Hitchhiker's Guide (Part III): Hitchhiking on Compassion.

How Caring People Become Cheerleaders for Hurting Children

Photo by Sandra Seitamaa on Unsplash

And now for the most egregious hitchhiking of all.  Gender Identity Ideology’s ride on the compassion people have for children, transforming that compassion into support for policies that destroy children’s health and their rights. 

The Suicide Ploy

The co-optations discussed above prime people to believe that doing extreme harm to children is actually helping them.  They assume that gender identity is akin to and somehow advancing gay rights, and that any questioning of it is analogous to gay conversion therapy.  They assume that gender ideology “frees” children from sexist stereotypes and oppression, even as it does the opposite.  They assume, based on misrepresentations about DSDs, that there’s some physiological basis underlying children’s rejection of their sex.

Into this confusion, gender ideologues add another important misrepresentation—one guaranteed to pull on the heartstrings of any caring person.  They say that failing to accept children’s perceptions about their sex could well cause them to kill themselves, an outrageous claim that is not borne out by the evidence. 

They rely heavily on a 2014 analysis, asserting that it shows that 41% of trans people attempt suicide, and implying that they do so because they’re not allowed to medically transition and/or they’re not affirmed in their trans identities.  The analysis’ own authors say that these conclusions cannot be drawn from the survey results they analyzed.  First of all, they did not do follow-up investigations with respect to reported suicide attempts, and in other studies, those investigations regularly find that initial suicide rates are greatly inflated. Secondly, it cannot be claimed that suicide attempts happen as the result of failure to transition or lack of affirmation.  One could even interpret the survey results to indicate that transitioning could increase the risk of suicide for some. 

It is well-established that a substantial percentage of children who are distressed about their sex have other mental health and neurological conditions, such as autism, ADHD, eating disorders, and clinical depression.  Sexual abuse and other traumas often precede children’s identification as trans or nonbinary.  Numerous studies and various assessments of gender clinic clientele document this reality.  At least one major study shows that children who needed psychiatric treatment or had problems in school, peer relationships, or coping with everyday life continued to have those problems after medically transitioning. In a 2021 study, gender dysphoric children were found to have high rates of at-risk attachment patterns and unresolved traumas and losses similar to those of non-dysphoric children receiving medical care for psychiatric disorders.  Gender ideologues like to imply that any mental health problems experienced by trans- and nonbinary-identifying children arise as a result of people not affirming them in their chosen gender identities, but when this assumption is challenged empirically, it does not hold up.

For thorough debunking of the hyperbolic claims tossed around by gender ideologues and an overview of other data relevant to the matter of suicide, see these four articles.  Also see the discussion under “Failing to Address Underlying Problems” in this article.  And see this analysis of a study published in February of 2022 which found that puberty blockers and hormones didn’t improve trans-identifying kids’ mental health, but was touted as doing the opposite. Finally, see also a new study published in May of 2022 which reviews the two Dutch studies from which the entire field of “gender affirming” care sprang, and this article which explains why those studies are an extremely unstable foundation for “the gender-affirming house of cards.”

Despite the absence of data backing up their claims, and the prevalence of data contradicting them, gender ideologues push the threat of suicide non-stop.  Parents of girls are given a choice: “Do you want a dead daughter, or a live son?”  Parents of boys are asked the corollary: “Would you rather have a dead son, or a live daughter?”  Anyone who raises doubts about Gender Identity Ideology is admonished to be quiet because children’s lives are at stake. But it is precisely because children’s lives area at stake that we must speak out.

Affirmation Only 

The upshot of all this is that many institutions have put “Affirmation Only” policies in place.  If a child says they’re born in the wrong body, they must be immediately affirmed in their perceptions, without question.  If parents consider affirmation to be inappropriate for their child, many schools implement detailed plans to ensure the parents don’t find out what is going on at school. 

Schools are aggressively promoting Gender Identity Ideology through curricula from kindergarten onward.  They teach children that everyone has a “gender identity.” This identity rather than anatomy is said to determine the child’s sex.  Children are taught that there are more sexes than boys and girls and that people can be born in the wrong body.  They’re taught that it’s important to spend time figuring out one’s identity and how to “express” it.  Females should be referred to as “people with vulvas.”   Males can have babies, and females can have penises. 

Seattle Public School slide for teachers explaining they should use terms like “someone with a vulva” rather than “girl” or “woman.” While this slide indicates that the terms “male” and “female” were still used, at least for elementary school students, even those terms are being obfuscated and erased by the schools. See Gender Ideology in Our Schools Part I and Part II.

Children learn that only ignorant and cruel people use sex-based pronouns rather than the pronouns requested by those who identify as trans and nonbinary.  They learn that everyone must treat trans-identifying people as the sex they wish to be rather than the sex they are. 

Children are taught that they decide their sex, and it has nothing to do with their anatomy. They are taught that some kids are born in the wrong body. (This is a page from I Am Jazz, read to Seattle public school children in Grade 4.)

Gender identity curricula and policies in the schools harm all children.  They withhold biologically accurate information, provide inaccurate biological information in its place, undermine critical thinking skills, force children to lie, and compel them to forfeit their rights to sex-based privacy and sex-segregated sports. They contradict basic safeguarding by encouraging children to keep secrets from parents, and by impressing on girls that its “transphobic” to report a naked man in their bathroom or locker room. 

But it is the children who reject their sexed bodies—those who identify as trans or nonbinary—who are hurt the most. 

Transing Children: The Basics 

The harm begins with “social transitioning”—everyone obsequiously agreeing with a child that they were indeed born in the wrong body.  The child’s preferred pronouns are used instead of accurate pronouns.  He or she is praised for flouting the rules that apply to everyone else regarding sex-segregated spaces and sports.  Some schools even have special celebrations or announcements for those who “come out” as trans or non-binary.

