Lesbian alarm in the room where it happens.

This essay is based on the audiobook "It's Not Transphobic to Say Your Daughter Is A Girl: The Wise Lesbian Guide for Progressives," by Amber Alt, newly available on Audible.com

“When you’re used to being on the right side of history—to seeing yourself as someone who’s in the business of bending the moral arc of the universe towards justice—it’s really hard to suddenly be called a bigot and lumped in with your political enemies.” — Helen Joyce

Photo by Arseny Togulev on Unsplash

I am both a sociologist and a clinical mental health worker. As a sociologist, my work centers on feminist analyses of LGBT lives and movements, on violence against women and other hate crimes, and on the social construction of mental health diagnoses that stigmatize homosexuality and gender nonconformity, such as Gender Identity Disorder and Gender Dysphoria. In addition to teaching and research, I’ve engaged in applied work in university Diversity, Equity, and Inclusion programs. I’ve published articles on Gender Identity Disorder, lesbian and bi women’s identities, and hate crimes policies, and have taught courses on sex and gender, including a class on LGBTQ mental health. After a long stretch of time in higher education, I decided to expand my skill set and train in mental health.

As a clinician, I have studied personality disorders and suicidality, and cared for people suffering from both. I’ve worked in medical settings, including emergency rooms, where I spent several years assessing patients for suicide risk. Those included gay, lesbian, and trans-identified youth. In my private practice, I’ve worked with adults in many crazy-making situations in which they have been gaslighted and manipulated — led to believe things that are not true by people who benefit from selling deception. I’ve trained clinicians and students to work with gender non- conforming youth — most of whom in previous cohorts grew up to be gay or lesbian adults. I’ve supported adults through medical transition process and continue to provide therapeutic support to trans-identified adults.

Like the incredibly brave and principled Jamie Reed, author of a 2023 Free Press expose essay entitled “I thought I was saving trans kids; Now I’m blowing the whistle” I like to consider myself left of Bernie Sanders. It is because of this history, not in spite of it, that I decided to write a book to encourage parents to do what they can to preserve their daughters choices. I wish I had written it sooner.

Five years ago, I was working in a primary care clinic. That year, 2018, the American Association of Pediatrics instituted guidance that dramatically changed the situation in the United States for kids who don’t conform to sex stereotypes. Suddenly, physicians began to administer puberty suppressing drugs and cross sex-hormones to healthy kids who didn’t feel comfortable in their bodies, paradoxically setting them on the path to infertility, anorgasmia, osteoporosis, emotional dysregulation, a host of other disabilities and difficulties, and life-long dependency on the medical system.

I observed medical workers present these interventions as “plans of care” without advising parents or children that such plans were experimental. I observed their failure to disclose that the teenaged patient would likely experience a resolution of their dysphoria as they grew through adolescence if they were not medicalized. I observed their failure to discuss sexual identity and sexual orientation with gender non-conforming pediatric patients and their families. Given my previous research on the psychiatric medicalization of gay and lesbian people and of gender nonconformity, I found myself incredulous --- and deeply worried. We — gay and lesbian people, progressive people — had seen this before.

We had known for some time that therapeutic efforts to force kids into gender conformity were ineffective. The impulse behind such efforts often reflected a desire to prevent homosexual adulthoods. The very essence of conversion therapy is this: attempting to make gay and lesbian people heterosexual —- or to appear heterosexual. These efforts have a long track record of failure, and a long record of traumatizing the children and adults subjected to them. Now, medicine was doubling down on gender non-conformity and same-sex attraction in kids by chemically constraining their normal development to make them appear more like the opposite sex — albeit at an incredible price. I witnessed practitioners begin these processes in an amazingly cavalier way, often giving the impression that they were engaged in some sort of merciful, enlightened intervention.

Therapists attempting to ask questions were silenced.

