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Historically, when this was diagnosed as Gender Identity Disorder or transsexualism through strict clinical pathways, it was considered extremely rare. Estimates were around 0.005%-0.014% of males and 0.002%-0.003% of females.
Now we are told that around 0.5%-1.3% of the population is transgender, with some youth surveys claiming even higher percentages. Depending on what figures you compare, that’s dozens to hundreds of times higher than the old clinical estimates. That should make people stop and ask what exactly is being measured now, because it clearly isn’t the same thing.
It looks like we’ve moved from careful assessment to rapid affirmation. Puberty blockers, cross-sex hormones, and surgeries are often talked about like harmless and reversible tools for self-discovery or self-expression. They are not. They are serious medical interventions with real lifelong consequences.
A lot of people dealing with gender distress may actually be struggling with autism, unresolved trauma, internalised homophobia, body image issues, identity confusion, personality difficulties, and plenty more besides. Those people need proper help to address the root cause of their distress, not a conveyor belt toward transition before they fully understand what any of it means.
We cannot change sex, and too many vulnerable people are being told that they can. No life-altering treatment should be fast-tracked when someone does not fully understand the risks, limitations, and permanence involved.
Years ago, we as transsexual people were expected to go through therapy, psychiatric care, and attempts to rule out every other explanation before transition was considered. It was seen as an absolute last resort, not as a first option.
I entered psychiatric care at 11 years of age and didn’t begin medical transition until 21. In this time frame, I had 10 years of therapy, multiple types of antidepressant, multiple antipsychotics, and a three-month psychiatric hospital stay. Everything else was tried first. Nothing worked. Transition did. Today, I live a functional and fulfilling life. I have truly found joy.
But that does not mean transition is the answer for most people. It helped me, and it can help a very small minority of us, but it is exceptionally rare that this is the right path.
That is why gatekeeping matters. Proper assessment, time, challenge, and differential diagnosis are not cruelty. They are not conversion therapy. They are safeguards. They protect vulnerable people from irreversible mistakes while still allowing truly sex dysphoric people access to treatment.
Safeguarding is not hate. Reality matters, especially in medicine. Sex is real and cannot be changed.
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