There is a nearly 100% that a person who starts on Puberty Blockers will proceed to cross-sex hormones and surgery. It's because when puberty is halted, they really do't have a way to make peace with their sexed bodies. They are just counting down to the day they can take cross-sex hormones. Nobody knows how many will regret it (definitely more than what's currently being estimated), but one thing is for sure. Giving puberty blockers to 11-12 year olds is effectively committing them to a life of patient hood, reliance on drugs and surgeries, and likely sterility. That's really the reason why puberty blockers need to be far more regulated than they are. They are not a harmless pause button.

I am so sorry for your loss. This may not be the right time to mention it, but it sounds like Michael was led into this by a therapist ( reading his posts). There has to be justice. Too many young people are led or even pressured by therapists into a medical transition. There therapists are not using any evidence-based approaches, and are either unaware of this as an outcome of transition (long-term studies show sex-reassingmed individuals have a nearly 20 x rate of suicides) or are hiding this information from the patients. Either way, it is pure malpractice with terrible damages to the individual and the families.

There are attorneys that will work with your family. PM me if you'd like to get connected. It will not bring back Michael, but it will stop one bad actor from doing harm to many other young people--and may send a message to the greater therapist community to wake up.

I have to admit I am worried about you. I looked through your posts, it appears that you are struggling. You are actively pursuing a hysterectomy, want to make sure you parents insurance pays for it but that they never find out because they don't approve. At the same time you are worried if your eyebrows are too manly or if you look like a boy or a girl. You self-confess to having OCD -- you decided to stop testosterone because you couldn't find the precise ice-packs you liked before. Of all the reasons people chose to detransition, this sounds the most eccentric. Of course I am glad you stopped poisoning your body, whatever it took. I think you are going through a tough time and I hope your therapist is there to help you and not just to write a letter for your hysterectomy.

It sounds like your parents have been concerned about your for awhile. Your sense of self seems unstable. You have considered a diagnosis of BPD? There is highly effective treatment for BPD called DBT. I suspect that you won't like this post but I want to make sure you hear it from a person who means well. You need to seek serious psychiatric help, and you can and will get better. Going to a "gender therapist" who will write you a letter for a hysterectomy is to cheat yourself of a chance at a healthy and stable future. You have your whole life ahead of you. Don't f*ck it up.

Consider yourself ... normal? Like others said, 80-90% of people outgrow their gender dysphoria sometime before mature adulthood. Your feelings may fluctuate a few more times, but this is a more than a serious signal that you should pause your transition plans and see if you can find peace in your body. The alternative is a life time of hormones, which btw for women increase heart attacks by a factor of 5, and cause lot of other symptoms such as vaginal atrophy and uterine pain, a receding hairline, acne, dropped voice, altered genitals, infertility, and worst of all--the very real possibility of having to live in a masculinized body when you really are a female and no longer wish to present male.

The current political correctness and the fear of offending "trans people" has led many clinicians to automatically affirm people as "trans'. Trans is not a diagnosis. Gender dysphoria is. There are many causes of gender dysphoria, and many paths to resolution. On rare occasions, some people can get relief from gender reassignment long term, but more often than not, the excitement only lasts as long as there is another procedure they can chase. Once doctors are out tricks (mastectomy and phalloplasty is where it ends) , the journey is over, but the problems have not receded (or one set of problems got replaced with the other, much worse). Are some people who transitioned happy long-term? Probably yes. But far fewer truly are than those who claim they are. I have talked to a transwoman of 40+ years and she knows hundreds of people, and her genuine belief is that only 2 of them successfully integrated their trans personality. Otherwise are faking it, definitely to others, and sometimes even to themselves, as they are too far on the path, with nowhere to return to.

Long-term outcomes on gender reassignment are poor (8-19 times rate of suicide compared to norm; several times the rate of mental health hospitalizations; it's not pretty). Experienced gender therapists (of which there are very few, and they are all in their 60-70's) know that only a few cases ever benefit (and most are males with a life-long history). Unfortunately, it's no longer politically correct to stay it, and the new crop of therapists are basically activists, not clinicians.

So whether you want to consider yourself lucky or normal, it sounds like a pause button at the very least is in order. And if the dyshporia returns, remind yourself that it had subsided before and it will probably subside again. Living in a healthy, unadulterated body and not becoming a patient for life is a huge gift, and your body will thank you for it with many healthy years.

