On the Science of Changing Sex

Transphobic Propaganda Aimed at Parents of Transgender Kids

Posted in Autobiographical, Editorial, Transgender Youth by Kay Brown on June 9, 2018

Kay BrownI’ve been interacting with parents of transkids for many years now.  What they go through is heart wrenching.  I’ve talked to both supportive and non-supportive parents.  I’ve talked to even more transfolk, both those who were transkids and those who were adult transitioners.  Each was impacted either positively or negatively by their parents attitudes… but none were hurt more than those transkids who had been emotionally abused or abandoned by their parents as teens.

TransSupportUntil the advent of ubiquitous social media, the main means of “trashing trannies” was mass media and churches.  But now, with social media, parents of transfolk are bombarded with conflicting messaging from all sides and can have difficulty knowing which information to trust.  Just as in politics, there is now a great deal of “fake news”, propaganda, misinformation, half-truths, even outright lies to be found online.  Some of it from people whose only interest is to hurt transfolk because of religious or socially formed trans- and homophobia.  Some of it is from transphobic parents of transkids themselves.  There are even websites and discussion fora created by these very same parents bringing together such like-minded folks to create a wave of disinformation, fear, uncertainty, and doubt in others so as to bolster their own decisions to deny their own children the respect, agency, and medical services they so clearly need.

In this post I will actively gather such propaganda and explore how it works and why it is wrong.  My goal is to help parents recognize when others are trying to manipulate their emotions to effect their decision-making.  This will be an ongoing effort so this essay will be updated whenever I see or remember an issue that needs to be addressed.

Blaming the Internet and Other Transkids

A recent meme to question the validity of gender dysphoria in teenagers is the concept of “Rapid Onset Gender Dysphoria” (ROGD) in which being trans is described as a “social contagion”.  Gee… that’s just saying this is a “fad”… and like the old “phase” claim that transkids were discredited with in the past.  I’ve written an entire essay on this.

Therapy

In the past, it was near universal for therapy of gender atypical children, most often male, to mean attempts to “fix” them so that they were no longer gender atypical, as that was seen as a disorder in and of itself.  It was also believed, falsely it turns out, that if they could get these boys to be gender typical in their behavior, they wouldn’t develop into transsexuals or gay men.  Therapies ranged from gentle “play” with a masculine role model to direct punishing and shaming children for atypicality on one hand and rewarding gender typicality on the other.  Both philosophies encouraged parents to remove any and all cross-gender toys and activities and to shame children, especially boys, for such play.  Therapy for gender dysphoric teens was to “talk” them out of wanting to transition, usually by shaming them.  Today such therapy, along with therapy meant to “talk” gay & lesbians out of being homosexual, is recognized as being both ineffective and abusive.  Some states and countries have outlawed such practices.  Professional societies of therapists and physicians have declared them to be unethical.

{Personal note:  I was sent to play therapy as a ten-year old with Dr. Peters (you can’t make this stuff up) a tall bearded man as a role model.  While at home, my mother would jump down my throat if I so much as looked at a girl’s toy.  Of course, that didn’t work, so I was sent to talk therapy at 15/16, but knew enough not to talk about either my sexuality nor my gender behavior and identity so as to avoid any opportunity to shame me.  Thus, I know about these practices first hand.}

Today, most caring therapists and other caregivers recognize that gender atypicality is not in and of itself a disorder.  They also recognize that most young mildly gender dysphoric children will desist on their own as they near adolescence, so there is no need for drastic measures either way.  However, extremely dysphoric children need outlets for their gender expression and that attempts to suppress or change their innate behavior is abusive and will only result in low self-esteem and shame.  They also know that such children need reassurance that they are loved by their parents.  If punished for gender atypicality and/or expressing the pain of dysphoria, the bond between parent and child is put at grave risk.  And yes, some therapists and their caring families recognize that some pre-adolescents and adolescents are better served by social transition.

This new kinder and gentler approach to gender atypicality and gender dysphoria has led to disinformation put out by those who wish that they could continue to offer abusive  reparitive / conversion ‘services’, falsely claiming that such therapies do work.  Transphobic parents and members of the public also lament this situation and put out the lie that “affirming” therapists are forcing gender atypical children and teens to become transgender.

