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.



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




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)


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.



Lady Valor — The Trans Navy Seal CNN Doc

I thought I would slip in a quick movie review because I do think the film on CNN about Kristen Beck, the ex-navy seal who has come out as MTF is worth watching if you get a chance. I think the filmmakers, Mark Herzog, Sandrine Orabona and, in particular, cinematographer Jen White, have done a surprisingly good job of documenting some of the issues that society faces as it struggles to make meaning of the wave of people now identifying as “trans”.

The filmmakers allow Kristen to tell “her own story” throughout the film, through her running commentary about her life growing up, her decision to transition, what her life is like now and what her plans are for the future. Although it is clear that they have compassion for Kristen, I believe that they have not let that obscure their duty as documentarians to provide their audience with the larger story that often directly contradicts what the onscreen dialogue is saying.  “Lady Valor” plays like a long series of extremely awkward moments. That is no coincidence—for many trans people that is the world they live in. It is fascinating to watch as the non-trans people in this film seem painfully stilted as struggle to say what they believe they “should say” as opposed to the sincere and honest emotional freedom when they let their “guard down” and refer to “Chris” in a way that still feels authentic to them—as a man.

Most of the people Beck encounters use male pronouns when speaking with “Kristen”. They are not doing this because they are “transphobic” or “transmisogynistic” or “cis-sexist”.  Most of them are clearly good people, many of whom love Beck very much. This is just their natural reaction to use this term—and when watching this film one has to wonder if it is ever going to be possible to “reprogram” them to speak in a way that is not in direct contradiction with what their natural intuition is telling them. And if they are able to “train” themselves to speak this way, will the wall that comes when people can’t speak honestly with each other ever allow Kristen to feel the sincere connectedness with others that I believe all humans need in their lives for basic survival?  I am not going to answer that question—but I believe it is part of the subtext of this movie.  We see many people forcing smiles and patting Beck on the back saying “good for you”—and yet to what end? At one point Beck laments that even though she is meeting lots of new people, her new friendships feel superficial and very different from the sustaining friendships she formed with others before her transition.

As the documentary shows, when Beck first came out with her story she had a nice house and seemed to have at least some kind of future ahead of her.  The Beck we see in this film is now living out of a van, driving from LGBT event to LGBT event to speak out for the “cause” and sell whatever “Lady Valor” chotskies she may have so as to eek out a living.  She speaks of how she connects online with young people to let them know that being trans is ok, and yet I wonder exactly what uplifting stories she has to tell them. The film ends with a postscript that basically says Beck is now broke.

So much of what I find interesting in this movie is what is NOT included in the film. First and foremost among the missing is any definition of what it means for Beck to be a woman. It is clear that she likes short short skirts, make up and very high heels—but those aren’t definitions of womanhood are they? Or are they, to Beck at least? Beck presents a common narrative of how dressing as a girl was always a way of coping with stress. I think the most awkward moment in the film was Beck showing her young niece the closet where she had stashed her pilfered female wardrobe when she was a kid. The child’s father utters probably the most unconvincing “that’s nice” I have heard in a looooooong while.

Of course, the people who are missing in this film tell a story of their own. Beck’s mother and two of his sisters, that refused to be part of the film are the most obvious absentees. (Beck’s ex-wife and two young sons are also not featured in the movie but this is much less surprising, especially since the film strongly suggests that there were other “situations” that had nothing to do with transgender that has led Beck’s ex-wife to seek distance from Beck.)

Actually, for me personally, the most interesting “absentees” from this film were the people in the various scenes who have their faces digitally obscured to prevent their being seen in this film. Why did the woman standing next to Beck at the football game sign a release so that we would see her face while the guy she is with obviously did not want to be associated with this film? (A few seconds later we see her embracing Beck.) Maybe it isn’t so much “why” (which is kind of obvious) but more of a curiosity on my part about what how the conversation between the couple about the decision to appear or not went down. There are many little moments like this throughout the film and I find them all fascinating.

One last little moment that somehow got my attention was the credit for “Excecutive Producer”,  Anne Speckhard, Ph.D.  Who was this? It turns out it she is an adjunct associate professor at Georgetown University who co-authored the Beck’s recent semi-autobiography. Surprisingly, a person who appears to be Beck herself has taken to social media to request people not buy her own book. A person who identifies herself as Beck has this to say on Amazon.