Socially transitioning a child is not a minor or a benign thing. Here’s how one clinical psychologist puts it in an excellent essay on the topic that is well worth reading:

“Agreeing with young people that they were born in the wrong body and organising their life around that belief is not a low risk thing to do. It’s a serious psychological intervention based on denial and avoidance. Believing their happiness is conditional on denying reality puts young people in a fragile state, dependent on the pretence of others for their psychological wellbeing. Affirmation feels like such a relief, but it’s a seductive illusion.”

For lots of girls, social transitioning includes “breast-binding.”  This is a debilitating practice that injures their bodies and makes it impossible to engage in sports or any physical activities where breathing is important. 

Breast-binding is a “social” transition practice that can injure girls and interferes with their ability to participate in sports and other physical activities.

If allowed to go through puberty, most gender dysphoric children become comfortable with their sex. Many realize that they have been wrestling with being gay or lesbian all along.

Children who socially transition, however, may well end up “medically transitioning” instead of going through puberty with their peers.  They’ve been claiming to be a different sex, often for years, and they’ve been insisting that everyone go along with that.  Few people, if any, have challenged their sex denialism; most or all have reinforced it instead.  As his or her body threatens to make a child’s actual sex more and more apparent, it stands to reason that many will be appalled by that prospect and choose to medically transition. Indeed a new study published in Pediatrics in 2022 found that 94% of youth who socially transitioned continued to identify as “binary transgender” (seeing themselves as the opposite sex) and another 3.5% as “non-binary” at an average of 5 years after their initial social transition. As the authors put it, “Most commonly, transgender youth who socially transitioned at early ages continued to identify that way.”

Breast binding can be so painful and debilitating that girls find the prospect of cutting off their breasts appealing.  A study by a prominent doctor cites “numerous complications” associated with breast binding as a reason that mastectomies must be made more readily available to girls.  This is one example of how social transitioning can deepen a child’s fixation on what they see as problematic body parts, creating psychological and physical discomfort that nudges them toward medical transition.

“Medical transition” is a euphemism for chemically and surgically altering children’s healthy bodies through three different avenues:

• Children as young as 9, are put on Puberty Blockers, drugs that keep their bodies from maturing.  It isn’t just the development of sex organs that are stymied by these drugs.  Brains, bones and the entire body change radically via puberty.  Blockage affects the entire body.  There are also major social and psychological risks associated with remaining a child as one’s peers grow up.

• Puberty blockage virtually guarantees that children will move on to the second type of medical transition: wrong-sex hormones.   Young people are given hormones in concentrations for which their bodies are not designed.  In other words, they are given concentrations of hormones appropriate for someone of the opposite sex, not for their own sex.  (As a result, boys grow breasts, girls grow beards, etc.) 

• The third type of medical intervention is surgery:  cutting off breasts, removing and/or massively altering genitals, shaving tracheas, and much more.  Children, as well as adults, regularly go under gender surgeons’ blades.  Double mastectomies are regularly performed on girls as young as 13.  Gender clinics provide other sex reassignment surgeries for people under 18 as well, despite claims by some people that this doesn’t happen.

Gender ideologues and the doctors who profit from medically transitioning people, use euphemisms to obscure the barbarity of what they are doing to healthy young bodies.  So-called “bottom surgery” is female or male genital mutilation.  So-called “top surgeries” are mastectomies.  The gentle-sounding term “cross-sex hormones” is used instead of the more accurate term “wrong-sex hormones.”  Puberty blockage is inaccurately depicted as a short and reversible “pause.”  

The Painful Realities of Medical Transition 

What’s in store for children who undergo gender medical transition?  All sorts of things that are never mentioned in the pretty picture books read in elementary schools or in the units on Gender Identity taught in middle school and high school.  Here are a few examples of common outcomes of medical transition, the tip of the iceberg.  For a detailed overview of adverse health impacts associated with gender affirmation medicalization, see this article.

• Infertility. (This is a given for children who go on puberty blockers and then wrong-sex hormones, as it is for those who have gonads and other reproductive organs surgically removed or altered.)

• Sexual dysfunction, including inability to orgasm. 

• Girls who have mastectomies lose the ability to ever nurse an infant.

• Weak bones that break easily. Inadequate bone density resulting from puberty blockage has serious lifelong implications.  (Details and study cites here.)

• Adverse impacts on the brain.  Puberty is crucial for brain development. Animal and some human data indicate that puberty blockers could pose risks for memory, IQ, and other aspects of cognitive function. (Details and study cites here.)

• Vaginal atrophy and other menopausal problems in young women. 

• Higher risk of cardio-vascular problems.  A woman taking testosterone has four times the odds of heart disease than one who is not taking it. Compared to men, her odds are two to one.  After about 5 years of taking estrogen, a man will develop blood clots and strokes at two to three times the rate of women and of men not taking estrogen.

• Kidney damage.

• Several cases of prolactinomas have shown up in males given estrogen.  While these noncancerous tumors are not life-threatening, they can cause vision difficulties and other problems.

• Increased risk of certain cancers.

• Post-surgical pain, and problems like incontinence.

• Surgical complications, and the need to undergo additional surgeries.

• While rare, a person can die from complications associated with gender identity surgeries.  The death of an 18 year old male who wanted to be a woman is discussed with clinical detachment in this study: “a severe progression of necrotizing fasciitis was lethal, despite repeated surgical debridement, intravenous antibiotic use, and supportive care at the intensive care unit.”  They conclude that physicians and patients “need to be aware of serious complications that might arise.”    Bear in mind that this young person had a healthy body before opting for medical gender identity care.

This is not a complete list by any means. There are undoubtedly other known adverse health consequences of gender medicalization that are not included on it.  This list also does not include impacts of medicalization that aren’t diseases or injuries per se.  A guidance document for health professionals explains that in female-to-male patients, especially at the beginning of therapy, injectable testosterone has been associated with “mood lability”—intense or rapidly changing emotional responses out of proportion to the situation at hand.  

