I've written three different pieces on how trans youth and their families can access support and navigate a climate of increasing hostility.
This one is a little different.
Maybe you’ve noticed: there’s been a shift in how people and movements that are anti-trans present themselves, and it feels designed to make them more palatable to people who would otherwise recoil at arguments that position trans people as threats. They don’t hate trans people! They’re very concerned about them! Think of the risks! Think of the children!!
If that language sounds familiar, it’s because the anti- abortion movement has used this same playbook. The part of that playbook I want to focus on is the creation and promotion of entities, “experts,” and resources designed to confuse and misdirect those looking for care. Just like a crisis pregnancy center might advertise itself as offering pre-natal care, counseling or free pregnancy tests, an anti-trans provider might offer “ gender exploratory” therapy or claim to offer valuable information on the “harms” of transition . Just like reporters being too willing to parrot unsubstantiated, anti-choice claims to the greater public, anti-trans groups are using places like the New York Times—and the fact that many people within those spaces were already held anti-trans beliefs-- to spread misinformation and position their “experts” as the reliable voices on trans care.
Why does this matter?
This matters because trans people deserve to access care and information that doesn’t consider their very existence as a trans person a problem to be solved.
The longer answer is that, quite contrary to articles that claim people are being rushed through transition, accessing gender affirming care remains difficult for most people, especially young people. There are a limited number of places that provide it (and, due to transphobic violence both digital and physical, some of the places that used to aren’t able to anymore), waiting lists, and a dozen other barriers to access. Not to mention that plenty of elements of transition, especially physical transition, require at least a letter from a therapist.
And now, on top of that, you have healthcare providers and resources who seek only to discourage or pressure all trans and nonbinary folks into not transitioning. This is a recipe for trans folks, or the people helping them access care, to walk right into a trap, and enables ongoing, anti-trans bias more broadly.
Who is this guide for?
If you’re a trans person, you can use this guide to help you navigate seeking or getting care, or pass it around to whoever you think may need it. But I intend this piece mostly for cisgender adults : parents, other caregivers, teachers, therapists, and so on who are in the position of helping a young person who may or does want to transition. For many Scarleteen users, the adults in their life are the people with the power and resources to help them access care they need, so, it’s crucially important that those adults are able to identify legitimate — and illegitimate — sources of trans care.
So much of the current anti-trans rhetoric hides behind language of “concern.” If you’re a parent or other supportive adult who is earnestly concerned about a young person, that language can make you feel like seeking support that may or does include gender-affirming care for a trans youth isn’t a wise or caring decision. This is the exact reason that language is being used.
Think back to anti-abortion rhetoric, for example, to the bills that force waiting periods (waiting periods we know only make things more difficult for those seeking abortion) deceptively stating they are out of “concern” that the people seeking abortions are rushing their decision. It’s the same thing with trans care; “concern” is used to introduce a (often poorly disguised) barrier to care, in hopes of eventually making that care inaccessible.
I’m going to go over some of the clues that a resource or person’s only concern is directing people away from trans-affirming care and towards harmful, anti-trans spaces or approaches.
I’ll get to the list in a second, but my biggest piece of advice is: If a resource, person, or service presents being trans as the result of trauma , social contagion, peer pressure or of literally anything other than one of the many ways humans experience gender, do not pass go.
Notice what research they use
Not all research is created equal. As I talk about in our piece on media literacy, things like sample size, language, and the biases of the researchers can all make for inaccurate findings. The research supporting the need for and benefit of trans-affirming care and transition is massive. The incomparable Julia Serano has compiled a whole timeline of the research here, including the ways it refutes anti-trans talking points. Heck, the biggest ever study of trans Americans—92,000 people surveyed—found 94% of trans people are happier post-transition. The research saying kids only think they’re trans because of social transition? Not supported by the data. The data saying most trans youth regret their transition or “grow out of” being trans is based on faulty data. If someone is telling you to forgo wanted treatment that has been shown, over and over again, to be beneficial, they’re not a trustworthy source on trans care.
Read up on the signs of a created moral panic
Seriously. The framing of the “concerns” around trans youth is a textbook case of a manufactured moral panic, and being able to spot those tells can also help you spot someone whose understanding of the issue is driven by that moral panic rather than a robust understanding of the realities of trans healthcare and trans people’s experiences.
Research the background
This is one of those steps you’d ideally do for any kind of care provider or resource you turn to for help. What are the backgrounds of the people offering to help you? Are they trans or nonbinary themselves? Do they have a history of working for those communities? What is their education and training with this population and for this kind of care? If they’ve written about or researched trans topics, what do any examples of their work you can find show you about their perspectives?
As with spotting crisis pregnancy centers, a good rule is that with a reliable resource, information about it and the people providing it is usually very easy to find. Unreliable or deceptive resources or people will be much harder to get clear information about.
Learn their reputation in the trans community
Because trans affirming care can be hard to come by, and used to be even less accessible, the trans community has a long history of keeping track of and sharing information about surgeons, therapists, primary care providers, and other care providers. If you don’t have a local trans community or space you take part in, the internet makes these clusters of information even easier to find, and they offer excellent starting places for locating needed care. You’re also always welcome to come to one of our direct services for help finding or vetting resources.
The other function this community knowledge serves is to tell people who to avoid. Even if an organization or provider is new and hasn’t built a reputation, your community can still help you. Folks who are tuned into the political fights around trans care, people with a lot of experience navigating or vetting healthcare resources, or even someone who just seems to have a good radar for bullshit can help you spot if something is “off” about a resource description.
