âąÂ LINK: Sexchange at Pattaya is a new section of their commercial site. http://www.pattaya-inter-hospital.co.th/service_sexchg.html
Ellie Zara Ley (born ~1973) is a Mexican-American surgeon. She performs gender surgeries with the Gender Confirmation Center in California.
Background
Ley was born in San Luis, Sonora. She received treatment as a child in the US for a medical condition. She earned bachelor’s degrees in Spanish literature and biochemistry from University of Arizona in 1995. She earned her medical degree from the medical school of Universidad AutĂłnoma de Guadalajara in 2000, then returned to the United States to work at New York Medical College and at University of Arizona. Following her fellowship in pediatric craniofacial plastic surgery at Primary Childrenâs Medical Center in Utah, she trained at UCLA in hand and microsurgery. She then returned to the University of Utah for a fellowship in plastic and reconstructive surgery.
She founded the LEY Institute of Plastic & Hand Surgery before joining Toby R. Meltzer at The Meltzer Clinic in Arizona. In 2022 she joined the Gender Confirmation Center with Scott Mosser. She is licensed to practice in Arizona, California, Oregon, and Utah.
Gender identity and expression take on different meanings within different systems of thought. Because medical technologies are available to assist in the somatic expression of these identities, several medicalized disease models of the phenomena have developed. This article examines three disease models as typically applied to those who seek feminization:
The GID model is currently considered legitimate within psychological literature and is a required diagnosis to receive access to trans health services in many places. The author reviews several problems with mental illness models, including âchildhood gender nonconformityâ and âtransvestic fetishism,â two other âmental disordersâ currently considered legitimate diagnoses. The article makes several analogies, asking readers to consider whether âracial nonconformityâ or âreligious identity disorderâ seem legitimate as well.
Pathology (âbirth defectâ model)
This third metaphor of impairment describes a physical disorder rather than a mental one. The âorderâ implied by positioning these traits and behaviors as diseases reinforces heteronormative hierarchies. These models use scientific-sounding terminology to reinforce the social belief that the âpurposeâ or âfunctionâ of sex and sexuality is procreation. This leads to an examination of historic problems with anatomical thresholds for determining sex. The author then draws parallels with other bioethical debates about technologies that disrupt the ânaturalâ order of procreative sexuality. Interest in feminization is stigmatized in many cultures, and the article concludes with some suggestions for ways to consider it independently from models of sin or disease.
Authorâs note: This personal viewpoint is not intended to be representative of any side or group participating in these discussions.
Download a printer-friendly version: A defining moment in our history (PDF)
Introduction Interest in feminization, historically revered or feared, has benefited from advances in science that expand possibilities for its physical expression. These advances led to scientific models of gender variance, which were positioned as objective alternatives to the judgmental âsinâ models promoted by some religions. Unfortunately, some allegedly scientific models being used merely replace metaphors of sin with metaphors of disease and impairment, rather than using objective scientific language. The time has come to examine these judgmental models: the assumptions behind their definitions, how they masquerade as science, their roots in eugenics, their impact on our access to health services, and their political implications.
The most insidious disease model appears at first glance to be progressive, even liberal, but on closer examination, it views gender variant behavior in children and adults as a psychosexual pathology (a fancy way of saying itâs a sex-fueled mental illness). Though the idea has been around since the 19th century, new language for this âdisorderâ was proposed by Ray Blanchard (1989) and restated by Anne Lawrence (1997) and J. Michael Bailey (2003). Though the Bailey-Blanchard-Lawrence (BBL) model claims to be non-judgmental in a moral sense, it is undeniably judgmental in suggesting gender variance is a disease.
These old school sexologists still use terminology based on century-old ideas about gender-variant behavior as a sex-fueled disease. Their definitions tangle up several distinct threads about sex and sexuality in our community. Inflammatory language about transwomen like âman who would be queen,â 1 âman without a penis,â 2 or âmen trapped in menâs bodiesâ 3has led to responses in kind about BBL and their apologists, but thankfully, such polemics are now limited to shrill but secluded fringes of discussions about untangling the mess theyâve made.
Definitions and thresholds
Scientific language evolves with understanding, and scientific discussions require that words be used with scientific precision. In short, definitions matter. A definition simultaneously includes and excludes. It affects how people view our community, especially those who expose problems with existing definitions. BBL and their apologists mock the evolution of definitions and ideas as âpolitically correct,â 4, 5, 6, 7 a term used by guardians of convention that signals a lack of intellect and contempt for scientific progress. For instance, Lawrenceâs opening salvo brags of being one of the âtroublesome people who are inclined to doubt the conventional wisdomâ about transgender eroticism, then just ten sentences later defends Blanchardâs use of the inaccurate and offensive term âhomosexual transsexualâ because it is âconventional usage in the psychiatric literature.â 8 [emphasis mine]
Specialized definitions for many words in this debate evolved within separate institutional realms. Though used differently, a term as defined in one field influences another field, especially as we see attempts to merge biology, psychology, law, and medicine into biopolitics. 9 Within the current medico-juridical system, clinical thresholds affect legal thresholds and vice versa.
Imprecise and idiosyncratic definitions plague this debate. The BBL model declares transsexual women are men with one of two sexual desires: âhomosexualâ (males aroused by males) and âautogynephilicâ (males aroused by the thought or image of themselves as women). Both categories efface our identities as women, but âautogynephiliaâ is more problematic in many ways. One major problem is the tendency for some who embrace the term to look at the etymology and think it denotes an innocent and happy form of feminist self-esteem: âI love myself as a woman!â theyâll say. I do too, but thatâs not what this word denotes. When I say, ââAutogynephiliaâ is defined by its creator as a type of paraphilia,â some say, âWell, thatâs not how I use it.â Thatâs like saying someone is a pedophile because she loves children, or that someone is a zoophile because he loves his pets. Those terms are clinical and legal descriptors. Yes, âpedophileâ literally means âlove of childrenâ in Greek, and âautogynephileâ means âlove of self as woman,â but both terms are inexorably linked to their clinical origins as psychosexual pathologies.
Calling oneself or others âautogynephilicâ is participating in oneâs own pathologization, and it legitimizes this fake disease when people claim they donât have it. BBL are engaging in scientific McCarthyism, where they claim a hallmark of âautogynephiliaâ is that those afflicted will deny it. Any refutation becomes proof they are right, a no-win situation like asking âwhen did you stop beating your wife?â
When we say âautogynephiliaâ is a made-up disease, some mistakenly think we are claiming erotic interest in feminization is made-up, too. Obviously, this exists. Many women in our community have been very open and honest about their erotic interest, 10 yet still take issue with labeling it a disease. 11
Sex and sexuality
My response to âsexologyâ is similar to how a person of color might respond to âraceology.â I question anyone who seeks to draw bright lines between nuanced possibilities of sex and sexuality, especially when they claim their attempt is science instead of something arbitrary and subjective. Trying to map a scientific schema onto complex traits and behaviors is like turning an impressionist painting into a paint-by-numbers. Those who fear miscegenation of the sexes or sexualities are just like those racists who use âscienceâ to reinforce socially constructed categories of ethnicity. As Anne Fausto-Sterling notes, âLabeling someone a man or a woman is a social decision. We may use scientific knowledge to help us make the decision, but only our beliefs about genderânot scienceâcan define our sex. Furthermore, our beliefs about gender affect what kinds of knowledge scientists produce about sex in the first place.â 12
What kinds of knowledge about sex are BBL producing? They claim variously that homosexuality appears to be an evolutionary mistake 13 and a âdevelopmental errorâ 14, and gender variance is a âdefect in a manâs sexual learning,â 15 and a âsexual problem.â 16 It makes sense that a doctor would choose a disease metaphor and psychologists would use a mental disorder model to describe their observations and impressions. If we have a disorder, then what is the âorderâ to which they adhere? They imply the âpurposeâ and âfunctionâ of sex and sex organs is procreation. Why, itâs so obviously true that the belief shouldnât even be examined, right? According to people who believe this overly simplified idea, males have evolved (or were designed) to be attracted to females, and vice versa. In their worldviews, anything that deviates from that is, well, deviant.
Well, to borrow a phrase, a few troublesome people are inclined to doubt this conventional wisdom. 17 Many of us question Lawrenceâs claim that sexual desire is âthat which moves us most.â 18 We point to our experiences and feel our identities are what drive us; Wyndzen shows psychology supports our recognition of how powerful a force âidentityâ can be. 19 We even question some passages of Darwin and the Bible (at the same time, no less!). BBL get very upset when highly respected evolutionary biologists like Roughgarden 20 or Gould 21 question their most deeply-held beliefs about sexual selection and human behavior.
Eugenics, genetics, degenerates, gender
The words âeugenics,â âgenetics,â âdegenerates,â and âgenderâ all derive from the same Greek root meaning âto produce or bring forth life.â Some sciences and some religions seek to explain our genesis and control our reproduction of subsequent generations. New reproductive technologies are ushering in a host of bioethical issues and raising the specter of a new wave of eugenics, where the genocide (another related word) will happen before or shortly after conception, after genetic material is screened for âundesirableâ traits. Should people with Down Syndrome or dwarfism be eliminated from the gene pool? How about intersexed people? If Baileyâs colleagues find the âgay gene,â 22 should we wipe out sexual minorities, too? What about gender minorities? Will we see a âtransgenocideâ? Who decides whatâs a disease or a degeneracy?
