Thank you for sharing your thoughts and experiences. I agree that it is a society problem rather than true mental illness. I think the main benefit (perhaps the only benefit) of repathologizing gender identity disorder would be to grant therapists the opportunity to work with trans-identifying youth and adults to address their gender dysphoria through therapy rather than just through medicalization.
As it stands, most therapists are afraid to do anything other than simply affirm a trans identity and work with a youth or even an adult on how they can accept their trans identity, how they can deal with family or others who don't accept it, etc.
As the parent of a trans identifying child, I have struggled to find a therapist who will actually address my child's mental health issues (and I don't mean gender dysphoria). My child had anxiety, OCD, and ADHD before ever deciding she was trans. Now, everything is eclipsed by the trans identity. No therapist seems willing to help her look at the thoughts or experiences that led her to suddenly decide she is trans. Several therapists simply avoid it altogether and have told me they don't "deal with gender issues." Most are afraid of losing their licenses if they don't immediately go along with a child (or adult) claiming a trans identity.
In my opinion, a trans identity is not something a child or adolescent (especially- I'm not really addressing adults here) should embrace without serious introspection and psychological examination. In today's society it seems that so many young people are saying they are trans or non-binary. Perhaps it is the cool thing to do, perhaps it addresses their need for belonging, perhaps it is based on a long-standing feeling about themselves. For some of these people, they may be happy with a medical transition but for many others they will not. Either way, medical transition involves serious and risky surgeries and hormones with side effects (some known and some likely yet unknown). It seems only logical that therapy should be the first treatment for gender dysphoria. Every attempt should be made to enable a person to live happily in their body without surgical or medical modifications. As it currently stands, most therapists avoid really examining or challenging a trans identity at all and simply affirm and actually strengthen the identity.
So, while I do agree that it is not trans individuals who are mentally ill and repathologizing could have unwanted effects in that regard, the benefit would be that therapists could actually treat gender dysphoria, hopefully allowing people to develop an identity that can integrate their sense of self as a man or woman with an acceptance of their male or female body.
Thank you for your thoughtful response and I'm sorry your family is navigating such a difficult situation. Regarding finding a therapist willing to do the work, I agree it can be very challenging. Therapyfirst.org is one organization that is trying to change this.
Thank you for keeping me from riding my wave of self-righteous fury. Honestly, this is a compelling piece, as always. I have been indifferent to causation and pathologizing. For me its not purity politics but more so preservation of innocence and preventing harm. There is an enduring belief preservation that is rock solid when it comes to transistion. Sadly for some that barrier to the mind is impermeable - especially if you capture children when they are young.
I do think your experience matters, even if it is only an N-1. When these experiences mount, like the breasts left behind on an operating table, it should not be ignored. Griffin Shaun Sivret, 24, of Woonsocket, RI died 23 July 2024 in UMASS Memorial Medical Center. Griffin was surrounded by a loving family that all believed in Griffin’s need to make a life saving transistion as a young teen. Sadly Griffin spent years tethered to a colostomy bag, in and out of hospitals. Griffin was the recipient of double-digit surgeries that cost well over $600K. Griffin suffered infections and sepsis until finally the body could no longer endure the years of abuse. Was Griffin mentally ill? Is it any different to the broken mind of an anorexic or addictive disorders?
I still think of the experiences of Yarden Silveira. A young teen caught up in this social contagion, Yarden came to believe the awkwardness of his everyday life was somehow the result of being "born in the wrong body". On 11 March 2021, Yarden's posted about his experiences on the YELP page for Align Surgical Associates. Soon after he posted these words Yarden's life came to an end, he was 23. Yarden was completely broken by those who he trusted. Yarden seemed to realize he was living in a real version of, "The Truman Show" and it cost him his life:
“I wish I never listened to the medical and psychiatric community when they told me it was possible to change my sex. What a lie. Very dangerous and unethical…No one is truly there for me. There's no need to pretend. I have a gaping hole in my genital area with my colon spilling out… What hurts me the most is the loneliness and the inability to find a partner. I can't have a normal sex life. I'm a loser and I probably deserve this deception. This is what I get for messing with nature.”
Thank you so much for your story. It is both informative of a perfectly sane thought process, and a rare one from a trans man. I was at the Genspect conference when Mia Hughes made this announcement of repathologization. The way it was presented, near the end of the conference coming after so many stories of wrong decisions made and physical harm done to young people, this came across as a pragmatic decision rather than a judgement on those struggling with a gender journey they hope will relieve them of their stress. I took it as a decision that would allow for a more thoughtful and nuanced assessment, rather than straight up affirmation, here's your hormones, and next in line please.
At the same time we, of the San Francisco TERFs who attended in a large pack, thought it was a mis-step, as did Sasha Ayad it seems. We attributed this to the difference between our American sensibilities, and the British, with their socialized medicine and long history of government control of the medical lives of their citizens. I'm not sure how it will pan out, but it has thrown open a door to more dialogue, for which I'm grateful to see you joining.
I come from a country where a third gender presentation is the norm for gay and lesbian people. This concept informed my whole gender non-conforming journey and I hang onto it fiercely as my own, so I understand absolutely your complaint that it is on society (Western society) that we struggle to have a place where we can be ourselves. I believe that how Thailand integrates this intense level of cross-sex presentation is what keeps the peace between the sexes and in between the sexes. This heritage makes everything so clear to me regarding what is going on in this country. I am trying to get a purchase on delivering this perspective, but the West is very stubborn in its attachment to its own theories, and would rather appropriate our example as proof that "trans has always existed" than take any advice on how we managed to do it within our society.
