We Need A “Standards of Care” for Detransitioners

One of my biggest takeaways from attending the recent USPATH conference is that many clinicians and other providers sincerely want more information on understanding the needs of detransitioners and are looking for resources to support best practices in supporting this population.  More and more clinicians are working with detransitioners and are finding out in real time ways to support their individual clients. Additionally, many detransitioners are undertaking this journey on their own either due to their mistrust of providers or due to the difficulties in finding competent providers who can assist them with this process.  It would be helpful if there was a document that functions much like WPATH’s Standards of Care, that puts forth some of the emerging best practices when working with this population.  Are there others out there interested in collaborating with me on working on such a project?

I am looking to get input from not just detransitoners, but also Trans men and women and Trans and non Trans clinicians that work with the Trans community. Ideally a small core of people that is representative of above would also form an informal workgroup. The format would be similar to WPATH’s but shorter, and cover key topics such as mental health care, medical issues, legal issues, adjustment issues (for the individual and their family and loved ones) and a look at research in terms of what we know and what we need to know. The goal is to be peer reviewed.

If the only thing I accomplish is to help contribute to the growing impetus to create such standards, I will be equally happy if there are others who are better positioned than myself to pick this up and run with it.  I do know that there are others who are working with detransitioners. It would be helpful if emerging best practices could be shared.  Also, beyond psychosocial issues which I believe are the most important to address, medical and legal issues ideally need at least cursory attention (i.e. how detransition impacts HRT, surgical options, insurance, documentation etc.)

If you know of anyone who I might reach out to (I have a few ideas) I would really appreciate letting me know or passing along my info to them. I can be reached at j@dotb.be


Joel Nowak


My Slides from USPATH panel on Detransitioning

Here is a 30 minute video of me talking through my slides as a primer for clinicians based on my perspective on some things I believe it would be helpful for clinicians to be mindful of when working with clients interested in detransition. As I say in the video, this is only my “slice” from my own perspective and there are many other important ideas and suggestions (in some cases contradictory from mine) from others who need to be listened to. I will append transcription to this post when I can.  A lot of this is really basic stuff and if you had been reading this blog when it had a lot more of my content there is not much new here.


Collecting my thoughts from USPATH

I wanted to do a quick post on a things from the USPATH conference.  First of all, thanks to my fellow presenters and to USPATH for having us.  I thought the other presenters did an amazing job and I was really pleased to have people who attended the symposium come up to me throughout the conference to sincerely thank us for providing fresh perspectives on the subject of detransitioning.  I think it is a huge step in the right direction. Thank you to all who came out (or wanted to come but had schedule conflicts.)  It was really heartening to see you there.

I am sure pretty much everyone who reads this blog knows Dr Kenneth Zucker (who was one of those who came out to our panel) had his own symposium cancelled the following day following a large protest by those who perceived his participation as an act of violence (through inflicted trauma) against the Trans community.  I posted the following on the WPATH facebook page and usually when I post there I don’t repost it here for lack of context , but in this case I will repost it here.

“I have to say that I am disappointed in WPATH’s no-platforming an invited speaker. I saw the protest, and for me it was a sad and chilling reminder that voices that run counter to traditional Trans talking points are often silenced by the community. As a detransitioner, I have experienced it directly time and time again. I am thankful that the detransition mini-symposium was low profile enough not to be the subject of a similar ban as I know that there are those who feel the voices of detransitioners are not “helpful” to the community and need to be minimized. While I respect the passion and advocacy of the protesters (many of whom were represented in a powerful symposium on the academic and clinical marginalization of WOC within the field of Trans care which was one of the best sessions I attended) I see the actions of calling for no-platforming those that they disagree with as a step backwards, not forwards.”

Today, some of the ideas for the 8th iteration of WPATH’s Standards of Care were discussed.  I applaud a lot of these ideas, such as moving more towards making the document much more evidenced based and also the solicitation of a more diverse group that is representative of the population served is determining the standards.

I know that a call was made to remove the data on desistance from the document because of “bad data”. This comment was met with some of the strongest applause of the session today (discussing the upcoming SOC). I strongly urge WPATH and its membership to aggressively pursue trying to get better data on this and keeping it as an important part of the standards.  Unfortunately, because desisters often fall off the radar, this is historically difficult to track.  And that is part of the problem …

We have to do better not to let them fall through the cracks.  We need to be better prepared to anticipate desisters. We need to have Standards of Care in place to meet the needs of those who “desist” or detranstion. Any substantive discussion of the issue  is sorely lacking at this point. The subject was not even brought up in the opening remarks of what needs to be added to the SOC, which did actually surprise me because my impression was that this was on the radar for WPATH as an emerging issue.   To not even get a mention was disheartening and worrying.

I have offered whatever assistance I can to WPATH in helping move forward in developing standards for this population and I encourage other detransitioners to do the same because yours is the input they need the most.  I am ever the optimist (sometimes to my own detriment) and I know that others might worry that this as an exercise in futility. I get that and understand.  But at least I believe it is important to try so I will offer whatever I have.

I encourage those who work with the population to work with researchers to aggregate better data on who is desisting.  Longitudinal studies are key (and will continue to take time of course)  but case studies are still helpful here as well, because it is important to learn what happened and begin to consider what interventions, supports and resources may be helpful to this population.  Of course we need more researchers on this topic as well so who wants to sign up or collaborate with a (soon to be) MSW? We should not be afraid to be curious on this most important topic. We need to be prepared to have some ideas of what to do when youth (and adults) begin to desist/detranstion. I have a feeling that a lot of clinicians are lost here just because there is so little information on the topic and so few venues to share information and discuss this topic openly and without fear of professional marginalization.   (Full disclosure, I am nervous even writing this here as someone who is going to be entering the job market in a few months.)

