To the Editor:
Re “Gender Dysphoric Kids Deserve Better Care,” by Pamela Paul (column, Feb. 4):
I’m an L.G.B.T.Q.+ teenager. Ms. Paul cites stories of detransitioners as if they are damning to the practice of gender-affirming care as a whole. Not all detransitioners regret their transition, and not all transgender people will medically transition. An overwhelming 98 percent of people who started their transition care as youths continue into adulthood, per a 2022 study from the Netherlands published in The Lancet.
Speaking from experience, my peers and friends who have undergone medical transitions have never “regretted” it, and after beginning care, their quality of life greatly improved. If Ms. Paul wants to demonize a procedure with a high rate of regret, she should look toward knee replacement, where one in five people end up dissatisfied.
By writing this article, Ms. Paul further stigmatizes health care for transgender people. Transition care may be good for some people. It may not be for others. This is a basic premise of medicine — people must have the right to make decisions with their doctors on what is right for them.
What we do know is that transgender youth are under attack across the nation. Texas’s attorney general, Ken Paxton, last month demanded records from providers outside his state to single out hospitals or clinics that have treated transgender youth from Texas.
I fear for my future. I fear for my friends and their futures.
By continuing to harbor this dangerous rhetoric in her pieces, Ms. Paul makes it harder and harder for trans people to get the care that they desperately need as lawmakers across the country clamp down on our rights. I understand her concern, but it is misplaced.
Charles Yale
Omaha
To the Editor:
I was a trans child. From 12 to 17, I identified as male and was entrenched in the online world of radical trans activism. And, like many other female detransitioners, I am a lesbian, a survivor of childhood sexual abuse and on the autism spectrum.
My doctors knew all these things, and prescribed me testosterone at 15 anyway with minimal questioning. When I was approved for “top surgery,” I had just been released from a two-month stay in a teen rehabilitation facility after suffering severe suicidal ideation.
Now, I’m 17, and I feel as if my adolescence was taken from me. When I decided to detransition, it felt like leaving a cult. I was quickly forced into the role of “outsider.”
Detransitioners are viewed as just a rare minority who made a mistake. It’s all our fault for not thinking our transition through, despite doctors and trans activists assuring us every step of the way that this was the only way we could ever be happy.
I was officially diagnosed with gender dysphoria and was in many ways the textbook presentation of transgender identity, and I still ended up growing out of it. If it can happen to me, it can certainly happen to the thousands of teenagers who get on hormones after identifying as trans for significantly shorter periods of time.
Our stories have to be listened to and taken seriously, and I am grateful for people like Pamela Paul who are willing to give us a chance.
Maxine Doak
Doylestown, Pa.
To the Editor:
As the father of a healthy, thriving late 20s trans and nonbinary child who transitioned in their teens, I’m appalled at the lack of credible, large-scale research in Pamela Paul’s column.
We parents notice the media’s drumbeat of detransition stories, with no similar focus on the overwhelming majority of trans people who lead healthy, fulfilling and successful lives — thanks in large part to their ability to access proven and affirming health care.
The research done to date on whether the majority of people who received gender-affirming medical care have any regrets is crystal clear — overwhelmingly good, positive news.
In a meta study across 7,928 people in 13 countries who had received gender-affirming medical care, only 1 percent expressed regret.
We are begging you to cover positive and affirming stories of trans people who are leading “normal” happy and comfortable lives thanks to the care they’ve received.
Tom Murphy
Long Beach, Calif.
To the Editor:
Thank you so much for having the courage to print Pamela Paul’s piece on detransitioning. I am the mother of a socially transitioning college-aged person (assigned female at birth). My child is gay and has autism, A.D.H.D., major depressive disorder and anxiety. They exhibited no gender dysphoria or nonconforming behaviors until their junior year of high school.
Their mental health struggles are extremely complex, but we have been told by multiple therapists to be affirming and not question their identity. I am concerned that the challenges they are facing will not be resolved through gender-affirming care alone. My kid is desperate for a fix for why they don’t fit in, why they don’t feel well. They are searching for community and exploring their identity.
I fear that the therapy they receive will focus too much on gender affirmation and miss the unique and complex person that they are while leading them down a path that will result in more harm than good.
Angie W.
Atascadero, Calif.
The writer’s last name has been withheld to protect the privacy of her child.
To the Editor:
Pamela Paul’s column misses an opportunity to shed light on the very complex and nuanced topic of adolescent mental health and gender identity. Just like the gender binary itself, the black-and-white thinking laid out in the piece is overplayed, outdated and simply unhelpful.
In my work as a parent of a trans kid — and the leader of a support group for parents/caregivers of trans kids — I have observed the very real phenomenon of teens questioning their gender at the onset of puberty. It makes sense because this is the time when kids’ bodies are changing, and they are being slotted into binary gender lanes.
