregated spaces continued. At recess the boys would play soccer, and the girls would be on the jungle gym. Once when I tried to play soccer, the boy who I was told had a crush on me (and that’s why he picked me), close-lined me as I was running for the ball. Everyone laughed. I was already in Tae Kwon Do by then, and I had been told never to use my skills to hurt anyone unless I really had to. So I didn’t. I just left. At recess, I started walking the perimeter of the field alone.

My mom never did entertain my idea of thinking I was a boy. Instead she just put me in martial arts class, which helped me in many ways but also perpetuated my confusion. As inclusive as Tae Kwon Do could be, some parts were still sex-segregated. Girls couldn’t fight or partner with boys. I was way too strong for the girls, and I was told to hold back on them. I would get pulled aside by the instructors and given talkings-to. “I’m a boy,” I thought, and I would ask, “Why can’t I fight a boy?” “It’s against the rules,” I was told.

But that changed as I rose higher and higher in rank. It was a fairly new martial arts school, and I ended up being the first person ever awarded a black belt at 8 years old. Something shifted then because I became such an authority. And my instructor started letting me fight boys. I felt somehow…accepted. That I had proven myself. I acted “like a boy” in mannerisms and speech, I fought “like a boy,” and I trained like the male instructors did, but I was the only girl. And I was only 3 feet tall.

I started to become somewhat of a freak show, the girl who was really good. I was featured in demonstrations, because, “look at that little girl!” I wanted to stop being a girl, though. I wanted to be taken seriously.

When I was 9 or 10 years old, something happened to me that must have deeply impacted me. There was a male-to-female transgender person named Kate who we met when my mother was taking care of a dying old woman named Pat. I only vaguely remember Kate. He sort of looked like a woman but he had man hands, and big feet, and something looked different about him. He was transsexual, and he had gotten all of the surgeries.

According to my mom, Kate went to my mother and said, “your kids are asking me questions, can I tell them?” My mother said, “yeah, tell them whatever you want.” My mother didn’t hide things from us; she didn’t whisper under her breath or spell words to keep things secret. She was flat out. She answered our questions, and she let other adults talk to us candidly.

He evidently told us he regretted transitioning. That after everything he’d done to his body, he said “I don’t know what I am.” He also said he knew he was a man, that it was never his body that was wrong. He called himself a he-she. I don’t remember this story. Maybe it was over my head at the time.  I do remember hanging out with Kate, and him laughing when I would ride Pat’s wheelchair around the apartment. I think I block a lot out because I loved the old lady, Pat, and Pat died. But I have no doubt that it had an impact on me.

Now’s as good a time as any to tell you more about my mother. I haven’t mentioned her much in this story so far because being a boy was just not something she entertained. My mom was a full-disclosure kind of mom, and she was also frank, and certain. About everything, it seemed. She would say, “What the hell are you talking about? No. You’re a girl.” She didn’t have an existential crisis, she didn’t send me to therapy, she didn’t sit me down to talk. She answered the question like she answered any other questions: to the point, with conviction, and then went on with her day.

She also blurred the lines of gender for me. I didn’t grow up with a father, and when I would get sad about it, she would tell me, “I am the mommy and the daddy.” She wore suits sometimes. She cut her hair short. She talked like my uncle, sometimes, when she was angry. She used body language that men used. I just remember thinking, “alright.” Because that’s how it was, she’d told me the answer, and I accepted it. Even though it didn’t feel that way, and I still hated it.

When it came to Tae Kwon Do, she’d say, “you’re not a boy, you’re better than the boys.” She was always proud to have two daughters. When everyone would make fun of me for wanting to do stuff with the boys, mom would say, “Rachel can do whatever she wants.” She was strong, and fierce, and when she was around, what she said would go. When people would make fun of me, she would say, “Fuck ‘em.” She never called me a “tomboy,” she mostly called me peanut and babygirl.

She wasn’t afraid of what people thought of her. I started to pick that up from her. People would get on her about how open she was with us, about swearing, about “adult stuff” and burping, and how rude we seemed to other people. “Oh, get over it. They’re kids,” she would tell them, and she would write them off.

When I wanted to cut all my hair off, she just told me how good it looked on me. It wasn’t an ordeal. None of my “boyish” qualities were an ordeal. They were what they were, and I was a girl.

When I got to middle school, and I found other girls who were weird, and wanted to be weird, and get dirty, and be unlady-like, was when I started cherishing the idea of being a girl. I kept my hair short, and everyone called me a dyke. I didn’t know what that meant, but it was okay, because I had all of my weird friends–all girls, 10 of us, and we called ourselves the Golden Mangoes. Four of us were what would be considered “tomboys,” and none would have been considered “girly girls.” We started food fights, got into trouble, loved rock climbing in gym class, and we didn’t talk about clothes and styles. We made sculptures out of garbage and told people off that were picking on us. We weren’t afraid to get dirty when we went outside for science class. We were loud and obnoxious. For the first time in my life, I recall loving being a girl, because it meant I could be in that group.

One of the Golden Mangoes started to transition to male in high school. It caused a huge rift in the whole group. She would get angry with us when we would misgender her, and I mean, really angry. This was when the idea that I was not a boy really sunk in. I saw her desperately trying to convince everyone that she was a boy, and we all knew it wasn’t true.

The group started meeting behind her back, not to be cruel, but to talk about how uncomfortable we were with it, and how mean she was to us about it. We didn’t try to misgender her, we had just known her as a girl for so long that it was hard to change. There were other things as well. She was touchy-feely with us. We had all always been touchy-feely with each other, but, we thought, if she wanted to be a boy, the rules would have to change. We didn’t want her to touch us anymore, we didn’t want her to be at sleepovers. Everything shifted in response to her anger at us. I knew that if I joined her thinking I was a boy, that would happen to me too. I gave up thinking I was born in the wrong body then.

