Gender change agents: when pressure from outside complicates the pressures within
Ollie Davies was 26 and at the lowest ebb of his life when he made a decision to come out as a trans woman. “People just started suggesting that I question my gender.”
Ollie Davies was 26 years old and at the lowest ebb of his life when he made a decision to come out as a trans woman.
Suffering depression, anxiety and behavioural problems as well as a crisis of self-identity, he existed in what felt like a dissociative state. He had distanced himself from family. “I felt as if I had no free will,” Mr Davies says. “I was completely nihilistic and lonely and self-hating and had no self-esteem. I was experiencing a total loss of identity and lack of sense of self.”
Mr Davies, who was openly bisexual, had never questioned his gender identity as a child or young adult. But when people within his group of queer activist friends repeatedly suggested to him that he was trans, he began to believe it was true.
“Ultimately it came from suggestions from others, people just started suggesting that I question my gender,” Mr Davies said.
In the wake of the order to close London’s Tavistock Clinic, there is growing disquiet in medicine at what a British review labelled the “unquestioning affirmative approach” to gender identity and the lack of evidence base behind hormone treatment as the numbers of young people presenting with identity issues explodes. Psychiatrists want “evidence-informed assessment and treatment”, a stance fiercely resisted by trans health doctors who insist mental health assessments should not be part of the decision-making process in gender transitioning and that a diagnosis of gender dysphoria is not even necessary to begin hormone therapy.
Ian Hickie from the University of Sydney’s Brain and Mind Centre, says: “I don’t think any ideological approach, either gender-affirming or gender-denying is necessarily what best clinical practice is about.
“This is not a place for ideology; this is not a place for fighting other cultural or gender issues.”
When Mr Davies announced his decision to transition, the affirmation was immediate and intoxicating.
“Everyone I knew put trans people on a pedestal,” Mr Davies says. “It was fashionable. I knew it would be celebrated and promoted. At first it was euphoric. I felt like coming out as trans was my coming home and the key to everything that was wrong in my life.”
But, despite signing up for hormone therapy enthusiastically, being a woman never felt right. “These feelings of negative self-image and negative self-reflection became a downward spiral, and I kept trying to solve the problem further by being more of a woman,” he says. “And it just became more and more incongruent with who I am and what is natural for me. I came to realise it was a waste of time and a delusion.”
In 2019, while still living as a woman, Mr Davies met Genevieve Hassett and fell in love at first sight. “We were both fairly deep into the woke trans ideology,” Ms Hassett says. “But the more I got to know Ollie the more I realised there was a lot of underlying stuff. I think he felt shame about being a man.”
There are no reliable statistics on how many people identify as transgender in Australia, but there is no doubt the numbers are on the rise. The number of children presenting at gender clinics has exploded in recent years and some predict Australia will begin to see legal actions as in the UK from those who allege they have been harmed by affirmative care.
Mr Davies has now completed his transition back to being a man. He and Genevieve want to have a baby, but he is infertile from the effects of oestrogen on his body.
“It’s devastating,” Ms Hassett says.
Mr Davies now wants to publicly challenge what he describes as an activist-driven approach to diagnosing and treating gender dysphoria.
He questions the Australian Professional Association for Trans Health (AusPath) standards of care that gender-affirmative doctors follow, which specify clinicians should take a patient-led, “affirmation enablement” informed consent approach “that recognises the patient is the final authority on their own gender”.
“The gender affirming approach in medicine I think is a complete mistake,” Mr Davies says. “I’ve seen an enormous amount of anecdotal evidence, including in my own life, that there are inadequate safeguards. I think that what has happened to me is just the thin edge of a massive iceberg.
“In my experience, people are inadequately educated about the risks when they initiate the process of transitioning, or even not told about them at all. It seems to me that to just say ‘we must affirm’ is just utterly failing those people and actually causing harm.
“And I think it has the potential to negatively affect the small community of people who have gender dysphoria that these treatments were developed for who may actually benefit from them.”
Trans health doctors under AusPath insist a mental health assessment is not required in order to facilitate a person to transition because “being trans is not a pathology”. But in the fallout from the ordered closure of Tavistock, there is now active debate in medicine in Australia about how to care for young people raising gender concerns.
Professor Hickie says providing personalised, holistic medical care to these patients is of utmost importance.
“These are issues that are being very actively debated in the profession,” he says.
“I think the concern worldwide is the extent to which these mental health considerations are being factored into the actual clinical assessment, and particularly the decision, or not, to proceed to medical interventions to support transition. This is a really important and incredibly significant health issue for individuals and the ramifications of making a decision are profound.”
Trans health bodies point to research that show gender transition regret is extremely rare. They say people who detransition usually do so owing to discrimination.
But Mr Davies believes if doctors had properly assessed his mental health, probed his motivations and taken an ordinary exploratory clinical approach, he may have taken a different path.
“I think that in Australia there are hundreds of people like me who now regret it,” he says.
“And I think that soon there will be thousands.”
After consulting a network of “trans-friendly” doctors, Mr Davies in early 2015 was referred to a psychiatrist. He had only decided he was a trans woman a few months before.
He had three 45-minute sessions which ended in the psychiatrist declaring “my impression is one of gender dysphoria”. The psychiatrist noted that “the World Professional Association for Transgender Health Standards of Care have been fulfilled’.”
“There was no therapy involved,” Mr Davies says. “He somehow managed not to figure out that I was depressed, emotionally deprived, that I had no relationship with my parents, that I had a completely f. ked-up relationship with my sexuality, that I could barely sleep because I’m so anxious.
“I’ve spoken now to people who were in my life at the time, who are like, yeah, you were f. ked up and it was bloody obvious to all of us, but we didn’t know what to do, and we didn’t know what to say. But the psychiatrist apparently couldn’t see it.”
Mr Davies believes that if doctors probe the motivations of many young people who present with gender confusion, they would discover external factors were sometimes heavily at play.
“I think there is a massive population of people who actually don’t have gender dysphoria who are now either being pushed toward or themselves being drawn toward this gender affirmative care pathway,” he says.
“It has infiltrated the culture, it comes from doctors, it comes from the school curriculum, it comes from the media, it comes from social media, it comes from the peak LGBTQIA+ organisations and the marketing that they put out, it’s everywhere, telling you if you don’t feel like you fit the stereotype, you might be trans. For me, it felt like I’d pretty much been involved in a cult.”
