Dear WPATH Doctors: I don't forgive you.
Dear WPATH Doctors: I don't forgive you.
This week I listened to podcasts and read articles that surprised me, along with a lot of parents I know. For years now we have all been told things that are deeply disturbing to us as parents. We've been told that puberty blockers are completely reversible and have no long term harmful side effects. We've been told that we have to affirm our kids and get them medical interventions, because they will kill themselves otherwise. We've been told that our kids have a gender identity that is part of their soul and will never change, that they were born with it, and that it's not a social contagion. Now just this week three of you have come forward to say that you aren't so sure about that after all.
Dr Laura Edwards-Leeper, you say that kids should always get a thorough assessment, that there could be other things going on with my child that ought to have been addressed before medical transition was started. You now say that you know that there are kids who deeply regret their transition, and that we really need to be more careful. You said that there's no actual proven cause and effect relationship between trans medical care and suicide, that it's not proven that I have to put my child on hormones because if I don't, she will kill herself. I appreciate that.
Dr Bowers, you now say that a child can't possibly consent to a lifetime of being inorgasmic and infertile. You said that children can't be informed of things they can't understand. You admitted that it's possible, likely even, that there's an element of social contagion going on. You said, “There's a little bit of 'yeah that's so cool. Yeah, I kind of want to do that, too'”. That doesn't sound like a fixed unchangeable identity to me. It sounds like you don't think it is, either.
Dr Anderson, I really appreciate that you admitted that you're not sure whether puberty blockers really are reversible.
I feel like I should be happier about this. After all, this is what we have all been saying for years now, and we keep being told we are crazy hateful bigots for saying it. No one wants to listen to us. They won't print our stories, or even leave our comments up on newspaper and online articles. It's like we never said it. But we did, and time and again we have been ignored. Now, finally, someone else dared to say it, someone with authority that people will listen to.
But as I listened, I noticed something.
It sounds like you are saying that you didn't do these things. You wanted my kid to be assessed. You thought she needed thorough assessment (which didn't happen). You knew my choices were not a live son or a dead daughter. You would not have said that, would you? You were setting the standards higher, and it's not your fault that not everyone followed them. So I shouldn't be upset with you.
The problem is, you did do these things. Every single doctor that rushed to prescribe life altering drugs to my child, every teacher, that told my child that her classroom was a safe space and my home was not, every therapist that told me, in front of my child, that she would commit suicide unless I affirmed, every one of those individuals used your standards in order to justify doing these things. I was told to trust the experts, and the experts all looked to you for guidance.
And then, when it turned out you were wrong all along, that's when I learned that there aren't any actual standards. Your “standards” don't hold any authority, and there's no reason why anyone even has to abide by them. That means that if it turns out you were wrong about my child, no one is actually responsible. You will be off treating the next trusting, vulnerable, frightened family, with an air of professional authority.
The World Professional Association of Transgender Health sounds like a pretty legitimate professional organization. After all, if you are the world experts, surely you ought to be able to set some boundaries and actual standards. I'm sure if I go in for heart surgery, there are standards about what should and should not be done. I'm sure that if it turned out that a significant number of heart patients experienced lifelong traumatizing irreversible harm as a result of heart surgery, someone would be doing something about it.
If you knew that it's quite possible that social contagion is real, that puberty blockers might not be reversible, and that children can't really give informed consent, why have you remained silent? If your “standards” are the best, and your recommended interventions are truly life-giving, then surely you can stand behind them. If gender practitioners aren't doing anything wrong, surely they should be willing to take responsibility if it turns out that the things they have done have actually created harm. Surely, if they have been doing the right thing all along, they shouldn't be afraid of litigation.
If you are the world experts, as you set yourselves up to be, why are you not actively promoting and sponsoring rigorous, unbiased research into the safety and efficacy of serious medical interventions for children and young adults? Research should be scientific, that means that we should be using time honored standards of research, things like controls and randomization and long term follow up. When I look at the “studies” that are being quoted as science in this field, it's truly scandalous. The methodology isn't just sloppy, it's not even deserving of being called methodology at all. You pretty much admitted that. And yet these flimsy reports that are in reality nothing less than propaganda are repeatedly called studies. Let's do some real studies, fund them properly, and believe and publish the results. Kids lives are hanging in the balance of your words, along with the families who love them. We deserved a lot more from you.