To understand what “mood lability” can be like, and what testosterone injections can do read this account by a woman named Helena.  She describes how things that would once have made her sad or upset her, regularly triggered explosive angry dangerous outbursts, when she was on testosterone. The anger was of a different quality than anything she’d ever experienced and while on testosterone “crying was no longer an option” short of extreme measures to induce it. “When I was emotionally overwhelmed, instead of easily crying like before I would start to feel extremely angry, and instead of hitting others or anything in my surroundings, I resorted  to hitting myself.  I would struggle against the anger by punching myself and eventually, after there was enough pain, I could cry and when I cried I’d cry for hours, often falling asleep and not remembering much when I’d wake up.  I had these kinds of meltdowns about once a week or so, and regularly had bruises on my head and body from where I would hit myself.”  Helena describes how none of the mental health professionals she consulted considered her use of testosterone as relevant to her emotional instability.  Instead they diagnosed her with various mental disorders.  Helena only experienced the mood problems described here while taking testosterone.  By detransitioning, she left those problems behind.

So-called “gender affirmation care” can also interact with patients’ preexisting conditions leading to problems for those particular individuals.  The guidance document mentioned above warns with respect to giving females testosterone: “Anecdotal reports exist of a destabilizing effect on bipolar disorder, schizophrenia and schizoaffective disorder, as well as adverse mood changes in patients with a history of psychic trauma.”   It tells trans-identifying men that “estrogen may possibly contribute to damage of the liver from other causes.”  And it warns women taking testosterone that “[s]ome trans men [i.e. women who think of themselves as men], after being on testosterone for a number of months, may develop pelvic pain; often this will go away after some time, but it may persist; the cause of this is not known.”

The list is also not complete because no one has any idea what’s going to happen to the young people being given “affirmative” medical “care.”  The “treatments” young people are undergoing are so invasive and entail such massive disregard for biological reality that there will undoubtedly be all sorts of other adverse impacts from them.  Biological reality includes the fact that females’ bodies are set up to deal with female concentrations of hormones; male bodies are designed for male concentrations of hormones.  Endocrinologist William Malone explains that:

“every single cell of our body that has a nucleus has either an XX or an XY chromosome in it.  And each cell behaves according to its complement of sex chromosomes, independently of hormones.  So, it’s not like we’re all made up ambivalent cells who will respond simply according to the bath of hormone that you put them in.  There are sex-specific differences, this is well-known in biology, not well-known by some people in gender clinics, I found out.  They think that, well, if you just put a woman’s testosterone level into the male physiologic range that her body will just act as if she’s male, so her risk will just go to male levels.  But that’s not true.  In addition, the way that our DNA expresses itself is also sex-dependent in terms of what genes are turned on and turned off. So, there’s a host of biological differences—some of them are poorly understood, but …it should be no surprise that if you take a male hormone and put it into female physiology at excess levels that bad things are going to happen.  And the reverse is true as well.”  

Endocrinologist William Malone, MD: “…it should be no surprise that if you take a male hormone and put it into female physiology at excess levels that bad things are going to happen. And the reverse is true as well.”

Medicine is supposed to proceed with caution, adhering to the motto of First Do No Harm.  Gender “health care” epitomizes recklessness instead.  It takes children with perfectly healthy bodies and subjects them to experimental risky procedures with serious known adverse consequences and a high potential for all sorts of other problems as yet unknown.

Each of the impacts listed above and others not on the list mean debility and pain for real people—children and young adults who had been led to believe that medical “transition” is a pathway to fulfillment and joy.  “Leo”, for example, a trans-identifying girl featured in an investigative journalism film in Sweden, has osteopenia as the result of being given puberty blockers. Two of her vertebrae have changed, and she is much shorter than expected.  “Leo’s back, shoulders and hips ache every day.  A 15-year-old shouldn’t have to deal with that,” says her mother.  Using male pronouns for her female child, she continues: “His bones shouldn’t look that way: a healthy skeleton that’s been destroyed by this medicine.” 

This x-ray shows that Leo, who was put on puberty blockers as part of female-to-male transition, has bones that are much too porous. The chart shows the normal range of bone density for a child Leo’s age. The yellow marker shows Leo’s result. Leo’s back, shoulders and hips ache everyday.

Another female-to-male transitioner named Carol, explains that at first testosterone lifted her mood and made her more energetic.  But after a couple of years awful side effects began.  She describes vaginal and uterine atrophy—which can cause tissue to crack and bleed—as “extremely painful”.  Her cholesterol levels rose, and she had palpitations.  These and other health effects coupled with Carol facing into and figuring out the psychological roots of rejecting her female body have led her to “detransition.” As a lesbian, she has come to see gender identity ideology as deeply homophobic

Young people have posted countless videos documenting their medical transitions.  Interspersed with upbeat music, mugging for the camera, and brave statements about getting through it all, some of these videos offer glimpses of the less-than-glamorous realities of medicalizing one’s body.  They show very young people enduring extreme pain, frightening emergencies necessitating transfusions, massive debility, major stress and more.  Youtuber Exulansic has produced commentaries on some of these videos, highlighting and explaining the outcomes of medical transition.  Her work makes it clear that complications described by doctors as unexpected are actually extremely common—perhaps even inevitable. A series of her commentaries focus on damage to the urinary system and what that entails for young people who have chosen a medicalized path.  A young person shows a catheter bag, at minute 37 of this video.

One of the risks of medicalizing children is that this may make it impossible for them to ever have an orgasm. If a child is “orgasmically naive” prior to puberty blockage, he or she is at risk of never having an orgasm. Dr. Marci Bowers, one of Jazz Jennings surgeons put it this way regarding a boy who wants to be a girl and goes on puberty blockers before having orgasms: “the clitoris down there might as well be a fingertip and brings them no particular joy and therefore, they’re not able to be responsive as a lover.” (The “clitoris” in the case of a boy longing to be a girl is not really a clitoris, of course.) On one of the Jazz Jennings’ TV show episodes Jazz seemed to say he’d never had an orgasm.

While most trans activists and gender “affirmation” care promoters don’t mention sexual dysfunction as a problem for medicalized individuals, this matters. Puberty blockage and other gender identity medical interventions deny people an experience that is pleasurable and fulfilling—an experience which should be a birthright for all human beings. Inability to orgasm can also interfere with a person’s relationships. Dr. Bowers worked in the past with victims of female genital mutilation—the kind that’s not promoted by the US medical establishment under the guise of Gender Identity Ideology. According to Bowers, “Those women, a lot of them experience broken relationships because they cannot respond sexually.”