As evidenced by BBLâs metaphors of disorder and disease, people can only express ideas in the language they have available. Their models of sex and sexuality originated with doctors and criminologists in the late 19th century eugenics movement, and BBLâs ideas havenât evolved much from the influential works that shape their thinking. After Darwinâs Origin of the Species (1859) came Francis Galtonâs Hereditary Genius (1869). Following ideas in that book, Galton coined the term âeugenicsâ in 1883, which melded with the emerging fields of criminology and sexology. Though the term âeugenicsâ is now rightfully associated with Nazism, a few modern adherents hope to usher in an âAge of Galton.â Bailey and Blanchard are charter members of a conservative-run eugenics discussion group devoted to this pursuit. 23
Three physicians who were Galton contemporaries are central to the BBL worldview: Richard Freiherr von Krafft-Ebing, who wrote Psychopathia Sexualis (1886); Havelock Ellis, who wrote The Criminal (1889) and Sexual Inversion (1897); and Magnus Hirschfeld (coiner of both âtransvestiteâ and âtranssexualâ), who in 1897 founded Germanyâs Scientific Humanitarian Committee, whose motto was âjustice through science.â Like BBL, these doctors genuinely believed that social ostracism of sexual minorities would be eliminated through science, but we all know what happened next in Germany. These doctorsâ âscientificâ models were imbued with eugenic paternalism (they believed homosexuals had a pathology and were unfit for procreation), and they claimed those who engaged in non-procreative sex were biologically different. By mid-century, Hirschfeldâs institute had been destroyed, and persecuted minorities had been rounded up and murdered based on âscientificâ models that claimed groups like Jews, gays, and other persecuted minorities were âdegenerate,â biologically distinct, and a threat to âsocial hygiene.â
Lest we think this is an isolated phenomenon that only happened in Nazi Germany, in America, disability and race took center stage in the eugenics movement, 24 which focused on sterilization and birth control for the âunfit.â 25 In Canada during the same period, the focus was immigrants, and the method of control was psychiatry. A physician named Charles Kirk Clarke oversaw the two largest Canadian asylums before accepting Canadaâs top mental-health post. Clarke advocated eugenic policies to limit the immigration and marriage of the âdefective.â He also used psychiatric diagnoses to incarcerate new citizens. Foreign-born patients were 50% of his institutionalized population, including political activists, homosexuals, and other âdefectives.â 26
Clarkeâs sociobiological leanings are still alive and well at the institution named after him, The Clarke Institute in Toronto, where Ray Blanchard works. 27 There, Kurt Freund and Blanchard used Freundâs controversial plethysmograph to delineate deviance. 28 Though the quack device is just a lie detector for the penis (open to manipulation and interpretation by both subject and observer), they used it extensively to separate homosexual from ânon-homosexual,â and later to do sex experiments on âmale gender dysphorics, paedophiles , and fetishists,â which they lumped together, yet divided into homosexual and ânon-homosexual.â 29
In historic diagnoses for sex problems, homosexuality and masturbation were âdiseasesâ that could strike either sex, but other problems were gendered degeneracy: women who had âtoo muchâ interest in straight sex had the now-discredited disease ânymphomania,â while men who had âtoo littleâ interest in it were inverts or perverts, a still legitimate disease category called âparaphilia.â
Dysphoria, disease, disorder, disability, defect
According to my medical records, I am mentally ill. The psychiatry industryâs Diagnostic and Statistical Manual of Mental Disorders (DSM) alleges that I am afflicted with âgender identity disorderâ (GID). Before that, I had âchildhood gender nonconformity,â from their special âkidsâ menuâ of mental disorders. Others with an interest in feminization get diagnosed with the âdisorderâ of âtransvestic fetishism.â 30 For many years, some in our community have relied on mental illness models as a form of validation. I ascribe to the view that âpsychiatric diagnoses are stigmatizing labels, phrased to resemble medical diagnoses and applied to persons whose behavior annoys or offends others. âMental illnessâ is not something a person has, but is something [a person] does or is.â 31
I suppose I had a âdis-ease,â an uneasiness, a dysphoria about the sorts of social and sexual expression I was allowed in the gender roles assigned to me at birth. I did not conform until it became clear in 7th grade that the other option was ever-increasing ostracism and violence, but since when is non-conformity a disease? Imagine a mental illness diagnosis for âracial nonconformityâ or âreligious identity disorder.â
Disease models affect the kinds of knowledge produced by those who use them. Bem called sex researchersâ preoccupation with the causes of homosexuality âscientifically misconceived and politically suspectâ because embedded in their preoccupation with causality is the idea that something went wrong that needs to be diagnosed and fixed. 32 The situation is no different when we look at how sex researchers study transgender persons. BBL are what Ordover calls âbiological apologistsâ who look to the body for absolute truths. A major medicalization of homosexuality occurred in the 1990s, in response to AIDS (a disease which led to renewed interest in a âgay geneâ and later a âgay germâ disease model of homosexuality). 33 While Bailey was drawing federal funds to isolate homosexuality the way others looked for HIV, nobody was looking for the âstraight geneâ or âstraight germ.â Like a good eugenicist who believes biology is destiny and genetics dictate human behavior, Bailey started linking gender roles to genetic discussions: âchildhood gender nonconformity does not appear to be an indicator of genetic loading for homosexuality.â 34 Is gender genetic?
Despite these problems, many in our community embrace a disease metaphor. Lawrence intones about âsymptomsâ of transsexualism, its âclinical course,â the benefits of âpalliative treatment.â 35 Lawrence then magnanimously claims that âeveryone has a right to self-define,â yet asserts that those who disagree with Lawrenceâs diagnosis arenât being very honest with themselves or others. A âpalliative treatmentâ helps symptoms while leaving the disease uncured, and the uncured disease can be a personal and political identity. In her important series of scientific criticisms of Blanchard, Wyndzen cites studies on self-verification where people âassimilated their illnesses into their identities.â 36 Almost everyone who is attracted to the concept of âautogynephiliaâ identifies through metaphors of impairment. Many participants in the main ââautogynephiliaâ supportâ newsgroup are on public assistance, which seems related to their fears about removal of gender variance from the DSM. They fear subsidized medical services will be denied if there is no mental illness classification. But what do they think will happen if there is differential diagnosis that claims their subgroup does all this to indulge an autoerotic interest? Should insurance companies give out high heels as âpalliative treatmentâ for shoe fetishists?
As Lawrence notes, âThere are many human behaviors that look like the same thing, but really aren’t.â 37 Previous medical attempts to catalogue behavior like Lawrenceâs were not only pathologizing, but insulting: People like Lawrence were âtransvestitic applicants for sex reassignmentâ 38 who are âagingâ 39 and âdistressed,â 40 suffering from âpseudotranssexualismâ 41 a ânon-transsexualâ variant of âgender identity disorderâ (GIDAANT), 42 and âiatrogenic artifact.â 43 Many notable âborderlineâ cases are doctors: Renee Richards, Anne Lawrence, Gregory/Gloria Hemingway. They may epitomize these published observations. They all self-treated, vacillated, and âdetransitionedâ to varying degrees, and all three challenge existing diagnostic categories. 44 If interest in feminization is an iatrogenic artifact (a disease made up by doctors), wouldnât doctors be the best evidence of that? Further, why would Dr. Marci Bowers transition without incident in the same hospital group that forced Anne Lawrence to resign? Do they really have the same âdiseaseâ? I have never heard Dr. Bowers have to assert sheâs a ârealâ transsexual, as Dr. Lawrence has.
I do not defer to people just because they are clinicians. My work fighting quacks and consumer fraud has put me in touch with countless âexpertsâ who have no business in science or medicine. Some âexpertâ will probably diagnose my questioning âexpertsâ as âauthority nonconformityâ or some other made-up disease to undermine my credibility. After all, my questioning the legitimacy of âautogynephiliaâ is evidence Iâm afflicted with it. To refute that kind of argument, we need to contextualize the term. âParaphiliaâ and âautogynephiliaâ
The term âparaphiliaâ first appeared in 1923, in a book prepared for doctors and criminologists by physician Wilhelm Stekel. 45 Over eighty years later, BBL collaborator Simon LeVay still calls paraphilias âillnesses that need treatment.â 46 âParaphiliaâ is the psychiatric term for problematic sexual desire or behavior. The current name for this alleged mental disorder first appeared in the DSM in 1980. 47 It describes âparaphiliaâ as ârecurrent, intense sexually arousing fantasies, sexual urges, or behaviors involving (1) nonhuman objects (2) the suffering or humiliation of oneself or one’s partner, or (3) children or other non-consenting personsâŠ. The behavior, sexual urges or fantasies cause clinically significant distress in social, occupational, or other important areas of functioningâ 48
Some people who identify with the diagnosis of âautogynephiliaâ chime in at this point and say, âWell, then I donât have a paraphilia, because I donât think I have a problem.â The most recent version of DSM was revised just for themâit says this illness can be diagnosed even if the person does not experience any subjective distress or impaired functioning. 49 LeVay notes: âThis is quite a significant shift; it emphasizes that psychiatrists may go beyond responding to clients’ complaints and may use their expertise for other purposes, such as protecting society from sex crimes.â 50
âAutogynephiliaâ is not a behavioral model, it describes a sex-fueled mental illness that lumps gender variance in with sex crimes. BBL believe that paraphilias cluster, meaning that they believe that âautogynephilesâ are more likely to be aroused by children, corpses, excrement and other illegal and socially unacceptable things. This diagnosis was widely ignored after Blanchard first suggested it in the Journal of Nervous and Mental Disease in 1989. 51 By the end of his series of papers, Blanchard was shoehorning other behaviors into his model with crackpot variants like âpartial autogynephilia.â 52 However, Blanchard and his colleagues had enough influence in this rarely-studied subspecialty to get âautogynephiliaâ mentioned in the DSM. 53 The work would have remained an obscure intradisciplinary skirmish until Lawrence found Blanchardâs articles in 1997, during a time of great need. A year earlier, Lawrenceâs erotic interest in ritualized genital modification led to indulging that interest. 54 Lawrence had taken âphysician, heal thyselfâ to heart previously, and after yet another failed âcureâ in the form of vaginoplasty, Lawrenceâs fascination did not wane. In 1997, a lack of social acceptance at work (described in one account as âbizarre behaviorâ) 55 and an incident where Lawrence examined an unconscious patient for signs of ritualized genital modification ended a respected career. 56 Discovering Blanchard was clearly revelatory for Lawrence, who now had a diagnosis to explain what happened. Suddenly, this forgotten diagnosis had a vocal and influential champion. I dismantle the pseudoscience behind âautogynephiliaâ in a longer essay elsewhere. 57
A scientific or reasonable discussion of âautogynephiliaâ is like a scientific discussion of horoscopes: thereâs no science to discuss, only pseudoscience. Yes, both concepts exist, but that does not mean either are legitimate science. Some people have a need to create an identity based on a worldview where people are predictable based on vague, unproven categories that arbitrarily assign traits to everyone, imposing order onto an unpredictable and incomprehensibly complex world.
