When linear thinking hurts gay kids
Having read this title, some people may have an urge to immediately add me to the list of ‘the suspect’. If you notice that impulse, I ask you to engage with what I’m saying here.
I write this piece because I’m worried about same-sex attracted kids and other vulnerable teenagers in the context of the contemporary queer ideology movement.
Queer ideology is a set of beliefs based on Queer Theory. This theory arose in academia, and is concerned with subverting the ‘normative’ and is invested in ‘queering’ the meaning of words and conceptual categories. Queer ideology discounts or denies biological sex, in favour of the primacy of gender identity. Following this line of thinking, same-sex orientation is now considered exclusionary, and ‘same-sex’ has disappeared from the lexicons of many LGBT+ organisations, to the astonishment of many LGB people. I will address how these ideas are being operationalised for young same-sex attracted people in this piece.
The concerns I have are shared by a diverse range of people: transmen, transwomen, gay men and lesbians, people with Differences in Sexual Development (intersex), and by experts in adolescent and gender issues. Many like myself are on the left spectrum of politics. The diversity of these voices shows that queer ideology is contested, particularly as more people appreciate that harms can flow from something well-intended.
This is complex, and I write from a complexity framework
Our biosphere is alive with systems that are complex: climate, reefs, ecologies. With multiple interacting elements that respond to each other, they are characterised by thresholds and tipping points. In the social realm these dynamics are present in systems for corporate control of climate policy, and equally in social movements to end the dominance of Big Coal. These dynamics are everywhere in our social world, including in the exponential increase in young people identifying as transgender.
When I refer to linear thinking, I’m talking about the kind of thinking that reduces complexity to a singular assumed causal relationship (sometimes called reductionism).
In this piece I will make the case that what’s happening to same-sex attracted youth is complex, and that they and other vulnerable kids are at risk where the cultural context assumes a simple linear relationship between gender non-conformity > gender dysphoria > being trans.
The queer ideology movement drives the view that all children with gender dysphoria are trans. It follows from this assumption that holistic therapy is considered irrelevant or undesirable, and the stated gender identity of the child should be immediately affirmed and that medical transition should be expedited. In this piece I’ll refer to this now-dominant model as the linear affirmation model, to distinguish it from holistic therapy that explores gender dysphoria in context of the uniquely complex issues of each child or young person.
I will describe what can go wrong when we apply linear thinking to something as complex as the rise in youth identifying as trans, and why we let these things happen even when there is evidence of unintended harm. Usually, if we notice something that’s harmful, we’re able to get information and talk about it. Then we can make adjustments to what we’re doing and change the trajectory. Another word for this is social learning.
But something is happening that stops social learning when it comes to this issue. I’ll explore this in terms of social bubble dynamics and how this shapes collective thinking.
I want to make it clear that this blog is not about trans people. It’s about a particular ideology that is either shared or not-shared by transgender people, and exists independently. My positive regard for trans people is not diminished by my critique of queer ideology.
This is about social bubbles, to which we are all prone.
This is about an ideology, and the harms that accumulate when unintended consequences are ignored, and when mention of these is enough to cause uproar and silencing.
It’s about what happens when a social bubble is hermetically sealed, so that the only thinking seen or heard is thinking that’s compatible with ideas already circulating. We’ve seen it with the dismissal of information about the climate crisis. We’ve seen it with QAnon…beliefs that race through networks, untouched by reality.
The stronger the bubble membrane, the more it repels information that does not comfortably align with the shared narrative.
Without information, there is no social learning. Errors compound. Bad things happen.
Red flags are waving for young gays and lesbians, and other vulnerable teenagers
After being swept up in the surge in young people getting body altering hormones and surgeries, Detrans Gay Guy came to realise he was gay and not trans. He detransitioned. At the time of this tweet, he was to have surgery for prosthetic testicles. Hereafter, Big Pharma will supply him with testosterone.
Detrans Gay Guy is not alone. There are increasing accounts of young people who detransition (re-identify with their biological sex). What is happening?
There has been exponential growth in numbers of children and adolescents presenting to gender clinics, and a dramatic increase in girls identifying as trans (Zucker 2019). In the UK, in the space of a decade, there was a 1,460% increase in referrals of boys and an astonishing 5,337% increase in girls. Although Australian data is fragmented, we follow a similar trajectory. In the US, in just one year 2016/17, there was a steep rise in people undergoing surgery: a 41% increase in natal males, and a 289% increase in natal females.
Amongst this surge in kids identifying as transgender, there is a high percentage of same-sex attracted adolescents, and children diagnosed with autism spectrum disorder (ASD) (De Vries 2010). Astonishingly, 35% of children and adolescents presenting at the UK Tavistock Clinic for gender dysphoria had a diagnosis of ASD (Butler 2018). In the Australian Westmead Hospital study, 13.9% had a diagnosis of ASD, and 16.5% had a diagnosis of ADHD (Kozlowska 2021).
Alongside this surge in children and adolescents identifying as trans has come an uptick in people who detransition. An online sub-reddit forum for people who detransition or desist currently has 51,000 participants. It is difficult to get data on numbers because few want to go back to gender clinics and are lost to follow up. In a recent study 70% of participants gave their reason for detransition as realisation that their gender dysphoria was related to other issues.
