Keira Bell: My Story

Keira Bell
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As a teenager Keira Bell chose to transition, but regretted it. In this article, he tells us how it feels to enter the history of the debate on transsexuality. Keira is the most famous right transitioner in the world.

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My home life was unhappy from the beginning. My parents, a white English woman and an African American, married while my father was in Britain because of his job in the United States Air Force and divorced when I was 5 years old. My mother, who lived on welfare, descended into alcoholism and depression. Even though Dad remained in England, he was not emotionally close to me or my younger sister.

I was a tomboy like many others: this was one of the best parts of my childhood. I lived in Letchworth, a town of around 30,000 people an hour away from London. As a child, I was willingly accepted by boys; I dressed like them and was very sporty. My gender didn't create any problems for me, I didn't think about it in the slightest.

When puberty hit, everything has changed for the worse. A lot of teenagers, especially girls, experience his arrival very badly, but I didn't know it. 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 very strong and I felt empty.

I could no longer be part of the “boys club” so I lost my group of friends; I didn't even feel close to the girls. My mother's alcoholism had become so bad that I didn't want to bring anyone into my home. In the end, I simply found myself without any friends to invite. We started moving a lot and I had to start all over again at a lot of schools; my problems got worse and worse.

When I turned 14 I was already suffering from a severe form of 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 just played video games, obsessively listened to my favorite music, and surfed the Internet.

Something else was happening: I started to get attracted to girls. I had never seen anything positive associated with the word "lesbian" or with relationships between two women, e.g I ended up wondering if there was something wrong with me. PAround that time, my mother asked me if I wanted to be a boy: I had never even thought about it for a second, until that moment.. On the Internet I found some sites that talked about transition paths dedicated to women who want to become men. Shortly after, 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 told her that I felt like a boy, and that I wanted to become a boy.

Looking back, I realized that it was my life experiences that led me to believe that ceasing to be a woman would be beneficial. I thought that by starting hormone therapy I would become taller and not be much different from a person born a man.

I started seeing a psychologist on the UK's National Health Service, the NHS. When I was 15, because I kept saying I wanted to be a boy, I was sent to London, to the clinic's gender identity development unit. Tavistock and Portman. There I was diagnosed with gender dysphoria, a psychological 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. In reality I was a girl with a bad relationship with her body, victim of abandonment by parents, isolated from othersi, anxious, depressed, unable to accept her sexual orientation.

At 16 years old, after a series of very superficial conversations with social workers, I was given puberty blockers. A year later, I started testosterone injections. At 20, I underwent a bilateral mastectomy. At that point, I had a more masculine physical structure, a beard, and a man's voice and name: Quincy, in homage to Quincy Jones.

(Courtesy of Keira Bell)

The further I went on my transition journey, however, the more I realized that I was not a man, and that I could never become a male. These days, they tell us 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 this was not the case. As I grew up, I realized that my gender dysphoria was a symptom of my discomfort, not its cause.

Five years into my transition to becoming a man, I began a detransition process. Many trans men say it's impossible to cry with high levels of testosterone in your blood, and it was like that for me too: I couldn't let it out. I realized I was going back to being Keira when I finally managed to cry again. And I had plenty of reasons to do so.

The consequences of what happened to me were serious: probable infertility, breast amputation, inability to breastfeed, atrophied genitals, change in voice, facial hair. When they examined me at the Tavistock clinic I had so many problems that it seemed reassuring to convince myself that I only had one to solve, that of being a man trapped in a female body. It was the job of the professionals who were taking care of me to consider all my comorbidities instead of pandering to me in my naive belief that hormones and surgery would be enough to make me feel better.

Last year I sued the NHS trust dedicated to the Tavistock and Portman Foundation by opening a case of judicial review, which in Great Britain allows anyone who wishes to report a public body that has failed to fulfill its legal duties. Few judicial reviews are successful; only very few are granted an audience. Ours, however, was heard: a panel of three judges of the Supreme Court deliberated on the real capacity of the young patients of the clinic I had addressed to give truly informed and conscious consent to such burdensome medical interventions.

Bell in January 2020, after suing the clinic. (Photograph by Sam Tobin/PA Wire)

My legal team argued that Tavistock had not protected the young patients who had turned to the clinic and who, instead of taking care of each case with cautious and targeted treatments, they had used us to conduct real uncontrolled experiments. Last December, we won the case with a unanimous verdict in our favor. Judges expressed serious doubts about younger patients' ability to understand the implications of experimental treatments with lifelong consequences.