âTranssexualâ defined
BBL have proposed several definitions for âtranssexualâ that include people not previously considered within that definition. Their definitions view gender variance through the lens of disordered sexual desire. Bailey defines âtranssexualâ as anyone who has âthe desire to become a member of the opposite sex.â 58 They do not have to act on this desireââonly serious thoughtsâ are enough to qualify. 59 This model reflects Baileyâs definitions of sexual orientation: someone is a homosexual whether they act on their desire or not. Lawrence believes transsexuality is âfundamentally about changing one’s anatomy, or sex; and that sometimes it may have little to do with gender identity, or with gender role.â 60 Some do this ânot primarily because they have a gender problem, but because they have a sex problem, and indeed a sexual problem⊠the expression of a paraphiliaâ 61Blanchard says heâs reluctant to label children as âtranssexual,â 62 which is reminiscent of the âpre-homosexualâ language used by his homophobic counterparts in âgay cureâ groups like NARTH. 63 Blanchardâs colleague Ken Zucker is a vocal advocate of reparative therapy for gender-variant children, and he considers transsexuality âa bad outcome.â64 In fact, Bailey has noted that unchecked, this disease could spread: a world tolerant of gender-variant children âmight well come with the cost of more transsexual adults.â 65
Echoing Lawrenceâs strict anatomical construction of âtranssexual,â a quaint aphorism claims, âIf you arenât a transsexual before surgery, you are after.â Really? What about David Reimer or others surgically altered as children who do not identify as transsexual? 66 Conflicting definitions occur within any demographic grouping. Extremist separatists from both sides of any constructed binary often create unlikely alliances: for instance, âpeople of colorâ and âAfrican-Americanâ are terms debated by both ethnic separatists and conservatives. 67 In our community, pluralist concepts like âqueerâ or âtransgenderâ are debated in circles where distinctions between gay men and transwomen, or between crossdressing and transsexualism, are very important.
Lawrence insists the few who embrace this diagnosis âdo not declare ourselves sick.â 68 Not morally sick, anyway, but physically sick. Lawrenceâs self-descriptions have remarkable parallels with descriptions of binge-and-purge cycles among crossdressers who hate their behavior, or those âafflictedâ with âunwanted homosexualityâ: âThe loneliness and disconnection from others that typically accompany autogynephilia [sic] are a large part of what makes this condition feel like genuine paraphilia (i.e., a âdisorderâ) to many of us who experience it (and I’m including myself here) and not merely a âbenign variantâ form of human sexuality.â 69 Swap âautogynephiliaâ with the word âhomosexuality,â and Lawrenceâs comment would feel right at home in a NARTH publication. Lawrenceâs âproblemâ is not self-love, but self-hate.
For those of us who view âgenderâ and âsexâ as socially constructed, transsexualism canât be separated from its social component. Phenotype can trump genotype; gender expression can trump anatomy. Those who need to use anatomy as evidence of their identity have failed in gaining acceptance within a social or institutional framework. Everyone has a right to self-identify, but if others donât accept that proclaimed identity, we must either accept their lack of acceptance, or work to change their minds. People can legislate rights, but not acceptance. That has to be earned.
Audre Lorde said âYour silence will not protect you.â 70 I say your anatomy will not protect you, either. Legal and medical models based on anatomical benchmarks for âmaleâ and âfemaleâ will inevitably conflict and fail. Sexists who wish to efface the identities of women like me can always find a physiological or behavioral reason to say I am ââreallyâ a man,â and some of the worst offenders are âhelping professionalsâ and people in our community. They echo the racists who came up with âscientificâ schemes to determine who was ââreallyâ black,â or heterosexists like BBL who create ways to determine who is ââreallyâ gay.â
Gatekeeping versus services on demand
Much of my early activism was informed by sex-positive, pro-choice feminism. We passed out condoms and âJust Say Yesâ sex-ed books at Chicago Public Schools, and we defended clinics from Operation Rescue. One of our major initiatives was family planning services (including abortion) that were âsafe, free and on demand.â I have always seen parallels between family planning and transition-related medical services, both of which were once only available through back alley clinics and black market sources. Women in our community died from this, and still die from illegal and unregulated products and procedures because of our legal status. I believe controlling our bodies is a fundamental human right. If someone wishes to undergo a vasectomy, vaginal rejuvenation, abortion, facial tattoo, piercings, tongue splittings, facial feminization, breast implants, mastectomy etc., I believe these procedures should be available to anyone who is willing to sign a release. I find it quite telling that our surgical procedures and abortion both face similar challenges, since both involve altering oneâs capacity to reproduce.
Psychiatric gatekeeping only works for those who are unwilling or unable to find easier and faster ways. Before the internet, most young people got what they needed through extralegal networks (many poor people still do), and anyone who had the means would skip gatekeeping altogether and jet off to an exotic locale, as it had been done for many years before the gender clinics began imposing controls. At the apex of the gender clinic system, only those willing to endure a process akin to criminals at a parole hearing took that routeâpeople who would say whatever the gatekeeper wanted to hear in order to get what they desired. 71 Ironically, many who tried to get around gatekeeping during their own involvement now insist it remain in place. 72 Lawrence, who is fond of quoting Audre Lorde, 73 must have missed âThe masterâs tools will never dismantle the masterâs house.â 74 Gatekeeping also appeals to those who donât get much validation except from gatekeepers. The acceptance letter becomes about the only acceptance they get. Not only is getting a vagina a status symbol and evidence of identity for this tiny group, but âbeating the systemâ is a status symbol, too (which might also explain the correlation between online ââautogynephiliaâ supportâ and welfare support).
I should note that I had a great therapist who helped me immensely. I probably would have gone even without being required. Therapy and support should be encouraged, but voluntary, and without the stigma of disease, in the way that someone questioning their spiritual beliefs might find therapy helpful without needing their spiritual journey labeled as a âreligious identity disorder.â With gatekeeping, we end up with people like BBL controlling access to services in exchange for money or sex. âSexologyâ is an unregulated activity in most states, meaning anyone could set up shop as a sexologist or sex therapist. Bailey, Lawrence, and others have all used their âsexologistâ credentials to gain easier access to sex partners. Some dismiss this as OK because they sign our little permission slips so we can get medical services. Call me old-fashioned, but I donât feel itâs ethical or scientific for gatekeepers and sex researchers to have sex with clients and research subjects. I also donât want my tax dollars federally subsidizing the sex life of a self-hating [trans]-chaser like Bailey, so he can meet women like me and later claim we âhave the brains of men but the genitals of womenâ 75 or are prone to criminal activity and sexual promiscuity.
Hereâs my question: why not cut out these middlemen and simply request and receive services? If people go to their physician and say they are depressed or anxious, the doctor believes their self-report and suggests options. Why canât it be that simple for us?
Replacing GID as the principal diagnostic means for obtaining medical service is considered a top health priority in our community. Citing a progressive San Francisco program, the National Coalition for LGBT Health states: âThere is a great need for more such programs that avoid GID as a requirement for access⊠this [requirement] results in many transgender people avoiding the psychiatric diagnosis process altogether, and not accessing medically regulated Trans Health Services.â 76 The interest itself isnât the problem, itâs the anxiety and depression caused by depriving its expression. 77 If in some cases hormones and surgery help relieve anxiety and depression, they should be available as an effective, time-tested option.
Roughgarden notes: âTheir bogus categories and made-up diseases are intended to subordinate, not to describe.â 78 Until we get away from this childlike dependence and deference to so-called âexpertsâ simply because they take our money or donât kick us out of their offices, our accommodation in healthcare and law will not be fully realized.
Beyond BBL
People like BBL rarely admit they are wrong, because they are very concerned about their academic legacy (which mirrors their beliefs about offspring). They will spend the rest of their lives fighting tooth and nail to defend their words and actions, but in the end BBL will be regarded as an interesting curiosity from the waning years when our community was considered disordered and diseased because of our interest in feminization, in whatever form that interest might take. Luckily, we donât have to convince them they are wrong; we just have to convince everyone else.
We need to embrace judgment-free models to describe these phenomena. I hereby suggest the phrase that leads off this article: interest in feminization (IF) and the subset erotic interest in feminization (EIF) as umbrella terms without the stigma of disease. It encompasses not only our community, but anyone regardless of motivation, affectional orientation, or gender assigned at birth. Change âFâ to âMâ in the acronym for the F to M folks. I can think of a laundry list of problems with this proposed terminology, but this article is part of an ongoing evolution of ideas. Iâll leave the definitive statements to those who fancy themselves âexpertsâ who claim they know âthe truth.â My thoughts here wonât be the end of old ways of thinking, but with luck, it will spark some new ones, where we describe ourselves and our identities without the stigma of sin and disease.
From the day in April 2003 when Professor Lynn Conway began an investigation into Baileyâs book, 79 it was clear that this was a defining moment for our community. We mobilized all around the world as never before. 80 We made sure this book did not become another Transsexual Empire. 81 BBL underestimated everything about us, from our numbers, 82 to our intelligence, 83 to our ever-strengthening network, to the direct contact we have with our youngest and most vulnerable, to our influential positions in every career and profession, to our ability to effect positive change. 84 This isnât just evolution, itâs revolution. Weâre replacing sin and disease with pride and strength, and this is only the beginning.
