Some things that have been around throughout human history:
Gender-diverse children and young adults
Distressed gender-diverse children and young adults
Discomfort with gender-diverse children and young adults
Unethical medical experimentation on vulnerable populations
Some things that have been around for a brief moment in human history:
Drugging, sterilizing, and sexually stunting gender-diverse and distressed gender-diverse children and young adults
Imagine for a moment that you’re the parent of an adolescent or young adult in today’s world. They’re shy or maybe a little different…but we’ve all seen that before. It’s no big deal. In fact, maybe you were that misfit yourself when you were young. You know as an adult that humans from time immemorial have fallen outside the mainstream, have had rough adolescent years, but may have ultimately benefited from having creative perspectives and unconventional interests. It’s no fun feeling like an outsider as an adolescent, but being different can be a gift in the long run. You think it’s nice that your quirky kid seems to have found a tight-knit gaming community on Roblox or Final Fantasy XIV. Or maybe they’re obsessively on TikTok and YouTube, and that doesn’t seem so healthy…kids these days! It’s so hard to get them to go outside and touch grass, as they say.
And then, slowly, something changes with your child. Sometimes it’s creeping depression or anxiety, the sudden recognition of disordered eating or self-harm, or an unusual withdrawal from school and friends. And sometimes, at the beginning of all this unhappiness or somewhere along the way, there’s a note, a text message, or a kid sobbing in their bedroom, “Mom, I’m trans...”
For parents who have embraced the LGBT community, this can still come as quite a shock. “I thought my kid might be gay, not trans!” is a common refrain. But for many families, the surprise comes because their child is completely gender typical. Behaviors and appearances start to change after the announcement, not before. As parents get vague or disturbing answers to their questions–“I don’t know, I just feel like a boy” or “I’m sure I’m a transwoman…I like lesbian porn”–they may feel more and more cognitive dissonance. They had a picture of what trans meant, and it was not their child. What in the world is going on?
No Questions Allowed
Parents quickly find that no questions are allowed. If your child is an adult, they’ll take themselves off to the nearest clinic for a hormone prescription. If they’re still a minor, cheerful school counselors and therapists will tell you to embrace your new daughter or son, or your child will likely kill themselves. Your child’s doctor will send you to a pediatric gender clinic, where you’re told that the right path forward is to put them on “gender-affirming care,” i.e. puberty blockers to give them “time to think” and then cross-sex hormones and first-step surgeries (double mastectomies for girls) as they get to their mid to late teens, with eventual full surgical sterilization for both sexes, usually at 18 and over (but with some very public underage exceptions such as Jazz Jennings or Jackie Green). Many parents are extremely trusting of the medical establishment and quickly drink the Kool-Aid. To be fair, they’re often desperate for help with a highly distressed child, a child who has spent many hours online absorbing that the solution to all their self-doubts and unhappiness lies in drugs, major surgeries, and a complete reinvention of the self.
But some parents are skeptical. They read the original medical and psychological research and are aghast. What are these doctors doing?
Just as the medically gung-ho parents have formed online communities to swap pharma-surgical tips, so too have medically skeptical parents formed online support groups to share stories and advice. These secret communities can be a lifesaver in a world gone mad, a world where a once-trusted advisor, therapist, or doctor may eagerly set a young person on a path of self-rejection and medical self-harm at the snap of a finger and never question their own virtue. But what do we know about these skeptical parents and their children? Are there characteristics and unique needs that might distinguish them from those who embrace medicalization? As a trusted resource for questioning parents, PITT decided to find out.
In early 2023, PITT sent out a survey to parents of trans-identifying children of all ages. Over 1300 parents responded. While it was open to all parents, those who read PITT are far more likely to have doubts about the current enthusiasm for the medicalization of trans identities, and that’s reflected in the responses. Topline results are below, and, as always, researchers are welcome to contact us for more detailed data.
