Experiences of an Australian Children's Gender Clinic

A few years ago, my teenager told me that she was transgender. It floored me, because she had never shown any interest in being the opposite sex throughout her childhood, despite having plenty of opportunities to do so.

As I was committed to doing the right thing as a mother – and trusting in medical professionalism – I arranged for us (my child, supported by her father and myself) to attend a children’s gender clinic. What I and my partner experienced there was horrifying.

To add some context, before any of this happened, I already had quite a lot of experience of treatment for psychological issues. Before my daughter was born, I’d undergone intensive psychotherapy. In the quiet space of his small consulting room, my therapist had shown me the power of non-judgemental curiosity, of slow, thoughtful exploration, and of careful untangling. It had changed my life, and from those experiences, I understood what good mental healthcare was. When I took my daughter to the children’s gender clinic to see professionals who specialised in child psychology, I believed she would be receiving medical care based on the same deep, complex understanding of the mind, and heart.

She did not.

For a start, the “care” offered in the first year comprised a two-hour visit with a psychologist, scheduled every three months. This didn’t seem like sufficient time to explore what was going on inside our child, particularly when she was considering a medical pathway with such drastic, life-long effects. Much worse though, was the psychologist’s very noticeable indifference to curiosity.

Not once were my partner or I ever asked about our child’s earlier years, about her development, about any significant events during her life. It was extraordinary. How can any medical professional ever recommend any course of treatment without gaining a good understanding of the patient, and all the facts around their medical complaint?

I had assumed that the specialists in any children’s gender clinic would explore each patient’s motives and feelings around their desire to be trans. I had assumed that, as responsible adults, they would work to determine if this was a temporary phase, or a conscious desire which lay on top of other, conflicting motives, or if the child in front of them was likely to embrace a transgender lifestyle and remain happy with it for life. None of that happened.

Instead, the attitude at the children’s gender clinic seemed to be that 100% of the children turning up at the clinic were 100% trans, and it was the staff’s job to simply support these children into transition. As my partner put it, “their minds were made up long before we got there”.

This underlying attitude is actually revealed in the name of the treatment approach: Gender Affirming Care. In other words, the transgender status of every child who arrives for treatment has been pre-decided, and what these children need is for their true (i.e. opposite gender) identity to be “affirmed”.

The standard – and appropriate – attitude of medical professionals is to be scientifically neutral and professionally curious. It’s not normal practise to pre-decide a patient’s diagnosis before they even attend an appointment. A neutral treatment approach keeps the door open to a number of different treatment outcomes.

Instead, practitioners who have chosen the “Gender Affirmative” approach signal that their attitude is that every child they will treat is transgender and therefore only one treatment outcome is viable. There will be no exploration to see if the child’s feelings are influenced by childhood sexual abuse, childhood trauma or other mental health conditions.

I remember, during one appointment, trying to voice some doubts about this strange certainty. In response, the psychologist asked me to “consider the suicide rate for this group of teenagers”. This was shocking and terrifying, especially considering my own previous mental health struggles as well as the fact that there had been a couple of suicides in my partner’s extended family. From then on, we were in fear for our daughter and chose to show support by being there while keeping our opinions to ourselves.

There was one thing I really wanted to say to the psychologist, if she had been open to my ideas. I actually accept that being in the opposite-gendered body to how you feel is very distressing – distressing enough to push people into feeling suicidal. But if that is the case, then isn’t it also incredibly important that we, as a society, get it right every time we encourage a child to medically transition? Because, by that logic, every child who is transitioned, and who later realises it was the wrong decision and they are now in the wrong body, is just as likely to be suicidal as those in the original group.

In the second year of attending the Gender Clinic, my daughter was moved on to having an appointment with one of the psychiatrists. The psychiatrist – an obviously gay man in his fifties, whose age meant he should have developed some appreciation of life’s complexity – started with questions about whether my daughter had, in childhood, played girl or boy games, with girl or boy toys and had girl or boy friendships. My daughter answered with the masculine choice to each question, yet those answers were completely untrue. I had been there throughout her childhood. Her room was always littered with pastel-coloured soft toys, and her best friends, her games and her playdates had all been with females.

However, I didn’t say anything, as by then I knew it would be dismissed. As a life-long Leftie, who has often been LGB-adjacent, it pains me to say that the children’s gender clinic staff we dealt with (the psychologist and two psychiatrists) were all same-sex attracted. My impression was that they were in this field for political/ideological reasons, and that their views were being shaped by their own unconscious material, which they had not worked through.

They seemed to be equating the experience of being same sex attracted with the experience of being transgender, and they presented themselves as if they had special insight into transgenderism, consequently placing parents and others in the “outsiders” group, whose opinions and perspectives could be dismissed.