Los Angeles September 2004
Acknowledgments
The author would like to thank Drs. Madeline Wyndzen and Nancy Ordover for key insights and research that informed this article.
References and notes
Please note: Anne Lawrence is notorious for removing website materials as soon as comments in them become difficult to defend. While every effort has been made to keep up-to-date links, some materials may no longer be available online.
4. Lawrence AA (2000). Sexuality and transsexuality: A new introduction to autogynephilia [sic] http://www.annelawrence.com/autogynephilia.htmlÂ
5. Pinnel R (2003). Gay, straight, or lying? Science has the answer. Joseph Henry Press sales materials for The Man Who Would Be Queen. http://www.jhpress.org/press_release/10530.pdf [archive]
6. Petersen M (2003). Resignation letter to HBIGDA, 4 November 2003. http://www.tsroadmap.com/info/maxine-petersen.html
16 Lawrence AA (1999). Lessons from autogynephiles [sic]: eroticism, motivation, and the Standards of Care. http://www.annelawrence.com/1999hbigda1.html
23 Bierich H, Moser B (2003). Queer science: An âeliteâ cadre of scientists and journalists tries to turn back the clock on sex, gender and race. SPLC Intelligence Report, Winter 2003. http://www.splcenter.org/intel/intelreport/article.jsp?sid=96 Sailer founded the group on 3 March 1999; Bailey and Blanchard both joined on 4 March. Like early eugenicists, this group advocates what they believe is a âbenignâ form of eugenics called positive eugenics, where âgoodâ traits are encouraged, but this inevitably leads to negative eugenics, where âbadâ traits are eliminated. For a Whoâs Who of the modern eugenics movement, see the full list at: http://www.tsroadmap.com/info/human-biodiversity.html
25 Buck v. Bell, 274 U.S., 200, 207 [1927]: Associate Justice Holmes: âIt is better for all the world, if instead of waiting to execute degenerate offspring for crime, or to let them starve for their imbecility, society can prevent those who are manifestly unfit from continuing their kind. The principle that sustains compulsory vaccination is broad enough to cover cutting the Fallopian tubes.â http://www.dnalc.org/resources/buckvbell.html (click “Court’s decision” and see page 3 for full text)
45 Stekel W (1923). Der Fetischismus dargestellt fĂŒr Ărzte und Kriminalogen. Störungen des Trieb- und Affektlebens (die parapathischen Erkrankungen) 7. [Volume 7: The fetishes, prepared for doctors and criminologists. Disorders of the Instincts and the Emotions (the parapathic illnesses)] Berlin/Wien: Urban & Schwarzenberg, 1923. First English translation by S. Parker as Sexual Aberrations. 1930 Liveright Publishing, New York. http://www.amazon.com/exec/obidos/tg/detail/-/0871400499/qid=1094416834/sr=1-1/ref=sr_1_1/002-8778638-7938457?v=glance&s=books
62 Federoff JP, Blanchard R (2000). The case for and against publicly funded transsexual surgery. Psychiatry Rounds, April 2000. http://www.tsroadmap.com/info/psychiatry_rounds.pdf
63 Byrd AD (2004). Book review: The Man Who Would Be Queen. via NARTH (National Association for Research and Therapy of Homosexuality) e.g. âBailey’s focus on femininity among pre-homosexual boys and homosexual men…â http://www.narth.com/docs/queen.html
64 Bailey JM (2003). The Man Who Would Be Queen, p. 31. http://books.nap.edu/books/0309084180/html/31.html
65 Ibid. p. 33. http://books.nap.edu/books/0309084180/html/33.html
66 Colapinto J (2001). As Nature Made Him: The Boy Who Was Raised as a Girl. Perennial. As I discuss in my essay âWannabes?â, transsexual women seek medical options to confirm their identities as women; others seek them to confirm their identities as transsexuals. Differential diagnosis appeals to some people who wish to be distinguished from or included with a group of people. Some people who seek bodily feminization base their evidence of inclusion on these procedures and use the disparaging term âjust a crossdresser,â as if that is a less legitimate interest or identity. http://www.tsroadmap.com/info/wannabes.html
67 Swarns RL (2004). âAfrican-Americanâ becomes a term for debate. New York Times, 29 August 2004. http://query.nytimes.com/gst/abstract.html?res=F60614FA345A0C7A8EDDA10894DC404482
68 Lawrence AA (2000). Sexuality and transsexuality: A new introduction to autogynephilia [sic]. http://www.annelawrence.com/autogynephilia.html
69 Lawrence AA (2004). Posted as âautogynephile1,â 25 August 2004. http://groups.yahoo.com/group/autogynephiliasupport/message/3682
70 Lorde A (1984). The transformation of silence into language and action. Sister Outsider. The Crossing Press. p. 41. http://www.amazon.com/exec/obidos/tg/detail/-/0895941414/qid=1094418917/sr=8-1/ref=pd_ka_1/002-8778638-7938457?v=glance&s=books&n=507846
71 Bornstein K (1995). Gender Outlaw: On Men, Women, and the Rest of Us. New York: Vintage Books. e.g.: âTranssexuality is the only condition in Western culture for which the therapy is to lie.â http://www.amazon.com/exec/obidos/ASIN/0679757015/qid=1094418971/sr=ka-1/ref=pd_ka_1/002-8778638-7938457
72 Lawrence AA (1998). Absence of regrets after a âshort real-life test.â http://www.annelawrence.com/shortrlt.htmlÂ
73 Lawrence AA (1999). Autogynephilia [sic]: Frequently-asked questions. http://www.annelawrence.com/agfaqs.html
74 Lorde A (1984). The masterâs tools will never dismantle the masterâs house. Sister Outsider. The Crossing Press. p. 110. http://www.amazon.com/exec/obidos/tg/detail/-/0895941414/qid=1094418917/sr=8-1/ref=pd_ka_1/002-8778638-7938457?v=glance&s=books&n=507846
75 Tremmel PV (2003). Study suggests difference between female and male sexuality. Northwestern University press release, 12 June 2003. http://www.eurekalert.org/pub_releases/2003-06/nu-ssd061203.php
76 National Coalition for LGBT Health (2004). An overview of U.S. Trans Health Priorities. August 2004 update. http://www.lgbthealth.net/TransHealthPriorities.pdf (requires reader)
77 Vitale A (1997). Gender dysphoria: Treatment limits and options. http://www.avitale.com/treatmentoptions.htm
78 Roughgarden J (2004). The Bailey affair: Psychology perverted. http://ai.eecs.umich.edu/people/conway/TS/Reviews/Psychology%20Perverted%20-%20by%20Joan%20Roughgarden.htm
79 Conway L (2003-2004). An investigation into the publication of J. Michael Bailey’s book on transsexualism by the National Academies. http://ai.eecs.umich.edu/people/conway/TS/LynnsReviewOfBaileysBook.html
80 Burns C and 1,460 signatories (2004). J. Michael Bailey book petition. http://www.petitiononline.com/bailey/petition.html
81 Allison R (1998). Janice Raymond and autogynephilia [sic]. http://www.drbecky.com/raymond.html Reviewing Raymond JG. The Transsexual Empire: The Making of the She-Male. Beacon Press, 1979. http://www.amazon.com/exec/obidos/tg/detail/-/0807021644/qid=1094430439/sr=8-4/ref=sr_8_xs_ap_i4_xgl14/002-8778638-7938457?v=glance&s=books&n=507846
82 Conway L (2002). How frequently does transsexualism occur? http://ai.eecs.umich.edu/people/conway/TS/TSprevalence.html
83. Bailey JM (2003). The Man Who Would Be Queen, p. 179. http://books.nap.edu/books/0309084180/html/179.html
84 Letellier P (2004). Group rescinds honor for disputed book. PlanetOut.com Network, 16 March 2004. http://www.gay.com/news/article.html?2004/03/16/3
Please send all correspondence and reprint requests via feedback.
This independent research was funded by reader donations. If you found this useful or interesting and would like to see more articles of this sort in the future, please consider supporting transgender scholarship.
Peggy Cohen-Kettenis is a Dutch psychologist who helped found an important early clinic that served trans and gender diverse youth and adolescents.
Peggy T. Cohen-Kettenis was born in 1948 in Jakarta, Indonesia. Indonesia declared independence from the Dutch on August 17, 1945, and the family left in 1951 when it became dangerous for Dutch colonialists to stay, since Cohen-Kettenis’ seminal parent was a police commissioner. After arriving at The Hague, they moved to Rotterdam, then Utrecht.
Cohen-Kettenis attended Stedelijk Gymnasium Utrecht and Johan de Witt Gymnasium Dordrecht and earned a doctorate from Utrecht University in 1973.
Professor of Medical Psychology VUmcVUmc Sep 2002 – Jul 2013
Professor UMC Utrecht Sep 1987 – Sep 2002
Nederlands Instituut van Psychologen (NIP) logo Voorzitter Sector G 1997 – 2000
Cohen-Kettenis served as Professor of gender development and psychopathology at the Department of Child and Adolescent Psychiatry, University Medical Center Utrecht.
Transgender research
In 1987, Cohen-Kettenis started the first outpatient clinic in Europe for children and adolescents with gender problems and intersex conditions.
Cohen-Kettenis was a member of the World Professional Association for Transgender Health’s Standards of Care Committee and of the Task Force of the Endocrine Society Clinical Practice Guideline on the endocrine treatment of gender-dysphoric/gender-incongruent persons.
Psychologist Peggy Cohen-Kettenis reacts less negative. She is, after reading parts of the book not surprised about the row, but âwhen Bailey says that sexual preference and gender identity are not two entirely independent dimensions, he is not necessarily wrongâ, she says.
In contrast to Bailey, Cohen-Kettenis expresses herself very diplomatic. As no other she knows the sensitivity of this terrain and the ease with which a âconflict can be created around this issueâ. The psychologist agrees that not all transsexuals are heavily gender-dysphoric in youth. She attributes the dominance of âthe woman captured in a manâs bodyâ image, to itâs endless repetition by the media.
