The Wounds That Won't Heal | Detransitioner Chloe Cole | EP 319

Well, consent has to be documented, but it also has to be informed. Informed means you have to understand what you're consenting to. You needed to be walked through in great detail all of the issues that were relevant to you on the psychological and medical front; all the options that were available to you; and the pros and cons of all those options.

I can't see in any possible way that that could have been done with any degree of thoroughness in something under six months of weekly therapy. I would say that's an absolute minimum to walk anyone through something as complicated as what you laid out.

The problem with me starting it so young was not only that I couldn't consent. I couldn't really fathom the full picture of things. You know, I'll never be able to breastfeed. I'll never have that erogenous sensation in my chest.

I do hate to speak about it, but I'm experiencing sexual dysfunction at the age of 18. That's something that women usually go through when they're in their 40s to 50s. How is this supposed to know? [Music]

Hello everyone watching and listening on YouTube and on The Daily Wire platform. Associated Podcast, we have a rough one today, so buckle up. I'm speaking with Chloe Cole, an 18-year-old so-called detransitioner from the Central Valley of California.

She started her transition at 12 years old: puberty blockers and testosterone at 13 and had a double mastectomy at 15 years old. She is now a strong advocate against gender ideology and seeks legally to hold those propelling it forward accountable. Hello, Chloe. Merry Christmas!

Merry Christmas! Thanks for agreeing to talk to me today. To everybody who's watching and listening, you've been through quite a complicated experience, to say the least, for the last five or six years. You've decided in recent months to go public with your story and also to initiate some legal proceedings against the medical professionals who aided you in your exciting journey.

Do you want to tell us exactly the situation you're in now and tell us about what's happened to you since you emerged from childhood?

Yeah, so at the age of 12, I started experiencing some gender dysphoria, and I started seeing a therapist. I got the diagnosis and started going on the path of medical transition at the age of 13, starting with blockers and then moving on to hormones. At 15, I got a double mastectomy, but it turned out that it wasn't the best decision for me, and I stopped transitioning at the age of 16.

Okay, so let's go back to when you were 12. About when did you hit puberty?

I had a fairly early puberty, actually. I started developing at around the age of nine, if not a little bit earlier.

Okay, and so at nine, do you remember if that changed you emotionally?

Yeah, it did. It was really difficult for me, actually.

Okay, so let me give you a little background. You tell me if anybody's ever told you this before.

So, boys and girls experience, before puberty, approximately the same levels of negative emotion, so that would be primarily anxiety and emotional pain or even sometimes susceptibility to physical pain. Emotions like frustration, disappointment, shame, guilt, and self-consciousness are all part of that network of negative emotion.

Now, what happens to girls when they hit puberty, and no one knows exactly why this is, is that their negative emotion levels go up. On average, biologically mature women are more sensitive to negative emotion than biologically mature men, and that kicks in at puberty.

Now, there's a variety of explanations for that, but no one knows for certain, and here's some of them. Okay, so first of all, sexual dimorphism and physical strength really emerge at puberty. Boys and girls are pretty evenly matched physically, but once puberty kicks in, boys are taller, stronger, and heavier. They're also much stronger in terms of upper body strength.

So, women are at a disadvantage physically in relationships to anything that might have to do with physical combat, and so on those grounds, it makes sense for women to be somewhat more sensitive to threat.

Okay, so another explanation is that women are more vulnerable sexually than men because they bear a much higher cost for reproduction, obviously with pregnancy and the protracted dependence of infants. So, they're more vulnerable on the sexual front, so it makes sense for them to be more sensitive to any threat associated with sexual activity.

Then the third explanation is that women are charged generally speaking with the primary responsibility for infants, and infants are extremely dependent and vulnerable. You could make a case that adult women's nervous systems are actually adapted for the mother-child dyad and not for the emotional well-being of the individual woman.

A woman needs to be threat-sensitive because she's going to be taking care of infants and extremely dependent children, and it makes sense for her to be more cognizant of threats. The negative consequence of this for women is that they are much more likely to suffer from depression and anxiety than men. Cross-culturally, it's between three to one and five to one.

Now, men have their associated pathologies. Men are more likely to be antisocial, for example, and to abuse alcohol, but women predominate on the negative emotion side. I would say that's exacerbated if you hit puberty early because you have to deal with the complexities of physiological transformation at a very young age.

So, that's a difficult thing to handle emotionally, and then there's the additional consequence of whatever hormonal turbulence might emerge as a consequence of the onset of puberty.

It's very common for young women to experience high levels of negative emotion, and for those emotions to be focused on their body because another thing that's characteristic of female negative emotion is that the self-consciousness associated with that tends to focus very particularly on body shame and self-consciousness.

That might be because women are evaluated more rigorously on the basis of their physical appearance than men. Men are evaluated more harshly sexually, let’s say, on the performance side, you know, with regard to socioeconomic status and so forth, but women are definitely evaluated more harshly by men and by each other in terms of their physical attractiveness.

So, that makes quite a complicated situation for girls who are making the transition into puberty. A lot of them are depressed and anxious, and that can develop into an intense focus on their body.

So, I don't know how much of that was explained to you by your therapists or the medical professionals, but that's all well-documented psychological and medical information.

Yeah, none of that was really explained to me by therapists or even growing up. I mean, even so, that all, every single part of what you said actually played a role in a lot of my childhood distress and my transition, and eventually my detransition.

Actually, you know, growing up, I was a bit of a tomboy and also on the spectrum, and I didn't know this until I was diagnosed just last year. But it did play a role in my socialization and my difficulty getting along with other girls growing up. I found that I fit in more with the boys.

When I hit puberty, it was a bit earlier than most of my peers, and I got taller than them. I had a lot of pride in that, but as the years went on, they started to get taller than me and outmatched me physically, and this did bring on a bit of distress for me.

As I got older, socialization began to become more sex-oriented, and I found it even harder to fit in with girls my age. At the same time, I was also starting to notice there was a divide between me and boys in several ways, and there was a lot of loneliness for me.

Because, on one hand, I didn't really feel like I was one of the girls, but on the other hand, I was losing my connection with some of my friends who I was close with and cared about. I also had some body image issues growing up as well.

I often talk about how social media played a role in it, but really it started from a very young age. I mean, I grew up in a very image-oriented, very sex-oriented society, and you know, before I hit puberty, I was looking forward to having a developed body and eventually going breasts.

Once I hit puberty, I was really disappointed in how I looked. I was very skinny and on the smaller-chested side, and I grew up in an age where we glorified bodies that are very voluptuous, lots of curves. People often use phrases like "body," I mean "bottom-heavy" or "hourglass pear-shaped" things like that, and I didn't look like that at all.

I was quite thin, a little on the muscular side, and if anything, my shoulders were probably the widest point in my body. I kind of had a complex over this. I also liked having my hair short because of all this. I felt like if anything, I didn't really look like a girl at all. I didn't look like the other girls my age, and I felt like I just wasn't pretty and that I would never really have that sort of experience as a woman.

It's a very rare adolescent, and probably a particularly rare female adolescent, who feels attractive in the early stages of puberty. Everything that you experienced, although you may have experienced it, you know, in an exaggerated manner for some of the reasons you laid out, but everything you experienced is, in some real sense, par for the course for the vast majority of people.

