The Genspect Parents' Survey: How It All Started

An interview with Hermes Postma

Illustration of mind–body dualism by René Descartes

Hermes Postma, a filmmaker and the Dutch author of the Genspect Parents’ Survey, is looking cinematic. A technical issue with the “zoom” causes him to appear in flickering black and white— “like a David Lynch movie,” he jokes. When he switches to his phone, he looks more like what he truly is: a concerned father. I have asked him to share the backstory of the new Parents’ Survey, an assessment tool that Genspect will launch this month. Postma’s survey provides clinicians with essential information needed to assess patients experiencing gender distress.  

The Inspiration

Genspect: I was hoping you could give us a little insight into what inspired you to create the parents survey, and why do you think no one has thought of this before?  

Postma: Honestly, I was surprised to learn that I was the first to develop a survey for families. I have never seen anything like it in Holland or online, which is odd given the number of psychologists working in this field. Such structured measures of diagnostic criteria are standard in the DSM (Diagnostic and Statistical Manual), which is considered the ‘bible’ for understanding mental health.  

Genspect: How does a filmmaker become so familiar with the DSM?  

Postma: Well, I am not a psychologist, but I have always been curious about personality types. I had a close friend who was a psychiatrist, and we would spend hours discussing narcissistic personality disorder, borderline personality disorder, schizoid personality disorder, and all those classic conditions, as well as the more unusual paraphilias. That is how I ended up reading the DSM-III twenty years ago—purely out of curiosity. Back then, it was only about 300 pages long—the DSM-5 is much larger—so it was manageable to read, and it gave me valuable insights into how psychologists approach diagnosis. 

Genspect: Were you always interested in Gender?  

Postma: I was aware of it. I had read a few articles, seen some early documentaries about it in Holland. I had also followed the scandal surrounding the Tavistock clinic. However, it became personal when my son announced that he was transgender.  

A Son's Journey and Some Initial Research

Genspect: Can you tell us a little bit about that?  

Postma: Sure. I was completely shocked. It made no sense at all. Trans? He looks like a goth or a rocker—he could pass for a member of Joy Division! He wears nail polish, but that is about it, and he does not wear it in a traditionally feminine way. He is not gender non-conforming and does not wear skirts or other women’s clothing. He looks like the average new wave band member. I kept wondering why he was saying he was transgender. It was very strange, not just for me, but for everyone around us.  

Genspect: That must have been disorienting. 

Postma: I was totally stunned, but at the time, there was a two-year waiting list to be seen, so I thought we had time. I was surprised then, when after only six months, he was invited to the hospital! Even so I thought it would be all right; I never believed he would make it through their intake. He is not remotely feminine—he is 100% Kurt Cobain! 

As soon as we learned about the hospital appointment, I began doing in-depth research. I read articles in newspapers and studies like "The Myth of Reliable Research" by E. Abbruzzese and Steven Levine, and Michael Biggs's study on “The Dutch Protocol” (a clinical guideline for the treatment of gender dysphoria in youth emphasizing an affirmative approach medical intervention). I went into shopping mode and started buying every book I could find. My first was Deborah Soh’s "The End of Gender," followed by Hannah Barnes’ book and then everything else I could get my hands on. I devoured works by Az Hakeem, Helen Joyce, Abigail Shrier, and Katherine Stock. 

As I read, I noticed a pattern in the experiences described in these books. Initially, the family of a child claiming to be transgender is invited to the clinic to share their impressions. The clinical psychologist appears serious and very compassionate, writing everything down. This continues through a second and sometimes even a third meeting. Then, suddenly, the psychologist overrules the families, stating, "Our consultation is complete. We have listened to your concerns and done our research. We believe your child has gender dysphoria and recommend starting medical treatment.” This triggered me to ask, “Well, what is gender dysphoria?” That is when I picked up a copy of the DSM-5 and began reading. 

The DSM—A Troubling Revelation 

When I finished, I nearly fell out of my chair, thinking, “What the hell is this?” The criteria used to diagnose gender dysphoria are absurd. “Do you feel like a girl?” “Yes?” Then you have gender dysphoria. “Do you want to wear a dress?” “Yes?” You have it. That is when it hit me: anyone who considers themselves transgender automatically receives the diagnosis, which rendered it meaningless. 

It became clear to me that my son’s situation closely aligned with what Lisa Littman described as Rapid Onset Gender Dysphoria (ROGD). It was a recent phenomenon; my son was not gender non-conforming—he was a goth. So, I started thinking about how we could capture this. Our family was in crisis and I worried that when we shared our emotional story in the office, we would get brushed aside. Just like the poor parents in the books, they would bring us in for a few appointments, pretend to listen, then proceed with a medical transition. 

Creating the Survey 

Then I had an idea: what if I took the diagnostic criteria from the DSM—since they work with the DSM—and created a survey for family members? I could ask them, “Have you ever seen my son playing with dolls? Did he ever dress in girls’ clothing or claim to be a girl when he was young?” 