[…] Gooren is scathing about Blanchardâs work. […] Cohen-Kettenis shares Goorenâs objections to terms like homosexual and non-homosexual transsexuals. She would rather differentiate between early and late onset transsexuals. But apart from the terminology, these groups are very similar to those of Bailey and Blanchard. Primary TSs are more often homosexual while secondary TSs usually have had straight relationships before entering treatment, Cohen-Kettenis explains. âIn the second group, during puberty cross-dressing is often paired with sexual excitement â she says. âWhen they enter treatment however, the cross dressing is very restfulâ.
Cohen-Kettenis estimates half the number of TSs are secondary TSs. Whether all secondary TSs have had a autogynephile history she cannot say. âExtreme gender dysphoria can, I think, come to be in all sorts of ways. Secondary TSs are a very diverse group. We also see people who still are autogynephile.â
Cohen-Kettenis thinks that patient care will not be influenced by this theory. TSs do not have to fear that Cohen would see autogynophilia as a disqualification for treatment. The decisive factor is the suffering of the client, and whether treatment can indeed help to relieve the pain. In this, Blanchard and Bailey agree and mention that autogynophiliacs do not have a higher rate of post-treatment regrets.
Vermij, Peter (September 27, 2003). Een man gevangen in een mannenlichaam.NRC https://www.nrc.nl/nieuws/2003/09/27/een-man-gevangen-in-een-mannenlichaam-7655797-a1162822 Translation: Arianne van der Ven.
Selected publications by Cohen-Kettenis
Dan J. Stein, Peter Szatmari, Wolfgang Gaebel, Michael Berk, Eduard Vieta, Mario Maj, Ymkje Anna de Vries, Annelieke M. Roest, Peter de Jonge, Andreas Maercker, Chris R. Brewin, Kathleen M. Pike, Carlos M. Grilo, Naomi A. Fineberg, Peer Briken, Peggy T. Cohen-Kettenis & Geoffrey M. Reed (2020). Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies. BMC Med18, 21 (2020). https://doi.org/10.1186/s12916-020-1495-2
The community of sex and gender minorities covers the full political spectrum. The size and inclusiveness of the community is debated, but this project takes a very broad definition of who is included.
This project also covers some topics that overlap with sexual minorities as well, including:
Gay
Lesbian
Bisexual
Asexual
Polyamorous
Pansexual
Kink and unusual erotic interests
While all of these communities and identities have overlapping interests and political goals, it’s difficult to generalize. The majority of the community seeks legal protections from harm and discrimination:
This site also covers people who are connected to our community, including those who do not consider themselves part of it.
It includes people who support the community, as well as people who hold a wide range of views that many in the community consider oppositional to one or more aspects of our community’s political goals.
Use the search feature to look for a specific person. If you don’t find a profile, please send a suggestion!
Milton Thomas “Milt” Edgerton, Jr. was an American plastic surgeon who served our community. Edgerton is widely considered one of the most important American plastic surgeons of the 20th century.
Background
Edgerton was born in Atlanta on July 14, 1921 and earned a bachelor’s degree in chemistry from Emory University in 1941. Edgerton earned a medical degree from Johns Hopkins University in 1944. Following a surgical residency, Edgerton joined the United States Army and operated on injured World War II veterans.
Edgerton joined the Johns Hopkins faculty in 1951 and got tenure in 1962. In 1970 Edgerton was recruited to the University of Virginia to found the Department of Plastic Surgery, working and teaching there until retiring in 1994.
Edgerton had many students and colleagues who served our community as well, including Howard W. Jones, Jr. and John Gale Kenney. Edgerton was author of four books and over 500 scientific papers on plastic surgery. As shown in the selected bibliography below, Edgerton’s articles when read from earliest to latest read like an unfolding of the history of our community.
Edgerton died at age 96 on March 17, 2018. The Milton T. Edgerton, M.D. Professorship in Plastic & Reconstructive Surgery at Johns Hopkins is named in Edgerton’s honor.
This paper reviews the senior author’s long-term experience with the surgical-psychiatric treatment of 100 aesthetic surgery patients with significant psychological disturbances. Patients with psychological disturbances of a magnitude generally considered an “absolute contraindication” for surgery were operated on and later assessed to determine the psychological impact of surgery. Patient follow-up averaged 6.2 years (maximum follow-up 25.7 years). Of the 87 patients who underwent operation (7 patients were refused surgery and 6 voluntarily deferred surgery), 82.8 percent had a positive psychological outcome, 13.8 percent experienced “minimal” improvement from surgery, and 3.4 percent were negatively affected by surgery. There were no lawsuits, suicides, or psychotic decompensations. Patients with severe psychological disturbances frequently benefited from combined surgical-psychiatric treatment designed to address the patient’s profound sense of deformity. This study suggests that plastic surgeons are “passing up” a significant number of patients who may be helped by combined surgical-psychological intervention. Comment in: * Plast Reconstr Surg. 1992 Aug;90(2):333-5.* Plast Reconstr Surg. 1992 Jun;89(6):1173-5.
This article describes plastic surgery patients who sought symmetrical recontouring of the width of the face and skull. The basic demographic and personality characteristics of these facial width deformity (FWD) patients and the surgical procedures performed on them are discussed. Details of the surgical and psychological management of three representative cases are given. Speculative conclusions regarding the general characteristics of the FWD population are offered. Suggestions are proposed for a combined surgical-medical psychotherapeutic collaboration in managing these patients.Comment in: * Aesthetic Plast Surg. 1990 Fall;14(4):299-300.
The evaluation and treatment of individuals with gender identity problems has resulted in an interesting and productive collaboration between several specialties of medicine. In particular, the psychiatrist and surgeon have joined hands in the management of these fascinating patients who feel they are trapped in the wrong body and insist upon correcting this cruel mistake of nature by undergoing sex reassignment surgery. Over the last two decades, some 40 centers have emerged in which interdisciplinary teams cooperate in the evaluation and treatment of these gender dysphoric patients. The model for this collaboration began at The Johns Hopkins Hospital, where the Gender Identity Clinic began its operation in 1965 (Edgerton, 1983; Pauly, 1983). This “gender identity movement” has brought together such unlikely collaborators as surgeons, endocrinologists, psychologists, psychiatrists, gynecologists, and research specialists into a mutually rewarding arena. This paper deals with the background and modern era of research into gender identity disorders and their evaluation and treatment. Finally, some data are presented on the outcome of sex reassignment surgery. This interdisciplinary collaboration has resulted in the birth of a new medical subspecialty, which deals with the study of gender identification and its disorders.
The increasing use of surgery for sex reassignment in the treatment of transsexualism is described. The author’s early experience over a twenty-year period with the Gender Identity teams at The Johns Hopkins University and The University of Virginia is summarized. Many of the reasons for slow acceptance of this type of surgery by many members of the medical profession are analyzed. The satisfactory subjective results described by patients who have received sex reassignment continue to exceed the results obtained by other methods. The author concludes that further study of surgical treatment is justified, but that it should be limited to established multidisciplinary teams working in academic settings. Physicians are urged to withhold judgment on the role of surgery in gender disorders until they have had significant personal experience with these desperate and complex patients.
Transsexualism is a poorly understood, uncommon, and controversial entity of recent interest to the lay public and medical profession. Important features of the condition are discussed, surgical procedures for genital conversion in male transsexuals are compared, and our experience at the University of Virginia where 53 patients have been treated surgically is presented. All patients have made satisfactory postoperative psychosocial adjustment despite a surgical complication rate approaching 50 per cent. It is concluded that alternative (better) surgical procedures for male transsexuals should be explored.
A 49-year-old male-to-female transsexual was administered voice therapy following surgery. Tape recordings were made of her speech prior to and each week during therapy. Selected sentences from these reocrdings were analyzed. Results indicate that changes in both fundamental frequency and perceptual judgments of femininity were statistically significant and supportive to the client. The voice of the client was still discernible from that of a female speaker, although less so than before therapy. It is suggested that a composite treatment program combined with laryngeal modification through surgical intervention may be necessary.
Turner, Edlich & Edgerton, 1978 Dept. of Obstetrics, Gynecology and Plastic Surgery, University of Virginia Medical Center, Charlottville, VA, USA In structure and representation this publication is closely related to the one of Edgerton & Meyer (1973), that is, it is no follow-up study with reliable data. Related are mostly surgical techniques for MFTs and surgical complications. Under historical viewpoints it is an interesting statement that Edgerton was already in 1963 the director of the Johns Hopkins Gender Identity Clinic in Baltimore, MD, while everywhere else the founding of this institution is generally dated two years later. Also it is interesting that a psychologist is given a key role or a veto right to the indication to surgery. For the rest, the necessity for a successful one-year-long “Real-Life-Test” as it was already in Edgerton & Meyer (1973), the experimental surgical breast enlargement is recommended as a step if the patient and treatment provider are insecure regarding the stability of the female identity of the patient. In how far the statement: “The only justification for the ongoing evaluation of surgery as a definite treatment entity is that patients with this condition have proved resistant to psychotherapy and drug therapy” (p. 121) is a general postulate or if the corresponding possibility has been tested with those who underwent surgery is not to be discerned by the publication. It is reported about 53 gender reassignment surgeries of MFTs that Edgerton made after changing from Baltimore to Virginia. Forty seven females came to the follow-up study in the first year after surgery. Globally it is said that all were subjectively happy and self-secure and socially better adjusted. “Psychological testing has substantiated these subjective claims” (p. 128). Suicide attempts after surgery or desires to role re-reversal were not observed. Eighteen females had gotten married and six had adopted children. In the series of the first 20 surgically treated, 14 females required corrective surgery; in the series of the second 20, only eight. The most frequent complication was the stenosis of the vagina. Injuries of the urethra or rectum with corresponding fistulae did not occur.