The worst day of my life is when I signed a contract, with no legal counsel…
I was just divorced, came out transgender, thrown out of my house, punched in face by my sister… THEN a psychologist who was an author/publisher and claimed “many great books” patted me on the back and told me that she was my friend and would save me.
She then shook hands on a contract that would be for a book and only a book…now it turns out that contract gives her my entire life with no say over the quality of the “stuff” she puts out…hence the poorly edited book with various fallacies and incorrect data…She owns me like a slave from my birth until I die….
she is NOW trying to make a movie in hollywood about my life without me, totally cutting me out of my life story.
The worst day in my life was the day I met Advances Press and was swindled into a very very very bad contract. Evil, deceit and greed at its worst.
That is the truth.
Kristin Beck


The same user also gave the book a one star review, writing, “All I can say is sorry about this book. 3rd person narrative of me laying on a psychologists couch….. :(

If this is indeed actually Beck who posted this comment, one has to ask some serious questions about the quality of psychological care Beck received. Of course I am sure Dr. Speckhard has a very different version of events, but all the same it shows that Beck probably sees herself more as a victim of the medical, entertainment industries than of a transphobic world. (This probably would extend to some of the political groups out there who seem to be more interested in the unique branding opportunity their partnership with her brings them rather than true compassion for Kristen Beck the person.)

The movie uses the open road as an ongoing motiffe. The opening sequence is a montage of endless highways, in America and the various countries where Beck saw “action”. There is a brief film clip of her in the cab of her little trailer shown each time the film returns from commercial break. Where is she going? Beck herself doesn’t seem to know. More importantly, what is she driving away from? Apparently Beck is not ready to look in the rear view mirror.

Blog note: There are a few more posts that I had hoped to push out this weekend. Because they seemed more timely, I decided to get to this and another post that is still coming out first, but please know I have some thoughts to share now that I have reached the one year milestone with this blog. I hope to see you tomorrow if I can.


Trans Suicide and Ethical Communication

Over the past few days I have been thinking a lot about the “Dr. V.” story and the intense discussions regarding the ethics of the piece’s reporting. It has been encouraging to see so many media organizations (including the one that published the original story) and reporters doing a lot of soul searching. This was a tragic and sad death.

Josh Levin’s thoughtful editorial on Slate contained a link to The Tampa Bay Times’ Leonora LaPeter Anton’s important piece about the suicide of a woman she was doing a story about on the eve of the publication of that story. (It is a very good read.)

At the end of her piece she contains includes a number of suicide prevention resources, including some ethical guidelines for reporters to consider when reporting suicides. There are many different (but essentially similar) versions of these guidelines for various organizations but they are all pretty similar. I like how these sound so I want to include them here.

• Avoid romanticizing suicide or idealizing those who take their own lives by portraying suicide as a heroic or romantic act.

• Don’t dramatize the impact of suicide through descriptions and pictures of grieving relatives, teachers, classmates or members of the community. This may encourage potential victims to see suicide as a way of getting attention or as a form of retaliation.

• Details about the method of suicide can encourage vulnerable people to imitate it. While reporters may need to provide a description of the cause of death, they should not provide a “how to” guide.

• Avoid oversimplifying the causes of suicides, murder-suicides or suicide pacts, and avoid presenting them as inexplicable or unavoidable. Social conditions alone do not explain a suicide. The cause is invariably more complicated than a recent painful event such as a romantic breakup or the loss of a job. More than 90 percent of suicide victims have a significant psychiatric illness at the time of their death. Mood disorders and substance abuse are the two most common.

• Conveying that effective treatments for most of these conditions are available (but often not utilized) may encourage those with such problems to seek help.

I believe that all responsible journalists should follow these or similar guidelines. But I also believe that these guidelines are helpful to anyone who is blogging, commenting or tweeting on the web. We demand that journalists follow strict ethical standards but so many of us do not take the time to be mindful in what we ourselves are putting out there for others to read.

I think that this is a particular problem in the trans community. Because of the sad reality that the rate of suicide within the trans community is so high, it is something that has to be discussed. It can’t be avoided. But I feel that how it is spoken about within the community has to some degree helped to “normalize” it amongst its members. I see this as a vicious cycle that actually is leading to more suicides.