The basic truth is simple… just as it is not possible to “fix” LGBT people, it is not possible to force them to be LGBT against their nature.  Saying otherwise is an outright lie.

Another tidbit of disinformation is claiming that therapists regularly “ok” teenagers to get hormones with only one visit.  In over four decades of experience and discussions with literally… oh I can’t even guess the number of transfolk of all ages I’ve met or corresponded with.  It would have to be the hundreds now, the fastest I’ve ever heard of for someone to get their “letter” approving HRT from a psych professional was five one hour sessions.  And when others hear of that low figure, they are incredulous because most adults were required to have at least several months of weekly sessions and most had more, some over a year or more.  There’s a reason why therapists and psychiatrists are called “gatekeepers”.  For minors, it might be faster to get onto puberty blockers if they are seen in longer more intense sessions with at least one second opinion since the clock is seen as “ticking”, but to switch from blockers, or for an older teen, one already past puberty?  That will take longer.

{Personal Note:  I was that teenager who had only five hours in 1975, a record even for the Stanford Gender Dysphoria Clinic: three one hour sessions alone, one hour with my mother, and one hour with my father.  You may read about those interviews here.  And no, I have no real idea why I got my letter with so few visits, but if I had to guess, it was because I still had to wait until I was 18 because my parents refused permission… and that I had previously been in therapy that had been anything but “affirming”.  Interestingly, when I was 23 and had the funds for surgery, the surgeon, a private doc in Colorado, required two recent “letters” from psychiatrists.  I had six one hour sessions with one psychiatrist and one hour for the second opinion… this too was considered a record.  This one I did know why… emotional maturity, intelligence, and five solid years post social transition with a great work and education history.}

 Social Transition

transkids

Transkids after social transition

I see over and over claims that merely allowing a child to cross-dress or socially transition is a form of “child abuse” in and of itself.  I’ve even seen transphobes complaining that letting non-transkids know that transkids and transadults exist and should be accepted and respected, is a form of child abuse!  These claims are usually from the most virulently transphobic and homophobic members of the public.  However, there is a more subtle form of this parental shaming in that people claim that because many pre-teens who are gender atypical will not be gender dysphoric, that they are “forcing” their kids to be transgender.  This meme even floats in the gay and lesbian community claiming that parents do this because they are homophobic and would rather have a transgender child than a gay or lesbian one (!).  My own experience has indicated that homophobic parents are universally also transphobic, so the logic of this assertion is faulty and groundless.

Parents should be advised that many pre-teens who are gender atypical will in truth grow up to be gay or lesbian, but there is no magic bright line difference between transkids and LGB individuals.  That is to say, that from our current state of research, we can’t tell them apart… and indeed, there may be no etiological difference, that the difference may in fact be one of degree and not of kind.  We see cultural and life experience differences leading to differences in rates of gender dysphoria in different cultures and subcultures in what may be the same biological groups.  Given this, loving parents should be open to listening to the needs of their children as they grow up and be flexible in their hopes.

A recent meme making the rounds is that if a child is allowed to cross-dress as a pre-teen, to use a new name etc. they will have social and personal difficulty later when they desist from being gender dysphoric.  Some go as far as to say that this will cause them trauma, having spent years growing up presenting as the “wrong sex”.  But this only shows their own transphobic bias, valuing the lives and welfare of desisting children over persisting transkids.   Consider this from the viewpoint of persisting transkids, if having to grow up presenting as the “wrong sex” is traumatic and that transitioning is a social and personal difficulty at that later age, won’t these kids have had a similarly bad experience if they are not allowed to socially transition earlier?  Either both are true or neither is true.  Actually, the truth is that children who will desist later are still in pain now.  And desisting children detransitioning is no more traumatic than either type transitioning in the first place.  But the transphobic propagandists aren’t interested in nuance and dealing with things in such a way as to reduce pain for everyone on a day to day basis.  Remember this.  Their goal is not to help your child be happy and emotionally healthy.  They are only interested in frightening the parents of transkids into NOT allowing them to socially transition in the hope that denying them this at a young age will force them to not get puberty blockers, which will them force them to endure a puberty which will make it that much more difficult for them to transition successfully as adults, which will keep them from being “one of those people”.