Now, you did add one additional issue, which we could delve into a little bit, which I think is relevant. You said that you're on the spectrum and that you had an easier time communicating with boys than with girls.

Here's something to know about that. The biggest reliable difference that's been documented between males and females—and this becomes even larger in egalitarian societies, by the way—is orientation of interest. Women are higher in negative emotion, and they're more agreeable. Agreeableness is both compassion and politeness.

Although the difference between men and women isn't massive, it's significant, and it also maximizes in egalitarian societies. So, it looks like it's biological. But the biggest difference is in interest.

Boys, males, are more reliably interested in things, and girls, females, are more reliably interested in people. People on the autistic spectrum are also more reliably interested in things.

For example, if you're extremely autistic, the psychological phrase used for descriptive purposes is "lacking theory of mind." Extremely autistic people have a hard time understanding what’s going on in someone else's mind at all. They tend to be almost entirely thing-oriented.

There’s a much higher preponderance of autistic symptoms among engineers. Then, if engineers in Silicon Valley, for example, male engineers and female engineers would often, by statistical comparison, would often marry, and their children are disproportionately likely to be autistic.

The fact that you were tilted towards the autistic end of the spectrum—as I said, that might just be an indication of neurological wiring that tilts you towards interest in things. Just so you know that, so that's not necessarily autistic in and of itself, it's just part of the normal variation in, what would you call it, well, in attentional orientation.

But the fact that you were on the spectrum, let’s say, and more interested in things is going to make it more difficult for you to communicate with girls, because girls are reliably more interested in people.

Then, on the image front, you know, this ties in with the idea of self-consciousness. If you're on stage and you're talking to people, and you become aware of yourself, that tends to make you nervous and sweat, and to become uncomfortable and experience high levels of negative emotion.

Self-consciousness itself looks like a manifestation of negative emotion. They're incredibly tightly linked statistically and almost indistinguishable from one another.

So, what you see happening very often in girls, because girls are self-conscious in relationship to their body, because that’s one of the primary ways they’re assessed, let’s say for attractiveness and for social status, is that self-consciousness tends to take the form of intense preoccupation with body image.

So, that can be exacerbated by whatever social trends happen to be in place, but it's a very deep-seated problem. The fact that you hit puberty earlier is going to make that, obviously, more complicated, because it means you're not as neurologically mature or practically mature when you have to contend with all these issues.

Everything that you described, in some sense, could have been attributed to the difficulties of normative development, just so you know. This proclivity of teenagers to develop depression and anxiety, I want to take that apart for a minute too for everybody who's listening.

So, imagine gender dysphoria, okay? So, 10 years ago, it was comparatively rare but not unheard of. But imagine it has two components, okay? One is a tendency towards negative emotion, so suffering, anxiety, depression, frustration, disappointment, pain, shame, guilt, self-consciousness, all of that, and then imagine there's a second part of that that's more specifically focused on discomfort with the body.

The first part of that is the bulk of it. So, if you look across forms of psychopathology, like mental illness, the major segment is high levels of negative emotion like depression and anxiety. A secondary segment is the particular manifestation of that in your case in body dysmorphia.

The uninformed mental health professionals make claims that you're at elevated risk for suicide if you're gender dysphoric, is erroneous because the elevated risk for suicide is actually a consequence of the general proclivity for depression and anxiety and not a specific consequence of gender dysphoria.

At least that’s only a small subcomponent of it. That's another thing to know: the main clump of psychopathological manifestations of mental illness is centered on heightened levels of negative emotion, and, of course, that spikes for adolescent girls.

Now, you may have been told this, but perhaps you weren't, so there are good long-term studies of children with gender dysphoria. Most of them were conducted in Toronto by a man named Ken Zucker.

Zucker ran a clinic for gender dysphoric kids way before this became part of the culture war, let’s say, and he was a very straight and honest scientist, a very good researcher, not a political person.

What he showed was what his clinic showed in many peer-reviewed studies was that gender dysphoria of the type that you described is relatively rare. If you leave kids alone until they're 19 or 18, 80 to 90 percent of them settle into their biological identity, although about 80 percent of them also are also homosexual in their orientation.

So, the pathway for him, before this was all politicized, was you'd have a child who was gender non-conforming temperamentally, somewhat like you were. You didn't have a pattern of female interests, let's say.

And then, prone to depression and anxiety, that combination would produce this gender dysphoria, and that would become quite intense around the dawn of puberty. But if you just back the hell off and waited, those kids would settle into their body, but generally would adopt homosexual orientation.

As far as I can tell, that was the best research. Now, Zucker got slaughtered for this once it became politicized. He lost his job; he was pilloried by the Toronto Star, the newspaper here. He won a lawsuit against them just a couple of years ago, but they demolished his career.

His guideline, medically, was "don't do any harm." You can provide these kids with support, and you can walk them through their emotional problems, but you should certainly not rush into anything more dramatic.

Now, you said you started therapy when you were 12. What were you told about what was plaguing you?

I think before I get into science, there are some things I should bring up. I mentioned that I did have a late diagnosis for autism. In preschool and in my elementary school years, my teachers often told my parents that I had some symptoms indicative of autism and they suggested that they get me diagnosed.

But when they brought me to my doctor as a kid, they were told, "Oh, she's too smart to be autistic. She's too socially developed to be autistic." So, I kind of missed the best opportunity window, the best ages, I guess you would say, to get the diagnosis. It wasn't until after I stopped transitioning that I got the diagnosis, actually.

Okay, and I find that that played a stronger role in the development of my gender dysphoria than my sexual orientation did. Because I'm mainly heterosexual, I'm mostly attracted to men, and I mean, I do have a very marginal attraction to other women, but it's mostly of a sexual nature. I don't really have any emotional attraction to them, and it's not something that I've ever really cared about because I do want to have a family one day. I do want to have children, and I can't really do that naturally with a woman, so I just don't really see a point in it.

Yeah, well, there is some evidence, by the way, too, and I would say this evidence is less compelling, but I think it's worth contemplating, is that the distribution of sexual attraction in men looks like it's more bimodal than it is in women. There seem to be homosexual men and heterosexual men and not much in between.

But on the female side, there's some evidence that women are more broadly attracted to—obviously, most women are heterosexual in their orientation—but a higher proportion of women report a co-attraction to other women than men who report a co-attraction to other men.

So, why that is again isn't exactly obvious, but I wouldn't say that research is incontrovertible, but it's also worth knowing because one of the things that young women who are confused about their sexual identity and their body might be wondering is, "Well, now and then I feel an attraction to another girl. What does that mean? Does that mean that I'm not female in my essence? Am I not female physiologically? Am I not female psychologically?"

I would say no, it doesn't mean that at all. It's pretty damn common. It might even be the norm, and I think most women would, when pushed, would make the same statement that you just made about their relative sexual attraction. So that's a good thing to know, too.

Okay, so back when you were 12, you weren't diagnosed with—you were diagnosed a little bit with autism when you were young, but you were told by your medical professionals that you were too intelligent for that diagnosis to be relevant.

So, part of that's this distinction, right? It’s complicated because what symptoms did you have of autism when you were a kid?

