Parents Deserve Answers before Medicalizing Gender Identity

On occasional Fridays, the PITT editors are republishing posts from the past. This is from June 3, 2021

What a difference six months makes. 

Some kids are born in the wrong bodies. Since gender identity is fixed by the age of three, kids can and do tell their parents their real gender, which is sometimes different than their natal sex. Good parents listen. These kids get to go to gender clinics where they are carefully treated by a team of professionals, there to protect them. The kids socially transition. They change their names, and they get to dress like the other gender. When it comes time for puberty, this is a stressful and traumatizing time, because they are now confronted with the sexual characteristics of the “wrong body”. We block puberty and then, when it’s medically appropriate, we give them the “right” gender hormones, so they can go through the “right” puberty. Later, they can have surgery that can make their bodies “right” at last, and they live happily ever after. 

Some parents don’t listen. In bad families, kids are repressed, trapped, unable to be their true selves. Their parents enforce old gender tropes. Dolls and cooking sets for girls, trucks for boys. Pink and blue. These kids are forced to follow gender stereotypes for their birth gender. The resultant unbearable dysphoria and mental anguish from being forced to live in the wrong body can last for any number of years. Some teens and young adults without access to appropriate treatment for their natural condition kill themselves. Some live out their whole lives in anguish. Some, after years of repression, finally get the help they need. With the support of the community, they are accepted as they are, get medical treatment, and finally transition to their rightful gender, and they also live happily ever after. 

All of the above is what this fairly liberal, Jewish mom believed until only a few months ago. I bought into that narrative wholesale, like many other well-meaning people, thinking “what’s the harm?”... until it came into my home.  

One night this summer, my young teen son revealed he was “trans”.  

My husband and I sat down with him right away to learn more about this strange new creature that had just appeared to us. He gave the following evidence: he did not feel comfortable in his body and about a month prior had realized that this was because he was not a boy. He knew that he was trans because when he put girl clothes on his video game avatar, he felt “euphoria”. He had had crushes on girls, but he recently wasn’t so sure since he may have had a crush on a boy. He didn’t like his shoulders or his voice. He felt different.  

My husband and I held his hands and told him how all his feelings sounded like regular old puberty, where nothing about your body feels right, and you are starting to develop your sexual identity. We told him that people like to pretend in games. That feeling a thrill or arousal at using a female avatar in a game is not what being a girl feels like. We love you no matter what, we said. Later, in bed, we talked about how confusing puberty was for us, about our early crushes, about my husband’s late development where he wondered if he was gay because he didn’t really like girls (or anyone) yet. We told ourselves it was just how kids express themselves these days. It’s no big deal. 

Because it seemed like the thing to do, we brought our child to a psychologist.  We had talked with her in advance and she said that our son certainly didn’t fit the mold of transgender, and that she’d be glad to speak with him. She spoke with our son for 30 minutes. Based on the parents meeting that followed, she had agreed with our son’s self-diagnosis. It would be a 10-year process to transition him from “boy” to “girl”. No doctors would see him until he was 16, but then he could start blockers and hormones, and later he could complete transition through surgery. Eventually his parents would come to accept that he was our daughter, but first he had to understand that we would be hurt and distressed, and would have to mourn the loss of our son. She asked him when he planned to tell his grandparents. 

Just like that, my son was a girl because he said so – and a therapist agreed after 30 minutes. This was strange to me in so many ways. My kid was not feminine. He never expressed an interest in girl things, he had no friends that were girls. He was happy, not in distress. I pored through my memory. Since kids “know” their gender by three, how had I so repressed him that he never told me? As a feminist, I had wanted to raise my son to respect women and to be a sensitive, good man who believed in gender role equality. I had given him cooking play sets, presented dolls, dressed him in gender neutral clothing. He wasn’t interested. He wanted trucks, he reveled in dirt and frogs. He climbed trees, ran around naked, had superhero sword fights with his brother. He ate with his hands and put spiders in my bed. Contrary to my understanding of how this all works, my son had no signs of distress or dysphoria, neither in childhood nor now.  

I got on the internet and learned, to my surprise, that you can become transgender at any age. According to the internet authorities, it’s biological, not mental, but sometimes you don’t really know who you are until you’re a little older. But once you articulate the feeling, it’s a permanent thing. Not everyone feels distress. The treatment for everyone in this state is transition, again according to the online “experts”. I read all sorts of reports from parents who were also initially confused because their kids didn’t fit the mold. But they trusted that their kids knew who they were, and after an initial period of angst and crying, they helped their kids to transition. Now their new, restructured families were doing great!

This was all news to me. I didn’t know it could happen that way. I wondered if my kid had always been that way. How did I miss that? How can I be sure now? I scoured the internet for research showing how transgender was an immutable biological trait, but all I found was a bunch of tiny, flawed studies, including false and misleading statistics about suicide, and a whole lot of propaganda.  

I started to make a table of facts and studies, to understand the various positions and what we “knew”. Try as I might, I could not find any definitive “facts”, only ideas and concepts, and a lot of emotion.  

I was told that parents have two choices: 

1. Accept our children's gender feelings, unreservedly and without question. In today’s world that means the following: accept their new “gender” as immutable, change their name and pronouns, dress them in stereotypical clothes for their “right” gender, and convert them to the opposite gender as soon as possible, up to and including cutting off healthy body parts. We need to accept that this is the right thing to do because it is how they are wired; their bodies must change because their minds cannot. 

2. Be a transphobe, reject your child and push them toward suicide, since living in the wrong body is an intolerable state. Subject them to mental therapy for an innate biological condition. Deny their very humanity.  