It was also worrying to hear the continued devaluation of the skills of mental health professionals in this field (ironically often coming from clinicians themselves.)  One of the ideas floating was opening up who can do gender related assessments to ANY providers who work with the Trans youth population (partly due to the shortage of available clinicians and the growing demand.)  For a lot youth, there are other issues going on (i.e. family systems, environmental factors, risk for suicidality, DV, trauma and other cognitive or  neurodevelopmental issues) that I believe ARE important to be assessed for that I do think that only clinicians have the training and the professional obligation to be uniquely qualified to perform. To forfeit the opportunity to provide a holistic and thorough assessment seems like a profound disservice.  And to be clear, I agree that most youth who identify as Trans certainly don’t need to be subjected to a distressful battery of tests such as the MMPI, TAT etc., but basic clinical assessment and judgement I believe is an ethical responsibility. This is especially so within the context that many are advocating that the requirements for minimum age for surgical procedures should also be eliminated.  (Another interesting proposal was the elimination of requiring testosterone for adolescents requesting chest surgery … which on one hand I support as less invasive but also worry that the magnitude of such surgery is minimized in the process.  I have heard from some that in retrospect this became too became a source of regret.)

That is all I have for tonight. I do want to emphasize once again that I believe that most of the providers I met with are working tirelessly to provide the best care they are able for a population desperately in need.  I also believe that this conversation must proceed in a way that does not inhibit the needs of those who (I believe) need access and benefit from these services. Unfortunately the political reality is that this population is especially vulnerable right now, so of course due diligence in how information is used and disseminated is more important than ever!  But that does not mean we need to silence the conversation … we just need to move carefully and mindfully, with respect and compassion.  And while continued passionate activism from the Trans community is absolutely essential and helpful, it cannot dictate the science itself as that does not do anyone a service.

I am going to upload my presentation slides from USPATH in the next day or so for anyone curious … they are mainly bullet points of what I was talking about so I may or may not do a quick video version.  I also want to make an effort to republish a small portion of reader comments from my blog from those who have so eloquently described their own experiences, which is the content that I feel needs to be heard the most so unlike my own postings I recently restored temporarily I may leave those up for awhile.


Putting some of my site back online temporarily

I am at USPATH conference and it was really fantastic today to see people come out for the detransition minisymposium.  I didn’t talk too much about my own journey there, but I have decided to re-publish a few of my posts on a temporary basis in case anyone is curious about what this blog was all about.  I’m leaving a lot out  .. mostly these are just random snapshots from the lifespan of this blog when it was a going concern.


Detransitioning USPATH Mini-Symposium

Sorry no updates but finishing up my masters and still busy with internship.  Just wanted to update to say I will be in LA participating in this mini-symposium at WPATH’s “USPATH” conference, February 3 8-9:30 AM with some other great people.   I am focusing my portion of time on how to normalize the conversation between client and provider and some of the obstacles faced on the micro, macro and meso levels (I’m a social worker now… what did you expect?)  I thank WPATH for making this happen … I believe this is progress.



Mini-Symposium Outline: People who detransition, retransition or transition back have been on their own to navigate the psychosocial and physical changes of going off of hormones and finding an authentic presentation.Detransitioners might include :People who had to stop their transition for medical reasonsPeople who transition, live as their chosen gender and then determine it was not the correct path.People with trauma issues who feel transitioning was a solution either consciously or unconsciouslyPeople who’s original transition led them to new insights about gender and have decided to move forward in the next step in their journeyPeople who transition back experience a variety of challenges ranging from lack of information about retransition, excommunication from the trans community, being vilified by the trans community, being used politically, and being neglected and ignored by the medical and mental health community. Further, they may be stigmatized as mentally ill, as failed transitioners, or as people who are intentionally trying to harm transgender communities.  When they approach providers for help, they often encounter doctors and clinicians who are unfamiliar and have no idea how to provide relevant help or information.  Their concerns may be dismissed or seen as momentary stumbles on their path to their affirmed gender identity and they may be encouraged to persist in transition.This workshop will discuss the developing language and clinical frames with which to understand people who transition and then transition back. Clinicians must be comfortable with a compassionately neutral stance, have the experience to contain ambivalence, awareness of trauma and grief issues,  must not foreclose the exploration of a variety of issues.
Category: Mental Health: Psychology, Psychiatry, Psychotherapy, Counseling– Adult


Hope all had a great New Year’s!



Quarterly Report

I got a text from a friend the other day saying “I know you are busy and I hate to ask -but can you set up a blog for me”.  Although I used to do this a lot for people, my friend actually really needs a blog (to keep his friends and family posted with some big life stuff he is going through right now) so tonight I started setting it up. And of course I thought about my own blog here … and how if I have learned anything over the past year, it is that I shouldn’t make promises as to when I will post here again.  The truth is since my last optimistic post, my final year for masters degree in social work kicked in, my duties at my internship ratcheted up a notch and I am not sleeping as much as I would like again.   But other than that I am doing fine.  It just means that a few things in my life have to go on the back burner until I get a bit of a break and this blog and updating it as I had planned is one of them … although I am still working on a few things in this area that I do hope to talk about soon.

For now though it is nice for me to take a step back and look at the big picture without having to immediately have to feel I have to write about Trans once every week or so. And even if I am not always thinking about Trans directly, I feel like I have been filling in some of the back story in my personal quest to understand some of the context of what is going on, just through my experiences and studies as a clinical social worker in training. I still think that for a lot of people, being “Trans” is at the end of the day,  just another way of coping — a way for people to feel ok enough to get through life. For some it works better than others.  (And sadly for some people it doesn’t work very well at all.)  But for a bunch of different reasons it is a way a lot of people are trying now.  I think as more people are honest about their experiences, maybe people can make more informed decisions about if this is really the right path for them.  And if it isn’t … that they can know that is ok too.  There are always other options in life.  I will always like options.

As it relates to Trans, I still think the mental health component is a huge piece in all of this that is not really being talked about the way it needs to be.  It has to happen.  And it is a discussion that has to happen in a way that is mindful of people’s dignity and identity.   But it does need to evolve.  Last year I was writing about Trans suicides a lot here. Writing this blog was not very fun.  The topic was unavoidable for me.  Also, just the lives of sadness I saw many in the Trans community plunging into.  I still see it (again I am not speaking for all) and it is frustrating to me that fears of going against current “political correctness” or “group think” in what we are currently allowed to talk about about is stifling conversations that need to happen.   A few times I popped on to reddit and saw confused kids saying that they were thinking of detransitioning because they realized this was not for them, and I was about to give a quick reply that they could follow their intuition and experiment with a few step back, but then I forgot I was banned from the Trans reddit pages (who remove detransitioners) and just had to read all the replies from others telling them to basically “double down” and try harder because they were going to end up suicidal if they didn’t.

