The Parent Trap

Gender-affirming care for kids is becoming the norm. Genspect has other ideas.

By Laura Jedeed

An illustration of a computer windows in different colors

The landing page for, an Irish nonprofit founded in 2021, is cheerful and inviting. It promises “a healthy approach to sex and gender” over pictures of possibly queer women laughing and smiling at nothing. Scroll a bit further and you’ll learn that the organization is “an international alliance of professionals, trans people, detransitioners, parent groups and others” that includes 25 groups from 23 countries in Europe and North America. “We don’t just speak for a few,” the website says of that alliance. “We speak for thousands.” 

Who are these thousands? Genspect advertises to help “anyone who has been impacted by gender dysphoria,” including parents of “gender-questioning” children, detransitioners (people who started transitioning but returned to identifying as their assigned birth gender), health care professionals, teachers, and school administrators. They advocate for “a society that supports gender non-conformity” but “doesn’t require the heavy burden of medical treatment.” They claim to welcome trans people and explicitly renounce transphobia, yet explicitly refuse to acknowledge that gender-questioning children might be trans.

“[Genspect] started off as an organization to give parents of trans-identified children a voice, since they weren’t being heard,” Joseph Burgo, U.S.-based Vice Director of Genspect tells me. He estimates that a couple  hundred parents are currently active within the group, and thousands more across allied organizations. “It has since evolved into an organization that is trying to present an alternative to the medicalized treatment that’s advocated by WPATH.”

The World Professional Association for Transgender Health, along with the World Health Organization, the American Medical Association, and every other major scientific and medical body, subscribe to the gender-affirming model of treatment, in which practitioners help trans people bring various aspects of their lives more in line with their identified gender. Genspect’s alternative path, exploratory therapy, seeks instead to figure out the root causes of gender dysphoria — not, they say, to rule out medical treatment, but to explore all options before committing to sometimes-irreversible changes.

Why do so many Genspect affiliates appear to be one degree removed from the forces pushing anti-trans legislation in states across the country?

Genspect claims to be nonpartisan. The organization’s founder, Stella O’Malley, describes herself as “generally liberal in [her] political attitudes” and claims that the parents in her support groups “generally skew progressive and left-leaning. They approve of same-sex marriage, often have marched for gay pride, and have happily waved LGBTQ+ flags.” She wrote these words for Quillette, a libertarian online magazine that endorses healthy, robust debate on subjects like whether there are “physical and psychological” differences between races and whether the overrepresentation of men in STEM can be explained by genetics. Quillette authors never come right out and say they believe that, for example, The Bell Curve is correct about Black people being less intelligent than white people. They just have a few questions.

Publishing an article in a magazine is no crime, but it did encourage me to ask a few questions of my own regarding the professed progressive politics of Genspect. What does Genspect’s “exploratory therapy” look like in practice, and is it really backed by science? Why do Genspect’s administrators and advisors chair so many different gender-critical organizations (“gender-critical” being the preferred term of those who do not wish to affirm trans identity)? And why do so many Genspect affiliates appear to be one degree removed from the forces pushing anti-trans legislation in states across the country?

When untreated, gender dysphoria is horribly painful. The parents of gender-nonconforming children are usually desperate to relieve their child’s suffering, but aren’t sure where to begin. So they do what most of us do when we find ourselves at a loss: turn to Google. 

“[Parents] find one organization and it leads to another organization,” Burgo tells me. “There’s lots of very below-the-radar organizations of parents with trans kids all over the world, all over America. And they all know who Genspect is. So once they get into the network, they’ll find us.”

Once there, parents can read up on Genspect’s ideas about trans health care, sign up for access to a Discord server for similarly conflicted families, and peruse the network’s Brief Guidance for Parents PDF — a 15-page instruction manual designed to provide basic information about gender dysphoria. 