Lisa Marchiano is a US clinician providing therapeutic support to detransitioners who describes her clients as typically in their early twenties whose complex problems were not addressed by gender clinics. Instead, cross-sex hormones and/or surgeries created a new layer of physical and psychological difficulties. Most of her clients came to understand they were butch lesbians: “they traced complex histories of coming to terms with their homosexuality. Some faced vicious homophobic bullying before they announced their trans identity”. This description is echoed in accounts from other detransitioners. Witness Elie: within a year of identifying as trans, she’d had a mastectomy:
In addition to young lesbians and gay men, detransitioners include adolescents with autism traits, eating disorders, and stories of abuse that had never been addressed.
Some, like Sinead, were failed by professionals whose tunnel vision enabled body modification for a person struggling with depression. I invite you to listen to Sinead who asks for better health services for all gender dysphoric people: We deserve the right to talk about our experiences
Notice that Sinead affirms trans people who have benefitted from medical transitioning. Notice also her description that detrans people who share their stories are dismissed, mocked, or told that they are hateful.
It’s as if detransitioners are a threat to the queer ideology movement.
It’s as if this is EITHER/OR. Instead of BOTH/AND.
This deaf ear, this dismissal of detransitioners is the bubble
Detransitioners provide another lens on the complexity of sex, gender and identity, and how these are mediated by network dynamics. But exclusion of their voices suppresses learning. Without social learning, we have unintended harm. None of this is good for LGBT communities.
If we listened, we’d hear a call for holistic assessment of gender dysphoria. A therapist who views all kids with gender dysphoria as ‘trans’ cannot see the whole. For example, when Mia who had an eating disorder told her therapist that she was “bringing up and purging, they were like “oh that sucks. How’s your dysphoria?”.
As detransitioners tell their stories in this booklet or on social media, we hear how complex issues were passed over in the linear pathway to transition.
It can be uncomfortable to acknowledge a red flag attached to something we’re aligned with.
Confirmation bias is another name for this unconscious discounting. It’s how people fail to notice red flags of the climate catastrophe. In the bubble of climate denial we slough off information – even when the east coast of the Australian landmass is ablaze in freakish heat. Information is dismissed at lightning speed, according to the ideas of the network currents we are carried in. We neglect to read the linked article. We shoot the messenger.
As you read on, I ask you to observe your reactions to what I’m writing here and to pause long enough to seriously engage with it.
The linear frame of ‘affirmation only’ cannot accommodate complexity.
While there are differences in clinical practice and policy across health jurisdictions, what is consistent is a queer ideology movement that insists on one intervention for gender dysphoric children and adolescents: to immediately affirm with social transition, and enable medical transition with puberty blockers and cross-sex hormones. Yet there is compelling evidence that prior to the affirmation-only model of care, the majority of children with childhood onset gender dysphoria resolved it during adolescent maturation. A review of 10 studies by Ristori and Steensma found that 61% – 98% of children diagnosed with gender dysphoria (GD) desisted (did not continue to experience dysphoria at follow-up):
“The conclusion of these studies is that childhood GD is strongly associated with lesbian, gay or bisexual outcomes and that for the majority of the children…the gender dysphoric feelings remitted around or after puberty” (Ristori 2016)
Despite this, there is now a widespread assumption driven by the queer ideology movement that there is a linear relationship between gender dysphoria in childhood and being trans. Wholistic and neutral exploratory therapy is framed as ‘suspect’, akin to ‘conversion therapy’.
But the stories of detransitioners show they needed help to explore dysphoria in the context of the whole person: their experiences of autism, or sexual abuse, or homophobic attitudes. Or the social isolation of geeky boys. Or for girls, anxiety about sexual maturity in a world that objectifies their bodies and where porn enacts humiliation and subjugation of the female.
Without information, there is no social learning. Without learning, harms accumulate.
The contemporary queer ideology movement suppresses research that might help us avoid harms coming to people like Sinead or DetransGayGuy.
James Caspian was stopped from researching the increasing numbers of detransitioners. Bath Spa University ended his research project because it was ‘politically incorrect’. Yet Caspian was a psychotherapist with years of experience helping people with gender transition, and was well-placed to add to knowledge about how some people come to regret transition and changes to their bodies.
Likewise, Dr Lisa Littman’s research was attacked. Having observed networked clusters of teenage girls identifying as male without prior history of gender dysphoria, Littman published a descriptive paper proposing that network dynamics were at play and coined the phrase Rapid Onset Gender Dysphoria (ROGD) to describe a new phenomena. Then all hell broke loose. Brown University was deluged with criticism. The journal retracted, then republished the paper essentially unchanged. Littman has defended her methodology (Littman 2020). You can read her paper here and an account of the pressures exerted by transactivists and what this means for research here. The requirement that public discourse conforms to queer ideology is everywhere. For example, this US conference cancelled a panel on detransition because it was ‘too controversial’.
The message had been delivered…you will be attacked if you attempt research that explores complexities not acknowledged by queer ideology.
Network dynamics are ever-present in our thinking, feelings and behaviours
To me, Littman’s research question was blindingly obvious.
Network cascades are the circulatory system for how populations change and movements grow. In Seeing Networks in a New Way, I describe these dynamics in the Gasfield Free Northern Rivers campaign in New South Wales, and provide links to research that opened my eyes to how powerfully we influence each other. To understand these dynamics, read Connected, by Nicholas Christakis and James Fowler: binge drinking and smoking cessation are networked, as is suicide, and happiness, and altruism. There is a body of evidence on how girls with eating disorders can influence each other to valorise starvation, and to maintain in-group/out-group boundaries Allison 2013, Vandereycken 2011, Harsharger 2008). None of this is new. None of it is surprising. And none of this negates the intense suffering of girls caught in these dynamics.