I know that a lot of Trans people say they were born in the wrong body. But I am convinced that for others, it is a way of managing situations. And it might just be something they are trying on, and then due to a lot of different psychosocial factors end up staying in a lot longer than they might otherwise and in many cases that becomes their final destination.  It is complicated. It is not easy.  For a lot of reasons, once you throw down the Trans card, it is pretty hard to walk it back.  But I do want to see an individual’s right to look at the etiology of their own transgender identity become destigmatized in areas other than just the biological side … because while I think that is probably part of the story in terms of predisposition, I think there are a lot more things we can be helping people with.  And again, it has to been done carefully, not because it is “politically correct” but because people deserve the respect and dignity to have this conversation move forward in a way that doesn’t marginalize them in the way that it has in the past.   On the other side of the coin though, loaded language and legislation that lumps ALL efforts of helping kids learn to be ok with their bodies as being “reparative therapy”  is not helping the situation.  People need to step back, breathe and think.  And again, people need to talk and be allowed to talk.  People need to tell their stories and we need to learn not to be afraid to listen.

I am very much enjoying what I am doing right now, even if it involves being away from here. A few friends (who have known me for, jeez, 30 years or whatever) have told me that this is what I was always meant to do. But I do hope to find time in the next few months when I can to circle back to this blog and keep on filling in some of the blanks that I think are still missing.  I console myself by saying that I am happy to see that the conversation is right now stronger than it ever has been before (and it seems to be growing every week) so I am not really needed. But as someone who cares about this, I want to stand up and do my part just like so many others are now doing. That is how we all get to where we need to be.



“People like you and I are virtually invisible”

I thought this comment (left last night by Juniper) was really on point and relevant to what I am concerned with right now so I wanted to feature it in a post (I know not everyone reads comments here.)   I am also including the reply I just wrote.



Hey Joel,

I think that it is very important that the gender spectrum be as inclusive as possible and that all kinds of differences in gender expression are supported in textbooks and are visible in the media.

At this time, I see no viable visibility in the media for people who are androgynous, de-transitioning, or who meet the textbook criteria of transgender but chose to live and accept their bodies. A young person who is gender-variant may feel that they have few options but to pursue transition or to live inauthentically. People overwhelmingly hear in the media that surgeries and hormones are absolutely necessary for people who are transgender to live meaningful and happy lives.

There is no representation in the media for people who live quite well and enjoy balanced and well-adjusted lives yet radically defy gender stereotypes.

Our story is not told. People like you and I are virtually invisible.

So, what happens to the kid who is questioning their gender? They look into their options and literally see a DEAD END. No matter what they do, no matter how far they go with surgeries and hormones, they cannot change their DNA or their root socialization. How can they be sure that society will change their perception of them? Can they be sure that they will “pass?” Can they be sure that the secret of their sex at birth will ever be exposed?

They hear that it will be difficult to find a life-partner, that the surgeries are prohibitively expensive and that they will never be 100% like other men and/or women. They learn that surgeries and hormones can only do so much.For instance, if they are FtM, it is unlikely that they will ever have a successful “bottom surgery” even after paying $100,000. And if you are 5’1 as a woman … guess what … you will be 5’1 as a man.

They hear from the media that their future is bleak. This is a lot of stress for a young person to handle. They seek support in the transgender community and there is no Transgender “Pride” parade but rather a Trans Day of Remembrance to remind them that suicide and murder are very real outcomes in their community and that they are disproportionally at risk.

Do you know how many women are raped or killed by boyfriends and stalkers? My god – if women’s history month was all about rape, I would have killed myself a long time ago!

Where is the support to believe in one’s inherent worth? Where are the examples of (so many) people who have lived long and well WITHOUT surgeries or hormones? Where are the stories of people who have survived extreme challenges and suffering yet have moved courageously forward to detransition and reclaim their lives?

Our voices are silenced as we are made out to be the “enemy” … We are called TERFs or transphobic or “failed transitions.”

No wonder young “transgender” people commit suicide. They are trying to find themselves and figure things out and when they seek help they are told that they have no option but to change themselves if they want to be loved. No one tells them that they are perfect just as they are. No one tells them that there are many ways to live. No one says “Hey, I made it … I am happily married, I have a good life … it will get better … I was a lot like you in High School and I am glad that I kept my body as it is and/or that I learned to love myself for who I am.”

Many people who are diagnosed as transgender may not be aware that there are lots of ways to live outside of the gender lines. More perspectives need to be shared so that young people can decide for themselves what what resonates, and feels right for them.

  • Joel Nowak says


    Thanks for this. I am going to feature this in a post. I really think that it is important that these alternative narratives to being Trans start getting heard. There is an embargo on these voices currently, with these narratives being ignored or removed from internet forums virtually nobody (aside from social conservatives) interested in publishing them or writing about them. (I applaud Michelle Goldberg among a few others for writing about this stuff.) There are alternative narratives to the Trans that don’t look like Walt Heyer’s judgemental and one dimensional “repent or die” blatherings … but when all people hear is that crap they get a very distorted view of how open and liberating some of those narratives can be (compared to the increasing rigidity of the Trans movement).



A Reader’s Thoughts About Nathan V.

I still don’t have time to write anything coherent (as evidenced by last night’s post) but I did want to share this email a reader sent in last week in response to my own post about Nathan Verlhelst. They said I could share it with you and I am going to because I think they make some really good points, especially a reminder that for a lot of trans people there remains an unmet need for GOOD therapy that helps people work through deeper obstacles in their life as opposed to the usual status quo of  simply cheerleading their gender decisions.