While I do not agree with much of what you have said , it is important to have your thoughts out there to be part of what will be a painfully long , drawn process of attempting to find sanity in all this.
I firmly believe you were betrayed not just by the medical profession , but by the media that helped create the context in which so much of this evolved. They functioned not as questioning journalists, but rather advocates for something they had little to no understanding of, and I doubt they are capable of owning up to that tragic error. Collateral damage is the loss of trust in so many institutions and professions, and I'm not sure how they recover from that.
This is definitely spot on. It's definitely not a mental illness. It's a problem with society.
Sasha Ayad understands what's going on and has brilliant insights and genuine compassion on this topic (and she opposes this re-pathologization), but Stella is off in the weeds with her aggressive approach and is so off-putting I wonder if she's the type of therapist that only gets minor patients when their parents force them to see her. If I were forced to see her as a therapist, I'd never speak. I wouldn't even read my daily to-do list to Stella. You're dealing with a woman who claims she grew up as a tomboy (kinda) and found her way back to girlhood who now thinks that little experience gives her insight on what trans people are going through because she "found her way out" - but she's femme presenting and I don't believe her, she has no masculine orientation to society and has no idea what she's talking about.
Stella did clarify that it's not the identity she wants pathologized, but the desire to alter your body. But I don't believe that for a second, and that isn't how it's going to play out because one goes with the other.
She keeps passing around a quote she said that goes something like, "I need to you to understand that you're mentally ill and I want to help you." She has no idea that she probably shouldn't be a therapist. I don't know who she's helping with gender issues, but it's got to be limited. But I suspect she gets a lot of resistance and pushback from her patients and they probably only go because their parents are forcing them to.
I didn't transition for the same reasons you did, I never felt unsafe. But I wanted the male "social package" I had as a kid when I was just one of the boys. The adult female social package is bunk, and I was going to lose my mind if I had to deal with another female social interaction. Most people don't know what I'm talking about if they haven't transitioned, but it's in everything - tone of voice, the way you get greeted, the way females try to bond with you, it's a mismatch when I am seen as female. I've never had a male gender identity (I wrote an article about that) nor have I ever hated my biology or thought I was male. I made a practical choice that got me around society's bogus BS I couldn't stand that did not apply to me.
I couldn't take another holiday receiving girly gifts from my mom's friends or strangers who just heard someone mention me referring to me as "she." You know how it goes. Once people talk you up to others and use she/her pronouns, they get a picture in their mind of who you are and that does not involve a masculine person... fine, but multiply these situations and interactions by every experience you have with people all day every day for decades and the fact that nobody out there will interact with me as a masculine person isn't a "me" problem - that's a "society" problem. Girls can be masculine of course, but society still wants to treat them as princesses and talk about girly things. As long as you're seen as female you still have to fight for the right to wear a male uniform at work to avoid frills and short sleeves.
I'm very gender critical, but it's mostly an issue with transwomen who are off the rails... and I'm not actually anti-trans because of course everyone can live their life as they see fit. But I am against it in the sense that I think surgery and hormones do serious harm and surgery disrupts the body's meridians, which are essential for health. But nobody is honest anymore about biological sex, it's become a fad, and I have an issue with that. We all know from experience that as much as we align with men socially that once we live as men it's easy to see how much we differ. But it's still possible to live a normal life when you're not trying to pretend to be male.
I was on T for 11 years, but off for 9 years. You can call me a "detransitioner" but I haven't changed anything in the way I dress or look since I was a small child. I simply stopped taking T. So I don't tell people I am a "detransitioner" because then they revert back to the female social package, despite me still passing as male as long as I don't shave my face. And that further highlights that the issue is with society, not individuals.
Everyone wants to say that men and women can dress and present however they want and they don't need to look like the opposite sex. But the reality is, unless you actually do transition, society still treats you according to the "social package" that comes with your birth sex that is not based on genitalia, but just social roles and expectations.
Most non-trans people will never understand this.
I transitioned in a time when you had to get a letter from a therapist, and you were diagnosed with gender dysphoria. It was 2005 when I started hormones. But I started my transition around 2003. Even back then we all just went in with the desire to start hormones. Nobody wanted therapy, we wanted the life we knew would be comfortable. But we also knew our biology and were not trying to invade sex-segregated spaces. Since transwomen needed surgery to be legally female back then, and legal sex was required to access bathrooms and locker rooms, we didn't see the insanity we see today...
The system was fine originally (see my additional comment below for a clarification on what I mean and how it worked - ex: nobody could enter sex segregated spaces without changing their legal sex or risk prosecution, and you couldn't change your legal sex without a letter from a doc stating you had "irreversible SRS" and SRS=bottom surgery only at that time. Most people wouldn't do that so that was a barrier for people who were "less committed." Compared to today where you can change your legal sex on a whim without a letter and you don't need to be a legal sex to enter sex-segregated spaces)...
The recommendation at the time was to get 3 months of therapy to get a letter, get a letter for hormones, get a letter from a doctor to change your legal sex, and when people did that nobody cared. It was illegal to use the restroom unless you had legally changed your sex marker so people didn't try it unless they fully passed and blended in. People who went through the system properly were mostly good candidates for transition in the sense that it wasn't a major disruption to their life.