I’m telling you, it’s all about finding your place. That’s what gender dysphoria is all about. I mean it.

It’s literally in Maslow’s hierarchy of needs. If your daughter or son’s self-actualization depends on having friends, feelings of accomplishment, recognition from society, and they can’t get those things in the body they are in, it makes perfect sense to me that they would think they are born in the wrong one.


I chose to do a speech about hair removal for my public speaking course last summer. I had read about a sociology professor who would get her students to change their shaving rituals for the remainder of the class. She remarked how she was surprised that the women quickly bonded over their behavior of not shaving. Though I’ve only taken intro level sociology courses, this didn’t shock me. We are reflections of our environment, always. When the environments change, we change, if only sometimes marginally.

The energy and attention around the trans issue isn’t just something happening in the home, it’s happening in society at large. See, some radical feminists (I think a little crudely) call liberal feminist ideologies “Special Snowflake Syndrome,” but in a way, they’re right. And it’s a paradox. Everyone does want to be special. That’s absolutely obvious in everyone’s life, even those of us who know that certain things are false because of the knowledge we’ve acquired. The paradox is, we all have a context in which that specialness is able to blossom, and self-actualization doesn’t come until we are accepted somewhere for who we are, for all of our special talents.

My conclusion is this: in society, and in the home, we are giving trans issues too much of our energy. Period. On a social, activist level, everyone seems to be in lockstep, because the trans platform is national and pervasive. It’s a fight that needs to be argued with logic. But in the home, especially in the sense of what’s actually happening around us in real life, we’re all becoming obsessed with a complete lie. Our bodies are our bodies. Period. No one was “born in the wrong body.” Body mutilation is body mutilation.

That’s easier for women, for feminists, to realize when we think about how we react to breast implants, and Botox, and all of these surgeries and medical mutations women are going through because they’re brainwashed by society to think they have to be beautiful and perfect. The trans thing is no different.

But the thing about thoughts is, the more weight you give them, the more important they become. That’s why mass media is so repetitive. It won’t stick the one time. You have to say something so many times to make it important.

The advice I would give to mothers, in all honesty, is stop taking this so seriously. I don’t mean to be callous, or write anyone off, and if it’s a struggle for you, then there certainly needs to be work and research done behind-the-scenes to deal with this.

But as a thought experiment, what if your 13-year-old daughter came to you and told you she wanted breast implants. Would you take her seriously? Or would you say “absolutely not, go do your homework”? Kids are uncomfortable in their bodies. Always. Being alive, growing up, is uncomfortable. To have intense reactions to this, to send kids to therapy, is to make it a big thing. It puts importance on it. Not all of kids’ thoughts are valid. They might mean something to them, but that doesn’t make them reasonable. Kids go through all kinds of phases. This might be one of them.

There’s something my mom used to tell me when I wanted something that she didn’t want for me. “When you’re 18, do whatever the hell you want.” This was how it was. My mom didn’t let me convince her that I knew more about the world than she did. She never let that get into her head. She let me get my ears pierced, but when I was 18, I could do whatever the hell I wanted. She didn’t take me to get my body piercings, she made me wait.

But when I was 18, she didn’t take me to get my piercings, she wouldn’t pay for them, sometimes she would say, “what are you doing to your beautiful body?” But I got some. After a few years, I took them out. They were uncomfortable. I couldn’t really move when I had them. And they were impermanent.

Injecting kids with hormones or giving them puberty stoppers isn’t good for their bodies. You don’t need any other reason not to let your kids have these things. Let them wear what they want, dress how they want, don’t make a big deal out of that.

But find them a place that they fit in. We are social creatures; we need that in order to become ourselves. You and your daughter need to find girls that like to do what she likes to do. And then give that all of the attention.

Guest post: I put the shotgun down

This personal narrative by Juniper, a frequent commenter on 4thWaveNow, touches on and corroborates several themes that have been previously written about on this blog:

  •  A formerly dysphoric girl child (now in her mid-40s) who comes to terms with and accepts herself as female—but only after weathering an intense personal struggle in adolescence and early adulthood.
  • A lesbian identity that was not fully claimed until early adulthood, with a first sexual relationship at 19—right on target with the data showing that same-sex attracted women are late to fully realize their sexual orientation. (If Juniper had been born later, it’s likely, as she herself says, that she’d have been identified as “transgender” and in need of medical intervention, long before she came to terms with herself as female and same-sex attracted.)
  • Shame and shunning due to “gender nonconforming” behavior and homosexuality, which led to self hatred, self harm, and even suicide attempts.
  • The profound and currently unmet need of dysphoric or “gender nonconforming” girls to have adult role models and mentors who aren’t egging them on to “transition.”

 Juniper makes a strong case, as I have, that medical transition ought to be an adult decision, made (if at all) no earlier than one’s mid-to-late 20s. Her story is a testament to how much things can change in a young person’s mind as their mental capacities mature.

 And her story is a reminder of how very important it is to experience the storms of adolescence, because out of that struggle is born a depth of character and self-realization that might not be possible otherwise—that is, if puberty were “blocked” and a childhood insistence on being the opposite sex were coddled and celebrated.

Juniper is available to respond to comments and questions below her piece.

