Thursday, August 11, 2016

Detransition, Desistance, and Disinformation (a follow up)

If you aren't aware of it already, last week I published an essay called Detransition, Desistance, and Disinformation: A Guide for Understanding Transgender Children Debates on Medium. It is a long-read, and my thorough response to recent mainstream op-eds and think-pieces coming out either for gender-reparative therapies and/or against gender-affirming approaches to transgender and gender non-conforming children. If you like the piece, be sure to recommend it (by clicking the "heart" logo at the bottom-left of the article) - the more recommends it gets, the more likely it will appear in other Medium readers' feeds!

In addition, German Lopez of interviewed me about my Medium piece - you can read that in the article: The debate about transgender children and “detransitioning” is really about transphobia. (note: if you take issue with that title, I didn't write it - see Twitter thread at bottom of this post.)

I received a lot of positive feedback about the piece. And I can tell that it made some waves outside of the trans/LGBTQ+/activism bubble by the numerous vitriolic & blatantly anti-trans responses I have received - sadly, this is par for the course. However, there are two categories of responses I received that addressed aspects of the article that I perhaps could have explained better, so I want to reply to those here.

First, a few people took issue with the section of my piece wherein I called the "80% desistance" statistic into question - many of these were admonishments along the lines of "well that's what the science says!" I'm not sure who these people are, but they are obviously not scientists. Or at least not good ones. Science is chockfull of debates where there is no clearcut answer, just pieces of evidence that people on either side of an issue can cite (or discount). The 80% desistance statistic is one such piece of evidence, and in my piece I linked to numerous other articles that point out the multiple assumptions and potential inaccuracies that have gone into how that number is derived (add to those this new critique from Kelley Winters). Furthermore, while I didn't link to them in my Medium piece, in my interview I mentioned several research studies (specifically, this and this and this) that support the gender-affirming position.

It would be irresponsible of me to point to those last three studies (which demonstrate that many children and adolescents who transition have good outcomes and stable identities) and suggest that therefore *all* gender non-conforming children should transition. Just because transitioning is a good outcome for some does not mean that it's necessarily a good outcome for all. But by same logic, people who point to the 80% desistance statistic to argue that *no children* should transition (which is the case many are making) are also being irresponsible. The key is to figure out which children should follow which path, which is exactly what the gender-affirming approach attempts to do.

Second, some people have suggested that I was discounting or erasing the experiences of those who detransition in my piece. This was most certainly not what I was trying to do: I did not at any point attempt to speak on behalf of people who detransition, nor did I suggest that such individuals should not talk about their experiences - they are most certainly free to share their stories with the world. Perhaps I could have made this clearer, but my article was never intended to be *about* people who detransition or who desist per se; it was about how trans-antagonistic and trans-suspicious commentators evoke these concepts in order to forward their political agendas. Even if there weren't any actual people who detransition, these commentators would no doubt simply invent stories about detransitioning (as they did recently with Caitlyn Jenner), much like how they invent stories about transgender sexual predators in bathrooms in order to promote their agendas.

But of course (unlike transgender bathroom predators), people who detransition do exist - I have met and had conversations with quite a number of them, and have read their stories and perspectives on the internet and elsewhere. What I can say (based on this information) is that their experiences are diverse: some detransition more for visceral or personal reasons, while for others it had more to do with constantly facing transphobia; some remain detransitioned, while others may re-transition at some later point; some who detransition continue to identify as transgender in some way, while others come to identify as non-trans or cisgender; some detransition in response to a change or shift in their gender identity or understanding of gender, while others come to a realization that they were never trans to begin with; some look back on their decision to transition and come to the conclusion that they were too impulsive, or mistakenly felt that transitioning would solve all their life problems, while others blame their trans health providers for insufficiently questioning them and/or for possibly pushing them toward transition. I have heard every single one of these views expressed, although admittedly none of us knows the relative frequency of each. And there is likely some truth in all of these experiences, at least for certain individuals, in certain instances. 

A few people took issue with the fact that, in step #6 of my Medium piece, I described people who detransition as being "on the transgender-spectrum" (at least during the time period in which they are considering or working toward gender transition). Some have misinterpreted this as me non-consensually labeling these individuals as "transgender" or as "really trans," even though I state very clearly in step #4 that 1) I don't believe in the notion that people are "really trans" or not (as "trans" is not an essentialist, immutable trait), and 2) I explicitly state in step #4 that some (albeit not all) people who detransition no longer identify as trans (and I have reiterated that fact in the previous paragraph here). This misinterpretation was exacerbated when Jesse Singal decided to use his platform as editor at New York Magazine to spread lies about me supposedly believing that people who detransition "don't exist" or are "really trans" - I address Jesse Singal's lies in this Twitter thread. Singal's purposeful lies aside, I think some of the confusion here stems from people using terms like "transgender" in very different ways, as I discuss more thoroughly in the section "Essentialism, Identity Labels, and Umbrella Terms" of my book Excluded (pp. 11-14).

In my article, I said: "I would love to see more support from trans communities (and from health providers) for people who choose to detransition." Specifically, while many trans health providers are trained in how to best help and serve trans clients, they are not similarly informed with regards to how to support and care for people who detransition (both with regards to therapy and potential physical interventions) - I have heard this complaint from people who detransition on many occasions. 

I had two people suggest that, in my article, I was discounting the difficulties that people who detransition often face because of irreversible changes in their body (due to hormones or surgeries) that are now incongruent with their identified gender. I never directly discussed this in the piece, so I'm not sure why people would come to this conclusion. As someone who has experienced irreversible changes in my body that I wish never occurred (i.e., hormonal changes during my puberty), I would never trivialize or dismiss analogous experiences in people who detransition. I think that most of us who are personally involved in these matters (as opposed to the many outsider commentators who were the target of my article) would agree that the ideal scenario would be to *minimize unwanted irreversible changes* - whether it be preventing unwanted puberties in strongly cross-gender-identified trans children, or in reducing the chances that people who will ultimately not be happy with physical transition follow down that path. As I stressed repeatedly throughout my article, this will most likely be achieved through individualized approaches; in contrast, one-size-fits-all approaches will fail many of these individuals.

Finally, most of the people who have detransitioned that I have personally known are not against access to trans-related healthcare more generally - they recognize that transitioning helps many people lead happy and healthy lives, even if it wasn't the right answer for them. However, other people who have detransitioned have come out against allowing trans children the possibility of transitioning, or in favor of greatly restricting or eliminating the means to transition for trans adults. Having personally lived through the old gatekeeper system and seeing the harm it inflicted on trans communities (as I describe in Chapter 7 of Whipping Girl), I believe such policies would do far more harm than good. So I am both scientifically and politically opposed to such positions, regardless of whether the individuals promoting them have experienced detransition or not. I'm sure that some of these individuals will continue to claim (based on my opposition to greatly restricting/eliminating access to the means to transition) that I "disrespect" or "refuse to listen" to people who have detransitioned. To the contrary, I do respect and have listened to people who have detransitioned, enough so to know that you do not speak for all people who have detransitioned. You are of course entitled to your opinions, and many of us are open to hearing your thoughts on how to reduce the number of unsuccessful or unwanted transitions. But if you are forwarding a one-size-fits-all approach that flat-out prevents other people from happily transitioning, then we simply do not see eye to eye on this important issue.

*note: an additional paragraph was added to this piece on 8-14-16

[note: If you appreciate this essay and want to see more like it, please check out my Patreon page]