The booklet tells parents that dysphoria is “linked with’’ autism, mental health issues, a bad home life, and/or other forms of “psychic trauma.” They learn that the number of trans-identified children has spiked in recent years, and that “the best account of the new cohort of gender-questioning adolescents’’ is something called Rapid Onset Gender Disorder (ROGD): a viral form of dysphoria that spreads through peer groups and/or internet exposure. ROGD, first advanced in 2018 by Genspect advisor Lisa Littman, is an unstudied hypothesis, not a diagnosis, and many medical organizations explicitly reject its use as an explanation for behavior. Nonetheless, the hypothesis serves as a lynchpin in Genspect’s ideology, and their literature often presents ROGD as established science.

“I do think it’s a thing,” Burgo told me when I asked him about it. “I’m just generalizing from my own experience. I don’t know for sure. But I don’t think the other side can say it’s not a thing either. I mean, let’s look into it.”

If childhood gender dysphoria stems from psychic trauma and peer pressure, it stands to reason that the ideal treatment for gender dysphoria would be anything but affirmation. Puberty blockers, the Brief Guidance for Parents says, are dangerous. Medical transition can lead to “significant health complications,” as can binding and tucking. Even social changes such as different pronouns or gender presentation are “powerful psychological intervention[s] that should not be undertaken without clinical supervision.” Then again, clinical supervision can be dangerous too; Genspect cautions parents to avoid gender-affirming therapists, since “bad therapy is worse than no therapy.” Instead, parents should monitor and limit internet access, do more activities with their child, and advocate for the child at school by ensuring no social transition takes place there either.

“I was sniffing the Kool-Aid for a few months at the start of this whole thing,” an anonymous mother says on Genspect Unheard, a 27-episode podcast that features parents of trans children sharing their struggles. “My immediate reaction to [her] declaration was looking into gender clinics,” she said. “This was before I started researching a little bit about autism, and I learned about ROGD, and found my way to Sasha [Ayad] and Stella [O’Malley].” Ayad is an exploratory therapist who sits on Genspect’s advisory board.

Most parents on the podcast, however, seem to have sought out Genspect to validate their existing views. “We hired a third [therapist] and fired her after the first session when we learned that she affirmed our [son’s] male persona” one parent reports. “For six months I researched how my [son] got here and finally found Lisa Littman’s study, and, bingo! I realized this is ROGD.”

While Genspect’s parental support group on Discord boasts just over 800 members, posting seems limited to a handful of replies on any given day and it is unclear how many of these members are actually parents. Their public-facing social media accounts focus more on policy and event promotion than parental recruiting. At this point, Genspect seems to primarily offer information and links to assorted third-party gender-critical support groups focused on ROGD and so-called exploratory therapy. 

Exploratory therapy sounds an awful lot like gay conversion therapy to Mallory Moore, a researcher at the Trans Safety Network who has tracked Genspect since its inception. “The original reparative therapy idea was that homosexuality was a gender identity problem created by a failure to connect with your appropriate gender identity due to childhood trauma,” she says. “This is something that’s been repurposed for trans people.”

Burgo, who is gay, does not see it that way. “Any exploratory therapist like me, who works in a truly open-minded way, does not have an agenda,” he says. “My job isn’t to try and talk you out of anything, and it’s not my job to affirm anything. My job is to help you know yourself as best you can so that you can make the most informed choice for yourself.”

Burgo tells me that medical transition makes sense in rare cases of persistent, decades-long dysphoria, but he talks about it as a tool of last resort. We do not think of parents who prevent their children from touching a hot stove as restrictive, but as responsible. The logic, for Genspect, is the same.

Some of Genspect’s members longed to touch that stove when they were young. As a child, O’Malley, the Genspect founder, thought of herself as a boy. “When puberty hit, it was like a train wreck,” she told the audience in her 2018 gender-critical debut: a Channel 4 documentary entitled Trans Kids: Time to Talk. “My body was changing and I couldn’t disregard my body anymore. But in a weird way, those dark times were the making of me. I emerged as a woman, and I’m glad I’m a woman.”

Burgo also fantasized about being the opposite gender as a child, and he does not think that this commonality with O’Malley is a coincidence. “I think it gives us a particular insight into motives,” he says. As children, Burgo and O’Malley believe they were prevented from touching the hot stove. Now they want to save a new generation from getting burned. 

