Soul Searching

This mother is far-left, progressive, bisexual and LGBTQ-supporting, but when her own daughter suddenly decided she was transgender at the age of 11, it threw her long-held values and beliefs into question.  

Names and identifying details have been changed.

Having been a far left progressive my entire life, a bisexual who married another woman before it was legal, I had not given much thought to the recent widespread emergence of trans activism and acceptance other than to think, fantastic, another group gaining civil rights. I vaguely wondered why there were so many trans kids when I had never before heard of this phenomenon in childhood, but I assumed increased visibility came from decreased stigma. I was confident that rigorous psychiatric evaluation must precede any gender reassignment procedures, to address any confounding issues. I celebrated people being accepted for who they are. LGBTQ is my tribe, and social justice is my religion.


When, after a period of isolation and internet immersion, my husband’s teenaged niece came out two years ago as trans, we accepted this without a second thought, explaining to our kids that he is now a man and has a new name. We congratulated ourselves on our open-minded extended family.


When my 11 year old daughter asked me "how many genders do you think there are?" I was glad she was thinking critically about the construct of gender. When she informed me she had, along with some classmates, chosen to use the pronouns "they/them" at school, I was bemused but accepting.


When she started wondering if maybe she was “actually a boy,” I didn’t flinch. She was always a tomboy, just like me. There have never been gendered behavior expectations in our family. She was never required to dress or behave any differently from her male peers. I believed being transgender is innate, so it couldn’t do any harm for her to explore the idea.


I was wrong.


After an extensive YouTube binge watching adolescent transition videos, she asked if she could start “puberty blockers.” I didn't know what that was. I told her sex hormones are rife with side effects and she informed me “blockers” are safe, and not sex hormones. I had to do some research.


At first I found widespread "gender affirming" information. Clinics, support groups, forums, and therapists, all celebrating brave transgender children and their heroic parents fighting for equality. It looked appealing and empowering. Standard treatment is to put the child on the powerful hormone Lupron, used off-label, starting at age 11 or 12 to suppress puberty and then, if still desired, to start cross-sex hormones at age 16. Lupron is described as benign and reversible.


I wondered, what does it mean to feel you are in the wrong body? I asked my daughter but got only "I'm confused,” "I'm dysphoric" and "I hate growing breasts." How is that different than anyone’s puberty? Weren't we all confused and uncomfortable in our changing bodies? It’s scary to start developing a woman's body, especially in the age of Trump. Does that mean you are really a boy?


Researching further, I found people are no longer required to have years of therapy and to "live full time" as their preferred gender before transitioning. Well-meaning therapists facilitate access to medical treatments for trans-identified kids starting at age 11 or younger. I discovered that Lupron given to children decreases bone density, and nearly 100% of kids given Lupron continue to cross-sex hormones, suggesting this is not an easily reversible step. Before this protocol, studies showed that 70-90% of gender dysphoric kids would ultimately “desist,” becoming comfortable with their biological sex. Many grow up to be gay


Chillingly, I discovered that Lupron followed by cross-sex hormones results in a 100% rate of permanent sterility.


A childless woman in her 20s will look long and hard for a surgeon willing to perform a tubal ligation. The concern is someone so young can't know what she might want in the future.


How is a prepubescent child better equipped to make such life altering decisions?


Sex hormones have myriad side effects, even when given to sex-congruent adults. Risks include heart disease, stroke and cancer. There are no long term studies of lifetime cross-sex hormone treatment. Some changes are permanent, even if hormones are stopped.


Gender surgery, including amputation of healthy body parts and delicate genital reconstruction, has risks, and removing healthy body parts seems to violate principles of medical ethics.


When I contemplate a healthy young person becoming a permanent medical patient, dependent on expensive, dangerous hormones and having possibly many surgeries, I feel apprehensive. When I consider this happening to my beloved child, I feel terrified. This does not make me a bigot. I am not afraid of transgender people. I am afraid for the health of my child.


Why are so many girls suddenly declaring themselves trans? I feel this represents the latest manifestation of body-hatred among girls. Girls have always felt uncomfortable in their bodies growing up into a culture of hyper-sexualization and misogyny. The male gaze is predatory, frightening, and omnipresent. What if there were a way to remove yourself from that gaze, to opt out?


Today, there is a way. You can become a boy! According to the internet, your life will be amazing once you are living as your “authentic self!”


Reading the words of other parents, I find our own story repeated endlessly: a young girl goes on an internet binge, and suddenly announces that she is actually a boy. She will have new lingo and new online friends who confirm that indeed, this is the cause of her unhappiness.


Adults realize information obtained online is often inaccurate and biased. Children are less skilled in critically assessing what they see online, and are more susceptible to social contagions, in which suddenly “trendy” behaviors spread through exposure, as has been seen with eating disorders and self-harming behaviors. The explosion of trans-identified youth appears to operate similarly.


One article my child showed me, "how do I know if I'm trans?" answered "if you’re reading this, there is a good chance you are not cisgender." The cavalier attitude and sloppy reasoning are stunning. Questioning your discomfort with the rigid gender role assigned to your sex does not necessarily imply that your body is the problem. Perhaps it means gender roles are the problem?


Ironically, the acceptance of transgenderism as the reason behind all gender dysphoria, and transitioning as the solution, is creating ever more rigid gender roles rather than freeing us from their tyranny. Feminists have long maintained that gender is a fiction. There is no trait, characteristic, skill or preference that is sex-dependent. The whole thing is manufactured. Rather than encourage our children to change their bodies to match their personalities, why not take the truly radical step of allowing all people to act and dress however they want in their own bodies?


I am not saying there is no situation in which a person's sense of well-being and authenticity has not been improved by taking drastic medical steps to change their body to more closely resemble their preferred sex. Clearly there are many happy, functional transgender people living fulfilling lives. Transgender people deserve full civil rights and respect, as do all humans.


However, as a parent and a physician, I have to start with what I know. First, do no harm. Given that gender dysphoria is common in puberty, and in most cases resolves on its own, it seems prudent to seek ways to alleviate this discomfort other than immediately assuming it necessarily reflects a transgender identity. Given that medical "transitioning" is off-label, unstudied in the long term, and has serious and irreversible side effects, it seems safest to take a very cautious approach to starting a child on this path.


As I look more deeply into the youth transgender narrative online it seems that often, normal adolescent angst and confusion is being interpreted as deriving from an underlying transgender identity, and medical transition is presented as the cure. A cure for the pain of adolescence is a very seductive promise, offered without evidence. Struggling with issues of identity, sexuality, bodily changes, and relationships is the work of adolescence. Learning to cope with discomfort and uncertainty is essential to maturing into a healthy adult.


I believe that my child is perfect just the way she is. I do not believe she was "born in the wrong body." I am unwilling to risk her health by acting on the unfounded assumption that she might be happier in the future as a transgender man. If that is the case, she will know it with certainty when she is grown, and she can take steps to manifest that when she has a fully developed prefrontal cortex with which to make decisions, with her health and fertility intact.


Exploring identity and sexuality, and feeling anxious and uncertain are normal aspects of puberty. I am unwilling to bring these natural developmental processes to a premature conclusion by uncritically affirming a child's self-diagnosis, gleaned from internet videos, that being transgender is the cause of these ordinary struggles, and transitioning is the solution.