At the opening of this article, we listed one thing that has been around for a very brief time in the arc of gendered human history: the Mengelian medicalization, sterilization, and sexual stunting of both distressed and undistressed gender-diverse children and young people under the deceptive label of “gender-affirming care.” For those of us who’ve read the scientific literature and understood that this practice is built on misinformation, misinterpretation, and medical hubris, we wonder in despair how our doctors and medical societies could have become so derailed. We also watch in anguish as activists, legislators, and journalists on the right and left around the globe turn medicine into political stunts and gotchas, with the result being that good care for all children is being stymied. While some countries' healthcare systems are correcting course, too many are stuck in toxic political battles.
Children are being harmed. Young people are being harmed.
In many ways, this story is not new. From snake oil to thalidomide, from lobotomies to opioids, medicine has a long history of fake cures and terrible practices. In his 2022 book The Skeptical Professional’s Guide to Rational Prescribing: The Impact of Scientific Fraud and Misconduct, Dr. Charles Dean writes that in modern times the challenges facing medicine include “untoward ties with drug companies, the power of the pharmaceutical industry to co-opt physicians and institutions, the failure of peer review, the use of fraudulent data, and the failure of institutions to monitor their investigators…other topics are also in need of review, including publication bias, spinning poor or questionable results into positive outcomes, omitting or changing the primary outcomes of studies after the data fail to deliver the expected results…” Certainly, many parents see all this in play in the unfolding gender medical scandal.
However, what is new is the Gordian knot of confused cultural ideas about gender and sex, along with a tangle of transgender activism, tribal politics, and medical lobbying that have ultimately allowed malpractice to continue. Those who can see some of the problems with the current protocol–otherwise ethical professionals–make calls for randomized trials, better research, and the restriction of these drugs and surgeries to “some” children. But they forget the most basic principle of medicine: primum non nocere: first do no harm. Decades of research have made clear that there is no good evidence that any of these medications or surgeries help anyone; there is good evidence that they harm. So what type of medical ethics is a clinician practicing when she begins the first stage of sterilizing a trans-identifying child, even a highly distressed one?
For those doctors, therapists, politicians, journalists, and educators who have grasped what’s going on, there is a tremendous urgency to raise awareness in order to change the current medical guidelines and stop the horrendous mistreatment of gender-diverse kids.
But for parents who know, who understand, but who have children who cannot see the truth–children who absolutely trust what the medical establishment and trans community are telling them–for these parents, there is a deep, sometimes unbearable grief at the physical and emotional harm being done by the very professionals who are supposed to help and at the loss of a child who seems to have vanished. A snapshot of their lives is below.
“I must confess that I lost faith in the sanity of the world”
H.G. Wells, from The Island of Dr. Moreau
PITT Parent Survey Results
Key Takeaway 1: In the PITT Survey, Most Children Were Gender-Conforming Before the Announcement
“I wouldn’t wish it on my worst enemy. We’ve worked hard to keep it from destroying our relationship with our child, but it has almost destroyed me and my husband. It was so out of left field and sudden that it’s surreal.” Anonymous Parent
Mimicking the results of other recent parent surveys, the PITT results showed that 79% of children were gender-conforming before their trans announcement–that gendered appearance and behavioral changes began afterward. 93% of respondents felt that their child’s trans identity fit the description of sudden or rapid onset gender dysphoria, and 92% were concerned about their child’s transition. One shift is that the children’s birth sex was 69% female and 31% male, compared to 75% female and 25% male in research based on earlier cohorts. It is unclear at this point if fewer girls are starting to identify as trans, more boys are identifying as trans, or some combination of the two is in play.
Key Takeaway 2: Many Trans-Identified Children Do Not Medically or Surgically Transition
“She assured me that she doesn't intend to take hormones and will tell me if she goes ahead with a mastectomy. I am both saddened and grateful.” Anonymous Parent
Well-publicized medical and surgical interventions that cause the permanent disfigurement, loss of sexual function, and sterilization of gender non-conforming people are the cause of a great deal of anxiety for parents. While they’re right to be worried, it’s important to note that many trans-identified people don’t ever take cross-sex hormones and most do not elect to have surgery. This bears out in the PITT survey, too.
