Sasha Ayad's Newsletter, June 2024

Trans as a conversion experience, speaking at Genspect’s upcoming conference in Lisbon, “mystery illnesses”, and more….

What’s on my mind…

You can now watch or read this section of the newsletter. The YouTube version is here, and the text version is directly below the embedded video.

Trans as a conversion experience: everyone’s blind-spot about gender-questioning youth

“My client became incensed when I tried to explain that she could not literally change sex.” I’ve heard variations of this statement from therapists dozens of times. Similarly, parents feel certain that their scientifically-oriented and logical kid will question his urgent desire for medical transition if he just hears the stats or learns about the known and unknown harms of becoming a medical patient for life. I’ve heard it argued, by people I greatly admire, that gender-questioning youth need to be given all the information about where their distress may be coming from and what options they have to treat it. I’ve probably even said that, in one way or another, myself. And that approach sounds great, theoretically. Especially in hindsight, when considering the horrific treatment detransitioners experienced when they wanted to transition in the first place: it was all too easy for them to get onto hormones and get approved for surgery when providers failed to sufficiently explain the truth and chose to leave glaring omissions from their informed consent process.

So, what’s going on here? Detransitioners, rightly, come to wish that someone had explained things to them more honestly. But in practice, dysphoric kids in the therapy room reject our attempts to help them gain clarity.

Here’s the problem: adopting a transgender identity is rarely done based on rational deliberation or some sort of factual calculus. Identifying as trans is an emotional conversion experience: the person imbibes and integrates a radical new belief system and self-concept for deeply personal and spiritual reasons. Sometimes this conversion is more intrinsic (classic gender dysphoria, which seems to emerge organically) and sometimes the conversion is more extrinsic (ROGD phenomenology with strong elements of peer/online influence, school curricula, or other time spent ‘learning’ about trans).

So let’s take an example which spares us the gender smokescreen. Imagine you’re a therapist and a new patient, Jose, comes in to work with you. You happen to be an atheist, but Jose is a devout Christian (for our purposes, he could be a devout Muslim, or devout Jew, Hindu, or Buddhist). A few sessions into therapy, you come to understand that Jose’s faith has gotten him through a lot of hard times, yet you come to learn some worrying facts about a new church he’s recently started attending: you think they use pretty manipulative tactics, some of their teachings are very strange, and the church seems fringe and insular. But Jose is hopeful that this church will help him deepen his spirituality and he’s thrilled about getting more involved. Even with your initial formulation, you know there’s more to learn. Ok here’s where the misunderstanding comes in: You would NOT begin talking with Jose about how it’s scientifically impossible that Jesus turned water into wine. You would not use this and other examples of “debunking” to dismantle the validity of Christianity’s holy book, or start pushing Jose to question tenants of his faith.

Yet this is precisely what happens when therapists (and parents) try to critically scrutinize the tenants of trans and gender identity beliefs. For most young people, transition offers them a promise: it may be a promise of salvation and rebirth. A promise of becoming more “authentic.” A promise of becoming who they were meant to be. This is a profoundly spiritual movement, and understanding this is crucial if you love someone who has adopted these beliefs.

When I deliver presentations for therapists, engage in parent consults, or give talks to parent groups, this is something really important to communicate, but it can be hard to stick the landing. First of all, with conversion experiences, sometimes manipulation and coercion have been used, which gets our backs up and raises suspicion. We can flatten the complexity of this experience and come to see all trans-identified kids as brainwashed zombies who are completely victimized by a “trans cult.” This framing, while it may contain grains of truth, does not tell the full story (especially for older teens and young adults who question their gender). The truth is that all conversion experiences are multidimensional and involve both positive and negative aspects. We don’t like to think about it, but it’s true. Another way to frame it is: “Each person is attempting to meet a need through this identity. The better we can appreciate that, the better able we will be to effectively connect and communicate with him or her.” This inconvenient fact of complexity helps explain how so many individuals claim that transition saved their life, while others claim that it destroyed theirs.

And conversion can happen for those in the vicinity of the trans-identifying person, too. For example, cult expert, Michael Langone explains that a person’s initial conversion (especially when it’s perceived to be extrinsic) is often received with skepticism by loved ones. Unless…the loved ones also come to adopt the beliefs and become converted, themselves. Like parents of “trans kids” who describe their own evolution from skeptic to enthusiastic supporter. The Texas mom, Kimberly Shappley, came from a conservative Christian upbringing where gender nonconformity was frowned upon. As a mom, she had 4 boys, one of whom started behaving in a very feminine manner in early childhood. From a young age, he claimed to be a princess and said he was a girl. Kimberly explains that in those early years, there were “spankings, yelling matches, and endless prayers”. She recalls “I wasn’t ready to face the fact that my one-and-a-half-year-old child was a girl.” Ultimately, I guess she did face it, though calling it a fact is all manner of wrong, in my opinion. Once she adopted the belief that her son was really a girl, she was converted (my words, not hers) and she became a staunch advocate for the idea of the “trans kid.” Generally, I don’t like to talk about specific families but since Kimberly has made her story so public, I thought it was a perfect demonstration of how conversion can impact perceptions about gender dysphoria and what to do about it.

