Gender Blog by Darlene Tando, LCSW

Hello to my blog readers, new and old: I have not written a blog post for almost 5 years. I chose to stop writing regular blogs in an attempt to center Trans voices. However, all of us need to stand up and have a voice right now for the transgender community. We will persist in doing the right thing, in the face of rampant adversity, transphobia, and misinformation. I stand with all of you.

The White House released an Executive Order on 1/28/25 that was geared to undermine the practice of medically affirming transgender youth in our country. Those who understand gender dysphoria read the order in disbelief, floored by how what is actually a life-saving, euphoria-inducing, affirming process be reduced to something implied to be negative and harmful. To those reading the order who don’t know a lot about transgender youth or gender dysphoria, fear-mongering was in full force with sensationalistic words like “chemical and surgical mutilation”. I would imagine most folks reading the order, no matter how involved with or informed about transgender youth, are against the mutilation of children. When presented like that, in creates a fear-based, resistant view of important gender-affirming interventions. This is purposeful.

The reality of gender affirming care for youth is this: medication is used to intervene with a process that causes distressing and often times life-threatening dysphoria. Hormones, which everyone has, are later used to allow one’s body to change in a way that feels right to them. There is extreme relief inherent in the process of blocking an unwanted puberty and then initiating a wanted one. If one undergoes surgery to change their bodies in a way that more accurately represents who they are, this is essentially the antithesis to mutilation. Youth who cannot access gender-affirming interventions are more at risk of actually mutilating their own bodies. Gender affirming care simply does not fall into this category. Parents who sign on off on these interventions do so because it has become clear it is the right, and necessary, thing to do for their child’s quality of life and mental health. It is an act of love. No order implying otherwise can undermine this reality.

A crucial, affirming process was misrepresented and coated in lies to instill fear and resistance in the general population, and to justify transphobia rampant in this administration. However, those of us in the know realize how dangerous and devastating this rhetoric is to transgender youth, and to the community at large.

The fear/myth of trans regret is an overstated narrative used to scare people away from believing and supporting trans identities, and is weaponized to undermine crucial and life-saving gender affirmation (social, hormonal, and medical). In the recent Executive Order, The White House indicated that many children transition against their will and later live to regret any changes that came from gender affirming interventions. This simply isn’t true. Multiple large-scale studies have recently shown that an overwhelming majority of those who seek gender-affirming care are satisfied with the outcomes and persist in their asserted, authentic gender identity.

While there may be a handful of folks in power in the current administration who are strongly uninformed and opposed to affirming transgender children, multiple respectable and long-standing organizations are in agreement with and support the idea of affirming children when they express a different gender identity than their designated sex at birth.

The American Medical Association (AMA), American Psychological Association (APA), American Academy of Pediatrics (AAP), Endocrine Society, World Professional Association for Transgender Health (WPATH) and National Institutes of Health (NIH) are some but not all of the major organizations that support gender-affirming care as a best practice.  

 Recent studies:

JAMAPediatrics | Original Investigation: March 2024: findings indicate that a small proportion of patients, and a very small proportion of those who initiated medical gender-affirming treatment, reidentified with their birth-registered sex during the study period.

Trans Youth Project [Kristina R. Olson & Selin Gülgöz]: May 2022: Young children who transition to a new gender with social changes are likely to continue identifying as that gender five years later. The study found that 2.5 percent of the group had reverted to identifying as the gender they were assigned at birth.

Gender GP: Detransition Facts and Statistics 2022: On average, 97% of people who are transgender are happy with their decision to transition. Only ~3% of trans people experience some form of regret, but may not detransition. Only 5% of people who detransitioned (0.4% of all trans people) did so because they felt the transition was not right for them.

American Journal of Surgery, April 2024: regret following gender affirming surgery is remarkably low, below 1%, compared to various elective surgeries and important life decisions.

In any trans individual’s journey (youth or otherwise), there can be changes and course corrections along the way. Gender is often an evolving aspect of self that deserves exploration and support of wherever the person is on their path. Current best practice is to believe and affirm one’s asserted gender identity, at every age.

The recent executive order undermines itself by using language that has been denounced by organizations who are actually informed about gender dysphoria. “Rapid Onset Gender Dysphoria” (ROGD) is not a recognized medical or psychological diagnosis because it is not based on sound scientific research or established clinical criteria. The term was coined in 2016 by a researcher named Lisa Littman, but her study and the concept it introduced have been heavily criticized for methodological flaws, misinterpretation of data, and lack of peer-reviewed support.

From Wikipedia:

“Rapid-onset gender dysphoria (ROGD) is a controversial, scientifically unsupported hypothesis which claims that some adolescents identify as transgender and experience gender dysphoria due to peer influence and social contagion, particularly those assigned female at birth. ROGD is not recognized as a valid mental health diagnosis by any major professional association. The APA, WPATH and 60 other medical professional organizations have called for its elimination from clinical settings due to a lack of reputable scientific evidence for the concept, major methodological issues in existing research, and its stigmatization of gender-affirming care for transgender youth.”

It is certainly scary to see those in power making such uninformed statements, and making rules that threaten the safety and well-being of the transgender youth, and those who love them, in our country. We are witnessing a national gaslighting, presenting a false, alternate reality as facts. Know that no matter how many orders are distributed, the truth cannot be erased. Trans people have always existed and will always exist; to embrace and affirm them will always be the way.