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When Sons Become Daughters, Part II: Parents of Transitioning Boys Speak Out on Their Own Suffering

This isn’t to say that all causes of transgenderism are exogenous: the presence of neuro-atypical cognition comes up over and over, as does the sons’ process of discovering (or rejecting) their sexuality.

· 32 min read
When Sons Become Daughters, Part II: Parents of Transitioning Boys Speak Out on Their Own Suffering

What follows is the second 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. To find out more about how the author collected and reported information, please refer to his introductory essay in this series.

 

Blindsided

You don’t have to spend long with Christine to get an idea of the kind of woman she is. She’s modest—perhaps even diffident—at first, and when we get to talking, I realize I interrupt her too much. But then, you begin to understand: this woman is a serious success story. She loves her work, and it’s pretty exciting work, too. I’m envious. She wouldn’t volunteer the information, but I bet she has a few people she could fire, if she wanted to. I could be wrong, but I’ll never know, because she wouldn’t let on if she did.

Christine was the tortoise; her sisters were the hares. She started off slow, at least by comparison with them; while they shot off into the world of dating, Christine was lagging behind, something which she attributes to “slow processing.” It always took her just that little bit longer to strike out, especially when it came to relationships. Yet she is now a higher achiever than any of her siblings. So when I ask her how her son Max’s claim to be female has affected her, I am taken aback by her answer. “It has totally ruined my life,” she says, plainly. “It has just—made me give up on what I thought was real life.” I find myself wondering how her colleagues would react to such a statement.

Max, like his mother, processes slowly; and it’s this factor, first identified by a therapist when Max was eight, which Christine believes to be at the bottom of his new trans identity. The therapist used the phrase “processing disorder,” which I find a vague term; so Christine explains. When Max’s teachers gave him an assignment in class, he would sit and stare at it—not because he didn’t understand the task, but because he wanted to find the best approach. It isn’t just a resemblance to his mother: Max’s paternal aunt, too, is unusually clever, but a social klutz; other family members, on both sides, had sometimes “tripped over the long swords of their intelligence,” to paraphrase Allen Ginsberg. So here you have a nerdy kid—but don’t let that fool you. Tall, athletic, and masculine, Max is not the Dexter of Dexter’s Laboratory, nor Milhouse Van Houten from The Simpsons. He wasn’t just smart, but sporty, too, hiking with his parents and playing soccer for his high-school team. And up to the age of 13, everything was going broadly to plan.

But then, he turned 14, and got cut from the team; and at this point, he turned in on himself. Quite suddenly, Christine found that her son was shutting himself away in the small office room at the top of the house. He became sullen, and disrespectful to his parents, and as winter came, Christine found it harder and harder to enjoy her son’s company—that is, on the increasingly rare occasions it was bestowed on her. “Try out for lacrosse,” she suggested; and he did, and that distracted him for a while. But he soon lost interest. He started cutting down on the meat in his diet, surreptitiously at first, and then more noticeably, shedding a few pounds in the process. She discovered he was sitting alone at lunch, texting a friend he knew from years back, while all his soccer buddies sat together somewhere else. He’d become miserable.

None of this is necessarily unusual. I think of the British TV sketch show, Harry Enfield and Chums, with its famous (although now horribly dated) “Kevin the Teenager” character. At the moment Kevin turns 13, he undergoes a monstrous transformation: out of a sweet-natured “tweenage” boy bursts, Hulk-like, a whining, gangly-limbed adolescent, dressed for dumpster-diving. Parents—of boys and girls—are usually ready for this kind of change, and sometimes kids just go through phases. Max certainly did: as a toddler, he was obsessed by trains; then it was cars. She put his latest fixation down to puberty, and losing his spot on the soccer team; and also to slow processing, as Max would need more time than most of his peers for these events to percolate.

So when Max told her he was trans, her immediate instinct was, “no, you’re not.” She almost felt annoyed by what he’d said. She’d worked alongside transsexuals before, and come to know them well enough to ask questions about their experiences, and how they saw themselves in the world. (“Transsexual” is a term that some trans individuals use to describe themselves, and which I prefer for reasons explained in the first instalment of this series.)

Max’s was an Internet self-diagnosis, which is what frustrated Christine more than anything else. He knew that he could talk anything through with her. They’d already had the talk about sexuality, when Christine had assured him that his parents would support him no matter who he was. There had been passing mention of bisexuality, but that’s hardly headline news. If he’d genuinely had dysphoric feelings, these would have come out in a way that she would have noticed; yet Max’s trans identity was presented as a finished package. He was trans; he wanted hormones; he wanted surgery. He didn’t want to debate it.

