What follows is the introductory instalment of When Sons Become Daughters, a multi-part Quillette series that explores how parents react when a son announces he wants to be a girl—and explains why so many of these mothers and fathers believe they can’t discuss their fears and concerns with their own children, therapists, doctors, friends, and relatives.

A few months ago, I was allowed into an online group of American parents of young men who have decided that they are in fact young women. I am neither a parent, nor transgender, nor an American, and therefore a tourist: there was an understandable hesitation about letting me in. In a few cases, such parents have been harassed, as they’ve left comments online that dissent from the received wisdom on transgenderism; in all cases, they are deeply wary of rights activists. The parents are mainly, although not entirely, mothers. They and their spouses are nervous of losing their jobs, and below everything rumbles the threat that their sons might discover their communications. While most have expressed to their families their scepticism regarding their sons’ announcements, all are wary of the parent-child relationship worsening. But they did let me in, even with these fears, and took me on a whirlwind ride over the terrain of the new gender ideology.

Each week, these parents meet over Zoom. A process of vetting applies: unidentified email addresses are admitted only if someone knows of a parent waiting to join the call. This enforces a sense of camaraderie among what would otherwise be a rather disparate group. Christians and Jews mix with atheists and agnostics; single working mums of only children swap anecdotes with stay-at-home mothers with large families; Texas and Tennessee meet California and Connecticut. In these Zoom calls, parents advise and support one another, often agreeing, occasionally differing in opinion, always prizing civility and constructive conversation. They have been addressed by a variety of speakers—principally, psychotherapists critical of the new gender dogma, but also others who have rebelled against the orthodoxy of the age. Abigail Shrier—hot property since the release of her recent book, Irreversible Damage—has been among the speakers, as have psychoanalyst Lisa Marchiano, and therapists Sasha Ayad and Stella O’Malley. The parents take notes during the meetings, collating links to papers and studies as they go. They’ve spent hours researching gender identity and the medical treatments associated with transgenderism. They’re not playing around.

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Sydney. London. Toronto.

QuilletteAbigail Shrier

Opinions in the group vary. Some parents take the view that gender dysphoria is real, but grossly over-diagnosed, and certainly so in the cases of their own sons. Others are what it has become fashionable to call “biological realists” or “biological essentialists”: XX means you’re of the fairer sex; XY, and you’re a guy. But the variation of opinion on this topic rarely comes up, being displaced by more pressing matters. The parents simply cannot get their sons’ therapists to deal with comorbidities: in particular, autism spectrum disorders, ADHD, and poor communicative and social skills, often coupled with an extremely high intelligence, which leaves parents unable to find schooling that can cater to their sons’ needs. In many cases, the boys have fixated on the prospect of sex reassignment, yet seem unwilling to engage in conversation about other options. When one son is confronted with some stubborn, genetic truth that he just can’t overturn, he answers that it is “mere biology” (a dismissive approach to gender dysphoria that the philosopher Kathleen Stock has discussed in some detail). And when parents ask their sons why they want to become women, the answers can be surreal. One reportedly describes testosterone as a toxin that’s destroying society; another says that he likes lesbian porn. The influence of friends, LGBT societies, and online fora is pervasive, but their sons usually treat any discussion of social contagion as heresy. Parents feel vilified. Many of the mothers and fathers have contemplated suicide.

I have yet to hear a single parent say anything bigoted, as that term would be normally understood. Almost all of these people are liberals, certainly in the British sense of the term, and many in the American sense, too. Most have gay relatives, colleagues, or friends; none showed me, an openly gay man, any hostility whatsoever. None believe that transsexuals (a term that some trans individuals use, and which also is commonly used among biological realists) should be subject to discrimination; at least two have transsexual co-workers. These are not people who pray each night to rescue the souls of unbelievers, or long for a return to the subjugated housewifery of the 1950s. It’s simply that they don’t believe that their sons’ lives will be improved by hormones or surgery. Yet their meetings are clandestine, and the sense of fear they live with frightens me: the spectre hanging over these proceedings is hyper-liberalism at its most intolerant.