To this incomplete list of networked behaviours I would add… our avoidance of uncomfortable information that challenges our sense of things.
Littman found that intense social media engagement was evident in the clusters of teenage girls identifying as male. If you think that teenagers might be somehow immune to network dynamics, watch this video in which young detransitioned women describe the role of social media in their teenage experience.
If we can shift beyond an EITHER/OR way of thinking about these issues, we could perhaps see that Littman’s research does not invalidate the experience of young people who experience ongoing, persistent and intense gender dysphoria.
If we could shift to BOTH/AND, we could open up to learning about what leads to harm for some (not all) people who embark on medical transitioning.
Young gay and lesbian people at risk of harm
Let’s return to these words:
“Everyday I wake up and am reminded of the fact that I was allowed an orchiectomy – removal of the testicles – only around 3 months into my transition”
You’d expect LGBT organisations to care for young gay men like Detrans Gay Guy, or young women who discover that all along they were lesbians and deeply regret the lasting impact of testosterone, and/or surgical removal of their breasts, and/or vagina and uterus. Concern should arise from the UK High Court case involving Keira Bell:
“The consequences of what happened to me have been profound: possible infertility, loss of my breasts and inability to breastfeed, atrophied genitals, a permanently changed voice, facial hair…”
When she presented to the gender clinic, Keira had been struggling with many challenges, including making sense of same-sex attraction, but she’d :
…never had a positive association with the term “lesbian” or the idea that two girls could be in a relationship. This made me wonder if there was something inherently wrong with me. Around this time, out of the blue, my mother asked if I wanted to be a boy, something that hadn’t even crossed my mind. I then found some websites about females transitioning to male…”
It should surprise no one that same-sex attracted teenagers are turning up at gender clinics. A body of knowledge confirms that childhood gender nonconformance and dysphoria is correlated with same-sex orientation in adulthood. In 2019, staff at the UK Tavistock clinic were saying it feels like conversion therapy for gay children:
- “So many potentially gay children were being sent down the pathway to change gender…there was a dark joke among staff that “there would be no gay people left”
- “It feels like conversion therapy for gay children…I frequently had cases where people started identifying as trans after months of horrendous bullying for being gay”
- “Young lesbians considered at the bottom of the heap suddenly found they were really popular when they said they were trans”
- “We heard a lot of homophobia which we felt nobody was challenging. A lot of the girls would come in and say, ‘I’m not a lesbian. I fell in love with my best girl friend but then I went online and realised I’m not a lesbian, I’m a boy. Phew.’
Yet despite the red flags, the queer ideology movement and LGBT+ organisations continue pushing the linear ‘affirmation only’ policy. They do this despite rising numbers of detransitioners who regret changes to their bodies, and despite the Littman study that points to network dynamics.
They push ahead despite:
- A longitudinal study of boys presenting to a gender clinic, during the era of wholistic care and ‘watchful waiting’, which shows 12.2% persisted with gender dysphoria, 87.8% desisted (resolved gender dysphoria), and 63.6% grew up to be gay (Singh 2021).
- UK research showing 66% of girls presenting with gender dysphoria were lesbian, 21% bisexual, and only 8.5% heterosexual. Of the boys, only 19% were heterosexual (Holt 2014).
- Studies that show homophobic bullying preceding adolescents identifying as trans (DeLay 2018).
- A body of evidence showing that, prior to the linear model, a large majority of children resolve gender dysphoria as they go through developmental processes of puberty (Ristori 2016). In other words, gender dysphoria in childhood is complex and multidimensional. Those with persistent and intense child-onset gender dysphoria are in the minority.
It’s important to note something here. In most western countries, the era in which the majority of kids resolved gender dysphoria as they matured has ended. The widespread model now is linear affirmation (social transition followed by medicalisation). Although puberty blockers are presented as ‘reversible’, research shows that the great majority of children who are given puberty blockers go on to cross-sex hormones (Brik 2020). In the UK Tavistock study this was 98% (Carmichael 2021). In other words, puberty blockers appear to disrupt natural maturation processes for those kids who would normally resolve gender dysphoria – and to set them on course for body altering interventions. For many, this means lifetime pharmacological dependence and increased risk of cardiovascular disease, osteoporosis, thrombosis and infertility, as noted in this Swedish policy statement to adopt the precautionary principle regarding hormonal treatment of minors.
It seems incredible that LGBT+ organisations would persist in advocating for linear affirmation-only when same-sex attracted youth are at risk of interventions that harm them and ‘trans the gay away’.
Are lesbian and gay youth of such
insignificance that adults would not bother getting across research that indicates a problem here?
A hostile and difficult environment for same-sex youth
The abandonment of same-sex attracted youth by LGBT+ organisations goes beyond indifference to the risks outlined above. Queer ideology has created a hostile and difficult environment for young people who are trying to make sense of same-sex attraction.
We fought for decades to have homosexuality acknowledged as an orientation, not a preference. But in a few years queer ideology has turned that on its head. The new ideology discounts and denies biological sex and in doing so has made sexual orientation unmentionable. The only thing that counts is gender identity. In this new framework, same-sex attraction is a ‘preference’ that can, and should, be unlearned.