As both a sociologist of LGBT experiences and a clinician, I could barely assimilate what I was seeing. Had something in the science of gender nonconformity changed? When I checked, I discovered stronger evidence than ever from countries that had been medicalizing non-conforming kids — again, most of them gay or lesbian — that medicalization doesn’t help and leads to worse medical and mental health outcomes, including higher suicide risk. So, nothing had changed in the scientific literature that would justify medicalizing gender non-conforming kids. And yet, I was seeing it and even being asked to participate, to be complicit in causing medical harm to minors suffering no medical illness. .

What had changed in the US was not the science but the ideology, fueled by big pharma and corporate medicine, delivered through social media and ideologically captured institutions, including some that historically have been iconic in social justice movements, such as Planned Parenthood, the Human Rights Campaign Fund, and the ACLU. Planned Parenthood, for example, had recently begun to include cross sex hormones for adolescents and young women as part of its reproductive health model.

The Human Rights Campaign, needing a new mission after the legalization of same sex marriage in the United States, saw trans rights as its next income generating issue, and appreciated large donations from industries that benefit from trans medicine. The HRC, not a medical organization, had begun offering medical institutions an HRC seal of approval for adopting so-called gender affirmative care. Social movement scholars know these frame expansion processes and have documented repeatedly how movement organizations pivot when movements achieve their goals, because activist institutions and the people in them have developed vested interests in staying in business that extend beyond their original purposes.

Other writers have further mapped the financial cooptation of these movement organizations by big money, mostly tied to the pharmaceutical sector and to the biotech industry leaders envisioning a post-human/synthetic human/ future. What stunned me, watching physicians confidently starting kids– mostly girls – down the path of medicalization that would cause them irreversible damage --- to use the term Abigail Shrier chose for her 2020 book on the topic — was the justification physicians

offered.

Physicians told that staff who asked that medicalizing kids aligned with “The WPATH Standards of Care” or would help the organization qualify for “Human Rights Campaign recognition” without asking questions about what and who the World Professional Association for Transgender Health and the HRC were, how little interest they had ever had in legitimate research, who sat on their boards, and what these standards reflected. Why were physicians allowing such organizations to set the course for the administration of experimental interventions, rather than turning to the FDA, the CDC, and the research literature?

I began to recognize the degree of institutional ideological capture that had already occurred, promulgated by these organizations, and how it had trickled down to the local level, coopting institutional practice, medical care, and language. Sociologists know the Thomas Theorem: “that which we take as real is real in its consequences,” which means whoever controls the terms we use to describe our reality controls our perception of reality.

In order for physicians to comfortably, even righteously, become complicit in sex destructive medicine for kids, they had experienced a profound shift in reality around sex, gender, and sexuality, fertilized by a transition from scientific to ideological language.

The idea that kids are “assigned a sex at birth,” that they can discover they were mistakenly assigned the wrong sex, “born in wrong bodies,” and must be hormonally and surgically be reconstructed on demand in order to reveal “their true selves” had been sold as a natural extension of the gay and lesbian rights movement. Unfortunately, many professionals consuming this narrative don’t know that homophobic medicine bolstered by Nazi experimentation had used the very same interventions for decades —- not to liberate but to persecute gay men and lesbians for our sexuality. They don’t know that the idea of sex change as a cure for homosexuality is rooted in the original pseudoscientific formulation of inversion — in the case of women, the idea that lesbians are “men in women’s bodies.”

As a result, even highly educated people began to believe that “gender” trumped sex, that “pronouns” could not be taken for granted as sex-based, that straight, sex conforming individuals needed to come out by sharing their pronouns and that inclusive care required massive changes in language, culture, and practice — no matter how disruptive to basic medical care or the safeguards in place to protect individuals. That medical practitioners who had cared for thousands of pregnant women and delivered thousands of babies suddenly believed that sex was assigned haphazardly at birth represented an incredible and incredibly dangerous ideological capture.

That which we take as real is real in its consequences, even if our belief is fantastical or fanatical.

This essay is based on the audiobook "It's Not Transphobic to Say Your Daughter Is A Girl: The Wise Lesbian Guide for Progressives," by Amber Alt newly available on Audible.com

You too can be published here. Send your submissions to lgbtcouragecoalition@gmail.com