Update 2/7/2016: Please see the comments section for an in-depth discussion and expansion of the many points Juniper introduces in her autobiographical account.

by Juniper

I grew up with a twin brother; I’m female, and we are fraternal twins. My brother was sensitive and gentle, while I was tough and rugged. At age five, I remember the two of us looking into a mirror as my brother said, “I should have been the girl and you should have been the boy, because I am the pretty one.”  Indeed, my brother was prettier than I was and I nodded in silent agreement.

We were socialized in a restrictive, gender stereotypical home.  My brother watched wrestling on TV with my dad while I made breakfast with my mom. My dad was into health and fitness and I was allowed to do push-ups and sit-ups with them but I was scolded if I ever did more reps than my brother. My brother was ridiculed for crying or showing signs of weakness. When we went off to grade school, my brother was bullied.  He would run to me for help, and I would then confront the boy who was picking on him, even if it meant that I would end up in a fistfight. Before I knew it, every little boy came running to me if a larger boy was after him. I became the kid who would protect the ones who were being bullied. My brother made me promise never to tell our parents and we agreed this was best for everyone concerned. We kept our secret. My brother thought of me as a brother and not as a sister.

I felt like god must have made some type of mistake and that surely, a miracle would happen and I would awake one day as a boy. At a very early age, perhaps age 5 or 6, I began to self-harm. I felt such intense shame about my body and sex-related anatomy. I wanted to scrub those parts away. I would scrub until I bled from the abrasions.

I began puberty at a young age and started menstruation in the 4th grade, before any sex education at school or “heart-to-heart talks” at home. I was devastated to learn that I had become a “woman” despite my prayers, despite my efforts to stop the changes. My parents and other adults seemed displeased with my inability to adopt or cultivate some semblance of femininity. My body had betrayed me. Because I developed early, I was targeted with harassment and unwanted sexual attention from boys (and men.) This contributed greatly to extreme feelings of isolation and hopelessness.

The self-harm escalated and became much more serious at age 11. I began contemplating suicide and made several unsuccessful attempts. I began to wear my clothes as baggy as possible. It became commonplace that I was mistaken to be a boy by people who did not know me.  (Today, I am still most often called “sir” by clerks in stores and other strangers.)

I began to come to terms with my history of sexual abuse at about this same time: age 11 or 12. Meanwhile, my brother began exploring his own sexuality and started cross-dressing and experimenting with my mother’s make-up with another boy while my mom was at work. (My parents had divorced by this time.)  My brother and the other boy were chased down and threatened. They were called “faggots” by a truck full of young men one day when they decided to venture outside while cross-dressing. My brother became more cautious, closeted and secretive about his cross-dressing after this incident.

After puberty, we remained close as siblings. We loved each other, but his friendships with other boys became increasingly important to him and he began to prefer their company instead of mine. At age 12, the bullying stopped for my brother as he began developing into a very muscular young man. Unfortunately, he also seemed to pair his new masculinity with misogyny and violence.

When we entered junior high school (now called “middle school”), my brother and his friends no longer wanted to associate with me because I was a “girl.”  I had been considered a gifted student through grade school but I began to struggle to concentrate on my studies. The boys lifted weights and did “guy things” without me. I felt intensely isolated. I became increasingly introverted and depressed, and I continued self-injurious behaviors. The suicidal ideation intensified and I developed bulimia. I would sneak out at night to take long runs of 10 to 20 miles, several times a week.

At 15, I became very involved in religion. I was quite fanatical, and this was a new escape from my struggles. I also began working after school. I found ways to keep myself as busy as possible so that I could avoid thinking about my body, my past history of sexual abuse, and my feelings of loneliness.

At 18, I began to come to terms with my attraction to women, but I had not yet acted on my feelings.  I told my youth pastor that I was concerned that I was homosexual and he told me that I would not be welcomed back until I was straight. This was a very dark time for me and I attempted to overdose on a mix of aspirin and Tylenol.

At 19, I fell in love with a young woman.  I began a relationship and as the result of this, my church rejected me and my closest friends abandoned me. My family was also very unsupportive.

When the relationship ended, I felt ashamed and hopeless and I decided to end my life. I loaded up a shotgun and I was ready to pull the trigger when I suddenly realized that “this is it … there’s no turning back.” Something told me “You could pull the trigger and have a shitty ending to a very shitty life, or you can decide to live and have a chance of changing the story.”

I put the shotgun down.

This was my final suicide attempt.

I told my mom and stepdad what had happened. They were angry with me, and said they would keep the rifle loaded in the house, where it had been, and that I had no right to touch it. I finally realized that they were toxic people and I could not continue to be around them, since they contributed significantly to my depression.

My brother had gotten into drugs and joined a gang by now; he was gone and I was completely on my own.

I moved out and rented a room. I worked two full-time jobs and started to build a new life. As my confidence grew and as I learned to not be ashamed of my sexuality, I grew stronger. I began to wear the clothes I liked, “men’s” clothes. I cut my hair very short and I finally felt comfortable with my appearance. I became healthier as I started to lift weights and feel better about my body. I was able to free myself of my eating disorder – on my own. I started to make friends who accepted me. Most were lesbians.

I made a few friends in my early twenties who confided that they were transgender. These friends came out to me because they thought I was also transgender. This has happened several times over the course of my life, and I have questioned my gender very seriously. This was before it was common to hear of transgenderism.  I could have easily succumbed to the pressure to transition had I been younger or less confident in my identity. I felt at one time in my life that life would be easier had I been born male, but looking back over the last two decades, I see that my brother had his own struggles and that his life is not enviable.

