Change of Heart

As growing numbers of former transgender youth turn their backs on transition, a trail of seemingly well-meaning affirmation lies in their wake. They look back on a chain of authority figures, peers, and influencers that spun their pubescent insecurities into a self-fulfilling narrative of being born in the wrong body. For these “detransitioners,” it took a series of painful consequences to realize they had made mistakes, which for some, cannot be undone.

Gender nonconformity has always existed, as has a vanishingly small cohort of youth whose disconnection from their assigned sex was severe enough to warrant treatment. But, by the mid-2010s, acknowledging this reality wasn’t enough. To accept “trans kids” was to affirm their identities and support them, no matter what — even if they hadn’t started puberty. Even if it meant placing them into a medical pipeline that begins with social transition and ends with elective surgical intervention. But now, in the aftermath of numerous medical scandals, a number of critics — including medical professionals, psychotherapists, and a group of former trans people known as “detransitioners” — argue that a line has been crossed.

This September, Vanderbilt University Medical Center faced a firestorm of criticism after reporting by the Daily Wire’s Matt Walsh uncovered that the Clinic for Transgender Health had been performing gender-affirming surgeries on minors as young as 14 years old. In one of the videos posted by Walsh, Dr. Shayne Taylor, a physician at the clinic, explains that the surgeries are “huge money makers” because they are labor intensive and require many follow-ups.

Within 24 hours, VUMC denied claims that they were acting unethically, stating that they require parental consent for anyone under 18 before temporarily disabling the clinic’s web page. Two weeks later, after mounting pressure from Tennessee’s Republican lawmakers, VUMC announced that they are pausing surgeries for minors to “review their practices.”

Since then, Senate Leader Jack Johnson and House Leader William Lamberth have respectively filed the assembly’s first bill of the upcoming session in January 2023, which seeks to prohibit gender transition surgery for minors. The move follows Florida's ban on gender-affirming care for minors. It’s hard to imagine this happening three years ago, when the aforementioned clinic celebrated its first year in business and Merriam-Webster chose as its Word of the Year the singular pronoun they. All the while, a burgeoning community of transgender people who have turned heel on their decision has begun to make itself known. These "detransitioners" have been subject to mockery, intimidation, and even death threats for exposing holes in the conversation surrounding trans issues.

It looks as if a new wave of public awareness around the excesses of gender ideology is finally cresting. But how did we go from apparently harmless notions of acceptance to full-blown obsession over allowing minors to surgically alter their bodies for life?

Social Contagion Theory

Data from the UK’s Gender Identity Development Service (GIDS) clinic shows a dramatic rise in overall referrals for gender treatment from 2009-2016; notably, a vast majority of these came from adolescent girls. (GIDS, a part of the Tavistock and Portman National Health Service [NHS] Foundation Trust, was recently the subject of a critical review that accused the clinic of rushing children onto puberty blockers, leading the NHS to order its closure in favor of more “holistic” clinics.)

In 2018, researcher Lisa Littman surveyed 256 parents whose teen and young adult children began experiencing ROGD (“rapid onset gender dysphoria”). Eighty-two percent of these were born female, with a median age of 16 years old. The surveys found that many of them surrounded themselves with validating friends, isolated themselves from their families, and had increased social media usage.

Discussing the results, Littman speculates on the “possibility of social influences and maladaptive coping mechanisms” in contributing to gender dysphoria. Which would make sense; generally speaking, adolescent girls are more likely than boys to experience negative side effects from social media usage: depressive symptoms, online harassment, poor body image. That young girls are now the majority of those experiencing dysphoria marks a dramatic historical turnaround occurring in just the past decade.

When we consider that adolescence is often rife with discomfort in one’s own body — coupled with extreme susceptibility to influence from peers and social media — the distinct possibility that gender dysphoria would otherwise be a passing phase for most becomes starkly clear.

Yet this common-sense thinking is often dismissed or suppressed, even in allegedly science-based institutions. In August, the American Academy of Pediatrics’s governing board allegedly shot down a resolution to review its gender-affirmative model in light of increasing international skepticism of gender transition for youth.

“Critics of our gender-affirming care policy mischaracterize it as pushing medical or surgical treatments on youth; in fact, the policy calls for the opposite: a holistic, collaborative, compassionate approach to care with no end goal or agenda,” the statement from AAP president Moira Szilagyi reads.

The Detransition Diaries

Former pediatric nurse Jennifer Lahl became a documentarian “to speak for those who have no voice.” The Detransition Diaries, which focuses on the lives of three young “detrans” women, marks her latest effort to do just that. She told the Pamphleteer she chose to focus on them since this phenomenon primarily affects young girls.

“Early on, I made the editorial decision to only focus on women because we are seeing this overwhelmingly affecting young women. . . this rapid onset gender dysphoria, this social contagion, girls typically are more prone to that.”

One of the documentary’s subjects, Helena Kerschner, suffered a serious loss as a child. By the time she was 13, she started isolating herself, and began to self-harm and develop an eating disorder as a result. A classic rock obsessive, Kerschner stumbled upon Tumblr while searching for images of a young Elvis Presley. Over the years, Tumblr had gone from hipster microblogging service to the trans community’s platform of choice, with a user base eager to affirm those experiencing dysphoria. As she fell deeper into the trans social media rabbit hole, Helena began to experiment with her identity.

"She was the cis white privileged girl. She wanted to fit in, so what did she do? Her first thing was she changed her pronouns to they/them and that made her less privileged,” Lahl explained.

“She had more social capital in the group, and then when she came out as non-binary and then she came out as trans, people threw her a party and celebrated. I think part of it is just wanting to fit in. A lot of trans kids. . . they're either socially awkward, [or] they're on some kind of an autism spectrum. They maybe are same-sex attracted and don't really know how to deal with that.”

“I had found the only community of other girls who were more like me in terms of personality, I could relate to them,” Kerschner said in the film. “But, it was so enmeshed in this belief system that made me feel really guilty about being a cis straight white girl.”

At 15, Kerschner began identifying as a non-binary demi-girl, choosing to go by she/they pronouns. After another year or so, she began to call herself a boy. Then, as a senior in high school, she told her mother she was transgender and planned on transitioning. When her mother didn’t affirm her new identity, she spoke to her school guidance counselor and with a psychologist, both of whom were supportive.

As soon as she turned 18, Helena says, she made good on her promise. She bypassed her mother, went to Planned Parenthood for an hour-long appointment, and left with a prescription for testosterone. After starting her new regimen, she became more irritable and sensitive, describing the feeling as being “possessed.”

Helena struggled through her first year of college and routinely experienced bouts of overwhelming anger. Eventually, she hurt herself badly enough to be admitted to the ER, where she was subsequently checked into a psychiatric unit. There, she was diagnosed with borderline personality disorder and psychosis.

Though Helena participated in group therapy after the episode, “deeper psychological work was absent, and once again the fact that I was a young biological female on a supraphysiological dosage of synthetic testosterone remained completely unaddressed,” she wrote on her blog, Prude Posting. “. . .my testosterone treatment was never identified as a potential source of mental health symptoms, and my desire to be a ‘boy’ was never questioned as possibly a result of pre-existing emotional issues.”

Eventually, she stopped testosterone — after being on it for 17 months — and started feeling like herself again.

“Someone close to me made a video montage of pictures of us. It was chronological order, from when we met, which was only a few days after I started the testosterone, up until a very recent picture. As I was watching this video, I watched myself transform from a young teenager to this really unhappy-looking person, and honestly, an unwell-looking person. It just finally hit me that ‘Oh my God, this has all been a mistake, everything.’”

Kerschner’s story shows the blistering speed at which the medical establishment has integrated gender ideology into standard practice. In doing so, little to no space has been made for questioning the validity of patients’ self-diagnoses of being born in the wrong body.

Transgender people are more likely to have mental health disorders; this is well-documented and not even debated by trans activists. According to the US Transgender Survey, published in 2019, more than 41 percent of transgender individuals are estimated to have attempted suicide — that’s about nine times higher than the general population.

As such, trans rights activists often frame the debate over minors being allowed to transition as a life-or-death scenario, arguing that transition, including surgery, alleviates dysphoria and reduces suicide risk, citing studies that purport to back their claims.

For Lahl, that minors cannot consent is self-evident. One of the things that outraged her most during the making of the film was the customary offering of fertility preservation to young transitioners.