Christine was wrung out—not just from the announcement, but also the 70-hour week she was putting in. The last thing she needed was to spend her precious home time listening to canned phrases regurgitated from social media. “I thought: nip it in the bud,” she says. So off Max went to the paediatric specialist. Much to Christine’s relief, the paediatrician concurred that puberty blockers were certainly not right for Max, if indeed for anyone. But he also seemed sympathetic to the idea that Max’s pronouncement might be related to ADHD, and the processing disorder identified some years before; so the family were then referred onwards, to an ADHD specialist.

That specialist confirmed that Max did in fact have ADHD, but suggested another onward referral, this time to a neuropsychologist. When Christine baulked at the price tag that apparently goes with Californian neuropsychologists, a different suggestion emerged: that Max be seen by a different specialist, whose expertise extended not only to ADHD but also to gender. A generous interpretation of these referrals is that healthcare professionals seem keen to leave gender issues to the gender specialists. A cynic might argue that a lot of people want to wash their hands of anything to do with transgenderism. Both views might be right.

So, finally, Max saw the gender specialist. Christine couldn’t go: it was in the middle of one of her busy weeks, so her husband took Max instead. She was shocked at what her husband told her when he returned from the clinic. Apparently, Max was suddenly at a vastly elevated risk of suicide, simply as a result of his newfound belief. Any questioning of that belief—its origin, its authenticity, its intent—had been neatly parked at the side of the road. The specialist was quite insistent that Max’s skyrocketing death risk was the only matter worth discussion. As soon as her schedule permitted, Christine booked a meeting for all three members of the family together. The specialist, a qualified psychiatrist, seemed to have lost interest in ADHD altogether. It was now all about trans. Specifically, they were told that 44 percent of trans kids will kill themselves if they don’t transition (completely untrue, as it turns out); that he’d never change his mind (also untrue); and that the only way to help him was to support his transition. “Maybe you should get used to saying ‘she’ and ‘her,’ the specialist said.” All of these statements were made in front of Max, adding a science-coloured gloss to this masculine young man’s asserted femininity.

At this point, Christine says she became “unglued.” For her, Parenting 101 was: You don’t give control to the child, ever. If all the parents’ power evaporates, what’s left is a boy in charge of his own family. This specialist certainly didn’t have a teenager of his own, but had the confidence of a fresh-faced 30-year-old product of fully awokened American academia. Christine was angry, but managed to stay civil: the specialist’s input was no longer needed. For his part, the psychiatrist was taken aback. The idea that his methodology was flawed had not occurred to him. However, everyone involved managed to remain polite.

Christine couldn’t leave her son stranded in such a state of depression. So she managed—on the same day—to get to another gender specialist, now without Max, in the hope that this one would be able to see beyond the new identity to the comorbidities behind it.

Gender specialist number two turned out to be a warm, comforting woman whose daughter had become a trans man: she presumably understood the complexities of identity. But here, too, it was “affirmation” all round. The specialist’s mother-in-law, Christine learned, had never seen her grandson (née granddaughter) so happy as he (née she) was after his (née her) transition. While this woman did seem invested in helping Christine and her son, she expressed certainty that Max would never change his mind.

Christine felt blindsided. By the evening, she was lying on the couch, crying, and it was her son who ended up trying to console her. “Why do you think you’re trans?” she asked. His response, more candid than anything he’d told the specialists: he liked lesbian porn and romcoms.

Max began to cry in the shower. He left the bathroom cabinet open, so he didn’t have to see the mirror. He started shaving his body—even his arms, despite Christine pointing out that very few women shave all the hair off their arms. Each shaving session was taking over an hour; it became a nightmare to get Max to school on time. And as his mood deteriorated, so did Christine’s. She thought about her own death more and more often—not the theatre of suicide, but a quieter death that would not humiliate her family. She wondered whether she might get cancer, or whether she might get blindsided on the road. She kept on thinking about “just disappearing”: taking herself off somewhere, never to return—although she didn’t know where, and the COVID-19 pandemic made such fantasies even less realistic. A further psychiatrist prescribed both mother and son with Zoloft, which helped each of them, a little.

At this point, Christine went back to square one, and got in contact with the therapist Max had seen when he was eight. This was at least someone who had some broader context, and whose input had been positive in the past. That therapist’s wife was also a therapist, and the two of them shared a practice in the same building; so, while the husband spoke with Max, the wife spoke with Christine. Finally, it seemed to Christine that she had found some rare voices of sanity.

But then, she overheard Max’s therapist tell him that his parents would have to accept their “daughter” one day; so Christine withdrew her son and herself from the practice. Even after the professional relationship had been terminated, however, Max was suggesting a compromise: that all three family members take part in a subsequent Zoom call. The therapist said that no, it should only be Max. When Christine and her husband appeared on screen as the call began, she reports, the therapist lost it.