If you are the world experts, please start telling the truth about your failures. Please start listening to, believing, and actively helping those who are coming forward to say that the interventions you have promoted were damaging. Please stop blaming them for the problems you helped to create. They need counseling, compassion, and insurance coverage to undo the damage that you have participated in. Instead they are shamed, ignored, and told that they are so rare they aren't worth considering. Are you interested in doing some serious research into how many detransitioners are out there, unable to find help for the wounds you so casually helped to create?
I'm really quite puzzled by the seeming lack of concern here. Actually, puzzled is not the right word. I'm intensely furious, and I think I have a right to be. From where I sit, you don't seem to take the lifelong health and well being of my child very seriously at all.
So no, I don't forgive you. It's far too little, and way too late. Step up and fix it. You have the power and ability to do so.
Hi everybody. Transgender woman here, historian, and only just now beginning my hormone treatments at 35 years old.
You talk about kids and children like all this happened when they were 8 or 12 years old. But then you talk about how your child is 18 or starting college, and how you've threatened to cut them off financially if they make the decision to undergo hormone treatments as an adult.
You mention that these "kids" are too young to smoke, although I'm pretty sure that only happened a couple of years ago, and I think we can agree, even smokers, that deciding to smoke is always a bad choice, but sooner or later, 18 or 21 or sometime, people have to have the freedom to make that decision for themselves. But there's no success stories out there for cigarettes.
You know, before all of this affirming care you're so upset about, there were assessments and so forth to prevent just anyone from accessing transitional care, all willy nilly. Older trans folks can tell you all about gatekeeping, how they had to convince multiple doctors they were "trans enough" to be treated. Sometimes they had to "live as" the gender they identified with for a period of time WITHOUT hormones, which some could do comfortably, but I can tell you first hand that for others that was an absolute nightmare.
I came out 8 years ago. But I could not access affordable and affirming care at that time, and I was forced to relocate to my home city, an even less accepting community, in order to make ends meet, just as the Trump administration began. To this day, only people who are close to me know me as a woman, and I go about my business in public presenting in a way that allows me to pass for a cisgender man. I have skin issues related to shaving, so most of the time I have at least light facial hair. I live and work in an area where I would be fearful to leave the house wearing a dress, much less pumping gasoline, or shopping at a hardware store. The idea of having to perform some doctor's idea of womanhood, to their satisfaction, for a YEAR? TWO YEARS? Before being able to start hormone therapy? That is deeply terrifying. That would make me fear for my safety.
I started the process of seeking out gender affirming treatment in late August. I had blood tests taken in late September. Now I have an appointment to see my endocrinologist in mid November. So from the day I filled out my intake forms, it will have been at least four months before I get my first dose of testosterone blockers, and that's only if there aren't any other hoops I will have to jump through first.
I have personally met and befriended more trans people than I can reasonably guess at over the past eight years. MOST of my friends and acquaintances are transgender. The best I can do for a number is that I am CONFIDENT the number of transgender people I have counted as close friends and confidantes is greater than fifty. Virtually all of them were already receiving hormone therapy. Many of them had already undergone surgical treatments I will never be able to have. Others have received surgical treatments since we met.
I have met ONE person who regretted her decision to receive hormone treatment, and it wasn't because she wanted to return to her birth assigned gender, but because the harassment and cruelty she faced from people who recognized her as transgender was so emotionally devastating that she couldn't bear it. She was bullied into detransitioning by... nobody in particular. The general public.
Now I did meet plenty of trans folks who went off of testosterone or estrogen for a while because their doctor moved to a new city and they couldn't just *find another doctor* in time to refill their prescriptions, or because their pharmacy experienced a shortage and even after rationing their dosages, they still ran out before they could get a refill. I've met plenty who could not afford to get their refills because they were close to homelessness. I've met a few who had pharmacists refuse to fill their prescriptions so they had to have them transferred to another pharmacy--fortunately since CVS fired someone for that in 2018, that one issue will hopefully be less and less of a problem.
