NY Times Magazine: The Battle Over Gender Therapy

AP Photo/Robin Rayne

The NY Times Magazine has published a lengthy story about the fight going on inside and outside the organization that sets standards of care for trans people, including children. The World Professional Association for Transgender Health (WPATH) last published standards of care in 2012 and has been working on revising them for months. But the issue has become far more contentious this time around, partly because some states are trying to ban some interventions for children and also partly because the pro-trans left is determined to punish anyone who seems to show any signs of weakness when it comes to providing what’s known as gender-affirming care.


Last December a draft of a chapter from the new standards dealing with adolescents left open the possibility that the sudden surge in patients might not be wholly due to greater acceptance.

[Scott] Leibowitz and his co-authors thought that the timing of the rise in trans-identified teenagers, as well as research from Britain and Australia, suggested that the increased visibility of trans people in entertainment and the media had played a major — and positive — role in reducing stigma and helping many kids express themselves in ways they would have previously kept buried. At the same time, the authors acknowledged that they weren’t sure that visibility was the only factor at play.

As they wrote in their December draft chapter, part of the rise in trans identification among teenagers could be a result of what they called “social influence,” absorbed online or peer to peer. The draft mentioned the very small group of people who detransition (stop identifying as transgender), saying that some of them “have described how social influence was relevant in their experience of their gender during adolescence.” In adolescence, peers and culture often affect how kids see themselves and who they want to be. Their sense of self can consolidate, or they can try on a way of being that doesn’t prove right in the long run as the brain further develops the capacity for thinking long-term.

And that, not surprisingly, led to a political campaign against the authors from people on the left.


In a publicly streamed discussion on YouTube on Dec. 5, activists and experts criticized the adolescent chapter, with the emotion born of decades of discrimination and barriers to care. “This statement sucks,” Kelley Winters, a moderator of International Transgender Health who is an interdisciplinary scholar and community advocate in the field, said of the assessment. “This is talking about singling out trans kids, and specifically with a mental-health provider, not medical staff, to interrogate, to go down this comprehensive inquisition of their gender.” The requirement for evidence of several years of gender incongruity before medical treatment is “harmful and destructive and abusive and unethical and immoral,” said Antonia D’orsay, another moderator of the group who is a sociologist and psychologist. In January, in a public comment to WPATH, International Transgender Health blasted the adolescent chapter for “harmful assertion of psychogatekeeping” that “undermines patient autonomy.”

And just like that, after four years of painstaking work, Leibowitz, de Vries and the rest of their group were being called out as traitors by peers and the community they sought to care for.

I don’t have time to explore all of the connections but if you read Ryan Grim’s story about the internal battles taking place at many left-wing groups, this will all sound familiar. There is a woke, young contingent that sees anything other than complete and instant acceptance of their views as unacceptable and probably racist, sexist or some other -ist. They aren’t interested in dialogue. They want to punish anyone who disagrees. And that’s what they’ve tried to do in this case as well. They targeted a Canadian psychologist and researcher who had found that “most young children who came to his clinic stopped identifying as another gender as they got older.” His views were represented in the WPATH standards of care published in 2012 but by 2015 he’d been shut down.


At the end of 2015, the Canadian medical center that ran Zucker’s clinic in Toronto shut it down because of complaints from activists and a parents’ group about his method. (Zucker sued the center for defamation and later received an apology and a settlement of $450,000.) In February 2017, protesters interrupted and picketed a panel featuring Zucker at the inaugural conference of USPATH (the U.S. affiliate of WPATH) in Los Angeles. That evening, at a meeting with the conference leaders, a group of advocates led by transgender women of color read aloud a statement in which they said the “entire institution of WPATH” was “violently exclusionary” because it “remains grounded in ‘cis-normativity and trans exclusion.’” The group asked for cancellation of Zucker’s appearance on a second upcoming panel. Jamison Green, a trans rights activist and former president of WPATH, said the board agreed to the demand. “We are very, very sorry,” he said.