That way, they could not realistically claim he was “true trans,” as they refer to early gender non-conforming behavior, because none of the people in his life had observed anything like that. How could someone be “true trans” if there has never been a neighbor, a nephew, an uncle, an aunt, or a grandmother who has seen a single indication? 

In our situation it was clear-cut, and the outcome of the survey with family members revealed that throughout his life, not one person who knew our son had observed any signs of gender dysphoria. I knew this would make a diagnosis of gender dysphoria, as outlined in the DSM, impossible. So, armed with my new survey, I prepared for our son's appointment with his psychologist. 

The Big Meeting: Presenting the Survey 

Genspect: So, you brought the survey to your son’s appointment. How did it go?  

Postma: Not great. The meeting with the psychologist quickly became tense. I did not present the survey right away; my wife was emotional; we asked about comorbidities like autism, narcissistic personality disorder, and self-hatred, but we were not making any progress. Our son sat there with a poker face, as if he were conducting business. 

I started questioning the psychologist, and he became visibly confused, like, “Uh-oh, what's going on here?” The conversation grew extremely uncomfortable because I made him justify every aspect of his “gender speak.” For instance, “gender” is an English word. In Dutch, we only have “geslacht,” which means sex. The English word, “Gender” can mean both sex and identity, so in that sense, it is a proper example of Orwellian Doublespeak (Orwell). A gender reveal party is really a sex reveal party, and gender affirming care is really identity affirming care. “We are here in the Netherlands” I told him, “So I want you to use Dutch words, otherwise it is unclear. Do you mean “geslacht” (sex) or “identiteit?’ (identity)?” I kept asking him for clarification. “You are saying “trans;” do you mean someone with a penis? Do you mean someone without a penis?” He grew increasingly annoyed and frustrated, claiming we were not getting anywhere. That is when I pulled the survey out of my back pocket. 

Genspect: What did he make of the survey?  

Postma: It totally surprised him. He said something like, “Well, this is very concrete,” so we arranged to discuss it at the next appointment. The following time we met, he complimented me on the survey, calling it very thorough, well administered, and well set up because it was based on the DSM. 

I responded, “Thank you very much. I believe it is well done too, and if there are ways to improve it, I want to see how I can make it better.” It was powerful because it reflected not just my impressions or my wife's, but the perspectives of the entire family, along with our family doctor’s input. It also included a section on potential comorbidities, focusing on common and familial traits. For instance, I have some narcissistic traits, though not to the extent of a personality disorder. I was antisocial at my son’s age and became even more so when I was burned out. Honestly. in my case, “willingness to bend the rules” would be a more correct term than “anti-social!” Like my son, I struggled with self-hatred when I was young. Does he have these traits too? And if he does, why don’t they overshadowing the gender dysphoria? 

By using the survey, I was able to invert the process, and shift the burden of proof. I did not need to get into debates about whether ROGD exists; I could demonstrate that he had no history of gender non-conformity and that he only began to think this way after three trans people entered his life. They are the ones who must prove there is no social contagion or comorbidities, which is a tall order. 

He thought he could win me over by approving the family survey, but the conversation became difficult again. I confronted him with all the books and studies I had read and asked, “Can you please show me what you’ve read?” He admitted he had not read anything except about the so-called ‘Dutch Protocol’ and had not explored any of the counter literature. 

In the end, he told us he could not sign off on medication for our son because the family needed to be on board. He expressed concern about the “family gap,” and I jumped on that opportunity, to propose that we pursue family therapy. 

What Happened After: Diagnosis & The Bigger Picture 

Genspect: Did that resolve it? 

Postma: When I left the clinical psychologist’s office, I felt good. I thought I had made a compelling case against my son's transition, but then I never heard from him again. In the meantime, we had some back-and-forth trying to secure a family therapy appointment. They expected our son to make the call even though he was the person causing the family stress! When he told them we disagreed with his transition, they refused to see us because we were “too difficult.” I thought, wow, this is interesting. I am proposing a solution, and now I am deemed too difficult. 

Then, unexpectedly, my son informed me that he had received a diagnosis of gender dysphoria, and there were two affirmative steps: sperm freezing and facial hair removal, both covered by insurance because “soon he will get hormones”! 

It turns out that the clinical psychologist who praised the family survey and acknowledged the quality of my research ignored it completely and diagnosed my son with gender dysphoria. He also ignored all the questions that dealt with possible co-existing issues. Remember, he could not clarify why the family’s observations differed from my son’s self-diagnosis, so he simply adopted my son’s desires as the truth. He justified this by claiming that the hospital had no diagnostic tools to measure gender dysphoria. That is what he told my son. 

So, they admitted they have no diagnostic tools to measure gender dysphoria, yet when given a different tool that could shed light on the situation, they dismissed it? To me, it is like comparing a thermometer and a barometer. They measure different things, but each provides valuable insights into the weather. Just because you do not have a thermometer for measuring gender dysphoria does not mean you should throw out the barometer, which in this case is the family survey. 