It was mainly social and emotional. I was very prone to emotional outbursts. Mainly, getting along with and maintaining friendships. I also had some sensory difficulties, like with certain textures of fabrics or certain smells. Certain foods, I wouldn’t eat.

So, it was mostly in the social realm. And what about your language development? Was it normal?

I was advanced, actually. I had taught myself to read and write, and I was further ahead of my peers in that area.

Okay, because you’d be a complicated case to assess as a child given your retrospective report. Another one of the stellar what would you say, cardinal characteristics of autism is delayed language development.

That might have been partly what the physicians were referring to when they said you were too smart to be autistic. But then it’s also difficult to parse apart the fact that it is a distribution. The mere fact that you had difficulties in social communication and were you interested in things?

Yeah, like were you interested in… are you more interested in mathematics or are you more literary in your orientation?

Definitely more literary. I’m also a bit of an artist. I’ve always liked drawing from pretty young age, as far back as I can remember.

So what do you do on the hobby side? If you're just left to your own devices, what kind of activities would you engage in?

Usually, either illustration or video games.

So you would regard yourself as a creative person?

Yeah, I guess that's relevant too, eh? Because creativity is associated with this personality trait: openness. Open people have pretty mutable identities. It's sort of the hallmark of being creative, right? A creative person isn't that stable in their identity.

I don't mean in the negative emotion sense. I mean they can be one person or another; they're changing. That mutability is part of being creative.

In your situation, if you had social difficulties, if you had high levels of negative emotion, if you were characterized by bodily self-consciousness, and you were creative, then you're a pretty good candidate for the idea that your gender might not be properly aligned with your physiology.

You’ve got all the risk factors, so to speak, that would put someone in that category.

Okay, so when you were 12, you started therapy. Why was that, and what happened?

So I was about 11 when I got my first phone, and I started using social media. The main platform I would use was Instagram, so very image-oriented, very very image-oriented, right?

Yeah, it further reinforced and worsened my body image issues. I was just force-fed a lot of content that was just very difficult to take in.

Okay, so tell me about that in some detail. So you're using Instagram; it's a very image-oriented platform, and you said that was really hard on you.

You alluded to the fact that you were looking at socially approved images of women, let’s say voluptuous women, and you were drawing a negative conclusion in relationship to yourself. So exactly how did that play out day to day?

I started comparing myself a lot to my family and the other girls around me. I mean, a lot of my female family members are larger-chested, but I got the smaller breast jeans, and I was really quite insecure about this.

Even though I hit puberty earlier than my other peers, a lot of them were outgrowing me, and I felt like I just couldn't keep up with other women. Also, in various conversations or conversations I would overhear between other girls and women, they often spoke very negatively of being a woman in general, like how difficult puberty is, the scary aspects of being pregnant and then giving birth, the expectations placed on you as a mother, and starting aging with all these bodily changes that will eventually lead to menopause.

It was all painted in a very negative light; I never really heard about the blessings that came with any of these parts of being a woman, so naturally, I wouldn't want to start growing afraid of that.

I would also start seeing a lot of feminist content at this time, which kind of reinforced those same ideas while also saying things that were pretty scary to me at the time, like, "Oh, we live under a patriarchy; we're being controlled by men, and they don't care about us." They're taking away our rights.

I don't believe that now, of course, but I kind of fell into that line of thinking, and I wanted— I mean, with all this, I just wanted absolutely nothing to do with being a woman. I didn't want to grow into a woman; why would I?

Okay, so two things were happening to you. You said, on the one hand, individually you were suffering from the consequences of felt inadequacy in relationship to these more voluptuous and clearly markedly feminine women, in relationship to their physiology.

You felt that that wasn't a domain that you could necessarily compete in. Then also, at the same time, you were being exposed to social and educational material that suggested to you that not only was this a game that you couldn't play very well in terms of your physical appearance, or maybe your temperament, but also that even if you did play it well, it wasn't necessarily a game worth winning.

That there wasn't anything positive on the female front.

You know, when my wife was pregnant with our kids, one of the things that really struck me, and I never really forgot it, was that so many would tell her horror stories about pregnancy— sometimes their own or sometimes the pregnancy of other people that they have known— and really do what they could to terrify her.

That always used to irritate me because my wife actually really enjoyed being pregnant. I mean, my daughter got quite ill when she was pregnant, so I know there's a huge variation there; I saw that with my clinical clients.

But it's not like there’s nothing positive about being female; there’s plenty positive about it. But it’s easy to fall into a situation where all you hear is that it’s oppression, it’s suffering, it’s vulnerability, it’s victimization, and that there’s nothing about it that’s positive at all.

You know, I think part of that’s a consequence of the higher levels of negative emotion, right? A necessary consequence of that because women are more susceptible to threat and punishment.

But that doesn’t seem to have all that much to do in any real sense with women’s actual place in the social hierarchy. The reason I say that is, as I mentioned earlier, there are societies that have become more egalitarian, where women clearly have far more opportunity on the socioeconomic front than they’ve ever had in the past.

Those countries, the countries that have gone farthest down that route, are probably the Scandinavian countries; and the consequence of that is that the difference between men and women in negative emotion is actually higher than it is in traditional societies.

It doesn’t look like the higher levels of negative emotion that are characteristic of femininity are a consequence, let’s say, of patriarchal oppression. So there's no evidence to support that hypothesis at all as far as I can tell.

I mean, obviously, there are individual women who are in abusive relationships and who are genuinely being victimized by, you know, psychopaths and sadists, but as a sociological explanation doesn't seem to hold water. In fact, quite the contrary is true.

In any case, you were worried about how you could compete physically, and that's sad too, you know, because men are actually much less choosy, so to speak, than women are when it comes to evaluating physical attractiveness.

For example, virtually every woman can find a sexual partner and usually very quickly. That's certainly not true for men. Men rate 50 percent of women as above average in attractiveness, whereas women rate 20 percent of men above average in attractiveness.

This variation in body type that you suffered so much from might not have been an impediment at all to your ability to manifest yourself as an attractive person in a reasonable society.

You know, I can understand because Instagram is a very heavy image-laden platform, and I can understand why you might have been under a misapprehension, but one of the things that a therapist might have done for you is to help you explore the full range of, say, body types that are classified as attractive.

To show you that, you know, it’s not—you don’t have to be J-Lo to be attractive, and that’s definitely the case. There are multiple dimensions to attractiveness that aren’t only body-focused as well.

You know, I mean, men do evaluate women on the basis of their physical attractiveness, but that’s not the only dimension of evaluation either. There’s more to the story than that by a lot.

So, okay, so you fell into Instagram, and you also started to become susceptible to this, what would you say, negative propagandization about the female role. So you couldn’t see anything positive in that for you, eh?

Yeah, and a lot of these feminists were kind of downplaying, I guess you could say—the traditional role of a woman and the importance of motherhood— or even just fulfilling a maternal role.

You know, I didn’t really value that a lot growing up because I was the youngest of five kids and I never really had to take care of anybody.

I didn’t really know what that felt like. And so I didn’t really think that I wanted to have kids. A few years later, after I stopped transitioning, actually, I realized that I did have a maternal instinct and I really did want to be a mother and have blood children.