A very moving post. I can’t speak from a trans experience, but I do want to share here that this is such a sad story of a bereft human being. From comments I read attributed to the mother, she was never loved as a girl, seen as monstrous from the moment of birth. I think in many way the tragedy began with the path to transition as a path of healing. Surgeons and psychopharmacologists are not the healers of such a deep self loathing and family abandonment. Nancy/Nathan was a tortured soul, given false hope of cure for this self hatred and extreme unhappiness in a transition that was mutilating and lead to the final tragedy.

State sponsored suicide seems to me different than euthanasia, and this is one of the elements that is so troubling about this. I don’t know how much therapy, good therapy, Nancy/Nathan chose and stayed with over the years. Maybe suicide would have been the outcome with or without transition. I do believe that therapy offers the chance to heal, to accept, to even experience a little love for self. It’s not always enough, but I think it’s the better way.


Remarks from San Diego TDoR

As I mentioned,  the highlight for me of attending the San Diego event marking the TDoR was hearing the remarks made at the opening by Connor Maddocks, who runs The Center’s Trans services.  I have known Connor for years and I have a lot of respect for his opinion. When I appeared on Maritza and Lynna Cummings’ webcast, I consulted with Connor to try to get some feedback on how I could do the show in a way where I could cover a very difficult topic and say what I needed to be say and yet  be respectful of the Trans community. Connor gave me a lot of great advice and I think the show went well—It was great talking to Maritza and Lynna who I think enjoyed the talk too.   I liked what he has to say here and I am hoping that the members of the community who were in attendance Friday night  are up for taking on his challenge.


Welcome everyone to the International Transgender Day of Remembrance.  Tonight we honor and remember those we have lost due to hatred and violence against our community.  We have lost too many lives,  to many amazing people gone for no reason.  This madness against our community must stop.   I hope you will indulge me as I would like to share some of my thoughts with you.

We each feel the pain of every loss, and we feel that because we are family, that’s what community is all about.  We laugh, love and learn together to make each of us stronger.  Community is something to be treasured and nurtured.  

But if we want to stop the hatred against us, then I think we need to start the process at home.  To me Community is home, you all are my people, my hopes and dreams, my strength against all outside forces that would harm us.   The only way that we can accomplish what we want in greater society is to raise ourselves up, raise each other up. And I wonder how we can do that when we in the community we are tearing each other down?  How can we do this if we are ridiculing, bullying, fighting, name calling each other?  We are all very different people and have different opinions and values.  We can’t build community up if we are tearing each other down.  Going forward I am asking all of you to strive to work together better, to sit down with a person and talk out your differences and come to an understanding of how you can support each other. It’s easy to use social media to spew rumors, lies or even past irrelevant truths about each other in order to hurt someone.  How can we ask the world to respect us, to acknowledge us, to value us when we don’t value or respect each other?  Instead of resolving to speak against each other, let’s resolve to solve our personal issues together.

Now , how do we, as a community battle the hate and discrimination in our own city?

Tonight I ask that we begin a war on the hatred and violence so many experience, and I would like to offer you some ideas about some weapons for this war.

These are my weapons which I gladly share with you:

LOVE –  show love, teach love give love, love others as you love yourself, and if you don’t love yourself, its ok we will love you just the way you are.

Education – always educate, anyone you can, everywhere you can.  It’s hard to hate something or someone when you understand and know them on a personal level

Collaborate – work with anyone who would be an ally, give and take in the community

Be part of the solution – find a way to help, volunteer, get to know all our communities in San Diego

If safe for you show yourself, stand and be proud of who you are

Be each others keepers, who else will do it for us?  Be safe, be smart and help others find safety

And when we need to fight,  let’s do it together and be a force to be reckoned with.


I want this site to be a “safe space” for all

Some facebook site linked to me yesterday I guess because I got way more traffic than usual … sometimes I can’t tell if they are pro-trans or right wing sites or whatever that link … and it is hard to gauge by comments.  I got a few comments on my site yesterday (it has been a long time since that happened) and it is nice to have some interest around here but I have to say that reading some of them DID make me feel a bit uneasy. It is like the comments, when they get going on my site … become this other entity unto themselves separate from what I am trying t do here.

I really do believe that there is a way that we can talk about these difficult issues without further stigmatizing Trans people.  I have said this before, but I have a lot of Trans friends.  I think it is unfair to say that all Trans people are delusional. More than that, I believe it is untrue.

In every post that I have written, even though I am critical of a lot of things within the Trans movement, I always strive to be respectful towards Trans people.  It was that way since day one.  I think I have done a pretty good job. Have I always gotten it right?  No.  But I am open to learning.

I want this to be a safe space for all. I don’t want to use triggering language. I don’t want to demean people or their lifestyles where they are not doing harm to others. I do want to continue to critical of things that I think are wrong, but looking more at broken systems or challenging paradigms that may not be as helpful as was once thought.  I am going to be doing this mindfully and in a way that respects all.  If someone comes here I don’t want them to be unnecessarily made more anxious or fearful than when they came to this site.  That is the opposite of what this site is about.   But I do want people to think.

I am holding back on publishing some of the comments today and I will start being more careful about what I let through. I don’t want conversation to spiral into vitriol.  Maybe that means nobody will comment here … so be it. I do want to see conversation going forward on this topic, at least in this space of my blog, as having the civility and respect for diversity that I am drawn to in the conversations I engage in in the “real world”.

I am considering other changes to this site as well in terms of content featured.  If you have any thoughts feel free to let me know.


Last weekend sucked … let’s have a better one this time around. Don’t stop living.  I like light and lightness … in these times more than ever.   If you are in Hillcrest tomorrow night maybe I’ll see you at the Trans Day of Remembrance.



One thought that keeps haunting me

There is something that Kurt said that had been haunting me lately … even before this weekend.  He spent a lot of time trying to raise awareness against bullying, speaking from his own experiences about what it was like to be bullied growing up. In Kurt’s case maybe it was for maybe being gay, maybe for being a little overweight and most likely just for whatever stupidly arbitrary reason kids pick up to relentlessly select a target and go after him or her in hopes that he or she will break (and hopefully they will get to witness it … otherwise it is no fun.)