The background to this is Queer Theory’s push to queer the boundaries. This entails an ambitious project to re-engineer language and meaning, to which everyone must fall into line including transgender and LGB people who do not accept Queer Theory. It may surprise you that the definition of trans has shifted dramatically in recent years. Trans now includes gender identities such as genderflux or demiangdrogyne.
Perhaps the most significant change has been that trans can mean a person who does not have dysphoria, makes no changes to their body or even gender presentation. Hence, the person in this photo goes into UK schools where confused girls learn that Alex Drumond is a lesbian. In this case, Alex has adopted some dress associated with the gender stereotype of femininity. But in the new thinking, even this is not necessary.
Along with the denial of biological sex has come the view that it is bigoted to define one’s sexual orientation in terms of the sexed body. Instead, we should be attracted to people in terms of their internal gender identity. But homosexuality and heterosexuality involves a stable pattern of attraction to a particular biological sex – the ‘sex’ in the middle of those words is a clue. (Stock 2021).
This degree of gaslighting is part of the problem we’re creating for young lesbian and gay people. Making sense of sexual orientation requires making sense. That means senses like sight, hearing, feelings and desire, and using words that accurately convey sensual experience. The accounts of detransitioners has made painfully clear how difficult it is for same-sex attracted young people to feel good about their sexuality. The requirement that young lesbians and gay men should override their senses and contort language to negate and then apologise for their emergent sexuality is Orwellian.
This dramatic cultural shift, with its new rules, manifests as pressure and/or abuse directed at young lesbian and gay people who articulate how they experience their sexual orientation. Arielle Scarcella describes the oppressive weight of this in Dear transwomen, stop pushing “girl dick” on lesbians. Increasingly, gay and lesbian dating apps allow someone to specify height – but not biological sex – because same-sex attraction is now regarded as transphobic. Young gay men may be censured for stating that homo-erotic desire involves… male bodies. If you find this hard to believe, have a look at abuse directed at gay boys and men on social networks. This is not coming from religious fundamentalists. This is coming from – and enabled by – the now dominant queer ideology movement.
This gaslighting is especially corrosive for young lesbians who report confusion and shame for ‘failure’ to experience male bodies as female. Thesedays, lesbians should be attracted to a ‘gender identity’ and adapt to being penetrated by the ‘female penises’ of transwomen who describe themselves as lesbian.
“I was told that homosexuality doesn’t exist and I owed it to my trans sisters to unlearn my ‘genital confusion’ so I can enjoy letting them penetrate me” (Lesbians at Ground Zero)
This is the cultural quagmire of queer ideology through which same-sex attracted kids must find their way. For all the reasons outlined above, they are at risk. In the absence of responsible leadership from LGBT+ organisations, gender non-conforming kids who would normally make sense of same-sex attraction through adolescence are now at risk of medicalisation, without the maturity to give meaningful consent. They must negotiate this swamp before they’ve had a chance to make sense of same-sex attraction, or even the safety to utter the words ‘same-sex’.
In response to this erasure of the gay and lesbian experience, LGB Alliance groups have formed to represent same-sex attracted people, starting with LGB Alliance UK and now in many countries including Australia.
It is important to observe that the gaslighting noted above is a product of a queer ideology movement and should not be associated with all transgender people, plenty of whom are concerned about where all this is going. With its relentless repurposing of words, meanings and categories, the queer ideology movement has become a kind of wrecking ball that upends not only the LGB but also the T. And being T is difficult. Let’s not conflate all trans people with queer ideology. The movement has generated such a head of steam that transmen and transwomen who have the wrong ideas are labelled transphobic.
Transman Aaron Terrell provides a window onto this in Ground Control to Major Trans:
“A lot of younger people define transgender or ‘trans’ as simply gender non-conformity, but even that isn’t a requirement. Trans is often simply regarded as an identity anyone can claim. It’s seen as a sort of moral cause or crusade to destroy, challenge, or ‘queer’ the gender binary. These folx are the Qs, often mistaken for the Ts. And in large part they seem to be lonely young people with the very normal psychological need for community and shared morality. I just really wish they would find it elsewhere.“
But you are unlikely to hear Aaron’s voice inside the bubble, and many left-progressive people who are unaware there is a critique of queer ideology may unwittingly help create the harms I write about here.
We are all part of this
There is significant distress associated with gender dysphoria.
Children and adolescents need access to timely, compassionate and evidence-based care.
Psychiatrist Roberto D’Angelo articulates how linear affirmation is a reductionist framework that decontexualises a child’s experience which may include trauma, autism, or homophobia. Gender dysphoria may be emergent from nested contexts: family, school, social networks, pervasive porn and gender stereotypes.
“ the uniqueness of each case and context must be investigated in order to arrive at an understanding of the meaning and function of that child’s gender identification and distress…Such an approach resists affirming and resists pathologising as both fail to encompass the complexity of children’s lives”. (D’Angelo 2020)
Clinicians at Sydney’s Westmead Hospital have shown how ethical holistic care is made difficult by a dominant discourse that prescribes a linear medical pathway and that shapes the expectations of children, parents, doctors and other professionals. Mindful of complex issues, the team offered holistic care. But very often the children and their families had a singular focus on puberty blockers and/or cross sex hormones.
“Coupled with the dominant sociopolitical discourse – the gender affirmative model that prioritises the medical treatment pathway – it is not surprising that the large majority of children and families were not motivated to engage in or to remain engaged in ongoing therapy” (Kozlowska 2021)
To the extent that we are all part of networks that carry the dominant discourse, we are all part of the cultural context that makes provision of ethical, holistic care difficult.