“It’s yarn-spinning,” Moore says flatly when I bring up this anecdote. She argues that O’Malley, whatever her own experience, has repackaged her childhood “for parents who have a child who’s said ‘I’m not this gender, I’m that gender,’ and they’re freaking out about it. Hearing that your child might grow up to be normal, actually, if you just give them a bit of a push
…It’s really, really powerful yarn-spinning. But what it isn’t is anything connected with trans experience.”

Most people experience some discomfort with gender, but Moore points out that discomfort is very different from dysphoria. “Some people are bullied for being different, but don’t grow up to be trans,” she says. “But I was absolutely terrified — genuinely terrified — that I was going to grow up into a gender that I couldn’t face living with for the rest of my life.

I grew up with my parents trying to make me normal. I ended up learning that I couldn’t rely on them when I was attacked in the street for wearing a skirt as a 16-year-old, because I would have to change into boys’ clothes if I didn’t want to get kicked out of my house. That’s not the sort of experience that Stella grew up with.”

The vast majority of modern academic research supports gender-affirming care. The proportionately small number of studies that do not have been cataloged by the Society for Evidence Based Gender Medicine (SEGM). The organization, which bills itself as an international cohort of researchers and clinicians, claims over 100 members. Of those 100, only 13 are currently listed on its website; the others are anonymous. Of those 13, seven hail from Genspect, including O’Malley herself.

“Gender is a small world,” Burgo says when I ask him about it, and he mentions two other organizations with significant overlapping public-facing personnel: the Gender Exploratory Therapy Association (GETA) and Gender Identity Challenge. And the world gets even smaller. Other groups with significantly overlapping leadership include the Institute for Comprehensive Gender Dysphoria Research; Rethink Identity Medicine Ethics; Gender Dysphoria Support Network; Wider Lens Consulting; Stats for Gender; Beyond Trans; and Parents with Inconvenient Truths about Trans. The Gender Dysphoria Working Group and International Association of Therapists for Desisters and Detransitioners are inactive as of recently, but they also overlapped significantly in terms of personnel. Add in Genspect and you get 12 organizations affiliated with the same small group of people.

“I wasn’t around when this happened,” Burgo explains, “but I believe that it was one large group, and that they decided it would be better for SEGM to focus on the strictly scientific factual studies — to challenge the evidence base and to not be political.”

Moore phrases it a bit differently. “You have this series of campaigns creating media fronts,” she says. “Some of them are explicit activist campaigning groups, and some of them are trying to pretend to be scientific bodies, and some of them are trying to produce sex and health education modules for schools that look like they’re legitimate. It’s a broad, mixed strategy platform around the world.” And Genspect directs parents and concerned citizens to whatever group best serves them; either to one of the 12 in-house groups or to allied organizations outside their direct orbit. From a distance, it looks like an enormous and robust movement. But administratively speaking, it’s mostly the same crew.

Similarly, SEGM appears to feature a robust catalog of academic articles, categorized into various Genspect talking points: Detransition and Regret; Social Transition; Importance of Biological Sex. The categories have subcategories, the subcategories have articles. But faculty at the Yale School of Medicine went scorched-earth on that research — and SEGM — after Alabama and Texas used that research to criminalize gender-affirming care. “[SEGM] appears to be nothing more than a website; it does not appear to hold meetings, screen its members, or publish a journal,” wrote several faculty members in a 2022 report. Citations are often missing; when present, they are often misleading. The listed advisors, including members of the Genspect crew, have published 39 articles collectively; of these, 75 percent were letters to the editor and none involved original empirical research. The larger article compilation also consists more of letters to the editor and case studies than research projects.

Children are being harmed. The question, as always, is how to minimize that harm.

“A contextual examination reveals that SEGM is an ideological organization without apparent ties to mainstream scientific or professional organizations,” the Yale report concludes.

SEGM’s archives, to be fair, also include some academically rigorous studies. After our conversation, Burgo pointed me to Kinnon MacKinnon, a York University professor of social work, whose research supports Genspect’s assertion that detransition rates are higher than previously reported, especially five years or more after the initial transition. But MacKinnon, who is trans, also fully supports gender-affirmative care, has expressed frustration about people with anti-trans agendas using his work to support their agenda, and has no affiliation with Genspect or SEGM (MacKinnon declined to comment for this article). He spoke at WPATH’s 2022 conference and remains a member in good standing.