There is another important thing I forgot to mention. The psychologist told us they were not just looking at gender dysphoria but completing a ‘cross-differential analysis.’ This sounds impressively scientific, as if they were employing a complex mathematical algorithm. What it really means is simply posing the question to the distressed child: “is the distress you are experiencing caused by gender dysphoria or by something else? Referring to this as a ‘cross differential analysis’ obfuscates the real meaning and confuses parents. The concerns parents express and enumerate about their confused child are the “something else” they should consider! Instead of taking parents’ seriously, therapists are affirming the patient’s view and using this pseudo-intellectual term to overwrite their parents’ concerns and insights. This is a massive betrayal on a super large scale. It means that all the parents who expressed reservations about the reasons for their child’s desire to transition and were told that the cross-differential analysis showed gender dysphoria were deceived! Once you realize this, it is impossible not to feel angry. Something must happen to stop this madness. The specialists responsible need to be scrutinized and suffer repercussions.

The Survey's Impact: A Call to Action 

Genspect: What does this mean for your son?  

Postma: We informed the hospital that we object to them giving our son hormones, so at least while he is under our roof—they are concerned I might kick him out and he would end up homeless—they will not treat him. But that does not mean this problem disappears. Think about it: if the psychologists acknowledge they do not have the tools to diagnose gender dysphoria, yet they proceed to use a diagnostic code for the insurance company, that’s fraud. It is like performing a knee operation without an X-ray or MRI. It is simply untenable. It dawned on me that not only are clinicians ignoring the family, but they are also potentially defrauding the insurance company by coding a non-diagnosis. That is not how the world operates. 

 By dismissing the family survey, our psychologist admitted that his diagnosis was nothing more than our son’s self-diagnosis. This situation is common among other parents as well. Without a family survey, a parent can be dismissed as conservative or biased. But when there are eight family members and a general petitioner whose observations conflict with the child’s view, it becomes much harder to do that. 

 This means that every other parent who has not completed a survey but disagrees with their child’s self-assessment will be dismissed. These psychologists may appear to be listening to parents and documenting their concerns, as insurance companies require, but then they proceed with the diagnosis of gender dysphoria anyway. The report may seem well documented, but it is really an abuse of the family’s trust in the healthcare system. It is also insurance fraud, because it is unlikely they can produce a solitary case where they have genuinely listened to the parents instead of the child. So, while it is unfortunate for us that the survey was disregarded, eventually it will be far more disastrous for the clinic because it exposes their negligence. It also demonstrates systematic corruption in their dealings with insurance companies. While it might look good on paper, their ‘cross differential analysis’ is no analysis at all.

The Genspect Survey: How to Use It 

Genspect: So, you have put together a survey for parents to use. Can you tell us about that? I mean, I assume that like in your case, most clinicians are not going to be asking families to do a survey, so are you suggesting that parents should complete the family survey and present it? 

Postma: Yes, exactly. My original survey consisted of the 16 questions from the DSM, which make up the first chapter. There is also a section with a checklist for comorbidities like autism or depression, and ethical questions for the clinics. I included 16 additional questions for family and friends, focusing on social contagion and the political background of the family members. I added this section to help counter the stereotype that parents who object do so because they are “far right” (on the contrary, most parents I meet are very progressive!) It has become quite a comprehensive document, allowing people to pick whatever suits their situation. That is important because circumstances can vary widely. I tried to consider scenarios like tomboyish girls compared to effeminate boys. What if the child is artistic? What if family members conflict, such as in cases of divorce? 

My goal was to create a flexible document that parents could use in full or in part. It includes advice and instructions on how to complete the survey as thoroughly as possible, and there is even a model letter to help present everything. 

Genspect: What should parents do with the survey once they have completed it? 

Postma: They can start by sharing it with their general practitioner, but the most crucial step is to send it to the insurance company. Insurance companies will get nervous when they learn that clinics are systematically ignoring parents and disregarding evidence. It also means they cannot claim they were unaware because we have documented proof that we warned against proceeding with the transition. 

This documentation also shows that clinics are not properly listening to families, and if any future trans regret cases arise, it will serve as invaluable evidence for potential lawsuits. 

Genspect: It sounds like it should be standard practice for any family facing this situation. 

Postma: Exactly. One family alone is not going to win this battle. It will help, but if a hundred or, better yet, a thousand families adopt this approach, it could transform everything. Insurance companies will start to get nervous. They will realize that if they continue to support the clinics, they could face significant repercussions. There will be lawsuits, and given the extensive documentation we have, it is likely they would lose those cases. 

I also hope that it will also serve as a useful tool for general practitioners and make them think twice when they are asked to refer patients. You can also share this information with the press and politicians. In fact, you can reach out to everyone even if the clinic itself disregards it. 

That is the hope I have. 

Genspect: Yes, that makes perfect sense. Thank you for putting together such a useful tool and good luck with your son.  

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