We experience job discrimination, housing discrimination, harassment while commuting, while shopping, while dining out, sometimes while checking our mail. Those of us who are lucky to have the right skill sets manage to get remote jobs, but many of us are relegated to low wage "back of the house" jobs like line cook or dishwasher. Or the worst jobs of all: customer service. Cisgender heterosexual people who work as retail associates, cashiers, or waitstaff can tell you that there are ALWAYS customers who treat you as less than a human being. Add the harassment and bullying trans people face daily on top of that. Now realize that coworkers and managers frequently speak disrespectfully of their trans coworkers when their back is turned. "But that can't be at every job," you might start to say... are you aware just how financially dangerous it is to quit every job where your manager and/or coworkers belittle you and make jokes about you? How long will it take you to find another one? What if you still don't get paid until two weeks after your start date? What if that workplace turns out to be just as hostile, and you're back where you started? Most Americans live paycheck to paycheck, and trans folks experience financial insecurity at disturbingly high rates, for all the reasons I've just described.
Stop me if you've heard this one, but WHY WOULD WE CHOOSE THIS? You talk about social contagion... I don't know if you're aware, but it's not "popular" to be transgender. What you call social contagion is just young people becoming aware that gender transition, or rejecting the gender binary altogether, is a possibility. I can identify signs that I was transgender dating back to when I was five years old. And I can identify the first few times that the concept of being transgender was introduced to me. Two of my relatives at a holiday gathering, laughing about a married couple in the local news who transitioned together, like they were side show freaks. A friend's mother telling a story to a group of us children about a boy who wished to be a girl, and had his wish granted at a great cost, but then realized she didn't want to be a girl anymore now that she had experienced it, and ended up paying double the price, just to be back where he had started. Kids in school making crude jokes and using slurs to talk about trans women.
Gender transition is NOT the cool new trend all the kids are excited about. But if they are allowed to know that it's a thing some people do, many will realize that they'd rather face down all the meanness and adversity than live stifling, inauthentic lives of quiet desperation. That's what's happening.
Why do we have high rates of mental illness? I mean, we absorb all the things you teach us about gender identity, and it hurts. Being told to man up, people making fun of us for our mannerisms or our interests or how we dress or carry ourselves, not for "cross dressing" or anything, just for failing to embody our assigned gender to other people's satisfaction. We feel something wrong, or something missing, and we become reclusive or we find unhealthy coping mechanisms. Because we live in a world where we learn very young that a lot of things are off limits to us, and a lot of things are expected of us, whether that's who we really are, or not.
You say that you are told when you speak up that those who regret transition are so few as to be negligible, and suggest that if heart patients frequently experienced life long irreversible complications as a result of heart surgery, it would be a big deal. NEWS: people who have open heart surgery *DO* frequently experience those things. And your children, at least a few of you who have discussed them, your children sound like adults who know themselves, not minors who have been medically harmed and emotionally scarred by the side effects of puberty blockers. It sounds to me like you're about to have your children achieve financial independence and then stop answering your phone calls. I would advise you to stop trying to control them and start showing them that you love them enough to accept them as they are. Or as they choose to be. Which brings me to my final point.
As far as whether it's a choice or an immutable part of who a person is? Gender isn't real. Biological sex isn't simple black and white. And the connection tying biological sex to gender is arbitrary. Examining and exploring your gender and how you present yourself is something EVERYONE should do, if only so that cisgender people will KNOW they are cisgender, instead of just being pushed into a mold the day they were born and conforming without really ever thinking about it.
Now, odds are slim that even a single one of you will think seriously about what I've said here. But that's on you. I hope your children live long, happy lives whether you step up to the plate and show them the love they deserve, or not.
I am glad to hear your anger! That Bowers character is a sociopathic ghoul in an expensive wig, still raking in $$$ ruining lives even as he backtracks. And he is set to be the face of WPATH into the future. I refuse to be among those who look past his weakness and venality to laud him in any way. He should be vilified, his name and face on posters wheat-pasted across every city alongside the names and faces of all the other ghouls we know by name who are making their fortunes and careers by driving this insanity. Thank you for a great essay!