Ultimately, I realized that I was a strong woman and that I did not identify as a man. My path has not been easy. I have been “gay bashed” several times.  I have been blatantly discriminated against at work and in housing (before laws included sexual orientation as a protected group.) I lost most of my friends from high school, as they were all very religious. But I moved forward and I eventually built a good life with my partner of 13 years (who is now my legal wife thanks to recent marriage equality laws.) I have created a life that is meaningful – a life that helps others. I have created a life worth living. My wife and friends today accept me completely for who I am.

My brother eventually found his way also.

The story of my brother and me is not picture perfect. (Most people’s true stories seldom are.) But we were able to find our way and make choices about our bodies and our gender identities, as we matured in our adulthood.  We both now identify comfortably with our birth sex.

I have friends who are transgender, who have personal stories that are similar to mine but who pursued transitioning in adulthood. Some have de-transitioned; others work to manage serious health conditions that have resulted from the use of hormones. We deal with similar social issues despite the fact that we have taken different paths in life.

Transition brings new challenges that are unexpected. Hormones and surgeries have limitations and complications. Still, I support everyone’s right to make their own choices about their bodies and identity. I think that for the great majority of people, with the exception of some children who are medically defined as intersexed, it takes time –perhaps well into one’s early twenties to sort out one’s identity in relation to gender, physical anatomy, and sexual orientation.

As difficult as my past was, I am grateful that I was not rushed into hormone blockers, hormones, or sex re-assignment surgeries.  For me (and my twin brother), this would have been a grave mistake as our issues with gender identity were rooted in traumatic histories and external societal pressures, which resolved when he at (age 12) and I (in my early 20’s) found kinship and support in our communities.

Societal pressures are even more complicated today because the transgender narrative omits stories like my own.

My oldest niece ended up being very “bookish.” She was also artistic and enjoyed wearing make-up and following fashion trends. Her younger sister loved athletics and hated anything “frilly or foofy.” Their mother was supportive and loving toward both of her daughters. She also had no problem with me, a “gender nonconforming” lesbian, being in the girls’ lives. She asked only that I never talked about “gay stuff” around them as she held the belief that homosexuality was a “sin.” She was a good mom who never pressured either child to conform to gender stereotypes. She seemed to love them both and did not prefer my “feminine” niece over her “rough and tumble” younger daughter.

Still, my athletic niece was taunted at school and her sister sometimes teased her at home. One time, when I came to visit, we were walking and I heard my older niece teasing her sister. My niece, who was eight at the time, ran up to me sobbing. “My sister says I am a boy!” I was in my early twenties and without thinking replied gruffly, “You aren’t a boy, you are a tomboy like me and that’s alright.” At that point, my young niece stood up tall, marched back to her older sister, leaned into her face and repeated what I had said to her, putting a quick end to their quarrel.

I didn’t think much about the incident but years later, when my younger niece came out as lesbian, she told me how important that brief conversation was. She said this was when she “knew” that she was “like me.” My niece was about twenty when she came out. I asked her during our conversation about gender and sexual orientation, if she ever wondered if she might be transgender. Without hesitation my niece said “No, I’m just a regular ole’ lesbian.” That gave us both a chuckle, but I assured her that I would love her either way. After a brief pause, I added that I was glad she would not need to change her body.

If my niece had told me that she was a boy at 8 years and that her sister was insisting that she was a girl, I would have asked the two what it means to be a “boy.” I would have explained my own past and how lots of people thought I was a boy and still seem to think I am a man when they first meet me. I would explain that for me, this does not affect my identity as a woman. I would explain that we are all different and that this is what makes us so amazing.

Teen decides she’s not trans, after all, but struggles with peer pressure

The guest post below, by pj white, is the personal account of a mother whose teen daughter temporarily identified as “trans,” but at 16, desisted.

While “gender specialists” and researchers often discuss younger children who persist in their gender dysphoria as they reach puberty, next to nothing is said about a phenomenon that more and more of us parents have personally experienced: the teenage daughter who, never having had a problem with being female as a child, suddenly insists she is trans at puberty–after a heaping helping of social media propaganda. And often these girls, like pj’s daughter, have other mental health issues that, once explored and addressed, help alleviate the desire to “transition.”

Every parent will respond to this situation in a different way; I’m grateful to pj for sharing her own parenting journey with us in such detail. And I’m particularly glad to hear directly from a parent about how difficult it can be for an adolescent to desist from trans-identification once they’ve started down the road. The glib insistence by trans activists and some “gender specialists” that social transition and puberty blockers won’t accidentally ensnare kids who really don’t want to persist is clearly unfounded. Peer acceptance and pressure is a real thing—yet another truism about adolescent developmental psychology that is ignored by the media, as well as too many providers entrusted with the care of young people. Luckily, a few researchers and clinicians, notably those in the Netherlands who pioneered the use of “puberty blockers,” are beginning to recognize the impact of media and “social transition” on those who might want to desist.

pj white notes that her daughter could have pursued her desire for “top surgery” had she been 18. But as I wrote a couple of days ago, the trend (supported by WPATH itself) is to allow such irreversible surgery at younger and younger ages. Can a move to permit total hysterectomy for 15-year-olds be far behind?

Pj white is available to respond to any remarks or questions you may have in the comments section of this post.

by pj white

My daughter has always been a dynamo. She hit the ground running as a toddler and didn’t stop until puberty hit her and knocked her flat. She never had the slightest interest in traditional girly gender roles. When she started middle school, I expressed fear that she’d be negatively influenced by other kids and want to start acting like a “Barbie Girl.” She put her hands on her hips, rolled her eyes, and said, “yeah, right, mom – I can’t wait to get in touch with my inner plastic doll.”