Jazz Jennings with the surgeons who cut and rearranged his penis and genital area to resemble female anatomy. (Dr. Marci Bowers center; Dr. Jess Ting right.) Jazz seemed to acknowledge on his TV show never having had an orgasm, which puts him at risk of permanent inability to do so. The matter of sexual fulfillment is rarely discussed when children are medicalized but it is important.

If you have been assuming that the medical transitioning of children and the social transitioning that precedes it are benign health-enhancing measures based in sound science, you need to reconsider.  Look at what is being done to children and young adults.   Read detailed descriptions of the surgeries (metoidioplasty, phalloplasty, scrotoplasty, radial forearm free flap procedures, vaginoplasty, orchiectomy, penectomy, etc.), studies bearing on the impacts of wrong-sex hormones (linked above), details from lawsuits against surgeons for the harm they caused, and young people’s videos detailing their medical transition journeys.  Visit the links in the section on detransitioners below. If you are participating in the funneling of children and young adults towards these surgeries and towards other gender identity medical care, you need to understand fully what you are promoting.

Out of Sight.  Out of Mind. 

Given the capture of major institutions including the news media by Gender Ideology, meaningful review of the impacts of medical transitioning is rare.  In Sweden, however, some journalists are doing their job. They obtained and reviewed patient incident reports from the Karolinska Hospital gender clinic, discovering that at least 13 children had suffered “injuries and serious side effects” from their gender care. These were euphemistically labeled “healthcare-acquired injuries” by hospital employees.

The experiences of these children were not shared with clinic managers responsible for overall care at the hospital, even as the numbers of young people seeking to medically transition skyrocketed.  Those managers were not tracking or even aware of the adverse consequences of the hospitals’ treatments.   In fact, a doctor who raised concerns about Leo’s case was reprimanded for his attempt to shine a spotlight on the harm done to a child. (Leo is the child with osteopenia mentioned earlier.)  That doctor’s experience is consistent with what happens to health care providers who raise concerns elsewhere.

Prior to the news story in which it is featured, the Karolinski Hospital had actually announced that it would no longer block puberty or prescribe wrong-sex hormones in gender dysphoric children outside of clinical studies.  The Hospital pointed to the Keira Bell case in the U.K. as evidence of potential risks of puberty blockers on children. (Keira Bell sued the Tavistock gender clinic because of the permanent damage they did to her body through gender identity medicalization.)  The Hospital made no mention in its announcement of children harmed within its own facilities.   Other clinics around the world are plugging right along getting more and more children onto puberty blockers earlier and earlier despite the harm to children’s bodies. 

Permanent Major Losses for Children?  Big Whoop. 

Gender clinicians and psychologists who promote medicalization of children are often dismissive of people who express concerns about the damage done to children’s bodies.  Psychologist Diane Ehrensaft has admonished parents worried about the fact that puberty blockers and wrong-sex hormones will render their children infertile, accusing them of selfishly wanting “genetically related” grandchildren.  “We have to work with parents on—these aren’t your dreams, we have to focus on your child’s dreams, and what they want,” she says.  The actual concern of those challenging her ideology is completely ignored: Each person has a human right to decide for themselves upon reaching adulthood whether they wish to be rendered infertile.  Sterilizing children is a human rights violation.  

Remarkably, in trainings Ehrensaft openly acknowledges that children are not developmentally able to understand the implications of signing away their fertility.  Younger children, those at the very start of puberty, when puberty blockage often begins, can’t even handle an explanation about how sexual reproduction works.  Talking to them about the mechanics of sex is inappropriate and will create emotional stress, she says. And yet, she has no problem with those children deciding to forfeit their future fertility.  Relying heavily on the assertion that children who are not medically “affirmed” will kill themselves (a debunked myth discussed above), Ehrensaft advocates forceful promotion of puberty blockers and other medical interventions on children. 

Children who forfeit their future ability to have a baby are incapable of comprehending the significance of this forfeiture. (Photo by Isaac Quesada on Unsplash)

Johanna Olson-Kennedy, a doctor who specializes in treating children who identify as trans or nonbinary, is equally dismissive about the impacts on children from the interventions she promotes.  Girls casting aside the ability to breastfeed if they have children in the future is not even mentioned in a study she did assessing the benefits and risks of mastectomies, which she euphemistically calls “chest reconstruction surgeries.” Patients in the study had had their breasts removed as 13- to 17-year-olds.  Loss of nipple sensation (32% of study participants) and of other breast sensations (41%) are treated as no big deal in her results.  The study was clearly designed to provide a basis for getting insurance companies to pay for mastectomies.  It failed to gather data on those who didn’t return to the “health care” providers who had facilitated or conducted their surgeries.  Nor did it provide long-term data on the patients that were included in the study.  In fact, 86% of the study participants were 2 years or less post-surgery; 58% only one year or less.   But Olson-Kennedy got the outcome she obviously wanted.  She claimed that the benefits of removing healthy breasts from teenagers outweigh the costs, and insurance companies should make changes to facilitate more breast removal surgeries.  (Olson-Kennedy has the gall to mention complications associated with breast binding as one of the reasons chopping off girls’ breasts should be facilitated.)

Life-long Medicalization and Maintenance

Medical transition condemns children to life-long medicalization.   They will always be tied to doctors and Big Pharma for wrong-sex hormones and for dealing with their surgically-altered bodies. As time passes and medical harms associated with what they’ve done to themselves manifest—vaginal atrophy, cardio-vascular problems, and more—they will need medical care for those problems as well.  

Do surgeons deliver to young people eager to be the other sex a body that makes them that sex?  Of course not.  Sex is immutable.  At best, you can pretend to be the other sex.  You can have a fake penis or a fake vagina that doesn’t function at all like the real thing, and that must be maintained.  If so-called “neo-vaginas” aren’t dilated regularly, they close up. Jazz Jenning’s mom has expressed frustration that Jazz isn’t good about keeping up with this task. 