Kurt lost his father when he was very young.  He talked about the day his father passed, his body was still in the house and there was confusion in the household. The doorbell rang. Kurt’s distraught mother sent him to answer the door. When Kurt opened the door he saw his schoolmates, who immediately punched him in the stomach and ran away.  I remember Kurt saying that even in that moment he couldn’t have peace and how he was still never really able to get over that.

There is a certain meanness in this world that is so cruel that, to truly comprehend it, I believe it really can drive one “mad”.  I don’t think we can ever make that sort of meanness go away. Maybe we can mitigate it to some extent. Maybe we can sanitize it. Maybe we as individuals and as a society can learn to “process” its effects upon us.  But I don’t think we can ever make it truly go away.



I lost a friend an ally over the weekend

I lost an ally and friend over the weekend. I just found out about this a few hours ago and I feel empty and horrible inside. I had gotten to know Kurt Cunningham over the past year as we both became suicide prevention trainers together under the Question Persuade Refer (QPR) training program. He also attended the same Suicide Prevention Council Meetings I did. We saw a lot of things the same way. He was really supportive of my blog and we would meet for coffee and he would grill me with all sorts of questions about what I was experiencing as a detransitioner.  He was really curious about why I hated the term “cis” and seemed to totally getit when I explained it to him. I know he was trying to understand and get things right … just has he was trying to understand other parts of the LGBT community he cared so deeply about but at times some of the more dogmatic infighting left him completely exasperated and I think that is why he and I had a lot to talk about. He was always asking me to critique his presentation that he would do around the community in his capacity as a mental health worker and advocate about the “new new” terminology around lgbt issues. (He also would get similar advice from other stakeholders in the community … again he wanted to get it right.)

So as I keep saying (excusing) I have been busy. I have been away for the past six weeks from people and projects I care about since I started school,   I guess you kind of expect people will still be there when you get back. When you are ready they will be there for you. Life doesn’t work that way though. Once again I feel empty and heartbroken inside. Kurt had told me that our little get togethers did him good … that it was ok to bother him because he probably needed breaks and diversions. They did me good too. Like me though hewas busy though too. Maybe even busier than I was. Both of us spinning our little wheels trying to save the world. I know I am missing a lot of stuff that is falling away right in front of me. Do I need to go to school to learn how to return an email or call a friend? It all seems so pointless and hopeless sometimes.

I was really looking forward to getting to know Kurt better this year and to work with him on a few things going forward that we had both been talking about. I know Kurt touched thousands of people and did make a difference. (I suspect he also pissed a lot of people off too … we had something in common there.)

I know a lot of people are also saying that we need to respect Kurt’s choice and that there is no blame here. People are pointing out that he was sick with depression and he didn’t take care of himself as much as he should have. This was inevitable.

For those of us who knew Kurt I guess we all need to find a story that makes sense to us. Sometimes that is hard to do in a world where nothing seems to make sense. I needed this guy around.  Someone told me he is in a better place now.  His pain is at long last over.   Kurt shared pretty openly about his experiences being bullied from an early age.  I do think that there is still something about this world that is unforgiving in a way that chases some of us out of here sooner than their time.  I still want to see a world where people like Kurt decide to stick around a little longer.

Kurt’s Page


I will be on TRTV Thursday 11PM Eastern

Here it is:

Update: I previously incorrectly listed the time as 9PM Eastern … it will be at 11PM.
Update 2: And I just realized I misgendered Mark.  Ughhh …. I try to get this stuff right.
Update 3: Watching TRTV now … now not really sure what pronouns Mark prefers … will have to ask.  I hope these guys don’t get me in trouble! Thursday is going to be interesting.
Update 4: TRTV Misgenders me on their website … it’s all good!   :-)   http://www.transitionradio.net/joel_nowak.html

Ok I guess this is a first around here – three posts in a day – trifecta (or hat trick or whatever). I wanted to let you know that I am going to be appearing on TRTV with hosts Mark Angelo Cummings and Lynna Lopez. (Here is the link.) I have been watching episodes of this program over the past few weeks and I believe that something worthwhile is going on here. Although I know that Mark Cummings and Lynna Lopez are passionate people (who I actually strongly disagree with on a number of things), the moments of this series that I love the most are when the guests are simply allowed to articulately share their journeys (and Mark and Lynna contribute here too). We aren’t hearing these conversations anywhere else (at least I am not) and that alone makes what Mark and Lynna are doing right now extremely important.

Mark asked me to appear on the show and since you aren’t hearing a lot of former MTFs talking about their experiences I accepted. This is the kind of venue I feel comfortable speaking in … this feels “right” to me … like this is where I should be right now.

Talking about this stuff is hard. I know I keep a lot of stuff sort of “close to the vest” in my blog and I will try to talk a little bit about that on the show. Someone recently told me that my blog seems to be about figuring out what I want to say and that pretty much hits the nail on the head. How borring. But at the same time, that question is actually kind of a lot more complex and difficult that I have really been getting into in this blog. Because the more of myself I “expose” through this blog, in some ways the harder it is to keep myself and my retransition healthy. I don’t want to talk too much about my life as a “woman” here because I fear that it will make it harder for people I know in real life to take me seriously as a man. So maybe it is time for baby steps … testing the waters …. saying a few things here and there that may be slightly out of my comfort zone but still trying to stay safe and keep moving forward. I will write more about this I promise. I am not going to be able to keep writing as much as I have been for much longer so I need to get some of this out while I can. And then I am probably going to be too busy with school to be around as much as I have been the last few weeks.

I really do be one of those who help clear the trail for others who come after me … only in the fact that I want to show retransition is possible should you really feel it is your necessary path. But here’s the thing I also HAVE to take care of myself first. I have to admit that I am a little scared (I have said this in my blog a few times recently you may have noticed) because I feel like I am out in no man’s land. It is reassuring when Third Way Trans gives me a shout out because I think he is one of the few people I know of out there who is in a slightly similar place (and there are a few others out there too). But I don’t want to step too far out into the public eye with this activism stuff because there are few men out there who have really had much experience talking about the stuff I am talking about that I can can turn to and ask for advice. I found myself turning away from some other chances to tell my story in some potentially powerful ways over the past few days because I feel they would be just too disruptive of the life I have right now and that I am creating and building upon everyday.