That was an instinct that wasn’t really fostered. It wasn’t really allowed to grow at all because I was playing the role of a boy and also taking testosterone on top of that.

But, you know, at the same time that I started using social media, I started seeing feminist content and just the hell that is Instagram. I would also see a lot of LGBT-focused content, and a lot of it was teenagers and young adults who identified as transgender or non-binary, and it was primarily young women.

I would often see they— a lot of them had the same struggles that I did socially, and many of them weren’t exactly the closest with their families.

You know, I would see them go from struggling to changing their expression and then eventually becoming more accepted by their families, and it seemed like people really supported them and had their backs, and they had this sense of community around them, and that was something that really touched me.

I didn’t really realize at the time, but that was something that I wished that I had.

Okay, so you wished that you had, what do you mean, a peer community? Like when you were feeling lonesome and isolated, what is it that you were lacking? What is it that you were wishing for?

I think mainly I really wished that I had friends around me who I knew could depend on.

When, Kate, did you have any friends at that period? Did you have any friends at that period of time?

I did, but I wouldn’t say that I was particularly close to them or that I had very many at school.

I didn’t really fit in. I didn't really fit in in middle school, I didn’t have a whole lot of friends, and I found that there was kind of favoritism among students by staff.

You know, I was like a new kid, and I wasn’t really involved in any sports or clubs or activities or anything like that.

I was kind of a difficult student, and I found that I was being bullied by both students and staff, right?

And I also like to show you I wasn’t like being abused by my family or anything, but I just wasn’t very close to anybody really. I mean, my siblings were all older than me. There’s about a right seven-year age gap between me and the rest of them.

And I mean, from a young age, they, you know, they got older, they started hitting puberty and becoming teenagers, and they didn’t always want to be around me; they were wanting to do their own thing.

Okay, so you’re having difficulties on the body image front, and that’s exacerbated by your temperament and by early puberty, let’s say. You’re not as popular with your peers as you might be; you’re somewhat isolated in relationship to your siblings because they’re older than you.

You’re having a difficult time socially in middle school, and now you’re seeing on Instagram the emergence of this explanation for your problems that’s generated by people who sound like they have the same issues that you do, and what you see is that when they adopt this new non- or gender-fluid identity, that what do you see?

What happens when they have a community? All of a sudden, people are supportive of them.

Like, why did that become attractive to you?

I think I saw the similarities between me and them in a lot of ways.

When I was younger, I was often compared to boys, and I liked hearing things like, "Oh, you’re being such a boy" or "Wow, you’re such a boy," from my older sister and mom and stuff.

It just made me—I don't know; I didn’t really know why at the time, but it just made me proud to appear things like that, I guess. It just felt like kind of an achievement because, you know, I didn’t particularly like other girls, and I didn’t really like the fact that I was a girl either.

Especially as I got older, I really wanted to weigh out, and when I started seeing this content, it taught me that there was—I didn't have to be a woman.

We’ll be back in one moment. First, we wanted to give you a sneak peek at Jordan's new series, Exodus. So, the Hebrews created history as we know it. You don’t get away with anything. So, you might think you can bend the fabric of reality and that you can treat people instrumentally and that you can bow to the tyrant and violate your conscience without cost; you will pay the piper.

It’s going to call you out of that slavery into freedom, even if that pulls you into the desert, and we’re going to see that there’s something else going on here that is far more cosmic and deeper than what you can imagine.

The highest ethical spirit to which we’re beholden is presented precisely as that spirit that allies itself with the cause of freedom against tyranny.

I want villains to get punished, but do you want the villains to learn before they have to pay the ultimate price? That’s such a Christian question, right?

Well, there is something complementary, let’s say, in some sense about having those masculine attributes—those masculine qualities attributed to you when you’re a young girl because they’re often associated, when they’re positive, with something like courageousness and the willingness to explore and the ability to sort of stand on your own two feet.

You can imagine how that might be attractive. Then you also were presented with a solution to your problems in some sense, right?

You had quite a complex series of issues that were besetting you, and all of a sudden, there’s a pathway forward. The pathway forward is something like—and correct me if I'm wrong; I do not want to put words in your mouth— is that while you have a non-standard gender identity, let’s say, and that means maybe you’re born in the wrong body or something like that.

Now, it’s interesting in your case because, you know, you actually—your basic core fantasy was that you wanted to be a fully developed and, let’s say, voluptuous woman.

I mean, so that was really driving this, but if I understand correctly, you were worried that wouldn't happen.

Then you started to become concerned about the adoption of a female identity. Then there was this alternative pathway that was laid forward before you.

What was happening to you in therapy at this time? Was all of this making itself manifest while you were in therapy? And what role was your therapist playing in this?

Yeah, so right around the age of 12, I decided that I wasn’t actually a girl. After some period of time questioning my sexuality and then eventually my gender identity, I switched between labels before I finally settled on, you know, I think I’m just actually a boy.

I started cutting my hair shorter, gradually wearing more boys' clothing, and I came out to my older sister, some friends that I was closer to, and at school and some people online as well.

After a few months, I decided that I wanted to tell my parents about this and also start the path of medical transition. I wrote a letter explaining to them that I wanted to be their son and that I wanted them to refer to me by a new name.

They were beyond shocked. I don’t really know how, as a parent, you could expect to hear something like this. I knew at the time even that it would be pretty shocking to them, so I wanted to allow them some time to think it over and think of their response.

I was also scared of how they would react, so that was why I wrote a letter instead of bringing it up to them face to face.

They wanted to support me, but they weren’t exactly sure what they should do. They wanted to seek the help of somebody who may be an expert in this, who was more knowledgeable, and they thought of it as like a psychological issue, and they wanted to get to the root of it.

So, they sent me to a therapist, and do you remember what specialization your therapist had? Did you see a psychologist or psychiatrist, a social worker? Do you know?

I don't remember the—I don't remember his title. I think he was just a generic pediatric therapist, and the first one I saw actually wasn’t very thorough. He didn’t really give me a diagnosis, I don’t think. He didn’t really go into the reasons why I was feeling this way.

He was just kind of like, "Oh, so you’re a boy?" Okay. And then he just never really went into anything.

Let me tell you for a second what should have happened. Just so you know and so that everybody listening knows, when somebody comes to see you as a therapist, you kind of have three questions that are paramount.

The first question is, "Well, why is this person here?" You don’t know. Now, what you assume is something generic, is something like, "Well, this person is suffering and confused for some reason to the point where that has become unbearable enough that they want to seek outside help."

And that’s not trivial, because people generally don’t seek outside help unless they’re pretty desperate.

So, the first question is, "Well, this person is suffering; why?" And then the next question is, "Well, is that something that goes along with—is that something that’s intrinsic to them?"

So, is there something wrong with them, say, in relationship to a mental illness or physical illness or something about their situation that would make anybody miserable if they were in the same situation?

And then the third thing is, "Well, having sorted out that the person is miserable and why they're miserable, what could be done about it?"

All of that should be open for discussion, right? So if you came to see me as a therapist, I would— the first thing I would do is kind of what I’m doing in this interview today: trying to figure out, "Well, what exactly is going on with you?"

