A Non-Crazy Take On Detransitioners - BCB #73
What could we learn if we weren't weaponizing the conversation around young peoples' medical choices?
Depending on who you ask, the existence of young detransitioners – people who decide to go back to their previous gender – is either an unwarranted media frenzy or proof that trans people don’t really exist. Lost in all this is the question of how best to care for transgender youth, a few percent of whom will come to regret their decision to transition medically (with hormones or surgery). Some of the doctors involved in trans healthcare are starting to take them seriously, but this is not an easy conversation to have. Detransitioners have become an unexpected crux of trans politics, at a time when trans politics is central to the Culture War.
In an interview with Medscape, clinical psychologist Erica Anderson, who is herself transgender, worries that some children are being incorrectly screened for treatment:
“Due to some of the, I'll call it just 'sloppy' healthcare work, that we're going to have more young adults who will regret having gone through this process.”
…
One of the "sloppy" things she says she's witnessed is providers "believing that the gender-affirmative approach is simply taking what the children say and running with it.”
This is difficult to talk about due to strong feelings and high stakes all around. Detransitioning minors are being used as proof that transgenderism is a fad, perhaps the result of social media. In particular, parents sometimes seize on the idea of peer influence to argue that their teen kids aren’t really trans. It’s heartbreaking for a trans child to feel their parents don’t believe or support them, and increases the already high risk of suicide.
Moreover, the idea that trans kids aren’t trans has consequences well beyond the personal. Over 20 states have now passed laws banning transgender healthcare for minors. Parents now find themselves unable to access medical care for their children even if they think it’s appropriate.
And yet, the World Professional Association for Transgender Health’s (WPATH) latest standards of care acknowledge for the first time that “social influence” may be important to consider “for a select subgroup of young people” (bearing in mind that there is also strong social influence against transitioning.)
Anderson notes that a variety of factors can influence a teenager's sense of self, including peer influence and societal acceptance.
"It's not the one area that's exempt from peer influence," she emphasizes, although she is also conversely certain "that a persistent, true trans identity is not caused by peer influence."
Some detransitioners also describe later realizing that they’re gay, not trans:
Many said they realized only after transitioning that they were homosexual, or they always knew they were lesbian or gay but felt, as adolescents, that it was safer or more desirable to transition to a gender that made them heterosexual.
These experiences are extremely hard to talk about because they have been so weaponized both personally and politically – by folks on the Red side who are using them to pass laws restricting healthcare choices, and by folks on the Blue side who are hostile not just to any discussion of potential social influence but to detransitioners themselves. Two trans scholars recently wrote:
Detransitioners who face social rejection, coupled with shame and isolation, may come to view anti-trans activists as their only allies—even when those activists portray them negatively, as damaged goods rather than as human beings who have survived medical trauma. Meanwhile, clinicians who receive threats of violence for assisting trans youth are vulnerable to developing myopic positions and overly optimistic clinical practices that ignore detransitioners’ accounts.
Gynecological surgeon Marci Bowers, who is herself transgender and currently the president of WPATH, put it this way in an interview:
There are definitely people who are trying to keep out anyone who doesn't absolutely buy the party line that everything should be affirming and that there's no room for dissent.
The medical community would like to have this discussion out of the public eye, but that ship has sailed. Instead, all we can hope for now is that everyone reaches for the tools of better conflict:
First, complexity: this isn’t a binary choice between invalidating trans people and invalidating detransitioners.
Second, curiosity: gender is very complex, and detransitioners can teach us something about it.
Above all, kindness: what is most compassionate for young people who are suffering?
Quote of the Week
All stakeholders in this controversy ultimately have the same goal: the long-term happiness of gender dysphoric youth.