One of the ugly issues I’ve seen thrown around is that of impugning the motives and values of various researchers and clinicians, on both sides of the issue of pre-teen transition.  Most professionals have nothing but good intentions.  Each has nuanced views because this issue is not black and white.  But many insist that it should be black and white… and thus will smear those who don’t agree with their own position.

After the age of twelve, social transition is, or at least should be, a no brainer.  If a teen was gender atypical and dysphoric as a preteen, their desire and need for social transition is one that they should decide for themselves.  In fact, attempting to socially transition is a great “test” since if it doesn’t help them, it will be an obvious fact.

Surgery

Perhaps the most common propaganda seen bandied about is the oldest.  In the mid-50s, as the public began to learn about transsexuality and its medical treatment, many were quick to note that “there is no such thing as a sex change”, as though that proved something profoundly debunking.  Well, this is both a true and yet misleading statement.  It is true in that no surgery, then or now, can take a fertile individual of one sex and result in a fertile member of the other sex.  What is misleading is that the goal of surgery was never fertility, but palliative.  It is to allow individuals who suffer, and suffer greatly, from somatic gender dysphoria to inhabit a body that approximates that of the opposite sex to a close enough degree that it alleviates their dysphoria.  Although many transfolk would love to be fertile in their new gender, they are willing to accept this trade-off to enable a good enough life.

Some people will point out that SRS sterilizes transfolk as though that were in and of itself medical malpractice, even incorrectly invoking the Hippocratic oath “to do no harm”.  This is a puzzling attitude since many medical issues are treated in such as way that also results in sterilization and no one calls that malpractice.  In fact, many healthy men and women chose voluntary sterilization which is an accepted practice.  For young adults (even if under the age of 18) to knowingly make the trade-off of continuing to suffer somatic gender dysphoria vs. accepting voluntary sterilization is a personal choice for them and them alone to make.

The next bit of propaganda is to describe the result of surgery as ugly, monstrous, or diseased to invoke visceral disgust.  Mary Daly, an extremely transphobic author in the 1970’s described post-operative transsexuals as “Frankenstein’s Monsters”, invoking the image of people hacked together by rogue mad scientist doctors.  Other comments focus on and exaggerate the potential for surgical complications.  Very recently (in fact, just this past week), I’ve seen an outright lie repeated and amplified in social media in which the result of Male-To-Female transsexual surgery is an “open wound” which is easily “infected”, rather than a functional neo-vagina.  What loving parent would want their child to experience such iatrogenic trauma?

A more subtle bit of misleading disinformation is to combine the two memes above, to describe the result of MTF surgery as taking functional male genitalia and turning it into “dysfunctional male genitalia” in an attempt to invoke disgust on one hand and parental concern for their child’s future happiness on the other.  The lie depends upon parents not being familiar with the cosmetic nor functional results because, lets face it, that’s not something to be bragged about in public.  So, I will attempt here, while remaining within socially acceptable bounds, to answer that, given that I myself have such “dysfunctional male genitalia”…   Ummmm… well… I’m VERY happily married to a straight man… and neither of us is unhappy with the results…  ‘nough said.

Another reason these particular talking points work is that parents hang onto the false hope that their child will desist and be heterosexual.  While it is true that pre-teens who are gender atypical but not particularly dysphoric are more likely to desist than persist,  such boys will most likely grow up to be gay, the girls may or may not be lesbian, given that many tomboyish girls are mislabeled as gender atypical.  These tomboyish girls will most likely grow up to be straight.  However, those teens who had been gender atypical AND notably gender dysphoric as pre-teens will not likely desist after age twelve.  Besides, one doesn’t perform surgery on pre- or even early teens.  One is required to wait until the late teens at the earliest and by then, it’s pretty obvious that surgery is right for those who know the trade-offs… and rationally chose to exchange genitalia which they will never use for those that they will joyfully use.

Another bugbear thrown around is the specter of post-operative regret.  I won’t lie in turn; this is a real phenomena.  However, what is not often discussed in the parental fora is that the vast majority of those who later regret SRS are “late onset”.  (If you are not familiar with this term and its implications, please see my FAQ.)  These are usually males who have successfully lived as adult men, very often married to women, fathering children, etc.  They previously had extensive sexual experience as men, enjoying their ‘original equipment’.  Post operative regret is nearly absent from “early onset” transsexuals.  And those few who were regretful weren’t regretting the loss of their ‘original equipment’ but complained of the rare complications that may occur with any surgery.