Medically transitioning children means trading in their healthy bodies for ones with permanent serious problems.  Children sign up for a lifetime of hormone usage, health problems triggered by puberty blockers and hormones, surgeries, and complications from those surgeries.  

No Going Back

In addition to all the unintended side effects of medical transition—urinary problems, early menopause, osteoporosis, organ damage, cardiovascular problems, and so much more—there are the intended effects to deal with as well.  Young people who medically transition permanently remove or massively alter major parts of their bodies.  If they change their minds later about what they’ve done, there is no going back.

It is clear that lots of people do end up regretting what they’ve done to their bodies.  The subreddit r/detrans has over 21,000 members—people who have detransitioned or are thinking about doing so.  Detransitioner groups like The Pique Resilience Project and the Detransition Advocacy Network have formed to provide support and facilitate organizing among detransitioners.  Keira Bell sued the gender clinic that maimed her young body. 

If you’ve been supporting Affirmation Only for children you need to hear the words of those who regret transitioning.  Check out some of the tales shared on detransitioner reddit and linked there. Read what Keira Bell wrote and read Helena’s detransition account. Make yourself listen to this painful recording of a detransitioner confronting a psychologist who facilitated the irreversible damage he has done to his body. Read statements from multiple detransitioners in this article, and listen when they say things like: “I paid a guy who does this every day for cash, to drug me to sleep and cut away healthy tissue….Now I’m still all f**ked up and I’m missing body parts” and “I have lost my breasts and I have lost the chance to reconcile with my breasts.  It wouldn’t be easy, but it would be work worth doing.  Now the work before me instead is reconciling with what I’ve done and with the chest I have now—flat, scarred, asymmetrical, and nerve-damaged.”  See also this article, and the accounts therein, including Athena’s who said, “I don’t understand how people don’t realize how abusive this is.” Read what a person nearing 50 wishes he had known at 19 when he transitioned. And read this statement by a woman who fortunately did not medically transition, as she explains the interplay of sexism, homophobia and having a child’s brain that led her to identify as male for years.

Candace Sharp, who medically transitioned as a child and has now detransitioned. “No child or teenager can consent to the medicalization, sterilization and nonreversible effects of testosterone and/or surgery,” she says.

Familiarize yourself with what those who study or work with detransitioners have learned. Psychologist Lisa Marchiano has noticed lots of parallels in the stories of the young women detransitioners who seek out her help:

• Transition failed to address the complex social and mental health issues each had and often exacerbated those problems.

• During their periods of identifying as trans, the women often became derailed from educational and vocational goals.

• When they detransitioned the women were abandoned and sometimes even vilified by the trans community that had once been so supportive of them.

• Many had faced vicious homophobic bullying before opting to identify as trans, and a majority had eating disorders before they trans-identified.   

• Although hormones had first brought an increase in self-confidence and well-being to these women, these drugs eventually seemed to make some of them more emotionally labile, and intensified depression and suicidality. 

A study of 100 detransitioners conducted by Dr. Lisa Littman found that:

• The most frequent reason given for detransitioning was: “My personal definition of female or male changed and I became more comfortable identifying as my natal sex.”  Other commonly endorsed reasons included concerns about potential medical complications, mental health not improving, dissatisfaction with the physical results of transition, and discovering that something specific like trauma or a mental condition caused their gender dysphoria.

• A majority (55%) of detransitioners had been diagnosed with at least one psychiatric or neurodevelopmental issue and 37% reported experiencing trauma before becoming gender dysphoric.  Nonetheless the majority (65.3%) said that their clinicians didn’t evaluate whether their desire to transition was secondary to their trauma or mental health conditions. 

• A majority (56.7%) felt that the evaluation by their doctor or mental health professional prior to transition wasn’t adequate.  Nearly half felt that counseling they received was overly positive about benefits of transitioning (46.0%). Over a quarter (26.0%) said it had not been negative enough about risks.

• The study found that “Most participants (58.0%) expressed the gender dysphoria was caused by trauma or a mental health condition narrative.”   It says that “[m]ore than half of the participants (51.2%) responded that they believe that the process of transitioning delayed or prevented them from dealing with or being treated for trauma or a mental health condition.”

Gender ideologues work hard to downplay the prevalence and importance of transition regret.   They maintain that regret and detransitioning rarely happen, but this is not supported by the evidence.  They also actively work to prevent research on detransitioning.  They claim that very few people regret transitioning even though the failure of most gender clinicians to track what really happens to patients makes it impossible to back that claim up.  With most people who detransition not telling their gender doctors and psychologists that they’ve done so, declarations about how almost no one regrets medical transition ring hollow.  It must also be noted that many detransitioners are treated poorly by those who retain trans and nonbinary identities, a fact which discourages them from going public with their detransitions. (See studies cited elsewhere in this report and see this article.)  In any case, it is clear that regret and detransition are common, and more and more detransitioners are standing up to tell their stories.

Gender Medicine is not Evidence-based. 

Most people assume that medical transition treatments are based on research and analysis that have determined that these treatments are beneficial and have shown that the benefits outweigh the risks.  But that is not the case.  Two Dutch studies from which the entire field of “gender affirming” care sprang have been persuasively exposed as failing to establish the safety and efficacy of that care. Multiple comprehensive reviews have concluded that the evidence on which medical interventions for trans- and non-binary-identifying children are based is of very poor quality. 

The situation has been aptly described by Carl Heneghan, editor in chief of the British Medical Journal.  According to Heneghan, the treatments children are subjected to are experimental. They are being implemented “in the context of profound scientific ignorance.”  They are a “momentous step in the dark.”

