Silencing critics of transitioning children is a mistake, writes Pamela Paul in a New York Times commentary based on interviews with "detransitioners," parents and therapists. "Many detransitioners say they face ostracism and silencing because of the toxic politics around transgender issues," she writes. Therapists face abuse and threats if they call for more careful evaluation and treatment of other mental-health issues before starting a child on puberty blockers or hormones.
European countries are becoming much more cautious about medical and surgical treatment for gender dysphoria, she writes. "In countries like Sweden, Norway, France, the Netherlands and Britain — long considered exemplars of gender progress — medical professionals have recognized that early research on medical interventions for childhood gender dysphoria was either faulty or incomplete."
But the issue has become political in the U.S. Those who question the current orthodoxy and call for more research are accused of being "transphobes" -- or perhaps Republicans!
The top-rated comments on Paul's article are uniformly positive. Every single person supports the idea that "gender affirming care" has gone too far, too fast and with too few safeguards for children. I've never seen so many comments start with "thank you."
It seems like an emperor-has-no-clothes moment.
Paul challenges elements on the orthodoxy. The evidence that transition prevents suicide -- "it's either a dead boy or a live girl" -- is weak, she writes. "In a letter to the Wall Street Journal last year, 21 experts from nine countries said ... they believed there was “no reliable evidence to suggest that hormonal transition is an effective suicide prevention measure.”
Researchers documents the existence of "rapid onset gender dysphoria" in teens, usually girls, with no previous evidence of gender issues, she writes.
"To the trans activist dictum that children know their gender best, it is important to add something all parents know from experience: Children change their minds all the time," Paul writes.
Studies show that around eight in 10 cases of childhood gender dysphoria resolve themselves by puberty and 30 percent of people on hormone therapy discontinue its use within four years, though the effects, including infertility, are often irreversible.
Grace Powell, a survivor of childhood sexual abuse, suffered from depression as a teenager. Puberty made her feel even worse about her developing body. At 17, she went to a therapist. " The narrative she had heard and absorbed was that if you don’t transition, you’ll kill yourself," writes Paul.
She took cross-sex hormones, had a double mastectomy and went to college as short, effeminate male. “I was told there is one cure and one thing to do if this is your problem, and this will help you,” says Powell, now 23.
"Grayson" became acutely depressed by the end of the first year of college. “I expected it to change everything, but I was just me, with a slightly deeper voice,” says Powell. After several years, she returned to her female identity.
At the age of 15, Paul Garcia-Ryan wanted to be a straight girl, rather than a gay boy. He lived as a woman till the age of 30, when "severe medical complications" from genital surgery and hormones led him to reconsider and detransition.
As a clinical social worker at a gender clinic, he changed his views on gender affirmation.
“You’re made to believe these slogans,” he said. “Evidence-based, lifesaving care, safe and effective, medically necessary, the science is settled — and none of that is evidence based.”
Now 32 and a psychotherapist, Garcia-Ryan is president of the board of Therapy First, which supports therapists who disagree with the gender-affirmation model, writes Paul."He thinks transition can help some people manage the symptoms of gender dysphoria but no longer believes anyone under 25 should socially, medically or surgically transition without exploratory psychotherapy first."
Here's a 2018 video: