Breaking boundaries safely

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Having recently read about the novel by Torrey Peters, Detransition, Baby (The Witness, July 7), it now becomes much more evident that growing numbers who embraced transsexual lifestyles because of apparent gender dysphoria, are now embarking on detransitioning, having discovered that their distress was unrelated to loathing of their female (or male) bodies, or they have matured into more relaxed acceptance of the person they were before committing to any reassignment procedures.

Transsexuality — seeking medical intervention to transition from the gender of one’s birth, choosing to live as the opposite sex, and the quest for an authentic sexual identity — has in recent decades begun to be regarded with respect in most westernised countries. The British medical community, and the Church of England, adopting a policy of protecting gender non-conforming and Trans people from discrimination.

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However, in Britain and America growing concern is being expressed around childhood gender transition, notably the rise in the number of girls seeking treatment. In 2018 to 2019 girls reversed the previous ratio, outnumbering boys to becoming 74% of the total, half of these children under 14 years — a phenomenon referred to by American therapist Lisa Marchiano as a “psychic epidemic”. This trend also appears to be manifesting itself in South Africa, with groups offering support to parents experiencing distress about children’s gender dysphoria diagnoses.

After a whistleblower alleged that the National Health Service (NHS) was prescribing puberty-blockers without proper psychiatric screening, Britain’s High Court effectively banned their use, ruling that children under 16 couldn’t consent to the drugs.

Many protests by feminists and others have opposed the over-zealousness of trans activists, arguing that hasty and ill-considered diagnoses and treatments are inimical to the wellbeing of young people, especially girls.

The call is growing for all therapists dealing with so-called gender-dysphoria to exercise far more cautious approaches to prescribing gender-reassignment therapy, particularly hormonal and surgical procedures.

There are growing numbers of accounts of girls and women transitioning to male — either partially or as fully as possible — who have recently attempted to reverse the process: detransitioning. One, being Carey Callahan who identified as transsexual for four years, before her work at a gender clinic led her to seek alternatives to transition, since 2016 advocating support for detransitioners, and gender-nonconforming people.

Keira Bell. Photograph by David Levene / eyevine / Redux

LANDMARK CHALLENGE OF KEIRA BELL

In 2020, Keira Bell, aged 23, took legal action against the British NHS Gender Identity Development Service Tavistock and Portman Clinic, London, where, aged 15, she was diagnosed with gender dysphoria because she was distressed about the changes in her body occasioned by puberty. She says, “I concluded that it would be best if I stopped becoming a woman. After a series of superficial conversations … I was put on puberty blockers at age 16. A year later, I was receiving testosterone shots. When I turned 20, I had a double mastectomy. By then, I appeared to have a more masculine build, as well as a man’s voice and a beard …

“But the further my transition went, the more I realised that I wasn’t a man, and never would be. As I matured, I recognised that gender dysphoria was a symptom of my overall misery, not its cause.

“As a result of the surgery, there’s nerve damage to my chest, and I don’t have sensation the way I used to.

“Living as a trans man helped me acknowledge that I was still a woman. I also started to see what I was living out was based on stereotypes, that I was trying to assume the narrow identity of ‘masculine guy’.”

"“What I am angry about is how my body was changed at such a young age. I do not believe in rigid gender expression. People should be comfortable and feel accepted if they explore different ways of presenting themselves. As I said in my statement after the ruling, this means stopping the homophobia, the misogyny, and the bullying of those who are different."
Alleyn Diesel

Five years after beginning her medical transition she began the detransition process.

“At the time our case was accepted, the NHS was asserting that the effects of puberty blockers are ‘fully reversible.’ But recently, the NHS reversed itself, acknowledging that ‘little is known about the long-term side effects on a teenager’s body or brain.’ That didn’t stop them from prescribing these drugs to people like me.”

Her legal team argued that the Tavistock had failed to protect young patients, and she won a unanimous verdict; the judges declaring doubts that the such young people could understand the implications of what amounted to life-altering, experimental, treatment, expressing surprise at the lack of evidence for putting children as young as 10 years old on drugs which require life-long continuation to maintain transition.