Are we OK with this?
The distress of gender dysphoric children and adolescents is intense, real and painful.
All of them need quality help, but the bus of LINEAR AFFIRMATION will take some to a destination called UNINTENDED HARM.
There will be more unnecessary suffering if we drive hell-bent through this complexity.
There will be more detransitioned people regretting surgeries, dependent on Big Pharma for hormones their bodies can no longer produce. There will be more people who lost years to depression and anxiety because their mental health issues were not assessed, or addressed.
There will be more well-intentioned health professionals who fail to see gender variance and dysphoria in the whole person, with complexities of autism, depression, abuse, trauma and flight from same-sex sexuality.
There will be more lawsuits.
The people I worry about are us.
That we would let this uncomfortable information slide. That we’d avert our eyes.
That we would fail to understand that queer ideology is separate from trans people whom we value and appreciate.
I feel concerned for all of us, that this harm happens on our watch.
Without information, there is no social learning.
Errors compound. Bad things happen.
It can be difficult to take on news that disturbs our group affiliation
If the information in this blog is new to you, this reveals something about the media you rely on. So far, progressive-left media maintain the bubble boundary.
I am reminded of an experiment in which a subject is asked to complete a survey form in a room which fills with smoke. If they are alone in the room, the subject attends to their senses, leaves the room and reports the smoke. But when the experiment includes actors who are under instruction to ignore the smoke, the subjects look around and observe the disinterest of others in the smoke-filled room. They override their senses. Most do nothing (Latane 1969).
These dynamics of the bubble are how we co-create tragedies. All those loving and well-intentioned grandparents…at ease inside a bubble of climate denial. They do not reach for information on global warming.
Then there’s the betrayal of children by the Catholic Church and other institutions. So many in the churches were good people with misguided faith in the priestly caste. But a pattern of sexual abuse that blatant must involve bystanders whose failure to observe, ask questions and speak in audible (not hushed) voices helped the harms accumulate. Fellow priests. Bishops. Lawyers. Cleaners. Nuns. Parents. Parishioners. There was no open discourse. There was no change in trajectory. When the veil of untouchability finally fell from the Church, so did its credibility which now lies in ruins.
How many times have we done this in history? Let allegiance dull our observations until harms accumulate that leave the thing we love in ruins? We’ve let this happen in political parties, corporations and institutions…sweeping stuff under the carpet until the pile started smoldering, caught fire, and burnt the building.
The smoke is in the room, people. It might be a different kind of smoke from the monstrous Church travesties.
But it’s a room. And it’s got smoke in it.
The rainbow flag has been associated with courage.
A different kind of courage is called for now.
As I’ve raised these issues with people I know, I’ve observed a pattern. A person might sit upright to say ‘something’s not right’, then recline into the gentle currents of non-inquiry. The trouble is, our averted eyes, our disinterest helps create the harm. Our indifference is networked. We may not know it, but we share and model it.
What could possibly stop us
from learning about about this?
Transgender adults are speaking out about what’s happening.
Here are three of their voices. As Buck Angel says: “Have the conversation, people. Before we have more collateral damage”.
Warm thanks to the people who shared feedback on this blog in draft form.
FURTHER INFORMATION
- LGB Alliance Australia
- The Lesbian Project
- LGB Alliance UK
- Gay Men’s Network
- Society for Evidence-Based Gender Medicine (SEGM).
- Stats For Gender – gender research at your fingertips
- Genspect – A voice for parents with gender questioning kids
- Gender Health Query: trans and LGB people working to ensure that youth receive quality care
- PODCASTS
- Transparency – 2 transmen host surprising conversations
- Gender: A Wider Lens – 2 therapists explore gender with guests
REFERENCES
Zucker K, Adolescents with Gender Dysphoria: Reflections on Some Contemporary Clinical and Research Issues, Arch Sexual Behavior, 2019)
De Vries et al, Autism Spectrum Disorders in Gender Dysphoric Children and Adolescents, J Autism Dev Discord, 2010
Butler G et al, Assessment and support of children and adolescents with gender dysphoria, Arch Dis Child 2018
Kozlowska K et al, Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service, Human Systems: Therapy Culture and Attachments 2021
Ristori and Steensma, Gender Dysphoria in Childhood, International Review of Psychiatry 2016
Littman L, The Use of Methodologies in Littman (2018) is Consistent with the Use of Methodologies in Other Studies Contributing to the Field of Gender Dysphoria Research: Response to Restar (2019), Archives of Sexual Behavior, 2020
Littman L, Parent reports of adolescents and young adults perceived to show signs of rapid onset of gender dysphoria, PLOS ONE 2018
Christakis & Fowler Connected: The Amazing Power of Social Networks and How They Shape Our Lives 2011
Allison et al, Anorexia nervosa and social contagion: clinical implications, ANZ J Psychiatry 2013
Vandereycken, W, Can Eating Disorders Become ‘Contagious” in Group Therapy and Specialized Inpatient Care?, European Eating Disorders Review, 2011
Harshbarger et al, Pro-anorexia websites: What a clinician should know, Int. J. Eating Disorders, 2008
Singh et al, A Follow-Up Study of Boys With Gender Identity Disorder, Front. Psychiatry, 2021
Holt et al, Young people with features of gender dysphoria: Demographics and associated difficulties, Clinical Child Psychology and Psychiatry, 2014
DeLay et al, The Influence of Peers During Adolescence: Does Homophobic Name Calling by Peers Change Gender Identity? Journal of Youth and Adolescence, 2018
Brik et al, Trajectories of Adolescents Treated with Gonadotropin-Releasing Hormone Analogues for Gender Dysphoria, Archives of Sexual Behaviour, 2020
Carmichael et al, Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK, PLOS ONE, 2021
Policy Change Regarding Hormonal Treatment of Minors with Gender Dysphoria, Karolinka Hospital, Sweden
Stock, K Material Girls: Why Reality Matters for Feminism, 2021
Arielle Scarcella Dear transwomen, stop pushing “girl dick” on lesbians
Stock, K Lesbians Aren’t Attracted to a Female ‘Gender Identity’. We’re Attracted to Women
D’Angelo R, The complexity of childhood gender dysphoria, Australasian Psychiatry 2020
Latane and Darley, Bystander “Apathy”. American Scientist, 1969
Thank you Annie,
This is a much needed exploration of the tragedy that is happening all around us and a deeply insightful explanation of the complex dynamics that enable it. Thank you for taking such care to lay this out..