But when she started to develop breasts at a young age (11), and men started hooting at her from their cars, her sense of strength and power evaporated. She stopped washing and brushing her hair. She wore baggy dirty clothes, and her hair hung over her face in greasy knots. The other kids made fun of her, and eventually, she became more depressed and started skipping school.

Right after turning 13, she told me she was really a boy. This shocked me, because she had always expressed such pride in being a girl. She was proud when her period started at age 10 (we called it “the good blood”) and I taught her from a young age to be proud of her vulva, too. Girl Pride had been a big part of her life. Now she told me she wanted to have her breasts cut off and to inject testosterone.

I was devastated, but I tried to hide it from her. I didn’t want her to be damaged by my “transphobia.” I had been a single mom for most of her life. It had always been the two of us – mother and daughter – two strong females taking on the world. But my daughter was telling me she didn’t want to be a girl anymore. And I was afraid I would damage her by challenging those feelings.

At her request, I took her to a barber to get a “boy’s” haircut (she looked adorable). I also took her shopping in the “boy’s” section of Target to get her a new “boy’s” wardrobe (which was silly, because her clothing choices had always been androgynous). She also asked me to order her a breast binder, which I did.

Perhaps luckily, I couldn’t afford a psychologist, so I took her to the Castro Mission Health Center in San Francisco where we live. The staff there is absolutely lovely, and did not pressure my daughter to transition. They just accepted her where she was. (This is actually a great resource for kids who are LGBTQ). But the staff could not protect kids from the peer pressure they felt to follow through on transitioning once the decision had been made. And to my knowledge, the topic of having room to change one’s mind was not addressed.

The pressure I felt came more from the pop psychology I’d read on the Internet than from professionals (I couldn’t afford private appointments with professionals). According to social media, I was supposed to wholeheartedly celebrate my daughter’s sudden desire to transition, and was forbidden to question or feel sad about it. I felt as if I had only two choices: to be evil and transphobic like the Duggars, or to be a great mom who loved having a transgender son. There was no room for doubt or fear or grief about losing the daughter I thought I had.

I sent my daughter to a free support group where she met truly wonderful kids. I would gladly have adopted the two young trans men I met through my daughter’s participation in that group. I’d have been proud to have them as my “sons”. But I couldn’t help noticing that they came from very traditional families (one’s family was devoutly Muslim and the other’s had come from rural China). I feared I was being transphobic for thinking they might not have felt compelled to transition had they come from backgrounds more accepting of gender non-conformity/lesbianism.

My daughter stood out like a sore thumb in this group for trans boys, because she suddenly decided, for the first time in her life, to start performing femininity. Her femme performance was so over the top she put Ru Paul to shame. Somehow, identifying as a boy gave her permission to perform femininity as an experiment and a game.

My head was spinning. My daughter was now claiming to be a gay male drag queen in a girl’s body. She also insisted, to my relief, that she did not have to cut her breasts off or take testosterone to be a man (I did an internal happy dance). But when I tried to explain to her that gay men would probably not be attracted to her (she looked like Drew Barrymore after an assault by a drunken makeup artist), she got very upset with me. She said only transphobic gay men would refuse to date her. I tried, as gently as I could, to explain that gay men are not usually attracted to people with female bodies. She angrily reminded me that she did not have a female body. When I persisted in explaining that gay men might disagree, she burst into tears.

That was checkmate. She had won. I assured her that any gay man would be thrilled to be with her. Ugh.

During this time, while she was doing female drag and looking more girly than she ever had in her life, she decided to assert her maleness by using men’s public restrooms. I was with her at a park, and when she went off to use the restroom, I assumed she’d use the women’s room. Nope. She walked right into the men’s restroom. And I walked right in after her and dragged her out (The LOOKS we got!). I angrily lectured her on the dangers of men’s public restrooms, especially when, to all appearances, you are a 14-year-old girl. She accused me of not affirming her identity. I said I didn’t give a damn about her identity when her safety was at risk.

Slowly, the hyper-femme drag phase passed, and at 16, my daughter has regained some of the self she lost at puberty. She once again identifies as female, but wears the same type of gender-neutral clothing she wore as a child. She currently identifies as a lesbian, but has not yet had a serious dating relationship.

When I was finally able to take my daughter to a psychiatrist, she was diagnosed with ADD and depression. The doctor explained that many kids with ADD miss out on developing social skills, and when puberty hits, they become very self-conscious – feel inferior – and become depressed. This is compounded in girls who also feel an acute loss of social status when puberty hits. They go from being cute little human beings to pieces of meat subject to adult male harassment and assault. I believe this is what happened to my daughter. She didn’t fit in socially “as a girl” and she loathed the degradation that came with being an adolescent female. She saw transitioning to male as a way out of her pain (sounds crazy, I know, but these are adolescents we’re talking about).

In our case, it was the trendy trans-ideology promoted on Tumblr that caused us the most difficulty. We both bought into the trivialization of a very profound and rare condition: sex dysphoria. I believe we all should be very suspicious of the sudden desire to change sex at puberty. People are so irrational and malleable at that age. Kids need room to experiment and grow without committing to permanent life-altering medical treatments and labels.

It can also be mortifying for an adolescent to change his or her mind about transitioning. My daughter is too embarrassed to face the sweet kids in her former support group. An adolescent’s need for acceptance by peers, and the pressure to follow through on transition when that’s what your peers expect of you, should not be underestimated. This is particularly true when a kid is celebrated as “brave” and “heroic” for coming out as trans. How do you change your mind about transitioning under that kind of pressure? And what if “the courage to be trans” is what people celebrate most about you? My daughter was too ashamed to tell her friends she’d changed her mind – she just withdrew/disappeared from the group. She was homeschooled at the time, which was likely a key factor in allowing her to pull back. If her peer group had been unavoidable (i.e, in school), I don’t know if she’d have been able to desist.

