When Chloe woke up from an elective double mastectomy, she texted her mother in the waiting room: “Booba gone.”
This was a little over two years ago. She was 15 at the time. “The typo was intentional,” she told me recently. “I thought it was funny.”
“Is that a good thing?” her mom replied.
“Yes,” Chloe texted back.
“I don’t think that answer aged well,” she said to me.
Chloe, who lives in California’s Central Valley, always hated her body. She spent a lot of time on Tumblr and learned words like “pansexual” and “bigender.” She remembers when she was 12, sitting on her bed, thinking, “Maybe I’m meant to live as a boy.”
By 2018, at age 14, Chloe was well along the path to what she imagined was boyhood. She was going by Leo. She was taking puberty blockers. And her mother was administering her weekly testosterone injections. Two years later, in early June 2020, she went under the knife.
Chloe was the beneficiary of what transgender activists call “gender-affirming care,” which means all the adults in her life—doctors, nurses, social workers, teachers, parents—actively supported her decision to become the person she believed she was meant to be, even if that person required an elective mastectomy in high school. Or taking puberty-blocking drugs. Or injecting cross-sex hormones, like testosterone.
In this, Chloe is also the poster child for the current administration’s recently announced transgender policy.
Gender-affirming care, the president’s spokeswoman, Jen Psaki, explained at a recent press conference, was “best practice and potentially lifesaving.” The point was: If trans kids weren’t able to transition, not just socially, but medically with cross sex hormones, puberty blockers, and surgeries, they might well kill themselves.
The Biden policy was presented as commonsensical, but it is out of step with many progressive countries and some leading experts. Countries that have gone down the “gender affirming” road—like Norway, Sweden, France—are now reversing course in the absence of evidence that such care actually improves mental health outcomes for dysphoric children. Pioneering doctors, like Erica Anderson of the University of California San Francisco’s Child and Adolescent Gender Clinic—herself a transwoman who has helped hundreds of teens through their transitions—are warning of the dangers of this policy. Critics say that even the phrase “gender-affirming” is misleading—a euphemism for something closer to medical malpractice. When else do we trust children to self-diagnose and make lifelong medical decisions?
And then there is the growing chorus of young people, including Chloe, who had come to regret—deeply—the decisions they had made and the gender-affirming care they had received.
In the middle of this story are teenagers who are largely going unheard by a government and a medical establishment that’s plowing ahead. “I don’t think gender affirming care helps kids like me,” says Chloe. “There should be more regard to alternatives in treating dysphoria, especially when it comes to kids.”
“I thought testosterone would transform me from being short and pudgy to lanky and male, but in a graceful type of way, not muscley,” said Helena Kerschner, 23. Helena is from Cincinnati, and she is one of the country’s most prominent detransitioners, as people who transition genders and then change back are called. She has a Substack with thousands of subscribers.
Growing up in Ohio meant Helena could only transition with a parent’s consent. (This is true in most states. Washington, Oregon, and California gave minors more wiggle room to transition on their own). But she was 15, and her parents were definitely not on board. She wore boys clothes and a breast binder, and cut her hair short.
The guidance counselor at her public school agreed with Helena that she was a man. She helped her make a budget for her transition, and referred her to the school psychologist, who was even more gung-ho. “I remember the psychologist saying, ‘Your mom is a transphobe,’ and telling me about suicide risks.” They had three or four meetings before inviting Helena’s mother to have a conversation with the both of them, which didn’t go well.
“I had a ton of issues with my academics and my mental health, but I never really got help with that,” she said. “As soon as I said I was trans, it was all hands on deck.”
Her parents—her mom is a doctor; her dad, an engineer—never came around. Days after she turned 18, Helena went to Planned Parenthood in Chicago. There, she saw a social worker, and then a nurse practitioner, who wrote a prescription for testosterone during that first visit. The nurse recommended a dose of 25 milligrams per week. “How high can we go?” Helena asked. Helena left the clinic with a prescription of 100 milligrams of testosterone. The whole thing took about an hour. She never saw a doctor.