Gender dysphoria was the "pathology" and even that isn't accurate because it's not the individual's issue. But you can't treat society, so... it worked. But if they actually succeed in pathologizing identity, the so-called "gatekeeping" will be worse than anything we've ever seen before, and you bet they'll come up with some kind of medication plan to put people on anti-psychotics.
Now here's a bigger problem. When you're diagnosed with a disorder that has a certain classification, it eliminates your right to own firearms. And it can be used against you in court with child custody battles or even divorce. And if you end up incarcerated with said diagnosis on your record, they will force you to take the "appropriate" medication even if you always chose not to.
Thanks for reading. Not sure I agree that the system was fine originally, but I take your point that there was a clearer process and no illusions of actually changing sex.
I don't mean to imply that the system was perfect, but unless someone lived it back then it's almost impossible to understand just how gated transition was. It's night and day.
20 years ago, you couldn't change your sex marker legally on a whim or "just because" like you can today. The barrier to getting your sex legally changed was having completed bottom surgery. Without bottom surgery (or a letter from a doctor willing to lie for you) you couldn't change your sex legally. And back then, without legally changing your sex, you could not enter sex-segregated spaces like bathrooms, locker rooms, dorms, clubs, etc. Employers didn't even have to treat you like the sex you identified as (even if you fully passed) and they could still impose sex-specific uniform policies, etc. They could also fire you for being trans and out of compliance with sex-specific dress codes. Trans people literally had no legal protections until or unless they got bottom surgery and legally changed their sex.
In other words, 20 years ago, people had to think long and hard about the choice to transition because there were no "protections" for anyone who wanted to live as the opposite sex unless they could afford $150,000-$300,000+ for bottom surgery (many did not want it because it was too risky and unsatisfactory), and therapists in general explained how difficult life would be navigating the world.
Doctors didn't know how to handle trans people so they went with the HBSOC guidelines to provide three months of therapy before providing a letter for hormones. There were some clinics in San Fran that skipped that and some trans therapists also skipped that but most people had to go through the three months of therapy on a weekly basis to even be considered for hormones. And therapists were not afraid to say no.
Back then, because the barrier in place was so high, a person had to be legally male or legally female to enter sex-segregated spaces, and while that isn't necessarily the right thing, since people had to go through genital surgery to get the letter required to legally change their sex, it wasn't that common. Of course it happened, but it wasn't the norm - most trans people did not get bottom surgery, couldn't legally change their sex, and remained stealth... if they entered sex-segregated spaces they only did so when they blended in and nobody was the wiser. Transwomen were not allowed in female locker rooms or restrooms if they had not had genital surgery and a legal sex marker change. Most never risked it unless they totally passed or came close to it.
At that time, legal sex had to be changed with Social Security first, and SS required a letter from a physician stating specific wording that a person had "completed SRS" specifically, and at that time, top surgeries were not legally considered a form of SRS. So doctors wouldn't write letters for people who did not get bottom surgery (at first).
It was possible to change the sex marker on your driver's license in some states, but not all, and in some states (like CA) you could only change it for 3 years... after 3 years it would revert back to your birth sex if you hadn't presented the DMV with a new birth certificate that had been amended. And in order to get your birth certificate amended, you had to get your sex marker changed with Social Security first. Which meant nobody could even change the sex on their driver's license or passport. If you wanted to change the sex marker on your passport, you needed to show your amended birth certificate. They weren't accepting doctor's letters back then.
It was really tough and really expensive.
Over time, the law loosened and SS's requirements for that letter's wording loosened and someone changed the rules so that doctors only needed to state that their patient had simply "completed their transition" and that's when people started getting letters without having surgery. But that took years even. At first, doctors still didn't know much about trans people so they were hesitant to provide letters stating someone had "completed their transition" because they still thought completion meant genital surgery. Eventually Kaiser's doctors got some "training" and started writing letters for people who only had top surgery. So then everyone started going to Kaiser because they were the most trans-friendly for letters and hormones (they have a walk-in injection clinic) and at that point, people were getting letters from Kaiser doctors to change their legal sex based on top surgery alone...
And then a few years later they started giving letters to people who had not had any surgery at all and were only on hormones, since they realized some people will never have surgery and it wasn't fair for them to be denied the legal sex marker change... and then that evolved to "well what the hell, let's just let everyone change their sex marker even if they haven't had surgery or hormones." And that's where we are today.
So when I say the system worked in the past, it worked in the sense that the barrier to entry was so high most people either never got the change to change their sex marker or they went on hormones and blended in, and the kind of drama you see happening today just didn't exist back then because of those barriers.
Thanks sharing your thoughts. Obviously, it is deeply personal and I suspect you are concerned, alarmed perhaps, about the way the genie has got out of the bottle. You have mentioned elsewhere about quitting testosterone and I came across a video from well over a decade ago from an individual that did the same, I found it remarkably insightful: “Testosterone did not bring me closer to the truth. It just helped to mask the pain…..This will not make you who you are, you already are who you are.”