I worked extremely hard not to pressure her during the whole process, because I didn’t want her to defiantly assert her “right” to transition. It’s one of the hardest things I’ve ever done: having to cry alone in another room over her desire to have her breasts cut off. I was terrified and horrified. And although I would never have let her do that under my watch, I knew she could if she were over 18. It was so hard to let her come to her own decision not to transition. In our case it worked, but I know every situation is different. In some other families, more assertive parenting might be necessary.

I am incredibly grateful that my child passed through her desire to transition. I think her depression, ADD, social awkwardness, and “gender nonconforming” personality all contributed to her falsely believing her gender was the problem.

My heart goes out to other parents struggling with this – it’s horrible to be accused of transphobia/bad parenting for not wanting your child to do permanent medical harm to herself. And while I’m very glad my daughter found her way back to herself,  it saddens and frightens me that current trans ideology made her journey back so guilt-ridden and difficult.

And then I woke up: Guest post

This is Part II (Part I is here) of a guest post by thissoftspace, a woman in her late 30s who experienced gender dysphoria, began transition to FTM, but pulled back and now writes her own Tumblr and WordPress blogs celebrating her return to herself as female. As in Part I, her mother’s thoughts are also included in this piece. thissoftspace is available to respond personally to questions and discussion in the comments section below.

 As I read this second part,  I was struck by the extent to which her insight and overall mental maturity helped thissoftspace to desist from a trans identity:

 I am so grateful I have had the life experience with my mental highs and lows that I was able to recognize the patterns as soon as I did.

How much more difficult must it be for younger people to change their minds? They have so few prior life experiences to reflect upon; they lack the patience and foresight of a woman in her 30s,  who, even so, nearly transitioned herself. Her story has made me feel all the more strongly that we parents must fight for children to be allowed to reach adulthood before considering such monumental, life-changing decisions.

Part II: There and Back Again

by thissoftspace

While using the labels “agender,” “non-binary” or “genderqueer” made me feel better by being not-female, I soon realized those words were meaningless to the general public. In order to get the message across that I was not female, I had to bend my presentation further towards male – just like so many other “non-binary” young women I had seen online. Once I did so, everything seemed to slide neatly into a more traditional trans narrative. I clung to the gender-neutral labels a little longer, but it was clear my intentions were to escape female by transitioning to male. Why not just use male pronouns, a male name, to make the message loud and clear?

My mother’s words:

I truly wished to keep the matter personal and give it time. I wanted to see how things worked with her changing her name with a few friends who would understand, rather than be out in public with a male presentation. I did purchase her some new men’s clothing and spent many hours tailoring shirts so they fit properly. I felt this I could do, this was how I could help. I had trouble with the male pronouns, often saying “he/she” instead of just “he”. I tried to keep things as normal as possible. We spoke about giving space and trusting more, but there was a current of stress at the time.

Articles and pamphlets from PFLAG and GLAAD and the HRC insisted my new identity should be embraced and recognized. Bruce Jenner’s interview on broadcast television supported my “feeling” of being more male than female as perfectly valid. I watched videos and read blogs of various female-to-trans people and took in all their enthusiasm and encouragement, all their happiness and all the celebration surrounding their lives. PBS News Hour ran a special on transgender kids that was heartbreaking. Look at them! Don’t they deserve happiness? Don’t they deserve the freedom to be who they are? I shared some of these things with my mom. I told her I could be a man, a straight, normal man, dress the way I wanted, be the person I’ve always wanted to be. I could freely love women if I wanted to. I could be my brother’s cool younger brother instead of his weird little sister. I could finally just be myself. She couldn’t have tried harder to be patient and understanding.

My mom said, “As long as you don’t cut your body.” I didn’t understand why this body I so hated was so precious to her. I would lie awake at night thinking about physical transition. Despite looking in the bathroom mirror and telling myself I had a male body because I said I was male, I knew others wouldn’t see so clearly. For so many reasons, I wanted to fully transition. I wanted to get rid of the breasts and the organs I’d feared all my life. A third of my hypochondriac worries could be gone in a few operations. I wanted to use testosterone to shrink my thighs, to build my shoulders and arms. Big boned? No, I would be strong, as I had always been, but now it would be right. As a transgender man, everything that had always seemed wrong about me would finally be right.

My mother’s words:

I knew very little about transgender and seeing she had done research on the Internet, checking doctors and psychiatrists as well as interviews from those who had transitioned, I trusted her opinion. We also watched the Bruce Jenner interview and a few other shows about transgender issues. I became convinced this was the best for her. However, I believed firmly that the body should not be cut to conform, and I was not supportive about using hormones either. What would happen to her overall health? Even with the name change through the courts, I was concerned about the cost—let alone, her paying for medical changes.

I had travel plans coming up in several months, so I decided to work on transition without making any permanent changes until after my trip. This would give time to experiment and see if I was right or wrong about it all (and I am so thankful for this now.) I researched how to change my name, settling on a male one. I styled my hair to resemble those cool eccentric guys I’d always loved. For the first time since my early teens I let every hair on my body grow out, my big dark eyebrows, my legs, my armpits. I was thrilled at how many dark chin-hairs I had, that I had been plucking forever. One night I ended up staying up late looking at how to shape a goatee. What a difference that would make! I shaved my face because a “passing” guide said it would help me pass as male, with no “female peach fuzz” to be seen.

