Detrans when transition.., p.3
DETRANS: When transition is not the solution, page 3
If an AGP male spends a lifetime having sexual fantasies of having a female vagina or breasts you can see how in his mind this must mean therefore that he should seek help in ‘becoming a woman’ and may present himself to his doctor as ‘trans’ or ‘transsexual and in need of a sex change’. His General Practitioner may only have ten minutes to see him, and during this limited time the man may be too embarrassed to go into much detail of his masturbatory fantasies. Once he has convinced his doctor that he must be a transsexual and in need of a ‘sex change’ he is referred to a Gender Identity Clinic but told that the waiting list is a couple of years. Imagine that the man in question feels that a couple of years is quite a long time to wait, and that he does not want to waste any more time now that he is confident what the solution is. So he then searches online as to where he can get the ‘sex change’ privately to avoid the long queue. This is the second type of AGP male patient I have tended to see clinically. Typically, they will have booked an operation somewhere overseas, usually Bangkok, to have a physical castration and neo-vagina fitted with or without breast implants. The surgeons are happy to take their money and give them surgery without the need for too many questions being asked, and certainly no psychiatric or psychological assessment. I will explain the problem with an AGP male having ‘sex change’ surgery. We have already established that AGP is a sexuality and NOT a gender issue. The wish to have a vagina is because that has been the source of his sexual fantasies, and not because he has believed himself to be a woman all his life. The first stage of a ‘sex change’ for a biological male is to physically cut off his testicles (castration) along with removal of the penis (penectomy), before creating a blind ending cavity which will be called the neo-vagina. Once a man is castrated all libido and sex drive is gone (which is why domestic cats and dogs find themselves with this unhappy fate to prevent them from getting frisky). The AGP male once castrated awakes from surgery to find himself now to be a eunuch with no sex drive. He finds he has a vagina in which he has no interest. He realises that he has had an irreversible operation from which there is no turning back. He is devastated. This is when some of them find their way to my consulting room in a state of grief and regret.
Autoandrophillic females do not have a corresponding libido-crushing surgical castration and so have not found their way to my consulting room via that route.
It is easy to see how the post-operative regret-filled AGP male is able to understand, in a post-hoc manner, that their wish to transition was due to autogynephilia (once this is explained to them) but for those AGP males who have not yet had this condition occur to them it can often be very challenging to help them understand that their wish to transition is due to AGP rather than what specifically was termed ‘transsexualism’. Whilst many trans-activists attempt to thwart the notion of AGP even existing as a phenomenon, it is unclear on what basis such a denial is based, as those of us working clinically in the area see very clear cases of AGP, and to those on social media the AGP trans male stands out a mile due to their overt sexualised excitement over female bodily parts (even if they cannot see it themselves).
Other Fetishists Under the ‘Trans’ Umbrella:
Fetishistic transvestites and autogynephilic males are not the only sexual fetishists to be included under the wide catch-all umbrella term ‘trans’. I have encountered a variety of other fetishists who also come under the ‘trans’ collective grouping due to their wearing of attire or adopting a persona which they identify as belonging to the opposite sex.
I have had sado-masochistic patients, usually male masochists who intentionally dress like a ‘bad transvestite’ (their own words) in order to get sexually aroused by the jeers from members of the public who correctly identify them as males and taunt them as such. For some males who feel emasculated or underconfident in their masculinity, having men shout “You’re a man” can even be reaffirming of the very aspect of themselves which they feel underconfident in.
There are cases (some very well known) of adult men who may have previously identified as transvestite but now prefer to be considered just ‘trans’ who, rather than adopting the appearance of a similar aged adult of the opposite sex, get pleasure from adopting the appearance and affectations of young children of the opposite sex. Some refer to this as being in ‘girl-mode’. Middle-aged men dressing up as little girls would previously have been considered both perverse and possibly a cause for concern due to the fetishization of underage children, but is now celebrated as ‘trans’. Not only that but those who raise concerns as to what this fetishization represents are brandished as ‘transphobes’.
Conversely, I once had a patient who was an adult male but spent his entire time cross-dressing as an elderly destitute woman in order to glean sympathy from women in a way which he felt he was unable to manage as his real self. He gave me an indication of how this worked one day on the way to my consulting room when he meekly uttered a ‘hello’ to a passing female analyst on the staircase. On seeing what she believed to be an elderly somewhat destitute woman (with clothes smelling of stale urine and carrying large nylon bags full of clothes) she tilted her head and gave a warm smile back replying “Hello”, in a caring manner. “You see!” he said after she had passed. His unrealistic fantasy was that one day one such woman would take pity on him and take him home. When I saw him, he had been doing this for eleven years and that had not yet happened.
I have also seen ‘flashers’ who get excited at the opportunity to expose their genitals to others, usually women. The new self-ID legislation in many parts of the world now allows such men to enter female only spaces, such as changing rooms, even in the absence of any ‘sex change’ or social gender transition on their part, merely by declaring themselves as female. This is of course a great opportunity and ‘too good to miss’ for such men to be amongst women at their most vulnerable, in order to expose themselves legally. They can simply get undressed in front of them and thus expose their intact male genitalia to the women and girls whose space they have legally entered and are sharing. Trans-activists like to state that this ‘hardly ever happens’ but scores of postings by men gloating in such deeds on Twitter on a daily basis proves that this is not the case.
