Facts over phobia: A response to Alleyn Diesel By Kellyn Botha

published on 3 September 2021 at this link https://www.news24.com/witness/opinion/columnists/facts-over-phobia-a-response-to-diesel-20210903

I volunteer at a support group for trans and gender-diverse minors and their parents. In these spaces I often find myself hammering home to the kids every time we engage, that the medical stuff isn’t everything - that they are valid and beautiful no matter what path they choose. I do this because it is true, but also because I find myself having to constantly fight a false narrative that we are pushing surgeries or hormones onto children. And yet, for most of the young people I work with, it is still something they desperately want and need.

On 25 August, an op-ed published in The Witness by one Alleyn Diesel caught my attention. As someone who has worked long hours with young trans and gender-diverse people, I cannot stress enough the kind of damage that articles like Diesel’s can do to the lives of innocent young people. To be transgender is not, as Diesel claims, a choice, or a desire to escape from social norms, or a form of mutilation, or a form of expressing one’s sexuality. To be trans is simply to not identify with the gender assigned to you at birth, and can involve myriad sexual orientations or forms of self-expression. I am not sure whether to read Diesel’s misrepresentation of such basic facts as merely a case of ignorance, or as deliberate malice. Having never met her prior it may not be wise to make assumptions as to which is applicable.

Diesel starts her piece off by referring to a previous review of the novel, Detransition, Baby, by Torrey Peters, as something which drew her attention to the “fact” that “growing numbers who embraced transsexual [sic] lifestyles because of apparent gender dysphoria, are now embarking on detransitioning”. Diesel either does not realise - or counts on the viewers to not realise - that the novel to which she refers is just that. A novel. A work of fiction. Further, Torrey Peters is a trans woman who was nominated for an acclaimed women’s prize for literature, much to the chagrin of the very anti-trans voices with whom Diesel aligns.

In reality there is no evidence that a “growing number” of trans people are detransitioning. While some anti-trans commentators like to cry that the rise in people coming out as trans is some kind of pandemic, the reality is likely just that more people now have the tools and language to describe themselves openly, where before stigma and ignorance forced them to remain in the closet.

The number of people who later in life return to identifying with their assigned sex at birth remains vanishingly small. A 2015 survey by the Transgender Centre for National Equality found that in the United States, about eight percent of respondents chose to detransition - but of those who did detransition, around 62 percent said it was only a temporary measure due to social pressure or lack of access to medical treatments. The survey found that only 0.4 percent of respondents detransitioned after realising they were not transgender.

Another study in Sweden, which took place over 50 years, found that only 2 percent of respondents expressed any form of regret after medically transitioning, while a similar report from researchers in the Netherlands found that 98.1 percent of people showed no regret or propensity for detransition.

Clearly then, this is not the great and growing threat that the anti-trans lobby would have us believe. I have often heard people decry the advancement of trans recognition and equality by claiming that to amend our way of thinking and acting for such a small minority would be totally unreasonable. And yet if an even smaller minority presents itself as being supposed evidence for the anti-trans lobby to go on the attack, well then, suddenly statistics don’t matter all that much.

This is not to belittle or ignore the lived realities of those who do detransition. Everyone deserves the freedom to decide for themselves who they are and how best to live their lives, and it is important to have open and honest discussions about how to best help and serve that small minority who do come to realise they are not transgender. But the fact that such people get touted as evidence against the necessity of medical transition is exceedingly harmful. An analysis by Cornell University of more than 4000 separate studies attests to the efficacy of medical transition in alleviating depression, suicidality, anxiety and social isolation among the vast majority of trans people. And we have known for decades now that “conversion therapies” aimed at changing a person’s sexual orientation and gender identity are at best ineffective and at worst, traumatic and dangerous.

Diesel goes on to claim that in Britain and America there is “growing concern” about the rising rate of young trans people seeking gender-affirming medical care. In fact the consensus in favour of offering such support to trans people has never been higher, but much like with those who detransition, a vocal minority are held up by the likes of Diesel, with little regard for what the informed, educated and compassionate majority are saying.

