What Detransitioners Taught Me About the Risks of Therapy
The Bad Feelings Experts Can Exacerbate Teens' Bad Feelings
At age nine, Chloe Cole started early puberty. By age twelve, she was uncomfortable in her body; online influencers convinced her that she was in some sense really a boy. She came out to her parents as “transgender” and, not knowing what else to do, they took her to a therapist.
“They didn’t expect that by seeing a psychologist, I would just be funneled further and further into this pipeline,” Cole told a rapt audience at AmericaFest this week.
For Chloe, that pipeline meant puberty blockers at age 12 followed by cross-sex hormones. A medically unnecessary double mastectomy at age 15. By 16, she was filled with regret.
It’s easy to see this as one more ghastly entry in the macabre chronicles of gender medicine: incompetent therapists and unethical doctors deconstructing young girls’ bodies for reasons that seem alternately depraved, mendacious and confused.
But if you take a step back from the case of the detransitioners—young women shepherded into medical transitions they later came to regret—another image emerges. Not merely of therapists’ “affirming” teens’ transgender identity, specifically. But one more instance in which the Bad Feelings experts made adolescents’ bad feelings worse.
“[My parents] didn’t expect that by seeing a psychologist, I would just be funneled further and further into this pipeline,” Cole said.
Like a lot of teen girls who suddenly adopt a transgender identity, Cole’s mental health treatment preceded her gender confusion. She had been medicated for ADHD starting at age nine or ten—given escalating levels of stimulants that made her feel lousy and disconnected from her body and didn’t seem to help. She now believes ADHD was a misdiagnosis.
“In general, this model of making everything a condition—if a child is different in any way, if they’re not focusing in school, if they’re a little bouncy in class and they won’t sit in their seat—it takes the responsibility off of the adults to say, ‘Okay, let’s just medicate them. That’ll fix the problem,’” Cole told me.
Writing my last book, Irreversible Damage, involved extensive interviews with many detransitioners and American families in general. In the course of my research, I became aware of three things: First, that unprecedented numbers of American kids were undergoing therapy or on psychiatric medication. Second, that therapists’ diagnoses were often altering adolescents’ self-understanding. And, third, that large numbers of parents had become profoundly dependent on therapists to guide their parenting and “fix” their kids.
It wasn’t only ideologically-motivated “gender therapists” who were making mischief, reifying the idea in adolescents’ minds that they were really, truly transgender. Ordinary, well-meaning therapists were doing the same, not primarily for ideological reasons. Sometimes the therapists were simply following the guidance of their accrediting organizations. But just as often, affirming the adolescent – in place of treating her – was simply par for the course. That was simply what the therapeutic relationship with the teen patient had become.
Sure, I’ll call you ‘Sebastian.’ I can see why you feel Mom’s taking away your smartphone was emotionally abusive. Losing a beloved cat can be devastating; let’s talk about coping with your grief for the next few sessions. It sounds like having to move after seventh grade was traumatic.
This model of making everything a condition—if a child is different in any way, if they’re not focusing in school … it takes the responsibility off of the adults to say, ‘Okay, let’s just medicate them, ’ Cole said.
When faced with a surly teen who isn’t yours, one you must somehow keep engaged for a potentially interminable 50-minute hour, and for whose mistakes you bear no direct emotional consequences—it’s just so easy to validate their perspective. Her mother’s decision to take away the smartphone, her pet’s death, her parents’ move—how did they make you feel? Let’s talk about your pain, every week, for years.
The rising generation is swimming in therapy. Forty two percent of Gen Z—those born between 1995 and 2012—has been in therapy (more than any other generation). Forty two percent has a mental health diagnosis. One recent survey indicates the extent of diagnosis may even be more dramatic: 60 percent of those between the ages of 18 and 26 may have been diagnosed with an anxiety disorder.
Perhaps most alarming, by 2016—long before the Covid lockdowns and well before American kids aged 2 to 8 were even on social media—almost 20% of these little ones had a diagnosed mental, behavioral, or developmental disorder.
They are receiving unprecedented levels of mental health treatment. Curiously, they also seem to be getting worse.
For well over a decade, teachers and school counselors have assumed the mandate (and curricula, and use of instructional time) to play shrink indiscriminately with kids, often styled as “Social Emotional Learning.” Parents stopped trusting their own judgment and family traditions regarding childrearing, instead relying on shrinks to guide their parenting. And we all allowed our kids’ (largely normal) bad feelings to be pathologized by the those in the bad-feelings business.
Gen Z is receiving unprecedented levels of mental health treatment. They seem only to be getting worse.
Harrison Ford made this point nicely in an interview with the Hollywood Reporter, in February of last year. A reporter had said to Ford, “Your fans online have done some armchair diagnosis, looking at things you’ve said about being shy in social situations and some of your talk show appearances. Some assume you’ve wrestled with social anxiety disorder. Are they onto something?”
“Shit,” he said. “That sounds like something a psychiatrist would say, not a casual observer.”
For the rising generation, the language of psychopathology provides the lens with which they understand themselves and each other. Where my generation would “self-diagnose” with laziness or procrastination, the rising generation might see complex post-traumatic stress disorder or ADHD.
But while laziness can be obliterated by a change of attitude and habits, a mental health diagnosis demands treatment or accommodation. Trying to lift yourself out seems futile. And so, unsurprisingly, the generation lavishly labeled with mental health diagnoses also has the least faith in its ability to meet even routine challenges or turn their lives around.
“No. I don’t have a social anxiety disorder,” Harrison Ford told the reporter. “I have an abhorrence of boring situations. I was shy when I first went onstage—I wasn’t shy, I was fucking terrified. My knees would shad so badly, you could see it from the back of the theater. But that’s not social anxiety. That’s being unfamiliar with the territory. I was able to talk myself through that and then enjoy the experience of being onstage and telling a story with collaborators.”
“No. I don’t have a social anxiety disorder,” Harrison Ford told the reporter. “I have an abhorrence of boring situations. I was shy when I first went onstage. But that’s not social anxiety.”
A case of the fantods. To overcome those, Harrison Ford didn’t require an expert or a prescription. He needed only to summon the guts.
Imagine if he’d been born in 2012 instead of 1942.
Pre-Order my new book, BAD THERAPY: Why the Kids Aren’t Growing Up.