Uhhh … I am tired …. long day.

I am enjoying this time here though on this blog and am happy I am finding time to spend here. I do believe this is officially my RETransition Summer.

PS … here is the latest episode of TRTV with a really great interview with Lynn Cadin


Beautiful Lights Going Out

Since march three children who identified as trans have suicided here in San Diego County. This is ripping apart my community. I am not talking about the just LGBT community, I am talking about large swaths of the ENTIRE community of where I live … this is casting a dark shadow over the entire county. Some people that I have a lot of respect for are doing a lot of work right now to educate – to try to improve tolerance and understanding. But I don’t think that is enough. I still think there is something fundamental we are missing. We need to keep thinking. Or, if we think we might have some of the answers, we need to start speaking out about what they are. This post is not the place to do that. This is for Kyler, who’s story is linked below. It is also for his mother and all who are trying to heal. That process is only now just beginning.


Need resources related to suicide prevention awareness or just need to talk?:





Not really sure why we need more boxes to try to stuff people in but congrats … cisgender is now officially a thing. Oh I just can’t tell you the warm fuzzies I feel when I get called this by trans activists (and, yes, I really do get called this by some trans activists) … which plays like a really insensitive attempt to invalidate the nearly half century of my struggling through a gendered world just because I have come to conclusion that I actually do believe that I was “assigned” the correct birth “gender”. Nah … I am “cis” and I will never be able to fully understand the unique struggles of “trans” people. (Note: The last few days I have been feeling good about getting called “sir” a lot lately but my streak came to an end today when I was greeted by a “Can I help you find anything today ma’am” at my local Staples.)

I still think this piece by Glosswitch was my favorite thing written on this … even though it is coming from a female perspective (which of course is not my experience) it really shows how absurd this whole business really is in a way that anyone can understand … no matter how or what they were “assigned” (or not assigned) as at birth.



It really does feel like a death cult to me sometimes

I guess one of the things that gets me down the most about the whole trans thing is that it really does feel like a death cult to me sometimes. Death portrayed as noble, beautiful, innocent and darkly poetic.   For some, you can can first set your sites on living your life by almost unobtainable goals and when you come up short and have no real safety net you always have this beautiful escape route in which your death can be ritualaized in the ways that the trans community and their allies have been getting so good at doing lately (due to all the opportunities for practice.)  I almost think that in the trans community, a well-memorilialized death is almost viewed by some as a “consolation prize” one can expect to get out of this if nothing else in transition works out right. This just seems to be getting out of hand and it continues to escalate.

The San Diego LGBT Pride Parade is a BIG event in this town every summer and has been for years.  San Diego is not the most progressive city in the world, but this has always been a great event and for the most part a great celebration of life, hope and a time to come together to make things better.  This year, THE ENTIRE TRANS COMMUNITY has been named the grand marshall for this years parade.  That is right … THE ENTIRE TRANS COMMUNITY.  (I guess that kind of even includes me.)  This is a positive sign of coming of age and once again another chance to show social responsibility.  Yes, things are still very messed up in the world, but we are all adults here and we can step up to the challenge to create better possibilities in the world for those who struggle with all issues of oppression.  We can do this in a positive, life affirming way and what better place to do it than at a celebration like SD Pride.

That is why I am really sad to hear that some local activists are going to use this opportunity to turn the parade route into a “die-in” and shut down the parade at various points to stage this event (the parade will be suspended at various points along the route while people will pretend to be dead bodies while others will encircle them with police tape while still others read out the names of trans people who have been murdered and who have suicided.)

This is a thing kids come out to. This is just a family day.

I find all of these deaths tragic. Each of these deaths is one too many.  I spend some of my free hours doing what I can to raise awareness in the fight against suicide and violence, for all members of my community (but my heart right now especially is going out to my trans brothers and sisters.)  But there is a time and place for everything and this is not the right time nor place for these staged events.   I am not the only member of the trans community who feels this way. There are others who are just as upset by this as I am.  I think it is a very selfish act and I am going to skip the parade this year.   It hits too close to home for me, literally.  Rita Powers died just a couple blocks away. This is triggering for me in the most horrible way possible.

I still hope that these Trans activists decide to do the right thing and decide to hang out at the grown up table just for this one day.  I really do think that this constant death fixation is part of the problem here. At the end of the day I want what they want … people staying alive.  I hope they can maybe think about how what they are doing actually MIGHT be adding to the problem and not the solution.

Here is a link to the SD Pride statement about the Die-In


Need resources related to suicide prevention awareness or just need to talk?:




Article About Me and Third Way Trans by Tracy Clark-Flory

Over the past couple of years that I have been blogging I get small but fairly consistent stream of interview requests for potential stories about retransitioning. Some of these have come from some pretty big names in the news business.  I pretty much always agree to do an interview and supposedly some stories have been written but, maybe not so surprisingly, none of them have yet appeared (although a few may still be “in the pipeline.) My media losing streak ended  today when Tracy Clark-Flory published a piece on the subject of MTF retransition featuring myself and ThirdwayTrans.

Tracy reached out to me last week and I had a quick chat with her before heading out the door to catch Cheap Trick at the San Diego County Fair (somehow I had never seen them before.)  I thumb emailed a few more answers to follow-up questions during the show (Peter Frampton was also on the bill and that was my … ahem … email time) and a clarified a few more things throughout the week and tada … she actually published this week, just as promised.  So congrats Tracy for actually doing what so many before you have not done.

I’ll have more to say about it soon (I am on a roll folks … catch me while you can – I’ll be here all week *snark*). This is not entirely easy.  In fact it is really fucking scary opening up about such personal stuff and I had a really pensive and anxious weekend.  I still feel some of that but I’ll talk more on all that later.  For now I’ll say I think Tracy did a nice job of showing how this subject can be talked about in a way that is respectful to all.  Please check it out … I have a feeling that not very many people are going to read this.




