I was speaking with a detransitioner 1:1 yesterday and one thing she found most negligent about her treatment was how an assessment was done, yet fully ignored when gender became the focal issue. Unfortunately, therapists are trained that affirming gender and getting a young person to change their body to “match” their gender feelings will fix all of the other mental health symtoms. This young woman had two of the most common underlying reasons why she felt “trapped in the wrong body”. First, she has some autistic traits. She described herself as an awkward teen and struggled socially in school. Second, she experienced sexual assault from a boy in her class. This made her want to run away from being a girl.
Her loving parents brought her to therapy for help and trusted the experts. Unfortunately, those so-called experts failed her and her family. She told me how all of this important information was uncovered in her mental health assessment, but was never addressed in treatment. Once gender dysphoria came up, all of those important factors were ignored and the entire focus became about gender. She was affirmed with her male name and pronouns, given hormone blockers and testosterone and even had surgery. What was done to her was blatant malpractice. We would like to hope that her story is rare, and she simply ran into a few “bad apples” in the mental health field. However, after attending the current gender affirmation trainings at the CAMFT (California Association of Marriage and Family Therapists) conference, meeting many other detransitioners like her, and speaking to parents with very similar stories about their children, I know her story is not rare. It is way too common. However, those pushing gender medicine will have you believe otherwise. My goal is to arm you with the knowledge and courage to push back on institutions and providers that may do harm to your child.
There are two major problems happening in mental health.
Assessments are being done poorly without gathering the appropriate information with assumptions and conclusions made too quickly.
-or-
The assessment is being done and then completely ignored.
The first issue is a result of poor training, lack of skills, laziness, or an overwhelming caseload.
The second issue is due to therapists who are trained by institutions that are ideologically driven.
None of these reasons are good excuses for why a child or young adult is lead to a lifetime of damaging consequences.
What is best practice?
First an assessment should be done properly which extends beyond just talking to a child or teenager. It’s important for a mental health professional to gather information from other sources including family, school, and collaborating medical professionals. This is why parental involvement is so important and necessary. A teenager is not going to be able to fully report on her history, family dynamics and how she behaves in different settings.
Second, the assessment should not just be a snapshot of the child, but take the child’s behavior in context. For example, a parent told me the story of how her daughter’s school counselor diagnosed her daughter with ADD in one session without talking to the mom. It turned out to be Valentine’s Day, a day her daughter consumed large amounts of sugar which had obvious impacts on her daughter’s behavior.
Third, an assessment should be re-visited regularly. It’s common to learn new information and therapists must be flexible in their treatment. Unfortunately, when gender becomes involved, this flexibility usually gets lost, or even prohibited depending on state laws, and a child is often fast-tracked down the “gender dysphoria” assembly line.
How can parents best advocate for their children?
Make sure you are involved. The therapist should get to know you, your concerns, your family history, when problem behavior started, and what other factors may be at play. A child can not give this kind of insight.
Make sure the therapist is gathering information from many different sources. A therapist should be working collaboratively with other involved professionals. They should understand any important medical issues that may be impacting a child’s mental health and if the child is on medication, how that may be impacting behavior. The therapist should know how your child behaves at home vs. in the classroom vs. with friends.
Be a direct part of creating the treatment plan. Make suggestions. Ask for a copy of the assessment and treatment plan and ask lots of questions. Don’t be shy. If the assessment states your child is struggling with issues such as trauma or anxiety and the treatment goals focus on affirming gender, ask why that is. We used to understand that we need to address underlying issues, rather than assume that a single change will resolve all other mental health conditions. In addition, if the treatment plan has goals and interventions you approve of, stay involved and make sure the therapist is following that plan.
Don’t forget, you are the parent, and you are your child’s best advocate. Don’t be intimidated by an expert, especially if something doesn’t feel right. Trust your instincts.
Pamela Garfield-Jaeger is a licensed clinical social worker in California. She completed her MSW in 1999 from New York University. She has a variety of experience in schools, group homes, hospitals and community-based organizations. Since getting fired for not getting the C*VID vaccine, she has dedicated herself to educate parents and embolden other mental health professionals to challenge the ideological capture of her profession.
For more detailed information on how to empower yourself as a parent and navigate the mental health field, see the Parents' Guide to Mental Health.
Hi Pamela: Great work. We are exploiting this solid clinical ground to the hilt. This is the way to stop the cancer. I encourage common sense therapists who want to work this way to come work for us in New Hampshire. We will work carefully within the boundaries of the conversion therapy law to do proper biopsychosocial assessments. Temporary licenses are available and they have reciprocity here. Therapists can contact me at www.iadmhp.org.
Very good post Pamela!
Two questions for you.
1) Has anyone started/compiled a list of honest providers, like yourself, who are following the" un-woke" standards of care? To be clear, I am referring to providers who will actively screen for ALL issues a patient may be dealing with and then treat those issues, in an unbias and comprehensive manner.
A listing of these providers, is painfully needed by the parent out here - as I'm sure you know.
2) In your experience with those who're de-transitioning (especially teens), do they ever allude to what might have made them think twice, about the panacea of the gender Kool aid? Of course, human nature being what it is - especially in crisis - having a Cloe Cole telling them it's a mistake, sham, scam and cult manipulation, may have made no difference at all.
Thank you for the work you are doing. It's critical, as this manically destructive Genie is not going back in the bottle. The fear the best we can hope for is early intervention/mitigation (parents) and then honest and comprehensive care/after care, for those coming out the other end, of this mental and physical meat grinder.