An Open Letter to the Mental Health and Gender Therapy Community

The importance of exploratory therapy and brave practitioners for dysphoric kids.

Dear Gender Health Therapy Community,

I am saddened to say that after instilling so much trust in you, I have lost faith in your ability to heal.

We came to you in need of help. Our child exhibited daily pain at being alive--slicing her arms and torso and talking about wanting to die. We were desperate. Our child was falling apart. We were falling apart. We would have followed any advice to save our child. We kept thinking, “if our child killed herself because we didn't try this, we would never forgive ourselves.”

When our child declared she was “trans”, we were skeptical about immediate affirmation, but our very credentialed mental health team assured us that this was the most suitable path for a child like ours. And of course, there was the suggested risk of suicide.

That year of social transition was our child’s worst mental health year. There were three hospitalizations for mental health crises, including one suicide attempt. However, we live in a state that has enacted a so-called “conversion therapy ban,” and affirmation is the only therapy option available to us. Even when the results proved to be harmful.

Talk therapy geared towards self-acceptance is not conversion therapy. You know this. But somewhere along the way, you forgot the objective of your profession—to take care of people and to help them find acceptance and peace in our material reality.

Most children presenting with dysphoria suffer from comorbid mental illnesses like depression, autism, OCD, ADHD, and more. They may experience dysphoria, dysmorphia, and distress directed at their bodies. These periods of distress are especially prevalent during adolescence. In most cases, gender dysphoria is a symptom of something deeper--something that should be worked on through exploratory talk therapy. After all, these feelings are not only expected, but they are also a healthy part of maturing into adulthood; they teach us self-acceptance, self-esteem, and most importantly, distress tolerance. When we fail to explore these issues before transition, we fail kids like mine.

What’s more, we know that people who transition have a 20x higher incidence of dying by suicide versus the general population. 20 times! And there are NO studies that look at the outcomes for people who have had exploratory talk therapies instead. It seems to me that allowing people to transition without ever engaging in exploratory therapy is like putting them into a boat with no oars and no rudder on the edge of a waterfall. You are denying them the necessary tools to learn to thrive emotionally. This is not only nontherapeutic but also wildly negligent.

The path to self-acceptance is not to treat distressed minds by distressing their bodies. As much as one may wish otherwise, we are not only our minds, we are also our bodies.

We engage therapists to help integrate mind and body so that we (or our children) may feel safe and happy in our healthy bodies, despite how we express or present ourselves in them. But healthy bodies do not need hormones and surgeries to be authentic and true. We cannot heal the mind by harming the body.  

When someone suggests that the only path to authentic happiness is to become a lifelong patient, you have to ask, “who is making these claims, and why should you believe them?” as transwoman Debbie Hayton keeps asking us.

One could possibly forgive the ignorance and maybe even the arrogance regarding the current treatment of these children. But from this moment forward we can no longer forgive the negligence.

Thank goodness there are professionals like Sasha Ayad, Stella O’Malley, Stephanie Winn, Gender Dysphoria Alliance, Genspect, SEGM, GETA (and more listed below) who, along with a fiercely brave group of researchers, parents and concerned citizens all around the world are raising their voices and calling for change. They are demanding that we engage dysphoric children and adults in exploratory therapy and that our first lines of care are those that are least invasive, least restrictive and most directed towards self-acceptance.

The tides have turned, we parents are rising, and you now have an obligation to do right by kids like mine.

I beg you to engage with new, informed voices on the best pathways for children like mine.

Sincerely,

Mom of a Dysphoric Kid

Here are some vital resources for your education.

Genspect, The Society for Evidence Based Gender Medicine, Stats for Gender, Parents with Inconvenient Truths about Trans, Detrans Voices, Gender: A Wider Lens Podcast, Deborah Soh  Lisa Littman, Post-Trans Transpsyche TransparencyPod The Detransitioners @SashaLPC @stellaomalley3 @ThoughtfulTs @MicllMackness @TaniaAMarshall @KnownHeretic @GDSNsupport @GETAtherapy @widerlenspod @Aaron_GDAC @sometherapist http://thoughtfultherapists.org

Photo Credit: @andrewtneel