To My Daughter's Therapist: You Were Wrong

To my daughter’s gender therapist: you were wrong.

It has been some months since you and my daughter had the last of four sessions. In the third session I was invited to sit in on a discussion of the effects of T, testosterone, on a human female body. You smiled calmly as you led us through a series of Powerpoint slides, explaining that my daughter’s reproductive organs would atrophy, that she would grow a beard, that her voice would deepen, and that “the phallus” would become enlarged. I sat listening, summoning all of my own skills as a clinical psychologist to not let a tirade loose at you in front of my brittle and fragile 17 year old.

Between your third and fourth (and final) sessions with my daughter you and I had a one-on-one conversation wherein I believe you recognized that this mother and this family were not going to easily or willingly surrender this child to whatever gender transition services you were prepared to refer her for after just three forty-five-minute meetings.

I asked what it was specifically about my daughter that convinced you that medical transition would be the right course of action to relieve her distress. You said, “He has Gender Dysphoria.” I said, “She has an eating disorder, body dysmorphia, and ADHD, all of which seem to have some overlapping features with Gender Dysphoria. Why wouldn’t you assess for and treat those before triggering any kind of medical intervention?”

I asked you what happens if my daughter, upon taking T and going through the changes you described, is not relieved of her dysphoria. What if her feelings and symptoms of self-loathing, dissociation, anxiety, depression, and self harm become exacerbated? You visibly cringed at my questions and responded that most people who transition are satisfied with their results and don’t regret their decision. I asked where I might find peer-reviewed longitudinal studies that suggest that affirming and facilitating social and medical gender transition produce happy, well-adjusted teens and young adults. You said you would gladly send me links to those studies. The links never came.

I was clear, perhaps brutally so, that affirmation of male gender identity would not be the focus of your subsequent sessions and that you would instead help her explore her discomfort with her now almost fully developed, curvy female body. You would talk with her about her anxiety, her depression, her giftedness, her sense of alienation from her peers at a highly competitive suburban high school, and the impact of the pandemic at such a pivotal point in her life. In other words, you would work to slow the transition train way down.

Thinking back to that conversation I feel a delayed sense of dread as that was before I knew that major medical and mental health associations, the law, and key players in our state and federal government had also adopted a gender identity affirming stance, albeit for their own personal and political purposes. At the time I was unaware that in some instances parents had been reported to Child Protective Services just for refusing to address a child with his or her chosen name and preferred pronouns. In a way, though, I’m glad for my ignorance because I believe my forceful early pushback saved my child’s life. I would not take any of it back.

With an abundance of unconditional love, real psychotherapy, solid psychiatric care, and some long-overdue changes in her personal and social life, my daughter is coming into her own as a quirky, witty, gender non-conforming young adult. She is grieving as she sheds her preoccupation with chemically and surgically transforming her body into something that would never result in her being male. She will not have to live out her life in a Frankenbody. No dry and shriveling vagina. No beard or male-pattern baldness. No irreversibly thickened vocal chords. And no enlarged and exposed clitoris. You called it a phallus, but she would never pee or ejaculate from her clitoris. It is anatomically impossible.

A critically important thing that we learned along the way is that my daughter, as many other young people who declare transgender identity in adolescence, is on the autism spectrum. She was diagnosed by an experienced child and adolescent psychiatrist and is now coming to understand how certain aspects of her autism resulted in collapsing and narrowing her focus into gender identity as a way of explaining and coping with what made life so difficult for her during her middle and high school years. She is learning to reconcile with being socially awkward and having idiosyncratic interests and will be better for it as she inhabits her full adult self sometime in her late 20’s. She is a brilliant and beautiful human being whose entire future came so close to being stolen from her by the gender transition industry. It is alarming that an entire generation of gifted children who may be on the autism spectrum is being sterilized in what amounts to a eugenics experiment with the participation of big-name medical and professional institutions, and to the benefit of a novel category of mental health practitioners: gender therapists like you.

