The New Gay Conversion Therapy: A Psychologist’s Perspective
By Trayce Hansen, PhD
Gay conversion therapy is a thing of the past. It comprised psychological interventions intended to convert homosexuals into heterosexuals. Critics denounced gay conversion therapy as dangerous and homophobic. It’s considered unethical by many, and has even been banned in some states and municipalities. Gay conversion therapy is thought to be defunct. But is it?
Over the last few decades, a modified form of gay-conversion therapy has emerged under the progressive-sounding label: gender-affirming care (GAC). GAC is being used to treat those with gender dysphoria — a psychological condition of distress related to one’s biological sex. Of particular concern, and the focus of this article, is the use of gender-affirming care with minors. Since most gender-dysphoric youth are prehomosexual, GAC treatment is tantamount to gay conversion — it’s literally converting prehomosexual children into trans.
So, what’s going on? What’s driving this new gay conversion effort?
Gender-Identity Ideology
Underlying this latest iteration of gay-conversion therapy is “gender-identity ideology.” This ideology is a nonscientific belief system that holds as its primary doctrine that everyone has an internal sense of being male, female, or something else. And, it is one’s internal sense that determines whether one is a boy or girl, a man or woman — not one’s biological sex. Under the tenets of gender-identity ideology, if a person’s internal sense is in conflict with their external body, then that person is trans.
Alarmingly, despite the unscientific nature of gender-identity ideology, most major institutions — governmental, medical, psychological, educational — have adopted and are spreading its belief system, as well as its vehicle of conversion: gender-affirming care.
The Trans Explosion
The Western world has experienced a dramatic upsurge in the number of minors reporting gender dysphoria or claiming a trans identity. As example, in less than one decade, the Gender Identity Development Services in the UK experienced a 1,460% increase in gender-related referrals for boys, and a staggering 5,337% increase for girls (Transgender Trend, 2019).
Much of that surge is the result of a new and novel type of gender dysphoria termed “rapid-onset gender dysphoria” (ROGD). ROGD is a trend wherein psychologically troubled teen girls — with no childhood history of gender dysphoria — abruptly report gender dysphoria and claim a trans identity (Littman, 2018). Historically, the vast majority of those who reported gender dysphoria were prepubescent boys and older men. Never before has it been a preponderance of adolescent girls. Obviously, something unique to our time and culture is occurring. So, what’s happening?
ROGD appears to be a culturally induced syndrome that emerged on the heels of increasingly pervasive pro-trans narratives — rooted in gender-identity ideology — that began in the 2010s. Those narratives spread among adolescent peer groups, as well as more widely via social media, mainstream media, and schools, and led to a trans social contagion that reshaped beliefs around sex and gender. As a result, many gender dysphoric, as well as generally dysphoric young people have come to believe all their psychosocial problems are due to being trans. But is that true?
To answer that question one can look at the two demographic groups who today constitute the vast majority of gender-dysphoric minors: prepubescent children (mostly boys) and adolescents (mostly girls).
Prepubescent Boys and Gender Dysphoria
First, let’s consider young, gender-dysphoric boys. These boys often say they are, wish, or want to be girls. But does that mean they’re trans?
Take for example a boy between the ages of 3 and 6. He notices he’s more like girls than boys with respect to his interests. He prefers cooperative play to rough-and-tumble and dolls to trucks. Overall, he prefers girls and their activities to boys and theirs. Such a boy can become gender dysphoric because he believes it’s only girls who can have “girlish” interests. He still thinks concretely and so concludes: “If I like girl things, I’m a girl.” Or, “I like girl things, so I want to be a girl.” He doesn’t yet understand he can have interests similar to girls and still be a boy. That more abstract way of thinking comes later.
As young, gender-dysphoric boys mature, cognitive development (and budding sexuality) leads to resolution of gender dysphoria for almost all of them. Here’s what longstanding research reveals: Sometime around adolescence, dysphoria will desist (cease) for roughly 85% of gender-dysphoric boys (Singh et al., 2021). The majority of those desisters will identify as homosexual or bisexual (American Psychiatric Association [APA], 2022, p. 516), not trans (Drescher & Byne, 2012).
So, based on that well-established data, gender dysphoria for most prepubescent boys is best thought of as a temporary mental health condition and an early indicator of homosexuality — not transgenderism.
Adolescent Girls and Rapid-Onset Gender Dysphoria
Next, let’s consider the more complex case of ROGD girls. These girls are reporting gender dysphoria and claiming a trans identity. But does that mean they’re really trans?
First, and quite importantly, history testifies to the highly suggestible nature of adolescent girls. Many teen girls have been afflicted over the years by various social contagions including: recovered memories; satanic ritual abuse; dissociative identity disorder (multiple personality disorder); anorexia; bulimia; suicide; and nonsuicidal self-injury. Social contagions such as those — just like the current trans contagion — arise out of cultural narratives that present new ways to understand and express distress.
