More girls are changing their gender from female to male than ever before. And it’s YouTube star Alex Bertie’s example that they’re following. What’s behind the surge in numbers? Janice Turner investigates.
The little girl who was once Alex Bertie liked action figures, toy cars and Lego. Above all she loved video games: her favourite times were sitting beside her father, Paul, a postman, while he played Nintendo and Dreamcast. Consequently at primary school her friends were all boys. “The guys were like, ‘I can’t believe I’ve found a girl who likes video games.’ And to them that’s like gold, isn’t it?”
Little Alex “generally steered clear of anything pink, frilly or sparkly”, but her parents didn’t care that their daughter preferred jeans and shirts. Nor did her many friends, who all lived close by in a modern estate in rural Alderholt, Dorset. And for the happy first 11 years of life, Alex never thought about gender.
At 13, there was the hated school prom: Alex didn’t want to wear a dress, but for once her mother, Michelle, insisted, and so Alex bought the dullest black gown imaginable but wiped the make-up off her face: it felt wrong.
That term, just before summer break, Alex realised she was attracted to her female best friend: “And I ended up, stupidly, telling people at school that we were in a relationship. I didn’t think I was a lesbian or anything like that. I just thought, ‘This is somebody that I’m really into. Why can’t we be together if we have a connection in a similar way that I would if I found a boy that I liked?’ ”
In September, starting at a huge new secondary school, Alex and her girlfriend found themselves surrounded by a jeering gang. News had spread. Alex felt panicked, anxious. She hadn’t even told her parents. “I was known as the ‘weird lesbian girl’ and nobody would speak to me, and suddenly it was just really hard, because I’d never found it difficult to make friends really.” She’d go over to her old mates, the video-game boys, but they’d walk away. “My sexuality tainted their perception of me entirely.” Among the post-pubescent “masculine” boys and “feminine” girls she was an oddity: a masculine girl. “I was the misshapen cookie, the one made at the end with the leftover dough that gets burnt and no one wants to eat.”
Lonely, dumped by her girlfriend, Alex was catcalled and harassed relentlessly by a gang of boys: “I was a bully’s dream: weedy, geeky and gay.” For three years, she endured shouts of “lezzer” or “you’re a boy” without reporting it, growing ever more troubled. She self-harmed by cutting her legs where her mother wouldn’t notice. She hated her now developing body, although cropping her long hair into a cool boyish cut felt great.
At this time, Alex assuaged loneliness by setting up a YouTube channel, making little videos in her bedroom about her sexuality in which she vented her misery but also created a perky online persona who quickly won followers. Then, around 15, Alex told a teacher about the bullying, self-harm and gender dysphoria – a discomfort with your body’s sex. A school counsellor made an appointment with an LGBT group, Over the Rainbow, which gave Alex a folder about transgender issues, including pictures of trans celebrities and how to begin the NHS pathway to transition. It was a lightbulb moment.
“At 15, I fully understood I’m supposed to be male,” Alex says. On YouTube he discovered many other female-to-male video bloggers, changed his girl birth name to Alex and started to strap down his breasts with too-tight swimsuits, before ordering a special breast binder online. “Suddenly,” he says, “my teachers looked out for me in class.”
At 16, he moved to sixth-form college where no one knew him, assuming his new male identity. As a man, his confidence soared. He learnt to act like a boy, to manspread and banter: “At first I was like the bro-iest bro.” On his YouTube channel he declared his intent to medically transition, and what he calls his “quest to a beard” began.
Now I sit with Alex, 21, in that same lime-green bedroom seen by his now 300,000 YouTube followers. In a tank is his snake, Tim. After 18 months on testosterone, injected into his buttock every three months, Alex’s voice is low; he has a passable beard and has filled out a little, but is still a birdlike 5ft 4in and his hair is receding. His periods have stopped and he is now probably infertile. “I’ll adopt,” he says cheerfully.
“I had so much dysphoria and distaste towards my body. And I knew in my heart and soul that I was not supposed to be a woman. It’s difficult for a cisgender person [someone who identifies as the sex they were born with] to understand. Now I have down days, but that’s not for gender reasons any more.”
Alex is a delightful person: by turns kids’-TV-presenter enthusiastic, then suddenly profoundly vulnerable. He recently had a very painful NHS operation to remove both breasts; it took weeks to recover. His book,Trans Mission: My Quest to a Beard, details his journey, as did his frequent videos, through GPs appointments and gender services. He works as a graphic designer for a local private school and is dating another young trans-man called Jake, whom he met in a support group: they transitioned together.