As the result of these reviews, whistleblowers exposing what’s going on at gender clinics, and the heroic efforts of some health professionals committed to the First Do No Harm axiom, cracks are beginning to appear in the gender ideologues’ Affirmation-Only narrative.  Even two well-known gender practitioners—Dr. Marci Bowers and Erica Anderson—recently went on record expressing deep concerns about kids being put on puberty blockers and wrong-sex hormones, and the lack of exploration of other causes of body rejection.  Bowers has done thousands of “vaginoplasty” surgeries, including Jazz Jennings’.  Anderson is a clinical psychologist at the University of California’s Child and Adolescent Gender Clinic.  Anderson has said, “It is my considered opinion that due to some of the…sloppy healthcare work that we’re going to have more young adults who will regret having gone through this process…it’s my experience as a psychologist treating gender variant youth…I’m worried that decisions will be made that will later be regretted by those making them.”  What does Anderson mean by “sloppy”?  “Rushing people through the medicalization…and failure – abject failure – to evaluate the mental health of someone historically in current time, and to prepare them for making such a life-changing decision.”

Several countries, including Sweden, Finland, the U.K. and Australia, are now issuing revised guidelines for gender care for children.  As noted, Sweden’s Karolinska Hospital announced in 2021 that it will no longer transition people under 18 outside of strictly regulated clinical trials.  Now, after completing a comprehensive review of the evidence, the Swedish National Board of Health and Welfare has updated its guidelines for care of minors with gender dysphoria or incongruence.  Given ongoing identity formation in youth, the low quality of the evidence underlying hormonal treatments, and the lifelong consequences of medical transition, the Board has concluded that the risks of hormonal interventions outweigh the potential benefits. Puberty blockers and wrong-sex hormones will now be rarely used on children in Sweden.  Psychiatric psychotherapeutic care will be offered instead.  

In lots of places, however, including in the U.S., it’s business as usual with regard to medically transitioning children.  And business is growing exponentially every day.

In fact, Gender Ideology forces are so strong in the U.S. that the Obama Administration adopted regulations requiring healthcare providers that do mastectomies or hysterectomies necessitated by cancer or other health problems to also do these on healthy people who want to “align their bodies with their genders.” Noncompliant providers could be found guilty of unlawful sex discrimination.  Proponents of the regulations, such as the National Center for Transgender Equality, indicated that they could be used to force health care providers to provide wrong-sex hormones, orchiectomies, and a wide range of other surgeries to those seeking “gender affirmation”.  Donald Trump rescinded these regulations, but Joe Biden restored them via Executive Order.  No distinction is made regarding the age of patients. 

Reasons Children Reject their Sexed Bodies

Most children who go through puberty desist in their belief that they are in the wrong body.  Desistance spares them medicalization and all that goes with it.  Why in the world would we enforce Affirmation Only policies that discourage desistance and put kids on a conveyor belt to irreversibly harming their bodies?

This brings us back to that core tenet of Gender Identity Ideology: the belief that sex has nothing to do with one’s anatomy.  Gender ideologues embrace the metaphysical concept of a gendered soul that floats above the body and can somehow be in conflict with the body’s reproductive organs.  Moreover, Gender Ideology posits that lots of children are born in the wrong body—more and more each year. This bizarre condition in which the soul ends up in the wrong place happens all the time apparently.   Not only is there some amorphous developmental disorder that has no name and no scientific evidentiary basis, but this condition afflicts growing numbers of children, and it often appears in clusters of children who belong to the same social group or attend the same school. 

We are being forced to accept this irrational quasi-religious interpretation of children dissociating from their bodies as real, and as the only possible explanation for their dissociation.  We are being required to go along with Affirmation Only based on this anti-science mindset.

But are there reasons beyond someone being born in the wrong body that could explain why children reject their sex?  Of course, there are.  We’ve already alluded to one reason: gay children struggling with homophobia can come to believe that they’re the other sex rather than homosexual.   As previously discussed, a high percentage of those who go through puberty and desist turn out to be gay, and many people consider Affirmation Only to be the ultimate gay conversion therapy.

Here are some other things that can lead to a child hating his or her sexed body:

• Sexual trauma

• Mental illness

• Autism and related conditions

• Living in a sexist, porn-laden world that objectifies women and fuels violence against them.

More than three quarters of cases of adolescent and young adult females now presenting with gender distress have significant mental health problems or suffer from neurocognitive comorbidities like autism spectrum disorder or attention-deficit/hyperactivity disorder.  The most vulnerable of children are disproportionately represented among those who reject their sex. 

A recent study of 100 detransitioners found that 55% had been diagnosed with at least one psychiatric or neurodevelopmental issue and 37% had experienced trauma prior to the onset of gender dysphoria, yet the majority of participants (65%) reported that their clinicians did not evaluate whether their desire to transition was secondary to trauma or a mental health condition. 

Materials for Seattle school teachers urge them to remember that sexual abuse is widespread and that they undoubtedly have children in their classes who are victims of rape, incest, and other sexual trauma.  At the same time teachers are told that any child who rejects their sex must be treated as the sex they claim to be, no questions asked. In some schools across the U.S. teachers are even taught that keeping parents unaware of their child’s “transition” is the right thing to do if parents don’t immediately affirm. None of this makes sense.

Despite attacks on those who challenge Gender Identity Ideology, more and more people are questioning Affirmation-Only.

The Number of Children Claiming Trans and Non-Binary Identities is Skyrocketing.

Obtaining accurate data pertaining to Gender Identity Ideology is difficult, because of loose and shifting definitions of who counts as trans and nonbinary, and a widespread failure to gather important data.  One thing is clear, however.  The number of children considering themselves to be trans or non-binary is skyrocketing.   

A Gallup Poll in 2021 provides background.  It found that 0.6% of adults identified as transgender.  The numbers for children are strikingly higher. This may or may not fully account for those who reject their sex, including those who use terminology other than “transgender,” such as “nonbinary”.  

In 2017, three to four of every 100 high school students said they were transgender or might be.  A 2021 study suggests that the number is as high as 9 out of every 100.  An in-depth study of high school students in Pittsburgh found that 9.2% identified as trans or nonbinary. 

Another way to get a handle on numbers is to look at how many children are seeking “gender affirming” medical care and the numbers of clinics offering such care.  Every major gender clinic in the world has reported a several-thousand-percent increase in recent years of youth presenting with gender distress. 