This story is familiar to many parents with whom I’ve spoken. They call the phenomenon “institutional capture”: healthcare practitioners are either indoctrinated with absolutist beliefs about gender identity that would have been seen as radical until just a few years ago, or are so terrified of running afoul of affirmation dogmas that they simply refer patients on to someone else. As a result, Christine’s trust in the medical profession has collapsed. “In California, you have no power,” she tells me.

But it isn’t just in California, I’ve learned. All across the English-speaking world, many of the professionals to whom parents have turned for guidance now appear to have embraced priorities that diverge from the well-being of the children they treat. Rational analysis is out; gender justice is in.

In some ways, Christine and Max’s story is typical: a gifted boy with the common comorbidities of trans presentation (in this case, depression and ADHD) suddenly presenting himself as dysphoric in a way that a parent struggles to interpret as authentic. In other ways, the case is atypical: Max is conventionally athletic, for example, a characteristic that rarely correlates. But this phenomenon of institutional capture is a universal element in the stories I’ve heard. Christine uses the word “blindsided” to describe her reaction to the manner by which professionals seem to have all been enlisted in the same cultish outlook. A hyper-relativist interpretation of anything pertaining to gender is now simply ubiquitous in clinics and therapeutic practices. And while there may be plenty of therapists and doctors who disagree with it, few have the courage to speak out openly.

Today, Max’s story isn’t as bleak as it once seemed. He still talks about gender fluidity and such, eagerly encouraged by his school, of course. But he’s happier, now. The claims of dysphoric feelings about his hair have died down, for instance. He seems more at ease within his own body, and within the home. His anti-depressant dosage has been reduced, too. The hard line that Christine took—no new pronouns, no new names, no hormones—seems to have worked. She feels closer to her son than she has for some months; and to her husband, too. When we spoke, Max was reading Animal Farm, which Christine hopes might jolt him into a little more critical thinking. He says he worries about child exploitation at the hands of multinational conglomerates. Christine isn’t going to point out how many young people are signing themselves up for a lifetime of medical bills as a result of sex-reassignment surgery; she’s waiting for that penny to drop by itself.

But in some ways, she’ll never be the woman she once was. She doesn’t want grandchildren, Christine now says: she couldn’t bear the idea of refighting this battle. And she is jaded about the forces at play in the world, as well as disillusioned by the apathy (or ignorance) of those whose families have yet to be caught up in this. “I thought that if you loved a child, they’d be okay,” she says. “It’s not true.”

When Sons Become Daughters, Part III: Parents of Transitioning Boys Speak Out on Their Own Suffering
Sydney. London. Toronto.

The Island of Misfit Toys

Diane speaks to me from the parking lot of her local Walmart. She mentions that the store’s WiFi signal is strong, and that the Internet connection at her home often drops out. But she also says that this arrangement allows her to speak freely. As we talk, it becomes clear to me that Diane feels there are fewer and fewer chances to do so. With a blue, chilly-looking December sky framing the background to our video call through the rear windscreen of Diane’s car, she starts to talk.

In some ways, we’re from different backgrounds, yet we quickly find that it is easy to open up to one another: she tells me about some of the decisions she made as a young woman at college, and how she came to regret them; I tell her I don’t really believe there’s such a thing as a “gay community.” The longer we speak, the more we find ourselves diving off at tangents, and I don’t think either of us expected to find the other so similar in beliefs. My own bigotry: only a few years ago, I would have assumed—utterly unfairly—that Diane was too conservative to befriend the likes of me. Born 1961, she is Irish Catholic, and speaks with Chicago vowels. These she apologizes for, which begins another tangential conversation about accents and self-deprecation, and where the Midwest starts and ends. In relation to her youngest, Michael, she counts as an “older mother”—untrue of her two other kids, who are a good decade senior. They’re the classic American family: passionately liberal kids, bemused conservative parents, and no-one can say the “T-word” without a verbal brawl. But for Michael, the generational difference is more existential than for the rest.

Michael’s development was splintered. As a child with Asperger syndrome, his communicative skills with adults were eerily precocious. “I really appreciate everything you did today,” he said to Diane on his sixth birthday, where other kids would just have chirped “thanks, Mommy!” But Michael could barely interact with his peers without a fight starting. It wasn’t that he ever started the fight, but he simply couldn’t react to those around him when they overstepped what he perceived to be a line. If he lost a board game, it didn’t faze him at all; if you changed the rules halfway through, you got war. The teachers called Diane in more than once; but they were progressive enough to understand that Michael’s social setbacks shouldn’t prevent him from excelling academically, especially given how bright he was. Diane could be forgiven for thinking that the changes that had rolled through the schooling system over the course of her lifetime were genuinely positive.

But as the years passed, Diane found that Michael wasn’t learning maths in maths class, so much as he was tutoring the other kids, instead. Diane moved him to a different school; but he was still unhappy. He never got invited to other kids’ birthdays—or, if he did, it was as a favour to Diane. She never had this problem with her older kids, and was unsure how to react when she saw her 11-year-old chattering away with his teachers—especially the male teachers—when he was so hapless with his peers. What were they talking about? Mortgages?

