Am I really “trans?”

[LoRez]

Lately, I been reviewing many accounts of detransitioners (MtFtM). In most cases, the counseling (if any) was insufficient to dig into the “identity crisis” that caused the individual to seek transgender (invasive) medical treatments. 

There appears a trend where the “informed consent” model enforces affirmative action rather than confirming gender identity. I find this especially sad when applied to minors who lack the life experience to make such drastic changes. Even with the physical changes, nothing addresses the underlying mental state nor resolve them. 
 

I’ve seen many reports of individuals going to an interview and getting less than 15 minutes time to discuss gender affirming care. Many report they didn’t have informed consent as they lacked enough information to properly grasp if they should proceed. 

 

People that get the GRS often continue to struggle with body dysmorphia and/or unresolved trauma. And more seem to regret the “surgical complications” that require more surgery from incompetent doctors. Which leads them to start thinking they were better off not getting GRS to begin with… 

I already know I don’t need nor want (vaginoplasty) “bottom surgery.” I don’t want breast implants either. However, I am interested in getting a panniculectomy ("tummy tuck") along with brachioplasty and thighplasty. I’d also consider FFS (feminine facial surgery).

 

My main reason to conduct this research is to not only be properly informed, but address the questions in my mind:

 

- am I really “Trans?”
- would I be happier as a (presenting) woman?
- is it worth the consequence of lowered income from companies run by toxic men?
- is it worth losing access to my sons?
- how could I find a middle ground with my wife on this matter?

 

When I reviewed the “happy” transgender women who have not regretted their transition, I observed they often have some internalized homophobia that drove them to become the socially accepted gender for their sexuality. As their community made it difficult to be homosexuals, they saw GRS as the only way forward. I don’t deny that it may be required for survival in some toxic regions of Earth. 

 

However, I’m bisexual, but mostly attracted to women (and effeminate men). I don’t have this internalized homophobia nor live in a region where such people are violently attacked. While I “know” that is more socially acceptable for women to be bisexual, I don’t see a major reason to change gender identity. 

 

Hmm, now that I wrote that… I wonder if I do have some residual homophobia internalized… 

 

All that said, my observations for the past 6 months suggests that I do find life more exciting when presenting as a woman than as a guy. I’m less depressed. But is this because of the “honeymoon phase” where everything is new and interesting? The Trans community is small but easy to find friendly people. I do want more friends. I’m still trying to figure out myself and not 100% certain how I should proceed. Is this my “mid-life crisis??” 😢

[Carolyn Marie]

I think that doing more research is a healthy approach, and going slow is also healthy.  For most people, there is no reason to rush into making any decisions about transition, whether that be medical (chemical), surgical, social or some combination of the three.  Someone close to me has transitioned socially and has had no medical interventions, and she's very happy and satisfied with her life. 

 

I don't know what the definition of a mid-life crisis is, but you seem to be making sound decisions and doing the right things for yourself, so to me it doesn't sound like a crisis of any kind.  Do what you think is in your best interests, what feels right, and don't worry about the judgement of others.  What do we know?  LOL!

 

Carolyn Marie

[AllieJ]

I have read accounts of young people who have transitioned socially and medically and now have regret, but in almost every case they had little assessment and advice from medical professionals and stated they were influenced by social media 'influencers' who promised them a fantastic life where they would be popular. Proper assessment would have found they had other issues than being 'trans', but the diagnostic criteria currently in place merely requires someone to say they have had persistent gender questioning. This is simply not adequate to find if someone is needing to transition. 

 

The role of a psychiatric/psychologist/therapist is to eliminate all other causes of gender questioning, which would take many sessions. I look forward to there being an accurate way to assess if someone would benefit from transition. The term Transgender Has been abandoned hy the medical bodies as it is generally seen as an umbrella term covering gender divers peoples including cross dressers, and drag performers. There needs to be a review of these terms and more specific descriptives.

 

As many would be aware, I am confident that the findings of conflicting gender features in parts of our brains will eventually form a basis for diagnosis, and a review of the understanding of Dysphoria will guide treatments, but as of now, these aren't available to us. If you are 'Trans' or not doesn't really matter, but the driver for transition should be the risk of adverse health effects from Dysphoria. This would underpin that transition is a need rather than the common perception that it is something which makes us happy.