In the ruling, the judges expressed their amazement several times at what occurred in the Tavistock clinic, and above all at its inability to collect fundamental data on its patients. They found no justification for prescribing puberty-blocking drugs to children as young as 10 years of age; it is a therapy that comes almost always followed by synthetic hormones of the opposite sex, which must be administered for life to continue with 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 issues. In the two-year period 2009/2010, 77 children were sent to the gender identity development service; the 52% were male. The percentage started to change in favor of girls over the course of a few years, as the number of people referred to that service took off. In England, in the two-year period 2018/2019, were reported to the service 624 boys and 1,740 girls, 74 percent of the patients. More than half of the adolescents referred to the clinic were under 14; some had as many 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 their surprise at the specialists' failure to collect data on the age of patients given puberty blockers.

The ruling does not prevent a minor from starting a medical transition process, but the judges recommended that doctors request theapproval by a court before starting these treatments on subjects aged 16 to 17 years; declared that they were "very skeptical" about the ability of patients aged 14 or 15 to understand the consequences of the therapies and be able to give informed consent, and they defined it as "very unlikely" that it would be possible to obtain it from a subject under the age of 13 years.

The NHS said that the Tavistock clinic had “immediately suspended receiving requests for the administration of puberty blockers and synthetic opposite-sex hormones 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 goal of therapy was to allow me to “take a break” to decide whether or not I wanted to continue my transition journey. This “parenthesis of reflection” sent me on a kind of menopause, complete with hot flashes, night sweats and mental fog. Thinking clearly about what to do has become even more difficult.

After a year of treatment, when it was proposed to switch to testosterone, I immediately accepted: I wanted to feel like a young man, not like an old lady. I couldn't wait to start the injections and change. At first, testosterone filled me with self-confidence. One of its first effects was loweringI noticed my vocal timbre, which made me feel much more authoritative.

Over the course of two years, my voice got lower and lower, I grew a beard, and my body fat distributed differently. I continued to bind my breasts every day, also because I now looked like a man, but it was painful and I struggled to breathe well. At 20, I was sent to the adult clinic. Testosterone and bandages had changed my breasts and I hated them even more than before. I wanted to make the look of my body conform to that of my new face, and so 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 had stayed in contact, even though it was very contrary to my transition path. He reluctantly accompanied me to the hospital for my surgery. I was a full-fledged adult when I had the operation, and I take full responsibility for my choice, but I had been set on that path, which started with puberty blockers and moved on to testosterone and ended up with surgery, when I was just a difficult teenager. As a result of the surgery, the nerve endings in my chest were damaged: it is no longer as sensitive as before. If I ever have children, I will never be able to breastfeed them.

A year after the surgery, something new happened: I matured. I reflected on my journey, and asked myself some questions. What made me a man?

I realized how wrong my reasoning was and how much it had been influenced by statements about gender that are increasingly widespread in general culture and which have been adopted in full by Tavistock. I remembered that at 14 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 realized that I was very different from males physically. Living as trans helped me realize that I remained a woman.

I also started to understand that my life experience was based on stereotypes, and that I was trying to define my identity in a very limiting way, dressing the role of “a very masculine man”. The more I thought about it, the less it made sense. I was also worried about the effect my transition would have on my ability to find a sexual partner.

More, no one knew what the long-term consequences of my treatment would be. Puberty blockers and testosterone caused me tovaginal atrophy, 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 quit therapy immediately, overnight. I immediately canceled my appointment for the next testosterone shot.

After making this decision, I found a subreddit dedicated to those who were embarking on a detransition journey. It was increasingly popular, as if all those girls had realized together the medical scandal of which they had been victims. 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 to those who had followed the events of Tavistock e the cries of alarm of its former employees, often published anonymously. Some professionals have abandoned the service over these objections. Transgenderism, unfortunately, is highly politicized and steeped in issues related to identity politics. Asking questions or doubting the gender transitions of all these adolescents can be dangerous; whoever dared to commit this sin was covered in mud and professionally discredited.

At the Tavistock clinic, professionals provide "care based on gender self-affirmation": in practice, when a child or adolescent expresses the desire to begin a transition process, this intention is considered definitive and is usually not questioned. This model based on self-affirmation is adopted in many countries. In 2018, theAssociation of American Pediatricians He released a declaration which aimed precisely at this methodology for the care of younger patients who identify as transgender or non-conforming.

Some former Tavistock employees however mentioned the other issues from which the adolescents and children who came to the clinic seeking help were afflicted: they were victims of sexual abuse, parental abandonment, homophobia by family or classmates, suffered from depression, anxiety or attention deficit disorder or were autistic. These serious pathologies, which could include dysphoria among their symptoms, were often ignored and untreated; the transition was considered a panacea capable of curing all patients.