There was one gender clinic serving children in the U.S. in 2007; now there are over 300.  These are included on a map maintained by GenderMapper, and one can click on each clinic for more information.  GenderMapper personnel have called every clinic to verify its existence and gather information on what services are offered to children.

Are Children Leading the Way? 

Many well-intentioned adults maintain that children know what they’re doing and should be allowed to lead the way.  According to them, children who announce that they’re a different sex should be told, “Why yes, you are” and everyone should join in reinforcing the child’s belief, using wrong-sex pronouns for them, ignoring the privacy rights of other children in sex segregated spaces, and allowing males to compete on female teams.  Trans- and nonbinary-identifying children should be applauded for their pronouncements, for getting on puberty blockers and/or cross sex hormones, and for double mastectomies, they say.  According to these adults, children participating in Gender Identity Ideology are leading the way forward to a world free of oppression, and older people should step aside and let them lead.

This is utter madness.  It is an abdication of the responsibility adults have to guide and protect children.

Those who go along with the premise that children always know best are ignoring the basics of early childhood development, the basics of adolescence and peer pressure, and the fact that children are children—their brains and understandings are still developing, and they need our guidance. They are allowing themselves to be gaslit by some of the most outrageous quackery imaginable. Psychologist Diane Ehrensaft, a favorite of gender ideologues, says that one-year-old boys who unsnap their onesies may be turning them into dresses, thereby signaling that they are actually girls.  Toddler girls who pull barrettes from their hair may be telling us they’re boys.  Anyone who knows anything about small children knows this is utter nonsense.

Gender Ideology-promoting psychologist Diane Ehrensaft says that toddler girls who pull barrettes from their hair may be signaling that they’re boys. One year old boys who unsnap their onesies may be turning them into dresses, and telling us they’re actually girls.

Adults buying into the Gender Identity agenda are also oblivious to the ways in which impressionable children are being steered into Gender Identity beliefs.  Steeped in the narrative advanced by gender ideologues, these adults may even believe that it is bigoted and “transphobic” to so much as suggest that external forces could influence children. 

But the forces steering children towards declaring trans and nonbinary identities are very real and very big:

• The Seattle K-12 curriculum is a typical example of what schools are teaching children. In kindergarten it introduces children to the idea that each person gets to declare their own sex via a book about a teddy bear.  Onward from there, school children are read books each year and given activities that reinforce this and other Gender Ideology messages: children are often born in the wrong body; everyone has a Gender Identity; everything you do “expresses” that identity; it is important to spend time figuring out your gender identity and fixating on your expression of it; “being yourself” includes spending time to do that; children who reject their sexed bodies are “being themselves”; children who chemically and surgically alter their bodies are “being themselves”; and so on.  Sex ed lessons show reproductive anatomy diagrams without clarifying which is male and which is female, because they want children to know that penises are sometimes female organs, and uteruses are sometimes male. Men can have babies.  Females impregnate people.  Watch this video and its sequel for a look at Gender Ideology propaganda in the schools and why it’s so harmful.  And look at these pages from It Feels Good to Be Yourself, read to elementary school students.

• As of 2019, 95% of teenagers in the U.S. had access to smart phones, and 45% reported being online “almost constantly.”  Tumblr, Instagram, TikTok, Youtube and other platforms are extremely popular with teens and are a major conduit of Gender Ideology. Kids tap into an endless supply of young people’s videos and photographs glorifying transitioning.  Those posting euphorically announce: “Started T [testosterone] today!”  “Just had my top surgery!”  “I finally have my freedom!”  They receive lavish praise from commenters. “Way to go!”  “Congratulations!”  “So proud of you!”  Any child who enters internet realms where advice is offered about whether a person is trans is greeted with immediate responses declaring them to be a “textbook case” and the like.  Children are also greatly influenced by other children they know in real life who are steeped in the same Gender Identity propaganda.  Groups of children, especially girls, often “come out” together. 
  
  Big Tech corporations have direct relationships with Gender Identity-pushing organizations.  TikTok announced a partnership with Stonewall in February of 2021, for example.  Stonewall aggressively campaigns for policies pressuring everyone to agree that people are whatever sex they claim to be, and that trans-identifying men are entitled to women’s spaces, sports, and other sex-based rights.  Tik Tok’s materials about the partnership and its guidelines against “hateful behavior” are chilling to read.  Clearly, anything pointing out the downsides of medicalization or spotlighting alternatives to transitioning will be viewed as “hateful” and removed.  Anyone who is gender critical will be blocked.   
  
  TikTok data in the U.K. shows that children between the ages of four and 15 who sign up for the app spend an average of 69 minutes per day on it.  Videos with the hashtag #Trans have been seen more than 26 billion times.  In the U.S. 32.5% of people aged 10 to 19 use TikTok, and those who are between 4 and 15 years old spend an average of 80 minutes per day on it.
  
  TikTok influencers make “transitioning” seem cool and edgy.  Alex Consani, an 18-year-old with 680,000 followers went viral at age 12 when Cosmopolitan featured him as a trans model. He tells viewers that they are “one estrogen pill away from a glow up.”  A “glow up” is a mental, physical, and emotional transformation for the better.  The video in which that statement was made has been seen 2.3 million times.  Messages regularly encourage children to not involve their parents.  “Gender is seen as the new rebellion,” says Stephanie Arai-Davis of Transgender Trend.  “It’s no coincidence that the growth of TikTok coincides exactly with the exponential growth of children presenting with gender dysphoria,” notes Kate Harris of the LGB Alliance. 
  
  The internet doesn’t just expose children to people who make declaring a new gender identity sound wonderful and fulfilling.  It is part of society-wide forces that tear down children’s, especially girls’, self-esteem, making them susceptible to messages about transitioning as a solution.  Children now face an onslaught of images 24-7 showing them what’s considered cool and beautiful, and feeding their sense that they and their bodies don’t measure up.  Moreover, the average age at which children now see pornography is 11.  Ever more violent and degrading, pornography is addictive and children are justifiably frightened by it and by the messages it delivers about what sex is.
  