 

If you are not sure if you should transition, first establish that you get relief from gender affirming things, as this indicates dysphoria is affecting you, and then assess if dysphoria is significantly affecting your life to establish how much you need to treat it, and how far you should go.

 

Hugs,

 

Allie 

[KayC]

4 hours ago, AllieJ said:

If you are not sure if you should transition, first establish that you get relief from gender affirming things, as this indicates dysphoria is affecting you, and then assess if dysphoria is significantly affecting your life to establish how much you need to treat it, and how far you should go.

^ This ^

 

 

[emeraldmountain2]

11 hours ago, LoRez said:

There appears a trend where the “informed consent” model enforces affirmative action rather than confirming gender identity.

Someone please correct me if I'm wrong, but I don't think minors are allowed to receive hormone therapy under the informed consent model, which is prudent.

 

While I agree that a 15 minute consult prior to starting HRT is probably not enough, I don't know if it is actually that common. When I went through the informed consent model, I had to sign paperwork acknowledging the risks and benefits of HRT and the provider spent a lot of time kindly answering my many questions. Furthermore, I agonized for decades about whether or not transition was right for me and I admit I did seek therapy to sort out my thoughts before trying HRT, but many people do not need therapy and know that HRT is right for them.

 

As a person who started HRT in adulthood, the informed consent model has been lifesaving and I am forever grateful to the medical providers who have opened up informed consent to help people. I don't know how old you are or where you're from, but before the informed consent model took shape, we had to go through sometimes humiliating therapy for long lengths of time before getting HRT, doubt and sometimes ridicule from medical and psych practitioners who were very reluctant to help us and saw medical transition as a sad last resort, and insurance wouldn't cover HRT because they obnoxiously considered it not medically necessary. I for one was traumatized by such a system and did not gain the strength to transition well into adulthood. Without the informed consent model, many of us would never have been allowed to receive HRT and many of us have suffered immensely.

 

Whether or not HRT is for you is completely up to you, especially if you go the informed consent model. That is your decision and yours alone.

 

I don't often ask people to change their mind, but for the sake of our community's well-being, please, please reconsider your thoughts about other people receiving HRT through the informed consent model.

[KathyLauren]

I am not a big fan of the "informed consent" model of treatment for trans people, especially for minors.  But the regret "problem" has been overblown by the haters. 

 

In a recent study by Johns Hopkins University, the regret rate for gender-affirming surgery is less than 1%.  (Article)  Especially if people have several hours of counselling by properly-qualified therapists, regret simply isn't an issue.

[MaeBe]

Also, realize, that a lot of detransition information out there is weaponized propaganda; a few loud voices making grand statements, using over-generalizations and citing debunk-able "data" or people with anti-trans agendas boosting those voices. Many videos posted have an agenda to get clicks, read: money, and a sensationalized story or headline is far more effective to generate traffic than a sensible one. Those that want to push an anti-trans agenda are going to latch onto these narratives and put them into the echo chamber. That's why you see a million videos with or about the Chloe Coles of the world.

 

I tend to think of the online noise like yelp reviews, the most dissatisfied are the ones that post their reviews; the vast majority of happy customers don't feel the need to share, but the complainers sure will complain!

 

Youths aren't forced to transition medically or surgically and, at least here, Informed Consent is not available for children. The data that is out there is that affirmative care vastly outstrips other methods in efficacy and reduces negative results such as self-harm or suicide. Like others have stated, regret rates for affirming surgeries are quoted between 1-3%, but regret is a standard human response to change. For instance, between 6 and 30% of people are dissatisfied with their knee replacement surgeries. It's really a numbers game, in any large group of people there is going to be dissatisfaction, regret, or in this case detransition. It's natural for someone struggling with themselves and looking at the world that has a loud and active agenda against people like them to worry, doubt, try to find ways to "not be this way". Doubt is a very human response.

 

Am I writing this to prove anyone is or should be trans? No. The only person that can say that is the person themselves.