(From California)


Conversion Therapy: A Fundamental Confusion

Just a quick post this morning as I mull over the morning news …

The Obama administration has responded to the online petition (inspired by the suicide of a trans youth late last year) calling for an end to “Conversion Therapy”. On the surface, this appears to be a humane and well-informed decision.  I believe that the Obama administration has the best of intentions.  The horrors and ineffectiveness of conversion therapy for the LGB population is widely documented.  In the administration’s statement, written by Valerie Jarrett, statements from the World Health Organization, the American Medical Association, the American Counseling Association and others are cited that express the ineffectiveness of conversion therapy on sexual identity.   The problem here is that the petition (and the response) are about not only sexual identity (orientation)  but also gender identity.  They are not the same thing and this is a fact that is commonly overlooked (or, in some cases, delibveratelyobscured.)

Ironically the statement by the American Counseling Association that the administration’s statement links to specifically addresses why they are not including gender identity conversion therapy in their report.

“The coalition is aware that it is becoming common to include “transgender”when one refers to “lesbian, gay, and bisexual.” However, the coalition decided that it was not accurate in this instance to make that addition, because the subject is the promotion of therapies and ministries to change sexual orientation (attraction to the other sex, to one’s own sex or to both), not gender identity (psychological experience of being male or female). The coalition notes that the two populations of youths are not mutually exclusive. Some lesbian, gay and bisexual youth are transgender. Furthermore, those whose appearance and behavior are perceived as inconsistent with gender norms and roles are often targeted for sexual orientation discrimination and violence. By not including transgender in this booklet, the coalition in no way intends to minimize the real concerns for the safety and well-being of transgender adolescents in schools. We have tried to include resources relevant to transgender youth in the Resources section (pp. 17–19).”

I have to admit that I find it frustrating that many trans activists will  assert that sexual identity and gender identity are two separate things and yet will not speak out when the two get lumped together as they often do in situations such as these. Trading off of the general public’s knowledge of sexual identity issues to raise awareness seemingly similar struggles faced by the trans population is not always helpful … especially when there is serious difference between the lesbian and gay experience and the trans experience.

I want to be clear about something.  I am not saying that a child’s struggles with gender identity are any less valid (and sometimes painful) than a child’s struggles with sexual identity. I am also opposed to unethical psychological “treatment” to make a child try be someone they are not.  I believe that kids do not need to conform to preconceived gender roles or identities to grow into well adjusted adults.  But, to go back to the original petition, the statement asserts.

“Therapists that engage in the attempt to brainwash or reverse any child’s gender identity or sexual orientation are seriously unethical and legislation is needed to end such practices that are resulting in LGBTQ+ deaths.”

Despite many attempts to define it (and even legislate its definition) I feel that the concept of “gender identity” is still nebulous.  I also believe that conversations regarding how to live one’s life in a sexed body that does not conform to one’s sense of what that sexed body SHOULD be do not have to be unethically conducted as painful behavior modification therapies.  What I worry about is that the current confusion about what conversion therapy actually is will lead to parents and therapists being afraid (or face cultural shunning) for trying to help kids make sense of their sexed bodies, which I think is something that can be helpful to many.  Therapy and treatment for the wide range of issues that present as “gender dysphoria” are still in their infancy and there is little hard science behind any of it (and a number of active movements from both pro and anti-LGBT forces to discourage all research in this area.)  If we are going to begin legislating the removal of treatment options we just have to make sure that we are clear that we know what we are actually talking about.


There is a candlelight vigil this evening in my town for a trans-identified youth who took their own life last week.  Although I will not be attending, this  breaks my heart and my thoughts and prayers are with the family and all of those touched by this tragedy.  This is a real issue.  This has to get better.

Suicide Prevention Resources


World Suicide Prevention Day: Please Let’s Do Something

Today is World Suicide Prevention Day – a day to mindfully engage in discussion and commitment to helping reduce the number of people we lose each year to this act.

Find out more here: http://www.iasp.info/wspd/

I believe there is so much more that the trans community can be doing to prevent suicides of people struggling with gender identity.  I am just as guilty as anyone. Handwringing can only go so far.  Last weekend I started the process of volunteering for the Trevor Project.  It is a very small step but a lot of small efforts from many people can make a BIG difference.

I also think that, for those of us in the trans community, it is good for us all to stop at least this one time of year and look at how we are talking about suicide amongst ourselves. It is a subject that at times needs to be acknowledged and discussed, but when it does it must be done mindfully—both for the people who are listening to our words and also for our own selves so that we are aware of how to keep our own mental wellness when we are engaged in these conversations.

I know that some LGBT and Trans-focused organizations and individuals have done a lot of advocacy in this area year round. I have named the Trevor Project, but there are others out there.  I would appreciate it if you know of any of these resources to please reply to this thread with information as I would like to compile as many as I can and make them available online.

There are a few other things that I would like to see happen and am willing to be involved in creating if I can find a few partners.

I think someone might have already done this but I can’t find it (again—please send me links or contact info if you know where it is.)  I think that there needs to be some readily accessible guidelines for how members of the trans community might want to think about when talking about suicide.  I have watched countless threads on internet forums where a gender questioning visitor (usually a young person or, increasingly, children) will ask if they should start the process of transition. In most of these threads a number of respondents (much older adults) will immediately tell that person that they will likely get to the same point that they themselves did – ready to get a gun out and pull the trigger. I really do believe that we are helping “normalize” suicide within the trans community by speaking of it so often especially in occasions such as this. (If anyone is familiar with trans forums they will know exactly what I am talking about.)  For many, I believe that this moment of very seriously contemplating or (in many cases) attempting suicide has almost become part of the Trans Mythos – a story of rebirth out of the debris of a life that had been there before.  I am not here to discount those stories. I believe most of them are true. I even have one myself.  But I believe that for those of us in the older “trans generations” can help younger generations find a new narrative, and set a tone where suicide is not something that is presented to someone right as they are “walking in the door” as it were. Let’s be mindful in our speech.