Morgan RF, Morgan EA (2019). Milton T Edgerton, MD: A Pioneer of Surgery of the Hand. Journal of Craniofacial Surgery: March/April 2019 – Volume 30 – Issue 2 – p 303â305 https://doi.org/10.1097/SCS.0000000000005063
Resources
Archival contact information:
University of Virginia Medical Center, Gender Identity Clinic, P. O. Box 376 Charlottesville, VA 22908 USA
Phone: (434) 924-5068
The previous version of this site had occasional essays and news posts between 2003 and 2014. This is an archive of those notes, shown in reverse chronological order.
Items in bold have been ported to this site. Other links go to archive.org for now.
I wrote a few essays in 2003, outlining philosophical and theoretical issues that have an effect on our community and beyond. They were intended to correct misunderstandings which arise in the course of debates.
This addresses accusations that I am “anti-science” and gives an overview of some ethical issues raised by first-wave sexologists like Bailey-Blanchard-Lawrence.
A reply to a post from Kendra Blewitt regarding my comments about those who identify as “autogynephiles.”
Scott Leibowitz is an American pediatric psychiatrist best known for working with gender diverse youth and with anti-trans journalists.
Like many psychologists and psychiatrists who get paid to do them, Leibowitz promotes “comprehensive psychological assessments,” a form of gatekeeping used for over a century to delay or deny medical transition options for trans and gender diverse people.
Leibowitz is a key source for journalists who feel it has become too easy for adolescents and young adults to get hormones and surgery, covering trans healthcare like an unfolding medical scandal. Leibowitz participated in numerous articles about the ex-transgender movement, most notably pieces by anti-trans activists Jesse Singal in The Atlantic and Emily Bazelon in the New York Times. Those pieces have been cited in proposed legislation banning trans healthcare.
Leibowitz believes that science, medicine, and journalism can somehow be separated from politics. In 2024, despite Leibowitz’s objections, Ohio passed HB 68 banning the care that Leibowitz offers in that state.
Background
Scott Farrell Leibowitz was born on May 20, 1978 in Smithtown, New York. Leibowitz earned a bachelorâs degree from Cornell University and a medical degree from the Tel Aviv University Sackler School of Medicine New York State/American Program. Leibowitz completed residencies at the Zucker Hillside Hospital in Queens and the Albert Einstein College of Medicine’s Long Island Jewish Health System. Leibowitz then did a Fellowship at the children’s gender clinic at Boston Childrenâs Hospital with colleague Laura Edwards-Leeper. In 2013 Leibowitz took a similar position at the Ann & Robert H. Lurie Childrenâs Hospital in Chicago. In 2015 Leibowitz was recruited to Nationwide Childrenâs in Columbus, Ohio.
2018 Atlantic article
Leibowitz was quoted throughout a 2018 Atlantic article by Jesse Singal on the ex-transgender movement. Similar to the ex-gay movement, the people who promote the medicalized concepts of “desistance” and “detransition” believe that interest in gender transition is a disease that can resolve on its own or through medical intervention. Proponents of these loaded terms make several assumptions that are not value-neutral and therefore not scientific.
[Laura] Edwards-Leeper is hoping to promote a concept of affirming care that takes into account the developmental nuances that so often come up in her clinical work. In this effort, she is joined by Scott Leibowitz, a psychiatrist who treats children and adolescents. He is the medical director of behavioral health for the THRIVE program at Nationwide Childrenâs Hospital, in Columbus. Leibowitz has a long history of working with and supporting TGNC youthâhe served as an expert witness for the Department of Justice in 2016, when President Barack Obamaâs administration challenged state-level âbathroom billsâ that sought to prevent trans people from using the public bathroom associated with their gender identity. Edwards-Leeper and Leibowitz met at Boston Childrenâs, where Leibowitz did his psychiatry fellowship, and the two have been close friends and collaborators ever since.
While itâs understandable, for historical reasons, why some people associate comprehensive psychological assessments with denial of access to care, that isnât how Leibowitz and Edwards-Leeper view their approach. Yes, they want to discern whether a patient actually has gender dysphoria. But comprehensive assessments and ongoing mental-health work are also means of ensuring that transitioningâwhich can be a physically and emotionally taxing process for adolescents even under the best of circumstancesâgoes smoothly.
[…]
Scottâs assessment process centered mostly on the basic readiness questions Edwards-Leeper and Leibowitz are convinced should be asked of any young person considering hormones.
[…]
But progressive-minded parents can sometimes be a problem for their kids as well. Several of the clinicians I spoke with, including Nate Sharon, Laura Edwards-Leeper, and Scott Leibowitz, recounted new patientsâ arriving at their clinics, their parents having already developed detailed plans for them to transition. âIâve actually had patients with parents pressuring me to recommend their kids start hormones,â Sharon said.
[…]
Leibowitz noted that a relationship with a caring therapist may itself be an important prophylactic against suicidal ideation for TGNC youth: âOften for the first time having a medical or mental-health professional tell them that they are going to take them seriously and really listen to them and hear their story often helps them feel better than theyâve ever felt.â
[…]
âWould you rather have a live daughter or a dead son?â is a common response to such questions. âThis type of narrative takes an already fearful parent and makes them even more afraid, which is hardly the type of mind-set one would want a parent to be in when making a complex lifelong decision for their adolescent,â Leibowitz said.
Johanna Olson-Kennedy, a physician who specializes in pediatric and adolescent medicine at Childrenâs Hospital Los Angeles and who is the medical director of the Center for Transyouth Health and Development, is one of the most sought-out voices on these issues, and has significant differences with Edwards-Leeper and Leibowitz. In âMental Health Disparities Among Transgender Youth: Rethinking the Role of Professionals,â a 2016 JAMAPediatrics article, she wrote that âestablishing a therapeutic relationship entails honesty and a sense of safety that can be compromised if young people believe that what they need and deserve (potentially blockers, hormones, or surgery) can be denied them according to the information they provide to the therapist.â
[…]
Perhaps a first step is to recognize detransitioners and desisters as being on the same âsideâ as happily transitioned trans people. Members of each of these groups have experienced gender dysphoria at some point, and all have a right to compassionate, comprehensive care, whether or not that includes hormones or surgery. âThe detransitioner is probably just as scarred by the system as the transitioner who didnât have access to transition,â Leibowitz told me. The best way to build a system that fails fewer people is to acknowledge the staggering complexity of gender dysphoriaâand to acknowledge just how early we are in the process of understanding it.
The story is about the editing of the WPATH Standards of Care 8 chapter on youth.
Leibowitz, [Annelou] de Vries and their co-authors held their ground on assessments. The final version of their chapter said that because of the limited long-term research, treatment without a comprehensive diagnostic assessment âhas no empirical support and therefore carries the risk that the decision to start gender-affirming medical interventions may not be in the long-term best interest of the young person at that time.â
[from original version] In his Atlantic story, Singal also justified his skepticism of letting kids transition by relying heavily on two care providers, Scott Leibowitz and Laura Edwards-Leeper, who believe in the desistance myth, and whom Singal has cited in the past. Despite the fact that their views are shared by few other experts, Singal has suggested in the past that their theory is mainstream.
CORRECTION: An earlier version of this article referenced child and adolescent psychiatrist Scott Leibowitz and his colleague Laura Edwards-Leeper in a context that misrepresented their work. It has been updated to remove reference to them.
Singal, Jesse (July 2018). When a child says she’s trans. The Atlantic https://www.theatlantic.com/magazine/archive/2018/07/when-a-child-says-shes-trans/561749/
Simons LK, Leibowitz SF, Hidalgo MA (2014). Understanding gender variance in children and adolescents. Pediatr Ann. 2014 Jun;43(6):e126-31. https://doi.org/10.3928/00904481-20140522-07
Edwards-Leeper L, Leibowitz SF, Sangganjanavanich VF (2016). Affirmative practice with transgender and gender nonconforming youth: Expanding the model. Psychology of Sexual Orientation and Gender Diversity 3(2):165-172 https://doi.org/10.1037/sgd0000167
Calzo JP, Melchiono M, Richmond TK, Leibowitz SF, Argenal RL, Goncalves A, Pitts S, Gooding HC, Burke P (2017). Lesbian, Gay, Bisexual, and Transgender Adolescent Health: An Interprofessional Case Discussion. MedEdPORTAL. 2017 Aug 9;13:10615. https://doi.org/10.15766/mep_2374-8265.10615
Janssen A, Scott Leibowitz SF, eds. (2018). Affirmative Mental Health Care for Transgender and Gender Diverse Youth: A Clinical Guide. ISBN 9783319783079
The research term for this is desistance. This has become a rather controversial discussion because the studies themselves vary in the populations they included and how they handled the children that were lost to follow up.
Strang JF, Powers MD, Knauss M, Sibarium E, Leibowitz SF, Kenworthy L, Sadikova E, Wyss S, Willing L, Caplan R, Pervez N, Nowak J, Gohari D, Gomez-Lobo V, Call D, Anthony LG (2018). “They Thought It Was an Obsession”: Trajectories and Perspectives of Autistic Transgender and Gender-Diverse Adolescents. J Autism Dev Disord. 2018 Dec;48(12):4039-4055. https://doi.org/10.1007/s10803-018-3723-6
Strang JF, Janssen A, Tishelman A, Leibowitz SF, Kenworthy L, McGuire JK, Edwards-Leeper L, Mazefsky CA, Rofey D, Bascom J, Caplan R, Gomez-Lobo V, Berg D, Zaks Z, Wallace GL, Wimms H, Pine-Twaddell E, Shumer D, Register-Brown K, Sadikova E, Anthony LG (2018). Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals. J Am Acad Child Adolesc Psychiatry. 2018 Nov;57(11):885-887. https://doi.org/10.1016/j.jaac.2018.04.023
Leibowitz SF, Lantos JD (2019). Affirming, Balanced, and Comprehensive Care for Transgender Teenagers. Pediatrics. June 2019, 143 (6) e20190995 https://doi.org/10.1542/peds.2019-0995
Exhibit 37: Expert Declaration of Scott F. Leibowitz, MD. United States of America v. State of North Carolina, et al. (2017). No. 1:16-cv-00425 [PDF] https://www.aclu.org/sites/default/files/field_document/de_076-37_-_leibowitz_decl_iso_mot_for_pi_us_07-06-2016.pdf
Leibowitz SF, Telingator C (2012). Assessing gender identity concerns in children and adolescents: evaluation, treatments, and outcomes. Curr Psychiatry Rep. 2012 Apr;14(2):111-20. https://doi.org/10.1007/s11920-012-0259-x
Leibowitz SF, Norman Spack (2011). The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives. Child Adolesc Psychiatr Clin N Am. 2011 Oct;20(4):701-24. https://doi.org/10.1016/j.chc.2011.07.004
Stoddard J, Leibowitz SF, Ton H, Snowdon S (2011). Improving medical education about gender-variant youth and transgender adolescents. Child Adolesc Psychiatr Clin N Am. 2011 Oct;20(4):779-91. https://doi.org/10.1016/j.chc.2011.07.008
Note: In 2025, this site phased out AI illustrations after artist feedback. The previous illustration is here.