  The huge influence on children from on-line sources is discussed in Abigail Shrier’s book Irreversible Damage.  See especially Chapter 1 which reviews the mental health crisis that grips teenagers in the U.S., Canada and Great Britain with record levels of anxiety and depression.  The book discusses factors that contribute to that crisis and how it feeds into children declaring trans and non-binary identities.  Lockdowns associated with the pandemic have likely made matters worse.

• A study of 100 detransitioners (people who identified as trans and then reversed course) found that more than a third had felt pressure to transition.  Clinicians, partners, friends and society were identified as having applied pressure.   More than a third of the people in the study said that “Someone told me that the feelings I was having meant that I was transgender, and I believed them.”  Some of the detransitioners described having experienced friendship group dynamics wherein peers mocked people who were not transgender and popularity increased for those who declared themselves trans.  Several social sources that encouraged people to believe that transitioning would help them were identified including YouTube transition videos, blogs, Tumblr, and online communities.  

To make matters worse, gender ideologues are succeeding in suppressing any and all information that might influence children to accept and celebrate their sexed bodies instead of rejecting them.  School materials explicitly fail to mention any of the down sides of transition; they make a point of not including analyses of gender identity by those who consider it sexist, homophobic and deeply irrational.  The voices of gender critics are thoroughly censored in larger society as well, which means children never hear anything but the gender ideologues’ version of things.  This is discussed at length in the section on Suppression in Part IV of this report. 

Among the most important voices kept from children’s ears is that of their parents.  Increasingly, schools are keeping parents in the dark as to their children’s announcements regarding being trans or nonbinary at school.  Parents have begun to sue school districts over this policy.  

If parents are aware of their children’s new identities and they do not wish to proceed with an affirmation approach, they risk being cut out of their children’s lives altogether.  Read Abigail Shreier’s chilling article on social workers and others helping children file emancipation petitions and use other procedural avenues to sever their connection with their parents.  Youth shelters now define “abuse” to include not affirming a child’s gender transition, thereby enabling teens to stay at the shelter, break contact with their parents, and proceed with medical interventions absent parental input or agreement.  Read Shreier’s equally chilling account of a father denied custody of his child because he wanted to observe caution regarding medicalization.

Affirmation isn’t the only option.

There are ways to respond to a child who dissociates from their body that don’t involve affirming that dissociation. These approaches are evidence-based and compassionate.  Many parents have been able to steer children who declared themselves trans away from rejecting their bodies, and away from medically damaging themselves.  Their stories are a testament to what can happen when children get psychological help and other care from loving adults. See for example:  To My Daughter’s Therapist  and Lily Maynard’s  A Mum’s Voyage Through Transtopia.     For information and support in going against the flow on this vital issue, contact Genspect which provides “a voice for parents with gender-questioning kids.”

Trying to protect individual children from harm won’t be enough, however. We need to tackle this problem at a societal level as well.  We need to get Gender Identity Ideology out of the schools and to object to parents being silenced and prevented from protecting their children.  We need to insist on quality education including on the topics of biology and sex education.  The latter must teach accurate biological terminology and provide clear age-appropriate information on sex and reproduction.  For an example of a book that can be read to grade school children see My Body is Me by Rachel Rooney.  Read the full text of the book here, and marvel at how gender ideologues describe it:  “If you wouldn’t let your kids read terrorist propaganda, don’t let them read this.”

To improve the education delivered to children, we need to radically increase the ratio of teachers to children, so time can be spent with individual children.  Greater one on one attention is needed not just in teaching lessons, but also in providing social and emotional support for children.  We need to do a much better job of preventing bullying, promoting good self-images and confidence in children, making sure gender nonconformity is not punished, and tackling homophobia.

To do any of this, we need to make major societal changes, including getting beyond an economic system based on profits which produces a Big Money class that calls the shots.  We need to create a world in which parents can have financial security and the ability to give children the time and attention they need.  We need to take on Tumblir, TikTok and other internet corporations that are harming children.  We need to get beyond the powerlessness that is leading all of humanity over an ecological cliff—a powerlessness that is deeply affecting children’s mental health.

Our children’s world is disintegrating.  The gap between rich and poor grows worse each day. Multiple environmental crises threaten our very survival as a species. Children live disconnected lives, many with more virtual friends than real ones, early exposure to pornography, inadequate assistance with learning challenges and mental health issues, and other major problems. They are aware of the environmental Armageddon barreling down on all of us, and the powerlessness their elders feel against this and in dealing with their daily lives.  Suicide, depression, anxiety, and other problems are widespread among young people. 

We owe it to children to pay attention to what’s going on.  We owe it to them to address the huge problems that surround them creating such chaos, stress, loneliness, and uncertainty. Patting ourselves on the back for “supporting” children by letting those mesmerized by Gender Ideology “lead” the way, and by delivering the most vulnerable of children into the hands of Big Pharma and unethical medical professionals, is unacceptable.

Think again. 

If you’ve been keeping quiet or even applauding the affirmation of children’s trans and nonbinary identities, it’s time to ask yourself some important questions:

Can you honestly think of no explanation for a child dissociating from their body beyond them having been “born in the wrong body?”   Why are you ignoring multiple scathing reviews of the inadequate evidentiary basis for medically transitioning children?

What if you’re wrong about affirmation as a compassionate act, and as something based in defending the rights of children? What if you are part of abridging a child’s most fundamental rights, including the right to be protected from harm, the right to fertility, and the right to sexual fulfillment? What if in the name of social justice, you’ve been cheering for female and male genital mutilation? What if the I Am Jazz TV show is televised child abuse, and you are amplifying that abuse by pushing the I Am Jazz book in schools? What if you’ve been unwittingly enabling greedy corporations and Big Pharma to enjoy lifelong profits from growing numbers of medicalized people in one of the biggest medical scandals of all time? 

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You have reached the end of Part III of Hitchhiker’s Guide to the Transgender Galaxy. Why We Must Opposed Gender Identity Ideology. To move on to Part IV, click HERE.

To go to PART I which contains the full Table of Contents at the end, click here.