I sometimes search for the term “detransition” on social media because that is something that I am STILL struggling through. So many of the results I get are along the lines of “I would rather kill myself than detransition”.  I totally support the right of people to say that, but just keep in mind that for someone trying to hold their detransition together seeing this stuff online does have an impact and will have consequences of one form or another.  If you need to say it, do say it.  But maybe it is something you need to be saying to a therapist instead of shouting blindly out into the internet.

A lot of trans people use social media to make suicide threats. I think it is a good thing that they are at least calling out for help. Many in the trans community rally around to assist these people in their time of crisis to keep them talking and distracted enough so that the suicidal moment will pass.  Again, I would like to see guidelines for how these conversations should be conducted.  Maybe this is already out there on the net (I know there are a number of things for the general population and I will be gathering those as well as publishing them.) If anyone has anything they can let me know about I would appreciate it.

The reason why guidelines are important here is twofold – both equally important. Firstly, it is important to know how best to interact with someone in this situation and how to make sure that they are safe and will ensure that they connect with the resources and professionals who it is critical they speak to. Secondly, and just as important, how to keep one’s self healthy in the process. Talking to someone about suicide can be extremely draining and, if not done mindfully, can seriously impact the “helper’s” own mental wellness. Boundaries are really important here. I think a lot of people don’t really take care of themselves when they are trying to help others.

One of the resources available to anyone in the US is the National Suicide Prevention Lifeline. http://www.suicidepreventionlifeline.org/  Their phone number is 1-800-273-8255.  For those who are not familiar with how the crisis line operates, it is a federally funded non profit organization that serves as a coordination point for 165 independent crisis centers through out the country, fielding calls from people in crisis.  If you are trans and in crisis, this could be a good resource for you if you are unable to find anyone else to talk about.

I deliberately used the word “could” because right now I know that a lot of trans people will not call this number because they feel that the people answering the calls will not be sensitive to their trans identities.  I was curious about this so I reached out to the training department (in another lifetime I used to do training and quality control for a group of call centers so I am interested in this stuff.)  I was surprised to learn that they have not received any guidelines on how to handle trans* identified people in crisis.  (This is what I was told—if this is not the case, again someone please let me know.)

When I first approached the training department, I believe they thought I was suggesting some sort of intensive new training curriculum for “all things trans” that I wanted the crisis line and all of its independently affiliated call centers to adopt.  This is not the case. I think it can be as simple as a one sheet page of things to be mindful.  I think that there is probably a way of establishing that when a caller in crisis comes through that caller is immediately given the confidence that they will be treated with the dignity and lack of judgement that is their birthright. It is also important to find a solution to “neutralize” the negative impact that a callers perception of being “misgendered” might have on them. For those call centers (or individual counselors) who have difficulty using the caller’s prefered pronouns, a few tips for effective “gender neutral” communication would be extremely helpful.  It goes without saying that crisis counselors should not attempt to  ”counsel” the caller’s actual gender identity struggles.  I think a reminder in guidelines would be helpful.

I would like to work with others to put together such guidelines. I believe I can offer some valuable input, but I do not have the expertise to do this alone. Additionally this really needs to be put together by a diverse but unified group of stakeholders.  If anyone would like to assist me in this or has recommendations of people I can approach to partner with please let me know j@retransition.org.

There is no guarantee that the National Suicide Prevention Crisis Line would follow these guidelines—but I say it is at least worth a try and I believe these may be useful for other non LGBT-specific points of contact for people in crisis.

Also, I am hoping that some of the more prominent activists out there will build awareness that, yes, being referred to as one’s affirmed gender is important, getting “misgendered” is not the end of the world—especially in matters of life or death.  I believe that if the gravity and catastrophizing of getting “misgendered” was de-escalated a bit a lot of our trans family would find more wellness.

And speaking of “wellness”, there is one last point I want to make.  I have watched over the last ten years as the subject of “mental health” has been purposely driven from the larger conversation we are having about trans issues today. This is also happening at the therapeutic level—so many who express feelings of gender confusion actually lose potentially helpful psychological assistance because of the fear on the part of many providers that to dig a little deeper looking at and working through potential root causes for GID would be to dishonor their patient.  A false equivalence has been set up between the unspeakable and unnecessary damage done by so-called “reparative therapy” to some members of the LGB population with spending a little bit of time with a client presenting with gender identity issues to look for what really might be going on.  I believe that it is possible to live in a world where we acknowledge that being gender non-conforming is a perfectly valid (and quite possibly immutable) foundation of many people’s identities, while also recognizing that some cross-gender behavior and ruminations can also be a red flag for something much more serious going on in the background.

And that is the final point I want to make. We all know that the suicide rate (and the number of people who have at least contemplated it) is unacceptably high in the trans community.  A lot of this IS situational. The effects of bigotry and discrimination due have their cumalative toll and there is no doubt they have been a contributing factor to some trans people’s arrival at a place where they felt they truly had no more options. Again, practicing steps toward mental wellness can be helpful here, as well as the continued efforts to promote a more tolerant and compassionate world.  But I also strongly believe that there are also many deaths within our community that actually have little to do with being trans.  What makes me frustrated is that I believe that many of these are preventable, but because mental illness has now been deliberately stigmatized even further in the trans community than it is for the general population (where it already carries a huge stigma all on its own) these people are slipping through the cracks.

I say it is time to step forward to work toward building an environment that is safer for all and is even more respecting of everyone’s dignity. My fellow detransitioner thirdwaytrans is trying to untangle some of this in his website. Again, I know there are others out there (again, please let me know of any that you are familiar with.) In the coming days I too will be launching a website devoted to trans mental health based on some of what I have described here. It will be simple—it is just meant as another signpost for those who are struggling to find their way. In my case, my own path involved detransition, but I know this is certainly not for everyone so that is why I  am planning on this second site that only focuses on trans mental health.  My hope is to be one of many trans related sites that remind those who are suffering that we always have more options in life than we realize. We are never really “stuck” as long as we are here in this world alive today.

I hope you join me in this conversation.