The American Society for Suicide Prevention has a helpful PDF for how to talk cover suicides. It includes some important guidelines for bloggers and “citizen journalists” that I think are also helpful.

• Bloggers, citizen journalists and public commentators can help reduce risk of contagion with posts or links to treatment services, warning signs and suicide hotlines.
• Include stories of hope and recovery, information on how to overcome suicidal thinking and increase coping skills.
• The potential for online reports, photos/videos and stories to go viral makes it vital that online coverage of suicide follow site or industry safety recommendations.
• Social networking sites often become memorials to the deceased and should be monitored for hurtful comments and for statements that others are considering suicide. Message board guidelines, policies and procedures could support removal of inappropriate and/or insensitive posts.

I think many us can do a better job in practicing mindful speech while online. I know that I still don’t always get this right but that doesn’t mean I can’t stop trying.


No Words – The Death of Nathan Verhelst -Warning: Extremely Disturbing Video

Update – Please scroll down for english translation and to view the trailer for the documentary about Nathan by filmmaker Roel Nollet of @Redhorsetv. Thank you Roel for providing the translation to me. The film on Nathan has been completed and @Redhorsetv will be a good place to follow along to find out when it will screened in your area. (Roel will be travelling the world with film in the very near future.)

Nathan Verhelst Death of a Transsexual

Nathan Verlhelst wanted to share this video with you. In the final moments of his life he briefly spoke with a documentary film crew and then, after hugging a loved one goodbye, laid down in a hospital bed to receive the chemicals that would end his life. The video is at the end of this post. You very well may not want to watch it. It is ok if you don’t. (I need to credit user ibleedpurple who posted the link on gendertrender, which I have to admit has been doing an excellent job picking up some important stories that others are missing.)

This video is not in english. I hope it will be translated by someone out there later today. I will update this post if a translation becomes available and I will also provide a link if there is one. If there isn’t something available by day’s end I will hire someone to do it for me – I am desperate to hear what is being said (as if that could really provide some “answer” or justification to what I have just seen.)

Sometimes stories can be told without words. That is the case here. The sounds and images in this video will haunt me forever. I can draw some analogy to the images of people falling out of the Trade Center towers in that I will never have to watch this again. This has now been burned permanently into my consciousness.

First and foremost I see a beautiful human being. There has been some controversy over what gender Nathan would have liked us to refer him as in death. My suspicion is that Verhelst had gone far beyond the point where formalities like gendered pronouns mattered any more. They were most likely of no use to him other than for legal purposes in executing his will, disposal of his body etc. In the end “gender” was probably just a matter of paperwork and nothing more.

When Nathan speaks to the camera he laughs a few times. It is a gentle laugh but I can also hear the sadness within it. It is a laugh that concedes defeat on every level. It resonates with an underlying belief in the absurdity of one’s own attempt at existence. I am confident that I would hear this even if I didn’t know the horrible context behind it. I know that laugh well – I laugh that way too.

In the clip we see old family photographs of Verhelst as a child. I am sure we can all relate to these, the frozen slices of the ordinary moments that together make up a life. I have been going through my family’s photos over the past few weeks, so these pictures are especially poignant. I want to ask the girl in Verhelst’s photos the same questions I have been asking the little boy in mine. What are you thinking? What are you dreaming about and where do you want to go? When you are a kid it always seems you are waiting around. That is ok though because you know you are waiting for the wonderful things that will eventually happen for you in life. Eventually it will come – the arrival of your “happily ever after”. That waiting is called “innocence”.

As the video begins to wind down we see Nathan is now on the move. He is packing up his things for his final journey – his wait is almost over. His speech now sounds tenser. He is movements are jerky. It takes him a few tries to make sure his pants are folded as he stuffs them into the garbage bag where they now belong. He is mindful in his work and in not letting his emotions slow him down from the task at hand. He is powering through whatever torment lies within him and getting the job done. It looks like he has gotten good at this.

Verlherst is now in his efficiently small hospital room. A news source says that the final person with him was an MTF named Dora who has now begun the process of being approved for euthanasia herself. She states that she is “tired of being rejected” and now sees a pathway to end her suffering through this procedure.