Hey there. I don't blame you for being confused about the "Am an MTF" bit. The whole state of gender medicine has become a royal mind-f*ck. Experienced gender clinicians--those who have worked with people with a cross-gender identity for decades and who have a nuanced understanding of the issue and how to help people--have been silenced in the recent years by "activist gender clinicians" whose only goal seems to be to medically transition as many people as possible. I will elaborate on the mixed incentives of present-day gender clinicians at the end of the post.

Let's start with the basics. There is no diagnosis of "transgender", "MTF" (or an "FTM" for that matter). What we have is a diagnosis of Gender Dysphroia (GD)--a persistent wish to be the opposite sex and to be distressed by this feeling. There are many things that can predispose one to developing GD.

GD has different course of progression in different people. It turns out, for many females it spikes around puberty and young adulthood, and subsides and resolves without any interventions, or with psychological interventions (but it's not the story you hear today). For males, the story is a a bit different--some have a similar pattern (most recently referred to ROGD), others have what's known as AGP (sexually-driven urge where one is turned on by the idea of presenting as a female), yet others are naturally extremely effeminate and think (sometimes with good reason) that life would be easier, and they could have more satisfying sex lives, to live as a woman rather than an ultra-effeminate gay man.

When the more mature group transitions (around early 30's not teens), after about 10 years, suicides are very high, and mental health hospital admissions are very high, which tells us many of them are not really "happy", even if they are not detransitoining (many have nothing to come back to--no male genitals left, so they continue to live as women.. this is what data cannot capture, but if you talk to mature post-op transsexuals, while some are happy, many others are hiding their disappointment and regret deep down because it's too painful to admit to self, let alone others.).

You are not an "MTF". What you are is a male with gender dysphoria. You may discover that with time your gender dysphoria subsides. You may find less drastic ways of dealing with it that don''t involve hormonal and surgical manipulations, which have many permanent effects. Or you may end up being one of those people (which used to happened rarely), for whom all avenues have been exhausted, there is no way for you to live with an unadulterated body, and you want to begin the process of taking life-long hormones and undergoing surgeries. The latter used to be the last resort, when everything else fails, and men used to pursue it in their early 30's--not as teenagers, as it happens today. That's because LOTS of things will change for you as you mature. Doing something permanent right now, that's so drastic, is not wise IMO.

Why are gender clinicians not telling you this right now? It's a range reasons. Many really enjoy being a mx of Santa Clause and God, giving desperate patients what they want. And for a while, patients love it (the honeymoon seems to ear off on average after 5-10 years and then you are stuck for the rest of your life, depending on the changes). A number of these therapists have chosen the medicalization path themselves and it's validating to them to have you follow down the same irreversible path they themselves chose. And of course, don't forget about the money. There is a ready and growing supply of young people suddenly wanting to make these drastic changes, and they (and their insurance companies) are willing to pay good money, so it's a profession.

Experienced gender clinicians (who are not TERFs and not bigots) have been warning everyone about the Wild West of gender medicine in the past 5-10 years, and how much harm is being done, for several years now, but alas they are getting silenced.

My advice to you as an 18-year old: don't do it. Wait until you are at least 30 and only if you see no other way to be. Until then, try some DBT and learn how to tolerate distress better. Lots of things will change for you. By far the healthiest thing for you long-term is to find a way to be at peace with your body without undergoing risky (strokes) and permanent (sterility, loss of genitals) medical interventions.

You got lots of good advice. I would definitely get on Sasha Ayad's waitlist and talk to her for specific recommendations. She also has a Patreon account and if you sign up you can see her content.

This is becoming an epidemic. Although girls are disproportionally affected, there are a number of boys too.

