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A day in the life of working with trans youth: Navigating the fallout of harmful media coverage

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How one psychotherapist navigates the challenges posed by misinformation and politicization to support transgender and gender-diverse youth and their families.

As a gender psychotherapist, my commitment to providing compassionate and informed gender-affirming care is unwavering. A set of personal values does not define this.

Still, radical actions are taken to protect the patients who find solace in my office and the staff that supports them. Unlike the many other group practices in this area, you often won’t see our office address on marketing materials. We invest in data mining protection to ensure that should any of us be doxxed, the impact is, at the very least, mitigated. Virtual programs and workshops are held on secure servers, and our clients meet online with therapists before entering our office. Our location has cameras that track the comings and goings of everybody who enters the hallway outside.

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These steps are not only a precaution but, increasingly, a necessity for anyone working with trans and queer youth to be safe and responsible. And for perspective, we practice in New Jersey — one of the most liberal states in the country, one considered a “sanctuary state” for LGBTQ people.

The work that my staff and I do is made more difficult by opinion pieces like Pamela Paul’s, published in the New York Times on Friday. While this article is similar to many others written before, laden with misinformation and lies, the impact is more dangerous due to its published outlet. Advocates for transgender youth rely on trusted news outlets to be allies. We don’t expect publications to censor stories of detransition or even to avoid writing about the experience. These stories inform our practice, and the voices of people who detransition deserve to be heard. However, we expect that media outlets hold opinion writers to a higher standard of truth. The New York Times has fallen short for some time.

It is disheartening to see a parent question their support for their child as a result. For the families I serve, this emotional toll adds to an already labor-intensive process of educating themselves and their communities. Being a parent shouldn’t require an advanced degree in methods and research. Even with my expertise, it isn’t always easy to sift through all the pseudoscience published to justify the many care bans being proposed nationwide.

In the wake of the NYT’s most recent piece, I have been flooded with emails and phone calls from concerned parents. These parents are anxious or frustrated, seeking guidance on responding to the people who have sent this article, posted it on Facebook, or expressed concerns about me: does your therapist know what she’s doing? Are you feeling pressured in any way to take hormones? Are you sure your kid is trans?

The reality is that these questions do not scare me when they are asked in earnest. They’re valid questions. Transgender and gender-diverse youth, like all youth, deserve comprehensive care. Parents also deserve to know they can be worried, vet their providers, and feel reassured that their child is being cared for by someone who listens to their unique circumstances and keeps up with the emerging science in our field. It is a field where there is a growing body of knowledge in support of gender-affirming care. Still, one that is like any other field of medicine — constantly evolving.

The scrutiny directed towards me, as opposed to my colleagues, lies in a relentless and politicized weaponization of treatment outcomes. Even more egregious is that many of the outcomes weaponized are either outright lies, statistics published by debunked or recanted “studies,” or shamelessly exploiting the pain of individuals who indeed received inadequate care.

This phenomenon is notably absent in other health care disciplines. It has led to an environment where practitioners like me find themselves in an enduring state of defensiveness. The consistent publication of this misinformation also places us all at significant risk. Much like our clients have big questions about their safety, we ask ourselves what-ifs. What if someone complains to the licensing board? What if that non-affirming parent sues me? What if the gender clinics shut down? What if my new client is the person who wrote the death threat?

Science is an evolving field, and we must anticipate changes over time. The New York Times could write this story because this is their reality when I sit with families. They are doing the best they can for their children now that they are familiar with the science and best practices we have.

The repercussions of publishing misinformation are not abstract; they ripple through the lives of transgender and gender-diverse people, their families, and the practitioners dedicated to providing care. Families seeking support for their transgender children are particularly vulnerable to the influence of media narratives. Still, the erosion of trust in healthcare professionals affects the entire field and sets a dangerous precedent that allows politicians to legislate health care, control bodies, and supersede parental authority.

I also want to assure families with transgender youth that a dedicated network of practitioners stands firmly by their side. You are not alone. As practitioners, we will continue to weather the challenges and advocate for the well-being of your children. The media can contribute to this effort with factual journalism or exacerbate their struggles with irresponsible lies.

Laura Hoge practices in Montclair, N.J. To learn more about her work and practice, visit her website.

Views expressed in The Advocate’s opinion articles are those of the writers and do not necessarily represent the views of The Advocate or our parent company, equalpride.

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