As a teenager, Keira Bell chose to embark on a path of transition, but regretted it. In this article, she tells us how it feels to be part of the history of the transsexual debate. Keira is the world's most famous destransitioner.
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My family life has been unhappy from the beginning. My parents, a white British woman and an African American man, married while my father was in the UK for his job in the US Air Force and divorced when I was five. My mother, who lived on welfare, fell into alcoholism and depression. Although Dad stayed in England, he was not emotionally close to me or my younger sister.
I was just another tomboy: this was one of the best parts of my childhood. I lived in Letchworth, a town of about 30,000 people about an hour from London. As a child, I was willingly accepted by the boys; I dressed like them and was very sporty. I had no problem with my gender, I didn't think anything of it.
When puberty came, everything has changed for the worse. A lot of teenagers, especially girls, experience its arrival very badly, but I didn't know that. I thought I was the only one who hated my hips and my ever-growing breasts. Then I got my period and it was really debilitating. Often the pain was so bad and I felt drained.
I could no longer be part of the 'boys' club', so I lost my group of friends; I didn't feel close to girls either. My mother's alcoholism had become so bad that I didn't want to bring anyone to my house. In the end, I simply found myself with no friends to invite. We started moving around a lot and I had to start all over again in a lot of schools; my problems got worse and worse.
When I turned 14, I was already suffering from severe depression and I gave up.I stopped going to school and leaving the house. I stayed locked in my room and tried to avoid my mother. I limited myself to playing video games, listening obsessively to my favourite music and surfing the Internet.
Something else was going on: I started to be attracted to girls. I had never seen the word 'lesbian' or relationships between two women associated with anything positive, and I ended up wondering if there was something wrong with me. Pat around that time, my mother asked me if I wanted to become a boy: I had never thought about it for a second, until that moment.. On the Internet I found sites that talked about transition paths for women who want to become men. Shortly afterwards I went to live with my father and his partner at the time, who asked me the same question my mother had asked me. I replied that I felt like a boy, and that I wanted to become a boy.
Looking back, I realised that It was my life experiences that led me to believe that it would be beneficial to stop being a woman. I thought that by starting hormone therapy I would become taller and would not be much different from someone born a man.
I started to see a psychologist from the National Health Service in the UK, the NHS. When I was 15 years old, because I kept saying I wanted to be a boy, I was sent to London, to the gender identity development unit of the clinic. Tavistock and Portman. There I have been diagnosed with gender dysphoriapsychological suffering caused by an incongruence between one's biological sex and one's perceived gender identity.
When I arrived at the Tavistock Clinic, I was sure I needed the transition. It was an absolute, clear certainty, typical of adolescence. I was actually a girl with a bad relationship with her body, victim of parental neglect, isolated from others, andi, anxious, depressed, unable to accept her sexual orientation.
At 16, After a series of very superficial conversations with social workers, I was given puberty blockers. A year later, I started testosterone injections. At the age of 20, I underwent a bilateral mastectomy. At that point, I had a more masculine physical structure, beard, and a man's voice and name: Quincyin homage to Quincy Jones.
The further I went on my journey of transition, however, the more I realised that I was not a man, and that I could never become a boy. These days, we are told that when a person suffers from gender dysphoria it is because of their 'true' identity, that it is an expression of the desire to change gender, but for me it was not like that. As I grew up, I realised that my gender dysphoria was a symptom of my malaise, not its cause.
Five years into my transition to become a man, I began a process of detransition. Many transsexual men say that it is impossible to cry with a high level of testosterone in the blood, and this was also the case for me: I could not let off steam. I realised that I was becoming Keira again when I finally managed to cry again. And I had plenty of reasons to do so.
The consequences of what happened to me were severe: probable infertility, breast amputation, inability to breastfeed, atrophied genitals, voice change, facial hair. When I was examined at the Tavistock clinic I had so many problems that it seemed reassuring to convince myself that I had only one to solve, that of being a man trapped in a female body. It was the responsibility of the professionals who were caring for me to consider all my comorbidities instead of indulging me. in my naive belief that hormones and surgery would make me feel better.