I personally didn't have any issues with testosterone, I wasn't searching for anything when I started taking it, I just wanted the masculinizing effects so I could get the "male social package" in society because the "female social package" is a total mismatch so I took it. The only source of suffering for me came from the way society interacted with me. It wasn't about my body but masculinizing changed my body in a way that made society recognize instantly the type of person I am. (I don't mean "male" I mean the social aspect of what goes with being male - (there is a distinct way people treat males and females and it has nothing to do with actual sex). Getting the right social interactions was all I ever cared about.
For me, taking T was the best choice I ever made. It did wonderful things for my body, it got me stronger, healthier, and somehow managed to fix whatever hormonal imbalances I had that fixed my weight issues long-term as well as gave me normal painless periods when I went off- it triggered my body into a very positive state internally and externally. It only added to my life. The reason I went off was not because it was any kind of mistake. But I didn't want to be part of the medical system anymore, I couldn't handle getting blood drawn because I started blacking out during the process, and I didn't want to put anything exogenous into my body even if it was helpful (I don't even take Advil).
It's definitely not something that I would take long-term because it does age you faster and is hard on the body. I was just fine with where I was and didn't feel the need to keep taking it. But for me, it was all a very positive experience. But I wouldn't recommend it for most people. Definitely not how it's being handed out like candy right now. But for me it was a great experience.
"Speaking from my own experience, I was only offered one treatment for my gender distress — a medical one... I was told that a medical transition would resolve my depression and anxiety."
sorry to hear about your experience. it sounds like you would have been better off if you had more information. reminds me a little of a story i heard once when my grandma was pregnant in the 1910s, she got a fever and drs told her to drink whiskey. the baby died. drs dont know everything. but they act like they do. when they told you gender "care" helps depression and anxiety that was false. theres no evidence it does. we know that now. but back then people werent as sure. psych meds help depression and anxiety. there maybe some people who the medical route helps. but theres no way to tell who it would. for most, it doesnt help. but certainly there should be continued health service availability for those affected.
"Both explanations do not take into account the context within with my distress occurred."
its only via the exploratory route that distress is explored and can be resolved. medicalizing distress forces one to relive trauma again and again via the constant reminder of the trauma. they say time heals all wounds. that may not be entirely true. but contant reminder and focus on trauma via medicalizing the trauma cant be helpful.
"Why am I the one being labelled as mentally ill, from Genspect’s perspective, and not the doctors who inflicted this on me and others like me?"
other than what you have mentioned in this article, i dont know anything genspec is saying or doing. but in general, this is a legal issue involving minors. the two choices in schools, courts, parental rights , medical care etc is affirmation and exploratory response to gender dysphoria in kids. currently, its illegal for parents to even know if kids are taking gender meds or have socially transitioned at schools. courts are saying not giving kids gender meds is child abuse. yes, there are those who have been caught holding the bag and have been super effected by an issue that used to be not many knew about and now was one of the reasons kamala lost the election. transgender ID is a protected trait in terms of work place discrimination. and i dont think many adults care how anyone identifies, if they are an consenting adult. but when kids are told medicalizing trauma helps, they are just being given one more bum steer and most affected have already had a tough time their entire lives.
"What about the adults who turn their backs on their effeminate sons or masculine daughters?"
this claim is made in gender industry narratives. once i checked footnotes that was supposed to support this claim. one footnote was based on parents of first generation parents in NY city in the 1980s with gay kids. a lot has changed since then. another footnote was a study where all the parents were affirming. i havent seen any evidence parents turn backs on kids with gender ID. yes, there are plenty of shitty parents out there. kids can move out when 18. for ones younger than that yes its tough. does that mean those kids should be further harmed by an intervention that we now know has no benefit and doesnt help distress.
"Were they mentally ill for wanting safety? What of the people doing the discriminating?"
theres a 1000 reasons why ppl choose to ID as opposite gender. adults are free to do as they want. promoting the idea that people should medically harm themselves as a form of protection doesnt address why kids may go this route.
lets get people care that actually helps. if people have adults in their lives that are harming them or feel unsafe, those issues should be specifically addressed.
Oh and one more comment. I am now wondering what it was, in actuality, that you describe as your"gender non-conformity"? What did you *do* that earned you mistreatment from the society at large? Tomboys are generally well tolerated...?
Tomboys are not always well tolerated. Culture plays a role. I was chased out of washrooms by angry women because I was a tall, boyish looking girl. I was constantly navigating comments that I wasn't girly enough. I didn't understand what I was doing wrong. So I started to think that maybe I wasn't meant to be a woman.
It can be annoying, that I know too. I was constantly being put down by my mom for not being a little miss. That too was a reason why I did not like being a girl past 13. I hated my first period. If they had offered me to "delay puberty" with drugs I would have jumped on it. Thank goodness I grew up in a saner age. It never occurred to me that being a woman could be somehow unchosen. :-)
That's a very lovely piece of writing. Such anguish... my heart goes out to you.
At the same time, I think they are right, the people who point to the mental health aspect. You yourself say that it was only when you began to tackle that, you were able to come through. There is no reason to feel ashamed, is there? Admitting there is a mental health component? And yes, that mental health component goes for our society that just effing makes us all crazy. (I would love to read your thoughts on the last bit. I think that many doctors are "mad, bad and dangerous to know.")
When I reflect on the mistakes that cost me dear in my own life, there is always a mental health component there.... I see it as a given.
