These days, questioning the dictates of gender ideology can feel tantamount to a criminal act. That’s why Resident in Counseling Olivia Nelson* is part of an under-the-radar network of therapists who refuse to practice affirmation-only counseling – risking their licenses and livelihoods in the process. 

“A lot of us are nervous because unfortunately, if activists find out that you are a non-affirming therapist and working with clients, they will do anything from putting you on blacklists to actually filing complaints with your state’s board of counseling,” Nelson told IW Features, speaking under pseudonym to protect her identity.

Nelson, who is a mother herself, went back to graduate school to become a Licensed Professional Counselor after a successful career as a wellness coach. She quickly realized that her experience made her a minority among her ultra-liberal, younger classmates.

“Unlike most of my classmates, who were probably in their late twenties or early thirties, I had raised children,” she said. “I had witnessed the different stages of development.”

In addition to raising her own children, Nelson worked as a teacher and youth athletic coach, and also counseled young people in treatment for eating disorders. In recent years, she said, the social contagion that once led young girls to develop eating disorders is now leading many of those same girls to identify as transgender. 

The deadly combination of unmonitored internet access and isolation during COVID-19 lockdowns only heightened this social contagion among young people, Nelson said. 

“Their entire world shut down and went online,” she said, adding that parents were essentially removed from their children’s digital life. “[Parents] need to be the ones who are establishing boundaries and limits.” 

According to Nelson, this common thread of social pressure and contagion is largely ignored in the United States, to the extent that even her graduate-level psychology teacher was unaware of this connection. Nelson believes this may be because the studies her teachers used to justify so-called “gender-affirming care” were woefully out of date. When she tried to bring up newer European studies that discourage medicalization of gender dysphoria, however, she said her classmates verbally attacked her.

“[Europeans] are hitting the pause button on any medicalization of ‘gender affirmative care’ for young people,” Nelson said. “I brought this information to a few of my classmates, and I was reported for being transphobic.”

In addition to being reported by her classmates, Nelson said that she feared speaking out in class due to the personal biases of her professors.

“Several professors were very open about the fact that they were in the LGBTQ community themselves, and a few of them had young children who identified as trans, and they were affirming their kids,” she said. 

For counselors like Nelson who do not support affirmation-only therapy, losing their licenses is a real risk. That’s why many of them have chosen to stop working with children altogether, she said.

“They’ve actually let their licenses lapse, and they’re now coaches because as a coach, you have a lot more autonomy about the way that you practice and you don’t have to affirm things that you don’t agree with,” Nelson said.

Nelson, however, has chosen to stay in her field and help gender-confused children and their parents, despite the many difficulties that come with it. 

“The closer [gender-confused children] are to being 18, the harder it is for us therapists because we already know that they’ve probably made up their minds about getting hormones and interventions,” she said. “They don’t even need a prescription – they can get hormones off the black market.”

The “cult” mentality of gender ideology, Nelson said, leads even the brightest children to accept at face value the pro-medicalization messaging they find online. And without parental guidance, many fall prey to the propaganda these internet communities push.

“A lot of them are very creative and intelligent, but they’ve also experienced depression, anxiety, and other things like conflict at home,” she said. “You really need the family to be involved in the healing process. Parents are a main part of the treatment for eating disorders, and I believe that with gender dysphoria, it’s the same thing.”

Nelson also works with parents who have been blindsided by their children’s desire to “transition” genders.

“I think the parents are almost the saddest part of this whole story because they have so much against them,” she said. “Parents really become ostracized if they push back – they become pariahs at school, to their families and their peer group. And quite frankly, they don’t realize that there are other options.”

That’s where Therapy First –– the group of therapists who do not practice affirmation-only counseling –– comes in, Nelson said. While many therapists are hesitant to put themselves on the site’s public directory due to fear of backlash, filling out the contact form will connect parents with a like-minded therapist in their area. 

For now, Nelson said, she focuses on relationship-building with her young clients –– no matter how hopeless the situation may seem. 

“If, further down the line, they decide to desist or detransition, then hopefully they’ll remember that we had a great relationship and they’ll reach back out,” she said. “I do see them as these beautiful human beings that are just going through something really hard.”

*Name has been changed to protect storyteller’s identity.