Soft Focus

An (undiagnosed) Autistic Mother and Daughter Navigate the Trans quagmire

“You are autistic,” the doctor said to my daughter 12 minutes after meeting us for the first time. Our usual doc was on maternity leave. Behind her ill-fitting paper mask, this psychiatrist seemed young. Peppy. A real go-getter.

I blinked, glad my required mask was hiding my slack jaw. 12 minutes in and an autism pronouncement?!

The new doctor followed my gaze, glancing from the clock to the folder in her hands. “My intakes are usually twenty minutes, and we’ve been here almost fifteen. So, I want to ask: I see you are using He/Him pronouns.”

My kid nodded with serious gravitas. She was thrilled. At 13-years-old, her pronouns were a new and interesting aspect of her identity.

Soft Focus, I reminded myself of my personal rule. Keep this gender stuff in soft focus. Breathe. I gripped the edge of my chair with both hands. I blinked again. She just said my daughter’s autistic? I was reeling. Get it together. I smiled at my daughter.

“So, should we begin gender affirming care?”

The doctor wasn’t asking me. She was asking my child, who looked to me, her beautiful eyes wide.

“I…” I stammered. Soft Focus. I did not want to take a stand on this. I did not want to make this an issue between me and my kid. I did not want this to be her special-something-to-rebel-against, or her thing-that-makes-her-a-virtuous-victim.

Soft Focus. I took a deep breath. Crap.

“Yes?” Peppy doctor rounded on me.

“I…think 13 is too young to make life-altering decisions.” I didn’t say, I mean, have you ever met a 13-year-old? They don’t know shit!

As a feral Gen-Xer, I can definitively attest that the latest models of 13-year-olds are less worldly than we were. Yet, even though we could smoke cigarettes, be latchkey kids, and work in restaurants, we were still easily swayed by things like free candy or getting lots of attention. We were children.

You just told this 13-year-old she’s autistic? And now, she’s allowed to self-prescribe?

“I want to go on T!” my daughter stamped her feet. “I want to go on T!”

I closed my eyes. “T” meant the hormone testosterone. How the heck does she know about T?!

“So, you’re refusing gender affirming care?” The doctor said.

I opened my eyes.

The doctor’s pen was poised over the manila folder.

I gulped. “Yes.” Fuck.

She scribbled something in her folder. I imagined it was, “Mom is a terrible monster.”

The doctor turned back to my daughter, who was now playing with a dinosaur-shaped fidget. That kid liked dinosaurs a lot—maybe even more than she liked the idea of synthetic hormones that could sterilize her and destroy her musculoskeletal system. “Does your family respect and use your pronouns?” the doctor asked, an edge to her voice.

I watched with a flicker of anxiety as my sweet, darling, 13-year-old swelled with what must’ve been a delicious taste of power.

Oh man. I thought. I’ve read a lot of Orwell.

She refocused on the dinosaur, kicked her legs, and shrugged. “Yes.”

I exhaled. “Welp. Seems like our time is up,” I said. I stood, grabbed my kid’s hand, and fled.

Until the next appointment.

##

When this doctor said my kid was autistic, it was not a diagnosis. This was an autism pronouncement. Three other doctors had already pronounced her “not autistic.”

I knew that, to get an official autism diagnosis, you need to be evaluated by a neuropsychologist. The process takes hours. We had been on a waitlist for that appointment for three years. We wouldn’t have it for several more months.

In the meantime, I called one of my closest friends to tell him the story of the appointment. He is a brilliant writer and a wonderful father. He hails from a Latin American country, which gives him a fascinating perspective on the American Progressives. We work together in academia, whispering about how nuts things are and wondering how long before we’re both canceled.

We’ve discussed gender disparities. He’d noticed the difference between his wife’s teaching evaluations and his own. The same students who loved him and his foul mouth would say she “cussed too much.” He compared it to how people react to their parenting. Once, when he was tying his son’s shoe. A woman approached him and said, “You’re such an amazing father.”

“I was tying his fucking shoe,” he said. “I’m a man. And so, I’m amazing. If it had been my wife, someone would’ve come over and said, ‘you’re doing it wrong.’”

“You should write about that,” I said. “You’re a man, so people will find your thoughts on sexism amazing.”

I should say here: I am not a social conservative. I’m in a multi-ethnic family. I’m fine with my kid being gay. I’m fine with your kids being gay. A lot of my friends are very religious. I’m also friends with atheists. I also have close, grown-up friends who are transgender. I think it would be un-American for us to limit what grown-ups say or do, as long as what they say and do isn’t hurting anyone else.