You see, that’s different than affirming your identity, right? Because you could come to me as a client and say, "Well, I think I’m a boy." The proper response for me as a therapist is, "Okay, well, you’ve said that, and I want to find out why that is." But I’m not going to take that as gospel; I'm going to find out because we’re trying to solve a complicated problem here, which is, while you're suffering, and it isn’t exactly obvious why.

In fact, it’s not obvious at all. And it’s not up to me as a therapist to leap to a conclusion. It’s up to me to talk to you and maybe for hundreds of hours find out exactly what it is going on.

Because I found out already, look, your initial fantasy was that you wanted to be female, but you felt that in some ways your body was failing you on that front. Then you looked for—and then you found out that being female wasn’t, you know maybe it had some downsides and maybe all downsides.

So then you were looking for an alternative, and you found one that also explains some of the difficulties you were having socially. That’s what you’ve told me so far.

Okay, but that doesn’t mean we know what to do about it yet, right? We’ve laid out the problem landscape, but the logical conclusion of that isn’t, "You’re a boy, and you should go on puberty blockers and then move towards surgery."

We’re nowhere near that. We’re dozens of hours or hundreds of hours away from any decision like that. So, well, that’s what should have happened to you when you went for therapy. You should have had the time to lay out the whole problem and then the space to explore this really deeply so that you could come to terms with what it was that you need, how you needed to move forward, okay?

So you said that, as far as I could tell, so far you said your therapist accepted the idea that you should be a boy pretty damn rapidly. I should also point out to everyone who’s listening that that’s actually now mandatory by law in many jurisdictions.

Now, because of standards of gender-affirming care, therapists are required—if you say something like, "You’re a girl," you say something like, "Well, I'm a boy," the therapist is now required to agree with you on pain of license loss.

So beware, everyone listening and watching, because that’s now the law in many places. And to me, that’s the end of psychotherapy because all psychotherapy is is a questioning approach fundamentally. You know, to find out what the problem is and then to try to work towards, first of all, non-harmful solutions.

So I would have worked with you, for example, I would have explored some of the realm of alternative forms of beauty that would have been a nice thing to walk you through so you could see more of what the range was of acceptable and admirable physiological types.

That's, you know, I don’t know for sure that we would have done that, but we might have because that would have been good for you to get a broader picture of attractiveness, right?

And then also to tell you about the fact that a lot of the misery that you were experiencing was well par for the course for females at puberty, but was also exacerbated by your temperamental proclivities, and so that might help you calm down a bit, right?

Because you get a bit of an explanation for your misery that way and also some hope that you’d kind of grow out of it with time.

Okay, so you went to the therapist, and he more or less agreed with your prognosis and diagnosis that you were a boy.

Okay, so was the therapeutic process of any utility to you?

No, he didn’t really do anything, actually. I was actually pretty disappointed with him. I did have some stuff going on at home and at school that he just never went into.

My full picture of my mental health wasn’t really explored at all, actually, throughout the course of my transition, and a lot of what I mentioned I didn’t even know was a problem until recently—well after I stopped transitioning and I was old enough to really be able to introspect well enough to figure out where it all stemmed from.

But it was never explored by the adults who put me on this path.

Okay, so how often did you go to see your therapist and what actually happened during the so-called therapeutic process?

I was seeing maybe about once a week to once every two weeks. It’s hard to remember so far back, but I remember nothing really ever came out of the appointments.

I would tell them, like, "Oh, my phone got taken away," and I don’t really have contact with the outside world, for example.

He would just be like, "Oh, okay. How are you doing with that?" and I’d be like, "Um, you know, not very well," and he would just say, "Okay," and not really do anything about it.

He didn’t really offer me anything at all. Eventually, I’d say after a month or so, he maybe got fired or transferred somewhere else because he wasn’t there anymore.

Then I got sent to another therapist, and roughly around that time I expressed to my parents that, you know, I’m not really satisfied. I want to go through with a medical transition; I want to go on hormones.

They actually pushed back on this at first. They were very cautious of this; they didn’t know why I was pushing for it so much, and they wanted me to wait a little bit because, at this point in time, I was only 13 years old.

I was quite young to be doing such a thing, and they stayed that way. I got my gender dysphoria diagnosis, and during one of the appointments that they're— they’re very for— they told my parents, "This is pretty much the only means of treating dysphoria."

There was like no regards to any alternative treatments. My dad asked, like, about the regret rates, and they said, like, "Oh dude, they didn’t even—I don’t think they even used the word detransition."

They said, like, "Oh, there’s less than a one-to-two percent regret rate."

Yeah, they also told my parents that if I wasn't allowed to go through with this, then I would be at risk of suicide.

Okay, so I want to take all of that apart because every single one of those statements is a lie.

So first of all, the American Psychological Association and their guidelines for gender-affirming treatment makes the case that—and because of prejudice, that there are no good long-term follow-up studies of transgender individuals.

They attribute that to prejudice against transgender individuals, which is not the reason, by the way. The reason is that there’s a very low base rate, or there was, of transgender dysphoria and the follow-up studies haven’t been done, in large part, because the surgical and hormonal treatment regimen is relatively new.

But there are no good long-term follow-up studies, and they actually complain about that. A couple pages later in the same document, they say that, well, it’s necessary to affirm an alternate gender identity because otherwise the client or patient is at heightened risk of suicide.

Okay, so first of all, both of those things can't be true. There’s no way that people can know that suicide risk is elevated if gender transition is delayed unless the long-term studies are in place, and they already stated that the bloody long-term studies aren’t in place.

So, that's all just a lie. It's worse than that, it's way worse than that. You see, gender dysphoria is a variant of the suffering that’s associated with negative emotion, depression, and anxiety.

Now, depression and anxiety are the primary drivers of suicidal ideation, not gender dysphoria per se.

And so they’re confusing the source. Now you were—and then there is no evidence whatsoever that transition of the medical sort actually has a salutary effect on mental health, partly because the long-term studies simply haven't been done.

The idea that we know from a research perspective that a child is much safer if they start transition than if they don’t, that's just, again, simply not true.

Ken Zucker's work has showed quite clearly that if you just leave the kids alone, then by the time they're 18 or 19, most of them settle into their biological identities.

Now, so the reason I'm stressing this is because your parents, like many parents in this situation, were put in a very difficult position.

I would say it's corrupt to the point of malevolence what the medical professionals are doing on this front, and that is the insistence, "Well would you rather have a live trans child or a dead child?"

I don’t think there’s anything more toxic you can say to a parent than that because that backs them into a corner. Their alternatives are then, well, you can let your child go ahead with this absolutely life-altering hormonal and then surgical treatment or your child can die and it’s your fault because you don’t care enough.

Parents, like, they’re accustomed to trusting their medical professionals at least to some degree and accustomed to assuming that the knowledge they put forward is valid and reliable.

The information that your family was given was none of those—in fact, it’s pathological to a degree that’s almost imaginable. It’s criminal in my estimation what you were told, because there is simply no evidence that any of that is the case.

There’s no evidence that transitioning kids are less likely to be suicidal, there’s no evidence that that's the only treatment path that works, and there’s certainly no evidence that there’s no alternative to transition or suicide.