I bought a binder from a very friendly, helpful company run by “queer and trans people.” When I wore it in public, people called me “young man” – enough of a triumph to make me ignore the back pain it caused. I went to an air show and stood right up against the fence with the men with their cameras, asserting myself as having the right to be there because I was one of them, not some weird woman trying to worm her way in, as I had always felt before. It was so exciting to feel possibilities opening up before me like that. I spoke lower, spoke less. I pushed myself out physically. For some reason, I felt a little angry all the time.

Deep down, a part of me was grieving. A part of me felt I was betraying all I had ever really loved, all the wonderful lesbian characters I had written of and my faith in the invincibility of strong women. Deep down, I felt a part of me had given up, had surrendered. Maybe other women were invincible, but not me. I could only assure myself life would get better as a man; life could only get better when I wasn’t a woman at all.

In the midst of this, friends new and old supportively told me, “Whatever. We like you whatever.” I can’t express how much the word “whatever” stung. It sounds like such a sincere offer of unconditional love and support, but please understand: I did not want anyone to remain attached to any part of the person I had been. I had decided that person was a failure. Worthless. Something I hated deeply, something I was trying to escape. I didn’t want to hear “We like you whatever.” I wanted to hear “We love the new you!” I didn’t want unconditional acceptance of who I was. I wanted absolute celebration of what I was becoming. I wanted my new identity validated so badly it consumed my days and began affecting my health.

My mother’s words:

Try as she might, she never did look like a man, certainly not a man her age. She looked like a teenage boy, similar to her nephew, though when people called her “young man” I was supportive as it seemed to make her happy. I didn’t want people to be confused, so while in public, I had to be sure to support her and even say “my son.” I felt I was walking on eggshells, trying to give as much support and keep her as happy as possible because it was so stressful and she seemed so strained.

We no longer could talk openly and honestly without anger and emotion; I couldn’t say “You keep trying but you can’t totally look like a male. Why can’t you go back to being my daughter?” I did insist, however, that she be honest and present when friends visited – I would not let her hide in her room and become totally obsessed with this transition. I wanted her to know that even if she changed herself to a point, life would still be the same, with the same challenges and expectations. When people responded positively to her changes and new identity, I thought,wow, she really is accomplishing something, but I always woke up wondering what new thing would she be experimenting with today. I would go to bed wondering how everything would work out.

Looming before me was The Bathroom Issue. I was anxious about using a men’s bathroom, but increasingly afraid of being “caught” in the women’s bathroom. I had trouble sleeping, worrying how I would handle it all. My digestive system ran amok with the stress. I felt terrible, unfocused, distracted, unhappy. I played simple puzzle games for hours as my mind spun. How would I get the money for T and for surgeries? How would I bring this up to my doctor? Would T end up giving me cancer? Would I lose my hair? What would my brother think of me? Would I ever see my nephew and nieces again? How could I continue my work, so tied to my name and identity? How would any of this ever work out?

Time and time again I thought, stressed to my limit, “If it doesn’t work out, I may as well kill myself. There is nothing else. There is no alternative.” I felt trapped on a treadmill. Sometimes exhilarating – but I wondered how long I could run.

It happened that in the midst of this I volunteered to drive my mother and her friend to an opera three hours away. It was Mozart’s The Magic Flute. He had been one of my special cool guys growing up and I’d always wanted to see The Magic Flute, so I was happy to go along and do the driving. But the night before I found myself staring at the ceiling, wondering how I would use the bathroom. The venue, I knew, would be full of older conservative people. As this weird in-between thing, how could I use the bathroom? What would I look like to them? Could I ever just walk into a bathroom again? Would life ever be normal again? The ordeal before me – six months? a year? three years? five? – loomed in the darkness, full of impossible costs and fears.

In that frustrated and tearful moment, I wanted this transition to be over, but couldn’t see any possible end. I checked the time and the night had slipped away in sleepless worries. Feeling sick and so very tired I tossed and turned, desperate to get some sleep so I could drive safely, knowing I had six hours on the road ahead of me the next day. I would not be able to keep my eyes open. I could get us in a terrible accident.

Then it suddenly dawned on me: my quest for this new identity had become so overwhelming I was now putting other people’s lives in danger because of it. That thought struck me like an arrow. This was deeply unhealthy. This could not be right.

The push for validation and the self-absorbed mindset I had seen in some trans blogging and trans communities had always rubbed me the wrong way, but finally seeing it in myself was stunning and humiliating. This was not the kind of person I was, not the kind of person – male or female – I wanted to be. I wanted to be useful; I wanted to be happy. As I stepped back and looked at it objectively, not only was this fixation on transition potentially harmful to the people around me, it was also not helping me at all. It was obsessive, inescapable misery, as much as any bout of hypochondria or depressive cycle. Despite the flashes of hopeful possibility, at the end of the day it didn’t actually fix anything. It only made everything worse. If I had been self-conscious before, it was nothing compared to the constant struggle to assert myself as the opposite sex, both to others and to myself. And that constant self-involvement was destroying all the best parts of me.

I am so grateful I have had the life experience with my mental highs and lows that I was able to recognize the patterns as soon as I did. I had spent almost six months dedicated to this desperate hope that transition would solve all my problems – six months of trying to change everything from my name to my underwear – none of it easy, none of it comfortable. And then I woke up.

The next morning as I hurriedly ate breakfast, I told my mom to drop the male pronouns and just call me by my real name because there had to be another way. Somehow in that night of turmoil I had realized the transgender narrative would not solve my problems. It was just too difficult, too much, too illogical, too separated from material reality. I had no idea where to go from there, but I knew there had to be another way.

