A Letter to Parents from A Concerned Therapist

For the last few months, I have been reading parent accounts of how some people in the medical, mental health, and educational fields have hurt your children and helped pull families apart. You understandably tell each other to stay away from these providers all together because you never know who you can trust. I have found myself in the same situation. I do not know how to connect to others in my field when all I see are individuals violating all ethics and reasonable standards of care, and in doing so, completely ignoring the education and training we all received. I have looked and looked to find others that share my views, but I have had very little success. My wish for this piece is that it will provide support, validation, and most of all, let you parents know that there are some of us trying to figure out how to make this stop.

The first ten years of my career I worked with all ages of children and younger adults. I held several clinical positions with a large and well-respected community mental health clinic and, from the early through mid-2000s, I worked with hundreds of children. Many were victims of abuse, many were severely mentally ill, and some just needed support. I saw extreme behaviors, complex mental health issues, eating disorders, and substance abuse. I saw ADHD, PTSD, BPD, Autism and learning disabilities. I saw plenty of teenagers that were questioning or struggling with sexual orientation, but what I did not see, not even once, was a child experiencing distress with gender identity.

Much of my work predated widespread cell phone use, and as soon as it became more common, we immediately saw an uptick in eating disorders and self-harm behaviors. It was clear that there was a social contagion aspect to this, and we openly talked about it in our supervisory meetings. We all saw the bleeding-arm-holding-a-rose screen savers on our client’s phones that clearly romanticized self-harm. We saw scars go from being hidden to becoming badges of honor, a way to prove how much someone was suffering. We saw the rise of “Pro-Ana” websites, where girls learned how to be better Anorexics and found words and images that empowered them to be sick. No longer were they battling just their own minds, but they now had access to and support from the multitudes of others that vied for the rank of most ill. A mental health diagnosis was no longer something to be hidden or kept private, now it was an identity. At first, we were hopeful that this de-stigmatization might help more kids that were suffering, but it quickly became clear this was not the case, and we knew that we were in a scary new frontier in children’s mental health.

Not too long after this I left that organization to start a family. I was occasionally on social media but had very little time to keep up on current events. My life was content, but I was anxious to get back to work. I had found my niche as a mental health provider for children in my early twenties, and I was absolutely dedicated to giving them outstanding services. In late 2017 I returned to work in private practice, and within just a few months of starting to see clients, I had my first trans-identified, pre-teen girl. We had been meeting for several months when out of the blue, she disclosed that she felt like a boy, wanted a new name and new pronouns, and wanted a chest binder and hormones. I was not prepared for any of this and immediately started to research. At the time I was only focused on finding out how I was supposed to be addressing this as a therapist. I read that the APA was recommending that I use all her preferred pronouns and new name, and that I was to simply affirm her choices and perhaps offer referrals for medical services.

For a while, even though I knew this child was not suffering from gender identity disorder, I followed the guidelines. I used the new name and pronouns, but I also told her parents that I did not believe their daughter was transgender. I explained that I was worried about the influence she was getting online, specifically on sites like Discord. They agreed with me but were scared that their daughter would hurt herself, so they did not want to risk pushing back. This was a smart, beautiful young woman who was telling me that she suddenly wanted to transition to a boy, or she would die, and I felt professionally frozen. Soon after this I began to see more and more girls under age 25 identifying as trans or non-binary. Some of these were on the Autism spectrum, some had been sexually abused or traumatized in some way, and all of them very clearly had other mental health issues.

Over the next two years I tried my best to handle this the way I was being told that I should. I did not believe that anything about this was reality-based, and it all went against what I know about mental health and human development. I had worked with other forms of dysphoria, and I had never once been instructed or inclined to affirm a delusional belief. When I talked to the parents, some were supportive of this new development in their kids, but most were confused and scared. The ones that were supportive were doing it in very public ways, and when I tried to gently talk to them about my concerns regarding posting on public platforms, I was met with anger. I started to think that maybe I just did not understand, and I knew that I needed to educate myself in order to provide ethical services. I then did something I never thought I would do, I stopped working with children.

Once I dove more deeply into the topic, it quickly became clear that something was very wrong. The numbers of children self-identifying as something other than their actual gender was statistically improbable, and the number of girls specifically was off the charts. Even in the face of these numbers, the word from psychology organizations was affirmation only. It felt like a war on childhood, and especially an attack on those of us who did not fit the standard mold. I started to feel very protective of these young children who were being told that the only path to true happiness is to be something other than who and what they are. I knew what that felt like, and I know how powerful it would have been to be told there was an easy way out.

I began looking more closely at the parents in these situations, the ones posting joyous videos and messages, and saw clear evidence of attention-seeking behavior. This seemed like a new version of Factitious Disorder Imposed on Another (FDIA), previously called Munchausen by Proxy, and now professionals seemed to be participating. I started seeing interviews with therapist, blissfully talking about the “really important work” they are doing by helping children transition, and I felt like I was living in an alternate reality. I wanted to believe that most of these “allied” parents truly believe that they are doing the best thing for their child, just like I wanted to trust that the therapists and doctors participating in this believe they are practicing good care. Unfortunately, what I know to be true is that there are parents who are intentionally pushing this onto their child, especially the youngest ones. I also know there are care providers who know this is true, and still go along with it.

This brings us to the final piece of this awful puzzle, which is the “allied educators.” My trip down the rabbit hole on the internet unearthed the trove of supportive teachers that are ready and willing to provide students with all the love and affirmation they are not getting from transphobic and hateful families. There is a litany of offers to these vulnerable and confused kids to DM them for help, these grown adults talking about how they will provide advice to aid them in finding their true selves, away from the prying eyes and hurtful influence of parents. I believe that this is the most chilling of everything that I have seen, because I know how detrimental it is to put a wedge between parent and child, and how unbelievably vulnerable a child is once that wedge is in place.

As I write this, states like California and Washington are passing laws that claim to protect children from unsupportive families that do not affirm mental illness. If I was practicing with children in these states, I would be required to affirm them or face losing my license, and I would be expected to report parents if they do not fully support. Schools are now hiding things that are dangerous for parents not to know, especially about mental and physical health. Without question there are some situations where children need the protection of a professional, but the people doing it cannot have their own agenda.

To the parents who are navigating this nightmare, I want you to know you are right. You are right about everything, and I wish more therapists, care providers and educators could say it, but I understand why we don’t. I never thought I would stop helping children, but I am so hopeful that if we can turn this tide, I will be able to again. What allows this hope is that I am finding other professionals that feel the same way but are not yet sure how to safely act. I have also found therapists like Stephanie Winn that are, at great risk to their careers, openly speaking out. There is strength in numbers, and if enough of us can find each other and combine our voices, I truly believe we can enact change. Until then, just know that we are out here, and we want to help.