There was a brief relationship with a girl, whom Michael took to a school dance. It was clear to Diane that what Michael wanted from this young lady was friendship; but there was something sweet about how he wanted to look good for his new belle, how he picked out the perfect rose to give her for the occasion. It became a platonic infatuation, and an unrequited infatuation at that. She broke up with him, causing Michael to hurl himself at the school counsellor, and sob and sob and sob. Scroll forward eight months, and Michael was non-binary; a couple of weeks later, he said he was actually a girl.

This bent Diane’s brains. First, it was clear to her that he wasn’t non-binary, nor a girl, nor anything other than a lonely boy who had a little too much riding on a youthful crush. But he’d never been feminine: that was certain. In fact, Diane bought him a light pink polo shirt to wear to a family party, and he was so aggrieved at this rupture of the only-girls-wear-pink rule that she had to get a refund. He never played with his older sister’s toys; he’d once listed all the girls in his class whom he’d decided were pretty. It all seemed to come out of nowhere. But while the announcement seemed bizarre, Diane recognized the black-and-white thinking for what it was. Michael lurched to an extreme. “He said, ‘if I could cut off my you-know-what, I would,’” Diane says—but she’s still not sure if he meant it, or said it because it was required by the category into which he’d placed himself. He said he was bisexual, but Diane strongly doubts he’s had any sexual or romantic interactions with anyone of either sex. In fact, she’s not even sure he’s ever masturbated. But any attempt to raise the topic of sexual activity with her son is quickly flattened.

Michael’s older brother, long out of college by this point, had a theory: guys can be jerks, and Michael was hearing their accusations that he wasn’t really a “man” as a genuine belief, rather than being part of the cruel typology of jocks and dweebs. (I tell Diane that I partly blame Friends—Chandler, Ross and Joey were all so nice, and tricked us into thinking that all men were “new men” from the mid-90s onwards—and Diane seems to agree.) Michael had different options than his brother’s generation; indeed, he told his father that he “didn’t know being a girl was an option.” It was an avenue to explore; things might get better if he followed it.

And in one sense, things did get better. Suddenly, as a “trans girl,” Michael had a reason why he didn’t fit in. This came with a pre-loaded peer group—all female—whom Diane and her husband secretly refer to collectively as “the Island of Misfit Toys.” Two girls are bisexual; but they’re all a little bit different in one way or another, which helps them in some sense to be all a little bit the same. One day, when Michael was outside doing chores, he turned to his mother to announce: “I had a miserable childhood, and I’m not having a miserable teenage.” On the Island of Misfit Toys, Michael still gets to go to college to study astrophysics. But he also gets the girls. He gets invited places. One of the girls from the island sent a Christmas card in the post, with Michael’s new, female name spangled across the front in weirdly oversized letters, to hammer home the point. Diane began to see that she was the villain of this piece, as it was seen from the island’s shores.

At school, clothing quickly became an issue. The expectations for boys were strict: no blue jeans, shirts tucked in. Girls—including, of course, “trans girls”—had more freedom, with only a few rules about midriffs and skirt lengths to constrain them. This suddenly became a battleground on which Michael’s new identity would be fought; and so Diane and her husband went to see the school principal and the counsellor. She quickly realized it was going to be a negotiation with them, rather than a consultation with her. They simply refused to believe that her son was a victim of a trend. Nor would they listen to the statistics on the ballooning number of trans-identifying children which she’d researched, hoping that they might be open to quantitative evidence. “That’s just because there’s more acceptance,” the principal said dismissively. “So why didn’t gay marriage create more gays?” Diane countered; but she never got an answer.

Other parents had “affirmed,” she was told—the implication being that this was easier, and probably better, regardless of her son’s character, condition, or history. A compromise was reached: Michael would dress androgynously. In the home, this détente turned out to be more capitulation than compromise: unisex plaid shirts became bright Hawaiian flowers; bright Hawaiian flowers became delicate, pastel flowers. Michael smuggled clothing out of the house, and got changed halfway between home and school.

The school had policies on pronouns, too. Diane suggested that while the teachers could refer to Michael as “she” and “her,” they could use “he” and “him” when discussing her son with his parents. But this, the principal said, would be unfair to the teachers. The revolution in education, Diane concluded, had not been as child-focused as it had claimed to be: the child’s right to live in a cohesive family environment gives way to the teacher’s right to work in a cohesive professional environment. Parents have to juggle dual identities so that teachers don’t have to. “It was like the principal was trying to prove a point,” says Diane. “That we’re not ‘affirming.’ Like he was giving us the middle finger.”