For parents of Female-to-Male (FtM) transkids, there is often fear that “top surgery” to remove/reduce unwanted breasts will be regretted as well.  This fear is especially potent in the mothers of FtM transkids because of the natural empathy one feels, of putting themselves into their child’s position and feeling angst at the thought of the loss of their own breasts.  Of course, this is putting their own shoes onto their child, instead of walking a bit in theirs.

Puberty Blockers

CoreyOne egregious lie that I’ve seen bandied about, even by physicians, is that puberty blockers cause permanent sterility, often with the misleading term “chemical castration”.  They do not.  In fact, that was the whole point of puberty blockers, to reversibly delay the onset of puberty and its effects to allow young teens some time to emotionally mature before making more permanent changes in the course of their sexual maturation.  Without such blockers, their bodies will make the decision for them… and this may be very much against their wishes (it certainly was against mine!).  Cessation of the blockers allows the natal puberty to resume, with no loss of fertility, unless other medical intervention is begun (such as cross-sex hormones).

Another outrageous lie that I’ve seen recently is the assertion that Lupron (puberty blocker) directly causes suicide.  I guess if one is going to lie, one may as well make it a whopper.  To be clear, there is NO reported association between puberty blockers and depression / suicidal ideation in transkids.  However, if a child who is extremely gender atypical and dysphoric experiences negative social and familial attitudes, that may be an independent source of stress leading to depression.  Depression is unfortunately common and people who are prescribed Lupron as adults are often under severe stress due to their underlying illness, leading to reports of depression.

I’ve also seen a rather strange assertion that having been on puberty blockers then switching to cross-hormone replacement therapy somehow leaves the child in a prepubescent state. In the sense that the child won’t experience the changes that would have occurred had they not been on blockers, namely for natal females breast development or for natal males, enlargement of the penis and testicles, voice deepening, beard growth, along with increased upper body strength, this assertion is true… and indeed is the desired effect.  So why the strange assertion that this is somehow a problem?  The meme is also sending the false message that somehow the child will remain forever looking like a prepubescent child, never to appear to be as a sexually mature adult.  The fact remains that cross-sex HRT will allow the child to mature with all of the cross-sex secondary sexual characteristics in a manner closely approximating that of the opposite sex, which is, after all the goal.

Perhaps the most bizarre bit of misinformation is that somehow, if an MTF transkid doesn’t go through the typical natal male puberty to sexually mature, they will never be able to experience sexual satisfaction.  While testosterone does cause human male brains to develop at puberty, estrogen and micronized progesterone, both part of HRT protocols, will do much the same.  In fact, though never published, there is very strong anecdotal evidence that MTF transkids experience very strong libido development on natural estrogen (E2) compared to other sources (e.g. premarin or estinyl-estradiol).  If you think about it for a moment, this makes sense… given that women have sexual drives as much as men do… and they never went through a male puberty!

It could be argued (and indeed I have so argued), that it would be better to switch from puberty blockers to HRT earlier than some clinicians insist upon waiting, so that the final results are better and so that the teens will appear to be maturing on the same schedule as their peers, for better social functioning.  There are also concerns about bone strength later in life which may be impacted by extended use of puberty blockers.  This is an argument for earlier HRT, NOT against the use of puberty blockers.

One of the most illogical arguments I’ve seen against the use of puberty blockers is twisting the statistics that most transkids who go on puberty blockers will persist and require HRT and perhaps surgery… as though being on puberty blockers caused them to persist (!).  This is a failure to note that desistors do so before puberty.  The fact that most persisters in puberty who go on blockers continue to be gender dysphoric is a non-causal correlation.  The fact is that persisters who are unable to obtain blockers or HRT at that age will also remain gender dysphoric and will seek out and obtain HRT at a later age (either on the street or legally when they reach majority as I did).  Refusing to provide blockers or HRT in puberty will not increase the rate of desistance but will increase the need for more medical / cosmetic interventions later on (e.g. mastectomy / electrolysis) and likely leave such an individual “funny looking” as an adult (e.g. wide hips on a transman, androgynous face and low pitched voice on a transwoman).