It’s so pathological, I can't believe it, but it’s no wonder your parents were pushed into a corner.

Because that's a dreadful choice for a parent to have to make.

Yeah, they were definitely coerced into it and, um, after that they obviously were more open to the idea of me being medicalized. A gender specialist decided to refer me to an endocrinologist.

The first one who I saw actually was the only person who really pushed back on this. After the appointment, he said, “You know, you're very young; you’re 13, and this could have some negative implications for your brain development going forward, so I think it’s something that should wait; I’m not going to prescribe these to you.”

And after that, I was just referred to another endocrinologist who, after about two or three appointments, gave me the consent forms for blockers. I started about a month after that and then I had another appointment to sign off on the forms for testosterone.

My mom also had to sign off on them. This was around late 2017, early 2018. And I don’t know if it’s still true now that you need your parents to, if you’re a minor, to sign off on forms for hormones or anything like that because they're trying to push for kids being able to make that choice.

But, you know, when I started— when I was reading these forms, you know, they listed a few side effects for either of them. But I was a perfectly healthy kid before I started transitioning, so, you know, it was kind of hard to determine which of those I might experience.

And I was also— I was barely a teenager; you know, kids kind of tend to think that they’re invincible, that nothing could get them.

But I started experiencing some complications that affect me to this day.

Okay, so three questions: What were you experiencing socially at this time? How broadly had you made your transition known? What was the consequence socially?

And then, what were you fantasizing about your life being like if you were successfully transitioned to a boy, so to speak?

Then what were the consequences of the hormonal treatment?

So, let’s go through those one by one. What was happening to you on the social front at this point?

So I was in eighth grade at this point, and I wasn’t really out to anybody other than family and a few people at school, but my other peers who I didn’t necessarily speak to about this did notice my change in presentation.

That was that I started to look more like a boy, and they weren’t necessarily the nicest to me about it.

I was kind of ostracized amongst my peers, they would call me names, and there was one boy who would harass me over the course of the school year.

There was an incident with him that I will bring up later, but I wasn’t necessarily—my peers weren’t necessarily the most supportive media at this time.

But once I started on the hormones and I started having the physical changes, I’ll get into that later, actually.

Okay, so, and what were you hoping for now? I’m presuming your fantasy life switched to some degree. Now, you told me earlier that in the earliest stages of your transformation into adulthood, you were thinking about this voluptuous female ideal and then bemoaning your distance from that.

But now you’ve decided to change sexes, essentially, and so you have a new vision of who you could be and what life would be like, I presume that would be going along with that. What was happening in your fantasy life?

I presumed that you wanted to be the best version of yourself as a boy, but what was the new vision of yourself?

I mean, you did mention how you wanted to be perceived as more courageous, confident. What else?

Yes, you know, I wanted to be by this idea of myself in my head that I wanted to be more like a man. I wanted to be strong, both physically and mentally, independent, and not really have to worry about how other people felt about me.

I also wanted to be, I guess, just more confident in general than in myself as a person and also my body. Once I started on testosterone, I started seeing all the physical changes.

You know, my hair, my eyebrows got thicker, I started developing more muscle. My face and my body became more squarish, and I felt good about myself. I felt like I looked good for pretty much the first time in my life, and I felt like I had some control over how I looked, and initially, it felt great.

Yeah, well, testosterone can have that effect directly pharmacologically as well.

Okay, so we can take that apart a little bit. Look, there is nothing wrong with you wanting to have those things, right?

I mean, why wouldn’t you want to be more confident? Why wouldn’t you want to be more comfortable in your body? Those are perfectly reasonable goals, but the problem comes in making the assumption that the only pathway to those goals is physiological transformation, right?

Because there’s an idea there that, "Well, if you’re female, those goals are obviously impossible." It’s like, “Well, no, they’re not. There’s lots of women who are confident and who can stand up for themselves, and who are courageous and forthright.

And like, that’s perfectly within the realm of the full range of feminine behavior.” A therapist who had any sense would have helped you at that point understand that there were practical steps that you could have taken to bolster yourself on all those temperamental dimensions that wouldn’t have required anything radical.

They would have required, well, first of all, a vision, and then a strategy, and then some diligent practice, you know? And you could have made a fair bit of progress on that, I would think, within six months to a year with a bit of alteration in your social behavior.

So, the idea that the only pathway to this was through, you know, radical hormonal and physiological transformation is just preposterous.

Then, of course, there’s the additional complication, which would be, well, you were enticed, let's say, into the idea that you would be better off being a man. But that’s really not a pathway that’s open to you in some fundamental sense either because there are physiological impediments to that that aren’t— they can’t be overcome.

I’ve done a reasonable amount of research into penile construction, for example, and to call that a primitive science is to give it far more credit than it’s due, and so that’s a huge technical problem.

And then there’s the problem, of course, that lurks underneath that which is even if you do manage that, which is highly unlikely and extremely invasive and unbelievably dangerous and very experimental, and there are no long-term studies whatsoever done on the consequences, you’re still not going to be fully physiologically functional as a man.

You’re not going to be able to procreate as a man; and you’re going to sacrifice your ability to have children as a woman. I mean, this is a big bloody sacrifice.

And so what were you— were you led through contemplation of those sorts of things by your therapists?

Not really. They never really went in-depth. I mean, they would talk to me about the side effects, and also basically give propaganda to my parents that thought this was gonna make me better; this is going to improve my distress and make me happier.

I felt the same way. I thought, you know, the things I heard from both the physicians and from the research I did online basically gave me this idea that I was going to become my real self, that I would become the whole person in doing this, and it fractured my sense of self even further.

This is something… Why did it fracture? Why did it fracture your sense of self further? What do you mean by that?

There’s a lot to that, actually. I mean, I was basically living a life for a few years that was very stressful, and I was trying to uphold this idea I had of myself in my head that was false; it was an illusion.

I genuinely believed that I was somehow a man despite being a biological female, and in a lot of ways, I missed out on certain developments, mostly social.

I’m so… you know, I didn’t really go through the crucial female socialization that goes on throughout late middle school or high school.

My dating pool was also affected by this. You know, I was mostly attracted to men; I didn’t really have much interest in women. But most of the people who expressed interest in high school were women.

And the few guys who admitted to attraction to me, it seemed very sexual in nature, and it felt like, if anything, I was just like a fetish to them almost, and I didn’t really—I didn’t want to have anything to do with that.

Yeah, that sounds extremely complicated, and there's also another element to it that I haven't spoken on before, but I feel like it does need to be said. It is kind of uncomfortable because I was just because of my age at the time, and it's also a very sensitive topic, but I think I did also have some sexual motivations in doing this.

I liked the idea of the changes that testosterone would bring on to my body, and you know, I guess I mean, people, a lot of feminists and activists who speak out about transgender people and the transitioners, they often talk about AGP or autogynephilia.

Which is like, I don’t know if you’re familiar with that. Yeah, it’s like a man’s—autogynephilia is the fantasy, it's a sexual fantasy generally, and it often characterizes men who become transsexual and start cross-dressing later in life.

They develop a sexual arousal from picturing themselves or acting out being the opposite sex. Some of that, by the way, you know you talked about the fact that you wanted to have some of the classic male attributes, right? Like self-confidence and courage and so forth, and that you were complimented when you were referred to in that manner.