Thank you for sharing your thoughts and experiences. I agree that it is a society problem rather than true mental illness. I think the main benefit (perhaps the only benefit) of repathologizing gender identity disorder would be to grant therapists the opportunity to work with trans-identifying youth and adults to address their gender dysphoria through therapy rather than just through medicalization.
As it stands, most therapists are afraid to do anything other than simply affirm a trans identity and work with a youth or even an adult on how they can accept their trans identity, how they can deal with family or others who don't accept it, etc.
As the parent of a trans identifying child, I have struggled to find a therapist who will actually address my child's mental health issues (and I don't mean gender dysphoria). My child had anxiety, OCD, and ADHD before ever deciding she was trans. Now, everything is eclipsed by the trans identity. No therapist seems willing to help her look at the thoughts or experiences that led her to suddenly decide she is trans. Several therapists simply avoid it altogether and have told me they don't "deal with gender issues." Most are afraid of losing their licenses if they don't immediately go along with a child (or adult) claiming a trans identity.
In my opinion, a trans identity is not something a child or adolescent (especially- I'm not really addressing adults here) should embrace without serious introspection and psychological examination. In today's society it seems that so many young people are saying they are trans or non-binary. Perhaps it is the cool thing to do, perhaps it addresses their need for belonging, perhaps it is based on a long-standing feeling about themselves. For some of these people, they may be happy with a medical transition but for many others they will not. Either way, medical transition involves serious and risky surgeries and hormones with side effects (some known and some likely yet unknown). It seems only logical that therapy should be the first treatment for gender dysphoria. Every attempt should be made to enable a person to live happily in their body without surgical or medical modifications. As it currently stands, most therapists avoid really examining or challenging a trans identity at all and simply affirm and actually strengthen the identity.
So, while I do agree that it is not trans individuals who are mentally ill and repathologizing could have unwanted effects in that regard, the benefit would be that therapists could actually treat gender dysphoria, hopefully allowing people to develop an identity that can integrate their sense of self as a man or woman with an acceptance of their male or female body.
Thank you for your thoughtful response and I'm sorry your family is navigating such a difficult situation. Regarding finding a therapist willing to do the work, I agree it can be very challenging. Therapyfirst.org is one organization that is trying to change this.
Thank you for keeping me from riding my wave of self-righteous fury. Honestly, this is a compelling piece, as always. I have been indifferent to causation and pathologizing. For me its not purity politics but more so preservation of innocence and preventing harm. There is an enduring belief preservation that is rock solid when it comes to transistion. Sadly for some that barrier to the mind is impermeable - especially if you capture children when they are young.
I do think your experience matters, even if it is only an N-1. When these experiences mount, like the breasts left behind on an operating table, it should not be ignored. Griffin Shaun Sivret, 24, of Woonsocket, RI died 23 July 2024 in UMASS Memorial Medical Center. Griffin was surrounded by a loving family that all believed in Griffin’s need to make a life saving transistion as a young teen. Sadly Griffin spent years tethered to a colostomy bag, in and out of hospitals. Griffin was the recipient of double-digit surgeries that cost well over $600K. Griffin suffered infections and sepsis until finally the body could no longer endure the years of abuse. Was Griffin mentally ill? Is it any different to the broken mind of an anorexic or addictive disorders?
I still think of the experiences of Yarden Silveira. A young teen caught up in this social contagion, Yarden came to believe the awkwardness of his everyday life was somehow the result of being "born in the wrong body". On 11 March 2021, Yarden's posted about his experiences on the YELP page for Align Surgical Associates. Soon after he posted these words Yarden's life came to an end, he was 23. Yarden was completely broken by those who he trusted. Yarden seemed to realize he was living in a real version of, "The Truman Show" and it cost him his life:
“I wish I never listened to the medical and psychiatric community when they told me it was possible to change my sex. What a lie. Very dangerous and unethical…No one is truly there for me. There's no need to pretend. I have a gaping hole in my genital area with my colon spilling out… What hurts me the most is the loneliness and the inability to find a partner. I can't have a normal sex life. I'm a loser and I probably deserve this deception. This is what I get for messing with nature.”
You nailed it
Thank you so much for your story. It is both informative of a perfectly sane thought process, and a rare one from a trans man. I was at the Genspect conference when Mia Hughes made this announcement of repathologization. The way it was presented, near the end of the conference coming after so many stories of wrong decisions made and physical harm done to young people, this came across as a pragmatic decision rather than a judgement on those struggling with a gender journey they hope will relieve them of their stress. I took it as a decision that would allow for a more thoughtful and nuanced assessment, rather than straight up affirmation, here's your hormones, and next in line please.
At the same time we, of the San Francisco TERFs who attended in a large pack, thought it was a mis-step, as did Sasha Ayad it seems. We attributed this to the difference between our American sensibilities, and the British, with their socialized medicine and long history of government control of the medical lives of their citizens. I'm not sure how it will pan out, but it has thrown open a door to more dialogue, for which I'm grateful to see you joining.
I come from a country where a third gender presentation is the norm for gay and lesbian people. This concept informed my whole gender non-conforming journey and I hang onto it fiercely as my own, so I understand absolutely your complaint that it is on society (Western society) that we struggle to have a place where we can be ourselves. I believe that how Thailand integrates this intense level of cross-sex presentation is what keeps the peace between the sexes and in between the sexes. This heritage makes everything so clear to me regarding what is going on in this country. I am trying to get a purchase on delivering this perspective, but the West is very stubborn in its attachment to its own theories, and would rather appropriate our example as proof that "trans has always existed" than take any advice on how we managed to do it within our society.