The opera was lovely, and though tiring, the drive turned out fine.

The next day I sat down at the computer and with great trepidation typed “transgender critical” in the search bar. I found Third Way Trans and my eyes were opened to some of the psychological issues behind gender confusion. I found 4th Wave Now and my eyes were opened to the societal issues, leading me to begin reading about radical feminism, which led me to deeper reading about lesbianism and the experiences of detransitioned women. Gleaning all of this information, so long unknown to me, was like waking up in a hospital after a horrible accident. Suddenly I was surrounded by voices that could explain how I had been hurt, why I had been hurt, and what was being done to repair the damage. These were no linguistic band-aids, no cosmetic cover-ups of old wounds. This was major surgery and strong medicine. It made me angry and it made me sad – there was so much about myself and the rest of the world I had to finally see and accept – but little by little, I began to heal.

My dis-identification from being female was healed by the knowledge that I was born female, down to my very chromosomes. No one – not even myself – can deny that natural fact or take away my right to be female. I was female when I was the kid with muddy knees, I was female when I was being mistaken for male, I was female when I was telling myself I had a male body. As a female human being, I can be useful and I can be happy without any confusion, without ever having to prove what I am. Those hated parts of my body? The bushy eyebrows, the fat thighs, the breadth of my shoulders and the sound of my voice: I learned that those, too, are all natural parts of the female human body. I am a perfectly good female human being. I can just be, residing in this body, and at last – at last – feel a real connection with other women, other female human beings, for the first time in my life.

My sense of shame and failure at being a woman was healed by the knowledge that the things I thought made a female a real woman – beauty standards, pornographic sexuality, submission to men – were not natural inclinations I was somehow missing, but rather forced upon all women by an oppressive society. Others have treated me the way they have only because I existed outside their frame of reference; I was something foreign to their idea of what a female human being should be. I can understand this myself, because it was my own limited ideas of what a woman should be that drove me to believe I was not one. Those views, however, only serve to reveal the narrowness of an individual perspective; they do nothing to actually invalidate who I am. The harsh judgment of “what a woman should be” is something I imagine all women, at least now and then, experience and endure in our society. Now I live with the constant hope to see all women free from those judgments, free to just be themselves, sweatshirts and jeans and all.

My rejection of my sexual orientation was finally healed by the knowledge passed down from mature lesbians – not lesbians depicted in the media or young women just beginning to experience their sexuality – but older lesbians embodying what a female-loving female actually is. All my life I have feared and repressed my attraction towards women because I had only ever learned what male attraction is, and as a lesbian, I wanted no part of it. The knowledge that lesbian attraction and sexuality exists distinct and separate from the male gaze – that lesbians are not like men – was revolutionary to me. At last I could open my heart, regardless of how I present myself or what clothes I wear. The only thing that has ever mattered was the sincere love I have always held for other female human beings.

My mother’s words:

What a relief when she said she would just be my daughter again, and when she shared with me the new information explaining how transition is not always the answer. When she spoke of what she had learned, I felt she was very sincere about it – there was no possibility left for her to change her mind. The information she brought me made so much more sense, I wondered why I hadn’t known about it before.

I still wonder why both sides of the transgender issue are not presented together. The material from trans-positive sources now sounds like propaganda in comparison. So much difficulty could be avoided if the right information were available to both young people and their parents.

 Our relationship is now better than ever. Going through the process over several months built a stronger trust and friendship, allowing us to be more honest about everything. I respect and love her as who she is, a gay woman with many talents and a wonderful human being. For the first time I believe she finally knows who she is, and has the confidence and independence to move forward in both her work and personal life. This has lifted a weight from my shoulders, as I had always worried about her, not knowing how to help. Now I know so much more about the issues and challenges she has faced and can even relate them to some of my own, so that we can properly support each other through them. Though she had to find all this out on her own, we really took the journey together and became better friends because of it. It was not easy, but thank heavens she discovered her true self.

Now, for the first time in my life, I feel like I have the right to exist just as I am. Yes, the words matter – embracing the words “female human being” and “lesbian” matter a great deal – but underneath those words is, at last, an understanding of the basic truths of human nature, that we are what we are and deserve to be loved and respected for that alone. It is only longstanding societal fears and ignorance that insist otherwise, and their effects are more subtly damaging to vulnerable individuals than we might often assume.

People tend to approach a person struggling with their gender identity with the words “I support you in whatever you need to do, even though I don’t understand,” as if gender confusion happens in a personal bubble. In the current cultural climate, it’s now seen as rude and harmful to even question a person who is considering transition – certainly no one ever questioned me. But I so wish they had. Nothing I experienced stemmed from some essential “feeling,” some innate discord between body and mind. All of it, as I’ve written about here, emerged from a lifetime of experiencing oppressive gender roles and confusing expectations, ignorance about what it meant to be a homosexual woman and both internal and external homophobia. It added up to the long-term reinforcement, in a very susceptible mind, of the idea that I was “wrong” in my body and my sex, and that led me to identify as transgender. Transition to male seemed to be the only fix for what I had deemed so unacceptable in a female. For the sake of so many others, I hope these root causes are further discussed and explored, so that transition is no longer viewed as the immediate answer to gender identity confusion. It is an act of compassion to ask “Why do you feel this way?” It is an act of compassion to ask, “Where do you hurt?” We may be surprised by how many of these pains we share.

For myself, I feel like I can finally start living as who and what I am, no longer obsessively worried about how I appear to others or what sort of strange being I might be. I am simply a female human being who loves other women. And it’s a consolation to know that the kid in her sweatshirt and muddy jeans was always okay just as she was. I just wish she had known all along.