Transgender psychologist who helped hundreds of teens transition is ‘concerned’: ‘I think it’s gone too far’

After helping hundreds of teenagers transition, a transgender clinical psychologist is concerned that the recent explosion of youths identifying as trans or non-binary may be the result of peer pressure and a lack of rigid mental health evaluations.

Now, says Dr. Erica Anderson, a former clinical psychologist at the University of California San Francisco’s Child and Adolescent Gender Clinic, social influences coupled with lax evaluations are leading to more teens taking hormones and undergoing surgeries before they are truly certain that they want to transition.

Anderson, now 71, transitioned when she was 45. She says it is unrealistic to think peer pressure doesn’t play a part in a teen’s decision-making process, and it’s time to take a step back and evaluate what is really going on.

“I think it’s gone too far,” Anderson told the Los Angeles Times. “For a while, we were all happy that society was becoming more accepting and more families than ever were embracing children that were gender variant. Now it’s got to the point where there are kids presenting at clinics whose parents say, ‘This just doesn’t make sense.'”

With the advent of COVID-19, school closures, and lockdowns in 2020, Anderson began noticing more shocked parents and more children announcing new identities. At the gender clinic, Anderson saw 373 new patients last year — more than double the number she saw in 2019.

According to Anderson, the teens are sharing similar stories of more time to surf sites such as TikTok, Instagram, and YouTube and to play more video games, all of which allow for “virtual identities” that they then explore in real life.

“Online, a stream of transgender influencers and activists told teens that if they felt uncomfortable with their bodies, or didn’t fit in, maybe they were trans,” the Times reports. “Some coached kids on how to bind their breasts, how to change their name and pronouns at school, how to push their parents for testosterone.”

It’s the perfect social media storm in which to brew peer pressure.

“To flatly say there couldn’t be any social influence in formation of gender identity flies in the face of reality,” Anderson said. “Teenagers influence each other.”

While Anderson noted waves of eating disorders and cases of repressed memory syndrome in the teens of years past, she says this is something new.

“What happens when the perfect storm — of social isolation, exponentially increased consumption of social media, the popularity of alternative identities — affects the actual development of individual kids?” Anderson asked, adding, “We’re sailing in uncharted seas.”

Anderson recalled the case of one 13-year-old who, after hitting puberty, suddenly began identifying as male, much to his parent’s surprise. The child was put on testosterone by a pediatrician before the teen had even met with a psychologist.

“Why is this kid on testosterone so precipitously?” Anderson asked her colleagues at the clinic.

Soon after, the team discontinued the hormone regimen and referred the child to a gender specialist.

“Numerous studies show that transgender teens are more likely than their peers to experience depression and anxiety and that gender-affirming care can help relieve those problems,” the Times acknowledges. “But questions remain about how to weigh the benefits of medical interventions against the risks, which include sterility, decreased bone density and other potentially permanent side effects.”

The majority of studies touting the benefits of medical intervention involve either teens who did receive “extensive mental health evaluations” or on adults who choose to identify as transgender, but according to the Times, “Neither group may be representative of teens seeking care today — much like the universe of people who apply to college differs from the universe of those who graduate.”

The World Professional Association for Transgender Health (WPATH) proposed in December a new set of standards for the care of transgender youth that would set minimum ages for certain procedures, including hormone therapy (14), chest masuclinization (15), and genital surgeries (17). All are predicated on comprehensive assessments to show the patient meets the “diagnostic criteria of gender incongruence.” Trans teens would need to demonstrate “persistent” issues with their gender identity for a period of several years prior to receiving medical therapies.

While most experts agree that caution and in-depth evaluations are a good thing before embarking on life-changing decisions, some healthcare providers argue the proposal only serves to set up unnecessary hurdles for transgender teens, who, they say, are as capable of knowing their gender identity as adults.

“Being trans or gender diverse is not a mental illness, and compulsory psychotherapy is not the stnadard of care in the gender-affirming medical model,” said Dr. AJ Eckert, the non-binary trans medical director for Stamford, Connecticut’s Gender and Life-Affirming Medicine Program at the Anchor Health Initiative.

“Forcing transgender and gender diverse youth through extensive assessments while their cis peers are affirmed in their identity without question conveys to [them] that they are not ‘normal,” Eckert said.

For Anderson, the practice of prescribing treatments with no therapy and after only a one-hour intake interview — as Eckert reportedly operates — is only going to result in more heartache for children and their parents.

“Giving over to hormones on demand will result in many more cases of poor outcomes and many more disappointed kids and parents who somehow came to believe that giving kids hormones would cure their other psychological problems,” said Anderson. “It won’t.”


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