Thanks for this very thoughtful essay. I do worry that we are lumping all kinds of issues under the “trans” umbrella, and sending young people down a path of medicalization that they may later regret. I feel that adults can do whatever they think is right, but young people deserve better safeguarding.
Thank you Annie for this thoughtful and respectful post on such a complex and controversial issue. You cover so many important issues – which we need to think about. I agree that it is vitally important to have an open mind and ability to hear respectful viewpoints without just shouting down, demonising and shutting out. I also agree that homophobia has many manifestations and it is a real concern that some of today’s queer ideology and transgender medicine maybe a dangerous enactment of such homophobia. We need to proceed cautiously – especially in the medical interventions of still developing children and adolescents who need support, time and thinking space to sort out the complex identity issues of self-body-gender identity- sexual orientation prior to being set on a path of life long medicalisation/surgery/sterilisation etc. Thank you for having the courage to speak – voices such as yours are needed .
Thank you for your very thoughtful, insightful + well researched article Annie. So support Alice’s clear assessment. An excellent contribution to a deeply important, profoundly intimate matter of how we explore sexuality + sense of self amid some very curious theories.
All of these concerns are warranted. I have been heavily immersed in LGBT identity politics and have thoroughly researched the issue of pediatric medical transition (most of the peer-reviewed papers, hours of lectures by gender clinicians, parent accounts, detrans stories, anti- and pro-pediatric transition arguments from trans people, reflecting on personal experience and experiences of loved ones and other LGB people, hearing concerned therapists and doctors, and attending pro-transition gender conferences, etc.).
What health professionals are accommodating is young people who will want to transition in adulthood no matter what. They exist. But I was shocked to see the callous apathy in the “affirmative” circles towards potential desisters who may need time and support in their maturation process, not drugs and surgery. There is also money to be made providing additional motivation (especially in the United States). In years of researching this, what seems to hardly matter to the “affirmative” crowd is:
1) The medical side-effects are more severe than someone who transitions as an adult may opt for (like stunted genital development, loss of sexual function, and sterility, explaining why some trans people oppose this). Yet, it is moral for 11-year-olds to make this decision before they have even had their first crush when they go on blockers that chemically castrate them.
2) There are undoubtedly grey-area youths, many if not most who are same-sex attracted. Anyone who says otherwise is lying. They don’t need a gender clinic. They need time to struggle through puberty and young adulthood and grow up, the way pre-LGB kids or teens suffering in puberty used to do. Instead, they will be medicalized, which here means removed body parts and sterilization. We don’t have to wonder if this will happen. It already is happening. It’s only a matter of how many there will be. This would be considered a human rights violation (sterilizing minors, destroying sexual function, and subjecting them to other potential serious side-effects from Lupron and underage surgeries) in any other circumstances. In this case, people who point out this is dangerous risk losing their jobs and are attacked by people who want to ostracize them.
The people who do this fall into 2 categories:
1) People who are very uninformed about the previous research on desistance and its association with adult gay and lesbian identity, as well as data that indicates people should be worried about social contagion. They just want social justice and view anyone else not in alignment with their concept of an SJW agenda as the enemy.
2) People who are informed about the above realities but merely view over medicalized pre-gay and lesbian children and same-sex attracted, ASD, awkward, trauma victim teens struggling with puberty as morally acceptable collateral damage for “trans positive healthcare” for tweens, teens, and YAs.
The justification for the #2 position is trans youth are saved from suicide. It’s too complex to go into here, but be skeptical about this claim. The data on suicide reduction and medical transition in minors or adults is mixed and inconclusive despite what you always hear in most media, which defaults to a narrative of medicalization as panacea.
And on queer theory- I have never seen LGBT youth angrier, more gender/sex confused, with worse sexual boundaries, and more self-absorbed than at any other time since I was young and came out (I was involved in support groups and safe sex education in the past). Not a fan.
Thanks for this well-written post. It is the kind of thing I would have written 6 years ago as a centrist skeptic waking up to the dangers here, polite and reasonable. I’m more cynical about the people who are doing this now and the leftists so confident of their moral superiority in supporting this (and enthusiastically). I don’t think they will care much about the negative impacts of this on LGB (and het.) youth not best served by transition unless someone gets sued. And I am aware of plenty of stories where someone deserves to be.
