All posts filed under: Mental Health

Gender Transition and Desistance in Teenage Girls: Two Psychotherapeutic Case Studies

When doctors always give patients what they want (or think they want), the fallout can be disastrous, as we have seen with the opioid crisis. There is every possibility that the medical treatment of young people with gender dysphoria may follow a similar path. Practitioners understandably want to protect their patients from psychic pain. However, quick fixes based only on a patient’s self-reporting can have tragic long-term consequences. There are now a growing number of people who once self-identified as transgender but now have reversed or renounced their trans identity. Depending on their circumstances, these individuals are variously known as desisters, detransisitioners, or regretters. Some are seeking accountability from the medical professionals who affirmed their wish to transition, without adequate assessment. An increasing number are speaking out on social media and at conferences, arguing they have been let down by mental-health services that failed to assess their psychological problems before prescribing medical treatments such as puberty blockers and cross-sex hormones, and referring them on for surgeries. Having initially felt welcomed in and encouraged by the …

When Sons Become Daughters: It’s Time to Admit That Reflexive ‘Affirmation’ Has Been a Mistake

What follows is the seventh and final instalment of When Sons Become Daughters, a 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. “What are your preferred pronouns?” I ask Rene Jax, somewhat in jest. The answer: “Your Imperial Majesty. Look, you call me what you want. I don’t care. My friends say I’m half this and half that.” Rene (a real name, unlike the pseudonyms I’ve generally been using to describe others) is a 60-year-old male-to-female post-operative transsexual who looks both like a woman (hair, clothing, style of glasses) and a man (hands, Adam’s apple, jawline). My question felt farcical to both of us because Rene has written openly about the pathway that led to transition—and then to regret. …

When Sons Become Daughters, Part VI: Asexuality, Intelligence, and the Trans Co-Option of Intersex Discourse

What follows is the sixth instalment of When Sons Become Daughters, a seven-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. Whether they exhibit autism spectrum disorder, obsessive-compulsive disorder, or attention deficit hyperactivity disorder, many trans-identified boys seem to be fixated on a hypothetical future self: Once brought to life, it is believed, this woman’s mere presence will resolve whatever existential crisis the young man is going through. In many cases, the boy will spend a lot of his time thinking about the differences between his status quo and his imagined (feminine) ideal. This “hyper-ruminative” behaviour is something many parents I interviewed discussed with me. From Milwaukee, Liz emails me a number of papers she’s found over the years …

Trauma and the Psychedelic Renaissance

Military veterans with post-traumatic stress disorder (PTSD) and the wildly imaginative British writer and philosopher Aldous Huxley are increasingly finding common ground. In 1954, Huxley published The Doors of Perception, a short monograph detailing his psychedelic experiences on mescaline the previous May, and the book became a bible for the “turn on, tune in, drop out” movement of the 1960s counterculture. Now, the arguments Huxley made in defence of psychoactive drug use are being consulted by doctors exploring innovative ways to treat psychological wounds and mental health problems resulting from military service and trauma. Research into the therapeutic potential of drugs such as MDMA (methylenedioxymethamphetamine) and LSD (lysergic acid diethylamide) collapsed when the drugs were made illegal worldwide in the early ’70s. However, the merits of psychedelic science are currently undergoing an international reappraisal and renaissance, gaining media attention and traction among scientists, doctors, and in the wider public sphere. Psychedelics first appeared on my radar after I left the British Army in 2010 following tours in Kosovo, Iraq, and Afghanistan. As I wrestled with …

When Sons Become Daughters, Part V: The Links Between Trans Identity, Gifted Minds, Categorical Thinking—And Anime

What follows is the fifth 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.   The first four instalments in this series already have covered many disparate topics, each of which merits a fuller discussion than one writer can present. But younger readers with knowledge of trans Internet culture may have noticed that, until now, I’ve failed to cover one of its most prominent aesthetic motifs. I am referring to the Japanese art form known as anime. Parents of trans-identified boys mention anime repeatedly. The animation style seems to loom large in the lives of many—at least half—of the young men whose stories I’m telling. Many of these boys have anime alter-egos, …