Last year I sued the NHS fund. dedicated to the Tavistock and Portman Foundation by opening a case for judicial review, which in Great Britain allows those who wish to do so to sue a public body that has failed in its legal duties. Few judicial reviews are successful; only very few are given a hearing. Ours, however, was heard: a three-judge panel of the Supreme Court ruled on whether the young patients of the clinic I had approached had the capacity to give truly informed and conscious consent to such burdensome medical interventions.
My legal team argued that Tavistock had not protected young patients who had come to the clinic and instead of taking care of each case with careful and targeted treatment, had used us to conduct real, uncontrolled experiments. Last December, we won the case with a unanimous verdict in our favour. The judges expressed serious doubts about the ability of younger patients to understand the implications of experimental treatments with lifelong consequences.
In the judgment, the judges repeatedly expressed their astonishment at what had occurred at the Tavistock clinic, and especially at its failure to collect basic data on its patients. They found no justification for prescribing puberty blocking drugs to children of even 10 years of ageIt is a therapy that is used in the almost always followed by synthetic hormones of the opposite sex, which have to be administered for life in order to continue the transition. They were also concerned about theabsence of follow-up data, given 'the experimental nature of the treatment and its profound impact on the patient'.
More and more girls are seeking help for gender dysphoria problems. In 2009/2010, 77 children were sent to the gender identity development service; 52% were boys. The percentage started to change in favour of girls within a few years, when the number of people sent to that service took off. In England, in the two-year period 2018/2019have been reported to the service 624 boys and 1,740 girls, 74 per cent of the patients. More than half of the adolescents sent to the clinic were under the age of 14; some were as young as 3. The judges noted that Tavistock professionals had found "no clinical explanation" for the dramatic increase in the number of girls involved, and expressed surprise at the specialists' inability to collect data on the age of the patients they had given puberty blockers to.
Judgment does not prevent a minor from starting a medical transition processbut the judges recommended that doctors apply for theapproval by a court before starting these treatments on 16- to 17-year-olds; they said they were "very sceptical" about the ability of 14- or 15-year-old patients to understand the consequences of the treatments and to give informed consent, and described it as "very unlikely" that it would be possible to get informed consent from someone under 13.
The NHS stated that the Tavistock clinic had 'immediately stopped receiving applications for the administration of puberty blockers and synthetic hormones of the opposite sex for patients under the age of 16, which in future will only be granted with the permission of a court'. The Tavistock clinic has appealed, and will return to court in June.
The puberty blockers I took at 16 were designed to block my sexual maturation.The aim of the therapy was to enable me to 'taking a break' to decide whether or not I wanted to continue my transition. This "parenthesis of reflection" sent me into a kind of menopause, complete with hot flashes, night sweats and mental fogginess. Thinking clearly about what to do has become even more difficult.
After a year of treatment, when it was proposed to me to switch to testosterone, I immediately accepted: I wanted to feel like a young man..., not as an old woman. I couldn't wait to start with the injections and to change. In the beginning, testosterone filled me with self-confidence. One of its first effects was a lowering of the testosterone level.my vocal timbre, which made me feel much more authoritative.
Within two years my voice got worse and worse, I grew a beard and my body fat was distributed differently. I continued to bandage my breasts every day, partly because I now looked like a man, but it was painful and I found it hard to breathe properly. When I was 20, I was sent to the clinic for adult patients. The testosterone and bandages had changed my breasts and I hated them even more than before. I wanted to make the appearance of my body conform to that of my new face, and therefore I had a bilateral mastectomy prescribed.
