The “T” in “LGBT” is the rainbow’s fastest-growing segment. The past few years have witnessed an exponential increase in the number of Americans, especially young people, “coming out” as transgender. Academic research proves this, pop culture proves this, and your own relationships probably prove this. The number of transgender youths in the United States is now estimated to be in the hundreds of thousands. Another trend, less discussed, is that females — people born with two X chromosomes — are now far more likely to transition than are males — people born with X and Y chromosomes. This is a reversal from decades past, when males were three times more likely to transition.

But from this skyrocketing number of transitioners has emerged a countervailing trend: a growing community of detransitioners, people who have realized that, despite feeling deeply unhappy before medical and social transition, their gender identity was not the culprit. These individuals, many of them young women, report that they had no problem accessing life-altering medical intervention, often as teenagers, often only days or weeks after announcing their symptoms. They are now attempting to return to their prior selves, in bodies that have been changed significantly, often irreparably.

In the medical establishment and in our left-leaning media, the detransitioners are dismissed or ignored. They face the cold shoulder from LGBT groups, or even aggressive attacks online, as their stories are being used to blow the whistle on America’s mass youth transition and the narratives on which it was built: namely, that gender is “assigned at birth” on the whim or guess of a doctor and reinforced by an intolerant society. Detransition suggests untreated mental and interpersonal issues that superseded the question of gender and weren’t aided by it — the depression, the social discomfort of puberty, the profound malaise that was neither addressed nor improved by social and medical transition.

Physically, the detransitioners grapple with infertility, permanently feminized or masculinized features, loss of the ability to orgasm or become aroused at all, and the medical aftermath of years of hormone treatments and invasive surgeries. Mentally — well, it’s not so clear what the long-lasting effects of America’s wave of youth transitions will be. But as the wave grows, the testimonies of those who went back may give us a hint about what is to come.

The stories from detransitioning young people are strikingly similar. As lonely and alienated teenagers, they were exposed to transition on social media and thought it might cure their isolation or unhappiness. They went through a cursory process to acquire “puberty-blocking” hormones, then testosterone or estrogen, and then surgeries. They realized, horribly, that they had made a grave error. And now they are posting about it on Reddit and Twitter.

Chloe Cole is the most prominent American detransitioner. Now 18, she recalls “being exposed to a lot of LGBT content and activism” at age 13 and seeing “how trans people online got an overwhelming amount of support” on social media. As she grappled with adolescence, online supporters pulled her toward what she then viewed as a good decision. “The amount of praise they were getting really spoke to me because, at the time, I didn’t really have a lot of friends of my own,” she told the New York Post last year.

Cole does not recall ever feeling that she was being raised in the “wrong” body or was misidentified at birth. She sought medical intervention soon after “coming out” as transgender to her parents. At 15, she underwent a double mastectomy, one consequence of which was permanently losing the ability to breastfeed. Less than a year later, she realized she had made a mistake.

The friends she made while transitioning, Cole tells me, abandoned her when she changed course. With transition came the exhilaration of social acclaim and the rush of testosterone injections. Afterward, a cold and lonely withdrawal. She now travels across the country, speaking about her ordeal to anyone who will listen.

Another testimony, from YouTuber Jalisa Vine, who underwent both “top” surgery (mastectomy) and “bottom” surgery (the removal of her uterus and ovaries and the construction of a phallus using grafts of her skin), is one of hundreds of detransition “diaries” available online. “I can’t have kids,” Vine, in her 20s, laments. “I’ll never ‘lose my virginity.’ . . . I feel like I’m left to just, like, accept the scraps of the life that I could have had. . . . I’m angry. I’m sad. I’m consistently questioning, like, why this happened to me — how did this happen to me?”

Why, and how, did Vine take these irreversible steps? “I don’t want to use the word ‘indoctrinated,’ but I was young, and I was sad, and I was impressionable, and I thought that this would fix everything.”

More American teens are preparing to go under the knife as you read this, and we aren’t doing much as a society to consider them. The phenomenon of “rapid onset gender dysphoria” describes a subset of young people, typically females, who like Cole and Vine become suddenly dysphoric during or shortly after puberty. Many of them have underlying mental-health or interpersonal issues, very often including autism. Among this group, double mastectomies are not uncommon for girls and women under the age of 20. Why?

It could be a “baby led” approach to parenting in which adults (particularly parents but also teachers) are told by the education establishment, the media, and books and other cultural content (such as the book and reality-TV series I Am Jazz) that children are right, that children know best what their gender identity is. Then there is the concept of “gender identity” existing as separate from biological sex, a bifurcation with roots in the post-structuralist thought of French philosopher Michel Foucault, applied to gender by the American theorist Judith Butler in the 1990s, and left to ferment in the halls of the American academy. The effort to separate sex from gender reached a tipping point in the 21st century, becoming hegemonic in the last decade and spilling out from gender-studies departments into boardrooms, newsrooms, locker rooms, and entertainment and social media. Today gender theory’s assertions are considered self-evident by medical professionals, educators at all levels, and psychologists.

