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Childhood social transition is portrayed as ‘kind’ and ‘affirming.’ But what are we setting a child up for when puberty hits, if we pretend they are the opposite sex for the best part of their childhood? A clinical psychologist, with over 15 years of experience of working with adults, children and families, explains the inevitable consequences.

Originally Published by Transgender Trend


A childhood is not reversible

It was when it happened the third time in a week that I started to really wonder. The parent would be telling me about their teenager, about their mental anguish, suicidal thoughts and self harm, and then they’d drop something in, so casually that I’d almost think I’d missed it, ‘Oh, and he’s a transboy (or girl), transitioned when he (or she) was five (or six or seven), but that’s all fine’. And with that, I knew I’d been warned off. Nothing to see here.

I’m a psychologist, my job is to explore, to look for meaning. I work with families and young people. I try to understand why people behave and feel the way they do and to share that understanding. I ask uncomfortable questions sometimes, particularly of parents, about how everyone’s behaviour in the family is inter-related and how children can sometimes show the distress for the whole family. Usually I’m curious about any big change in a child’s life. I’d ask, so how did that happen? What was going on about that time? How was that decision made?

Not with this though. I can’t really ask about their gender identity for fear of being seen as transphobic, and of being accused of practicing conversion therapy. I’m meant to celebrate their trans identity, use the preferred pronouns and definitely not ask any questions at all about what this might mean. I know what is expected of me.

These children’s stories started years before, and I know that because I saw some of it happening on Facebook. Distant Facebook friends would say things like “We’ve known for a while this day was coming. But today we took the plunge. The barber cut Joanna’s hair and we have thrown out her old clothes. We welcome Joseph to our family!’ accompanied by a picture of a beaming 4-year-old with short hair wearing a Spiderman t-shirt. So easy to do for a four-year-old. Cut or grow their hair and no one will know the difference, and anyone who raised any concerns would be told that it’s ‘Fully reversible, it’s just clothes and pronouns! No one is medically transitioning children! Stop the moral panic!’

So now Joanna is Joseph, and they live their childhood. Everyone is told to call them ‘he’ and they shop in the boy’s section of the supermarket clothes aisle. They play football and their mother posts muddy pictures captioned ‘Boy through and through!’ to be met with a stream of comments about what a great parent they are and how lucky Joseph is and how much of a boy he is. If Joseph likes dolls or hangs out with the girls or even likes to wear dresses that’s just him breaking gender stereotypes or showing his sensitive side. Joseph spends his childhood being affirmed as a boy every hour of his life.  Anyone who has any qualms keeps quiet, because they know that they will be blocked and cast out immediately.

Except that Joseph is a boy with a secret. Before transition, Joanna was a girl who sometimes wanted to be a boy, and this was out in the open, everyone could talk about it. Now Joseph is treated as a boy, but there’s something different about him and lots of people don’t know this. He knows it, his parents know it, but people aren’t allowed to mention it or ask him how he feels about it. If they do, they’re transphobic.

Joseph has a choice and neither of his options are good. Either he pretends there’s nothing different even though he can see there is in the boys’ toilet every day, or he gets increasingly distressed about the fact that everyone is telling him he is a boy, he lives in the world as a boy – but he doesn’t actually have the body of a boy. Usually this is too much for him to deal with and so he blocks it out. He disconnects from his body.

Joseph is in a really difficult position. The different facts in his life don’t add up. The adults in his life are telling him that he is a boy, but he can see that he doesn’t have the body of other boys. He will often completely refuse to talk about this. This is interpreted as a sign of his gender dysphoria – he won’t even look at or acknowledge his genitals. His parents will say that they can’t mention it, as he’ll get so upset.

Sometimes his parents will tell him stories about how when he grows up he will be able to have surgery and acquire a penis, and because he is a child he believes them utterly, and dreams of the day that he will no longer have to deal with the dissonance between what his family and friends tell him that he is, and the body he knows he has. The dissonance that was set up by his social transition.

Social transition is a strategy with an expiry date. It’s a short-term strategy with long term consequences. It works so easily for young children – pre-puberty it truly is impossible to tell for many whether they are male or female. The young child who is transitioned is treated by everyone as the opposite sex, and because they are small, they believe that this is how things are. Everyone is happy and the social transition provides short term relief all round. Child is happy, parents are happy, we all celebrate. But in the long term, it creates a problem which is not reversible. Puberty is going to arrive, and the child who has been socially transitioned is put in an impossible situation. They’ve been told all their life they ARE a boy (and that anyone who says they aren’t is transphobic), but their body knows otherwise.

A childhood is not reversible.  What we grow up being told in our childhood matters for our whole lives. It forms part of how we understand ourselves and our place in the world. A child who grows up being told they are a boy whilst knowing they are a girl will only have that experience. They can’t go back and do it again.

Joseph grows up and for several happy years there are no apparent problems. His parents get heavily involved in the trans community and feel very connected and affirmed in their decision. Joseph loves his short hair and football boots.  He’s ‘one of the gang’.  Then he gets to age 10, and his breasts start to grow.

He’s spent the last six years being told he is a boy. There has been no preparation at all in his childhood for the fact of his biological femaleness. No identifying with female role models, no conversations about what puberty means for girls. That has been something to be denied and ignored, or not talked about at all. And now his breasts start to grow.