While I do not agree with much of what you have said , it is important to have your thoughts out there to be part of what will be a painfully long , drawn process of attempting to find sanity in all this.
I firmly believe you were betrayed not just by the medical profession , but by the media that helped create the context in which so much of this evolved. They functioned not as questioning journalists, but rather advocates for something they had little to no understanding of, and I doubt they are capable of owning up to that tragic error. Collateral damage is the loss of trust in so many institutions and professions, and I'm not sure how they recover from that.
Thank you for taking the time to read even though you do not agree with much of what I said
This is definitely spot on. It's definitely not a mental illness. It's a problem with society.
Sasha Ayad understands what's going on and has brilliant insights and genuine compassion on this topic (and she opposes this re-pathologization), but Stella is off in the weeds with her aggressive approach and is so off-putting I wonder if she's the type of therapist that only gets minor patients when their parents force them to see her. If I were forced to see her as a therapist, I'd never speak. I wouldn't even read my daily to-do list to Stella. You're dealing with a woman who claims she grew up as a tomboy (kinda) and found her way back to girlhood who now thinks that little experience gives her insight on what trans people are going through because she "found her way out" - but she's femme presenting and I don't believe her, she has no masculine orientation to society and has no idea what she's talking about.
Stella did clarify that it's not the identity she wants pathologized, but the desire to alter your body. But I don't believe that for a second, and that isn't how it's going to play out because one goes with the other.
She keeps passing around a quote she said that goes something like, "I need to you to understand that you're mentally ill and I want to help you." She has no idea that she probably shouldn't be a therapist. I don't know who she's helping with gender issues, but it's got to be limited. But I suspect she gets a lot of resistance and pushback from her patients and they probably only go because their parents are forcing them to.
I didn't transition for the same reasons you did, I never felt unsafe. But I wanted the male "social package" I had as a kid when I was just one of the boys. The adult female social package is bunk, and I was going to lose my mind if I had to deal with another female social interaction. Most people don't know what I'm talking about if they haven't transitioned, but it's in everything - tone of voice, the way you get greeted, the way females try to bond with you, it's a mismatch when I am seen as female. I've never had a male gender identity (I wrote an article about that) nor have I ever hated my biology or thought I was male. I made a practical choice that got me around society's bogus BS I couldn't stand that did not apply to me.
I couldn't take another holiday receiving girly gifts from my mom's friends or strangers who just heard someone mention me referring to me as "she." You know how it goes. Once people talk you up to others and use she/her pronouns, they get a picture in their mind of who you are and that does not involve a masculine person... fine, but multiply these situations and interactions by every experience you have with people all day every day for decades and the fact that nobody out there will interact with me as a masculine person isn't a "me" problem - that's a "society" problem. Girls can be masculine of course, but society still wants to treat them as princesses and talk about girly things. As long as you're seen as female you still have to fight for the right to wear a male uniform at work to avoid frills and short sleeves.
I'm very gender critical, but it's mostly an issue with transwomen who are off the rails... and I'm not actually anti-trans because of course everyone can live their life as they see fit. But I am against it in the sense that I think surgery and hormones do serious harm and surgery disrupts the body's meridians, which are essential for health. But nobody is honest anymore about biological sex, it's become a fad, and I have an issue with that. We all know from experience that as much as we align with men socially that once we live as men it's easy to see how much we differ. But it's still possible to live a normal life when you're not trying to pretend to be male.
I was on T for 11 years, but off for 9 years. You can call me a "detransitioner" but I haven't changed anything in the way I dress or look since I was a small child. I simply stopped taking T. So I don't tell people I am a "detransitioner" because then they revert back to the female social package, despite me still passing as male as long as I don't shave my face. And that further highlights that the issue is with society, not individuals.
Everyone wants to say that men and women can dress and present however they want and they don't need to look like the opposite sex. But the reality is, unless you actually do transition, society still treats you according to the "social package" that comes with your birth sex that is not based on genitalia, but just social roles and expectations.
Most non-trans people will never understand this.
I transitioned in a time when you had to get a letter from a therapist, and you were diagnosed with gender dysphoria. It was 2005 when I started hormones. But I started my transition around 2003. Even back then we all just went in with the desire to start hormones. Nobody wanted therapy, we wanted the life we knew would be comfortable. But we also knew our biology and were not trying to invade sex-segregated spaces. Since transwomen needed surgery to be legally female back then, and legal sex was required to access bathrooms and locker rooms, we didn't see the insanity we see today...
The system was fine originally (see my additional comment below for a clarification on what I mean and how it worked - ex: nobody could enter sex segregated spaces without changing their legal sex or risk prosecution, and you couldn't change your legal sex without a letter from a doc stating you had "irreversible SRS" and SRS=bottom surgery only at that time. Most people wouldn't do that so that was a barrier for people who were "less committed." Compared to today where you can change your legal sex on a whim without a letter and you don't need to be a legal sex to enter sex-segregated spaces)...
The recommendation at the time was to get 3 months of therapy to get a letter, get a letter for hormones, get a letter from a doctor to change your legal sex, and when people did that nobody cared. It was illegal to use the restroom unless you had legally changed your sex marker so people didn't try it unless they fully passed and blended in. People who went through the system properly were mostly good candidates for transition in the sense that it wasn't a major disruption to their life.