 

Here's a short that covers the basics:

 

Here is a sensible interview with a woman that detransitioned that goes over a lot of the noise you see online:

 

[MaeBe]

1 hour ago, KathyLauren said:

I am not a big fan of the "informed consent" model of treatment for trans people...

I would love to hear your opinion on this, either here or in a direct message.

 

While it's probably true it's not a perfect policy, but it is one that reduces expensive barriers, removes the burden of defining what a trans person is and "how trans you must be" to receive specific care, and ultimately allows for the individual to decide what's right for them. Yes, there will be those that cannot comprehend the risks and sign the form, or will react poorly when a risk they accepted occurs, but isn't it better for people to have access to care than restrict it?

 

Would it be preferred that people have their brains scanned, their psyches plumbed to the core, so that they meet a "standard" to receive care? Who would be responsible for that standard and maintaining it? Also, in the US, this would all be on a person's dime, effectively adding a "trans tax" to the hoops one must jump through to get any kind of affirming care. That kind of system would leave many behind, but I guess there would be "proof" that a person is trans. I feel icky writing that.

 

Walking down the transgender path should definitely not be taken lightly or on a whim, but to make a "better" system would cost the government a lot of money on something that a good number of people just don't think should exist.

[MaeBe]

18 minutes ago, MaeBe said:

Who would be responsible for that standard and maintaining it?

I realize there are standards such as WPATH out there. There have been many iterations of that and others. Some of those historical standards could be viewed as dangerous, too. Sorry for the extra post.

[Audrey]

Hi all, just my thoughts... this thread has been on my mind all day long.

 

I am a strong supporter of an informed consent model of care for adults, including competent medical and mental health support. But above all, an honest self-assessment about one's hopes and expectations related to transition is essential. That is where the professionals can and should help someone have those conversations, not just in the doctor's office but with oneself at home. When I was younger, I am not sure I would have had the clarity of heart and head to decide to transition at all. No medical or social transition step can alleviate mental health issues unrelated to gender dysphoria, like depression, anxiety, substance use, and so forth. Nor can it achieve results that are the things of science fiction. Without an informed consent model, who knows what hoop-jumping one would be required to do to transition or even access care - if it would even be possible at all. For younger people, I think the model can hold up if the parents or guardians can be healthily involved in the conversation with the same competent professionals. I personally feel that more time to reflect and consider the life-changing choices is only a good thing, especially for a younger person, but I also understand that there may be a "race" against puberty and the changes associated with it.

 

Regret will never be reduced to zero even with the very best care - not for affirming surgeries or for anything else a human being might choose to do. I agree that a few very vocal and visible people have made the presence of *any* regret a reason to advance draconian policies against the transgender community. Such voices can and will go to great lengths to achieve an end and prove whatever point. The reasons may be complex, but I believe many boil down to a core determinist belief about sex and gender, and fear of what one does not understand.

 

@LoRez To your comment about "internalized homophobia" and "happy" transgender women not regretting transition... I think it is important to understand that gender identity, gender expression, orientation and attraction, and biology all exist independently. There may be some interrelatedness between them, but one does not cause or necessarily flow linearly from another. In fact, in my self-reflection, thinking I was a cisgender man and being attracted to women caused me to reject the idea of being transgender for a very long time. Because obviously I was "straight" (at least related to my birth sex). Early in my college years I encountered the Ray Blanchard theory that did considerable damage and reinforced this in my mind for years. Today, I self-identify as a lesbian *and* I am very happy with my life and decisions!

 

Love,

~Audrey.

[LoRez]

3 hours ago, KathyLauren said:

In a recent study by Johns Hopkins University, the regret rate for gender-affirming surgery is less than 1%.  (Article)  Especially if people have several hours of counselling by properly-qualified therapists, regret simply isn't an issue.

That single study you referenced doesn’t show the data on how many patients they compared nor the methodology of the study. 
 