Let’s take a look at the psychological process by which a girl might be led via social contagion to identify as trans: An anxious teen girl feels a vague sense of distress. She feels oddly disconnected from others and uncomfortable with her sexually maturing body. She learns from trans-identified peers and social media that such symptoms are indicative of being trans. She ruminates over that idea and even co-ruminates with others with whom she seeks affiliation. She immerses herself in Internet videos that glorify transitioning. She eventually becomes convinced she, too, must be trans. At that point, she channels her general distress into gender distress, becomes “suddenly” gender dysphoric, declares herself trans, and seeks transition which she’s been assured is the answer to all her problems.
But why do teen girls, more than teen boys, tend to fall victim to social contagions? The primary answer lies in the higher levels of negative emotions experienced by adolescent girls.
At puberty, teen girls experience a more severe upswing in negative emotions than boys, and then often worsen their emotional state by brooding — a behavior more common to females. Teen girls with psychiatric disorders, as well as adverse childhood experiences, are particularly vulnerable to contagions because their level of emotional suffering is already elevated. Thus it’s not surprising that adolescents who seek gender transition suffer from increased rates of mental health conditions (Kaltiala-Heino et al., 2018), neurodevelopmental disorders (Barnes, 2023 p. 156), as well as sexual, psychological, and physical childhood abuse (Thoma et al., 2021).
Homosexual attraction in teens girls is also very relevant to gender dysphoria and trans identification. Roughly 70% of adolescent girls seeking transition at the Gender Identity Development Services in the UK were lesbian or bisexual (Barnes, 2023, p. 162). Many such homosexually attracted girls have internalized misogynistic and homophobic attitudes and are quite distressed by their physical maturation and same-sex attractions (Vandenbussche, 2021). These girls don’t so much want to become “men” as much as they don’t want to become women or lesbians (Joyce, 2021; Shrier, 2021).
So, the vast majority of girls with rapid-onset gender dysphoria aren’t trans at all—they’re just girls suffering from high levels of negative emotion, who desperately seek an explanation for their misery, as well as a way out of it. Transition offers both.
Now let’s summarize the findings for both gender-dysphoric boys and ROGD teen girls: Gender dysphoria is a temporary mental health condition for most prepubescent boys, is associated with social contagion and mental illness in most teen girls, and is strongly linked to eventual homosexuality in both groups. These young people aren’t trans, they’re mainly prehomosexual youth seeking relief from emotional distress. Outrageously, despite such findings, most medical and psychological organizations — driven by ideology rather than science — push to convert these children into trans using gender-affirming care.
The stated goal of gender-affirming care is to better align a person’s physical appearance with their inner feelings of gender — which is usually the opposite sex. In order to accomplish that goal with minors, GAC utilizes interventions such as social transition (including change of name, pronouns, and presentation) and medical transition (including puberty blockers, cross-sex hormones, and surgery).
Gender-Affirming Care: Social Transition
Social transition is the first step in the gender-affirming care protocol. It may sound benign, but it’s far from that! Hilary Cass, MD, a preeminent medical doctor and pediatric consultant, was tasked with conducting a thorough review of gender-identity services for children across the UK. In her interim report, Dr. Cass cautioned that social transition is an “active intervention because it may have significant effects on the child or young person in terms of their psychological functioning” (Cass, 2022, p. 62). It’s certainly well established that social transition prolongs gender dysphoria in children (Hembree et al., 2017, p. 3879) which thereby increases the likelihood such children will pursue more serious interventions in order to alleviate it (Levine, 2023).
Social transition isn’t an innocuous intervention — it’s a consequential one that puts children on a fast track to medical transition, a step that holds far graver ramifications.
Gender-Affirming Care: Medical Transition
First, pediatric gender-affirming care medical procedures are completely experimental. There are no large, randomized, controlled studies to prove safety or efficacy (Zucker, 2019). Moreover, the guinea pigs in this trans experiment are not only mostly prehomosexual youth, they also include disproportionate numbers of children of color, children with mental developmental disabilities, children on the autism spectrum, children with ADHD, children living in foster care, adopted children, children who have been victims of abuse, and those with a history of psychiatric illness (Levine, 2023).
Pediatric medical transition typically begins with puberty blockers and cross-sex hormones, neither of which is FDA approved for such purpose. Moreover, research finds the use of these drugs can lead to sexual dysfunction and sterility, and also may affect bone health, brain development, and cognitive functioning (Hembree, 2017). Sweden, Finland, and the United Kingdom, liberal countries who were early advocates of gender transition for minors, have reversed course due to mounting evidence that the benefits of puberty blockers and cross-sex hormones don’t outweigh the known and unknown risks (Cantor, 2023).
The next step in medical transition is surgery (which may or may not be available to minors in all areas). For girls, such surgery can include bilateral mastectomy (the removal of both breasts), or vaginectomy and phalloplasty (removal of the vagina and construction of a neopenis using tissue flayed from the forearm or thigh). For boys, surgery can include penectomy and orchiectomy (removal of the penis and testes) and vaginoplasty (construction of a neovagina using tissue harvested from the penis or colon).
Tragically, radical surgeries such as those described leave young people physically disfigured, sexually dysfunctional, and permanently sterilized. Moreover, they carry with them significant medical risks and complications (Levine, 2023), including the possibility of death (Negenborn, 2017).