Thank you Annie for this beautifully written paper. I have been working in this area for about 2 and a half years now, and even since the beginning of this year I have sensed a growing public and professional push back against the medicalisation of youth with gender dysphoria. I welcome the insights you provide and appreciate the courage you demonstrate in writing and sharing this paper.
Thank you for writing this great article So many important points made. I urge any reading who might be new to the topic to continue researching—some links below to help if interested:
The majority of children with gender dysphoria will have resolution of their dysphoria by early adulthood are summarized here. (https://www.tandfonline.com/doi/abs/10.3109/09540261.2015.1115754?journalCode=iirp20)
This high rate of resolution holds true regardless of the diagnostic criteria used. You can read more about that here and decide if you agree. https://www.tandfonline.com/doi/abs/10.1080/15532739.2018.1468293?journalCode=wijt20
Today the largest cohort of gender dysphoric adolescents presenting to clinicians do not have a history of childhood gender dysphoria, read here, and here. https://onlinelibrary.wiley.com/doi/abs/10.1111/jsm.12817
https://pubmed.ncbi.nlm.nih.gov/29535563/
Most (80%) are females with mental health struggles and/or neurodevelopmental issues, read here,
https://capmh.biomedcentral.com/articles/10.1186/s13034-015-0042-y
and the role of social influence in this phenomenon is unclear. https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0202330
This new population with adolescent-onset gender dysphoria is almost completely unstudied, and clinicians who work with these adolescents are calling for more research.
https://www.researchgate.net/publication/334530426_In_Support_of_Research_Into_Rapid-Onset_Gender_Dysphoria
The Dutch are warning that their “Dutch Protocol” of puberty blockers and cross sex hormones has not been studied for use on this new cohort.
https://pediatrics.aappublications.org/content/146/4/e2020010611
The WPATH and Endocrine Society Guidelines* (*not “standards of care”) that recommend puberty blockade and cross-sex hormones are not supported by high-quality evidence.
https://www.segm.org/endocrine_society_GD_position_rebuttal
Several European countries are turning away from hormonal and surgical interventions for youth with gender dysphoria after systematic reviews of the evidence in this area show no convincing evidence that these interventions improve the long-term mental or physical health of youth with gender dysphoria.
https://www.segm.org/Sweden_ends_use_of_Dutch_protocol
https://www.segm.org/Finland_deviates_from_WPATH_prioritizing_psychotherapy_no_surgery_for_minors
https://www.segm.org/NICE_gender_medicine_systematic_review_finds_poor_quality_evidence
After reading the medical literature, and seeing first-hand the absence of good data to guide decision making, I came to the conclusion that it is completely appropriate and ethically sound to offer psychotherapy as first-line treatment to distressed young people with gender dysphoria.
https://www.segm.org/danger_of_conflation
Great piece. Quite an eye-opener for me. Good luck Annie!
We are indeed in a “social bubble” that is “hermetically sealed”. I have been writing about the need for adequate therapeutic exploration to examine the inevitably complicated issues that are intertwined with gender dysphoria in young people. One of these factors in some individuals is shame and dread of same-sex attraction. This is often mischaracterised and dismissed as a call for “Conversion Therapy”, one of the many ways the social bubble excludes information that does not support the dominant narrative. We need more dialogue and debate, not less, if we truly want to find the best way to help young people with gender dysphoria.
Such a well constructed, thoughtful piece, Annie. Thank you so much. I can think of hundreds of people who I want to read it. It is so hard though for people to read material that challenges their world view. How can we break that bubble? Just keep bravely speaking up, as you do here. Love and courage!
Thank you Annie for your compassionate, well-researched, and brilliant analysis of the significant concerns that queer ideology has on young people, especially those who are same-sex attracted. I have directed friends and colleagues to your site to read this. Keep up your excellent and brave work.
Thankyou Annie. You have given me much needed clarity for an issue I’ve seen slowly gaining ground in unsuspecting circles. Now I understand what’s really happening. I’m reminded of the politically correct term ‘ gay-friendly’ that governments adopt, thinking they’re so cool. However, all it’s doing is conveniently over-riding , reducing and minimising the elephant in the room i.e., the derilect absence of grass roots acceptance and human rights for LGBD+ people.
Thanks for the analysis and putting into context the queer ideology.
We really do need to ditch this ridiculous “LGBT” initialism, together will all its extensions (LGBT+, LGBTQ etc.), and the sooner the better. It’s illogical and misleading, and therefore obscurantist.
Thank you from Canada
This is excellent. I’m involved in campaigning for women’s and girls rights in the UK. What is happening to young people in particular is scandalous, and I’m astonished how influential Stonewall and groups like Mermaids have become. The amount of access the have to government ministers, and the funding they receive is disproportionate.
Amazing how many adults who have no intention of undergoing any sort of medical transition are pushing for vulnerable children to sign up to a life long medical interventions.
Not everyone who transitions regrets it of course, but few would deny that it’s not to be undertaken lightly or without consequences.
Having only a passing knowledge of queer theory this has explained it wonderfully.
Great essay Annie. As someone who was a member of the Greens for ten years, and who’s worked at feminist (self-described) organisations most of her career, I have come to despair of the Australian left. Thank you for speaking up. With each person who does, hopefully it will give some courage to those who agree with us but remain silent.