As the Supreme Court has noted, the effectiveness of a large part of the therapies proposed by the clinic is not supported by certain evidence. When our case was accepted, the NHS used to say the effects of puberty blockers are “completely reversible”, but recently claimed the opposite, acknowledging that “there is no data on long-term effects” of these drugs on the body and mind of a teenager. That didn't stop them from prescribing them to people like me either.

Dr. Christopher Gillberg, professor of child psychiatry in Sweden, at the University of Gothenburg and specialized in the study of autism, was summoned to our case as an expert in the field. In his testimony, Gillberg stated that in more than 45 years of experience with autistic children he had rarely encountered 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 happening from Tavistock was a “live experiment” on children and adolescents.

Parents who are reluctant or alarmed at the idea of having their children begin a transition journey come warned: “Do you prefer a dead daughter or a living son?” (Or viceversa). As a teenager, I thought about suicide. Suicidal thoughts are a symptom of serious mental problems, which require careful diagnosis and appropriate treatment. When I spoke about these thoughts at the Tavistock clinic, I was told they were all the more reason to get me started on my hormone therapy quickly and make me feel better. After the ruling, however, Tavistock released a study of 44 patients who began taking puberty blockers between the ages of 12 and 15. In the study, it is declared that the treatment did not improve the patients' mental health, and that it had no notable effect "on their psychological health, their self-harm and their self-image". Furthermore, out of 44 patients, 43 chose to switch to synthetic hormone therapy of the opposite sex. This data invites us to think that blocking puberty does not provide a break, but a further push towards the transition.

Before I started taking testosterone I was asked if I wanted to have children, or if I wanted to freeze some eggs in case the transition left me infertile. As a teenager I didn't think I wanted children, and my egg retrieval procedure wouldn't be covered by the NHS. I said not having children wouldn't be a problem, and that I didn't need to save some of my eggs. Today, however, as an adult, I realize that I had no idea about 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 himself, Tavistock had young trans people testify who were happy with the care 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 a a hypothesis that he is not considering at this moment."

Many teenagers, when they think about their future sexual relationships, feel perplexed and often even disgusted at the idea. As adults, more often than not, they will think in a completely different way. I know this very well, because it happened to me too. I had never had sex when I started my transition, so I had no idea what the journey would look like for me sexually. 

S.'s statement demonstrates how difficult it is for a minor to give consent to procedures that he cannot 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 functions will mean for the future of many of them.”

Bell speaks to the media after the sentencing last December

Today at 24 years old, I entered into my first stable relationship. My partner supports me in everything I do, and I do the same for her. She has a lot of friends who accept me for who I am, and it's been very healthy for me. Right now, I don't talk to my parents and I don't have any relationship with them.

Every now and again, I still get mistaken for a man. It's understandable, and it doesn't make me angry. I know I'll have to live with this for the rest of my life. What makes me angry is the change my body has undergone so early. Many want to know if I will have breast reconstruction surgery, or other operations to look more feminine, but I am not yet over my mastectomy. For now, I want to avoid further interventions of this type.

When I decided to participate in the cause, I didn't realize how important it would be. After the sentence, my life was filled with ups and downs. Many thanked me. Others insulted me on the Internet. If you regret the transition and talk about your experiences with it, you are labeled a bigot. You are often told that you are trying to take away rights from trans people, that children know what is best for them and their bodies, and that you are ruining the lives of innocents.

My goal is to give the best possible care to young people in difficulty. Many girls undertake the transition because they are suffering, whether from psychiatric illnesses, trauma or other reasons. I know what it means to convince yourself that transition can solve any problem.

Even though sharing my story was cathartic, I still suffer today, and have yet to receive proper therapy. I want to continue to commit to this cause. I want the message sent by cases like mine to help protect other children from going down the wrong path. This year, I helped establish the first one detransition awareness day, scheduled for March 12th. I hope that, in the coming years, this day can be a beacon of light capable of helping other people to emancipate themselves.

I don't believe in rigid rules of gender expression. Everyone should be comfortable and accepted if they choose to experiment with the way they express themselves. As I stated after the sentence, this would stop homophobia, misogyny and violence against those who are different from others.

I appeal to professionals and clinics to establish more adequate services for the treatment of mental health problems and adequate models to help those suffering from gender dysphoria. I don't want other young people as desperate, confused and alone as I was, to be pressured into believing 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)

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