Two days later, she was moving into her college dorm. (For privacy reasons, she’d only say that she attended a small liberal-arts school in central Ohio.) Helena’s family helped her move in; she made sure to hide the glass vials and needles from them. She started going by Vincent, after her favorite anime character. She injected herself with testosterone weekly.
The drug made her feel irritable and angry, and it gave her sex drive a massive boost that she called “overwhelming.” She began hitting herself, and once she cut herself with a serrated kitchen knife, which landed her in a psych ward for a week. After a year-and-a-half on testosterone, it began to dawn on her that “the reality I was living was not lining up with the fantasy I’d had as a teen.”
Helena’s roommate, who was also a transman, made a video chronicling their friendship. It started on the second day of college, and it spanned a period of about a year-and-a-half, and it was supposed to be upbeat—a celebration of their shared liberation from the shackles of their girl bodies. But when Helena watched it, she saw herself becoming more despondent. (The roommate, as it turned out, eventually also detransitioned.) That was in early 2018. Slowly, Helena realized she wasn’t a boy. “It was a crushing and terrifying feeling,” she said.
She went cold turkey off the testosterone, and bought a wig and make up and new clothes. (When I asked Helena whether living with another transman had had an influence on their decisions to transition, and to detransition, she said, “Definitely.” It was the inverse of the theory that the explosion of gender dysphoria among girls, starting about a decade ago, was really part of a social contagion.) Helena also started spending less time online—she was partial to Tumblr, too—and more in the real world interacting with real people, like her coworkers at her job at a bakery.
The next year was “confusing and awkward,” she says. Over dinner, a few months after the video montage episode, she told her parents her decision to detransition. They said they thought she was making a good decision, but didn’t say much else. Now, she calls her relationship with them “cordial.”
Proponents of gender-affirming care say its benefits dramatically outweigh the risks. But there’s little data to back that up, and in any case this is still a new phenomenon about which a great deal is not known. The American Medical Association staunchly supports gender-affirming care. Same with universities, especially elite universities. Same with the president of the United States. It’s unclear whether there is any academic or professional space left for the skeptics.
Trans activists argue that trans patients knew the risks. The kids or their parents gave informed consent, they say.
“There’s more to the story,” counters Helena Kerschner, who feels failed by her doctors and therapists.”The fact that there’s adults as high up as in the administration putting out these claims that young people need to medically transition is really dangerous. There’s no logic to it.”
Before her top surgery, Chloe went to a therapist, then a gender specialist, then a surgeon, who she had two consultations with. She also went to a class put on by her healthcare provider in a building in Oakland with other kids and their parents about top surgery. It was about things like incisions and how to change bandages.
A few months after she had her breasts removed, she was in class, and the teacher started talking about the psychologist Harry Harlow and his experiment with rhesus monkeys. The experiment showed that the bond between mother and child was much more critical to the development of the child’s brain than had been known. “It occurred to me that I’d never be able to breastfeed my baby,” she said. She was 16.
She liked boys, but didn’t feel that she’d ever be taken seriously. She was a five-foot-three trans boy. In the summer of 2020, she started to have regrets. “I badly wanted to go out shirtless and feel that freedom,” she said. But she was confined to her bed, healing. Her nipple grafts and the scars were UV sensitive. She began feeling jealous of the girls she saw online. “I missed being pretty,” she said. In May 2021, she stopped the testosterone.
Detransitioning senior year was tough: She was dressing like a girl again, but still had “rough” features and a deep voice from all the testosterone. “I got looks from people, and other students would talk smack behind my back,” Chloe said. Her friends abandoned her. Another friend told her that “the gay side of my school hated me” because she detransitioned.
Recently, she met someone, a boy from two towns over, through a family friend. “I genuinely think he was a gift to me from God,” she said. She wished she still had her breasts. “I was looking for a niche to fit in and a sense of fulfillment,” says Chloe of those years of medicine, consultations, surgery, recovery, and self-discovery. Now? “I don’t really believe in gender identity at all.”