Parents whose children express gender dysphoria are being guided by medical professionals and psychologists who have been educated in the principles of “affirmative care,” the model currently taught by the American Psychological Association and accepted by major LGBT and medical groups. At its heart, affirmative care validates rather than treats a patient’s expressed gender dysphoria. If a twelve-year-old girl comes into a clinic and says she is a boy, the next step is not to question this claim, or to consider that there might be some other problem afoot, but to give her puberty blockers. There are significant mental-health benefits, the APA says, in “affirming children’s gender identities.” But “affirming” the views of a patient is not technically, and has never been, the role of therapy.

Parents who are skeptical that their teenage daughters may actually, suddenly be sons — that they’ve been boys all along — may be told by clinicians that their children will self-harm or even commit suicide if not allowed to transition. The parents could lose custody or parental rights, as California father Ted Hudacko did last year. Hudacko was legally barred from seeing his 17-year-old child because he opposed the child’s transition. (The youth is a male who was, as of early 2022, undergoing transition.)

The question “Would you rather have a living son or a dead daughter?” is emotional blackmail used against hesitant parents. It smothers an obvious truth: Perhaps the vast majority of these youths are suffering from discontent unrelated to their biological sex — or, like the young in every generation, are in a phase of experimentation — and do not require life-altering hormones and surgery to “cure” them.

While the U.S. barrels ahead with mass youth transition, other countries are pumping the brakes.

After a public outcry, Britain announced the shuttering of the Tavistock gender clinic in north London, owing largely to whistleblowers inside the clinic and to British detransitioner Keira Bell. Bell filed a lawsuit against Tavistock, the central provider of youth transitions in the U.K., five years after beginning her medical transition at 16. She argued in court that the clinic “had failed to protect young patients” and had conducted “what amounted to uncontrolled experiments” on youths such as she. A panel of judges agreed. The U.K.’s National Health Service is now overhauling its approach to youth transition to “embed the care of children and young people with gender uncertainty within a broader child and adolescent health context” (emphasis added). In other words, therapists and medical providers must consider whether for a certain portion of youths who seek to transition there are other mental-health factors to treat as well — or instead.

The British government is not alone in its U-turn on the affirmative-care model. Sweden and Finland are rethinking their approach too, with the former having banned transition surgeries for minors, and both countries, as Leor Sapir wrote last year in City Journal, having instructed “clinicians who deal with minors to utilize an approach that emphasizes talk therapy as the first line of defense and ‘affirming’ drugs only in extreme situations, if ever.” The National Academy of Medicine in France is now emphasizing “psychological support” and “careful decision[s] about medical treatment” in lieu of affirmative care. And the Royal Australian & New Zealand College of Psychiatrists has announced that it is reconsidering its “affirmation only” patient model.

Sue Evans, a British nurse who worked at Tavistock from 2003 to 2007, wrote last year in the Free Press (at the time, Common Sense) that her team “recklessly prescribed puberty blockers and cross-sex hormones to kids,” regarding the transitioning of incoming youths as a “fait accompli . . . even if we, the mental-health-care professionals, had legitimate questions about the appropriateness of the treatments that patients and patient advocates were demanding.” Much of the Western world is now coming to regret this recklessness.

But in America, caught in an endless culture-war spiral, we are blazing ahead with so-called affirmative care as the only acceptable model for youths seeking medical transition. The American Academy of Pediatrics recently reiterated its support for the “affirmative care” approach. Boston Children’s Hospital caught flak for its “vaginoplasty” web page, which featured an image of a toddler — something the hospital claims was an accident. The nationally renowned Children’s Hospital of Philadelphia deleted a training video that coaches medical staff to aid teenagers in gender transition without those practitioners (or the teens themselves) informing the parents.

The White House itself may be considering an executive order that would label talk therapy, even for minors, a form of “conversion therapy,” according to a memo leaked to City Journal last summer. The use of this much-hated term, which has traumatized countless gay and lesbian teenagers, is not an accident; a therapist who suggests talk therapy for a 16-year-old girl who is seeking a double mastectomy and vaginoplasty is cast in the same light as a religious zealot recruiting gay teenagers for a “reform” camp.

From Greek myth to the modern world, transgenderism — and the phenomenon of people who wish to live and present as the other sex — is a historical and cultural fact. There will always be among us, for biological or social reasons, men who are so feminine that they are more comfortable, mind and body, presenting as women; the reverse is true for exceptionally masculine women. (There is also some evidence that transgenderism and cross-dressing can be a fetish among some straight men.) These individuals have not drawn an easy lot in life.