Similarly, there have been several cases (and these are increasing all the time) of male sex offenders, including men who have raped women, who suddenly declare themselves to be transgender, in order to be placed in women-only prisons, thus giving them ‘captive prey’ to predate. And we see in the news many cases of where this has happened.
So, as you can see from the above, the term ‘trans’ is neither a specific nor a helpful one. It does not exclusively imply people who have undergone physical ‘sex change’ measures, nor those who intend to do so. I Indeed the majority of trans people have the intact genitalia of their biological sex. The numbers of non-transsexual trans have always greatly outnumbered those who would have in the past been referred to as ‘transsexual’. The majority are males with a fetish involving some appropriation of aspects afforded to the opposite sex. These are mostly transvestites but other fetishes which are now not named but merely subsumed under ‘trans’ are included, whereby they are all mistakenly and unhelpfully considered one and the same.
SECTION II: PRETRANS: RECIPES FOR CREATING TRANS
3. TRANS AND AUTISM (AND HOW PRONOUNS BECAME SO IMPORTANT)
Previously the term autism was reserved for what was also called ‘Kanner’s Autism’, named after Leo Kanner, who first described early infantile autism in 1943. These individuals rarely had any speech or language development and had significant learning disabilities. I once worked in one of the very few residential autism units as a junior psychiatrist. The adults in the unit had no language development and could not differentiate living persons from non-living objects and would treat them similarly. The core deficit in autism is a lack of ‘theory of mind’, which is the ability to appreciate that other people have a mind with their own thoughts which may be different thoughts to what they themselves have.
A similar related condition also lacking in theory of mind but far less severe and not usually associated with speech, language or intellectual disability was referred to as Asperger’s Syndrome or ‘high functioning autism’, named after Hans Asperger, who described the condition in 1944. Individuals with Asperger’s, unlike Kanner’s autism, can be extremely gifted in certain areas especially those involving logic or mathematics (there is a very high representation of Asperger’s in those studying mathematics at post graduate level), physics or computer and software programming.
These days the previous distinction between Asperger’s and (Kanner’s) Autism has been removed and all such people are now termed as being on the autistic spectrum and having an autistic spectrum disorder (ASD). All share the common feature of a lack of ‘theory of mind’, the inability to really discern what another person with whom they are interacting is thinking or feeling, instead having to try and work it out from overt clues or deduction which is often misplaced or inaccurate, leading to social errors and awkwardness at times. Another feature is a very black and white style of thinking, with a tendency to apply a binary style of logical thinking, considering things to be right or wrong and struggling to consider or embrace more ‘grey’ or less distinct possibilities. They excel with learning sets of data but struggle with social nuance. They work well with clear rules and frameworks of understanding (such as legislation) but do less well where there is an absence of rules or frameworks to understand concepts. The sense of right and wrong makes it near impossible to understand and keep in mind differing models of understanding such as philosophical models, and compare these models in mind. Essentially, they live by rules which they decide to be right, and expect others to see the world as they do; if they do not, then the others must be wrong, and this can be intolerable. Young children with ASD can get extremely angry if something does not fit in with how they believe it should be. We have all seen this in non-ASD children who have a tantrum if the baked beans are in contact with the fish fingers on their dinner plate. ASD individuals have a characteristic ‘autistic meltdown’ when others do not agree with their way of thinking of what is right, or comply with how they believe others should be behaving. An autistic meltdown is rather like an infantile tantrum of epic proportions, when the infantile wish to destroy and annihilate the perceived adversary in the moment can sometimes attempt to be enacted by an ASD adult. I had one ASD adult patient who used to beat his long-suffering elderly mother with his shoe when she did not comply with what he thought she should be doing or thinking. People with ASD struggle socially and tend to prefer to interact online and tend to spend more time online than their peers (although with many teenagers this may be hard to distinguish) and may be more likely to go into computer-based jobs such as software programming, and favour logic/maths-based degrees to the arts and humanities. They may have a narrow repertoire of interests and habits which may include the esoteric or collectable in some combination.
In clinical settings ASD is not routinely tested for in a formal manner. It is possible but involves exhaustive testing and the result is usually of no benefit as there is no treatment for ASD, so stretched public clinical services understandably do not consider this a good use of resources. Usually, people who are well informed have a sense that they may be ‘on the spectrum’ and clinically if we describe the usual features to a patient, they are able to identify with the characteristics described to them.