There is one moment in this video that has to be one of the most unimaginably saddest things I have ever seen. Nathan is shirtless, showing his “botched” chest. His teeth appear clenched and his body is stiff – his shame at revealing himself to the camera (to us) this way radiates from within him. On his body, stretching across his chest towards his left shoulder is a tattoo. There are two white birds and a rainbow. And for the first time there is english that I can understand. His tattoo reads “Free As A Bird”.

Of course that was Nancy’s dream for herself all along – to finally live life free from whatever torments were holding her down. Nancy was an optimist after all. Despite all of her obstacles she was waiting for her own “happily ever after”. Nathan came to believe that the only way to achieve that freedom was by giving up on life itself. He might have even felt slightly prepared. In the end this was just one last transition.

Related: Available Resources for Transsexuals who Detransition: Jesus Christ and Euthanasia

English Translation of News Report

Be sure you follow the light.

Send my regards to Philippe.
Tell him I love him very much.

I will tell him

I love you
I love you too.

Farewell everybody.
– Bye Nathan.

Surrounded with friends, Nathan Verhelst walked out of his own life yesterday (Monday) in the afternoon, guided by medical care. After a failed gender operation, he didn’t see any ways to continue anymore. Professor Wim Distelmans of the VUB (Vrije Universiteit Brussel = Free University Brussels) was one of three doctors that gave him the permission to execute the euthanasia.

QUOTE Wim Distelmans – Professor palliative care VUB
In this case we deal with both psychic and fysical suffering, as a result of an incurable disease, that is beyond repair. We surely did not decide this lightly. We have followed him for months, with a decent team. We have seriously discussed this and we have concluded that we need to respect the demand of the patient, and that we were willing to agree with this demand.

Nathan was born as Nancy. At home, in Hamme, Nathan had never experienced much love. When he finally decided to have a gender operation, he had never been happier.

Nothing can break this. Noone can break this. This is who I am.This is my life.

When he received a new – male – identity card, it felt for him like being born again.

I am, let’s say, a bit euphoric. It’s a good feeling. I would like to cherish this.

But the transition failed. Especially the penisreconstruction didn’t go as planned. That was too much for Nathan. He started the euthanasia procedure.

Suffering every day. Having pain every day. Dying from grief. Well, I don’t think anyone can live like that. I know that, according to a lot of people, I’m not sick on the outside, but I am sick on the inside. And I just can’t live with the consequences. Period.

Nathan said goodbye to all his friends. And although they tried to convince him to stay at first, Nathan stuck with his decision. He is the first Belgian that has euthanasia after a gender operation.

It is incomprehensible that there are only three countries in the world that have legalised these regulations: the Benelux countries, Belgium, The Netherlands and Luxemburg. From experience I know that inhabitants of other democratic countries in Europe and the US, are jealous of our legislation. More and more, people find their way through the internet to come to Belgium and have it here.

Nathan was born as a woman, but died as a man. There will be no grave. He donates his body to science.


Available Resources for Transsexuals who Detransition: Jesus Christ and Euthanasia

I had a bad day yesterday. I was tired from working, everyone I interacted with seemed cranky and I was frustrated by my lack of success in connecting with people within the LGBT community offering ANY outreach or support for those who detransition (or are wondering about it) and who need help with the many psychological, medical, legal and social issues they will encounter.

About the only people I can find actively doing this are usually fundamentalist Christians who require that you repent for the “sin” of being who you are and accept Jesus Christ as your savior. Last night I found another resource provider – Dr. Wim Distelmans, who made news this week for performing euthanasia on post-op ftm to relieve their “unbearable psychological suffering” after a sex change surgery failed to meet the patient’s expectations.

Coming at the end of my long day I saw this story and as I read it experienced a profound episode of cognitive dissonance. I read the headline several times. I even read the first few paragraphs of the story and my brain still couldn’t process what was being said or what it was even talking about.

And when I finally began to comprehend the horrible reality, that a beautiful human being, Nathan/Nancy Verhelst, was so unhappy after a sex change operation that they decided to end their life and that their decision was supported and assisted by a doctor, I became even more depressed. And angry. I had a lot of trouble sleeping last night.