“[WPATH] is the professional forum for battling out those questions, finding the evidence and finding the facts,” Moore tells me. The organization receives input from hundreds of doctors with different viewpoints, collects systematic input from patients, and develops best-care practices over time. “Trans health activists especially have big problems with WPATH being too conservative, as far as we are concerned. But the scientific process isn’t a debate in the New York Times. It’s journal papers back and forth and people going to meetings and stuff. It’s boring.”

Genspect cannot win a fight over health care for trans children that hinges on journal papers, mainstream medical organizations, or the experiences of the vast majority of people who transition. Instead, they’ve shifted the debate into the broadsheets — and, increasingly, into the political arena.

“I don’t think the government should be regulating medical care,” Burgo told YouTuber Benjamin Boyce, whose show is often critical of trans identity and feminism, two days before he spoke with me. “But on the other hand, what do you do when the institutions [like WPATH] have been captured by a kind of ideology and they won’t regulate themselves? It seems to me it’s a legitimate position for a government to say ‘fine, we will come in and we will regulate you if you won’t do it yourself.’”

Legislation outlawing gender-affirming care for minors is currently sweeping the nation. The Trans Legislation Tracker estimates that 382 bills limiting trans rights are under active consideration, and 50 others have already passed in 2023. All over the country, trans people find themselves stripped of their right to health care — and many of the bills that accomplished this passed with the help of Genspect-affiliated individuals, along with groups whose administrative board members significantly overlap with the organization. When Texas Governor Greg Abbot directed his state’s protective services to treat gender-affirming care as child abuse, they his administration cited SEGM research to do it. So did Governor Kay Ivey in Alabama. In 2020, Idaho used SEGM to support its prohibition against trans people changing their sex designation on official documents. A SEGM spokesperson told Buzzfeed that they did not endorse the bill and “object to the politicization of healthcare,” but that did not stop the group from filing an amicus brief in support of Arizona’s 2022 law that bans gender-affirming care for anyone under 18.

One individual affiliated with Genspect has gone much further. Stephen Levine currently serves on Genspect’s advisory board and received a $5,000 research grant from the organization in 2022. He has also served as an anti-affirmative-care expert witness in both West Virginia and Arkansas for the Alliance Defending Freedom, an enormous and well-funded conservative legal organization. ADF helped create the anti-abortion legislation that was contested in Dobbs v. Jackson Women’s Health Organization, actively opposes gay marriage, and considers the concept of gender identity “an existential threat to society.” Transphobia has become a major feature of Republican campaigns and, as reported by the New York Times in April, a powerful mobilizer of the conservative base now that gay marriage has been legalized. 

It’s a subject of debate within the movement, Burgo tells me when I ask about the Alliance. “I don’t think I would work with the ADF. That’s not an organization I would feel comfortable collaborating with. But I think there is a huge risk” of transition regret, he says. He deals with this in his practice, and it haunts him. “What do you do with a gay man who had full surgery — bottom surgery — and realized when he was 27 that he was actually a gay man? And now he doesn’t have — he has no genitals, really.” Burgo’s speech is halting. His voice is tight. “When you see people that have been ruined by a rush to medicalization, it makes you worry about more kids being harmed.”

Burgo is describing the terrible calculus of being alive. A 2020 study found that trans kids are almost eight times as likely to attempt suicide as their cisgender peers. The Trevor Project’s large 2022 survey suggests that over 50 percent of trans teenagers considered suicide in 2022, and 20 percent of those teenagers made an attempt to die. Gender affirmation from their parents, their schools, and their communities significantly lowered that number. Children are being harmed. The question, as always, is how to minimize that harm.

“The enemy of my enemy is my friend” is a dangerous supposition, especially when so many of them are your enemies as well. Mother Jones recently obtained over 2,600 pages of email exchanges between a small group of right-wing activists, conservative lawyers, and anti-trans activists. The collaboration they reveal goes well beyond expert testimony or footnotes. The group painstakingly workshopped the wording of South Carolina State Representative Fred Deutsch’s 2020 “Vulnerable Child Protection Act,” which would have made providing medical gender-affirming care to anyone under 18, including puberty blockers, into a criminal offense. The bill did not pass, but the working group’s effort was not in vain: 18 states are currently considering bills with very similar language. 