“I mean, what 12-year-old, what 15-year-old, is even thinking about having children when they're being informed that you can freeze and bank your eggs and preserve your fertility in this high-tech fashion?”

As Lahl concludes, informed consent is simply not possible under such circumstances, especially for minors.

“People that are minors. . . these people have so much dysphoria that they chop off healthy breasts. How can you say that person is competent? How can you say that person has clear decision-making capacity, right?” Lahl said. “To me, informed consent just falls flat in this area.”

A Psychic Epidemic

Psychotherapist Lisa Marchiano started working with detransitioners in 2018, with about six of them being long-term clients. She has both worked with those who have only taken hormones, as well as those who have had hysterectomies and ovariectomies. Specializing in Jungian analysis, she is also a co-host of the popular podcast This Jungian Life.

She told the Pamphleteer that while she believes there are only “male gametes and female gametes,” there are certain people for whom “living a life presenting as the opposite sex is their best way to live to address the discomfort of gender dysphoria.”

However, Marchiano underscores that in recent years there has been a skyrocketing increase in the number of young people presenting as transgender.

“Do I think the astounding increase in young people presenting this way is related to an actual increase in the number of people who need to live this way? No, I don't,” Marchiano said. “These ideas can catch hold of us on a collective level. And then, we all sort of go a little bit mad.”

In the vein of the social contagion theory, she described the ongoing surge of trans-identifying young people as a collective madness. More specifically, in a 2017 journal article, she wrote that Swiss psychologist Carl Jung described such phenomena as “psychic epidemics.”

Having bore witness to the devastation of World War II, Jung classified what he saw as a “psychic epidemic,” emphasizing that these psychic epidemics are in fact the main threat facing humanity:

“We are still as much possessed by autonomous psychic contents as if they were Olympians. Today they are called phobias, obsessions, and so forth: in a word, neurotic symptoms. The gods have become diseases. Zeus no longer rules Olympus but rather the solar plexus, and produces curious specimens for the doctor's consulting room, or disorders the brains of politicians and journalists who unwittingly let loose psychic epidemics on the world.”

How gender dysphoria actually arises is still empirically unclear. But Marchiano makes a distinction between the condition itself and the ideology. She described the latter as “regressive” in that it claims to “smash the binary,” but prescribes surgical intervention at the slightest deviation from gender norms.

“Nowadays it's like, ‘You're a girl who doesn't like makeup and crop tops? Then, you must be non-binary, or you must be a boy. Or, maybe you actually need to cut your breasts off.’ Instead of, you know, just throwing a flannel shirt on and going out and enjoying yourself.”

In her work with detransitioners, Marchiano says they tend to express a realization that their idealized picture of transitioning didn’t make them happier or even made them feel worse. Many felt as if they were “chasing an impossible dream.”

For those who only take hormones and eventually quit, detransitioning is obviously still a major challenge. However, their physical presentation is not usually confusing to others.

“It's a little different if you've had a double mastectomy. There's a lot of feelings of awkwardness about the body. There's often a lot of regret. There can be a lot of concern about dating, like, ‘Who's gonna date me now that I don't have breasts?’”

In Marchiano’s anecdotal experience, suicidal ideation correlates with the degree of intervention: “Someone who’s had a hysterectomy is much more suicidal than someone who just took testosterone.”

“That degree of regret, to be 22 years old and realize that you had a hysterectomy for nothing, for no good reason. And now, you've got this altered body and real health concerns. And you're 22 years old. That is a really, really hard thing to live with.”

During our interview, Marchiano recounted the story of detransitioner Grace Lidinsky-Smith, who was featured both in Jennifer Lahl’s “Detransition Diaries” and on 60 Minutes. She transitioned in her early 20s and underwent a double mastectomy just four months after starting a testosterone regimen.

Like Helena, Grace began chronicling her detransitioning journey via Substack. “When I realized that being a trans man wasn’t what I wanted anymore, I fell into despair,” reads one entry. “My body was permanently changed. The surgery was the hardest thing to deal with. The scars hurt. I missed the feeling of having an intact, unscarred body. I was convinced my life had been ruined.”

In a viral Twitter thread, she shared how she pushed through the crushing regret by knitting a blanket over the course of six months.