Pay attention to language
If a resource or practice frames itself a being about making sure trans youth aren’t “rushed” into transition, or talks a lot about how it’s trying to prevent regret, that’s a sign it’s not on the level. Not only are those terms anti-trans dogwhistles, they’re also not reflective of the experiences of the majority of trans people, which tells you that person hasn’t spoken to or worked with a representative sample of trans folks (if they’ve worked with them at all).Waiting lists for gender affirming care are long—one study in the U.K found it takes an average of 18 months to get into a clinic. And for most young trans people, that care is talk therapy.
Watch for a heavy focus on hormones and surgery
Gender transition, or exploration for that matter, looks a lot of different ways for a lot of different people. For most minors, transition is most likely to involve trying out a different name and pronouns, and different kinds of non-surgical self-presentation, like clothing choices or hairstyle. For about 1.6% that may involve puberty blockers . Surgery or other kinds of hormone therapies are very uncommon for young people. Leading with discussions of surgery or hormones , which are often seen by the general public as being irreversible and drastic, is a tactic to make people react with alarm or disgust to the idea of young people transitioning while hiding what the reality of transition for youth most often entails.
Talk about transition goals
If you have a conversation with a potential provider, pay attention to how they approach any conversations about transition, even impermanent elements of it like wearing different clothing or going by a different name. If they’re offering “exploratory” therapy but seem like they only want that exploration to follow one or two acceptable paths, and not include low stakes changes like new pronouns, they’re only interested in supporting a gender journey if it leads to where they think it should.
Notice how they talk about detransition
Detransition, a term for when someone is pursuing or has pursued steps of gender transition, and then stops or does things to try and reverse those steps, is commonly trotted out—and seems to have been introduced into the discussion of trans care-by anti-trans people as proof that most people, especially young people, who transition come to regret it later on and therefore there should be more barriers to care to prevent such an outcome. However, that is not reflected in data or anecdata.
The majority of young people who transition continue to be trans. . However, some people do detransition (though only some will call it that), and may make those choices for any number of reasons. Maybe hormone therapy causes issues with certain health problems for them that require them to stop, or some side effects are unwanted or less bearable than going without that kind of care will be. Some people find themselves in a situation where presenting as trans is increasingly unsafe and “detransition” for them can be stepping back into the closet to survive. In rare cases, someone may pursue some components of transition, then discover it isn’t what’s right for them..
None of the anti-trans measures people advocate for address any of that with honesty or integrity, if at all.
In many cases, those measures—banning any kind of gender affirming care for those under 18, requiring teachers to inform parents if a student is trans, suggesting trans youth be forced to undergo therapy designed to deter them from being trans are actively contributing to the very situations that lead some people to feel unsafe or otherwise unable to continue with transition when it is wanted. This kind of rhetoric is how we get states where trans people are banned from using the correct bathroom or told that having the correct gender marker on their ID is fraud. If you were a trans person trapped in that state and unable to leave, you, too, might choose to detransition.
If we want young people to have space to thoroughly and safely explore their identity before they pursue medical or surgical transitions, we can’t side with people creating, passing or supporting legislation that endangers trans people, like policies that forcibly out trans students to their parents.
If someone were earnestly worried about people shouldering the costs of transition, only to discover later that those costs were for something they didn’t, or no longer, want, they’d seek to make the costs of transition, both social and economic, lower, not build up more barriers.
Any medical intervention, for anything, carries some risk, including the risk of regret. But we don’t demand the government ban or heavily regulate knee surgery because 6% to 30% of people regret it, and tell people experiencing debilitating knee pain that the ban is for their own good. Bariatric surgery has a regret rate of 8% to 20%, but is still promoted as a treatment. People who detransition, or regret their transition, deserve our care and support. Using their experiences to prevent an entire population of people from accessing care is both ultimately nonsupportive and predatory.
Notice how they talk about, and to, young people
Are young people talked about and treated with respect and as the experts on their own feelings or experiences? Is their own assessment they’re trans as correct the default assumption? A common tell of anti-trans resources in disguise is that they tend to talk about young people as misguided, extremely susceptible to peer pressure/social media, or as incapable of thinking through the pros and cons of transition. In reality, we know that young people’s self-assessment of their gender identity is usually highly accurate (and, in our conversations with users, something they’re thought about a lot before they ever tell anyone).
A final consideration, whether you’re evaluating a provider, a piece of information, or your own beliefs is: if there is real concern, what does it pertain to? Is it for the young person involved, about the distress they’re feeling now, in this moment, that they’re asking for help alleviating? Is it concern where the next step is asking the person , “What do you need from me? What will help you feel more at home in yourself?” Or is the concern a charade? Telling you or anyone else to prioritize hypothetical harms or your own discomfort over the very real trans people standing in front you telling you what they need to be happy and to survive is not concern, it’s insidious and selfish. Increasingly, pretended concern covers the face of something ravenous, a worldview that won’t be satisfied until it’s swallowed down every last scrap of happiness and freedom that trans folks and their allies have fought so hard to achieve.
When, as a cis person, you encounter that second kind of concern, do what you can to push back against it and reveal it for what it is. Some of the steps above offer starting places for that, and you can find more tools for identifying it and pushing back against that concern and that world it creates at the end of this piece. You can also offer to be the person to help a trans family member or friend vet their resources, so that the burden of finding affirming care doesn’t fall to them alone.
What I’m asking is that you be an ally in more than just name. That you educate yourself on how to spot the resources and rhetoric making the world more hostile to trans people. That when yet another opinion piece comes out voicing “concern” about trans care, you help elevate the voices of trans individuals and educate others on why the piece, and the arguments underlying it, are wrong. And you can help re-center the conversation to actually be about trans experiences, rather than cis people’s concerns.