The doubts that these parents share typically arise from the way their sons describe what they’re going through. Many of the young men in question have, in moments of candour, hinted that their motivations for transition are unrelated to actual gender dysphoria. They’re lonely; they want affection; they don’t see another way to relate to girls; they don’t want to become the infamous “straight white man.” It’s interesting to me how many of these boys wax and wane: one moment, they are reportedly adamant that they will have surgery as soon as they hit 18; the next moment, they seem to be wavering, only to return to intransigence a few days later, leaving their parents’ heads spinning.

Since the publication of Irreversible Damage, there’s been more media attention surrounding transgenderism—and detransition, too, whereby trans-presenting people revert to living as a member of their biological sex. Douglas Murray’s The Madness of Crowds, which voices many of the otherwise unvoiced realities of sexual identity, has also—as its author puts it—“danced over a few landmines” when it comes to gender ideology, thereby offending the sensibilities of some institutions traditionally seen as strongly feminist.

These two works in particular have sparked growing interest about sexual and gender identity in the English-speaking world; and Quillette readers may already be familiar with some of the worrying details emerging. The high staff turnover at the UK’s GIDS Tavistock Clinic, for instance, has cast a cloud over that institution’s reputation. Former Tavistock practitioners such as Marcus Evans believe they were funnelled into recommending sexual reassignment procedures, rather than other therapies that might have alleviated young people’s underlying distress.

Healthcare researchers’ concerns over the long-term effects of transition, the pathologizing of non-conformity, the shaky nature of the evidence on mental-health outcomes, and, more generally, the breathtaking spike in cases of trans-identification once rarely made it to the surface in mainstream media outlets. Websites such as transgendertrend.com and parent-support networks such as ourduty.group sprang up to counter the prevailing narrative on transgenderism, especially when it comes to suicide, so frequently mobilized as a justification for “affirmation-only” treatment pathways. Those were often lonely voices. But in recent months, there’s been a sense that a new wind is blowing, especially now that Keira Bell has successfully taken legal action against Tavistock for rushing her through gender transition when she was a confused teenager. Brown University researcher Lisa Littman had already broached the taboo of what is now called Rapid Onset Gender Dysphoria among girls. Ms. Bell, now 23 years old, has given a face to the phenomenon.

But the more balanced media environment that now exists, welcome as it is, might be incorrectly taken by some observers to suggest that this trend barely affects boys at all. This is far from true, as the asymmetry in the numbers isn’t as stark as one might think. The number of boys showing up at the Tavistock Clinic rocketed from 24 in 2009 to 426 in 2016. While only 17.2 percent of parents participating in Littman’s study were parents of boys, the figures from the Tavistock Clinic suggest a proportion closer to 32 percent, hardly an insignificant minority.

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Many families are seeking a process that doesn’t push transition on children who struggle with their biological sex.

QuilletteStella O’Malley

This significant increase in MtF (male to female) transitions is mirrored in the wider culture, with videos and message boards bubbling up across YouTube, Reddit, and Tumblr. Many transitioners eagerly act as influencers who extend a sense of community and validation to young men struggling with pubescent feelings of inadequacy, insecurity, and isolation. In the comments sections of these sites, boys who might otherwise be overlooked find themselves showered with adulation as they profess their trans identities. Videos made by MtFtM detransitioners (that is, male to female and back to male) are also increasing in number. The proliferation of trans-identifying young women is indeed quite remarkable. But young men should not be treated as footnotes.

There’s also a lingering assumption among some that male transgenderism is confined to cross-dressing middle agers, with the odd hyper-effeminate gay man sprinkled in here or there. This dichotomy dates back to work undertaken by sexologist Ray Blanchard at the end of the last century: on the one hand, autogynaephiles (men who fetishize themselves as women); on the other hand, those a little cruelly dubbed “so gay that they go girl.” But this typology—perhaps somewhat misunderstood in the first place—has been challenged as the numbers of trans-identifying boys rise. While there are many young men who, as young boys, struck their parents as “pre-gay,” to use a term employed on the Gender: A Wider Lens podcast, there seem to be many more whose gender presentation was always unremarkable. As seven-year-olds, many would roll their eyes at anything seen as “girly,” and as 14-year-olds, some were playing first-person shooters. Moreover, autogynaephilia, although suspected by some parents, seems to be far outweighed in prevalence by cases in which a child exhibits an aversion to sexual activity overall. (In some cases, parents strongly doubt their sons have ever even masturbated, despite being well into their teens.) The overwhelming sense the parents get is that their boys are, more than anything, terrified of sex, even while they incessantly ascribe sexuality labels to themselves and to their peers.