What I see is a generation of kids who simply do not buy into gender binary norms. All of us old folks can sit around wringing our hands about transitions and detransitions. But the social construct of gender is changing.
Instead of fear mongering and drawing lines in the sand, the Gray Lady might dust herself off and put her Opinion section to better use illuminating the societal changes in the way we think about gender.
Kate Rubick
Portland, Ore.
The writer is chair of the Portland chapter of TransParent.
To the Editor:
As someone who is seen as a “detransitioner,” I reject this label. I was on hormone replacement therapy and presented as a woman for five years, starting when I was 27. That period turned out to be one of the most emotionally and intellectually fruitful of my life thus far, and it’s for this reason that I don’t regret any of it.
I stopped my hormone regimen because I had doubts about the idea of marrying a straight man, since they’re generally less funny than gay men. However, I continued to have access to prescription estrogen, and would dabble for months at a time when I felt I wanted to mix things up.
If this lifestyle sounds irresponsible or unsustainable, then this is because we operate within a conception of identity that forces us to conform to the same systems that privilege heterosexuality as the norm.
Unfortunately, when it comes to gender-affirming care, it is indeed political, as long as we continue to treat people like they’re “born this way” and therefore only valid insofar as they satisfy a standard of biological determinism. It’s political because politics should be able to account for lives that inevitably twist and turn and proceed, unbidden by convention or expectation.
I never detransitioned, I just kept transitioning, but my driver’s license certainly looks outdated.
Audry Basch
Brooklyn
To the Editor:
As a health care provider, I have found it exceedingly frustrating in recent years to realize that any questioning on my part of the need for gender-affirming care puts me at risk of being ostracized in my profession as anti-L.G.B.T.Q. The care of gender-questioning patients can be more comprehensive and depoliticized.
I have been in health care for over 30 years and have seen the tides turn on many treatment beliefs. It is heartbreaking to have to acknowledge a parent’s fears and be unable to give them a comprehensive response about their adolescent’s care with science backing up our decision-making.
I can cite a particular case of a young adult who opted to transition because of hate for their body. They suffered many years of childhood sexual abuse. This history was never asked about, the trauma never addressed. That young adult was labeled as “borderline personality” when requesting detransition and is now being treated for complex trauma, as well as suffering from health and psychological effects of irreversible hormone and surgical therapies.
There is much more that can be done so providers like me won’t have to mince words and be indirect in our approaches to a holistic assessment of a patient who is suffering from distress related to identity and their lived experience.
Thank you for publishing this piece.
Ann Dryden
Vermont
The writer is a psychiatric and mental health nurse practitioner.
To the Editor:
As a trans woman and civil rights advocate, I am deeply alarmed by Pamela Paul’s piece. She has chosen to ignore the lived experiences of most detransitioners — those who have medically or socially transitioned and then returned to living as the gender they were assigned at birth.
I, myself, am a detransitioner. I initially pursued transition when I was 17. Then, at 19, I detransitioned.
Like most young people who detransition, I did so not because I was coerced, “medicalized” or misled. I did so because of the harassment, familial rejection and violence I experienced as a visibly trans person in a world that has grown increasingly hostile to the existence of people like me.
Then, I once again pursued transition. I’ve now been living successfully, happily and openly as a trans woman for six years.
My experience aligns with the majority of detransitioners, who cite external pressures as their primary motivation for detransitioning and, ultimately, end up pursuing transition again.
Like many far-right lawmakers I met with in 2023 to discuss their attempts to ban gender-affirming care for minors in Kentucky, Ms. Paul chose to elevate the small group of outspoken detransitioners seeking to further restrict this care without regard for the majority of us who do not regret the care we received.
Instead of painting a nuanced portrait of how we treat youth experiencing gender dysphoria, Ms. Paul chose to peddle the very same anti-trans propaganda that she claims to denounce.
Emma Curtis
Lexington, Ky.
To the Editor:
Thank you for publishing Pamela Paul’s extremely balanced column. As someone who spent several years thinking I was trans, I understand that the topic is complex.
Ms. Paul does an excellent job of debunking the idea that all opposition to transition is right-wing. When it comes to pediatric medical intervention, the public is in notable disagreement with Democratic Party orthodoxy.
A 2023 survey of 1,262 registered voters across the country on behalf of Women’s Declaration International USA reported that “when asked what adults should do when female children say they are boys, ‘nonbinary’ or something else other than girls, just 12 percent of respondents, including 17 percent of Democrats, thought they should seek immediate medical intervention for a 15-year-old, and only 7 percent (including 11 percent of Democrats) supported immediate medical intervention for an 8-year-old.”
I am a leftist radical feminist. Americans across the political spectrum have legitimate questions about what it means to “identify as a gender.” It’s refreshing to see that The New York Times acknowledges that.
Elizabeth Chesak
Chesterton, Ind.
The writer is coordinator of the Women’s Declaration International USA Desisted and Detransitioned Women’s Caucus.