In hindsight, Diane regrets a lot of the ground she ceded in these minor wars with the school. But it was hard to know what else to do: suicide was mentioned, not as an imminent threat, but as a serious and permanent concern, like rising sea levels. When the career counsellor said “she” to refer to Diane’s son, Diane had a moment of revelation: there was no compromise with this logic. “My son is a boy,” she said loudly. “And his name is Michael. And he’s always going to be a boy.” The wall of pick-your-pronouns met the wall of reality. Diane felt like she might have been rude; then, she realized she didn’t care. The rest of the meeting was spent walking on eggshells.

The peak of intransigence came at the beginning of a warm South Carolina autumn, at the school’s traditional meet-and-greet picnic, where students, teachers, and staff would mingle with one another, emphasizing the school’s desire to build a community. Formal electronic invitations were sent out: Michael’s contained his female name, and the word “her.” Diane was so upset at the sight of it that her husband had to edit it on the computer, switching female for male. So she phoned the school for assurance. Would they be referring to her son as female in front of all the other parents and kids? she asked them. And they promised her that no, they would not: the meet-and-greet policy was strictly gender neutral.

It wasn’t. The school had lied. When another mother sidled up to Diane to ask about a certain girl mentioned by a teacher, and whether Diane knew who she was, Diane realized with horror that the girl in question was in fact her son. When she told the mother, Diane was congratulated: how wonderful, that her daughter was trans. The mother realized that Diane didn’t share those feelings, and sidled back off. For the rest of the afternoon, it was like there was an exclusion zone around Diane and her husband, keeping other parents at a safe distance. Some, she believes, were hostile; others just didn’t know what to say. She wishes she’d never gone; the whole episode was so stressful that she wound up at the doctor’s office. It’s almost impossible to see the school’s attitude as reasonable, given the promise made to Diane, and easy to see it as hostile. Only a few years ago, it was unthinkable that a school would debate a child’s name with his parents; and they certainly wouldn’t have gotten away with lying about what they were calling him.

When I ask Diane about how her son’s decision to live as a girl has impacted her mental health, her response is saddening. She’d seriously contemplated suicide, more than once. “So that’s how someone gets to this point,” she recalls realizing. It wasn’t just losing the boy she thought she had; she was put down by others for her entirely normal responses to the situation. Her marriage was under a huge amount of stress, as her husband was not as consumed by the situation in the household as she was. When a neighbour suggested that she just “get over it,” Diane’s Midwestern politeness held up; but the reactions to her concerns about her son’s future have shaken her faith in her community, if not in humanity more broadly. Valentine’s Day, the day of the big announcement, is permanently ruined.

“I’d have sent him to a decent public school,” Diane says. That, she believes, would have given Michael a wider pool of friends. His private school was too preppy, too middle-class, too susceptible to ideology. I wonder whether the grass is always a little bit greener on the other half of the public/private divide: Diane wants to find fault in herself, as that fault would be within her own control.

Today, Michael is still insistent: he’ll take hormones, and have surgery. But their agreement—which Diane intends to enforce, without compromise—is that he has to wait until after college, which she hopes will “buy him time.” She wants something to shake him out of the desire to modify his body so drastically. In the meantime, the sense of loss over her son of 15 years is hard to overcome. The way Diane was treated, by the school in particular, was worse than any other parent I have spoken to. Teachers on a permanent hunt for victims don’t seem to realize that they’re victimizing women such as Diane, scorning them without any regard for their wellbeing.

“I have the right to my own soul,” Diane told her son, when he was deep in the mire of establishing his new identity. But she feels this right is being eroded—and she’s certainly not the only woman to feel this way.

When Sons Become Daughters, Part IV: Parents of Transitioning Boys Speak Out on Their Own Suffering
Sydney. London. Toronto.

Cheerleaders

Anne’s story has several of the now-familiar elements: Her son, Christopher, has a knock-it-out-of-the-park IQ, and an autism-spectrum diagnosis. While other kids were still mastering the alphabet, he was reading the staff memo that a teacher had left pinned to the wall. His autism often comes to the surface in ways that may surprise people who don’t know much about the condition: he hums, a lot, often a little intrusively if you’re not expecting it; when he was younger, he liked to spin around in circles in the playground. Anne was lucky enough to live near a selective public school in Delaware, with a reputation for getting excellent results with smart kids. She enrolled him there, and then watched him flourish.

And then puberty hit. There was a Thanksgiving so testy that Anne and her husband almost cut short a family stay in Boston, as neither of their children seemed able to communicate civilly with anyone else. As Christopher became more internalized, Anne’s daughter Katie—two years her brother’s junior—was also confronting uncomfortable changes, bodily and otherwise. But the two of them had always been close, and Anne was confident that they could ride out the turbulence of their teenage years together.

Both kids were getting political, and Anne certainly wasn’t going to discourage that, aware that each generation shakes its parents’ conscience in unforeseen ways. But the depression in her son, in particular, was troubling; so, like any good mother, she e-snooped.