Had my daughter continued on the path she was on when you were her therapist, she would be well into a regimen of weekly testosterone injections and eventual surgeries that would not have resolved her Gender Dysphoria, a diagnostic category that was included in the DSM-5 (APA, 2013) as a way of validating the experiences of a very small percentage of the population who suffer with lifelong feelings of discomfort and disconnection with their biological sex, all while creating billable codes for gender clinics and mental health professionals (see Drescher, 2013: “…it is difficult to find reconciling language that removes the stigma of having a mental disorder diagnosis while maintaining access to medical care”). I know this because one of the experts on the DSM-5 workforce on Gender Dysphoria is a long-time friend who is, himself, appalled at what has come from this diagnostic category that he, no doubt with the most compassionate of intentions, helped forge. It is disappointing that he is hesitant to come out on the side of best and safe practice and to publicly state that gender exploratory therapy is NOT conversion therapy; that, in fact, putting so many young LGB people on a fast-moving conveyer belt to medical transition is the latest iteration of gay conversion practices.

Our daughter was not “assigned female at birth”. She was born with the full complement of normal female sex organs and all the eggs that her ovaries will release over the course of her fertile years, regardless of whether or not she ever chooses to become a mother. We expected as much because prenatal DNA testing let us know unequivocally at ten weeks’ gestation that we were having a baby with XX sex chromosomes in every cell of her body. And no, she isn’t “intersex”. Her phenotypical features reflect her Southwest Asian genetic heritage and she is fine and healthy just as she is. Nothing about her body is or has ever been out of place. If the gender transition industry is anything it is profoundly racist and disturbingly sexist.

I believe that the medical fast tracking of trans-self-identifying children and young adults is a contemporary twist on American individualism taken to its point of absurdity. We are now in a situation where corporate wolves are passing effortlessly as progressive sheep. Even Planned Parenthood, perhaps seeing the writing on the wall that was confirmed with the recent Texas abortion ruling, may be hedging its bets by offering “Gender Affirming Hormone Therapy”. Institutions’ needs for staying relevant and projecting themselves into the future trump any fidelity to stated guiding principles. And a parent’s need to protect her child’s mind and body trumps any and all political affiliations. Our wallets and our votes will speak for us.

*   *   *

It is now September and my daughter and and I have been living in a city in the former Soviet Union as of mid August. She is connecting to her roots, her land, and her cultural heritage; to rich and lasting sources of identity that synthetic hormones and manufactured gender ideology were threatening to undermine and replace. She recognizes that going down the path of medical transition would have made her into a lifelong patient as well as holding her back from so much joy and freedom that she now has access to. She is coming to terms with the inevitable losses that growing up brings and discovering facets of herself that she never would have if we had taken your advice and initiated medicalization. Gender ideology would have had to become the central focus of her intellect and creativity for the rest of her life.

It helps that the local language, which my daughter is quickly absorbing and starting to speak, is devoid of gendered grammatical markers. I think she is relieved to not have to ask or answer questions about “preferred pronouns” and such. Here, no one is compelled to participate in a mass delusion that requires thought control and speech policing. They had more than enough of that during seven long decades under Soviet rule. Simply put, people have more pressing daily challenges and live highly interconnected social lives as a result. When you fall passers-by stop to help you up and dust you off. As other young people my daughter feels confident walking around the city on her own at all hours. She increasingly feels safe and at home in this city and in her body. And I grow more hopeful every day that removing her from a culture that would pathologize normal developmental struggles and push costly and irreversible medical treatments, will enable and reinforce long-term remission of gender dysphoria and trans ideation from her life.

I took the unpopular risk of holding my child’s ambivalence and keeping it alive rather than surrendering her to a process that would make her the docile object of bogus “affirmation” and “celebration”. And while I became the target of so much hatred and rage for many exhausting months (affirming and facilitating social and medical transition, by far the less conflictual path for parents who have the financial means, would have gained me temporary status as the heroic mother), she never lost sight of the fact that her father and I were the ones who truly had her back; that social-media groomers’, glitter families’, and gender clinicians’ approval could never be a replacement for her own self esteem and her family’s unwavering love.

Let me close by saying that things are changing in parts of Europe and in the UK. In the US a growing movement of parents and ethical clinicians, most of whom are lifelong progressives and active supporters of LGBTQ people and causes, are organizing and becoming vocal with their outrage and rejection of gender ideology and the unsupported diagnostic claims and harmful treatment practices it has given rise to. When the lawsuits start coming this will be exposed as one of the biggest medical scandals in history.

It is only a matter of time.