Goodness, this is not a very nuanced article, Annie. I can’t help but wonder where such a reactionary attitude stems from. I thought someone with your research skills would give a more balanced approach to this topic. Where are the studies of trans* kids whose medical interventions such as puberty blockers were lifesaving? Why focus on the detransitioners when they are in the minority? Of course there are always a small number of young people, and older people too, who regret their gender transitioning decisions and which you cover in painstaking detail, but it is to the exclusion of other important empirical research findings. There is other literature you may consider for a more balnced perspective, for example, Australian researcher, Damien Riggs’ chapter, ‘Challenges and Joys in Adolescence’ in the book Working with Transgender Young People and their Families: Critical and applied approaches in sexuality, gender and identity. Also there is the Trans Pathways study freely available at https://www.telethonkids.org.au/projects/trans-pathways/ which is the largest Australian study ever conducted of the mental health and care pathways of trans and gender diverse young people with some alarming statistics of poor mental health, suicidal ideation and attempted suicide compared to LGB youth. I hope you will take the opportunity to better inform yourself before espousing such uncritical streams of consciousness.
Jae, perhaps you might be interested in Damien Rigg’s commentary on the parents of gender dysphoric minors, where he accuses them of “gaslighing” and “abuse” for expressing any concerns about transgender identification in their children. He also suggests that therapists attempt to gain access to these minors privately, without their parent’s consent. This is a clear breach of ethical and child safeguarding guidelines. I would be sceptical about any work produced by such a person.
https://4thwavenow.com/tag/damien-riggs/
With regard to the telethon kids survey, I wonder if it provides any evidence that hasty medical affirmation leads to sustained improvements in the long term in these parameters of mental health and well being. I can answer that for you – it cannot possibly do so, as these intervention are so new that such long term data will not be available for decades. Hence the need for caution in applying these experimental interventions.
To speak of puberty blockers as “lifesaving” is nonsense. Puberty is not a life-threatening disease, or indeed a disease at all. Neither puberty nor lack of puberty blockers is a recognized cause of death when filling in a Death Certificate.
Powerful scholarship, eloquent exposition. Congratulations Annie!
You do us all a service by illuminating the damage that can be done by unreflexive ideology when imposed on those least able to understand or foresee its consequences. Soundly reasoned and passionately expressed analyses like this are invaluable – indeed essential – in these times of witless culture wars and dogma driven repudiation (canceling) of those holding ethically sound views unpopular with the digital mobs.
Ours is an age of cultural upheaval and moral disorientation, when so many of our long-held tacit assumptions about the world and our place in it are being revealed as untenable. Such times too often see the rise of doctrinaire fundamentalisms right across the political spectrum. We need courageous and tough minded thinkers like you, Annie, to name these abuses and expose the profound dangers they represent both to unwitting individuals and to society at large..
Deeply grateful for this article as an educator on the sidelines watching our gay kids get pushed on a path to being trans that needs lots of deep thinking and healthy scrutiny. Our youth ( and older ppl for that matter) need to know it’s ok to be gay. It’s ok to be gender non conforming. Those exploring identity need to be embraced for being on a journey that takes time, compassion and patience— not automatic surgery or drug therapies. I truly hope that people will really listen to your logic. Thank you for this thoughtful and researched piece. I wish you a positive and open minded reception.
Thanks for this terrific piece. Parents who are seeing their gay, autistic, or mentally ill teens being caught up in this social contagion are grateful ! Our kids need competent, thoughtful care, not drugs and surgeries.
Thanks Annie this is an incredible well thought out and powerful exploration of an issue I had wondered about but had no clarity on. You are a superb writer, an amazing researcher and very caring activist. I have just finished reading Clem Bastow’s Late Bloomer about her late discovery of autism. In later chapters she explores her gender dysmorphia and discovery of being a lesbian. Some interesting exploration in her book about how easy it was to take on other peoples ideologies about her sexuality and gender identity. Worth a read. Thanks Annie I hope your article contributes to changes and lessening of potential suffering for people already having a hard time. Taking on uncritically ideology can lead to many sorts of harm.
Annie, thank you for this thoughtful essay written on a complex and complicated issue. You have explored multi-dimensional aspects of the psychological, spiritual and physical harms that the operationalisation of queer ideology can have for same-sex attracted children and young people. Your use of complexity theory has illuminated many issues particularly the way the examples added depth to our understanding. Thank you for that.
Your thoughts and those of the scholars you drew on, indicate an urgent need for further research locally as well as internationally, on holistic approaches to same-sex orientation. Our thoughts are that further research could include children and young people as well as families using an intersectional framework to contextualise experiences. As queer theory(ies) and ideology(ies) have multiple perspectives like feminism(s) and postmodernism(s), discourse analysis may well illuminate the key language that marginalises and constructs same sex attracted people as transphobic. This would be a wonderful project for a post graduate student!
The arguments you put forward are undoubtedly convincing, have revealed the extent of the disturbing erasure of gay and lesbian lived experiences.
Kierrynn Davis PhD & Nel Glass PhD
Bravo Annie! An extraordinary essay illuminating the unintended consequences of misguided, if well intentioned ideology in such complex, sensitive situations. I had no idea. You have really opened my eyes to the tragic disservice being done to our understandably confused young people so in need of empathy, guidance & appreciation of who they are…& perhaps just time to ponder. Thank you.
Beautifully written, researched and explained. Thanks for deepening my understanding.
I support trans people’s right to be trans. I have first hand experience of how trans people are treated in the streets on a day to day basis. Trans people are at risk of ostracism and violence just by being themselves in public. I’m concerned this article makes life harder for them and their loved ones.