The early reporting that is coming out on this is very sketchy and “tabloidy”. I have learned that there is always more to stories like these so I don’t want to make too many assumptions. Someone pointed out that the story had misgendered Verhelst – the photo caption used one gender and the story used another. The sad truth is that we may never know what pronoun Verhelst would have wanted us to use. Maybe Verhelst didn’t even know for sure.

I have to respect Verhelst’s decision, but I also strongly argue that it was not necessary, at least from the details of the story as reported so far. My dream is for us to get to a place where this NEVER happens again (although for now I am sure it will, this has been going on for years under the name we use when it is not medically sanctioned – suicide – and it quite common for trans people both pre and post-op.)

One of the few quotes attributed to Verhelst in the reporting is an expressed dissatisfaction with the results of his surgery. “When I looked in the mirror, I was disgusted with myself. My new breasts did not match my expectations and my new penis had symptoms of rejection. I do not want to be … a monster.”

This in particular haunts me – I went through something similar. Starting in the the months after my surgery I too became afraid of mirrors. I somehow managed to get through life completely avoiding them for years. And, needless to say, during that time I totally “let myself go”. I loathed my body and basically gave up on it. I gained a massive amount of weight. My hair was a knotted mess. Forget about passing as a female, I was no longer passing as a human being who cared about life.

I know we have screening processes for people who undergo gender reassignment surgery and the medical community also does what it can to ensure that people have realistic expectations for surgical outcomes. But I think sometimes we, the people who go on this journey, still secretly hope for more than is realistically possible. Even though we are often very rational people – a lot of us expect something mystical and magical will occur on that operating table. The fact that many of us, including Verhelst, refer to a relatively short medical procedure as our “second birth” underscores our belief that this surgery carries with it the same incomprehensibly wonderful magnificence that is the true “miracle” of birth.

I have met many transsexuals who after surgery describe a specific kind of depression that impacts them. It is often temporary and they are able to happily get on with their lives in their new gender, but after the surgery a lot of people just feel kind of let down when they realize it isn’t as transformative as they had thought it would be. Some flesh has moved around, there are some new physical realities (and opportunities) but basically life is still “life”.

Again, going by the limited details available in this story (I feel I need to keep repeating this disclaimer – I am going to stop but please be mindful that using sketchy tabloid-style reporting to talk about very real issues of life and death is always tricky) it seems like Verhelst was looking to surgery to escape to a new life. Or to say it another way, maybe Verhelst wasn’t running to one gender as much as running from another.

I think a lot of us trans people do this and I will talk more about this some other time. Although everyone’s story is unique, I have noticed some differences between the experiences and motivations for transition between MTFs as a group and FTMs as a group. Verhelst’s story is something that I have heard from other (though certainly not all) former FTMs. It is not so much about becoming a man – it is more about escaping the social and biological hassles of being female. From the reporting:

“I was the girl that nobody wanted,” he said. “While my brothers were celebrated, I got a storage room above the garage as a bedroom. ‘If only you had been a boy’, my mother complained. I was tolerated, nothing more.”

And then there is this heartbreaking quote from the mother:

“When I saw ‘Nancy’ for the first time, my dream was shattered. She was so ugly. I had a phantom birth. Her death does not bother me,”

Again that word – “birth”. You know – there is part of me that wants to believe this is a hoax. I am still not entirely convinced that it isn’t but that probably is a remnant of my cognitive dissonance. Assuming it is true, if this is really what the mother said it is no wonder Verhelst felt so devastated. Again, more unrealistic expectations – surgery would never repair the relationship between mother and child, nor was it going to heal the scars left from years of emotional and psychological hurt inflicted on a helpless, scared little girl. With any dreams of validation and acceptance perceived to be gone, Verhelst apparently felt there was no other option but death.

It is important to add that there is nothing in the reporting that states Verhelst wished to detransition. What is clear is that after surgery Verhelst could see no further options for leading a fulfilling life. Whether it be considering retransition or one of many other options available (perhaps spending time with other people who have faced some large obstacles in life but persevered and found some sense of fulfilment) I think that it was too soon and tragic to throw in the towel.

