A ‘detransitioned’ teen tells her story at the University of Iowa

For Chloe Cole (no relation to your friendly neighborhood opinion columnist,) the puberty process wasn’t a normal function of adolescence. It was a condition to be treated — and cured.

“These normal feelings that I had were perverted into something that it wasn’t,” says the formerly transgender 19-year-old from California, who spoke to a capacity crowd at the University of Iowa last Monday evening, appearing at the invitation of the college’s Young Americans for Freedom chapter. “It was made into a condition that I had, rather than just a part of my experience growing up from a girl into a woman.”

Born female, Cole remembers feeling conflicted with her sex as she started physically developing at the age of nine, feelings that were complicated by what she perceived as a negative public perception of womanhood. At the same time, she remembers relating more to her father, brothers and male peers than her mother or any of her female peers. Things would be better, the confused adolescent thought, if she were a boy instead of a girl.

She came out as a transgender male at the age of 12 to her parents, who she said were very supportive. Research her parents did online suggested Kaiser Permanente, already the family’s current health care provider, as a “top choice” for adolescent gender affirming care.

“To them, care meant psychiatric treatment. They thought it would mean therapy for me to help me cope with these feelings, and that I would just be allowed to be a kid in the meanwhile, that I would just be allowed to grow up, finding ways to express myself without necessarily going through any permanent interventions,” stated Cole.

Instead, she continued, the family was “blindsided about what was to happen next.” Citing preexisting mental health issues ranging from ADHD to body image issues and a possible eating disorder, she stated she had also exhibited signs of being on the autism spectrum that were reported to by teachers to her parents, who sought unsuccessfully to receive an official diagnosis. All of those conditions were “completely ignored” as treatment was being established, said Cole. The distress she was experiencing was attributed to simply being “born in the wrong body.”

Her feelings of despair only intensified as she saw a therapist, who affirmed her gender identity from the start. Despite her worsening condition, her parents were told by the therapist that the gender-affirming treatment she was receiving was the only course of action that could help their child. According to the therapist, the options were simple: Did they want a living transgender son, or a depressed, suicidal and possibly dead daughter?

“But I wasn’t suicidal until I started on these treatments,” Cole told her audience. In hindsight, her struggles was largely, if not entirely, attributed to the angst of puberty, perhaps exacerbated by her other conditions.

In the middle of eighth grade, she was prescribed a puberty blocker, identified as “Lupron” in a letter sent by Cole’s attorney’s to her health care providers last year informing them of her intent to sue for what she alleges to be gross negligence. Lupron is a brand name for leuprolide, a synthetic form of gonadotropin-releasing hormone (GnRH.) Leprolide is mainly prescribed to adults for issues such as uterine fibroids but is also approved by the FDA to treat precocious puberty, or early physical sexual maturity in children.

Leuprolide has not, however, been approved by the FDA to treat gender dysphoria. The FDA has not evaluated whether leuprolide would be safe or effective if prescribed for gender transition. Any use for such purpose would be considered “off-label.”

The puberty blocker put Cole in a state she described as “pretty much a chemically-induced menopause.” She started having daily hot flashes and full-body tingling sensations that are frequent in menopausal women, and for the same reason: the severe fluctuation of sex hormones.

“I was very lethargic,” said Cole. “It was a terrible way to live. I pretty much prayed each day … to be on the next intervention, which was, of course, testosterone.”

Compared to simulated menopause at the age of 13, testosterone therapy felt pretty good — at first. “You could say I was experiencing the euphoria that the transgender community talks about,” she said, describing the feelings of intense joy many transgender people report right after their transition, their first experiences as a person of their identified gender.

Testosterone therapy can bring about an onslaught of physical and emotional changes sometimes described as a “second puberty.” For Cole, that meant an intense libido, which, she said, left her vulnerable to being preyed upon sexually.

Her voice started deepening — deeper than most of the boys her age. She began to lose fat in some of her curvier areas. Weight was redistributed throughout her body to a more male shape. Feeling a sense of control over her physical appearance was satisfying enough that she didn’t feel a need to hide the fact that she had female breasts.

But a few months after she started hormones, said Cole, she was sexually assaulted by a classmate. Already distrustful of her school, which she said was neglecting to follow her Individualized Education Plan, she opted not to report it. In her mind she was a male — telling someone, according to her perception of male traits, would be a show of weakness. Her only choice, she felt, was to “man up.”

Though she says she has put it behind her, Cole links that “incident” to her sudden and pervasive awareness that others still saw her as a girl and states that it influenced her decision to undergo what’s frequently called “top surgery.” She had been wearing a chest binder and continuing with weekly testosterone injections, but when she would bathe, the appearance of her own breasts made her feel more dissociated from her own body than ever.

By her sophomore year, she was diagnosed with — and treated for — a major depressive disorder. “But nothing was working. I clearly was not responding to this treatment I was getting. In fact, it was making me worse.” Yet with her distress still blamed on being born in the wrong body, Cole underwent a double mastectomy at just 15 years old.

The mastectomy would prove a turning point. Side effects notwithstanding, each step in Cole’s transition had, up until then, left her hopeful of what was yet to come. The scars from her mastectomy became reminders of what was only supposed to be. “I’d been on hormones for about 2-3 years by this point,” she said. “My voice was so deep that it was unmistakably masculine. And everybody in my life knew me as a “son … a brother … a boy named Leo.” The more she tried to “fit in” as a male, the less happy she felt. But she was so advanced in her transition that she felt she couldn’t go back.

Her transition ended after an unexpected “epiphany” during her junior year of high school while studying childhood development. Realizing that she possessed a desire to someday bear children and become a wife and mother prompted Cole to consider that dreams she had for her adulthood could be lost to decisions she was making as a child.

“It was heartbreaking. I didn’t know how to live with myself after having gone down this path. But eventually, I just couldn’t take it anymore. I couldn’t even look at the vial of testosterone … I knew that I couldn’t keep living in such a way. It was destroying me. And that marked the very end of my transition, as well as the beginning of a new chapter in my life — my detransition.”

Cole would find out that contrary to her original transition, which was done with support at every step, she had “absolutely no guidance on how to go back. Not even from my own doctors.” The gender specialist who referred her for surgery repeatedly suggested that what she was feeling was just a part of her “gender journey.”

She also feels that the physical complications from her surgery have been ignored, stating that the skin grafts used in her have turned into “open wounds” that “weep fluid.” She now wears bandages over her chest daily.

“(The surgeon) told me that I just need to put Vaseline on it,” she said. After following those instructions, she developed a skin infection.

Detransitioning socially — from male back to female, from Leo back to Chloe — also proved incredibly difficult, said Cole. “It was humiliating. It was shameful. And my mom and dad, they felt incredible guilt. They felt that this was all on their hands.

“But frankly, I don’t blame them, even if they had signed off on the treatments. Because they were told that there was no other choice, by our doctors. They were emotionally manipulated.”

This week, I present for your reading and reflection a story: the lived experience, in her own words, of one teenager struggling with gender identity who proceeded down a path of social and physical transition she came to deeply regret.

As for my own commentary? I’ll dive into that next week.

Comments: 319-398-8266; althea.cole@thegazette.com