I was the misshapen cookie, the one made at the end that no one wants to eat
And now Alex Bertie is a trans poster boy. His book is a how-to manual for confused girls with an appendix on how to make your own breast binder. Why does he think so many girls now transition? “It’s a lot more public than it used to be. People can see it as an option. Like, ‘Oh, I can actually alleviate this pain I feel towards my body.’ ”
These girls write to him with questions and he replies honestly online; thinks it’s important not to hide the gravity of transition. “How do you cope with gender dysphoria in the bath?” one asks. “Bubbles,” he replies, “lots of bubbles.” Alex’s body hatred endures to some degree, but in his book he says he won’t yet have what is known as “bottom surgery”, using his female genital tissue to create a penis and testicles, one of which acts as a pump to simulate an erection. Both of the two current methods risk infection and loss of orgasm.
He’ll wait until genital surgery has advanced. But, I say, they’ll never create a functioning penis that can ejaculate. “Never say never!” says Alex brightly. Meanwhile he “packs” his boxers with a prosthetic device that allows him – once he’d got the hang of it – to pee standing up. He feels he is now “my authentic self”.
Downstairs I speak with Michelle, who is the deputy manager of a care home. She weeps as she speaks of Alex’s double mastectomy. “Seeing him go through that … But he had such a pure hatred of his body. He said, ‘It’s your fault for giving birth to a girl.’ ” She never really tried to challenge his transition. By the time she even knew, he was being cheered on by thousands of online fans.
As a small girl, Jessie hated dresses and skirts, wearing jeans and T-shirts, and was often mistaken for a boy. Her quirky, nonconformist parents, in south London, encouraged her to play with trucks as well as dolls.
Around 13, Jessie realised she was attracted to girls and came out to friends as bisexual and then gay. Her favourite bands were All Time Low and Twenty One Pilots, all-male groups whose members were young, cute and fun. She didn’t fancy them; she wanted to be them. These boys had exciting lives, girlfriends, cool haircuts and wore clothes she liked to wear.
Online, Jessie could find no one like her. YouTubers Rose & Rosie were gay but too “girlie”. And she discovered that her favourite bands had a huge Instagram following of girls just like her: young, “butch”, high-achieving and gay. Her fellow fans became online and then real-life friends.
They’d hold meet-ups in Hyde Park. “No one uses the word ‘lesbian’ any more,” she says. “It’s so uncool. It has really negative connotations.” Rather, these short-haired androgynous girls, many of whom had previously self-harmed, started to identify as boys. Some went by male names only online, others just among close friends. A few were “socially transitioned”: out as male to family and school. “It’s weird,” says Jessie. “It’s as if a switch is flicked and suddenly you feel different. I felt I will no longer be that weird girl who dresses like a boy. I will be a boy.”
Jessie had felt uneasy about puberty, but now “it felt 100 times worse. ‘I’m not a girl: why do I have to go through this?’ ” To her 5,000 Instagram followers she became “Jake”. “And if you are on your phone as much as me, that means I was Jake most of the time.” She planned to become Jake permanently when she started sixth-form college, taking testosterone at 16, growing a beard … She followed Alex Bertie’s transition avidly online and was excited to meet him at a YouTube event.
Then she told her parents. They’d been warm and accepting (and unsurprised) when she came out as gay. But they were appalled when Jessie said she was “in the wrong body”. Her mother, Lily, refused to let her attend a gender clinic. Instead, she challenged her thinking: why did having short hair, loving other girls and preferring the menswear department make her a boy? Why must she change her body to match her personality? The rows were epic. “I was forever texting that my parents were awful, that they wouldn’t let me be my authentic self.”
Jessie’s friends had started to bind their breasts: some strapped so tight, they threw up. She tried, but it made her out of breath. Then her mum found her binder and threw it away.
Over a turbulent 18 months, the feeling she was a boy gradually faded. Why? She got a girlfriend and saw her transitioning friends were still deeply troubled. “But the biggest factor was that I moved from music stuff to TV fandom.” She watchedSupergirl, which has two lesbian characters, Maggie and Alex, a secret agent and a cop; andWynonna Earp, with action lesbians Waverly and Nicole who fight demons. “It sounds mad, but they changed my life: finally I saw girls I wanted to be.”