But the transgender population has always been small and overwhelmingly male-to-female. In the West, this changed only as we moved into the 21st century. What explains a doubling of the number of transgender teens in the past five years alone? Social influences, not biological ones — especially for youths already struggling with their sexuality.

“The social-contagion aspect does cause a lot of people who are already outside of social norms [lesbian, gay, and bisexual] to come to a conclusion that they are just trans instead of gay,” Chloe Cole tells me of today’s LGBT youth. “I can think of a few specific people who have told me that they ‘transed the gay away.’”

That is a remarkable and sad statement. For an achingly short period of time, perhaps the first decade of the 2000s, just gay was okay — it was fun, even. This period, squeezed between centuries of suppression and invisibility and our new era of gender dissolution, was precisely the period in which I was growing up: after gay and lesbian people had stepped out of the shadows, after the AIDS crisis had stirred the American consciousness, but before the idea of gender transition had become endemic. Now gay people are boring, white gay men — as portrayed in LGBT media — are a scourge, and lesbians have nearly disappeared. (Three years ago, the gay writer and commentator Andrew Sullivan wrote this plaint in the Spectator: “I miss lesbians these days because so many are now becoming men.”)

A variety of studies suggest that as many as 80 percent of gender-dysphoric children ultimately experience “desistance” — or coming to terms with their biological sex without medical intervention. Desistance is a trend well summarized by Canadian sex researcher James Cantor: “Despite the differences in country, culture, decade, and follow-up length and method, all the studies have come to a remarkably similar conclusion: Only very few trans-kids still want to transition by the time they are adults. Instead, they generally turn out to be regular gay or lesbian folks.”

Many of today’s transitioning youths would have ended up being gay or lesbian adults in another generation, with no life-altering surgeries or daily hormone regimens.

I know — I am one of them. Like many gay boys, I did not feel like “one of the boys” on the elementary-school playground, a source of deep shame for me. I played dress-up and often had female friends. I was not punished for this. My parents did not try to make me “more of a man”; luckily, I grew into being the man I am today. But I also received no signals from my elders that there was something more deeply amiss with my “boy” self. My family spared me from the shame of forced masculinization, without making play, confusion, and the sadness of a child who is not like the others into a permanently pathologized experience. I am thankful above all that I am not that young boy today, when a well-meaning adult might expect me to dwell on this alienation from the other boys or even coach me to dive further into it, leading me down a path of despair.

Of the many transitioning children and teenagers today, a significant portion would have found comfort living in their original, medically unaltered bodies. That is what we should hope for, after all. “The body is not a video machine,” David Bell, a British medical doctor and gender-care whistleblower, told the Guardian. “You can’t just press a pause button,” or swap out new hardware.

Our bodies are not infinitely malleable. Infertility, a lifetime of hormone treatments with uncertain consequences, numerous invasive surgeries, and a number of psychosocial implications of transition are a difficult burden to bear. (What happens, for instance, when a transgender man who has tried for years or decades to present as male still isn’t actually happy, or even recognized as a man by most observers?) This is not even to mention the actual cost of treatments, which can add up to hundreds of thousands of dollars to cover medical procedures and plastic surgery.

The wreckage washing up in the wake of America’s mass youth transition are the detransitioners, entering adulthood, sometimes utterly destroyed but determined to have their voices heard. To warn us. They are both part and process of America’s growing “LGBT+.” They are in fact its last, silent letter — the final transition, back to what they started as, but nothing like they were before. Some things just cannot be put together again.

Almost none of the detransitioners have received any form of support from an LGBT organization. They are varyingly pilloried, silenced, or rejected; their social clout vanishes as they try to halt what has been done, to go back.

“I was cast out of the LGBT community as soon as I expressed any regret,” Chloe Cole tells me. “The mob mentality present in mainstream LGBT spaces is extremely dangerous. The pressure to go along with all the ideas present in the community will [drive] and has undoubtedly driven people to serious harm.”

It is a fearful prospect that many of today’s gay and lesbian adults could have been driven into dysphoria, ultimately rejecting their own physical forms, had they been born just a generation later. But it will be the reality for many of today’s LGBT youth, perhaps hundreds of thousands of them.

How can you measure their pain — the pain and confusion of an entire generation?

You could measure it in mastectomy scars, sewn at the ribcage, or trips to the emergency room to fix the countless complications and malfunctions of a lifetime of surgeries. You could collect all the prescription slips from the endocrinologists and the surgeons and the psychiatrists and plaster the streets of every American city with them. You could add up the years spent in medical treatment — the time taken away from all of life’s other pursuits — or all of the bills from the plastic surgeons.

The effects of transition and subsequent detransition are severe, they are graphic, and they are set to worsen significantly in the years to come. America’s growing wave of youth detransitioners proves it.