After that controversy, other providers were on notice that Zucker’s methods were no longer acceptable. His approach was likened to conversion therapy, which treats being gay or trans as a mental illness to be cured, and which many states and localities have made illegal.

But the pushback to this hasn’t solely come from people on the right. A significant piece published at Bari Weiss’ Substack last October quoted two trans doctors who expressed concern about the standards present in the field. They were themselves urged to remain quiet by WPATH but refused to play along.


Toward the end of the article there’s a description of how some children wind up announcing they are trans and them coming to regret that later when confronted with the reality of what being trans would mean.

Four years ago, when she was 12, Catherine (her middle name) left a note under her mother’s pillow saying she was a trans boy. She followed a script from YouTube videos she’d watched of other teenagers coming out. Catherine’s mother says she looked for a therapist who “would be open to whatever came,” and found Jennifer Butzen, a licensed counselor in the Atlanta area…

When Catherine started seeing Butzen, the pair talked about sexuality as well as gender identity and did exercises, using a whiteboard, about male and female stereotypes, which Butzen wants her clients to know they can challenge whatever their gender. Butzen also explained the physical and social changes that come with medical transition. “Everything became more real, and it got a little scary,” Catherine says. “But I was in this forward movement, like, ‘I have to do this.’”

But one day on the way to her appointment with Butzen, Catherine started crying and told her mother she’d been lying to herself. In retrospect, she thinks the YouTube videos gave her a way to relieve discomfort she felt about being attracted to girls, which wasn’t accepted at her Catholic school. Later, Catherine came out as bisexual.

This may not be the norm but it does happen. It’s an argument for making more careful assessments of people who, at a very young age, announce they want to make a major life-long change to the course of their life.


Finally, I can’t end this without noting the very top comment on this story which has been upvoted more than 1,300 times:

I attended an art exposition at the high school my kids attend, and I was struck by the number of girls in that department (it is overwhelmingly female) who have adopted gender neutral pseudonyms—kids whose last names I recognize from their elementary-school days. Then there are the friends and acquaintances of my kids, all female, who’ve adopted male names and pronouns (or who’ve vacillated between he/him and they/them or the head-scratching he/them). Something is going on with teenage girls, and it’s not because so many of them were closeted transgender.

I very rarely agree with conservatives, but in this area, I do. My 16 year old cannot have spinal surgery to correct a severe curvature — altering her body for pain relief — without my consent, and yet trans activists are agitating for adolescents to be allowed to permanently alter their bodies and adopt a lifelong, medicalized existence. 18 is even too young to be permitted to take cross-sex hormones when the brain doesn’t fully develop until 25.

I was once quite sympathetic to the trans community. I don’t really care how anyone dresses or what name they call themselves. But the inability of many trans activists to have reasoned discussion about legitimate issues, their campaigns of rage against anyone brings up such concerns, and their irrational rejection of the reality of biological sex has lost them many allies, including this one.


It’s not just conservatives objecting to this. One more, this one upvoted about 800 times:

I object the article’s statement about a “right-wing backlash in the United States against allowing them to medically transition, including state-by-state efforts to ban it.”

I’m a lifelong moderate Democrat, but I strongly object to medical transitions for people under the age of 18. I just don’t think people are responsible under the age of 18 to make irreversible medical decisions.

I also question if “gender” is central to identity. I’m female, but there is a wide range of “feminine” behavior among women. I would say that I am on the “more masculine” end of this spectrum as I don’t care that much about clothes and have a male profession. I was also depressed a lot as a teenager (as are many teenagers).

Despite this, I am straight, happily married to a wonderful guy, and have two great children. I worry that if I were a teenager today then I might think I was “really a man,” have surgery, and miss out on the best part of my adult life. I just wouldn’t know myself, or the world, at such a young age to make an irreversible decision. And, again, I don’t think gender is important to who I am as a person.

My opinions do not make me “right wing.”

The Times deserves credit for covering this in a way that is a lot less simplified than trans activists would like. Still, when it comes to the politics, they aren’t really getting it right.


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