The “transgender tipping point,” in the words of Time magazine, supposedly came in 2014, when trans adults living proudly public lives began showing up regularly on mainstream screens. Such figures are still around—one is even in Congress. And yet, we seem to be tipping the other way. Laws regulating which bathrooms trans people can use are back. The Trump administration is kicking us out of the military. And in United States v. Skrmetti, the Supreme Court okayed state bans on gender-affirming care for trans minors.
Sometimes I think a lot of people want us to disappear. Others will tolerate us without acceptance: If you must be trans, you can have basic rights, but don’t encourage it, and for God’s sake don’t flaunt it. And yet, we’re still here, and still visible, especially among the young. UCLA’s Williams Institute estimated in 2022 that 1.6 million Americans 13 or older identified as trans: 14 per 1,000 kids ages 13 to 17 and 13 per 1,000 for young adults ages 18 to 24, compared with about five in 1,000 for adults 25 to 64. In a survey last year, Gallup found that 1.3 percent of adults identify as trans. Some writers see in such numbers a fad, or a bubble. Others see gender-affirming care, as recommended by mainstream medical associations in many countries, as the best way to the most fulfilling adulthood, and the least painful teenage experience.
To trans adults like me, some self-described skeptics look less like truth-tellers than like merchants of doubt: The debate around trans issues feels analogous to the ones around climate change, or vaccines. When you’re not winning an argument, you say nobody should act without further study, or demand unattainable certainties. It’s tough for people who’ve taken a position—doctors who speak out against trans-affirming care, or parents who feel sure they’re raising a girl—to change their beliefs. Those who do shift their views often do so not by comparing numbers, but by asking why they believe what they believe, what they want, and what other people can show them firsthand. Clouds and vaccines can’t talk. But trans people can.
I’m one. I lived out a closeted transgender childhood in the 1970s and adolescence in the ’80s, when transition wasn’t remotely an option. I felt grindingly frustrated by my own body, and my male social role, almost all the time. And I got lucky. I remember grade school as a sustained misery that kind adults tried to remedy, enlivened by two close male friends, assorted special interests (minerals, chemistry), and stacks of comic books. My teen years brought dramatic improvements: I found teachers who supported my reading and writing. I made friends with girls who trusted me with their secrets, even if I could not trust them with mine. I threw myself into televised quiz competitions (sometimes my team even won). In college, I learned how to put on a radio show (one way to feel heard while nobody sees your body). And I found supportive professors, and a path to one, then another, great job. Then, in my 40s, I realized I’d always feel disembodied, unsatisfied, not quite real, if I kept on trying to live as a man. I wore dresses and lipstick on special occasions; I talked, and wrote, about how I felt, without getting doctors involved. Then, one day, my spouse remarked that I’d be happier if I could just live as a woman. Everything suddenly seemed to come together for me: I felt like a crystal dropped in a supersaturated solution. I made an appointment for hormones that same day. Eight years on, I know I made the right choice.
Quick digression: During the Second World War, the Pentagon had to decide where to put armor on Air Force planes. Military brass expected to fortify airplanes’ wings, because most of the planes they saw had been struck there. Then the mathematician Abraham Wald explained why they should armor the engines instead: The generals had counted only the planes that came back. That’s called survivorship bias. If Wald hadn’t countered it, the Allied forces could have lost a lot more planes.
In Wald’s terms, I’m one of the planes that came back. I’m the best case you can find, or something close to it, for growing up trans without trans-affirming care. You might think that I, and trans adults like me, are a good case for making kids wait to transition: I had to wait, and I turned out okay. But that’s survivorship bias. Other kids who grew up with my gender, without my advantages, probably resigned themselves to their assigned gender role and their frustrating fate; there’s no way to count them in retrospect. And I know that if I could have lived as a girl—if I’d had access to gender-affirming care in grade school, in middle school, in high school—I would have made more friends, and learned more sooner, and avoided countless hours rereading the fiction of James Tiptree Jr., wondering why its unease around bodies and gender and its themes of self-annihilation spoke so strongly to me.
It’s possible that adults like me, as well as the internet, by providing non-gloomy examples, encourage some teens to see themselves as trans who would otherwise just go on living cis lives. You can’t prove a negative. But you can seek parallels. Consider the risks involved in coming out as a gay teen in 1965 versus 1985, or in 2025. No wonder we see more gay teens now than I did back then.
Wary parents might answer that cis gay kids do not ask to alter their bodies. Nor, generally, do trans, maybe-trans, or gender-nonconforming children in grade school, where care means social transition: names, pronouns, clothes, a safe place to use the bathroom. Acceptance for social transition—hence for kids who want time to figure things out—might even slow down demands for endocrinology, by showing that you can be a girl, a boy, neither, or both, even if you don’t get doctors’ help right away. Several new works of young-adult fiction showcase exactly that kind of acceptance among teens and tweens.
That said, with puberty, things change. Going through the wrong one hurts—and not just in the way that puberty is terribly awkward for pretty much everyone. It turns what could be exploration and self-discovery into concealment and needless sadness. Gender-affirming medical intervention, for teens, almost always means puberty blockers (the same drugs used for cis kids’ precocious puberty) or hormones. Less frequently, it might mean surgical intervention. But more breast and chest surgeries (including reduction and augmentation) are performed on cisgender girls, and on cisgender guys with gynecomastia, than on trans minors; bottom surgery on minors happens very rarely. Youth who choose gender transition report, overwhelmingly, that they’re satisfied; the Kaiser Family Foundation dismisses as misinformation claims about high rates of regret.
Cis parents of trans kids often get warned about suicide, just as straight parents of gay kids got warned years ago. A better discussion would be whether parents want their kid to be sad, or withdrawn, or feel locked into a numb life, when they could learn how to flourish and find joy instead. Teen suicide is hard to study: Reporting is poor, and there aren’t many. We can, though, examine suicidal feelings, depression, self-harm. Studies exist on all these subjects. And despite disputes over data quality, most of them tend to agree that gender-affirming care works at improving mental health in dysphoric teens. Better yet, we can study—and encourage—acceptance, fulfillment, and joy. Most trans kids who hate their body, as I did, will not take their life. They might think about it, though, as I did. And they might undergo years of needless sadness, loneliness, and fear because they’ve been told, in 2025, to wait, and wait, and wait some more, for help they can already see.