Those of us who have worked with gender dysphoria are increasingly of the opinion that there is a significant correlation between ASD and gender dysphoria. I would go as far as to say that biological males who would have previously been categorised as ‘transsexual’ have an almost 100% concordance with ASD, whereas those who are more fetishistic, such as transvestites, AGP or other presentations linked to a sexuality are not. I also do not think this feature necessarily applies to children with gender dysphoria who present with rapid onset gender dysphoria (ROGD), which I believe is actually just a youth subculture. I describe this in a later chapter in more detail. I also do not include those whose gender dysphoria occurred as a result of sex-based trauma which I will also describe in more detail in its own chapter, as this seems to be more correlative for biological females presenting with gender dysphoria.
Looking back at all the gender dysphoria patients I have seen over the years, ASD is certainly the case in the biological male transsexual patients. The ASD was evident in many ways. The very binary/logical/black and white style of understanding of the world lends itself very well to the concept of gender rules which they perceive in the world. Whilst most non-ASD people may be comfortable in either ignoring or subverting perceived societal gender frameworks as suits them, this is far more problematic for someone with ASD. My transsexual patients had very definite ideas of what males and females should look like, what males and females should have as interests and how they should behave. My transsexual patients divided the world into male and female characteristics, a bit like everything in French is ‘le’ or ‘la’, masculine or feminine (and in Welsh!). The male who did not like football or rugby, or getting into fights at school, later used this as evidence for not being male. Similarly preferring to have girls as friends meant they should have been a girl. I had a female transsexual stating that she did not like the colour pink as one of the reasons she was not authentically female. When I ask my transsexual patients what it is to be a man or woman, something they clearly feel strongly enough to want to undergo irreversible life changing surgery for, they are never able to tell me anything other than stereotyped characteristics usually involving clothing (dresses, long hair, make up) or behaviours (cooking, being sensitive to others, looking after the home) none of which are essentially female, except in their mind’s way of organising and understanding the world they are in.
One patient I saw had typically organised the world in this binary way, designating everything as ‘male’ or ‘female’. Due to his lack of interest in some of the things he had labelled as ‘male’, he then concluded that he should be female. For some it is the default other option e.g., ‘not male therefore must be female’, rather than strongly identifying as female. For others it is the feeling that they cannot legitimately be interested in the characteristics, qualities, or activities they have designated as rightly belonging to the sex they are which leads them to conclude that their biological sex must be wrong. For such patients the task was to help them to relinquish their unhelpfully restrictive sorting system. Remove the labels of masculine and feminine for everything they had labelled as such, and allow them to live as they liked, without it necessarily indicating anything about their sex. For many it was unfathomable that as a male they could entertain having long hair and make-up, or as girls they could prefer the company of boys and playing rugby. Such considerations would not pose similar problems if they were not encumbered with an ASD mindset with characteristic ‘concrete thinking’.
Another clear manifestation of the ASD mindset in the transsexual is in their interpersonal interaction with those around them. Once the transsexual has concluded that they should be presenting as ‘the opposite sex’, they follow the rules of their reductive and often stereotyped framework of ‘male’ and ‘female’ attributes, with the belief that if such rules are followed then everyone MUST also conclude that they truly are the sex they wish to portray themselves as. So, a biological male wishing to be portrayed as a woman may adorn long hair (real or a wig) and wear make-up, dresses, skirts or at least clothes purchased from a retailer aimed at women. Along with these appearance changes they will also endeavour to impersonate the mannerisms and type of speech which someone of the opposite sex will have (in their perceived rule system) in the hope that the composite of all these changes will make them appear to others as female. In reality of course men and women are more than a facsimile of stereotyped constructs, and the assemblage of such performances are not always successful. Instead, they may appear to be more of a parody or impersonation of what it is to be male or female. This parody is not intentional as occurs in drag (queens and kings). There the parody is essentially directed at society’s beliefs about gender (‘you think these rules I am following are feminine? I’m showing you how ridiculous such frameworks are’) and NOT, as many incorrectly believe, as an attack against women. The drag queen is not trying to look like a woman. They are wanting to show how societal gender rules can be a farce. Drag can be considered as an early form of Gender Critical performance. The transsexual with their ASD mindset is not able to subvert or critique their gender rules, let alone parody them. They are slavishly adherent to the perceived rules in the belief that if they follow the rules, then the result must be that they achieve their aim. Remember, the ASD mindset does not allow envisaging that others will come to a different conclusion than they have themselves. Therefore, their rules on gender must be everyone else’s rules, and if they have followed the rules then they must look like the opposite sex to themselves and to everyone else. Once again, social media sites such as TikTok and Twitter give us an inordinate quantity of examples of this on a daily basis— biological males in wigs and make-up wearing a dress (following their perceived rules on what being a woman is) proclaiming their astonishment that some member of the public perceived them as male when they truly believed it was obvious to everyone that they were otherwise. Many of my transsexuals talked of how they would go out ‘dressed’ (as a member of the opposite sex) and that everyone who saw them perceived them as such. When asked how they knew this to be the case, their answer was that no-one said anything otherwise to them, so they must have perceived them as they hoped they would. Again, this is an example of the ASD mindset. Everyone must be thinking what they are thinking, and if not, surely, they would say so. The concept of differing thoughts held privately can be a struggle for the ASD mind to contemplate.