My relationship with my parents continued to be difficult. I had stopped talking to my mother; my father had thrown me out of the house shortly after my seventeenth birthday and I went to live in a youth hostel. We kept in touch, even though he was very much against my transition. He reluctantly accompanied me to the hospital for my surgery. I was a fully fledged adult when I had the operation, and I take full responsibility for my choice, but I had been led down that path, which started with puberty blockers and moved on to testosterone and surgery, when I was just a difficult teenager. As a result of the operation, the nerve endings in my chest have been damaged: it is not as sensitive as before. If I manage to have children, I will never be able to breastfeed them.
One year after the surgery, something new happened: I matured. I reflected on my journey, and asked myself questions. What made me a man?
I realised how wrong my reasoning had been and how much it had been influenced by statements about gender that are increasingly common in the general culture. and were adopted in their entirety by Tavistock. I remembered that when I was 14 years old I was convinced that hormones and surgery would turn me into someone who could look like a man; I had become that person, but I realised that I was very different from males physically. Living as a transwoman helped me to realise that I remained a woman.
I have also begun to understand that my life experience was based on stereotypes, and that I was trying to define my identity in a very limiting way, by dressing up as 'a very masculine man'. The more I thought about it, the less it made sense. I was also concerned about the effect my transition would have on my ability to find a sexual partner.
Plus, nobody knew what the long-term consequences of my treatment would be. The puberty blockers and testosterone have caused me to have thevaginal atrophyThis is a process of thinning and weakening of the vaginal walls that normally occurs after menopause. I started having problems with my appearance again.
I decided to stop the therapy immediately, overnight. I immediately cancelled my appointment for the next testosterone shot.
After making this decision, I found a subreddit dedicated to those who were embarking on a process of detransition. It was increasingly busy, as if all those girls had realised together the medical scandal they had been victims of. We could talk about our experiences and support each other. I felt free again.
What happened to me is happening all over the western world. My case was not at all surprising for those who had followed the events in Tavistock and cries of alarm of its former employees, often published anonymously. Some professionals abandoned the service over these objections. Transgenderism, unfortunately, is highly politicised and steeped in identity politics. Questioning or doubting the gender transitions of all these adolescents can be dangerous; those who dared to commit this sin were covered in mud and discredited professionally.
At the Tavistock Clinic, Professionals provide 'gender self-affirmation-based care': in practice, when a child or adolescent expresses the desire to start a transition process, this intention is considered definitive and is usually not questioned. This model based on self-assertion is adopted in many countries. In 2018, theAssociation of American Paediatricians released a declaration which relied on this very methodology to treat younger patients who identify as transgender or non-conforming.
Some former Tavistock employees, however, mentioned the other problems from which the adolescents and children who came to the clinic for help were afflicted: they were victims of were sexually abused, abandoned by parents, homophobic by family or classmates, suffered from depression, anxiety or attention deficit disorder, or were autistic. These serious diseases, which could include dysphoria among their symptoms, were often ignored and not treated; transition was considered a panacea that could cure all patients.
As the Supreme Court noted, the effectiveness of a large proportion of clinically proposed therapies is not supported by conclusive evidence. When our case was accepted, the NHS used to claim that the effects of puberty blockers are 'completely reversible', but has recently claimed the oppositeacknowledging that "there are no data on long-term effects". of these drugs on the body and mind of a teenager. Even this did not stop them from prescribing them to people like me.
Dr Christopher Gillberg, professor of child psychiatry in Sweden at the University of Gothenburg and specialised in the study of autism, was called in for our case as an expert in the field. In his testimony, Gillberg said that in more than 45 years of experience with autistic children he had rarely found gender dysphoria in this category of patients. In 2013, however, the number of people with autism and gender dysphoria took off, especially among girls. Gillberg then told the judges that what was taking place at Tavistock was a "live experiment" on children and adolescents.
