Gender detransitioners and experts say there should be more caution in pushing sex reassignment treatment on young people, according to a New York Times opinion piece Friday.
In addition to offering anecdotes, Times opinion columnist Pamela Paul argued that transgender activists are pushing "ideological extremism" by recommending gender medical operations as the cure-all for young people confused by their own bodies, rather than trying to get to the bottom of their psychology first.
The piece told the story of Grace Powell, a 23-year-old biological woman who is currently destransitioning from the sex change she began years ago.
Powell told the paper that when she was 12 or 13 she "discovered she could be a boy," and at that time came to believe "that the reason she didn’t feel comfortable in her body was that she was in the wrong body. Transitioning seemed like the obvious solution."
Paul wrote, "The narrative she had heard and absorbed was that if you don’t transition, you’ll kill yourself."
According to Powell, she began hormone therapy during her senior year of high school, followed by a double mastectomy the summer before college, where she described herself coming across as "a very effeminate gay man."
Looking back, however, the woman feels as though she should have asked more questions about her desire to transition before making the decision.
The columnist described the young woman’s mindset, saying, "At no point during her medical or surgical transition, Powell says, did anyone ask her about the reasons behind her gender dysphoria or her depression. At no point was she asked about her sexual orientation. And at no point was she asked about any previous trauma, and so neither the therapists nor the doctors ever learned that she’d been sexually abused as a child."
Suggesting she was misled, Powell told the columnist, "I wish there had been more open conversations. But I was told there is one cure and one thing to do if this is your problem, and this will help you."
"What should be a medical and psychological issue has been morphed into a political one. It’s a mess," Powell said.
Paul went on to claim that right-wingers aren’t the only ones who have "inflamed this debate" over allowing kids to transition, but "transgender activists have pushed their own ideological extremism, especially by pressing for a treatment orthodoxy that has faced increased scrutiny in recent years."
"Under that model of care, clinicians are expected to affirm a young person’s assertion of gender identity and even provide medical treatment before, or even without, exploring other possible sources of distress," the columnist added, noting that there are "many" who think there should be more caution when it comes to recommending solutions here.
DETRANSITIONING BECOMES GROWING CHOICE AMONG YOUNG PEOPLE AFTER GENDER-AFFIRMING SURGERY
"Powell’s story shows how easy it is for young people to get caught up by the pull of ideology in this atmosphere," Paul said.
Another detransitioner, Kasey Emerick, age 23, who had a double mastectomy at 17, said, "I transitioned because I didn’t want to be gay…Transition felt like a way to control something when I couldn’t control anything in my life."
As Paul explained, "But after living as a trans man for five years, Emerick realized her mental health symptoms were only getting worse. In the fall of 2022, she came out as a detransitioner on Twitter and was immediately attacked. Transgender influencers told her she was bald and ugly. She received multiple threats."
Emerick said, "I realized that I had lived a lie for over five years." Despite going off testosterone, her voice has been permanently changed to the deeper voice of a man.
Paul Garcia-Ryan, now 32, detransitioned after being a trans female for 15 years from the age of 15.
According to Paul, "Once in college, he began medically transitioning and eventually had surgery on his genitals. Severe medical complications from both the surgery and hormone medication led him to reconsider what he had done, and to detransition. He also reconsidered the basis of gender affirmation, which, as a licensed clinical social worker at a gender clinic, he had been trained in and provided to clients."
"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."
He now supports moving away from affirmation and doesn't believe anyone under the age of 25 should transition without engaging in psychotherapy.
"When a professional affirms a gender identity for a younger person, what they are doing is implementing a psychological intervention that narrows a person’s sense of self and closes off their options for considering what’s possible for them," Garcia-Ryan told The Times.
Continuing, the author noted that there are plenty of adults who feel that getting a sex change "was life changing, even lifesaving," however, she cited professionals who now believe that young people’s decisions on this front need to be better monitored.
Laura Edwards-Leeper, the psychologist behind the first pediatric gender clinic in the U.S., said that most of her first patients had "longstanding and deep-seated gender dysphoria," however, she feels that it’s not so cut-and-dry among new transitioners, with many patients not having a proven history of childhood dysphoria.
Edwards-Leeper stated, "As far as I can tell, there are no professional organizations who are stepping in to regulate what’s going on," as many of her newer patients display mental health issues "unrelated to gender."
The doctor added, "[Y]ou have to take time to really assess what’s going on and hear the timeline and get the parents’ perspective in order to create an individualized treatment plan. Many providers are completely missing that step."
Paul noted that the doctors and medical professionals who insist upon caution are "often afraid to speak out" and even "don't feel safe."
She also mentioned how many European countries are taking a step back from medical "gender affirmation" for youth after controversies and realizing the studies their methods were based on were flawed. She cited the World Health Organization saying, "the evidence base for children and adolescents is limited and variable regarding the longer-term outcomes of gender-affirming care for children and adolescents."
In the U.S., she concluded "rising above culture-war politics and returning to reason" would be "the most humane path forward."