Quote

currently believed to be very low…

Furthermore, it focuses on those that took the surgical route. If the data is collected from the surgeons that provided the care, then we won’t know the actual regret rate as it would affect that doctor’s reputation and thus business. I find it odd that “complications” and “revisions” are not included in the overall statistics. Patients are often told that revisions are common and gaslit to believe it a “natural” part of the process. I see revisions as a regret the surgery didn’t provide expected outcomes the first time around by less than competent doctors. 
 

With regards to regret rates for those that only took HRT, I have yet to see any studies compiling the data. Plus, we can’t assume that everyone that takes HRT gets surgery of any kind. 

3 hours ago, emeraldmountain2 said:

Someone please correct me if I'm wrong, but I don't think minors are allowed to receive hormone therapy under the informed consent model, which is prudent.

There are States that appear to have extended the “informed consent” model to minors. (https://schoolhouseconnection.org/state-laws-on-minor-consent-for-routine-medical-care/)

 

• Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults
• Informed Consent in Paediatric Telemedicine: Challenge or Opportunity? A Scoping Review

 

 

Now, with all of the above stated… I agree that HRT and affirmative care is needed for adults. I draw the line, however, when it comes to minors. They often lack sufficient life experience and knowledge to make a truly “informed consent.”

[VickySGV]

@LoRez  When the footnotes of the papers listed above contain the names of the well debunked  nay sayers to any Trans Care, from Littman to Blanchard and more, who are the darlings of the conservative wing of life, I think you have a skewed viewpoint there. 

 

The Informed consent link referred to a very narrow segment of young people who could be deemed legally competent  for common illnesses such as physical injuries and at the extreme end for treatment of sexually transmitted diseases including HIV/AIDS and in recent years even receiving Covid vaccines where they have been disowned by their parents.  Even so, such young people are referred to public guardians who become "in loco parentis" by order of local dependency Courts.  In my state that protection will extend to treatments for GD with the appointed guardian who is trained for dealing with GD Clients being the one to allow the treatment for the young adult. 

[LoRez]

39 minutes ago, Audrey said:

@LoRez To your comment about "internalized homophobia" and "happy" transgender women not regretting transition... I think it is important to understand that gender identity, gender expression, orientation and attraction, and biology all exist independently. There may be some interrelatedness between them, but one does not cause or necessarily flow linearly from another.

Absolutely agree with you. I’m aware that gender identity, gender expression, gender roles, and sexual orientation are not explicitly linked but can overlap and are often influenced by the local cultures. 
 

I’ve managed to cope for decades with unanswered questions regarding myself. Finding myself depressed and abusing alcohol or recklessly racing my crotch rocket at dangerous speeds with a gang at night. Doing “canyon runs” where a single mistake would send you flying into the canyon’s bottom - where death was certain. Same with my high-speed skiing. I’ve busted my legs a number of times now. I’ve been “racing” from myself for a long time.

 

Now, I’m in my mid-forties and forced to reflect on why I have been running. I’ve been “living” with a “socially acceptable” mask and now find it suffocating. When I go out to the “Girl’s Club” in Tokyo dressed as a woman, I feel relieved and happier - almost uninhibited. I can flirt with the guys and girls. Have a good time. Actually smile at the guy ogling me. 
 

When I’m at work or around my wife, it feels confined. My 3 year old twin sons love “PaPa” and don’t care how I dress around them. Papa is always fun. My wife, sadly, has become ultra-conservative. While she threatens divorce, she admits she can’t afford to leave. Besides, the biggest losers in divorce would be our twins. I don’t want them to suffer the life of a broken home as I grew up in. 
 

Work isn’t something I’m ready to “come out” to just yet. While the company is supposedly supportive of LGBT+, I’m not sure how my team would react. For now, I’m taking the snail’s speed approach: letting my hair grow out and slowly introducing more feminine features. Dressing more androgynous. If I find myself more comfortable (and secure in my employment), I would eventually dress completely as a woman at work. But I see this as a multi-year project. 

[Sally Stone]

1 hour ago, Audrey said:

But above all, an honest self-assessment about one's hopes and expectations related to transition is essential.