My advice as you are reeling from this is:

1. Realize there is a good chance it will pass, esp if you focus on handling the right way. It's not hopeless.
2. It may take months OR years, so prepare for a marathon
3. Try to stay as close to your child as possible, as hard as it may seem. If his mannerism change, think of it as a performance (it is) and try to see your kid through all of it as the kid you know.
4. Totally accept all gender non-conformity. But do NOT accept the pronouns or the new identity. If you already have, gentle explain that you cannot participate in the denial of reality. His gender dysphoria is real and his suffering is real--but he is still a boy and your son (Sasha has good content on how to back track if you have already accepted the pronouns).
5. Do find a therapist but only if you can find one who is not on the trans train. It's very hard to find one these days so I would interview a theorist extensively. If they cannot promise that they won't affirm him as a girl, he is better off with you as his therapist, presuming you have a good relationship.
6. You will get a PhD in this issue over the next months. Prepare to learn. Get on Twitter and follow some key people. Learn about medical risks, the long-term poor transition outcomes, the facts. The facts do not support transition for the vast majority of dysphoric people, let alone youth. Transition only alleviates dysphoria for a while and then it comes back, with massive social, medical, and psychological consequences.
7. Take care of your relationship with your spouse. This will test your marriage in a massive way.
8. Take care of your health. This will push you to your mental health limit and take a physical toll so double down on self-care.
9. Join Kelsey Coalition, Parents of ROGD kids, and find other parents to talk too. Again, I would suggest Twitter if you don't use it already, and start by following a few people like Brie Jontry, Sasha Ayad, Kelsey Coalition, 4th wave now, Dr. Laidlaw, Dr. Malone, and your list will grow form there. You will learn a lot from them.
10. Prepare to lose friends and family for not being "supportive". This has become an epidemic of sane people believing that hundres of thousands of kids are born in the wrong body and are suddenly discovering it as teens. Doctors also know very little and many are on the bandwagon. It's starting to change in the last 6 months, but its a Wild West and it will get much worse before it gets better.

PM if you need more specific advice. You are not alone.

​

https://www.patreon.com/SashaLPC

Talking to someone whom you love deeply but with whom really disagree with their thinking and actions on this issue is a familiar territory for me (although as a parent to child). Not all that I learned transfers to a GF/BF relationship but here are a few pearls I have learned:

1. High functioning autism has a lot to do with his rigid thinking and with body disassociation, which lays the perfect groundwork for this situation. The increase in trans-identification has increased exponentially in the past 10 years and data shows that trans-identified individuals (youth esp) have over 20 times the rates of autism compared to the general population.
2. As maddening as it is, you won't be able to talk him out of it or get through. The more he argues his position, the more entrenched he becomes. If I can repeat this 1000 times I would. It's utterly maddening. But them I remind myself. Some of the smartest people fall for cults. It's a known if puzzling reality. Only he can help himself, and it may take him years.
3. Unlike me, you have no responsibility for unconditional love or for saving him. You fell in love with a man. If he is making a choice to change his physical characteristics to female (which hormones will) OR if he falls for an ideology you firmly disagree with and this ideology becomes core to his life, you DO NOT HAVE to be his significant other. You can still be a supportive friend--and he may need your support down the road when things start falling apart.

If you want to talk to him about it, these points might be helpful, but not so much in changing his mind, as in explaining your concerns and why you can't whole-heartedly support his path in the GF capacity:

1. Acknowledge that his gender dysphoria is real. And that lots of people suffer from it, and that many more recently started attributing their body discomfort to GD, and in naming it, found that it grew in intensity. His suffering (whether self- or societally-induced) is real.
2. Tell him that the evidence does not support transition as a good long-term solution. Only short to mid-range studies show anything positive and that positive thing is a subjective "happiness' that they are taking hormones/got surgeries. All long-term studies show continued GD, with the added nearly 3x mortality from heart attacks, strokes and cancer and an almost 20x rate of suicidality. The honeymoon phase of medical transition seems to last <10 years.
3. It's tricky if you want to mention his use of female spaces or not. If he is really in pain, it may pain him even more to hear he is not welcome there, but may be gently hint that he may also be stressing out women around him in female spaces.
4. Share that you cannot support a path that statistically will likely harm him in the long term, even if it feels right at the moment, but that you still care about him deeply.

Above all remember: each person has their own journey. Even as a mom I am learning to accept my children will make really bad mistakes no matter how convincing I am and how smart they are. What's happening with gender is a societal zeitgeist and we as individuals are mostly helpless. But does not have to be YOUR problem.

Be honest, gentle, and stick to what you know to be right.

​

Best wishes.