Her son had created a new identity for himself, with a new name inspired by a female anime character with spherical breasts; out of this new identity flowed new friendships and new avenues of self-exploration. Mother and son had a conversation, and he told her he was trans. It turned out that Katie had known about this for some time, as she moved in the same digital circles as her brother.

Christopher showed no signs of gender non-conformity. Sexually, he seems to be straight (which is to say, he sees himself as a lesbian). Anne had taken to heart the idea that “trans women are women”—and still does believe that, for some, this adage applies; she wouldn’t wish a transsexual anything other than to be accepted within his or her community, with all the protections from harm and harassment that entails. She hadn’t guessed that Christopher would become a transsexual, but she decided to do what she could to support him, tentatively using the new name and the requested female pronouns.

Only when she began to research the connections between Autism spectrum disorder, transgenderism, and intelligence did she realize that her son, quirky as he was, wasn’t such a rare specimen as she’d imagined. Two other students at Christopher’s tiny school alone also said they were trans. His new Internet-enabled peer group was saturated with gender non-conformity; transgender identities were common, and heterosexuality was relatively rare.

Armed with an inquiring mind and some free time, Anne began to make contact with similarly situated parents. It was then that Anne realized that her son had been swept up in a craze, with multiple, complex causes—and, if handled badly, terrifying consequences. She listened to the detransitioners’ stories not as a political actor but as a mother. For Anne, the low bone density caused by puberty blockers isn’t some abstract symptom, to be weighed against other abstract factors in a debate about medical policy. It’s her son’s future. It’s the prospect that he might wind up with osteoporosis—not to mention a dozen other possible conditions.

By this stage, Katie—also smart, though not in the same immediately striking way as Christopher—was developing a militant streak. Here again, Anne can see both sides of the story: after all, female activism got us female suffrage. But Katie’s keen sense of justice was moving from passion to fixation, and everything was political. When George Floyd was killed, Katie wanted to start a fundraiser; Anne didn’t discourage her. Yet it wasn’t just that Black Lives Matter: it was that racism permeated every nook and cranny of our society. It wasn’t just that Trans Lives Matter: transphobia was lurking behind every corner.

Katie’s approval of her brother’s new identity went beyond staunch. And she became a sort of enforcer within their household, almost as though her brother’s transition meant more to her than it did to him. When Anne would say “your sibling” as a neutral formulation, the response from Katie was a hard “my sister.” Christopher’s real name was a “dead name,” not to be spoken. Artwork he’d done as a young kid, with “Christopher” painted neatly at the bottom, was to be kept away from him, in case it caused him dysphoria.

And now Anne is getting worried. Will her daughter’s fervent idealism lead her down the same path? Before she’d learned about the spiralling incidence of transgenderism, Anne wouldn’t have thought much of Katie’s declaration that she was bisexual, quickly followed by lesbian; but sexual orientation now seems to be muddled with gender identity among this generation. (While readers may see Anne as dismissive about Katie’s sexuality, she situates herself on the left side of the American political spectrum, and tells me she’s proud to have donated funds to the campaign for gay marriage.)

At the same time, Anne is blessed with two children who actually get along, and neither child is acting out of malice toward the other or anyone else. So Anne treads a fine line, pushing back where she can, keeping shtum when she needs to, hoping that her children’s love for one another doesn’t steer her son towards medicalization.

In many of these stories—including those of Christine and Diane, described above, though I did not mention it in those narratives—there is a girl such as Katie who acts as a cheerleader for the trans-presenting boy. Anne’s case is notable in that Katie is a sister, whereas in Christine and Diane’s cases, the equivalent role is played by a girlfriend. In all three instances, the cheerleader figure identifies herself as bisexual, and has deep, perhaps even all-consuming, political convictions. In later interviews, a mother would say to me, “he had this friend, who’s a girl…,” and I’d compose what comes next in my mind.

My interviewees have implied that these young women’s sexual identities are somehow inauthentic. Maybe their professed bisexuality is a political statement; maybe, as one parent puts it, it’s a form of play-acting, or even a sort of holding pattern until their internal feelings become clearer. Several parents told me they suspect that these children feel a huge pressure to flee from the perceived ogres of heterosexuality and cisnormativity; and to present as nominally bisexual signals progressive open-mindedness.

In these cases, the boy’s mother sees the girl as encouraging or even enforcing the boy’s experimentation with gender. In one case I observed, the girl self-described as non-binary, transforming from Olivia to Olly, and wanting to go by “they” and “them.” But it’s notable that, in the cases I’ve investigated, these cheerleader characters don’t claim to be trans themselves, and the relatively limited genderbending these girls exhibit seems to be cosmetic. The girls support the boy’s desire to take hormones, but don’t want hormones themselves. In one case, the boy tells his parents that he’s going to the mall, but doesn’t tell them that the girl, on her parents’ dime, will be buying him a new, female wardrobe.