Key Takeaway 3: Having a Trans-Identified Child Can Cause a Great Deal of Stress on Parents and Families
“This has torn our family apart, and my child is miserable since trying to be their ‘true self.’” Anonymous Parent
Almost 20% of families had conflicts between caregivers in how to respond to a child’s trans identity. Of the latter group, over 80% had had custody challenges and 3-4% had had Child Protective Services involvement (most resolved in favor of the respondent, but the exceptions were frightening). Full estrangement remains low at 13% while 47% rate their relationship with their children as still close or very close. At the same time, more than two-thirds of parents rated themselves as depressed to extremely depressed.
Key Takeaway 4: Parents Are Right to Be Concerned
“It is emotionally exhausting. It's not JUST gender dysphoria, it is a laundry list of mental health concerns–suicidal ideation, depression, anxiety, autism, school refusal, sexual assault–that are not the by products of a trans identification but probably the cause of it.” Anonymous Parent
Decades of research show extremely high mental-health comorbidities in trans-identified populations, and this is reflected in the PITT survey results. Some researchers believe that the co-morbid conditions are caused by gender distress, influenced by the minority stress model, and will improve with medical transition. But this research has been repeatedly debunked. Many parents have the opposite belief: that a factor in their child’s gender distress is one or more pre-existing mental health or neurological challenges. In the PITT survey, only 19% of children did not have a professionally diagnosed condition. The most common diagnoses were depression, anxiety and ADHD.
We also asked parents of adult trans children if their children were financially independent after completing their education. The overwhelming response was no: only 29% were living and working without financial support from family, friends, or the government. Their transitioned adult children are not doing well, and parents of younger children are right to be concerned about the future.
Key Takeaway 5: We Can’t Read Too Much Into PITT Demographic Data
“I'm very liberal and accept my children's sexual orientation, however I don't believe in the notion that my son is actually a woman/girl.” Anonymous Parent
PITT is based in North America and the vast majority of respondents to our survey were from North America. Parents who responded skewed female, highly-educated, upper income and politically liberal or independent. Only 35% of PITT parents partially or completely affirmed their child’s trans identity by the social use of a new name and pronouns. Please note that this does not reflect the demographics of the global trans population or global skepticism of key tenets of modern transgender ideology. A number of surveys show that the trans population tends to reflect the demographics of a community as a whole, and recent national surveys show a dominant and growing public skepticism of transgender ideology across populations (See the Kaiser Family Foundation/Washington Post Poll, Pew Polling and YouGov polling in the UK).
Key Takeaway 6: Many Questions Remain
“This is the worst kind of torture for a parent — knowing your child is harming him or herself and being not only powerless to stop it but shamed for trying.” Anonymous Parent
“The hardest part of this journey, without a doubt, has been dealing with the mental health community.” Anonymous Parent
“I constantly have to weigh up the pros and cons of being honest with new acquaintances and friends.” Anonymous Parent
Skepticism of transgender ideology is broad-based, but is there something unique about PITT parents that makes them less likely to believe? It is certainly not their politics nor the type of schooling they provided their children–both school choice and political views are wide-ranging. Does it make a difference that their children were originally gender-conforming? Do the types of mental health diagnoses a child has make a difference? Are there other religious or cultural factors? Is there a different long-term impact on parents and children if parents are non-accepting vs accepting vs affirming? What types of psycho-social supports could best help distressed parents whose personal boundary is material reality? Many questions remain, and it’s important for high-quality research to expand in these areas. We encourage researchers to pursue neutrality and to do a great deal more study on what’s going on in all types of families with trans-identified children.
Thank you for doing this. On Point One, what you've found is that the ROGD kids of skeptical parents tend to skew a little male. This is actually what I would expect. We are heuristically made to respond to the distress of a boy a little faster than the distress of a girl. Feminists and evolutionary biologists argue about whether this is nature or nurture, but no one disputes that the difference exists.
Whenever an ideology is prioritized over the truth, the scope for harm is infinite: https://lucyleader.substack.com/p/first-do-no-harm