A recent lie I’ve seen is to talk about parents putting their children on puberty blockers as early as age eight (or even age six in one recent agit prop piece in the Federalist !!!).  Of course, this was a deliberate distortion of the truth that some children ARE placed on puberty blockers at age eight or nine.  But NOT because they are gender dysphoric, but because they have precocious puberty.  These children are on puberty blockers because entering a precocious puberty at age eight or nine is not good for their long term health, regardless of whether they are gender dysphoric or not.

Hormone Replacement Therapy

The most common bit of propaganda about hormones is that their use will be “life long” as though that was somehow an evil in its own right to be avoided at all costs (even including living a life of unhappy gender dysphoria and social akwardness).

To make a personal digression, swallowing a few pills each day has never been a major issue for me these past four decades and some.  Far more impactful in my own life is the fact that I’ve been dependent upon asthma medication since I was five years old, medication which has far more harsh side effects (theophylline caused insomnia for years, rescue inhalers cause the heart to race and the lungs to itch uncomfortably, steroid inhalers increase the risk of fungus infection in the mouth and throat… and if the meds fail to control the asthma, a trip to the emergency room is needed or one could die, no joke) and far more expensive.

Those who have diabetes are similarly dependent ‘life long’ upon insulin, a life saving medication.

However, forgetting to take one’s hormones for a short period of time is NOT life threatening, nor even very uncomfortable.  A few weeks of not taking them, if one has not had their gonads removed, they will begin to produce steroids again.  If they have had their gonads removed, they may experience ‘hot flashes’.  While not comfortable, they are not life threatening.  The greatest danger is the potential risk for osteoporosis.  But this an increase in the risk, not a certainty.

A number of individuals point to HRT as being inherently dangerous, increasing the risk of blot clots, etc.  These risks are no greater than girls taking birth control pills and if one is seriously worried about it, one can simultaneously take baby asprin as a blood thinner.

Another bit of propaganda is to grossly exaggerate the risk of breast cancer from estrogen.  However, with decades of HRT use by transsexuals, we have only seen a small handful of cases which were certainly NOT indicative of increased risk compared to natal females.  In fact, the risk seemed to be at about the same level as natal males who were not transgendered.  (Yes, men get breast cancer too.)

Interestingly, the risk of some cancers is significantly reduced in transsexuals due to surgery and HRT.  For example, top surgery reduces the risk of breast cancer prophylactically.  Radical hysterectomy (as part of ‘bottom surgery’) eliminates the risk of ovarian cancer.  For MTF folk, SRS eliminates the risk of testicular cancer and reduces the risk of prostate cancer, as does HRT itself.

As well as claiming risks of cancer, I’ve seen outright lies that HRT causes mental illness!

Another gambit is to point to a couple studies that show that estrogen “causes cognitive deficits” in MTF transfolk, specifically reducing their mental rotational abilities, while also saying that testosterone reduces FTM transfolk’s verbal fluency.  The HORROR, HRT causes mental problems!  Actually, what they are measuring is the very tiny subtle differences already found in men and women in which men are very slightly better, on average, than women at mentally rotating three dimensional figures and women are very slightly better, on average, than men at verbal fluency.  These turn out to be influenced by hormones in the brain, so no surprise that they should influence transfolk on HRT.  But the effect is so small as to be almost impossible to detect in any one individual.

I think the silliest claim I’ve heard is that “Big Pharma” is pushing the diagnoses of gender dysphoria so that they can sell more hormones.  Given that gender dysphoria is extremely rare… but even if it is silly on the face of it, officials in the UK actually investigated that claim and debunked it.

Parents deserve accurate information, not propaganda and lies — from either side.

 

NOTE:  If you see anyone spreading these memes, please respond with a comment and a link to this post?  If you have seen other examples of false propaganda directed at the parents of transkids, please share them with me?   formertranskid@gmail.com

Further Reading:

Advice to Parents of Transkids

Shameful History of Reparative Therapy of Transgender and Gay Children & Youth

Further External Reading:

When Children Say That They Are Trans by Jessie Singal

Transphobic Parents Activists Target Journalists With MisInformation About Pediatritricans by Tara Haelle

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