Where these relationships are non-familial, it isn’t quite clear what the word “girlfriend” implies. Texts are exchanged, sometimes quasi-sexual; but when I ask the mothers if the two have had sex, my interviewees typically say they don’t think they have. They may not even have reached first base. I get the strong impression that, like Katie, these girls are simply the boys’ best friends.

Given that I am speaking with open-minded American women, I ask a rude question: Is it possible their son’s transgender identity results from being programmed by this charismatic girl figure? All of them—including Anne—agreed that there might be something in this idea, and these are not women who stand for woman-bashing.

The effect of social contagion in regard to the modern phenomenon of transgenderism has been well-documented by Abigail Shrier and others. Whether it’s eating disorders or skin-cutting, females typically are more susceptible to peer-transmitted crazes centered on bodily rejection. And so one possible reason why young women are more likely than young men to describe themselves as trans is that, while girls and boys are both vulnerable to this particular type of social contagion, the girls are more likely to spread the message to others in their peer group.

An ungenerous depiction would cast Katie, and other girls like her, as manipulative agents, treating boys as accessories to their own ideological fixations. And the mothers I’ve spoken to understandably feel somewhat resentful of these girls’ behaviour. But they are also aware that today’s young women—bombarded by sexual imagery, hyper-aware of self-image, privilege, and prejudice—may simply be reacting to their environments.

Anne is in a unique position: Unlike Christine and Diane, she can’t try to pivot her son away from his greatest cheerleader, as that cheerleader also happens to be her daughter. So far, her high-wire parenting strategy has managed to keep her family from falling apart. But it may not work forever.

When Sons Become Daughters, Part V: The Links Between Trans Identity, Gifted Minds, Categorical Thinking—And Anime
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When Sam disclosed to his mother, Ellen, that he was bisexual, she didn’t provide him with the celebratory fireworks he’d apparently expected. Ellen, a rational-seeming, politically liberal Massachusetts parent with a background in microbiology, suggested that Sam take time to think about things. After all, she pointed out, he might be gay, which would also be fine—but he shouldn’t rush to any conclusions. Ellen’s husband, a paediatrician, agreed.

Ellen connects the anti-climactic nature of Sam’s disclosure to his further revelation, a few months later, that he was transgender. Sam had asked his mother to take him shopping; and, after a couple of hours of symbolic, purchase-less schlepping from store to store, he finally plucked up the courage to buy what he’d wanted all along, which was a girl’s jersey. There were tears in the car, and he told his mother that he wanted to show her his “other” Twitter profile when they got home. This turned out to be his trans account, heavily inspired by the visual aesthetic of Japanese anime. Sam had been using it to pour out his teenage angst to his few followers, while exploring his trans identity as he did so. He said he wanted to take cross-sex hormones, and have surgery, although the endpoint of that process wasn’t quite clear. He certainly wanted breasts; but didn’t seem sure of what he wanted south of the border.

Ellen realized that this new, curated identity was closely linked to other developments that she’d found rather strange. Like many young men of his generation, many of Sam’s schoolfriends—especially the girls—were coming out as bi or trans. This seemed important to him, especially when it came to one girl in particular; but Ellen put that down to a teenage crush.

One thing that struck Ellen was how intimately her son was associating anime—Japanese animation—with the drive to become female. He’d long been obsessed with an online gamer called Queeb, who dressed up as female characters from popular online role-playing games. As Queeb branched out from live-commentary gaming on platforms such as Twitch and Discord, and began to style himself as a big-breasted, tight-waisted female superhero, his popularity spiked. Sam saw him as a role model. He was going to buy a similar costume and take photos of himself so he could post them on social media.

The photos, for Ellen, were a red line. She wants her child to have autonomy, but also wants to protect him from exposure in the public sphere. She doesn’t want his teenage experiments and indiscretions to be part of his permanent online record.

Ellen pointed out to her son that he was unlikely to replicate the social-media success of Queeb, who evidently spent many hours on hair and make-up to create hyper-realistic effects. In the end, Sam did take his pictures, but under Ellen’s supervision; in them, her son looked coquettish, and Ellen had to explain that he looked like he was flirting. I ask her whether she thinks Sam knew what he was doing, but was too embarrassed by his fledgling sexuality to admit it—or, on the other hand, genuinely didn’t understand the signals he was putting out to the world. She isn’t quite sure. (When I ask Ellen for details about the outfits, she says that he was going for the look of a super-slick anime girl in a tight white body suit, drawing particular focus to the breasts and backside. But the actual result was, well, different.)