The Role of “Gender Specialists” in Pediatric Transition
Most parents aren’t familiar with gender dysphoria, its treatment options, or the serious risks associated with transition. So, understandably, parents of gender-dysphoric children may turn to “gender specialists” for help. Parents expect such specialists will complete a thorough assessment of their child and then offer a variety of treatment options. But that’s rarely the case. Most of these so-called specialists are actually trans activists with only one option in mind — transition.
Gender specialists can be quite persuasive in their quest to convince parents to transition their children. For instance, they often describe transition as “life-saving” while downplaying its many consequential medical risks. When faced with hesitant parents, these specialists may say the children are likely to estrange themselves from the family if not allowed to transition. Even more frightening, parents may be told their child is likely to commit suicide if not transitioned. “Do you want a dead son or a live daughter?” is a common threat posed as a question. Such a threat isn’t only emotionally manipulative, it also dishonestly portrays transition as the solution to suicide when it’s not: Sadly, those who are trans-identified continue to have high rates of suicide long after transition (Dhejne, 2011).
The reason suicide rates for trans-identified youth tend to be high is because many suffer from comorbidities such as depression, anxiety, eating disorders, and autism spectrum disorders which each independently contribute to suicide risk (Levine, 2023). Transition doesn’t resolve complex psychiatric conditions. These young people need a comprehensive psychological evaluation and treatment, not transitioning, which will leave their comorbid conditions and suicidality unaddressed.
Psychological Treatment for Gender-Dysphoric Youth
Fortunately, effective psychological solutions for gender dysphoria exist and can be found in traditional exploratory psychotherapy. Exploratory therapy can be beneficial because it seeks the root of gender dysphoria, which once identified, becomes the focal point for intervention.
Here are two real-world scenarios to illustrate the value of exploratory psychotherapy for gender dysphoria and highlight why gender-affirming care is so grossly inappropriate.
Scenario one: A “feminine” boy is born to a hyper-masculine father who wanted his son to be like him. The father is embarrassed and disappointed. The father lets the boy know, in subtle or not-so-subtle ways, the boy isn’t acceptable as is. The father’s message is that “real boys” don’t behave as the boy does, but rather behave in stereotypically masculine ways. In response, the boy becomes dysphoric, unable to reconcile the gender-stereotypical wishes of his father with the gender-atypicality of himself.
Should that boy be transitioned into a “girl,” or would psychological interventions for the family be more appropriate?
Scenario two: Imagine a teen girl living in foster care, born into a chaotic, alcoholic family, and sexually abused by multiple male family members throughout childhood. She concludes the only way to avoid future sexual exploitation is to reject her femaleness, and embrace a male identity.
Should that girl be given testosterone and a mastectomy, or should her childhood traumas and the emotional aftermath be compassionately addressed in therapy?
As the above scenarios elucidate, traditional exploratory psychotherapy can be deeply transformative, whereas gender-affirming care is merely superficially transformative and leaves the origins of distress unresolved. Moreover, exploratory psychotherapy doesn’t aim to affirm or prevent any particular identity — only to alleviate distress. The same cannot be said for gender-affirming care.
Gender-Affirming Care Is Today’s Gay-Conversion Therapy
Trans activists use gender-affirming care to affirm youth in a trans identity and thereby prevent them from identifying otherwise. Prehomosexual youth are easy prey for such activists because they’re often gender nonconforming or confused and distressed by their emerging sexuality. Activists use the false claims of gender-identity ideology to convince those young people their gender atypicality, confusion, or distress means they’re trans, when in reality it means they’re on a path to adult homosexuality.
As review, without gender-affirmation procedures, about 85% of gender-dysphoric boys (Singh et al., 2021) and 70% of girls with rapid-onset gender dysphoria (Barnes, 2023), are likely to embrace a homosexual identity by adulthood. Trans activists prevent that from occurring by transitioning them before their homosexual identity has a chance to stabilize. The result: those youth will live their lives as trans, instead of the adult homosexuals they would have been. That’s gay conversion, plain and simple!
Some homosexual adults have publicly expressed gratitude that gender-affirming care wasn’t readily available during their own gender-dysphoric youth. Rupert Everett, an acclaimed actor and a gay man himself, conveyed such a sentiment: “[During my childhood] I really wanted to be a girl. Thank God the world of now wasn’t then, because I’d be on hormones and I’d be a woman. After I was 15 I never wanted to be a woman again” (Press Association, 2016). Many of today’s prehomosexual youth will one day feel the same if we put an end to this gender-affirming barbarity.
Safeguarding children begins with shielding them from the reality-denying tenets of gender-identity ideology. Such tenets create sexual confusion and disorientation for all children, and send the most vulnerable down a treacherous path to gender transition. Children must be allowed to grow up naturally into healthy, whole-bodied, non-medicalized adults. No longer can we permit them to be sexually mutilated and sterilized by gender-affirming care — a dangerous and gruesome new form of gay-conversion therapy.
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Header image by Isi Parente on Unsplash
This article was first published at Genspect.org on 6th September 2023.