To the School Administrators, about Our Daughter's IEP
A letter urging caution in social transition
Dear XXX:
We, the parents of XXX, first want to thank you for the ongoing, individualized support you have given XXX and our family during the mental health crisis she has been experiencing over the past year and a half. We are truly grateful for the care and hard work you have put in to provide her with a customized plan that best fits her unique educational and emotional needs.
As you know, although XXX has made tremendous progress, she continues to receive regular psychological and psychiatric treatment in the outpatient setting for ongoing mental health challenges, including (but not limited to) gender dysphoria. Based on our recent discussions, we are requesting an urgent meeting with the CSE to discuss adding further stipulations to XXX’s IEP to protect her from being referred to as anything other than her legal name and female pronouns, based on clinical concerns expressed by us and her healthcare team (and explained in further detail below). We recognize this may not be possible prior to the start of school on Thursday. Therefore, to make XXX’s transition back to the public school setting as seamless as possible, we request that all staff consistently refer to by her legal birth name and female pronouns (consistent with her current IEP) both verbally and in writing, including all documentation, both formal (transcript, etc.) and informal (e.g., concert programs, yearbook, etc.)—effective immediately.
For both safety and mental health reasons, she must also not be allowed to use opposite sex facilities (i.e., bathrooms, locker rooms). If XXX makes any request (verbally or in writing) that runs counter to these requests, please inform us immediately. Although we were unable to find any policy specific to this on the XXX website, our requests are not in any way at odds with efforts to be inclusive of all students, regardless of sex or gender identity (which we applaud and support). In our recent discussions, you acknowledged the legitimacy of our concerns about affirming XXX (ie, using her preferred name and pronouns) and the clinical appropriateness of this request, but expressed legal concerns. We have consulted with XXX (an educational attorney), who confirmed that these requests do not violate any laws designed to protect students against discrimination, including Title IX of the Education Amendments of 1972 and the Dignity for All Students Act (“DASA”). Although the affirmative approach may be the standard guidance, rigidly applying a “one size fits all” approach to XXX’s case—against the advice of her mental health providers and the wishes of her parents—is in direct opposition to The New York State Guidance to School Districts for Creating a Safe and Supportive School Environment For Transgender and Gender Nonconforming Students:
“This guidance cannot anticipate every situation in which questions may arise relating to transgender and gender non-conforming students. Therefore, the specific needs of each transgender or GNC student should be assessed and addressed on a case-by-case basis.”
As we and mental health providers have conveyed, we have compelling reasons to believe that calling XXX by a male name and male pronouns would be detrimental to her psychological development and in opposition to goals of providing a safe environment for our child. Affirmation is a clinical intervention that is not necessarily the optimal way of supporting a child having a gender identity crisis. In XXX’s case, using an affirmative approach fails to consider her emotional disturbance and individual psychological needs, as well as the valid concerns of us (her parents), and the recommendations of the members of her recent and current mental health team, including XXX, (Executive Director of XXX, the therapeutic boarding school where resided for the entire 2020-2021 school year), and XXX( current outpatient therapist), and in consultation with XXX, an internationally renowned expert on gender dysphoria in children and adolescents, in conjunction with our own scrupulous research.
Evidence to support an affirmative approach is lacking for students such as who presented as transgender suddenly in adolescence (rather than in childhood), with no prior history of signs or symptoms of gender dysphoria. Furthermore, this identity emerged in the midst of severe psychological turmoil, and with heavy influence from similarly presenting peers in the inpatient mental facilities she had been in. presentation is also known as “rapid-onset gender dysphoria,” or ROGD. (See ROGD Resources at the end of this letter.) There is mounting evidence (both published and anecdotal) of high contagion and particular vulnerability for adolescents with comorbid mental disorders (anxiety, depression, etc.) surrounding ROGD. For many adolescents with ROGD (including XXX) the transgender identity becomes yet another maladaptive coping mechanism, similar to self-harm and disordered eating (both of which XXX has also experienced). This cohort is considerably different from those who have been experiencing childhood gender dysphoria that persists into adolescence—a subset that is better studied and on which affirmative recommendations are based. Those recommendations, therefore, cannot be extrapolated to XXX’s case. In cases of ROGD, there is evidence to suggest that social transition (including use of opposite sex name and pronouns) is both damaging and difficult to reverse. This point is underscored by an abundance of testimonies from young women who experienced ROGD and then decided to detransition; detransitioners often note the difficulty of changing their minds when those around them went along with their male names and pronouns for months or years.
Affirming a male identity for XXX, who struggles with black and white thinking, imperils her exploration of the deeper issues at play and sets her on a path toward harmful and irreversible medicalization at the end of her high school career, when she will be of an age to make such decisions without our consent. It is imperative that we actively intervene now, before XXX is of age to make decisions that may be associated with long-term negative consequences and possibly life-long regret. Although we continue to work diligently with XXX’s therapist to help her explore these issues, we are much less likely to be successful if we do not have a consistent approach being used across all facets of life, including school, where she spends a high percentage of her time. We continue to support XXX’s exploration of gender identity, while setting boundaries within our home, in extracurricular activities, and with extended family, regarding the use of her legal birth name and pronouns and facilities that align with her sex. Although it is not XXX’s preference, she is accepting of this, and we continue to have positive interactions using this approach.
As always, we appreciate your time and attention to this important matter. Please let us know whether there is further information you need from us to enact our request immediately, prior to the start of the new school year.
Sincerely,
XXX
Clinical Resources on Rapid-Onset Gender Dysphoria
Websites
Rapid-Onset Gender Dysphoria: A Primer: www.youtube.com/watch?v=U7FI6 OKrzc
o If you are not already familiar with ROGD, this is an excellent primer in a discussion with
Dr. Lisa Littman, the researcher who published a seminal peer-reviewed study identifying this phenomenon (see Littman 2018 under the Studies and Articles section below), and Sasha Ayad, a licensed therapist with extensive expertise working with ROGD children. (See Inspired Teen Therapy website in this section.)
Society for Evidence Based Gender Medicine: https://segm.org/
Pediatric and Adolescent Gender Dysphoria Working Group: http://gdworkinggroup.org/
Genspect: https://genspect.org/team/
Stella O’Malley: www.stellaomalley.com/
Inspired Teen Therapy: https://inspiredteentherapy.com/
Podcast
Gender: A Wider Lens: https://gender-a-wider-lens.captivate.fm/episode/rapid-onset-gender- dysphoria
o Episode 2 is specific to rapid-onset gender dysphoria, but all episodes I’ve listened to have been excellent. A new episode is released each week.
Studies and Articles
Outbreak: On Transgender Teens and Psychic Epidemics [Marchiano 2017]
Parent reports of adolescents and young adults perceived to show signs of a rapid onset of
gender dysphoria. [Littman 2018]
‘Taking the lid off the box’: The value of extended clinical assessment for adolescents presenting
with gender identity difficulties [Clarke 2019]
Sex, gender and gender identity: a re-evaluation of the evidence [Griffin 2020]
One Size Does Not Fit All: In Support of Psychotherapy for Gender Dysphoria [D’Angelo 2020]
Gender Dysphoria Resource for Providers [D’Angelo 2020]
Why I Resigned from Tavistock: Trans-Identified Children Need Therapy, Not Just 'Affirmation'
and Drugs [Evans 2020]
First, Do No Harm: A New Model for Treating Trans-Identified Children [Evans 2021]
Transgender Teens: Is the Tide Starting to Turn? [McCall 2021]
Books
The End of Gender: Debunking the Myths about Sex and Identity in Our Society by Debra Soh
Material Girls: Why Reality Matters for Feminism by Kathleen Stock