Hey Doc. Can I talk to you for a few minutes? Some things I've noticed are bothering me. I was wondering if they might be bothering you too?
So, first, let's say my teen binge watches Tik Tok, lnstagram, and YouTube videos about Tourette's syndrome and suddenly develops tics. What would you do? If I brought my teen to see you and my teen said "I have Tourette's!", would you affirm his self-diagnosis? Would you say to yourself, I usually only see Tourette's syndrome in children but here is this 15 year old adolescent before me and he says he has Tourette's. I will immediately affirm this poor boy's Tourette's syndrome so that he does not feel stigmatized by these tics.
Would you do this on your first appointment without even asking me if my teen had ever had any tics before? Would you seriously start lifelong drug therapy to treat my teen? I sure hope not. Yeah, I know the tics would go away with medication, but that would just be a placebo effect, wouldn't it Doc? I hope after a complete physical exam, you would take a complete mental health history and family history and learn that my teen has had a rough puberty. I hope you would pay attention to his descriptions of depression and anxiety and how all of his friends have abandoned him.
That part is all true, Doc. I hope you would listen to my descriptions of quirky behavior and poor social skills and no tics ever his entire life. That is all true too. I hope you would ask him about his internet binging and carefully note the hours a day he spends watching kids with Tourette's tics on Tik Tok, lnstagram, and YouTube. You might then make a diagnosis of mass social media-induced illness or Tourette's-like MSMI syndrome. A totally different treatment than Tourette's, right Doc?
Let's say instead that my teen binge watches videos by teenagers who make money filming themselves going through social and hormonal and surgical gender transition and my son suddenly tells me he is transgender. What happens then? If I brought my teen to see you and my teen said "I have a female brain trapped in a male body!", would you affirm his self diagnosis? Would you say to yourself, 20 years ago there were essentially zero teens newly presenting with gender dysphoria and now this teen tells me that he is among 28 transgender kids in his peer group of 35, I should really make sure I am not dealing with a mass sociogenic illness?
Of course not, because you (incorrectly) learned in medical school that gender identity cannot be externally derived. Besides, you believe it is unkind to make him think that changing his external sex characteristics might fail to solve all of his problems, don't you Doc? Would you say to yourself, I certainly cannot ask him how long he has been feeling this way, because that is against the law? Well, I wish you would Doc because he told me he never in his life wanted to be a girl until a couple of months ago.
Would you say to yourself: and his parents cannot be expected to have any useful information about his childhood and early adolescence? Hardly seems fair Doc as we were extremely close until he became so depressed and anxious with the pandemic. I know you would spend an hour or two alone with my kid. Would you ask questions about what led up to this feeling of being trapped? A feeling that my kid insists can only be cured with off label drug use and invasive cosmetic surgery? Would you ask him where he got his information and praise him for giving the exact answers to your questions that are posted on transgender websites and Reddit?
Because I am afraid my kid only sounds like a member of a cult when he speaks to me about it. You know the cult voice don't you doc? Kind of distant and detached: "I cannot answer that." I tried to talk to him about cults, about how they separate you from your old friends and your loving family, have slogans and specially created language to make you feel part of a cool crowd, give you a new name as part of your cult identity, advocate painful initiation rituals, and immediately denounce any one who leaves the cult, but I don't think he was listening.
What's this Doc? As a member of the Proud Team you are happy to let me know that I now have a daughter not a son and should use she/her pronouns?
Are you sure? What if you are wrong, Doc and this is a socially contagious illness? What if thousands of kids are getting the wrong diagnosis and treatment? What if the short term results you see are just a placebo effect? What if by affirming all these kids you are a causal factor in the epidemic? Too painful to contemplate Doc? It's not too late to change, Doc. You could start with my kid, Doc. Really help him figure out what is so painful about puberty that he wants to escape into a different identity. Talk to him about the harm of gender stereotypes and help him to recognize all the different ways masculinity is expressed. Maybe let him know he is stronger than he ever imagined? I sure would appreciate it, Doc. I love my kid, Doc. Don’t you?