“It was a scary, bleak feeling that I thought would never end. So I bought yarn for this blanket and told myself ‘finish this blanket first, then see how you feel,’” she tweeted.

“When the blanket was done, I did feel a little better. Not totally — I was still a mess. The identity crisis, medical fiasco, and subsequent total disintegration of my worldview was far from resolved — but I could see a little light. The blanket reminded me things can change.”

From Soprano to Baritone

Cat Cattinson, who uses a pseudonym, is a molecular biologist and semi-professional singer who started performing with her family when she was seven.

“I've always had so many different things I was interested in that it's been really hard to pick one path,” she said. “As a person, I need both. I need the analytical side and I need the creative side in order to be happy.”

Her struggles with dysphoria, she explained to the Pamphleteer, started two years earlier, at the age of five.

As a kid, she struggled socially and was often bullied by other girls. She started diving into the world of transgenderism at 13, becoming acquainted with trans websites and forums.

“When I found out about trans, I was like, ‘Oh, well it's my gender. That's the problem. No wonder I didn't feel like other girls.’”

At 17, she asked her parents to take her to a gender therapist.

“This person was very woke, immediately affirmed me and started calling me he/him. My parents weren't really on board with it, so I would kind of flip-flop and come out and then go back into the closet.”

Before embarking on hormone therapy, she worried about using testosterone because of the effect it would have on her singing voice. Still, Cat experimented with hormones at 23, then took the full plunge at 28 when she officially came out and started testosterone. Four months in, she’d turned in paperwork to legally change her name to Tony and had scheduled a top surgery (a.k.a a double mastectomy) — but ultimately, didn’t go through with it.

“The nail in the coffin for my transition was losing my singing voice, and not only losing my voice, but just having continuous pain and discomfort when I was speaking and singing,” Cat said. “I may not be able to sing at all if I continue.”

“I realized that my identity as an artist, as a musician, was way more important than just being perceived as a man by others. And also, I realized I'm never going to pass as a man. I'm always going to be seen as a trans man.”

She stopped medically transitioning, but still identified as a man. Next, she retooled her identity, self-ID’ing as non-binary for the next six months.

“Then, I went through some sort of ideological deprogramming. Finally I was like, ‘You know what? I'm an adult human female. I'm a woman. I'm not gender stereotypes. I'm not not a woman because I don't always want to wear high heels or have long hair or wear makeup.”

Cat documented the effects testosterone had on her voice on video over the course of eight months. Before taking hormones, her natural voice was a soprano. After treatment, she dropped to a baritone with audible cracks punctuating her singing, indicative of the damage taking root.  

Since stopping testosterone, the damage has recovered. However, her voice remains altered from her pre-transition state. She is happy with the progress she’s made through healing and training, and she’s luckily reverted to a natural female voice somewhere between tenor and alto.

Cat speculates that both the rise and intensification of gender dysphoria stem from our pornified culture.

“I think girls see that, and it's scary. It's scary to think if I'm a woman, this is what being a woman means. And then the gender ideology totally reinforces that and says, ‘Well, yeah, if you're not hypersexual, if you don't want to present hyperfeminine, then you're probably non-binary or maybe you're a trans man.”

“I think it's the social contagion, and it's exposure to the internet earlier on, and exposure to this toxic femininity that I think can really scare girls away from being girls.”

Cat stressed that some trans activists intentionally conflate the terms gender nonconforming and gender dysphoria, which provides an easy pathway for young people to jump onto the trans conveyor belt simply because they slightly diverge from stereotyped gender norms.

“Gender dysphoria and this feeling that it's my body that's the problem: ‘I must take hormones. I must cut off body parts,’ this compulsion aspect. I do think that is a mental illness and a lot of people think it's just synonymous [with gender nonconformity],” she said.

“I don’t really consider gender dysphoria a legitimate diagnosis because I feel like if they grew up in a society that accepted them for who they were, then would these people really still be wanting to cut off body parts? Or, is this really just the medical field and big pharma taking advantage of people who have been wounded?”

Cat was one of at least five detransitioners present at a heated Florida Board of Medicine hearing on Nov. 4, weighing in on a rule that would ban minors from undergoing gender transition with hormones and surgeries.  Trans activists attempted to shout down speakers during the public comment portion (though, afterward, the board voted in favor of the rule).