At this point, Ellen and her husband were worried. Their son’s claim to be bisexual didn’t faze them at all; as Gen X-ers, they’d known bisexuals. They’d also passed through their own edgy and exploratory phases, and know that Gen Z is even more open to experimentation with sexual identity. But their son’s social-media activity was evidently much darker than they’d thought: He presented as depressed. He said he wanted to run away. This didn’t seem to go with his everyday real-life behaviour, which seemed happy. He got excellent grades at school, stuck to his normal bedtimes, and maintained his friendships. Ellen and her husband took Sam’s Internet-connected devices away for a month, to see if things would settle down.

But things did not settle down. Sam began looking into whether or not he could get puberty blockers without parental consent. He obsessed over the shape of his face as it developed, as it took him further away from the desired aesthetic of his anime alter-ego. Most worryingly, he didn’t think there was anything odd about developing large breasts while retaining male genitalia; he presented this ideal to his parents as though it were normal, not realizing how drastically it would shrink the range of relationships available to him. Ellen even wonders if he believes that this choice would serve to increase his sexual and romantic options.

Sam’s parents have always been keen not to over-analyze their children, which Ellen describes as an occupational hazard among paediatricians. Her husband always considered Sam to be “at the edge of the spectrum,” but neither wanted to place too much emphasis on his more exceptional qualities, so that he’d be free to develop his character in his own time. She supports cross-sex hormone use and sexual reassignment surgery in cases where there seems to be no alternative. But her son hasn’t even begun to explore his alternatives, and she doesn’t think his word-for-word repetition of Internet-cadged mantras is enough to justify such a drastic step. She wants to prepare him for independence, not shift him onto the next parent figure, whether that’s a therapist or a pharmaceuticals company.

Determined to stop him from acting before he could understand the consequences, Ellen sought help from so-called “gender critical” therapists—therapists who reject the idea that reflexive affirmation is the best way to treat teenagers such as Sam—hoping they could disentangle the threads of her son’s new identity.

Throughout our conversations, a thought keeps occurring to me: Sam’s journey seems oddly reactive. He keeps bouncing his declarations and postures off his parents, even showing them his social media feeds, and seems highly focused on their reactions. Ellen calls it a sort of “dance”: Her son wants to put his parents in a box labelled “conservative,” thereby giving him a force to rebel against. But he got the wrong parents for that. One day, Ellen tested the waters. “I can try calling you she if you really want,” she suggested. But Sam said that no, she shouldn’t, because she wouldn’t really mean it. “Well let’s just give it a go anyway,” Ellen responded. But when she did, he looked distinctly uncomfortable, and that was the end of that.

We talk about gaming, and how it has developed over our lifetimes. I think back to the “Player Select” screens of Streets of Rage, Mortal Kombat, and other 1990s-era videogames. One of my secret pleasures consisted of scrolling between the available avatars to pick my favourite before the game started. The act of selection was an act of self-definition: how I would appear in this fantasy world, without the constraints of my real self. But those games only offered a few characters to choose from. The immersive online environments of 2020s gaming, by contrast, offer infinite choices. Social media, too, offers teenagers all sorts of opportunities to embrace fantasy identities. If they want to, boys such as Sam can live the majority of their waking hours in highly immersive, ever-expanding digital environments in which body parts come on an à la carte basis.

Eighteen months on, Ellen’s relationship with Sam is better. They still have intense conversations about the way he sees himself; when things get prickly, these happen via the more distanced format of email and text message. But Sam has matured a great deal as he has aged. He seems more thoughtful; he now says, “if I get hormones,” rather than “when I get hormones.” And while Sam still toys with the idea of adopting a more female form, the cosplay is less central to his life than it once was.

But Ellen says she still feels trapped, in part because there are few people she can talk about her situation honestly with. Her husband’s paediatric colleagues whisper dissenting thoughts about the now-conventional transition pathways young people are being herded down. She wishes their voices were louder.

* * *

I offer thanks to Christine, Diane, Anne, and Ellen for taking the time to speak to me. The four stories I’ve told, with their help, implicate external factors that are common in many of the case studies I’ve seen: a healthcare profession that parents believe has been co-opted by ideology (Christine); schools that have gone down the same path (Diane); female cheerleaders (Anne); and the fantasy world of the Internet (Ellen), which presents genderbending through the lens of harmless Japanese cartoon characters.

This isn’t to say that all causes of transgenderism are exogenous: the presence of neuro-atypical cognition comes up over and over, as does the sons’ process of discovering (or rejecting) their sexuality. But in every story I heard while performing my research, at least three of these external factors were present, if not all four. And in the next instalment of this series, I hope to further show how these common elements can interact with atypical ways of teenage thinking, sexual identity, Internet grooming, and mental health disorders—all of which can further complicate the responses of mothers and fathers wading through the resulting parenting quagmire.

Angus Fox (a pseudonym) is an academic working in an unrelated field of study. He can be contacted at gcri@protonmail.com.

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