This is a tender and vulnerable time for all young girls, but for those who have been told they are boys it can be devastating. Social transition has worked for Joseph due to the fact that pre-pubescent boys are very similar to pre-pubescent girls, but now things are going to change. Joseph’s distress becomes intense. They hate their bodies, they hate themselves, they can’t bear the idea of periods and curves.  They start to talk about self-harm, of cutting themselves, because they just can’t bear how strong their feelings are.

Of course they can’t. They were set up for this, right from that day when they were proudly taken to the barber to have a ‘boy’s cut’.  Social transition works so well in the short term, but in the long term there is no way it won’t cause worse distress. Because a childhood isn’t reversible, and this child has spent theirs being told they are of the opposite sex. The time they could have had getting used to their biological reality, they have spent hiding it. They could have been learning that they can express themselves in any way that they want, whether they are female or male – but instead they have been learning to deny the biological reality of their body.

Now of course, the distress Joseph feels is seen as gender dysphoria rearing its head again. ‘We were right’ the parents say to each other, ‘Look at how distressed he is about puberty, imagine if we’d been dealing with this for the last six years’.  Now is when the suicidal thoughts start, because the child is faced with an unbelievable reality – they cannot simply go on being treated as a boy, when they have the body of a girl. Their parents can no longer make everything alright. Of course they are upset. Of course they feel intense distress. Of course they are desperate for puberty blockers. They want to go back to how things were. They have been sold a lie and so has everyone around them.

What’s the alternative? Parents tell me their child was adamant, there was just no other choice. They had to transition them, otherwise….what?

Transitioning is an adult solution, and it’s an explanation our generation has found for children who defy stereotypes. The child behaves in a certain way and adults say ‘trans’ and act accordingly. Adults feel relieved because they feel they’ve found the solution – and they are scared of what might happen to their child as they grow older, because they’ve been told that the consequences of not transitioning a child are disaster. Usually suicide.

There really is little evidence for this.

There is, to my knowledge, no research which looks at outcomes for children who are supported to express themselves however they want, but whilst still being referred to by their biological sex. We had several children like this in my primary school. One of them played football, hung out with the boys and even wore a boy’s swimming costume for school swimming. I was confused. I went home that day and told my mother that Emma can be a boy’s name too.

Later I discovered that Emma was in fact a girl who looked like a boy, deliberately. She and I become good friends. She was supported to express herself however she wanted, but no one transitioned her.   She navigated puberty much like the rest of us. She’s a mother now, and works as a tree surgeon.

I think of Emma when I see these distressed teenagers, and I wonder what our generation has forgotten that our parents knew. For they held onto reality for us, when we were too young to know the difference.

So I tell parents to take their children’s gender distress seriously, but also lightly. Take their desires to cut their hair, to wear Spiderman t-shirts and to play football seriously, but hold for them your knowledge that this doesn’t make them a boy. They don’t know that. Young children think that the external stuff IS what makes a girl or boy. They don’t know any different.

We do. We need to hold that space for them. The space where they can do anything they want, be anything they want – but not change their sex or fly to Mars, because neither of those is actually possible. We can imagine it, fantasise about it, but we need to hold that space for them. Because they don’t know.

There’s an alternative universe where Joanna’s parents cut her hair and bought her a Spiderman shirt, but didn’t post it on Facebook. Where they told Joanna that of course they can call her Jo if she wants, she can play football all she wants, and she’ll always be their daughter because we can’t change sex.  That’s a world where Joanna’s parents let her be herself without bringing in adult explanations such as, ‘You’re trans’, and let her grow up and discover the reality of her female body. A body which is hard to live in, and which most women wish wasn’t so messy and inconvenient at some point – but which is her birth right, and which is the only body she will ever have. In this universe, Joanna’s mother and sister tell her about puberty, because no one has to deny her female biology. No one tells her that she needs drugs to stop her going through the ‘wrong puberty’.

When Jo reaches puberty she’s not overjoyed about the changes, just as many girls aren’t. She doesn’t like her new breasts much and she really isn’t impressed with periods. But she doesn’t feel that this developing body is deeply at odds with the person she is, because she’s spent her childhood knowing that she is a girl, and that she can express herself however she wants. She doesn’t feel she must get rid of the indicators of femaleness, in order to continue the illusion that everyone had created around Joseph. She hasn’t been disconnected from the reality of herself as female.

Social transition isn’t reversible, because what we tell our children for years can’t be reversed. When we disconnect them from their biological sex, we set up patterns of denial and secrets. We set them up to hate their bodies at puberty, to beg for blockers and binders, because for years we told them they could change sex, and they believed us. They are desperate to go back to the years when no one knew any different, but that time will never come again. Time is not reversible.

They don’t know any different. They think that could go on for ever, that they will wake up one day transformed into a male body. They live in a world of fantasy and magic. We know better. We owe it to them to hold that space.

We need to tell them that they can dream of being everything they want to be, express themselves however they want, but we know they can’t change their sex. We have to tell them this, even if they find it distressing. We need to be able to hold that distress and listen, whilst holding onto reality. For our only other option is to betray our children’s trust in us, and the consequences of that will be lifelong.

Transgender Trend © 2022. Reprinted with permission.