Gender dysphoria was the "pathology" and even that isn't accurate because it's not the individual's issue. But you can't treat society, so... it worked. But if they actually succeed in pathologizing identity, the so-called "gatekeeping" will be worse than anything we've ever seen before, and you bet they'll come up with some kind of medication plan to put people on anti-psychotics.
Now here's a bigger problem. When you're diagnosed with a disorder that has a certain classification, it eliminates your right to own firearms. And it can be used against you in court with child custody battles or even divorce. And if you end up incarcerated with said diagnosis on your record, they will force you to take the "appropriate" medication even if you always chose not to.
Thanks for reading. Not sure I agree that the system was fine originally, but I take your point that there was a clearer process and no illusions of actually changing sex.
I don't mean to imply that the system was perfect, but unless someone lived it back then it's almost impossible to understand just how gated transition was. It's night and day.
20 years ago, you couldn't change your sex marker legally on a whim or "just because" like you can today. The barrier to getting your sex legally changed was having completed bottom surgery. Without bottom surgery (or a letter from a doctor willing to lie for you) you couldn't change your sex legally. And back then, without legally changing your sex, you could not enter sex-segregated spaces like bathrooms, locker rooms, dorms, clubs, etc. Employers didn't even have to treat you like the sex you identified as (even if you fully passed) and they could still impose sex-specific uniform policies, etc. They could also fire you for being trans and out of compliance with sex-specific dress codes. Trans people literally had no legal protections until or unless they got bottom surgery and legally changed their sex.
In other words, 20 years ago, people had to think long and hard about the choice to transition because there were no "protections" for anyone who wanted to live as the opposite sex unless they could afford $150,000-$300,000+ for bottom surgery (many did not want it because it was too risky and unsatisfactory), and therapists in general explained how difficult life would be navigating the world.
Doctors didn't know how to handle trans people so they went with the HBSOC guidelines to provide three months of therapy before providing a letter for hormones. There were some clinics in San Fran that skipped that and some trans therapists also skipped that but most people had to go through the three months of therapy on a weekly basis to even be considered for hormones. And therapists were not afraid to say no.
Back then, because the barrier in place was so high, a person had to be legally male or legally female to enter sex-segregated spaces, and while that isn't necessarily the right thing, since people had to go through genital surgery to get the letter required to legally change their sex, it wasn't that common. Of course it happened, but it wasn't the norm - most trans people did not get bottom surgery, couldn't legally change their sex, and remained stealth... if they entered sex-segregated spaces they only did so when they blended in and nobody was the wiser. Transwomen were not allowed in female locker rooms or restrooms if they had not had genital surgery and a legal sex marker change. Most never risked it unless they totally passed or came close to it.
At that time, legal sex had to be changed with Social Security first, and SS required a letter from a physician stating specific wording that a person had "completed SRS" specifically, and at that time, top surgeries were not legally considered a form of SRS. So doctors wouldn't write letters for people who did not get bottom surgery (at first).
It was possible to change the sex marker on your driver's license in some states, but not all, and in some states (like CA) you could only change it for 3 years... after 3 years it would revert back to your birth sex if you hadn't presented the DMV with a new birth certificate that had been amended. And in order to get your birth certificate amended, you had to get your sex marker changed with Social Security first. Which meant nobody could even change the sex on their driver's license or passport. If you wanted to change the sex marker on your passport, you needed to show your amended birth certificate. They weren't accepting doctor's letters back then.
It was really tough and really expensive.
Over time, the law loosened and SS's requirements for that letter's wording loosened and someone changed the rules so that doctors only needed to state that their patient had simply "completed their transition" and that's when people started getting letters without having surgery. But that took years even. At first, doctors still didn't know much about trans people so they were hesitant to provide letters stating someone had "completed their transition" because they still thought completion meant genital surgery. Eventually Kaiser's doctors got some "training" and started writing letters for people who only had top surgery. So then everyone started going to Kaiser because they were the most trans-friendly for letters and hormones (they have a walk-in injection clinic) and at that point, people were getting letters from Kaiser doctors to change their legal sex based on top surgery alone...
And then a few years later they started giving letters to people who had not had any surgery at all and were only on hormones, since they realized some people will never have surgery and it wasn't fair for them to be denied the legal sex marker change... and then that evolved to "well what the hell, let's just let everyone change their sex marker even if they haven't had surgery or hormones." And that's where we are today.
So when I say the system worked in the past, it worked in the sense that the barrier to entry was so high most people either never got the change to change their sex marker or they went on hormones and blended in, and the kind of drama you see happening today just didn't exist back then because of those barriers.
Thanks sharing your thoughts. Obviously, it is deeply personal and I suspect you are concerned, alarmed perhaps, about the way the genie has got out of the bottle. You have mentioned elsewhere about quitting testosterone and I came across a video from well over a decade ago from an individual that did the same, I found it remarkably insightful: “Testosterone did not bring me closer to the truth. It just helped to mask the pain…..This will not make you who you are, you already are who you are.”
It is concerning for sure.
