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James Caspian and “fifty trans people” who regret transitioning

James Caspian: who is this character? A couple weeks ago, an article came across my feed from the UK’s Sunday Times, headlined: “Fifty trans people tell therapist of regrets”. Caspian is that therapist, a British hypno-psychotherapist with a Hotmail address and a homepage that’s been grabbed by domain squatters. According to the article, Caspian believes “rising numbers presenting with gender dysphoria have been too readily labelled as trans”, and he “has been approached by 50 people who want to reverse their transition”, most of whom are reportedly in their early twenties and typically experienced regret two to five years after medically transitioning. The Times states that he was “refused permission to research detransitioning at Bath Spa University”, while the university says “his research proposal was not refused because of the subject matter, but because of his proposed methodological approach.”

There are two areas of problems here: bad journalism and questionable science. What does this article tell us about the subject of this controversy, the phenomenon of regret after transitioning? Imagine reading this as a complete outsider, an average person with little reason to know anything about trans people or transitioning. How many is 50 trans people who regret transitioning? Is that the usual number of trans people? Is that too many trans people? How many trans people are there? Well, we know there’s at least 50. What proportion of trans people regret transitioning? Based on this article, somewhere between 0 and 100%. This conveys no meaningful information, only a rough sample size of participants in a still-unfinished study. The article provides no context or relevant background for understanding a figure like “50 people who regret transitioning”, and a lot of readers will come away thinking maybe that is too many trans people. In this way, weak and deficient media coverage continues to fuel confusion, suspicion, and alarm in the public discourse surrounding trans issues.

Now, just what is James Caspian’s background and history in this subject area? His previous publications include a glowingly uncritical book review in the Journal of Analytical Psychology of a collection of essays by non-experts opposed to the recommended affirming care of trans youth. This book was released under the imprint of “Cambridge Scholars Publishing”, a low-quality predatory publisher with no connection whatsoever to the University of Cambridge, and includes chapters such as “I’m Not A Hideously Bigoted Parent Who Doesn’t ‘Get It’” by esteemed authority “GenderCriticalDad”.

He also offered remarks to the House of Commons in October of 2017 on “transgender law concerns”, in which he talks up his previous experience counseling trans people and promoting trans awareness before launching into protracted scaremongering about the growing numbers of trans people who’ve come out and sought treatment since 2010, asserting that many of them are not actually trans. Specifically, he claims:

There is currently research being done in the US into three different types of gender dysphoria (unhappiness in one’s gender), the newest type being Rapid Onset Gender Dysphoria which is being seen in more teenagers and which it is thought has a connection to internet use and social contagion.

“Rapid onset gender dysphoria” – now there’s an interesting topic. This pseudodiagnosis originated with a set of medical conspiracies about trans people and transitioning that were widely trafficked on social media in a manner similar to that of anti-vaxxers. The “research” Caspian refers to has since been published in a remarkable study by Dr. Lisa Littman, who has since admitted that she has never worked with any trans patients. That study evaluated nobody with this supposed new condition, instead opting to survey anonymous users of three anti-trans websites who believe that their children – over 80% of whom met clinical criteria for gender dysphoria, and some of whom were as old as 27 – only believe they’re trans because of influence from their friends and the internet. It’s essentially a scientific laundering of every excuse ever made by parents in denial about their kids being trans, and the fallout has been delicious. Her university took down their press release about her study after these issues were brought to their attention, and the journal in which it was published is now investigating potential problems with its methodology and analysis.

Most concerning to me was that Littman’s study cited one of my own articles on a known comorbidity between untreated gender dysphoria and a major dissociative disorder, and presented this as an example of online materials supposedly misleading cis people into thinking they’re trans. I did inform the journal about this, and her university, and the Brown Daily Herald, and Slate.com, and she promptly walked this back in an interview with a conservative Christian news outlet. It was a whole thing and I loved playing a part in it.

But the maneuver James Caspian is attempting in establishing his credibility here is just a dirty move. Remember that old adage, “it’s not you versus them, it’s you and them versus the problem”? It’s great advice for long-term relationships, and it’s also something Caspian and other transphobes love to turn on its head. How many times have we heard throughout decades that some subset of trans people aren’t “real” trans people, because they’re not heterosexual, they don’t present as an overt gender stereotype, they didn’t know they were trans since early childhood, they’re on the autism spectrum, or just about anything else? It happens all the time and people who aren’t trans are constantly finding new and creative ways to repeat this mistake. In this instance, Caspian tries to enlist “real” trans people in an alliance against the supposed dangers presented by this new generation of inauthentic trans people – you know, the ones who are almost 30, who meet diagnostic criteria for gender dysphoria, and whose parents just aren’t happy about having a trans kid. Caspian wants to pretend that it’s him and trans people versus the problem, and that’s a misdirect. The reality is that it’s just Caspian versus the problem, and to him, we are the problem. The suggestion that trans people would happily join him in invalidating other trans people is absurd – we know exactly how this works.

So where does everything stand in regards to James Caspian’s dispute with his university? This controversy warrants examining similarly situated individuals and their experiences with working in this area of research – precisely the context that the Times omits. Are we to believe that Caspian, a hypno-psychotherapist currently working toward a master’s degree, is the first to dare investigate the phenomenon of regret after transitioning under the auspices of an academic institution? The truth is that research in this area has been conducted for decades without issue. This includes numerous peer-reviewed studies of dozens of recorded cases of regret in reputable journals, including the Archives of Sexual Behavior in 2006, 2014, and 2018; the Journal of Sexual Medicine in 2016 and 2018; and Acta Psychiatrica Scandinavica in 2007. Most of the authors were affiliated with major universities and academic institutions. How does any of this support Caspian’s contention that universities are engaged in academic censorship of research into regret after transition?

The problem here is not with this subject area. The problem is not with the actions of academic institutions. The problem is with James Caspian. On the subject of regret, Caspian has claimed that “This is a conversation that is being suppressed – this is a conversation that needs to be had”. But that conversation has been going on in the medical literature for quite some time before Caspian arrived on the scene, without being subjected to institutional censorship. The exclusion of Caspian’s questionable and potentially flawed contributions is not something that can only be explained by the machinations of a conspiracy to silence that entire area of research – a conspiracy that is by all indications woefully ineffective.

Zinnia Jones: My work focuses on insights to be found across transgender sociology, public health, psychiatry, history of medicine, cognitive science, the social processes of science, transgender feminism, and human rights, taking an analytic approach that intersects these many perspectives and is guided by the lived experiences of transgender people. I live in Orlando with my family, and work mainly in technical writing.