To the "helpers"

(those we teach our children to trust)

It must have been so exciting to the two of you when my son mentioned to you that he was exploring his gender!  You'd gotten one of those special kids that everyone talks about! 

For you, his pediatrician, it likely wasn't that much excitement, since you only see him once or twice a year, and your private conversation with him was only a few minutes.  But he respects you and listens to you!  And it meant a lot to him that you were so positive!  Treating him like he was not just some kid, but instead a special kid! Dealing with major important serious things!  I remember the smug look you gave me after you had your chat, but didn’t understand it at the time.

But for you, the therapist who was counseling him every week for anxiety and depression, it must have been a thrill, as you've told me since that you don't know much about gender dysphoria!  You told us parents much later, though, that you kept trying to bring it up repeatedly when he was discussing his other issues!  How daring!  (He brought up suicide, too, at one point, in both cases possibly because the school had a program on it.  I know you didn’t encourage more focusing on suicide. Why? With gender, did you realize you were nurturing a poisonous seed of misinformation that would explode like a time bomb when he developed severe mental distress about other things, later on? Do you know what the words “iatrogenic harm” mean?)

For you two professionals, it sounds like it was such an adventure!!!  But I ask, given that you, the pediatrician, are not an expert on my kid, you barely see him, and you, the clinician, are not expert on gender dysphoria, according to you….why did neither of you see fit to mention this questioning was going on?  

Why was this incredibly important information about our child not shared with us, his extremely involved, loving and supportive caregivers?  You know what sort of parents we are.  There was no reason to expect we would not be there for him. Do you have any evidence otherwise?  There isn't any.  Were we found in any way to be parents who were dangerous, abusive?  In that case, you should have called child protective services on us. You didn't.  You know we are no such thing.  

Nonetheless, instead of alerting us to this serious issue, you just kept it to yourselves.

Despite your admitted ignorance, you, the therapist, felt qualified and entitled to push him to revisit it over and over again.  Without providing appropriate informed support. And without telling us, his parents.  Just your little secret, the two of you! I'm sure he found your conspiratorial approach exciting, too! He got to be so grown up (you know very well he's young for his age)—we parents didn't need to hear a thing! How alluringly transgressive for him! How brave of you!  Keeping him safe! From us!

So what happened?

Well, after reaching legal adulthood, he suffered two painful traumas in a row, and fled online, obsessively. And the time bomb went off: he landed in a bubble where being trans was promised as a way out of his debilitating distress. Online “support” that “confirms” you're trans! Just take this test!  (No, there isn't a test.  Did you know that?) Soon after, we were presented with a very carefully rehearsed (rehearsed with you, the uninformed psychologist) coming out speech.  A misinformed coming out speech. Where he explained that the only way to be happy was to take drugs and that he was going to do it.  And that at his age he was able, he told us very proudly, to do whatever he wanted.

Just like you, we listened to him carefully. And lovingly.  We’re his parents, remember? But then, as his loving parents, we did our homework and found out (quickly, actually) that his "information" about what gender dysphoria requires for treatment consisted of a series of lies that are circulating on the internet (and with some irresponsible clinicians¹). That he was believing, mistakenly, that he had to do certain things or he’d be unhappy forever. These were deeply held beliefs, as is common for people his age, but also, as happens frequently with beliefs learned from young peers, they were beliefs based on lies. Certainly not beliefs that should be acted upon.  

Why didn't you find this out?  

(Are you even aware that there is an epidemic in gender dysphoria cases, suspected to be a social contagion? Why not?)  

We also learned very quickly that he needed differential diagnosis.  You didn't.  That his comorbidities indicated exploratory therapy was likely a much more promising path for him than drugs and surgery.  You didn't. (Did you even think of suggesting exploratory therapy to him, which an informed clinician would do? No.)  I bet neither of you even know the “affirmative” model is just someone's guess, unsupported by reliable studies; that the American Academy of Pediatrics adopted it by quoting the opposite of what its "supporting" studies actually found. That no one knows long term outcomes if you affirm.  They'd like data², but they don't have it. 

In sum, you're just as misinformed as our son, but instead of doing your homework, like a responsible adult, the trusted adult we thought you were, you clandestinely encouraged and primed him for more lies online.  And now very real mental and physical harm.  You should learn respect for parents, and the facts, before either of you go around advising, and harming, any more children.

By the time we heard this topic was something he was wondering about, it was too late to effectively intervene as his parents and get him appropriate support. (Did it not at all occur to you that plans for chemical and surgical castration were, perhaps, plans for self harm?) He had become deeply attached to these mistaken beliefs. The die was cast and he had staked his self-worth, and since, his body, on it. It was too late to stop him from following your terrible advice, and his similarly misguided online friends, to take the huge irreversible and extremely destructive steps of medicalization. 

Did you think you were being helpful? Did it make you feel important?  Special?  Noble? Proud? Hiding this serious concern from us parents?  "Rescuing" him from our (much more informed and attentive and loving) care?  Depriving us of the chance to be there for him when he was still young enough that our knowledge and expertise as parents could be used effectively to help him?  Crippling our ability to parent him?

There's a name for adults like you who encourage kids to keep harmful secrets like this from their parents.  It's not ally.

It's predator.

1. "The process is limited by: erroneous professional assumptions; poor quality of the initial evaluations; and inaccurate and incomplete information shared with patients and their parents.” (source)

2. “I guess time and data will tell.”--Dr. Safer, New York Times, 2022.

 “Yet, there is a real lack of long-term data to effectively and safely guide the clinical care of these youth. This study should address that need."--Dr. Rosenthal, UCSF News, 2015.