The Professional Association for Transgender Health South Africa (PATHSA), an organisation with members across the medical and psychological fields, states unequivocally in its policy statement on children that to consider trans identities and affirming healthcare to be some kind of ideology “is objectively false, inaccurate and could lead to significant harm should it result in parents being dissuaded to act in the best interests of their transgender and gender diverse children in accessing gender-affirming care.”

The policy goes on to state that “PATHSA’s firm and clear position on gender-affirming healthcare for children and adolescents is supported and substantiated by a number of outcome studies [...] that have produced good evidence for the improved mental health in children who were supported and allowed to socially transition.”

One of Diesel’s primary examples of the dangers of allowing young people to access gender-affirming medical care is the case of Keira Bell in the United Kingdom, who identified for several years as a trans man. She went onto puberty blockers at age 16. At 18 she started a regimen of testosterone. At 20 she received a double mastectomy. Later, Bell realised she wasn’t transgender and was swept up by a cohort of anti-trans activists who managed - only temporarily - to have puberty blockers banned for minors.

Let the details of the Keira Bell case sink in for a minute. Minors were prevented from accessing safe and reversible medical care which would give them time to grow up and decide their paths for themselves, because one person at the age of 18 and 20 - a full grown adult - made decisions she would come to regret. This case was clearly never about protecting children so much as trying to make life harder for trans people. 

In its public reply to Keira Bell’s court case, PATHSA stated its extreme concern that the judgement “ignores the fact that transgender youth have been put on hormone blockers for over 20 years now and the outcomes are overwhelmingly positive, among a group of teenagers with a very high risk of poor mental health outcomes without these interventions.”

“The judgement fails to appreciate the permanent poor outcomes of transgender youth having to go through the psychological trauma of going through a puberty that they do not want and which result in permanent physical changes (e.g. voices dropping and growing breasts) that cause them to face a life time of discrimination and gender dysphoria.”

And I should add here as a brief aside, for anyone concerned about this particular point: It is not practice or policy anywhere in the world to perform genital surgery on transgender minors! Not only that, but many trans people do not even want surgeries, and those who do are more often than not excluded by exorbitant medical bills. If you are truly outraged at the thought of such irreversible surgeries taking place on children, I encourage you to join the efforts of us LGBTI+ activists in banning genital surgeries on intersex newborns.

Diesel also uses the example of Katherine Burnham from the United States - similarly, a woman who thought for a time she was non-binary transmasculine, and who was above the age of consent when she briefly started taking testosterone. Burnham alludes the essay to which Diesel links that she was only able to access hormones after reaching the age of consent - so hardly a case of children being coerced into anything - and that she feels she could only have learned who she was by going on that personal journey, and not by being pushed away from her trans identity by others.

These two cases put forward by Diesel are very clearly cherry-picked to construct a narrative that, frankly, does not reflect reality. As PATHSA notes in its response to the Keira Bell case: “Youth are given hormone blockers only at [...] a stage where research had already shown over 90% of them will not change their gender identity. Deducing that hormone blockers cause more children to sustain a transgender gender identity is simply false.”

I could probably write a short novel if I had to go for a point-by-point takedown of every inaccurate or harmful thing contained in Diesel’s op-ed. Perhaps if I did I could be nominated for a literature award like Torrey Peters. But I am not sure what good that would do to anyone who has already made up their minds about trans and gender-diverse people. So instead I want to aim the closing of this piece at those who are on the fence. Those who do not hate trans people, but who are genuinely concerned about the children. To the parents, the teachers, the doctors, and the therapists out there who can still make a positive difference.

I am transgender. I do not want to be. It is difficult and painful and it has cost me so much. And yet, I will not and cannot change. I don’t hate being trans - I hate being trans in a world full of bigotry and disgust and violence aimed at people like me.

Transgender people are who we say we are. The research backs this up. We are not a fad or an ideology - we are your friends, your colleagues, your siblings and your children.

The teenagers I work with are not broken. Like anyone else their age they like drawing, gossiping, and watching hilarious TikTok videos. They speak in a slang that is often alien to me - a born-free millennial - making me feel older than I actually am. They get into fights, worry about their grades at school, and navigate the tumultuous world of love and relationships that all teenagers struggle with. They are, for lack of a better word, normal. And they are trans.

I dare Alleyn Diesel to spend an afternoon talking to the people most harmed by her words before writing another ill-informed article about them.