Some readers of this blog may notice that I have an interest in writing about the potential dangers associated with pediatric transition of trans identified children, teens, and young people. You may be wondering why I am interested in this topic, and where my views have come from.
Lisa, what is your agenda regarding transgender teens? What’s it to you, anyway?
Fair question. Until about a year ago, I hadn’t thought much about the issue of transgender teens and kids. I certainly would have agreed that trans teens deserve support and protection.
Then an old friend contacted me about her teen daughter. This woman has been a close friend of mine for decades, and I have known her daughter from birth. My friend — I will call her B — told me that her daughter had decided she was really a boy, and was imploring her mother for hormone blockers. She had even done research on getting a mastectomy.
B was shaken and upset when she called, and I immediately understood why. Amelia had always been a quiet, thoughtful, delightfully quirky child, but had never shown any discomfort with her gender or body until then. Her sudden announcement that she was transgender accompanied by a fervent interest in arresting puberty and even amputating her breasts came just a month after she was molested by an older teen boy. The incident had been frightening and traumatic. B had been sensitive and supportive and had sought counseling for Amelia right away. But since the assault, Amelia had become depressed and withdrawn.
It was clear to me as it also was to B that Amelia’s transgender identity and her wish to become a boy was related to the traumatic sexual assault. “You need to take her to a therapist so that she can sort this out!” I said.
What B told me next left me confused and frightened.
“I did. Our old therapist said she didn’t know anything about gender issues, and gave us the name of someone who specialized in working with trans teens. I took Amelia there, and at the end of the first session, this therapist had given me the name of an endocrinologist who could prescribe blockers, as well as a referral to a transgender support group.”
“Did you tell the gender therapist about the sexual assault?” I asked, incredulous.
“Yep. But she said that Amelia’s gender identity is inborn, and nothing can make someone trans. She said that if I didn’t affirm her identity, “he” would likely get more depressed and could even hurt himself.”
The next few weeks, I dove into the internet researching transgender teen issues. To my amazement, B’s story wasn’t an isolated incident. Therapists who focus on transgender issues generally affirm the identity of transgender teens and kids, and often do so without careful diagnosis.
The more I read, the more worried I became. I learned that kids were often coming out together in peer groups, or after prolonged periods of time on trans friendly social media sites such as Tumblr. In fact, B reported that Amelia’s announcement had been preceded by weeks where she spent days at a time online looking at such sites.
I found out that teens are being prescribed hormone blockers, often followed by cross sex hormones, which can result in permanent life-long sterility. I read the writings of the growing community of detransitioned men and women who wished that they had been presented with lots of options before being encouraged by doctors and therapists to transition. I discovered that some teens were even having “top surgery” to remove their breasts. And that all of this was being done with the support of therapists and doctors.
Okay. So now I know how you came to be aware of this. But what is it to you?
Well, I am a therapist. A licensed clinical social worker, to be exact. I believe I am witnessing something going on in my profession that, while certainly well-intentioned, is in fact quite destructive. While the increasing awareness of transgender issues and acceptance of pediatric transition will likely help a few kids with severe cases of gender dysphoria, I am concerned that there will be many “false positives,” — young people who could have managed these symptoms with less invasive methods who may come to regret the permanent changes to their bodies. I feel a duty to say something because this is happening in my house, so to speak.
So you are transphobic, right? You don’t believe that trans people exist, right?
No, and no. I don’t believe in the doctrine of innate gender identity, that we are all born with this immutable quasi metaphysical essence that is either male or female, that sometimes doesn’t match our physical bodies. I do believe that some people will need to transition as a result of acute gender dysphoria, and that this treatment could be lifesaving. I believe that the number of people for whom this is true is probably quite small. Science doesn’t really understand the causes of transsexualism at this point, but we will likely come to discover that it is not a single condition, and that these conditions have a complex mix of biological, psychological, and social causes.
Of course trans people exist. And of course they ought to be protected, respected, and cared for. But transition often involves drastic medical interventions that have not been well-studied and have potentially dangerous side effects. If we can help someone manage gender dysphoria well without transition, that would be a good thing. This is especially true when we are talking about children, teens, and young people who are not equipped to weigh the long-term consequences of their actions.
You’re a Jungian analyst. What the heck does that have to do with trans issues?
I admit it seems like a little bit of an odd fit. But Jung made several contributions to our understanding of psychology that are relevant and helpful when considering this topic.
First, Jung saw all symptoms as the psyche’s effort to heal itself. This means that we ought to take our distress seriously and assume it is trying to tell us something. What it is trying to tell us, however, may be in the language of symbol, which is the only way the unconscious can speak to us.
After the assault, Amelia was terrified of growing up to be a woman, and who could blame her? Her desire to rid herself of her feminine characteristics and to take testosterone to make her voice deepen and her muscles develop was in one sense a metaphorical expression of her need to armor and protect herself against another violation. At the same time, such impulses spoke to her need to grow into a stronger, more whole version of herself by developing the “masculine” aspects of her personality. If Amelia follows these impulses in their symbolic sense, she will deepen her voice not with synthetic hormones that wreck havoc with her endocrine system, but by gradually coming to claim her inner authority so that she speaks from deep within herself.
Second, Jung believed we were all a mix of masculine and feminine traits — an insight that is being born out by modern neuroscience. He discovered that each man has within an inner women, which Jung termed the anima, and every woman has within her an inner man, or animus. These contra-sexual aspects are a vitally important part of our inner worlds, for they act as a guide that leads us in the our depths, and mediates our relationship with our own creativity.
Given the tremendous importance of the anima and animus in Jungian thought, it makes complete sense to me that young people would be interested in exploring the ways in which they feel “male” or “female.” When this is done as a psychological exploration, it can help us grow towards health and wholeness. Indeed, Jung felt that psychological maturity required that we develop these opposites within ourselves. However, transition concretizes and medicalizes this important psychological work.
To wrap up this post, I just want to report that my friend B (who kindly gave me permission to share her story here) and Amelia are doing well. With patient support, Amelia came to accept her own body. She recently told her mom she was glad she held the line and didn’t immediately give in to giving her blockers.