Keep Social-Justice Indoctrination Out of the Therapist’s Office

One of the earliest stains on the legacy of psychiatry, my medical specialty, dates to the American 1840 census, when the US government first began systematically collecting information on “idiocy” and “insanity.” According to the results, the purported rates of mental illness among free blacks in northern cities were deemed to exceed those among enslaved blacks in the south by an 11-to-one ratio. South Carolina Senator John C. Calhoun, a notoriously strident defender of slavery, seized upon the results as “proof” that “the African is incapable of self-care and sinks into lunacy under the burden of freedom. It is a mercy to him to give this guardianship and protection from mental death.” Five years later, the American Statistical Association published a new analysis of the census data, in which it illuminated what distinguished American psychiatrist Edward Jarvis called the “inconsistencies, contradictions, and falsehoods” of the original. Jarvis’s own review revealed recording errors and deliberate misuse of data. Yet many citizens in pro-slavery states continued to believe that enslaved blacks were less inclined toward insanity because …

Gaslighting the Concerned Parents of Trans Children—A Psychotherapist’s View

I first met Jo and Carol in Manchester two years ago, when I spoke as a clinician on a panel at what is believed to be the first conference dedicated to the issue of detransitioners (people who once presented themselves as transgender, but then decided to live in accordance with their biological sex). At this event, seven young women spoke publicly about why they transitioned, why it wasn’t successful, and how they came to the decision to detransition. All of these women had undergone mastectomies, and some had hysterectomies and even oophorectomies (the removal of both ovaries). They had all taken testosterone, which permanently deepened their voices, and gave rise to new forms of body and facial hair. Although they had experienced much in their lives, none was over the age of 25. As you might imagine, these testimonials were shocking and harrowing. Jo and Carol both have daughters embroiled in the trans-activist cause. (As at all points in this piece, I am using terms such as “girl,” “boy,” “son,” and “daughter” in reference to …

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

What follows is the fourth 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.   The Man Who Wouldn’t Be Queen Menno is a gay man in his early 40s—Dutch by birth and a Londoner by choice. He’s “gender critical,” meaning that he rejects the fashionable belief that self-declared gender overrides the reality of biological sex. His YouTube channel features a satirical listing of newly conceived pronouns, set to the tune of The Sound of Music’s Do-Re-Mi; a song about pop star Sam Smith’s non-binary identity, modelled on Look at me, I’m Sandra Dee from the musical Grease; and a reworked version of Kylie Minogue’s Locomotion, in which a pharmaceutical pied piper …

The Search to Explain Our Anxiety and Depression: Will ‘Long COVID’ Become the Next Gender Ideology?

In December, I wrote a detailed report for Quillette about the race-based social panic that had recently erupted at Haverford College in Pennsylvania. One of the reasons why the meltdown seemed so surreal, I noted, is that this elite school appears to the outside world as picturesque and serene. The average annual cost of attendance is about US$76,000. And most of these students live extremely privileged lives, insulated (physically and otherwise) from what any normal person would regard as suffering. Nor is there much in the way of substantive political discord on campus. According to survey results released in late 2019, 79 percent of Haverford students self-identify as politically liberal, while only 3.5 percent self-identify as conservative. It’s as close to an ideological monoculture as you can find outside of a monastery or cult. On paper, it resembles one of those utopian micro-societies conceived by science-fiction writers or 19th-century social theorists. The survey results I’m alluding to originate with Haverford’s “Clearness Committee,” an excellent resource for anyone seeking to understand the attitudes of students at …

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

What follows is the third 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.   Coral’s story starts earlier than those of the other parents I’ve profiled, even if it contains familiar themes. While her prodigiously intelligent, literal-minded son wanted to talk about the science of black holes, his friends were still playing with Lego. Once he hit age 12, things got rough: All his friends left his school in one hit; the remaining kids took to bullying him; a close family member died. He was just beginning to realize how different he was, but not how he was different. He’d also just been given his first computer. The first declaration that …