Putting aside general concerns about gender ideology, there are medical worries that pertain specifically to males. In particular, there’s insufficient evidence to determine the efficacy or safety of hormonal treatmentsprescribed to many young men in the United States. A Swedish study has pointed out the alarmingly poor outcomes for many MtF post-operative transsexuals, suggesting that surgery is far from the mental-health panacea it is often portrayed to be. Another study shows that 19.9 percent of those taking MtF hormones stopped mid-course. Compare this to the equivalent figure for FtM (female to male) hormone treatments, which is 6.6 percent. In the same study, 23 of the 117 MtF transsexuals failed to participate in the one- to four-year follow-up, almost one-fifth of the cohort. This is a figure that might well raise eyebrows: Four years is not a long amount of time to stay in touch with a research team, particularly given the highly invasive nature of the associated surgical procedures.

Where there is discussion of transgenderism in men, it can exhibit a distorted quality. Therapist O’Malley—a co-host of the above-referenced Gender: A Wider Lens podcast, and who herself once struggled with gender dysphoria—has noted, for instance, how data from Brazil radically shift the global statistics on murders of MtF transgender victims. In Brazil, this form of transgenderism is often closely associated with prostitution—and prostitutes are far more likely to be victims of murder, regardless of their gender identity. (Statistics offered up as part of the debate on the subject in the United States are usually international, and fail to recognize significant differences among countries.) The skewed numbers that result cast men who have undergone sex-reassignment surgery as being at a vastly elevated risk for violence, when this may not necessarily be the case in the average English-speaking country. Parents report that many teachers present MtF transsexuals as a constantly endangered minority, navigating between one life-threatening encounter and the next. While it is clear that many of these individuals will face daily struggles to be accepted, prostitutes operating on the streets of Recife have little in common with office workers dealing with tactless comments in the HR-regulated cubicles of urban America.

My interest in this subject, more than anything else, is as a storyteller. I want to show how these parents are being made to feel; how their sons are at risk of being led astray by adults behaving with what appears to be an unconscionable sense of narcissism veiled as concern; and how the families being victimized by this mania have been blamed for their own suffering.

I am not a neutral party. Over time, I have become embedded within this community of parents, who see me as an advocate. In the process, I have also become a journalist, pretty much by accident. Trans activists, feminists, men’s rights advocates, LGBT associations, religious groups, and others besides have weighed in on the topic of transgenderism, each providing a distinct point of view, each with its own internal inconsistencies and ideological slants. I don’t see why these parents should be excluded from the discussion simply because they, too, may come to it with their own biases, and in their own self-selecting company. While some readers might object to my subjective stance and the protocols I’ve described, I’ll defend them by pointing out that I at least acknowledge them. Not everyone can say the same.

An Interview With Lisa Littman, Who Coined the Term ‘Rapid Onset Gender Dysphoria’

Sydney. London. Toronto.

QuilletteJonathan Kay

To tell these stories, I conducted interviews with parents, as well as others who have questioned the prevailing orthodoxy on male-to-female transition. My interviewees allowed me to record audio of our exchanges, giving me extraordinary entrée into their lives. This process also placed them at real risk in the process, as they had no guarantee that I would act ethically. In keeping with my editor’s suggestions, I’ve written up these interviews as short essays, for which this text serves as introduction. I will admit plainly (as my editor instructed me to do) that I received explicit authorization from the parents for every word of the reporting that follows: The reputational damage they would endure, and the exposure of their families to abuse, would be severe if I failed to anonymize their stories adequately. And so they have seen these accounts before readers did, as with an authorized biography.

But while the essays centre on the parents’ testimonies, I am their sole author. On occasion, parents wanted me to place more emphasis on this or on that point, and I had to find a polite way to decline. No parent co-wrote my words, nor dictated my ultimate conclusions. None sought to commandeer the process. Talking to me is only one of many ways in which these parents can—and may yet—communicate to the wider world what they are going through. While I am an ally, to adopt the common parlance, I am not a mouthpiece. As such, readers should attribute any fault, omission, or excess rumination to me, and not to the mothers and fathers who allowed me to tell their stories.

Angus Fox (a pseudonym) is an academic working in an unrelated field of study. He can be contacted at [email protected].