Although they had only known my daughter for 8, 10, 12 hours in total, they seemed to believe that they knew her more deeply than her father or myself, who had known her for the entirety of her 16 years. With their lack of interest in what we had to say, it felt like we had been, in their minds, subconsciously cast in the role of the judgemental, rejecting people who had failed to support or accept their sexuality in their own earlier years.

However, while both same-sex attraction and transgenderism are, essentially, feelings based inside a person, with no external physical sign to be able to identify, in other important ways, transgenderism and same sex attraction are quite different.

For a start, anyone could be in a romantic relationship with someone of the same sex for 10 or 20 years, and then realise that they were in fact heterosexual, and walk away with no permanent scars. Secondly, while sexual attraction is hardwired, the existence of detransitioners has been known about in specialist circles for decades.

With transgenderism, we have a combination of a psychological state which does not remain fixed for every person, and dramatic, irreversible physical changes which cannot be amended, no matter how much those amendments might be wanted. In these ways, transgenderism is a much more complex and much more perilous field, needing much greater caution.

I am certain that those staff members believed that they were doing the right thing for the children who came into the clinic. I believe they saw themselves as rescuers, who would be there for these children in the way no one had been there for them when they were growing up. And this was part of the problem. With the overlay of their own unrecognised, unprocessed emotions, any doubt about a child’s suitability for a lifetime of medicalised opposite-sex impersonation became just another example of homophobia.

I also got the impression, when interacting with these staff, that they didn’t have much experience in dealing with children outside their professional roles. Parents, and people who spend a lot of time teaching or caring for children, develop an appreciation of children’s basic contrariness: children are constantly changing, they can be delighted by saying things which offend or frustrate adults, and because they spend their lives conforming to what adults say, they can really enjoy throwing a spanner in the works. Children, including adolescents, cannot fully understand long-term outcomes, and part of parenting is holding them back from following quite a few of their impulses.

In adolescence and young adulthood, my generation dyed their hair bright colours, pierced our tongues and belly buttons, got tattoos, stayed out all night drinking. We did things that we knew our parents would hate, and we enjoyed that. Our clothes and our slang was our own, and we wanted it that way so that we could exclude our parents and the adults who represented authority to us. We played with androgyny: boys bleached their hair and wore silver latex; girls started their own bands and kissed each other under club lights.

If we look back, we can see that it’s completely normal for each new generation to define itself by rebelling against contemporary social expectations. In the early Twentieth Century, young women shocked their elders by smoking in public, cutting their hair short and wearing trousers. In the 1950s, young men rejected predictable career paths, choosing travel and freedom, while a whole new style of music developed that was designed to only appeal to the young. In the 1960s, young women got rid of the restraints of hats, gloves and pre-marriage chastity.

In the 1970s, young people experimented with getting rid of marriage and monogamy (“polyamory” is the latest name for what was called “free love”). Men broke gender roles by growing their hair long. By the end of the 1970s, youth culture had produced punk, which drew on BDSM with black leather outfits, chains and studs. In the 1980s, males in the subcultures of Glam Metal, Goth and New Wave were wearing makeup.

The recent trans-obsessed youth culture seems like the latest progression in the desire to push boundaries.

I tried to bring this up with the psychiatrist, but he responded with “The social contagion theory? No.” It was the first time I’d heard that term, but I could guess what it meant. That was the end of the discussion. Neither he nor the psychologist seemed to understand or appreciate the dynamics of having adults validate a teenager’s opposition to their parents, though adolescent rebellions seems like a very obvious component of the trans wave.

I felt so powerless. I wanted to shout “Where is the proof that my child is trans? What can you point out to me that shows that she is lastingly trans, and that she won’t regret this in 10 or 20 years?” But by then, I was so frightened of losing her, especially after her attitudes had been affirmed by these adults. And I knew that in 2 years, my daughter would age out of this clinic, and these alleged “experts” would never see her again.

They were so certain, yet they would never have to deal with the consequences. They would not be there in 5 years, in 10 years, in 20 years, picking up the pieces if my child struggled to find love because her appearance was too masculine. They would not be there, to try to hold her through dealing with romantic rejection. They would never, ever be there to deal with any of the long-term consequences of their actions. I wanted to ask them to commit something of their own, to show that they did indeed have a genuine belief in their advice. What if they had to pledge their own houses as security, to be used in the future for medical treatments if the children under their “care” changed their minds about transition. Would they be so keen to support medicalisation if there was a future cost to themselves for getting it wrong?

My impression was, not of a clinic which was there to investigate the complex, turbulent inner world of the children, but of a place which was there to validate the complex, unexamined feelings of a group of adults.