Audrey, I'm so glad you made this comment.  I believe there is a tendency to believe that transition solves all woes and exercises all personal demons.  That is not a reasonable expectation.  Of course transition can have a very positive effect on gender identity issues, but it isn't going to necessarily make life better.  Transition is a life changing event and unfortunately it often changes life in a negative way.  Examples include loss of job status, marriage problems, not to mention loss of friends and possible loneliness.  I'm not saying transition is bad or that it should be avoided, but as Audrey infers, it must include honest self-assessment and a realistic view of life afterwards.   

[emeraldmountain2]

Excellent insight @MaeBe, @Audrey, @VickySGV.

2 hours ago, LoRez said:

Now, with all of the above stated… I agree that HRT and affirmative care is needed for adults. I draw the line, however, when it comes to minors. They often lack sufficient life experience and knowledge to make a truly “informed consent.”

Why do you draw the line? With all due respect, who are you to determine this? I am certain that I would have been saved many years of heartache had I been given the opportunity to receive HRT during my adolescence. That is my lived experience. I was stuck in a body I despised for years before starting HRT and am only now starting to appreciate my body with the changes brought on by HRT. However, many effects of masculinazation during my adolesence are set in stone and will not be changed. If I had access to HRT as a teen, I would be in a body much more comfortable and congruent. I really wish more people could understand what immense help HRT would have been at that age. Please do your due diligence and learn about the excellent results, mentally and physically, that HRT provides to people who start in their teens before "drawing the line."

[AllieJ]

5 hours ago, emeraldmountain2 said:

Excellent insight @MaeBe, @Audrey, @VickySGV.

Why do you draw the line? With all due respect, who are you to determine this? I am certain that I would have been saved many years of heartache had I been given the opportunity to receive HRT during my adolescence. That is my lived experience. I was stuck in a body I despised for years before starting HRT and am only now starting to appreciate my body with the changes brought on by HRT. However, many effects of masculinazation during my adolesence are set in stone and will not be changed. If I had access to HRT as a teen, I would be in a body much more comfortable and congruent. I really wish more people could understand what immense help HRT would have been at that age. Please do your due diligence and learn about the excellent results, mentally and physically, that HRT provides to people who start in their teens before "drawing the line."

 

In reality, very few minors actually get hormones, with most prescribed blockers until they are old enough. But I have lived through the nightmare that having a suicidal child due to gender issues is, and it can be just important for them to receive gender affirming care as adults. I remember the horror I went through as I realised I could not stop puberty, and while I wasn't suicidal, it destroyed any social development I would have had, which is critical for developing teens. 

 

I have tried to console parents who were sure their child was at significant risk, while at the same time wracked by doubt that treatment was the right thing to do. In my country, affirming treatment requires consent from both parents, and a doctor, so if there is only one parent, it requires a court order after evidence of risk to life is established. I have seen the stress of this split marriages, and affect the health of parents, and it is why I so want a clear diagnosis, as many suffer simply because nobody is sure. But survival has to be the priority for children and youth, and blanket bans on treating kids is contrary to this.

 

Hugs,

 

Allie

[emeraldmountain2]

8 hours ago, AllieJ said:

But I have lived through the nightmare that having a suicidal child due to gender issues is, and it can be just important for them to receive gender affirming care as adults. I remember the horror I went through as I realised I could not stop puberty, and while I wasn't suicidal, it destroyed any social development I would have had, which is critical for developing teens. 

I'm very sorry to hear that @AllieJ. It really speaks to the importance of gender affirming care for youth, which does not necessarily mean hormone therapy (of which I consider puberty blockers to be included).

 

9 hours ago, AllieJ said:

it requires a court order after evidence of risk to life is established.

This is rather absurd and unnecessarily cruel to need a court order and to let it get so bad as to need to be suicidal before receiving care. This wicked system is making youth suffer, not protect them. 

 

9 hours ago, AllieJ said:

I have seen the stress of this split marriages, and affect the health of parents, and it is why I so want a clear diagnosis, as many suffer simply because nobody is sure.

To be blunt and at the risk of sounding cold, this dysfunction is the problem of those families. There are many families who are accepting and kind towards their gender diverse kids. A dysfunctional family is no reason at all to impose such drastic measures as in your country which place strict roadblocks preventing youth from receive gender affirming care.