Now Jessie is 17, starting A levels, a happy, sociable, “out” lesbian. “I don’t see why there should be a male box and a female box. Just people who happen to have a penis or a vagina.”
What would have happened if her mother had taken her to a gender clinic? “I would have been Jake now. No question. But I wouldn’t have been happier at all.”
Why do so many teenage girls now believe they are boys? Not just in Britain and the US, but across the western world, the number of female referrals to gender clinics has soared. A decade ago, girls were a fraction of patients at the Gender Identity Clinic in London, the UK’s main child gender service. But in 2011-12 girls surpassed boys, and now comprise 70 per cent of all cases: around 140 new girls every month. Typically they present at puberty, having hitherto never questioned their natal sex, and 90 per cent are gay: clinicians are calling it “rapid onset gender dysphoria”.
Disquiet among professionals has been growing, but until now few have spoken out, terrified of breaching a new orthodoxy that gender transition must always be “affirmed”, even celebrated, since it is the brave expression of the true self. Even if that person is a troubled 14-year-old girl.
James Caspian, a gender psychotherapist for 16 years, has helped many patients transition: he has no doubt that some people cannot live happy lives unless they do. But around seven years ago, his patient base began to change: his clients were younger and predominantly female. Most were lesbians and many had mental co-morbidities such as autism, depression or anxiety; others had suffered sexual abuse. All saw changing gender as a panacea. Yet Caspian believed this to be a fallacy: he discovered a growing US community of lesbian detransitioners (patients who change their mind). But when he tried to research this at Bath Spa University, his MA was blocked by the ethics committee as “politically incorrect”.
Since I interviewed Caspian, others have approached me: teachers noting a sudden clique of transitioning girls, parents whose girls abruptly identified as boys and several senior gender specialists. All wish to remain anonymous for fear they will be accused of transphobia, vilified, even sacked.
A woman I will call Dr K expresses years of frustration dealing with an unacknowledged epidemic of dysphoric teenage girls. “They are all the same, dozens and dozens of them. Short hair, boys’ clothes, probably liked rough and tumble play as small children. Now they like comic books or skateboarding or video gaming. Geeky, gauche, not many friends. They came out as lesbians, but then they went on Reddit and Tumblr and saw these transitioning videos. They decide they are trans. Suddenly they get lots of attention with everyone calling them by a new name, they get to chide anyone who uses the wrong pronoun while everyone tells them they are brave. They might get a special assembly at school.”
What we can’t underestimate, says Dr K, is the sheer homophobia outside middle-class liberal bubbles. “Lesbian” is at worst a grave insult, at best uncool. “The gay hierarchy is this,” she says. “At the top are gay men who can pass as straight, then camp gay men, then pretty, straight-passing lesbians. And right at the very bottom are butch lesbians. Masculine women have no cachet. But if you transition, you zoom right over the gay hierarchy to become a straight man. You can hold your girlfriend’s hand in public. As a butch woman you were unattractive, but lots of them become these cute little guys.”
Then, she says, there are the autistic girls, many undiagnosed. With a typically heightened sensory awareness, they find puberty particularly distressing, while a tendency to rigid categorical thinking means they see society’s pink and blue gender boxes and, if they like “male” clothes or pursuits, believe they must be physically reclassified.
Other girls who have been sexually abused simply wish to escape their vulnerable, desired female bodies. Dr K recalls one patient who came from a very troubled, violent family, where older female relatives were raped. “This girl was very tough, a real survivor. She’d gone through so much. And she said, ‘I can’t be female because girls are fragile and weak, and I don’t feel like that.’
Trans ideology is celebrated as progressive yet, says Dr K, it is deeply conservative, erasing homosexuality and enforcing gender stereotypes. Which is why, says another child clinician, Dr B, it has taken such a hold. “Parents, particularly those without much education, see it as the obvious solution. If your child had diabetes, you’d get him prescribed insulin. If your gay daughter is masculine and feels she’s a boy, you take her to the doctor for hormones. This is the narrative of trans activists groups such as Mermaids and it makes sense to a lot of people. It is far harder to challenge stereotypes, to be ‘gender critical’.”
Jessie’s friends started to bind their breasts; some strapped so tight they threw up
Moreover, a recently approved NHS “memorandum of understanding” states that questioning a patient’s declared gender or examining other underlying mental issues is equivalent to gay conversion therapy. A mother like Jessie’s, who refused to believe her 14-year-old was a boy, risks losing custody of her child. Already schools are pressed to endorse every child’s transition: a teacher in the West Midlands tells me of a very young girl who was allowed to take a male name and pronouns at school without therapeutic support or parental consent. “And you can’t even change a GCSE option without a parent’s signature.”