“They were making it very emotionally charged and telling us things like we're Nazis, we're online trolls. One of them actually threatened the board. I think it might have been a bomb threat or something of that nature. . . Multiple people just telling us ‘Children are going to die because of you,’ ‘You have blood on your hands.’”

Cat has been speaking out for about a year and a half now, so she’s grown somewhat desensitized to the activists. But other detransitioners there were not as thick-skinned.

“There were a few that were just shaking and had such a hard time getting their testimony out and were just breaking down in tears. You had these trans activists just shaming them and getting in their face,” she said.

“It was really disgusting to see that because I would hope that even if you disagree with our position, you could at least have some amount of human empathy for another human being. But, they just see us as online trolls. They just think we're all liars and grifters, and we want children to die.”

Though Cat has stressed that gender-affirming care needs to be banned for under-18s across the board, she’d prefer raising the age to 25 when the brain is fully developed.

“I think if anyone knows me at all, they’ll know that I actually care deeply about anyone suffering from gender dysphoria. And the reason I would want somebody to hold off on getting surgery or starting cross sex hormones or puberty blockers. is because I know that they're harmful and they don't treat the underlying issues.”

After her detransition, Cat said, she ruminated on why she had done this, why she did something to damage her voice and her health, and blamed herself. Eventually, she realized she didn’t do this in isolation, that gender transition was severely misrepresented by the mainstream.

“And so I don't really blame myself anymore. I feel like I was making the best decision that I could at the time, given the facts that I had. I mean, I literally thought that I would kill myself if I didn't transition.”

Transcendent Transgenderism

When detransitioners reflect on what happened, Dr. Marchiano told the Pamphleteer, they tend to bear the responsibility solely by themselves. After all, it was their own decision, one that could not have been made lightly.

However, transition has spiked overwhelmingly in young people of all ages. As shown by the HBO documentary Trans, school-aged children are being encouraged to transition by well-meaning teachers, librarians, and parents. Not to mention, the “trans movement” has the backing of almost every major institution in American life. If an adult as influential and beloved as J.K. Rowling can be tarred and feathered for sharing opinions that affirm the biological reality of sex, what chance do children have in standing up to a gender-affirming pipeline that ends with an irreversible surgery they may come to regret?

“There were doctors that performed these surgeries. There were therapists who wrote them letters. There were practitioners who wrote them prescriptions. And there was a whole society, including the media, who was very ready to tell them that this was the way to solve their problems, that they were a vulnerable young person. And the whole culture was saying, ‘This will make you happier.’ And that's not fair,” Marchiano stated.

“There's really a place here for some righteous anger about what's happening.”

Yet, as of this writing, slogans of “Protect Trans Kids” and “Trans Women are Women” have seeped into almost all corners of our institutions — even religious ones. In August, the Episcopal Church formally endorsed Episcopalians of any age undergoing gender transition. As some commentators have already said, worship of the divine has been supplanted by worship of the secular state.

“The way they're conducting this whole thing, it's very much a religion,” Cat said “I would even say it's a cult. . . But most [religions] are not going around militarily enforcing what other people believe and even trying to lose them their livelihoods and get them canceled and get them publicly ridiculed.”

That some trans rights activists react so strongly to the mere testimony of detransitioners, as seen during the Florida hearing, speaks to how the ideology has painted itself into a corner.

“The truth is that we're locked into this kind of one-size-fits-all narrative that anyone who professes to have this identity needs to be affirmed and transitioned. And the fact is that the existence of even one detransitioner proves that that's not true. It's a real threat to a whole worldview,” said Marchiano.

Embedded in gender dysphoria, Marchiano sees a skewed impulse for transcendence, a longing to rise above one’s own humanity. The desire to transcend is innately healthy, she said, but the promise of gender ideology rings hollow in fulfilling this end.

“We all need to have some kind of relationship with the infinite and our culture doesn't really offer very much anymore,” she laments.

“That you can kind of just opt out of these categories and be profoundly liberated as a result of that. It's an empty promise because it's not true. And as a matter of fact, the only way to really fully experience life is to kind of grow down into our limited bodies, our limited life, the limited time that we have.”