Seven years ago, in my first Public Discourse article, “I Was a Transgender Woman,” I shared that the reprieve provided by surgery and life as a woman was only temporary, and that traumatic childhood events explained my desire to identify as female. In my experience, and those shown in many other personal testimonies and academic studies, the neglect of traumatic childhood events and other mental health issues leads to an excessive focus on gender and a potentially dangerous rush to medical and surgical interventions.

Medical professionals have coined the term Adverse Childhood Events (ACEs) to refer to a range of negative situations a child may face or witness while growing up, such as physical neglect, parental separation or divorce, living in a household in which domestic violence occurs, or living in a household with an alcoholic. These experiences negatively alter the brain at a deep level where most basic needs originate and a person’s identity is formed.

According to Dr. André Van Mol—the co-chair of the American College of Pediatricians’ Committee on Adolescent Sexuality and a contributor to Public Discourse on transgender issues—in the overwhelming majority of cases, the desire to switch one’s gender identity is closely connected to adverse experiences in childhood. More broadly, studies have reported a high frequency of childhood emotional and physical neglect and abuse among transgender-identifying individuals.

In my case, my longing to identify as female was due to early childhood trauma that fractured my male identity. My grandmother made a purple chiffon evening dress for me and affirmed me as a girl from ages four through six, and my uncle sexually abused me before I was ten. In my desperation to cope with the abuse, my child’s mind invented the belief I should have been a girl.

Thousands of former transgender-identifying individuals have contacted me over the last twelve years, and their stories always include ACEs that were never treated. Hurtful events of childhood—a loss or trauma such as divorce, an alcoholic parent, or sexual abuse—started the desire to become someone else.

More recently, I’m hearing from parents whose teenagers suddenly announce they are transgender. With a few e-mails back and forth, the parents identify what might have happened to precipitate the child’s crisis. Some say their teens have anxiety over the bodily changes of puberty, or don’t have friendships and adopt a transgender identity to garner positive attention at school. Some parents review the teen’s internet history and discover that strangers on the internet befriended their vulnerable teens and urged them to transition.

I hear from young adults who transitioned and want their lives back. They share with me that they had mental illness, or they were addicted to pornography or anime games, or they were bullied, or perhaps they didn’t feel valued in the family.

The Role of Mental Illness in Transgender Belief and Surgery

Trauma in childhood is known to have broad impact on child development and on the occurrence of mental health problems later in life, while some academic research shows that mental illness precedes the onset of transgender ideation in young people. This suggests that gender distress is not the problem—mental illness is.

For example, a major 2018 study of mental health in transgender-identifying youth found overwhelming evidence that mental illness is present before the onset of transgender belief. This study compared over 1,300 trans-believing youth with age-matched peers using clinical data gathered from three large pediatric practices in California and Georgia. The findings were startling and alarming. Psychological disorders such as anxiety, depression, and attention deficit disorders were several times higher than the peer group, suicidal ideation was up to 54 times higher, and self-harm was up to 144 times higher.

Similarly, Professor John Whitehall, Professor of Pediatrics at Western Sydney University, reports that “numerous reviews reveal the majority of children confused about their gender also suffer from diagnosed mental disorders, such as depression and anxiety. Moreover, there is an extraordinary representation of children with Autism Spectrum Disorder whose appreciation of reality is already known to be challenged.”

Read More