I personally didn't have any issues with testosterone, I wasn't searching for anything when I started taking it, I just wanted the masculinizing effects so I could get the "male social package" in society because the "female social package" is a total mismatch so I took it. The only source of suffering for me came from the way society interacted with me. It wasn't about my body but masculinizing changed my body in a way that made society recognize instantly the type of person I am. (I don't mean "male" I mean the social aspect of what goes with being male - (there is a distinct way people treat males and females and it has nothing to do with actual sex). Getting the right social interactions was all I ever cared about.
For me, taking T was the best choice I ever made. It did wonderful things for my body, it got me stronger, healthier, and somehow managed to fix whatever hormonal imbalances I had that fixed my weight issues long-term as well as gave me normal painless periods when I went off- it triggered my body into a very positive state internally and externally. It only added to my life. The reason I went off was not because it was any kind of mistake. But I didn't want to be part of the medical system anymore, I couldn't handle getting blood drawn because I started blacking out during the process, and I didn't want to put anything exogenous into my body even if it was helpful (I don't even take Advil).
It's definitely not something that I would take long-term because it does age you faster and is hard on the body. I was just fine with where I was and didn't feel the need to keep taking it. But for me, it was all a very positive experience. But I wouldn't recommend it for most people. Definitely not how it's being handed out like candy right now. But for me it was a great experience.
"Speaking from my own experience, I was only offered one treatment for my gender distress — a medical one... I was told that a medical transition would resolve my depression and anxiety."
sorry to hear about your experience. it sounds like you would have been better off if you had more information. reminds me a little of a story i heard once when my grandma was pregnant in the 1910s, she got a fever and drs told her to drink whiskey. the baby died. drs dont know everything. but they act like they do. when they told you gender "care" helps depression and anxiety that was false. theres no evidence it does. we know that now. but back then people werent as sure. psych meds help depression and anxiety. there maybe some people who the medical route helps. but theres no way to tell who it would. for most, it doesnt help. but certainly there should be continued health service availability for those affected.
"Both explanations do not take into account the context within with my distress occurred."
its only via the exploratory route that distress is explored and can be resolved. medicalizing distress forces one to relive trauma again and again via the constant reminder of the trauma. they say time heals all wounds. that may not be entirely true. but contant reminder and focus on trauma via medicalizing the trauma cant be helpful.
"Why am I the one being labelled as mentally ill, from Genspect’s perspective, and not the doctors who inflicted this on me and others like me?"
other than what you have mentioned in this article, i dont know anything genspec is saying or doing. but in general, this is a legal issue involving minors. the two choices in schools, courts, parental rights , medical care etc is affirmation and exploratory response to gender dysphoria in kids. currently, its illegal for parents to even know if kids are taking gender meds or have socially transitioned at schools. courts are saying not giving kids gender meds is child abuse. yes, there are those who have been caught holding the bag and have been super effected by an issue that used to be not many knew about and now was one of the reasons kamala lost the election. transgender ID is a protected trait in terms of work place discrimination. and i dont think many adults care how anyone identifies, if they are an consenting adult. but when kids are told medicalizing trauma helps, they are just being given one more bum steer and most affected have already had a tough time their entire lives.
"What about the adults who turn their backs on their effeminate sons or masculine daughters?"
this claim is made in gender industry narratives. once i checked footnotes that was supposed to support this claim. one footnote was based on parents of first generation parents in NY city in the 1980s with gay kids. a lot has changed since then. another footnote was a study where all the parents were affirming. i havent seen any evidence parents turn backs on kids with gender ID. yes, there are plenty of shitty parents out there. kids can move out when 18. for ones younger than that yes its tough. does that mean those kids should be further harmed by an intervention that we now know has no benefit and doesnt help distress.
"Were they mentally ill for wanting safety? What of the people doing the discriminating?"
theres a 1000 reasons why ppl choose to ID as opposite gender. adults are free to do as they want. promoting the idea that people should medically harm themselves as a form of protection doesnt address why kids may go this route.
lets get people care that actually helps. if people have adults in their lives that are harming them or feel unsafe, those issues should be specifically addressed.
Oh and one more comment. I am now wondering what it was, in actuality, that you describe as your"gender non-conformity"? What did you *do* that earned you mistreatment from the society at large? Tomboys are generally well tolerated...?
Tomboys are not always well tolerated. Culture plays a role. I was chased out of washrooms by angry women because I was a tall, boyish looking girl. I was constantly navigating comments that I wasn't girly enough. I didn't understand what I was doing wrong. So I started to think that maybe I wasn't meant to be a woman.
It can be annoying, that I know too. I was constantly being put down by my mom for not being a little miss. That too was a reason why I did not like being a girl past 13. I hated my first period. If they had offered me to "delay puberty" with drugs I would have jumped on it. Thank goodness I grew up in a saner age. It never occurred to me that being a woman could be somehow unchosen. :-)
That's a very lovely piece of writing. Such anguish... my heart goes out to you.
At the same time, I think they are right, the people who point to the mental health aspect. You yourself say that it was only when you began to tackle that, you were able to come through. There is no reason to feel ashamed, is there? Admitting there is a mental health component? And yes, that mental health component goes for our society that just effing makes us all crazy. (I would love to read your thoughts on the last bit. I think that many doctors are "mad, bad and dangerous to know.")
When I reflect on the mistakes that cost me dear in my own life, there is always a mental health component there.... I see it as a given.
-- hug --
The depression and anxiety was a mental health issue, yes. The crossgender identification was a pragmatic response to social pressures.