“It was a nightmare,” I told my friend about the appointment. “So now, I’m withholding gender-affirming care.”

“Be careful,” my friend said. He wasn’t laughing.

Which was weird. We usually laugh.

“Why?” I asked.

“Don’t tell her dad,” he said.

Nine years earlier, I’d had to run away from my daughter’s biological father because he’d beaten me up. I’d taken my daughter, some toys, two trash bags of clothes, and fled to a women’s shelter.

Domestic Violence court assigned my kid’s biological father six weeks of anger management classes. Upon completion, he was deemed “rehabilitated.” He got supervised visitation with our daughter for six months. Eventually, we would share custody. My lawyer and the women’s shelter advocate said I could do nothing to prevent that.

Over the years, I’ve realized that rather than arguing with him, I need to dedicate myself to ensuring my child has a good relationship with her dad.

He wasn’t making it easy. He would never forgive me for leaving, so he was often awful to me. He gave my daughter whatever she wanted. For example, at his house, she had a cell phone and social media (where she’d learned about TERFs and T).

My friend was aware of my ex-husband. He and his wife were good friends to me throughout the long journey to being okay. Now, he said, “People here, in this state, are losing custody of their kids for not using their pronouns.”

“What?” I needed to sit down.

“If your ex hears you aren’t letting her have testosterone, you could lose custody of your daughter.”

##

I could tell my daughter was happy. She was waving her hands. She’d finally been told she was autistic. I know now that this was helping her understand herself. Why she felt lonely, exhausted, different.

Every month, as part of my daughter’s occupational therapy, at the youth health center, they would bring her in, weigh her, take her blood pressure, and ask her if she was suicidal. Then, they would ask her if she needed anxiety medication.

Every month, it scared the shit out of me. I held my breath until she said, “No and No.”

“Why do they ask me this stuff?” she said. “I hate it.”

She was right. You shouldn’t regularly bring up suicide to anyone.

Especially adolescents.

And, you shouldn’t ask children if they need medication. How the hell would they know? After my daughter echoed my thoughts, I went from being confused to annoyed at the youth therapists’ laziness.

I told them that I didn’t want them to give my kid the suicide questionnaire anymore.

The therapist’s eyebrows shot up. “Well,” she said. “We do have a new program. It’s group therapy for trans youth.”

“Huh,” I said. “Who runs it?”

“I will be running it with Dan,” she said.

Dan with the neck tattoo? I thought. Like a mean old lady. What was going on with me? I used to be in a punk rock band. I played bass. I shredded. Now I’m tsk-tsking at tats? But also, why did all these therapists have neck tattoos? This lady had one, too.

Group therapy for trans youth. With these clowns. It seemed like a bad idea. The specter of my ex-husband flitted through my mind. You could lose custody if he finds out you’re withholding gender affirming care.

I remembered being 13 years old. I cut all my hair off and wore my dad’s clothes because I didn’t want attention from men. I was tall and pretty, and (predatory) adult men became interested in me when I was 12.

I was already afraid of men. Men had hurt me. Also, men seemed to have it easier. They had all the power.

Add to that, I was getting a whole new body at a time when I was the most self-conscious that I would EVER be. I wasn’t used to my body; I had boobs and curves, and I needed some time to get used to that. My dad was eight inches taller than me, so his shirts felt like cozy flannel tents—with pockets.

I HATED the feel of tween girl clothes. The textures were terrible. Everything else felt wrong, too. The lights were too bright; the school was too loud. It had been hard when I was younger, but at 13, I could barely function.

Note: I wouldn’t find out I was autistic until I was 49 years old.

The counselor was waiting for me to tell her if my child would go to the group therapy for trans kids. Are you withholding gender affirming care? The room was closing in on me.

“When does the trans youth group meet?” I asked, stalling.

“It will be Tuesdays and Thursdays at 11 am.”

“During the school day?” I asked. When you get your kid from middle school in the middle of the day, it takes about 30 minutes for them to walk as slowly as possible to the office. We’d have to leave early enough to drive to this center. So, that’s an hour. Plus, 90 minutes of trans group therapy. Then, 30 minutes to drive back to school, and walk back to class as slowly as possible. “So that would be missing six hours of school a week.”