I think a lot of what happens to these men who develop these sexual fetishes later in life is that there’s a part of them that’s crying out for exploration of and development of their feminine side, right?

But instead of having that happen psychologically and starting to integrate, let’s say, compassion and care and concern for people rather than things— instead of integrating those cross-sexual proclivities, they start to act it out as if it’s a concrete reality, right?

You were definitely enticed into doing that, but you also said—please don’t let me delve into this more than you're comfortable with—but you also said that there was a sexual—the sexual elements specifically.

So was there something in your fantasies about what is—what was that? Was that about you being a boy? You said you were still attracted to women, so what did he— we brought this up; we might as well clarify it.

What was the nature of the interaction with sexuality? I mean, it’s obviously relevant. It was fantasies about being a man, about being male, and having masculine attributes to my body, and also a lot of it did involve, like, having a female partner, which I never really explored in real life because I didn’t have any emotional attraction to women.

I didn’t want to like have a relationship with another woman, and so I never really cared to actually act it out, but you know this is—so I guess you could say that I did have like a female analog of autogynephilia.

If there’s a word for it, I guess it would be autohandropehilia, but I didn’t really understand this at the time because I was so young.

Well, look, I mean, in adolescence, the range of sexual fantasy can be extremely broad. You know, when there is a difference between fantasy and real life, I mean, people will fantasize about things that they won’t do in their real life.

The fact of the fantasies—it can become pathological if people dwell on it, but the fact that the fantasy covers a wider range than behavior would is actually more an indication of the creative capacity of fantasy, right?

I mean, we’ll do things in our dreams, for example, or play out scenarios in our dreams that would never occur in real life, and it’s because part of the human capacity for ingenuity is the capacity to imagine multiple different scenarios, and some of those can be extreme.

You know, like I’ll find, for example, that if I’m angry with something, you know, I can have quite violent fantasies, and I think, “Oh my God, where did that come from?”

But that doesn’t mean that I would act them out or at least I hope it means that I wouldn’t act them out, you know? So, our fantasy life is broader than our actual life, and you bordered the acting out of your fantasies by, well, by social necessity in some sense, so the mere fact that you were having those fantasies—that’s not an indication of anything that’s pathological.

That’s still well within the realm of normative adolescent sexual fantasy, I would say. You know, maybe it was a little more exaggerated in your case because of the testosterone and maybe even to somebody because of your more masculine temperament, but it’s still well within the range of normality.

So what happened to you when you started taking the hormones and how did you react to that?

You know, I started having some physical changes, like with my appearance and also some behavioral changes, like I felt more confident. I started to develop kind of a competitive streak, especially with boys my age, and I started socialize just a little bit more like they did.

I also obviously, because I was taking androgens, I also started experiencing a very strong increase in my libido, and it was very difficult to keep up with. It started to become a problem without me even realizing it.

Unfortunately, I developed an addiction to porn, and I also just had a very unhealthy relationship with my body and sexuality, and I still do to this day.

So on the porn front, was that female images or male, or what was—mostly female?

Mostly female.

Okay, so it was mostly female, but you had no interest in establishing a relationship with females, and on The Dating front, you still wanted to, at least in principle, you still wanted to be with boys.

Jesus, that’s quite a confusing message to walk through so…

Yeah, no kidding. You must have really been going in five directions at the same time during that period.

Boy, yeah, there’s no clear pathway forward through that.

So how in the world did you orient yourself?

Ah you know, I didn’t; I really couldn’t because I didn’t really have dating opportunities, and I just couldn’t really explore that kind of thing.

You know, I had a lot of—this did become a bit of a source of distress for me in high school. You know, I was frustrated; I had urges that I couldn’t really fulfill. On top of that, I was watching all my other peers get into romantic and sexual relationships and had that kind of development while I was just at least—as I felt like—completely behind.

Right, okay, so now what kind of...well, those are complex effects of testosterone. What would you say, and the upside was you had more confidence and more self-assurance, you were more competitive, there was a heightened sex drive which is a mixed blessing.

What were the negative consequences for you of the hormonal treatment?

Sorry, I also forgot to mention that like because I couldn’t find a partner in real life, I eventually turned to dating online, which was a pretty— which only made me more stressed because, you know, I had these feelings for somebody that was that I couldn’t even see or touch, and it just added on to my stress, if anything.

I found that if anything, I just more often than not, I would just get used by other people, either either emotionally for support or for more intimate images of me but it was the closest I could get to real intimacy.

I was quite lonely throughout high school. I did end up developing depression, and this was a big thing driving that definitely effects of testosterone.

You know, at first, it made me feel great; it was kind of comparable to a stimulant almost. You know, I find while I was on the blockers, I’d say there’s about like a month-long period between starting those and the testosterone, and during that period of time, because I had no sex hormones in my body, I often felt very lethargic, a little bit depressed.

Once I had the hormones back, my energy came back. You could say there was a little bit of a honeymoon period that lasted for maybe no more than about a year-and-a-half.

But I found that I was more prone to anxiety, and I also, about I’d say about a year or so on testosterone, I started experiencing some difficulties with my urinary tract.

I started—I think I got my first UTI, and then eventually it devolved to me having like being unable to fully empty my bladder, or having to re-urinate frequently or even getting like blood in my urine.

None of this was listed on my consent forms. I didn’t even know that it was a problem that arose from taking testosterone until after I stopped taking it, and it got worse.

Alright, so now while all this is happening, you’re also marching down the transition pathway, right? So you went from blockers to testosterone, and then what, this is what, about 14 now? Where about where you?

Yeah, Jesus, that’s awful.

At the end of fifth grade, at the end of eighth grade, the bully that I mentioned earlier actually sexually assaulted me. You know, before this point— but I was about several months on testosterone.

I was very confident in myself, and you know, I never really cared to try to hide my chest or anything because I was maybe about like a B cup or less, and I was quite thin.

I would often wear like baggy shirts, so I never really thought it would be a problem, but he had groped me in the middle of a classroom.

But before this, I actually had a fear, a very strong fear of being sexually assaulted. A lot of my female peers and some of the older women I knew had been either assaulted or raped or sexually abused, and hearing these accounts growing up made me fear the same thing could eventually happen to myself, and then it did.

In that moment, it was like glass shattering. It felt like I was the only person in the room because it was as if nobody even noticed or cared that this happened to me.

I ended up downplaying it in my head. It was like, “Well, nobody noticed; nobody saw, so maybe it doesn’t matter what exactly happened.”

What exactly happened to you, if you don’t mind?

So he walked up to you; you were in class?

Yeah, this was in class, and he just walked up to me. He often did things to intimidate me, and then he took a step further by squeezing one of my breasts.

I see, and you know, at the time, it was like “Oh, maybe it’s just boys being boys, so I’ll just play it off, and I won’t be bothered by it.”

No, there’s definitely malevolent intent behind that. I knew that even if it did bother me, that I wouldn’t really have a chance to speak up because if I brought it up to the school office, they would just leave the kid with a slap on the wrist; he’d come back maybe after a two-day suspension and then potentially do something worse to me. So I didn’t bother.