Trans groups seek an “affirmative” model, as practised in the US, where a doctor’s only role is to agree with a patient’s trans self-diagnosis and to begin treatment. Dr K says most girls now arrive utterly certain, fully briefed by Mermaids or trans websites, often infuriated they must have counselling. Gender clinicians, she says, can only challenge a child’s notions about being in the wrong body “by stealth”. But she risks professional disbarment, because she feels increasingly uneasy about putting girls on a pathway towards an untested treatment regime they may live to regret.
She is scathing, too, about puberty-blocking drugs such as Lupron – prescribed off-label, without any long-term studies upon the developing body and brain – which “pause” development, theoretically to give a child a year for reflection. In practice, almost 100 per cent of children on blockers proceed to cross-gender hormones. (This causes certain sterility: the gametes never mature enough for eggs or sperm to be banked.) “That year on blockers should be when we have deep, intensive regular therapy. We should ask, ‘What is a girl? What is a boy?’ Instead we barely see them, their peers go through puberty and leave them behind, which makes them even more anxious and desperate to transition.”
Both doctors agree with James Caspian, a Jungian, who calls this trend in girls “a collective complex”, a form of mass hysteria fed by online communities. Tumblr and Reddit brim with transition webpages, support groups of girls egging each other on, celebrating when they start “T” (testosterone). As an experiment, I took several “Am I trans?” questionnaires, giving the most ambivalent answers. The result is always “probably” or “yes”.
Peter lived as a woman until his late forties when, after extensive therapy, he became a trans man. “I just knew I had to do this to be happy. I was simply not a woman.” He now runs a trans support group and is aghast at an online culture pushing young lesbians into hasty transition. “I think some of them actually want to hold on to the transitional state. For a girl who was once marginalised, it has prestige. You post videos updating your progress. You get endless attention.” But actually living in your new gender can be a letdown. “They find their old problems have not gone away. And we pick up the pieces.” Peter knows trans boys who consulted private doctors to obtain hormones without prior counselling “and now they’ve had a breakdown and are asking Facebook friends to donate money for therapy they should have had first.”
Growing up in a small Scottish town, Gill was bullied to the point of mental breakdown when she came out as a lesbian teenager. A doctor gave her a diagnosis as trans within ten minutes, but her mother refused treatment. Later she moved to London and encountered the newly emerging “queer” culture, where being trans was far more fashionable and edgy than being a lesbian. She took testosterone for several years, growing permanent facial hair, before desisting. Now 35, she says, “What I needed growing up was older lesbians to reassure me I’m fine as I am. And that’s what I think these girls need now: to meet women like me. But the LGBT movement wouldn’t allow us: they’d see this as transphobic.”
The LGBT community will not countenance that a huge spike in transitioning girls is – like anorexia or self-harm – a social contagion, because this counters a central pillar of trans doctrine that gender is “innate”. The trans lobby is led mainly by older trans-women – born males – who were never teenage girls in the maelstrom of female adolescence. Their view is that girls who detransition weren’t trans to begin with. Although the question, as doctors are told to prescribe drugs unthinkingly, is how can you tell? I email Ruth Hunt, CEO of Stonewall, to ask if she believes many young lesbians are transitioning in response to homophobic bullying. Although a lesbian herself, she refuses to answer; she simply says how “at Stonewall we support every lesbian, gay, bi and trans young person to be themselves”.
But what is the true self of the teenage girl bombarded with pink and blue gender stereotypes on one hand and encouraging trans messages on the other? Especially since one in four girls, according to a recent government survey, has suffered depression. “We must separate gender dysphoria from trans,” says Dr B. In other words, hating your female body is common when society continually tells women they must look a certain way, but this does not mean a girl is in the “wrong body”.
Maybe, I say to Dr K, you are old-fashioned, wrong. Maybe it is fine for a legion of girls to take testosterone, to trade their capacity to orgasm or bear children for a better outward appearance in our highly visual age. Maybe lifelong hormone regimes, moulding the body via surgery, breast binders and stand-to-pee prosthetics are progress? “Yes,” she says. “And I hope I am wrong, for the sake of all these young people. But all my instincts as a clinician say not. I’m thinking of opening a practice in a new field: detransition. I foresee a gap in the market.”