Mainstream debates about trans issues tend to boil down to two different positions:

One says a gender dysphoric person has a psychiatric illness, a flawed perception of reality, and they’re too sick to understand what’s really going on or make decisions about their medical care.

The other says that a person’s trans identity is only for them to define, since it is such a personal, and subjective experience. Therefore, questioning a trans-identified person’s self-perception represents a cis-heteronormative bias and therapists who do this are in gross violation of their role. Listen to trans people. Let your client tell you who they really are. Furthermore, a self-defined transgender identity is a perfectly valid basis for approving physical and medical changes.

Do you see how the second is a completely spiritual approach? And more difficult yet, do you see how the first will almost never get through to someone from the second camp? Langone, again, says: “An ideological antipathy toward the so-called ‘medical model’ seemed to make some of these academics oppose, in a knee-jerk manner, any theories, however sophisticated, that suggested that the conversions they observed were engineered or exploitative.” Langone wasn’t talking about gender, but the “cult wars” followed a similar pattern as what we’re experiencing today with pediatric gender medicine. Fervent defenders of gender affirmation claim that it’s categorically impossible for society to “make a kid trans” and refuse to consider that influence or online messages or confusing ideas about sex and gender might have contributed to a young person’s gender-questioning.

So what do we do with all of this? On one hand, the more I learn about gender medicine as a field, understand how it’s practiced, and meet people who have been harmed by the industry, the more antipathy I feel towards it. On the other hand, by placing gender medicine in the context of trans conversion, we can see that it operates to bring embodiment to the belief of gender identity. I don’t personally hold those beliefs, but can understand how someone who does would feel deeply compelled to preserve these medical interventions. And sometimes, this is exactly the conflict taking place between trans-identified patients and their therapists or gender-questioning youth and their parents.

Look, I’ve written and spoken in many other places about the need for parents to step into their authority with children and teens, taking the reins and establishing boundaries for health and safety. But outside of those decisions that parents can control, effective communication and connection with a trans-identified person is a different story. In some rare cases, I’ve come across young people who are persuaded to think more critically by exposing them to contradictions and thinking errors. But for the vast majority of families, trying to help your kids be more “rational” just exacerbates the divide and pushes the child deeper into their spiritual quest. So I invite you to learn more about spiritual and religious conversions—both the good and the bad. I suspect this is going to be much more helpful than pouring over DSM criteria or debating the safety of cross-sex hormones.

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What’s on my radar…

Genspect’s Upcoming Conference

Genspect is holding its third conference, Reframing the Future in Lisbon, Portugal this September 27th - 29th.

From Genspect:

“With a focus on ‘Reframing the Future’, we are dedicated to shifting the conversation from identifying problems to exploring solutions. Presentations, panel discussions, debates, and a live-stream interview ensure that all sides of this complex issue are addressed in a compelling manner.”

The guest speaker lineup is pretty thrilling, including:

• Lionel Shriver

• Michael Shellenberger

• Kathleen Stock

• Peter Boghossian

• Helen Joyce

• Andrew Doyle

• Julie Bindel

• and many more

Plus, someone else was recently added to the lineup…

me!

I’ll be discussing my work with gender-questioning children, soaking in all the amazing talks, and of course, eating some delicious pastéis!

I hope to see you there!

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What’s new in my Parent Membership Group on SubscribeStar…

Topic Video

I released an early preview of my latest project: I’m revisiting old newsletters and updating them based on what I’ve learned since 2016. This month I spoke about attachment: that special bond in a relationship that allows two people to support and guide each other. And for parents and children, this bond is the foundation of the family and of society more broadly. I discuss the book “Hold on to Your Kids” and what I have changed my mind about since writing the newsletter on attachment in 2017!

Don’t forget that you can always view short clips of Topic Videos and other educational videos on my YouTube Channel.

May Live Q+A

• We’ve stopped puberty blockers, how do we help our child stop living a secret life?

• After having affirmed, how do we challenge our child without betraying trust and connection?

• Testosterone was creating fainting spells for my daughter, how do I ask her to stop when she’s so emotionally distant?

• Our trusted therapist revealed that she thinks gender exploration is biased and “conversion therapy,” how do we handle this?

• Our daughter is thriving despite her trans ID and heading off to a gap year: what should we be thinking about?

• How can we strengthen the resilience of sensitive Gen Z kids who don’t tolerate discomfort as a normal part of life?