Laura Edwards-Leeper is a conservative American psychologist best known for working with gender diverse youth. Edwards-Leeper has become a favored source for journalists promoting the ex-transgender movement and a leading voice in a faction of therapists who have “concerns” that affirmative models of care for trans youth do not have enough gatekeeping. Edwards-Leeper believes trans people and their families should pay someone like her before getting access to medical transition options.
Background
Laura Ann Edwards-Leeper was born on January 18, 1975. Edwards-Leeper earned a bachelor’s degree from Lewis & Clark College in 1997, then attended Bowling Green State University, earning a graduate certificate in 2003 and a doctorate in 2004. Edwards-Leeper did internships through Montana State University, Bozeman at Crow/Northern Cheyenne Hospital and through Cambridge Health Alliance/Harvard Medical School.
Edwards-Leeper is married to Todd Steven Edwards-Leeper (born 1973).
Transgender youth
Edwards-Leeper worked closely with endocrinologist Norman Spack at Boston Children’s Hospital. Spack is an innovator in offering medical options to gender diverse youth, founding the Gender Management Service (GeMS) there in 2007. Edwards-Leeper and Spack co-authored several articles through 2012, when Edwards-Leeper left GeMs for a similar role at Seattle Children’s Hospital. After a year, Edwards-Leeper went into private practice.
After 2012, Edwards-Leeper began publishing on the correlation between neurodiversity and gender diversity.
2018 Atlantic article
Edwards-Leeper was quoted throughout a 2018 Atlantic article by Jesse Singal on the ex-transgender movement. Similar to the ex-gay movement, the people who promote the medicalized concepts of âdesistanceâ and âdetransitionâ believe that being trans is a disease that can resolve on it own or through medical intervention. Proponents of these loaded terms make several assumptions that are not value-neutral and therefore not scientific.
Singal presents Edwards-Leeper and fellow clinicians Erica Anderson and Dianne Berg as therapists who have “concerns” that more affirming care for minors may lead to negative transition outcomes. Edwards-Leeper’s assessment methods had led to a controversial reputation, Critics reportedly “nearly threw things” at Edwards-Leeper at conferences:
Those conference troubles signaled to Edwards-Leeper that her field had shifted in ways she found discomfiting. At one conference a few years ago, she recalled, a co-panelist who was a well-respected clinician in her field said that Edwards-Leeperâs comprehensive assessments required kids to âjump through more fiery hoopsâ and were âretraumatizing.â This prompted a standing ovation from the audience, mostly families of TGNC young people. During another panel discussion, at the same conference with the same clinician, but this time geared toward fellow clinicians, the same thing happened: more claims that assessments were traumatizing, more raucous applause.
Edwards-Leeper isnât alone in worrying that the field is straying from its own established best practices. âUnder the motivation to be supportive and to be affirming and to be nonstigmatizing, I think the pendulum has swung so far that now weâre maybe not looking as critically at the issues as we should be,â the National Center for Gender Spectrum Healthâs Dianne Berg told me. Erica Anderson, the UCSF clinician, expressed similar concerns: âSome of the stories weâve heard about detransitioning, I fear, are related to people who hastily embarked on medical interventions and decided that they werenât for them, and didnât thoroughly vet their decision either by themselves or with professional people who could help them.â
Singal (2018)
Via Jenny Cyphers, an activist in the ex-trans movement:
Two of the most important aspects of my familyâs experience that are not adequately addressed in the Atlantic article, are: 1) my daughter was given a clinical diagnosis of gender dysphoria, so she was just as âtruly transâ as the next kid, and 2) it was my insistence that my child wait to medically transition, not her therapistâs. My teenâs therapist, Laura Edwards-Leeper, listened to me and agreed. We were lucky. While there are some cautious, thoughtful providers, the current situation in the US is that there is also no oversight. The most vocal professionals are firmly in the affirmation camp which believes, without any long-term data to validate, that withholding hormonal interventions is tantamount to abuse.
2021 60 Minutes segment
Edwards-Leeper appeared on a 60 Minutes segment about the ex-transgender movement and was presented as a practitioner of “comprehensive assessment” in a way that suggested some colleagues were not doing this. When CBS’s Lesley Stahl asked about “this whole area of accepting what young people are saying too readily,” Edwards-Leeper said:
Yes, everyone is very scared to speak up because we’re afraid of not being seen as affirming or supportive of these young people or doing something to hurt the trans community. But even some of the providers are trans themselves and share these concerns.
This is a reference to conservative trans therapist Erica Anderson, who also appeared in the segment.
2021 Washington Post op-ed
Edwards-Leeper again joined fellow conservative clinician Erica Anderson to denounce what they consider insufficient gatekeeping in healthcare for trans and gender diverse youth.
In response, DC-area parents Rachel Cornwell and Liz Matthews wrote:
As parents of transgender youths, we are deeply concerned by Laura Edwards-Leeper and Erica Andersonâs Nov. 28 Outlook essay, âThe mental health establishment is failing trans kids.â Though we agree with their conclusion that improvements in care for gender-diverse youths are needed, their alarmist concerns about insufficient psychological evaluations for gender-affirming care are unfounded and sensationalized.
The writers based their opinion on anecdotal experiences and even admitted that âproviders and their behavior havenât been closely studied.â They pointed to a single study of an extremely small number of people who have detransitioned to support their argument in favor of delaying or even denying gender-affirming medical care to gender-diverse youths. They recklessly conflate safe, reversible medical interventions such as hormone blockers with more permanent gender-confirmation treatments such as surgeries, which are typically not performed on minors in the United States. And they dangerously play down the risk of suicide that can result from denying gender-affirming care.
Thousands of trans youths are now thriving because of gender-affirming care. Thankfully, our children are among that number because of the intervention of mental health providers and physicians, as well as the support of our communities. Trans kids need all the support they can get because they live in a world that too often denies and degrades them. That is why itâs such a shame that the authors would increase barriers to accessing gender-affirming care, rather than expand access for all who need it.
Clinician AJ Eckert, who was identified in the piece, wrote:
The essay misrepresented gender-affirming care, which is nuanced, complex and comprehensive. The writers mischaracterized transgender youths and pushed a damaging pseudoscientific narrative that serves to further limit health care for an already underserved, marginalized and vulnerable population. The writers leaned on the World Professional Association for Transgender Healthâs standards of care but failed to note that the standards acknowledge the damaging and irreversible consequences of an incongruent puberty, reject the stereotype of trans psychopathology and include harm-reduction strategies.
Contrary to the anti-trans arguments spread throughout mass media and repeated by the writers, research shows that detransition and regret are rare, trans youth suicide rates are alarmingly high, and trans children supported in their identities have better mental health outcomes. One of their most egregious lies was that those opposed to gender-affirming care are being silenced. This article was proof that isnât true.
Trans children deserve love, support and thoughtful medical care as much as cisgender children do. Pieces such as this are responsible for the closure of gender clinics, anti-trans sentiment and the spate of laws and regulations targeting trans youths.