Since I started my blog, one of the main questions I get asked a lot is “do you think people should be prevented from having gender reassignment surgery” or “are you afraid that your story will be used by those who wish to prevent people from getting gender reassignment surgery”. My answer is straightforward – I just want people to be able to do what is really necessary for themselves to be ok in their journey through life. If it is gender reassignment surgery that is going to help them get there – I say “great”. But I also think that this surgery is often used in place of addressing the harder to fix problems. A MTF gender reassignment surgery can be completed in as little as 90 minutes. Going through and attempting to heal the emotional scar tissue that builds up over the years for some of us is not so easy. Whether it is a biological disposition to depression (or other mental health issue) that afflict some of the unlucky amongst us, or having to live through any the cruelties that we has a human race are all do adept at inflicting upon each other, a lot of us have deep problems that can not be solved as quickly (or magically) as we would like.

I think that those who work to discourage any discussion of the fact that mental health issues can, in some cases, be a contributing factor to gender identity issues are doing a disservice to everyone. I have encountered many trans people who suffer from major mental health issues and yet move forward with transition – believing that their psychological issues arise only from being “born in the wrong body”. I am not saying anyone who has a predisposition for depression (for example) should be automatically excluded as a candidate for surgery but let’s be ok with talking about the potential root causes that lead someone to want to change their sex a little more instead of always going directly to the “born in the wrong body” stuff. I think more research needs to happen surrounding transsexualism and depression. Huge kudos go out to Jay McNeil, Louis Bailey, Sonja Ellis, James Morton & Maeve Regan and the Scottish Transgender Alliance for their important research and findings on transsexual mental health.

And while we’re at it let’s stop perpetuating acceptance of the totally unverified statistic that only 1-10% of all people who have had gender reassignment surgery have some form of regret. The fact is nobody really knows. The reason always given for this lack of data has always been that “trans people are too hard to track”. I think this has been true in the past, but I think we are easier to follow now if someone will make the effort. And there are still difficulties within the trans community feeling good about working “hand in hand” with academia. Over the decades there has been a build up in the distrust of academia (which is often encouraged by some of the more prominent members of the trans community) which discourages trans people from cooperating with any sort of research. That has to be healed. Members of the academic community are certainly not blameless here either – they need to repair some very real damage caused by a small number of individuals who abused their position of trust and respect as academics to engage in some pretty unethical behavior.

And lastly – I should not be having as much trouble as I have been finding resources from within the LGBT community itself for coping with detransition. When I call (as I did last week) and speak with the nice woman who answers the phone at the World Professional Association for Transgender Health: WPATH she should not be taken aback when I ask about resources for people who detransition. All she really could offer me was a polite “that is a really good question” and admit she had no idea where to direct me.

If there are organizations within the community who are doing this SOMEONE PLEASE LET ME KNOW. I am still hoping you are out there. And if you are please work at making yourself easier to find!

This conversation needs to be OWNED by the LGBT and specifically transgender community in a way that it isn’t presently. At the very least the trans community and their allies need to become more responsible stakeholders and contributors in these difficult conversations regarding regret, depression and detransition. Trans is in the news more than ever and almost everyone I know, straight, gay, bi or whatever, has a family member or knows someone who has faced some sort of gender identity challenge. Why is the conversation about detransitioning mainly coming from people who are anti-trans? Why are these resources coming from those who are least likely to provide an affirming and non-judgmental environment for people to work through these difficult issues?

And now it has come to this – euthanasia? Really? That’s all we’ve got?

As the trans community becomes more and more an accepted strand in the of the fabric of our society (at least some parts of it) it also has a responsibility to step up and start talking about difficult issues it has so far ignored. There are a lot of real people who’s existence is not even acknowledged, people who feel they have nowhere viable to turn to for help because they don’t have anywhere viable to turn to help. The people who feel that their only real option is to give their lives to Jesus or to just suicide out. Or the uncounted and unnoticed who just quietly withdraw from society all together – the people who become timid and afraid of life and withdraw to their rooms – their sole interaction with others now mostly online (this was and still is me in many ways.)

The trans community needs to evolve to the next level and become a better community partner. Taxpayer dollars and various grants going to many agencies and nonprofits based on the fact that they are serving the trans community. The transgender community is right to take pride in the strides it has made over the last few years but it also can’t be afraid to take some of the difficult steps that it needs to get to the next level. The time has more than come.

Things cannot stay as they are. The current status quo is not sustainable.