“We feel it’s important to prioritize children’s health,” the counselor said. The tattoo on her neck was a stalk of flowering bamboo. The fluorescent lights were getting painful. “Don’t you?”

You don’t prioritize your daughter’s health. My adrenaline started spiking. “Perhaps if you wanted to prioritize children’s health, you would have weekend sessions.” Shit. I was stressed. The words were out of my mouth before I could make them softer.

The counselor blinked. She made a note. I assumed it was, Horrible mother.

“I will let you know,” I said, silently thanking all creation that my ex-husband refused to participate in these appointments. His total disengagement was a blessing.

I never took my daughter to youth trans group therapy.

I was too scared of how much the health center talked about suicide. I’d lost a friend to suicide as a teenager. What if there were suicidal kids at the therapy? Those ideas are so contagious. Also, I knew from experience that group therapy, when not moderated properly, could cause trauma.

I did not trust these therapists to be proper moderators.

I didn’t know how dangerous that situation was until a couple of years later. One of my closest friends had agreed to let her daughter go to the trans youth group therapy. I’ve known her daughter, K., since she was 18 months old. Like my own daughter, K. was an undiagnosed autistic girl.

K. made a friend at the group therapy. A trans girl [a boy].

This trans girl sexually assaulted K., in her home. There was a police investigation, and we found out that this trans girl had assaulted more than one trans boy [to be clear: the boy had assaulted multiple girls].

The group therapy had been a perfect hunting ground for a predator.

##

I work with kids of all ages. For 30 years, I’ve taught them art.

Over the years, while working with thousands of kids and reading hundreds of books about child development, I have learned that teenagers explore different versions of themselves. They might engage in something outlandish, like shoplifting, to see if they like the stealing version of themselves, or develop a keen interest in bright clothing before switching to dark attire. They might be emo or athletic, an artist or an equestrian. These changes can happen within the same week or even the same day. This exploration is a crucial part of how they become individuals, testing the boundaries of what’s possible. They examine how each possibility feels to discover who they truly are.

As part of this process, they need to rebel against the people they’ve relied on to care for them. They must learn to be less dependent, and this sparks conflicts with their imperfect parents.

And so, you shouldn’t take any teenager’s behavior personally.

Even if they are yelling, “This is about you, Mom! You! You should take this personally!” It’s not about you. And if you find yourself actually arguing with a 13-year-old, you’ve already lost.

Whatever hard lines you decide to enforce, carry the risk of becoming your kids’ chosen form of rebellion. So, choose wisely. It’s not about them obeying you; they must be true to themselves. We want to help our children make decisions aligned with our family’s core values while ensuring they don’t hurt others or themselves.

Structure and boundaries are important, especially for neurodivergent kids. They need to know what to expect and where they stand. Once you set those rules, you must stick to them. However, you will need other adults, whom your teenager isn’t biologically programmed to rebel against, to help reinforce those limits—people like aunts, uncles, coaches, and teachers.

If these other adults actively undermine you, you’re screwed.

As far as the child and adolescent health providers went, I knew I was screwed. I didn’t expect the schools to fail me, too.

Back in 2021, every student in my middle school art class used changed pronouns, except for two boys. My sister, who has an MA in child development, runs a tutoring business and works with thousands of kids, mentioned that 75% of the teens she worked with were using new pronouns.

I looked, but it seemed like no one was studying this. Now, we have more data. For example, here is a chart of trans identification by birth year:

“Among young adults, identifying as transgender gender non-conforming increased 1260% (a factor of 13.6) between 2014 and 2023, identifying as a transgender man increased 309% (quadrupling), and identifying as a transgender woman increased 204% (tripling).”

Source:

Transgender identity: How much has it increased?

The abstract of a paper published in 2024: “An increasing number of US young adults self-identified as transgender between 2014 and 2022. Self-identifying as transgender nearly quintupled among 18- to 24-year-olds and quadrupled among 25- to 34-year-olds, but either declined or did not change significantly among those older than 35. By 2022, 2.78% of 18- to 24-year-old adults self-identified as transgender, up from 0.59% in 2014. The increase was driven by those identifying as transgender men or gender non-conforming; identification as a transgender woman did not change significantly among young adults and declined significantly among all adults. The increase in self-identifying as transgender was larger among White individuals than among Black or Hispanic individuals. Up to 2021, the increase was similar in states whose electoral college voted Democrat (“blue”) or Republican (“red”) in 2016, suggesting a nationwide shift.”