Right, right, right, right, right. So that made you feel more isolated, yeah? That’s what you said—it made you feel that nobody cared.

Yeah. That’s a real—you know, a lot of people get traumatized by malevolent, say like—it’s not even exactly the physical act, although it’s obviously also that; it’s the fact that someone is doing something literally designed to hurt you and subjugate you and make you miserable, and so you get contact with that intent, and that's really hard on people to encounter malevolence like that.

So it’s no wonder it bothered you, you know?

You can think, “Well, what did it really mean physically? You know, it really didn't damage me.”

It’s like— that’s not the point. The point is the intent of the person who did it, and this was a bully who was, what would you say, accelerating his bullying cycle.

You know, God only knows where that would have gone because someone like that, who doesn’t have enough internal constraint, there’s no limit in some sense to what they might eventually do.

So you had reason to be afraid and to be, you know, set back on your heels. So that’s really too bad.

Okay, so that threw you for a loop. How did that play into your next decision?

So very soon after that was when I decided to start binding my chest. I asked my mom to buy me a binder—buy me some binders online.

I don’t know if you know what they are, but they’re like a compression device covering part of the torso and in the chest area. They basically squeeze the breasts and make them look flatter.

I wore those for about, I’d say, two years before getting a mastectomy. I got sick of it. I would work out; I would swim; I would walk home in super hot weather in these things, and I just wanted to be done with it.

I wanted to be free of wearing this thing, but at the same time, I didn’t want my chest to be visible. I was afraid of the attention that would bring me, and also I genuinely believed myself to be a boy.

I wanted to look like a boy and be able to take my shirt off without any cares and not have to worry about wearing this uncomfortable, restrictive thing.

About halfway through my sophomore year, I told my therapist that I was seeking a mastectomy. Through a gender specialist, I was referred to a surgeon.

And so what did your therapist say?

Okay, so what’s happening with your therapist during all this time? I mean, now, so you’re a physiologically healthy young woman, and you’ve just announced that you want to undergo a form of radical surgery that’s generally reserved for advanced-stage cancer survivors.

The upshot of that is you’re hustled off to a specialist who can facilitate that. There’s no investigation into all the background issues that we’ve been talking about; instead, well, it was just seen as— it was part of the process.

Like, there is really no psychological evaluation.

Yeah, that’s utterly appalling. You know, I’ve been embarrassed for years to be a member of the intellectual academy under the current conditions that universities, uh, what would you say, have put themselves into.

And I’m equally embarrassed to be part of the therapeutic community to hear a story like yours. It’s absolutely appalling what happened to you.

There’s no excuse whatsoever for it. So it’s really too bad that it’s, you weren’t listened to in a lot more detail and with a lot more care.

You know, because what you went through, it’s not that abnormal. You know, everything you told me about your unhappiness as a teenager, the fact that you were isolated in middle school, the fact that you had some doubts about your developing identity.

It’s like, yeah, that’s pretty much par for the course for adolescence. Some kids get through it with a little less scarring than others, but most adolescents have a pretty damn miserable time for about three years.

So, the fact that that led you down a path to hormonal transformation and then surgery, and that adults aided and embedded this, you know, I have some sympathy for your parents because when parents are told, “You better support your child or it’ll be suicide,” it’s like, well, that backs them into a corner, but the medical professionals and the counselors who dealt with you, their negligence borders— their negligence, it doesn’t just border on the criminal; it crosses the boundary as far as I’m concerned.

Okay, so now you’re set. You go off to see a specialist. Who’s the specialist and how do they treat?

It's important to note that my treatment was negligence because I was given surgery for a problem that was psychological in nature.

In the months before that, I was diagnosed with depression and social anxiety. During my mastectomy radiation, I would— you know, I, at the beginning, they told my parents, like, “Your child will be at risk of suicide if you don’t affirm her identity,” but it wasn’t until after I started the treatments that I started feeling like committing suicide.

Did you have a plan?

No, I never really had a plan, but the feeling was prevalent enough to affect my day-to-day life.

Right, so when you assess people for suicidality, essentially what you do is you investigate the structures of their fantasies and their wishes, and the more developed the plan they have, the higher the probability is that they’ll actually commit suicide.

So if it’s a fully developed plan, place, location, implement, all of that, then the person's really at risk. Otherwise—and it sounds like this was the case in your case—it's more a marker of generalized depression and anxiety because that will often spin off, you know, quasi-suicidal thoughts like "Well, maybe it would be better for everyone else if I wasn't here," or "Life is too difficult, and so, you know, it would be simpler, all things considered, just to bring it to an end."

You know, that's bad, and it's often associated with a fair bit of suffering, but those thoughts in and of themselves are not associated with a spectacular high risk of imminent suicide.

So, okay, but in any case, you were miserable enough at this point.

Well, obviously, then you’d be looking for what? Further alleviation of your psychological symptoms, and you said the binding was very uncomfortable and troublesome, and so for some—so that also led you to conclude that it just might be simpler, all things considered, since you were already on the pathway to being a boy, just to go down the surgical route.

Yeah, so you were 14 when that happened.

I was 15 at that time; I was in my sophomore year of high school.

They also started to treat my depression. They decided to put me on medication for it, and you know, from what little I knew about medicating depression, I often heard that SSRIs have all these terrible side effects.

So I asked that they put me on something with as few side effects as possible, and they decided to put me on Wellbutrin, which I didn't know until after I stopped taking it, but it actually has a huge black box label warning on it for use in children and adolescents, and it actually made me feel more suicidal over time.

Okay, okay.

Alright, so, okay, so now you’re—you’re 15 and you go see a specialist in relationship to surgery. How were you evaluated at that point?

Um, when I actually moved forward for the surgery, I don't remember much of it, but it was—I mean, obviously they didn’t really do an evaluation of my mental health.

It was just like, "Oh, so you’re transitioning? You’ve identified as a boy, and you’ve been on hormones for such and such amount of time."

So that was—I was eligible. After my first appointment, the surgeon told me about a top surgery classroom that was taking place in the hospital building and encouraged me and my parents to attend it.

I went, and I learned basically the same things that I learned in the surgeon's office: about the different types of incisions and how it benefits gender dysphoria—basically just propaganda.

There were maybe about 12 to 15 other families in there, and I noticed right away that all the other kids in there looked to be either younger than me or like they hadn’t even started on hormones yet.

I was shocked that they were already seeking surgery, but I kind of—I didn’t really question it much at the time. It was just like, "Oh, I guess this is just normal, and I’m not the only one going through this."

Right, right, well. And you were already a long way down the road, and I guess you checked off the boxes as far as the medical practitioners were concerned. But at that point, it's also, for you, going to be increasingly difficult to, you know, to reverse your decision.

You’re already in a couple of years; you know, that’s a long time when you’re only 14.

So, so it was on to the next step. So that happened when you were 15, and so what was the consequence of the double mastectomy for you?

What's been the consequence?

By this point in time, you know, I was two years—two or three years on testosterone, and I’d been binding for roughly the same amount of time. My breasts had lost their shape; they didn’t look like they used to.

Before they didn’t really have—you know, to me, they looked strange. I actually just started developing more insecurities with my body as I went through my transition. You know, I had these masculine features pop up, but