Letter to therapists

Hello Dr. Caswell and Dr. Bashah,

While browsing around for podcasts on raising teens, I came across your episode on protecting kids from extremist ideologies from December of 2023. The two of you are clearly highly educated, skilled, and compassionate providers with impressive experience and expertise. Dr. Bashah, I appreciate your insights into extremism and how we need to be aware of toxic influences, especially when it comes to impressionable adolescents. We are just starting to learn about the tremendous influence social media has on our youth. That's why I felt compelled to write to you both.

It's unfortunate that you do not consider gender ideology to be one of these radical ideologies, although as a mental health professional myself, I understand the tremendous risk one takes when questioning this movement in any way. To wonder aloud whether we are doing a disservice to struggling young people by unquestioningly affirming their stated identity is to risk professional suicide.

My suspicion is that there are many more children falling victim to the belief that their perfectly healthy bodies are wrong and that they need life-altering hormones and medical intervention to "correct" themselves than are joining Neo-Nazi groups and other hateful organizations. I believe both are very harmful to our kids, as are the other extremist groups you referenced. I would classify gender ideology as a cult at worst, and an extremist group at best. There are an increasing number of detransitioners coming forward whose experiences are eerily similar to people who have escaped cults: being ostracized by their former friends, threatened with violence, doxxed, demonized, and more. 

This is another reason trans ideology should be considered a cult: it cannot be questioned, and those who dare to do so are labelled bigots, TERFs, and transphobes. People who refuse to declare their pronouns or use the preferred pronouns of others have been fired and blacklisted. This is not a "be kind" issue. It has become much more sinister.

Clinically-significant discomfort with one's body is very often linked to trauma, and it is increasingly shown that girls on the autism spectrum are disproportionally represented among youth with gender dysphoria. We need to be effectively treating the trauma, providing compassion, empathy, support, and guidance, and not affirming the lie that one can "change their sex." We need to assure kids that it's okay to be a feminine boy or a masculine girl and make it acceptable to fall outside the "beauty standard" (which frankly also may be considered a dangerous ideology, as it promotes eating disorders, unnecessary surgical procedures, self-harm, sexual acting-out, and the like.)

After all, isn't one of our jobs as parents and mental health providers to help people deal effectively with reality?

Shouldn't we WANT kids to be comfortable and love their natural, healthy bodies and accept biological reality, which has the highest likelihood of producing lifelong physical wellness? Shouldn't we WANT kids to desist from the idea that they were "born in the wrong body"? I am observing quite the opposite through public education, social media, and entertainment. Sadly, I've seen it completely infiltrate the field of mental health, so that a practitioner who believes the best way to proceed is to address the root of what might be causing a child's discomfort with her body is deemed "transphobic." Highly-qualified, compassionate therapists risk their jobs by not being immediately "affirming." It is quite literally everywhere you turn. Kids are encouraged to consider the possibility that they are "trans" or "non-binary" (which is a biological impossibility, as even the oft-touted people with "intersex" conditions are either male or female from a chromosomal standpoint. This video describes it well.) 

The way a person expresses him or herself should be open to variation. There are infinite ways to express one's creativity, individuality, and personality. But we cannot escape the inevitable path upon which our chromosomes put us. Surely, accepting one's body and avoiding unnecessary medical intervention produces the highest likelihood of lifelong health? The Nordic countries have already backed away from gender affirming care, admitting that there is simply not enough data to support medicalizing healthy children.

There is a group of concerned mental health workers who is compassionately speaking up called GenSpect. This is one of a few that I am starting to see pop up, and I'm so very thankful. They are cautioning us as a society, as parents, and as mental health workers to carefully consider what we are doing to a generation of children. I fear that there will be a reckoning in the next several years, when kids who were dealing with trauma, distress about physical changes during puberty, exposure to violent and misogynistic pornography, ASD, same-sex attraction, autism or just not "fitting in" will come forward and wonder where the adults were when they were advised to have double-mastectomies, penile inversions, orchiectomies, and inject hormones into their healthy bodies, and now want to have children, breastfeed, or simply have normal sex lives. 

The fact is that we have no idea at all what long-term exposure to these hormones will have on these children, as we have never done this before. We are, quite literally, experimenting on children. 

We do not allow teenagers to get tattoos, drive cars, vote, get married, sign contracts, open credit cards, run for office, and a host of other things. We all know teenagers are notoriously poor decision-makers. And frankly, all of these things are significantly less dangerous than major surgeries and hormone therapy. Why would we allow them to make choices like this? As mental health professionals, aren't we keenly aware that adolescence is a time of turbulence and change? A time to "try on" all different kinds of philosophies and beliefs? Don't we all think back to adolescent "phases" and cringe at our ill-advised choices (some irreversible), when we thought, with all the bluster of a teenager with insufficient life experience, "I know what I'm doing!"? 

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There is a thought that sends shivers of dread down my spine. It is imagining being asked, "Why didn't you stop me?" through tears and anguish, after a young person's body has been irreparably scarred for the sake of an ideology, and after the fog of gender confusion lifts and the brain completes its development -- as brains do in early adulthood, but not before. I am not willing to have a young adult ask me, "Why did you encourage me to do this? Why didn't you explore what was behind my discomfort with my body? Why didn't you encourage me to develop my personality without experimental medical treatment? Why didn't you walk me through the anguish of adolescence and help me cope with reality, instead of selling me on the idea that this was the magic bullet that would alleviate my distress?" 

In the coming years, gender-affirming mental health providers, doctors, teachers, and parents had better be ready to answer these victims. 

I, for one, will be able to say that I spoke out against it. Dr. Caswell and Dr. Bashah, what will you say?