Keira says, “When I joined the case, I didn’t realise how big it would become. What has happened since the ruling has been a roller coaster. Many people have thanked me. I have also been attacked online. If you’re someone who regrets transitioning and decides to speak out about your experiences, you’re considered a bigot. You may be told that you’re trying to take away trans rights, that children know what’s best for themselves and their bodies, and that you’re ruining kids’ lives.

“But I am focused on what is best for distressed young people. A lot of girls are transitioning because they’re in pain, whether it’s from mental-health disorders, or life trauma, or other reasons. I know what it’s like to get caught up in dreaming that transitioning will fix all of this.

“What I am angry about is how my body was changed at such a young age. I do not believe in rigid gender expression. People should be comfortable and feel accepted if they explore different ways of presenting themselves. As I said in my statement after the ruling, this means stopping the homophobia, the misogyny, and the bullying of those who are different.

“People want to know if I’m going to have reconstructive surgery of my breasts or do other things to make me look more female. But I haven’t fully processed the surgery I had to remove my breasts.

“I also call on professionals and clinicians to create better mental-health services and models to help those dealing with gender dysphoria. I do not want any other young person who is distressed, confused, and lonely as I was to be driven to conclude transition is the only possible answer. … I was an unhappy girl who needed help. Instead, I was treated like an experiment.”

Katherine Burnham.

KATHERINE BURNHAM’S ACCOUNT

The story told by American Katherine Burnham provides another poignantly compelling account of the anguish inflicted by such insensitive treatment (Dysphoria and Disintegration in Women Who Are ‘Too Much’ — July 22, 2021).

“I had been identified as gifted in school and had always been something of a social outcast. Despite my parents’ and teachers’ belief in my potential, by the time I got to middle school, I was struggling ... with my sexual orientation and identity.”

At puberty she felt betrayed by her own anatomy, forced into becoming a sexual object before she could comprehend what that meant. “The year before, I had been a child; but almost overnight I started to feel like a child wearing a Halloween costume that I couldn’t take off.”

And so the expectations piled up — being expected to shave her legs and underarms, painting her face with make-up, paying close attention to her clothes, wearing shoes that hurt her feet. To try to look good for boys, and go on dates; conforming to patriarchal standards of beauty and behaviour. Constantly told to behave “like the other girls”, although she didn’t have a clue as to how to do this.

“I didn’t want to do any of these things. Boys didn’t have to do these things; they could just be themselves. … So, I came to the conclusion that since I did not wish to conform to misogynistic ideals and could not conform, then I must not really be a woman.”

At 17 she discovered her same-sex attraction. Then, at the beginning of 2020, she began to identify as transmasculine — “a sort of catch-all term for a female person who has socially or medically transitioned to a more masculine presentation, but does not necessarily identify as a man”.

Slowly, she came out to her social circle, but relied heavily on online chats, still remaining debilitatingly depressed and anxious — desperate for a way out of loneliness and alienation.

The more she read about medical transition, the more she felt it was something she desperately needed. Her therapist supported her; all she had to do was to claim to be Trans to get a prescription for testosterone.

“I only wish I could have realised all this before I spent 13 months on testosterone … I wish I had been told that there were other options apart from transitioning. I no longer wish to hate myself and my body, including for the ways my body has been altered by cross-sex hormone treatment."
Katherine Burnham

“During my time on testosterone, I realised that trying to live as a man was just forcing myself into another box that was as narrow and meaningless as the one I was trying to escape from … One night, all these thoughts began coalescing and suddenly it all clicked. Transitioning was the wrong choice; I had made a mistake. I sobbed for hours.”

She realised that transitioning hadn’t solved her problems; only covered them up, allowing them to mutate into new insecurities; new feelings of pain and isolation. “It was body-hate that led me to the self-destructive decision to transition.”

She also became aware that there are many ways to be a woman. “I only needed to expand the definition of ‘woman’ for myself. Nothing had ever been wrong with my body — nothing had ever been wrong with me. I have always been perfectly fine the way I am.”