Strang JF, McClellan LS, Raaijmakers D, Caplan R, Klomp SE, Reutter M, Lai MC, Song M, Gratton FV, Dale LK, Schutte A, de Vries ALC, Gardiner F, Edwards-Leeper L, Minnaard AL, Eleveld NL, Corbin E, Purkis Y, Lawson W, Kim DY, van Wieringen IM, RodrĂguez-RoldĂĄn VM, Harris MC, Wilks MF, Abraham G, Balleur-van Rijn A, Brown LXZ, Forshaw A, Wilks GB, Griffin AD, Graham EK, Krause S, Pervez N, Bok IA, Song A, Fischbach AL, van der Miesen AIR (2023). The Gender-Diversity and Autism Questionnaire: A Community-Developed Clinical, Research, and Self-Advocacy Tool for Autistic Transgender and Gender-Diverse Young Adults. Autism Adulthood. 2023 Jun 1;5(2):175-190. https://doi.org/10.1089/aut.2023.0002
Coleman E, Radix AE, Bouman WP, Brown GR, de Vries ALC, Deutsch MB, Ettner R, Fraser L, Goodman M, Green J, Hancock AB, Johnson TW, Karasic DH, Knudson GA, Leibowitz SF, Meyer-Bahlburg HFL, Monstrey SJ, Motmans J, Nahata L, Nieder TO, Reisner SL, Richards C, Schechter LS, Tangpricha V, Tishelman AC, Van Trotsenburg MAA, Winter S, Ducheny K, Adams NJ, AdriĂĄn TM, Allen LR, Azul D, Bagga H, BaĆar K, Bathory DS, Belinky JJ, Berg DR, Berli JU, Bluebond-Langner RO, Bouman MB, Bowers ML, Brassard PJ, Byrne J, CapitĂĄn L, Cargill CJ, Carswell JM, Chang SC, Chelvakumar G, Corneil T, Dalke KB, De Cuypere G, de Vries E, Den Heijer M, Devor AH, Dhejne C, D’Marco A, Edmiston EK, Edwards-Leeper L, Ehrbar R, Ehrensaft D, Eisfeld J, Elaut E, Erickson-Schroth L, Feldman JL, Fisher AD, Garcia MM, Gijs L, Green SE, Hall BP, Hardy TLD, Irwig MS, Jacobs LA, Janssen AC, Johnson K, Klink DT, Kreukels BPC, Kuper LE, Kvach EJ, Malouf MA, Massey R, Mazur T, McLachlan C, Morrison SD, Mosser SW, Neira PM, Nygren U, Oates JM, Obedin-Maliver J, Pagkalos G, Patton J, Phanuphak N, Rachlin K, Reed T, Rider GN, Ristori J, Robbins-Cherry S, Roberts SA, Rodriguez-Wallberg KA, Rosenthal SM, Sabir K, Safer JD, Scheim A⊠(2022). Standards of Care for the Health of Transgender and Gender Diverse People, Version 8. Int J Transgend Health. 2022 Sep 6;23(Suppl 1):S1-S259. https://doi.org/10.1080/26895269.2022.2100644
Spivey LA, Edwards-Leeper L (2019). Future Directions in Affirmative Psychological Interventions with Transgender Children and Adolescents. J Clin Child Adolesc Psychol. 2019 Mar-Apr;48(2):343-356. https://doi.org/10.1080/15374416.2018.1534207
Strang JF, Janssen A, Tishelman A, Leibowitz SF, Kenworthy L, McGuire JK, Edwards-Leeper L, Mazefsky CA, Rofey D, Bascom J, Caplan R, Gomez-Lobo V, Berg D, Zaks Z, Wallace GL, Wimms H, Pine-Twaddell E, Shumer D, Register-Brown K, Sadikova E, Anthony LG (2018). Revisiting the Link: Evidence of the Rates of Autism in Studies of Gender Diverse Individuals. J Am Acad Child Adolesc Psychiatry. 2018 Nov;57(11):885-887. https://doi.org/10.1016/j.jaac.2018.04.023
Chen D, Edwards-Leeper L, Stancin T, Tishelman A. Advancing the Practice of Pediatric Psychology with Transgender Youth: State of the Science (2018), Ongoing Controversies, and Future Directions. Clin Pract Pediatr Psychol. 2018 Mar;6(1):73-83. https://doi.org/10.1037/cpp0000229
Strang JF, Meagher H, Kenworthy L, de Vries ALC, Menvielle E, Leibowitz S, Janssen A, Cohen-Kettenis P, Shumer DE, Edwards-Leeper L, Pleak RR, Spack N, Karasic DH, Schreier H, Balleur A, Tishelman A, Ehrensaft D, Rodnan L, Kuschner ES, Mandel F, Caretto A, Lewis HC, Anthony LG (2018). Initial Clinical Guidelines for Co-Occurring Autism Spectrum Disorder and Gender Dysphoria or Incongruence in Adolescents. J Clin Child Adolesc Psychol. 2018 Jan-Feb;47(1):105-115. https://doi.org/10.1080/15374416.2016.1228462
Shumer DE, Reisner SL, Edwards-Leeper L, Tishelman A (2016). Evaluation of Asperger Syndrome in Youth Presenting to a Gender Dysphoria Clinic. LGBT Health. 2016 Oct;3(5):387-90. https://doi.org/10.1089/lgbt.2015.0070
Tishelman AC, Kaufman R, Edwards-Leeper L, Mandel FH, Shumer DE, Spack NP (2015). Serving Transgender Youth: Challenges, Dilemmas and Clinical Examples. Prof Psychol Res Pr. 2015;46(1):37-45. https://doi.org/10.1037/a0037490
Tishelman AC, Kaufman R, Edwards-Leeper L, Mandel FH, Shumer DE, Spack NP (2015). Reply to comment on “Serving Transgender Youth: Challenges, Dilemmas, and Clinical Examples” by Tishelman et al. (2015). Prof Psychol Res Pr. 2015 Aug;46(4):307. https://doi.org/10.1037/pro0000029
Children and adolescents with gender identity disorder referred to a pediatric medical center. Spack NP, Edwards-Leeper L, Feldman HA, Leibowitz S, Mandel F, Diamond DA, Vance SR. Pediatrics. 2012 Mar;129(3):418-25. https://doi.org/10.1542/peds.2011-0907
Edwards-Leeper L, Spack NP (2012). Psychological evaluation and medical treatment of transgender youth in an interdisciplinary âGender Management Serviceâ (GeMS) in a major pediatric center. Journal of Homosexuality, 59 (3), 321-336. https://doi.org/10.1080/00918369.2012.653302
Spack NP, Edwards-Leeper L, Feldman HA, Leibowitz S, Mandel F, Diamond DA, Vance SR (2012). Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics, 129 (3), 418-425. https://doi.org/10.1542/peds.2011-0907
Edwards-Leeper L, Spack NP (2012). Psychological Evaluation and Medical Treatment of Transgender Youth in an Interdisciplinary âGender Management Serviceâ (GeMS) in a Major Pediatric Center. Journal of Homosexuality 59(3):321-36. https://doi.org/10.1080/00918369.2012.653302
Spack NP, Edwards-Leeper L (2011). Medical treatment of the transgender adolescent. In Fisher M, Alderman E, Kreipe R, Rosenfeld W (Eds). Textbook of Adolescent Health Care. American Academy of Pediatrics, ISBN 9781581102697
Edwards-Leeper L, Spack NP (2011). Gender identity disorder. In Augustyn M, Zuckerman B, Caronna EB (Eds.), The Zuckerman Parker Handbook of Developmental and Behavioral Pediatrics for Primary Care (3rd ed., pp. 229-233). Wolters Kluwer Health/Lippincott Williams & Wilkins. ISBN 978-1608319145
Note: In 2025, this site phased out AI illustrations after artist feedback. The previous illustration is here.
Rya Jones is an American former publishing executive who has espoused conservative transgender views. Jones posted many videos expressing conservative or religious views about gender, many of which were later deleted.
Background
Rya Jones was born on June 24, 1974. Jones graduated from high school in 1992, then earned a bachelor’s degree from University of Wisconsin-Madison in 1996. Jones served as CEO of Jones Publishing, Inc. It was founded by Jones’ parents in 1986 and has produced a number of specialty periodicals:
Religious (via Crosslife LLC): Today’s Christian Living, Today’s Pastor
Arts and crafts: Sunshine Artist, Dolls, Doll Costuming, Doll Crafter, Dollmaking, Popular Ceramics, Ceramics Arts and Craft, Teddy Bear Review
Jones transitioned in around 2015. Jones’ time as CEO ended in 2016. In 2017, JP Media LLC purchased Jones Publishing, Inc. in a planned transfer of the company from Joe and Maggie Jones to Diana Jones, Rya Jones’ former spouse. Rya and Diana Jones had seven children who were home-schooled. Jones has served as an ordained pastor in Cornerstone Churches in Wisconsin and studied part-time for a Master’s in Divinity at Trinity Evangelical Divinity School. Jones now identifies as a “former pastor.” Jones has been involved with Madison Community Cooperative and has been licensed as a health insurance agent with Humana.
Online activity
Jones uses several online handles, including:
Rya N.T. Jones
HeyThisIsRya
In around 2017, Jones published a number of videos on YouTube about various gender-critical topics including a possible “detransition” before removing all of the videos. One video, titled “I am an autogynephile,” led to Jones being listed on this site as an autogynephilia activist. Jones claimed in the 2025 statement below that the provocative title was to generate engagement and was not a statement of identity.
Starting in September 2022, Rya Jones and parent Joe Jones produced dozens of episodes of a podcast titled TranDescendant.
Statement from Rya Jones
In June 2025. Jones sent the following statement for publication on this profile:
I am not, nor have I have I ever been, an âAutogynephilia activist.â On November 3, 2017, I published a video arguing that gatekeeping in the transgender community needed to stop. I told the story of my interaction with a straight trans woman who told me I was not really trans because I am attracted to women instead of men. I then made the point that some people that call my condition autogynephilia in order to marginalize us. The point I intended to make was that, no matter what you choose to call me, it does not make me less authentically-trans. The thumbnail had a picture of me with the phrase, âNot Trans Enough.â
But then almost as an afterthought, I titled it âI am an autogynephile.â I knew that YouTube likes controversy, and that using such a title would almost certainly get more views. Once people saw the video, I reasoned, they would hear my argument and stop belittling women like me. That was almost certainly the wrong decision, because nearly everyone, from transphobes to trans people, took the title at face value. Ironically, some people used it as an admission that I was not really trans after all.
It didnât help that I posted some similarly provocative videos, including one where I talked about challenging gender norms by âdetransitioningâ but continuing to present female. I regretted the idea almost instantly after I published the video. I used my very next video to explain why I was wrong. Some commenters accused me of broadcasting internalized transphobia on that channel. I did my best not to do so. Looking back, they were probably right. I donât think I ever described myself as Gender Critical, but I was certainly trying to engage a Gender Critical audience in order to change their minds. When I realized that approach was never going to work, I quit the channel.
To those I hurt with my words, I am sincerely sorry. I cannot change that I said those things. But I did unpublish the channel years ago. I reject Ray Blanchardâs widely-rejected hypothesis of autogynephelia. And I most certainly would NEVER describe myself as a âman trapped in a manâs body.â If thereâs anything more I can do to right the wrongs I may have caused, please email me at rya dot nt dot jones at gmail.
Miranda Yardley and Rya Jones (July 12, 2017). ‘TERF’ and ‘Cis’: Misogyny and Homophobia in Transgender Culture. https://www.youtube.com/watch?v=AUP2csDBG-E [deleted]