There is a strong link between PCOS and gender dysphoria. I can dig up a study on it, I saw it. I think it needs to be looked into. I don't think doctors consider PCOS a reason not to transition a person. But the fact that it's such a strong correlation (I think a study showed a huge link) makes me think that if anything, the medical treatment should be addressing the underlying T levels by lowering them, not making them higher...All in all, there is too little research that has been done into GD, it's causes, and its treatments. By treatments, I do not mean transition--it's not really a treatment as much as a bandaid that seems to work for a bit for some, but eventually fails to resolve it for most.

Can she present this to her professional society? A lot of LCSWs are the ones perpetuating this madness (along with LPCs). She is actually smarter and more thoughtful than most gender therapists today and she still screwed up. You are among the first cases. There will be lots more kids who feel this way and who will NOT go back to their therapists to tell them about it.

Do you know that the prior versions of WPATH Standards of Care (SOC 6) strongly discouraged any permanent medicalization of youth due to the fact that “adolescents’ gender identity development can rapidly and unexpectedly evolve,” despite “firmly held and strongly expressed...identity beliefs, giving a false impression of irreversibility”. SOC 7 totally reversed this not due to any new scientific evidence, but due to the politicization of transgender health. You don't want to be a pawn in the political war.

I would recommend staying away from gender therapists altogether. Most have an agenda (instead of thinking of themselves as careful clinicians, they are vocal transgender advocates and many are trans-identified themselves). Many also derive a living from writing people approval letters--they would lose a lot of clients and their income if suddenly they began to tell people they do not need these procedures. They are good people who mean well, but there is virtually no science or evidence in what they do, and real gender therapists-those who worked with trans individuals for decades roll their eyes at the low caliber of people who call themselves gender therapists today.

Think for yourself: There is absolutely zero evidence that transition helps long-term. Not a single study to show improvement in physical or psychological help that holds after 10 years. Yet a lot studies that show long term health risks to physical health (2-3 times overall mortality from heart attacks, strokes and cancer), and well-documented deterioration of mental health (19 times suicidality). The only "good" results focusing on subjective "I like that I did it" sort of outcomes come from short-term studies that happen during the honeymoon period (a few years at best). And they are wiped out by long term results that show devastating health and psychological outcomes.

The evidence is clear. While serve dysphoria can be lessened through transition, the new problems that arise from transition (both medical and psychological) are so significant that it rarely works out on the balance. The honeymoon period, which can lasts form several months to several years, does not last. And when it goes away, you are stuck with irreversible consequences. Is there a rare person who appears to successfully incorporate their trans identity into their life? Yes. What are the odds that the person will be you? Likely very low with today's non-existent level of vetting.

Regret is not low-in fact it was never as low as trans advocates claim in the past, b/c most follow up studies lost an unusually high percentage of participants, which tends to overestimate positive outcomes. In today's climate regret will be even higher--sky-high. For example, someone like you--an 18 year old without a clear a well documented history of severe gender dysphoria from early childhood (my guess. recollections of not feeling right and wanting to run around w/o a shirt don'c count--I mean severe stuff that would be in your medical charts), and someone who is high functioning and who may even consider living in their sex as an option would NEVER have been approved for any of these procedures in the past. But because you can easily get these procedures so easy now, you can imagine that the numbers of people regretting these procedures will be astronomical compared to the "historic' low regret numbers.

Also consider your brain maturity. Neurolgically, you will continue to change rapidly until mid-20's. Believe it or not, your view of yourself may drastically change. That's the reason why in the past, the average age of transition was 30-35. Nobody in their right mind would ever advise an 18-year old to do anything permanent of this nature. Transition is a highly imperfect and highly invasive way of helping one appear as other sex, with lots of psychological and medical implications for life, and it used to be reserved as a procedures of last resort for mature adults who have tried and failed every thing. Very very few people should ever be getting these procedures -and certainly not 18 year olds (with or WITHOUT doubts).

My advice is Just be. Accept yourself. If you don't have a severe dysphoria (if what you feel is a wish to be male but don't have a situation where you are deeply distressed and cannot function), then accept a more masculine style and live as masculine person (forget gender). If you do have real and significant dysprhoria, as in psychological distress that impairs your ability to function, and you are obsessing about this, then look for a therapist who specifically works with OCD and body dysmorphia, and tell them you want to work on coping with gender dysphoria as opposed to wanted an approval letter. But stay away from "gender therapists". Many of them have hurt young people like you with their well-meaning, but non-evidence-based and totally misguided advice.