• Our gay son is identifying as a girl and wants to transition when he goes to college, help!

• My daughter has the chance to start fresh at her new school, with a new therapist and new peers, can I suggest she use her birth name and she/her?

• Our daughter seems to desist until she reconnects with her LGBTQ school friends: how do we help her?

• My insecure daughter knows she’s not a male but hates being a woman, and is leaving soon for college. How do I help her heal her relationship with womanhood?

To listen to this recording, you can join the Q+A tier of my Parent Membership Group here.

If you’re the parent of a gender-questioning adolescent and you are curious about how a big change (or small incremental adjustments) might help your child, you can join either tier of my Parent Membership Group here.

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What’s on my nightstand…

The Sleeping Beauties by Suzanne O’Sullivan

Irish Neurologist, Suzanne O’Sullivan gives us a glimpse into the most misunderstood conditions on the planet: functional neurological disorders. Historically referred to as mass psychogenic illnesses, conversion disorders, and hysteria before that, these “mystery illnesses” show us that diagnoses shape our physiology, and culture shapes our diagnoses. This book is a perfect compliment to what has been on my mind lately regarding the subconscious and compelling nature of gender dysphoria and how it emerges in the cultural context.

I love this book because from the very first story of girls in Sweden falling into a sleep-like state, the writing gripped me: there’s a richness to the case studies and a compassionate humanity with which O’Sullivan recounts mysterious psychogenic illnesses from all around the world. I found myself intrigued by some of the exotic locations and fascinating spiritual beliefs of the people she interviewed, while at the same time, clearly recognizing the way we too, have our own illness narratives which shape our understanding of distress and suffering, here in the West.

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What’s on our podcast…

We covered a lot of ground last month on Gender: A Wider Lens. Many of our episodes focused the impact of screens and online trends on our sense of self, sense of family, and sense of normalcy.

• The Over-treatment of Young People: This episode delves into the complexities of therapy, the necessity for critical examination of conventional wisdom, and the importance of nurturing authentic relationships both inside the family and social circles (but more specifically, outside of the clinical setting).

• Trans Ideology is a Restriction of Freedom, Not an Expansion of It, with Heather Heying. Stella and I spoke with Heather about the intricate interplay between biological, psychological, technological and cultural factors in shaping human behavior and identity. We covered topics like sexual signaling, when to trust your instincts, and the importance of risk-taking.

• Freya India - Gen Z and the Agony of a Screen-Based Life: Popular Substacker, Freya India joins us to offer deep insights about the impact of screens and technology on young people and offer up practical advice for balanced living in the digital age. We explore Gen Z's relationship with Instagram and dating apps, the fixation on mental illness and identity, and the misleading notion that you can buy your authentic self.

• Meghan Daum: Women, stop silencing yourselves! We sit down with the multifaceted Meghan Daum, distinguished author, cultural commentator, and fellow podcast host, for a compelling exploration of societal change, the complexities of modern life, and coping through humor. Known for her incisive commentary and fearless exploration of complex topics, Meghan shares her personal reflections on identity and the central and contentious nature of gender in modern culture.

• How Parents can Heal or Prevent Estrangement, with Joshua Coleman: In this episode we delve into the intricate world of family estrangement with psychologist and author, Dr. Joshua Coleman. Coleman's insights highlight the complexity and emotional strain of estrangement, emphasizing empathy, responsibility, and strategic communication as essential tools for parents navigating these challenging dynamics. This episode offers valuable insights and practical strategies for families coping with the heartache of alienation.

Also, Gender: A Wider Lens is now on Substack, so please pop over and visit us there. You’ll find all the old episodes plus lots of bonus content, community discussion, and more.

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I am available for one-on-one parent consultations. You can learn more about what these sessions entail, plus view my availability on my Substack.

Often I am booked quite far in advance, but if you are a Founding Member of this Substack, you will get priority booking.

In the meantime…

Here’s one thing to try…

In keeping with the themes we’ve explored here today, I will encourage you to focus on something simple but difficult: try to help lower the defenses of your child. Maybe in the past, you have tried to explain why you don’t think your child is trans and have gotten this sort of response: “Well, if I’m not trans, then why do I feel this way? Why would I choose to be trans?”

To borrow from Joshua Coleman, consider something like:

“I know you wouldn’t question your identity unless you felt that this is the best thing to do for your mental health.”

or

“I can see you’re just trying to figure out how to be ok with your body, and this feels like the right way at this moment.”

You don’t have to agree with your child’s conclusion, but you can try to reflect what they’re experiencing so that they don’t have to go through the dysphoria alone. See how the conversation unfolds if you really work to listen, understand, and see where they’re coming from. As trust builds and your child feels more comfortable speaking with you, there will be opportunities to gently question, offer different perspectives, or nudge them in a healthier direction.