[AllieJ]

6 hours ago, emeraldmountain2 said:

I'm very sorry to hear that @AllieJ. It really speaks to the importance of gender affirming care for youth, which does not necessarily mean hormone therapy (of which I consider puberty blockers to be included).

 

This is rather absurd and unnecessarily cruel to need a court order and to let it get so bad as to need to be suicidal before receiving care. This wicked system is making youth suffer, not protect them. 

 

To be blunt and at the risk of sounding cold, this dysfunction is the problem of those families. There are many families who are accepting and kind towards their gender diverse kids. A dysfunctional family is no reason at all to impose such drastic measures as in your country which place strict roadblocks preventing youth from receive gender affirming care.

 

To clarify, Emerald Mountain, a court order is only required where both parents haven't signed permission for treatment. There is a heightened fear of misdiagnosing kids as they are easily influenced and the decisions can have significant impacts on their lives. I have sat with parents who are anguishing over this, with nagging questions like 'is it just another phase?', and' are they just wanting to be like someone they have seen online?'. And I could not give them any assurances that treatment was the right thing to do, this is why I feel strongly about a more robust diagnosis. 

 

This is why families are under stress, not because they have any prejudice, but because they love their child and are forced to make huge decisions with little evidence to guide them. If the parents are not completely in sync with this, it creates enormous stress in the marriage. There is no dysfunction, but sometimes an impossible decision to be made with no assurances it will be right. There is a strong belief among child psychologists to 'wait and see' if a child grows out of gender stress, but this forces kids to go through puberty and many simply don't make it. And this is the sort of information parents are confronted with. 

 

Hugs,

 

Allie

[LoRez]

9 hours ago, AllieJ said:

I could not give them any assurances that treatment was the right thing to do, this is why I feel strongly about a more robust diagnosis.

☝🏻this is what I support when kids are involved.
 

Not say it should be banned, but it should take more than a single visit to discern if the child truly has gender dysphoria or body dysmorphia (with unresolved issues). 

[AllieJ]

1 hour ago, LoRez said:

☝🏻this is what I support when kids are involved.
 

Not say it should be banned, but it should take more than a single visit to discern if the child truly has gender dysphoria or body dysmorphia (with unresolved issues). 

 

It's the opposite problem here, the kids have to jump through so many hoops to get treatment, and the parents have to wait nervously, sometimes for more than a year. This is not good for anyone. A better diagnostic would lessen this time considerably.

 

Hugs,

 

Allie

[emeraldmountain2]

21 hours ago, AllieJ said:

To clarify, Emerald Mountain, a court order is only required where both parents haven't signed permission for treatment. There is a heightened fear of misdiagnosing kids as they are easily influenced and the decisions can have significant impacts on their lives. I have sat with parents who are anguishing over this, with nagging questions like 'is it just another phase?', and' are they just wanting to be like someone they have seen online?'. And I could not give them any assurances that treatment was the right thing to do, this is why I feel strongly about a more robust diagnosis. 

 

This is why families are under stress, not because they have any prejudice, but because they love their child and are forced to make huge decisions with little evidence to guide them. If the parents are not completely in sync with this, it creates enormous stress in the marriage. There is no dysfunction, but sometimes an impossible decision to be made with no assurances it will be right. There is a strong belief among child psychologists to 'wait and see' if a child grows out of gender stress, but this forces kids to go through puberty and many simply don't make it. And this is the sort of information parents are confronted with. 

 

Hugs,

 

Allie

I understand parents' trepidation, as mine were the same when I attempted to receive help as a teen, which I have stated on this website several times was not provided and which screwed me up for so many years. So, from my experience, yeah, I am 100% in support of trans youth receiving gender affirming care if it is appropriate and prudent care is taken to make sure this is right for the youth in question. However, I will not draw a firm "line" as some do that transition is only for adults, because we know that this causes great harm to many trans people.

 

As far as dysfunctional families go, I could only go off of what description you gave. If a marriage falls apart because the parents can not get a grip on helping their gender diverse child, I would call that dysfunction.