Parents who are reluctant or alarmed at the idea of starting their children on a transition path are warned: "Do you prefer a dead daughter or a living son?" (Or vice versa). As a teenager, I thought about suicide. Suicidal thoughts are a symptom of serious mental problems that require careful diagnosis and appropriate treatment.. When I spoke about these thoughts at the Tavistock Clinic, I was told that they were one more reason for me to start my hormone therapy quickly and to feel better.. After the ruling, however, Tavistock released a study of 44 patients who had started taking puberty blockers between the ages of 12 and 15. In the study, declares itself that the treatment did not improve the mental health of the patients, and that it had no noticeable effect 'on their psychological health, self-harm and self-image'. In addition, out of 44 patients, 43 chose to switch to synthetic hormone therapy of the opposite sex. This fact invites us to think that blocking puberty does not provide a pause, but a further push towards transition.
Before I started taking testosterone I was asked if I wanted to have children, or if I wanted to freeze eggs in case transition made me infertile. As a teenager I didn't think I wanted children, and the procedure of harvesting my eggs would not have been covered by the NHS. I said that not having children would not be a problem, and that I did not need to put some of my eggs aside. Today, however, as an adult, I realise that I had no idea of the consequences of infertility. Having children is a basic right, and I still don't know if it has been taken away from me.
To defend itself, Tavistock got young trans people to testify that they were happy with the treatment they received. One of them is S., a 13-year-old trans boy who received puberty blockers from a private clinic because the waiting list at the gender identity development service was too long. S. told the judges that he "had no idea what he might think in the future about the possibility of having children", and that since he "has never had a romantic relationship" the idea of having a child "is something he is not considering at the moment".
Many teenagers, when thinking about their future sexual relationships, feel puzzled and often even disgusted by the idea. As adults, they will often think in a completely different way. I know this very well, because it has happened to me too. I had never had sex when I started my transition, so I had no idea what the journey would be like for me sexually.
S.'s statement shows how difficult it is for a child to give consent to procedures he/she does not yet understand. As they have written the judges, 'it is impossible to explain to children of this age what the loss of fertility or sexual function will mean for the future of many of them."
Today, at the age of 24, I am in my first stable relationship. My partner supports me in everything I do, and I do the same for her. She has many friends who accept me for who I am, and that has been very healthy for me. At the moment, I don't talk to my parents and have no relationship with them.
From time to time, I am still mistaken for a man. It's understandable, and it doesn't make me angry. I know I will have to live with it for the rest of my life. What makes me angry is the change my body has undergone so early. Many people want to know if I will have breast reconstruction surgery, or other operations to make me look more feminine, but I am not over my mastectomy yet. For the time being, I want to avoid other such operations.
When I decided to join the cause, I didn't realise how important it would be. After the sentence, my life was filled with ups and downs. Many have thanked me. Others insulted me on the Internet. If you regret the transition and talk about your experiences with it, you are labelled a bigot. You are often told that you are trying to take rights away from trans people, that children know what is best for them and their bodies, and that you are ruining the lives of innocent people.
My aim is to give the best possible care to young people in difficulty. Many girls undertake transition because they are suffering, because of psychiatric illness, trauma or other reasons. I know what it is like to be convinced that transition can solve any problem.
Although sharing my story was cathartic, I am still suffering and have yet to receive proper therapy. I want to continue my commitment to this cause. I want the message from cases like mine to help protect other children from going down the wrong path. This year, I helped set up the first detransition awareness day, set for 12 March. I hope that, in the coming years, this day can be a beacon of light that can help other people to emancipate themselves.
I don't believe in strict rules of gender expression. Everyone should be comfortable and feel accepted if they choose to experiment with the way they express themselves. As I stated after the ruling, this would stop homophobia, misogyny and violence against those who are different from others.
I appeal to professionals and clinics to set up more appropriate services to treat mental health problems and appropriate models to help those suffering from gender dysphoria. I don't want other young people who are as desperate, confused and lonely as I was to be led to believe that transition is the only answer to all their questions.
I was an unhappy girl who needed help, and they treated me like a guinea pig.
original article here (translation by Duwayce)