What she hadn’t discovered was that there are innumerable women who felt just the way she did, and survived — odd, eccentric, intelligent, nerdy, strange women who lived wonderful, fulfilling lives. Discovering that “feeling like a woman” isn’t a feeling at all — it’s just a fact! She didn’t need to dress or speak, or behave, in any expected way in order to be a real woman.

“I only wish I could have realised all this before I spent 13 months on testosterone … I wish I had been told that there were other options apart from transitioning. I no longer wish to hate myself and my body, including for the ways my body has been altered by cross-sex hormone treatment.

“Looking back on my years in these online queer and trans communities, it seems I was one of many of a growing number of young women attempting to cope with unmanageable amounts of pain and shame, frantically searching for answers to try to understand and heal ourselves, and we stumbled across an idea that seemed like a miracle cure to escape the suffocation of being a woman in a woman-hating society.” She concludes: “Women do not need to alter our bodies in any way in order to be worthy and valuable as human beings. Now we must teach our girls how to create their own rules.”

Gender fluid male with skirt fluttering in air. Tr
Gender fluid male with skirt fluttering in air. Transgender male dancing in crop top and skirt.

CHALLENGING CURRENT ATTITUDES AND TREATMENT

This year, a British GP, Dr Helen Webberley, who ran an unlicensed gender-clinic offering sex-change treatment to children as young as 13 years, has been banned from practising, charged with 29 counts of failure to provide good clinical care to child patients who received hormone treatment.

Despite all this current evidence and discussion, a South African woman psychiatrist recently urged my friend’s daughter to go on hormone treatment, assuring them that its effects are completely reversible — a claim refuted by Bell’s and Burnham’s accounts.

A supposition apparently alarmingly widespread under the guise that children should be allowed the freedom to make their own choices about their bodies and mental health — frequently encouraged to resist and even scorn their parents’ advice.

We need reminding that there are good reasons for laws against children below the age of 18 years acquiring driver’s licences, indulging in alcohol and tobacco consumption — despite all early assurances that smoking was a safe and necessary accessory to “la dolce vita”.

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Urging anyone to think it is a simple and easy decision to take life-altering hormones, even to amputate and modify healthy body parts, is blatantly irresponsible, requiring very careful monitoring. Such mutilations can desensitise erogenous zones, creating what might later come to seem — and look — like a Frankenstein body, frequently not sexually functional. A body robbed of its human vitality and potential, irreparably damaged.

LONDON, ENGLAND - DECEMBER 16: In this handout pho
LONDON, ENGLAND - DECEMBER 16: In this handout photo provided by Pepsi on April 2, 2014, singer / songwriter / producer Janelle Monae is pictured on the set of Pepsis new global commercial and interactive film, NOW IS WHAT YOU MAKE IT. The creative fuses the worlds of football and music, as part of the 2014 Pepsi Football campaign. (Photo by PepsiCo via Getty Images)
MELBOURNE, AUSTRALIA - JANUARY 13:  Ruby Rose arri
MELBOURNE, AUSTRALIA - JANUARY 13: Ruby Rose arrives at the 2019 Crown IMG Tennis Party at Crown Entertainment Complex on January 13, 2019 in Melbourne, Australia. (Photo by Sam Tabone/Getty Images)
CHICAGO, ILLINOIS - JUNE 07: Television personalit
CHICAGO, ILLINOIS - JUNE 07: Television personality Jonathan Van Ness throws the ceremonial first pitch of the game between the Chicago Cubs and the St. Louis Cardinals at Wrigley Field on June 07, 2019 in Chicago, Illinois. (Photo by Nuccio DiNuzzo/Getty Images)

All so-called gender therapists, and others, should become mindful that they, too, could be found in contravention of their responsibility of care to patients/clients by recommending radical, possibly irreversible, interventions before trying safer, talking, alternatives. Ignoring the central principle of “First, do no harm.”

Crossing lines — disrupting gender stereotypes — has created a more receptive attitude to the complex issue of human sexuality, presenting a range of possibilities across a broad spectrum. The restless, ever-seeking human mind, continually searching for new connections and meanings, exploring and celebrating vital, healthy, sexually-responsive bodies. Extending the creative potency of “female” and “male” energies. Building a gentler, more equitable, tolerant world, less separated by rigid barriers of gender expectations.

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