Trans children will face more and more barriers to treatment unless there is a better way potential detransitioners can be protected from it.
My heart goes out to Max Robinson. She started T aged 16 and had chest masculinization aged 17 with parental consent, but by age 22 in 2018 identified as a woman, though her facial hair meant she is often seen as a man. Also in 2018, Carey Callahan claimed to have met seventy detransitioners, and corresponded with a further three hundred. The Detransition Advocacy Network does not give figures but claims to have local chapters around the world. Threateningly, they claim to campaign for “expansion of detransitioners’ … legal options”.
There is a great deal of sympathy for such people. JK Rowling and Julie Bindel among others have said that if they were aware children were transitioning, they might have wanted to. Max tells a common story: she was a happy tomboy until puberty, when she had awful experiences of being sexualised. Around 14 she was diagnosed with depression and anxiety. She explored gender identity on line, and convinced her parents who had been sceptical at first. Her therapist referred her to an endocrinologist, who she said was reluctant, but whom she persuaded. When she had the surgery which she now calls double mastectomy, “I was convinced it would solve a lot of my problems, and I hadn’t accurately named a lot of those problems yet”.
She did not feel happy in the trans scene. She had felt clarity of identity when she started hormones, and again when she had surgery, but that feeling receded. Possibly some unwise transitioners are fixated on the next point in their transition journey, when at last they will feel complete: but that completion never comes.
Ideally, I want trans children to get the treatment they need, but children who desire transition when it is wrong for them not to progress to hormones or surgery. There will be people in a grey area: there is such transphobia in society that even a child who is certainly trans may have periods of extreme discomfort, which may manifest as regret. I don’t know if, in a society without gender norms, people would transition or not. Gender norms have some basis in human nature: otherwise, my feminine sexuality, which I have had such difficulty accepting, would not have persisted.
At this point my relentless inner persecutor speaks up. Ah, it says, your mother accepted you were a pansy, she did not expect anything else of you, she only made you pretend to be a real boy. If you had been brought up as a real boy you would be presenting male now. I write this to show the contortions I go through even now, how hard it is to accept myself. I know I would be no happier detransitioned, but societal transphobia keeps my internalised transphobia simmering. If only it were not this hard!
Detransitioners say that it is too easy to get hormones and surgery, and there is insufficient exploration of their other issues. On exploration, I agree. I don’t want a trans child to wait any longer than necessary for treatment, but if there were more psychiatrists available there could be a more in-depth assessment and greater confidence that the decision was correct. WPATH says “Before any physical interventions are considered for adolescents, extensive exploration of psychological, family, and social issues should be undertaken.” Detransitioners say that does not happen in practice. I want to ensure that there are as few mistakes as possible, because otherwise there will be an outpouring of anger- against “trans ideology”, against trans people saying our experience of transition is a good thing, and against all trans treatment, including that which benefits actual trans people. Some will never believe there are true trans people, only seeing us as mutilated simulacra, and detransitioners angry about their mutilation will make such people more convinced.
Both detransitioners and trans people could agree that to avoid mistakes we need, not greater suspicion, gatekeeping and delay, but more intense diagnosis, and treatment of any mental health problems. Possibly a trans child will have a supportive family and no mental health problems, and can progress immediately to hormones. A psychiatrist could gain a better picture of a child from their family, and even their teachers. That needs more funding, but surely such an important decision, which could lead to a lifesaving transition and a fulfilled life in the true gender, is worth the money? The alternative is detransitioners and anti-trans campaigners in an unholy alliance, making treatment for children unavailable.
I want trans children to be able to find out about transition from trans people, but detransitioners see them too. Claire saw the youtube channel of Miles McKenna when she was twelve, and began to wonder if she was trans. She researched it, including looking into binders and hormones. She struggled with mental health problems, and this article by Jesse Singal clearly implies the distress was exacerbated by her investigation of trans. If only she could have been protected from trans ideology! Fortunately, by age 14 she is certain she is a girl.
How do parents and the general public find out about trans children? How do children find out- peers who we want to support and accept trans people, trans kids themselves, and potential detransitioners like Claire who felt she was trans before rejecting the idea. Singal blames the youtube algorithm.
We need proper diagnosis on a humane timescale. Psychiatrists will suffer for every trans diagnosis they make when the person detransitions. We need to be talking about protecting detransitioners too, or anti-trans campaigners will persuade the general public that transition is too risky for children.