I had a bunch of questions that I wanted answers to before my family set off on this life-changing path: 

1. How do we know this is “hard-wired” - biological and not mental? Is this like hair color, or more like anorexia? 

2. If it is hard-wired, why does it sometimes develop later in life, like it did with my teen? 

3. Why is it “conversion” therapy to help kids see if they can be comfortable in their own bodies (which has no social or medical consequences), as an alternative to “transition” to another gender (which has social and medical consequences)? 

4. Why do some people report that therapy helps, and they come to identify with their birth gender? 

5. If kids can be sure of what they are at a young age, why do most kids grow out of feeling gender dysphoric? 

6. If you can know that you are a different gender, why do many kids only articulate this after taking an online quiz, or hanging out on egg-irl on Reddit? 

7. Is self-identification appropriate in authorizing medical treatment for children or young adults? If so, why is only gender dysphoria handled this way, and not anorexia?  

8. Why are gender “feelings” immutable and factual, but other ideas of inner self are not, and are considered forms of mental dysphoria? 

9. If there’s no way to know, definitively, that transgender is a biological condition, why is medical treatment appropriate? 

10. What is the evidence that “transition” is the “cure”? What about the process works and why?  

11. Is the treatment safe? Why isn’t it FDA approved if so? 

12. Is the “cure” permanent? 

After combing the internet, I was baffled - why weren’t we asking these questions? Was I the only one in this boat? 

Six months later, I was entirely disillusioned. And I had learned why we aren’t asking these questions. All those happy rainbow stories, those glitter families - they are cover-ups. One-sided stories were designed to show a black and white version of reality that is simply false. At best, the noise on the internet is ignorant, if well-meaning. But in most cases, it is self-preserving, money-making propaganda that we are all adopting wholesale under the guise of social justice. It's not harmless and it is not about social justice. We are confusing an entire generation and it’s having a real, irreparable, harmful effect on way more people than you realize. I’m now one of them.  

We can’t ask these real and valid questions about gender dysphoria because other parents, doctors and therapists DIDN’T ask them before they prescribed puberty blockers and cross-sex hormones to kids and young adults. And now, we cannot face asking these questions because, if we were wrong – and transgender is a mental condition, not a biological one – we just gave our kids experimental hormones and allowed surgery on their healthy bodies to treat a mental illness. Then the doctors are liable. The therapists are liable. The activists would have to admit that they might have a mental illness, and that they are not a new gender. The pharmaceutical companies and gender identity clinics would be on the hook, sued out of existence, and deprived of their revenue stream.  

No one knows that we are wrong – maybe we are right, and gender identity is biological. But we cannot attempt to discover what’s true or real, because the costs of being wrong are too high for the stakeholders that have already bought in - and there is a lot of evidence that the current approach is not sound. For a great explanation of how good, smart people can fall into this trap, see Carol Travis and Elliot Aronson' s excellent book, “Mistakes were made (but not by me)”.  

We know that most kids outgrow a trans identity by their late teens. That there is strong evidence that what we call trans behavior in kids often turns out to not be about gender identity at all, but rather same-sex attraction, or a mental health issue like trauma, OCD, and others. We know that a great many people come to regret transition. We’re starting to hear the heart-breaking stories of young adults who fell onto the medical pathway for transgender as confused teens. After life-changing procedures, a few years later they now feel that there were no adults in the room (see Keira Bell's case) yet they are being told that their experience is not valid, and that they do not deserve our help. 

I’ve since found that there is a parent community made up of many caring moms and dads that want to ask these questions. There are also medical professionals, therapists, ethicists, politicians and philosophers horrified by the ethical implications of medicalizing gender identity, and that many – if not most – of them are afraid to speak out because of the inevitable and likely career-ending backlash. There are LGB groups that feel marginalized, that don’t understand what gender identity and transgender has to do with sexual orientation, and why they are lumped together. Most of this is being discussed in secret because it’s taboo to ask the questions, to lift the veil on what I now consider to be a mass deception of the American public.  

The parents’ stories are all like mine. Their teenage boys and girls announced they were trans out of the blue. (And don’t tell us we missed the signs – we are parents – we pay attention to our kids). These kids were never, for the most part, gender non-conforming. They were gifted loners that didn’t really fit in. Many, like mine, had had extensive grooming on the internet prior to their revelations, and had fallen into the reality-bending void of porn, virtual reality gaming, and adult-only chatrooms after engineering their way around our well-considered parental controls and screen time limitations. The parents come from across the religious, social, political and economic spectrum. Universally, we were told that if we don’t accept our kids’ new self-identifications wholesale, we’re horrible people, horrible parents and transphobic bigots.  

Well, name-calling and thought suppression like this should be a sign to all of us to dig deeper. Especially if we’re being asked to sign up for a lifetime of expensive and untested medical care.  

Do we KNOW that gender identity conflict is a mental illness? No, we do not. But we also don’t know that it isn’t.  

And we’re not allowed to ask.  

Just because others may have made life-changing decisions based on bad or non-existent facts doesn’t mean that we have to. Just because others signed the consent forms saying they understood that the risks were unknown and unstudied doesn’t mean we will. We shouldn’t be shunned by society or threatened with the loss of our kids if we don’t blindly follow. 

We are good parents, not bad ones, for asking questions and trying to understand the facts before jumping on the bandwagon that encourages our children to receive medical treatment for something invisible and theoretical. We are good parents to question dogma before we tell our kids and young adults that their natural bodies are “wrong”. It is not evil to think that maybe our children’s human potential and happiness is not solely defined by their gender identity, but by their appetite for self-improvement, personal evolution and internal growth, and that gender obsession will hold them back from reaching their potential. That happiness can come from within, not without. From internal, not external acceptance. 

Before you tell us what our children need, before you judge us, we want a real discussion. We want real answers.