Source: Twenge, J.M., Wells, B.E., Le, J. et al. Increases in Self-identifying as Transgender Among US Adults, 2014–2022. Sex Res Soc Policy 22, 755–773 (2025). https://doi.org/10.1007/s13178-024-01001-7 Twenge, J.M., Wells, B.E., Le, J. et al. Increases in Self-identifying as Transgender Among US Adults, 2014–2022. Sex Res Soc Policy 22, 755–773 (2025). https://doi.org/10.1007/s13178-024-01001-7

Were all the young lesbians becoming trans men?

##

“It’s just that I don’t feel like a girl,” my daughter said. “I don’t feel like what a girl is supposed to be.”

It was bedtime, and I was lying on the floor next to her bed. The time of night we’d spent rocking, singing, and nursing when she was little had become a time for her to talk quietly with me.

“I don’t either,” I said. “I never have.”

“So will you change your pronouns, too?”

“No,” I said.

“Why not?”

“No one cares what my pronouns are,” I said. Middle-aged women are invisible, except to each other.

“Oh, yeah,” she said.

“But also, I don’t think any woman feels like a stereotype.” I was hopeful as I said this.

“Yeah, but you don’t understand,” she was shutting down. I sensed I’d entered a trap. It would take another year until I realized what it was.

I sounded like a TERF. A trans-excluding radical feminist.

The trans activists love-bombing kids online warned them about TERFs. But I didn’t know any of that, yet.

“You don’t understand GENDER. Some things give so much GENDER.”

“Ok,” I said. “Sorry.”

She shifted in bed. We had just completed reading the Harry Potter series together for the second time. The first time we read it, she’d said, “I hope someday I write something like this.” My sweet kid, who’d had multiple Harry Potter birthday parties, now disavowed JK Rowling.

That night, my child said her name was Amelia. A few days later, she called herself something else (I can’t remember.) She then told us she was pansexual. Then, Demisexual. Followed by Asexual. She was Gender Fluid. She was Polyamorous. Gross. I hoped she didn’t really know what that meant.

A few days later, she said she was named Fay. Fay (He, Him).

She started telling people she used different pronouns—an ever-changing kaleidoscope of pronouns: (he/him, they/them, it/its, crow/crows, bee/bees—why is this all conjugated singular/plural like I’m back in Latin class?!)

I understood that she was trying out different versions of herself.

Plus, we were in a blue state during the pandemic. We’d just locked all these kids inside for 18 months and stuck them in masks for another six. We’d failed them.

The kids had a lot to process.

I decided, Soft Focus. Let the names change.

But, I couldn’t bring myself to use the pronouns. I began to speak about my kid in the third person. I’d remarried when my daughter was 5. My very sweet husband kept forgetting the new names and getting shrieked at.

Soft focus. I told him. Let it keep changing. Let’s not die on this mountain.

And then, I logged into the school communication system. My daughter, who was in eighth grade, had a man’s name and he/him pronouns.

I was stunned.

I gently asked my daughter about it, and she told me what had happened. A staff member (an aide of some kind) noticed my daughter had changed her name on the paper name tag the kids put on their desks. They were told to write the name and pronouns they preferred.

The staff member had approached my kid and asked her if she wanted to change her name and pronouns in the school system. My daughter had agreed.

So, they did.

Legally, in our state, they didn’t have to tell me.

They’d also made a note not to tell my daughter’s biological father about this change, at her request.

So, now, they’d made me part of keeping a profound secret from him.

I imagined how I’d feel if it were the other way around. If the school were keeping a secret from me, and my ex-husband knew about it.

I felt terrible.

I told my daughter that this wasn’t right. That we needed to find a way to be honest.

Eventually, she told him, after I prepared him for it.

He took it well.

Once the school changed my child’s name and gender permanently in the system without telling me, she stopped changing her name. She stopped changing her pronouns, too. It was like they’d committed her to being a trans man.

Three years later, I’d enrolled my daughter at the local community college for dual enrollment. College classes were quieter and easier than being in high school all day.

The high school principal called me to ask about the paperwork. “Did you change your child’s name and gender on the college forms?” she asked.

“I didn’t fill them out,” I said. “My child did. Why?”

“Your child put their birth name and female gender. I just wanted to see if I should change it back to the new name and gender.”

“This is why I wish you guys hadn’t changed it in the first place,” I said. “I was trying to keep that stuff in soft focus.”

“I totally agree with you,” the school principal said. “Soft focus.”