This email group included Dr. William Malone of SEGM. It also included Dr. Michael Laidlaw, an endocrinologist who has recently spoken at conferences hosted by the International Federation for Therapeutic and Counseling Choice and the Alliance for Therapeutic Choice and Scientific Integrity (ATCSI). Both of these groups openly support gay conversion therapy — in fact, ATSCI is a rebrand of the National Association for Research and Therapy of Homosexuality, the original “ex-gay” organization.

Laidlaw was also a member of the Gender Dysphoria Working Group, which existed from 2018 until August 2022. Other members of that group include Robert D’Angelo, Stella O’Malley, Sasha Ayad, and Lisa Marchiano: all current members of Genspect. Perhaps this is the original large group Burgo referred to in our interview — the one that split in order to fight the gender war on multiple fronts.

Another member of the email group, Michelle Cretella, served as executive director of the right-wing advocacy group American College of Pediatricians, which also endorses gay conversion therapy. When an activist asked Cretella about creating an alternate to gender-affirming care, she replied that her organization did not have the bandwidth, but that she knew of a group that might be interested. “Mike Laidlaw and Will Malone are active within it, I am less so.”

Gender-critical activists often allege that powerful forces are stifling scientific debate. I’m beginning to suspect that’s true.

“It is an ultimate, long-term goal of mine to make sure that the Endocrine Society [the mainstream professional organization of endocrinologists] is embarrassed, publicly humiliated, and sued mercilessly by the many detransitioners and particularly those harmed as children,” Michael Laidlaw wrote William Malone and another activist within the email group.

“What Mike said,” Malone replied. “It might take years, but we’re going to get them.”

Genspect carries water for the reactionary right outside the courtroom as well. The New York Times, which would never quote Alliance Defending Freedom as an authority on trans issues, tapped Genspect as an expert voice in Emily Bazelon’s now-infamous June 2022 magazine feature, “The Battle Over Gender Therapy.” The article, which presented the medical community as “deeply divided” over gender-affirming care for minors, described Genspect’s webinars as wildly popular and gave abundant space to affiliated parents’ rejection of the “gender cult” and claims that dysphoria is a symptom of mental illness.

When this article, and others like it, were denounced in a letter by New York Times contributors, conservative commentators in publications like the Daily Mail decried left-wing cancel culture. Opposition to the letter extended beyond right-of-center tabloids, however. “There is a familiar pattern here in the way left-wing activists shut down internal criticism by treating any criticism of their position as either identical to, or complicit with, the far right,” wrote Jonathan Chait in New York.

But the complicity of members of Genspect with the far right was no secret when the Times article went to press. Groups like Trans Safety Network, Health Liberation Now!, and Transgender Map, along with individual researchers like Zinnia Jones and Erin Reed, have spent years painstakingly researching, analyzing, and compiling information on groups like Genspect. But these groups, with their shoestring budgets and blog-style websites, tend towards the aesthetic of radical agitprop, while Genspect strives for respectability.  

The consequences of Genspect’s tireless push against gender-affirming care, and the presence of their leadership in attacks on trans health care for minors, are all too visible. The damage this work can cause within families is more difficult to see. Genspect is responding to the authentic anxieties of parents trying to raise kids who they don’t always understand. While groups like PFLAG and Gender Spectrum offer parents tools for working with their kids to explore their identities, Genspect moves parents into an increasingly right-wing network of gender-critical organizations that are feeding conservative political struggles across the country. 

“The loss of my son is unimaginable,” a South Carolina mother declares on Genspect’s podcast in reference to her daughter’s transition. “It is a deep rage that I want to act on, but fear quickly paralyzes me. What actions do I take? Will it push my son further away? Will I cause him harm?” Her voice is controlled, indignant, despairing. “Thousands of mothers are experiencing the same turmoil. The suffering I have seen in my support groups is hard to witness. We need help.” 

Laura Jedeed is a freelance journalist based in New York City.