Apologies for the variations in font and spacing. Sometimes the computer makes up its mind for me on such things when I cut and paste text and/or quotations. I hope readers will find the research and content sound, even if the formatting is a bit off.
Gender “Transitioners”
In part one of this
series, I discussed the relevance of names and noted with dismay the current practice among some youth who are casting off their birth names as part of a
sociocultural trend that has developed over the last few years. This often
occurs as part of an effort to change gender. A person attempting to change sex
often refers to his or her birth name as a dead name, and asks
acquaintances to refrain from using that name and henceforth substitute a new
name of his or her choosing.
The idea of referring to
one’s birth name as a dead
name seems both harsh and antithetical to the self-esteem
movement. If one’s name is dead, doesn’t it follow that one’s whole identity
while bearing that name is dead as well? If one’s birth name is now
meaningless, and the life an individual led while carrying that name spurned as
inauthentic, such “broad brush” treatment represents a lot of years,
experience, and even existence that count for nothing. With suicide
numbers among youth ever rising, wouldn’t it be wise to
reconsider encouraging members of this population to repudiate their former lives
and identities?
This practice of
deadnaming ties into a bigger phenomenon which some
young people are declaring malpractice – the “gender-affirming care”
paradigm for gender dysphoria, which
consists of chemically suppressing puberty, then administering opposite sex
hormones, and ultimately performing gender reassignment surgery. A growing
contingent of gender-affirming care recipients begs to differ with this
protocol.
"Detransitioners"
Rejecting one’s birth name
to participate in a cultural trend seems but an extension of a larger rejection
of a much larger entity – God Himself. If, as He claims, He fashions
us in the womb, that creation would seem to include our gender. To refuse
to accept the sex that He and He alone has a right to assign – without any help
from the delivery team, despite the popular phrase “assigned female or
male at birth” – seems a bold usurpation of divine authority. By rejecting birth
gender, one is casting off one of the first and most fundamental gifts God has
given.
Furthermore, where is a
person left if he or she later decides, as many do, to return to the name and
gender of their birth? Experts
agree the teen brain’s decision-making processes remain
underdeveloped until the mid-20’s. Not surprisingly, therefore, a “detransition”
movement among youth is gaining traction – young transitioners reverting back
to their birth sex after undergoing varying degrees of gender-affirming
treatment. Testimonies from individuals who have desisted from their
transgender identities – many of whom started their transition journeys at very
tender ages – include Chloe
Cole, Laura
Perry Smalts, Helena
Kerschner, Walt Heyer, Sydney
Wright, Oli London, Sophia Galvin, Scott Newgent, Soren
Aldaco, Layla Jane, Prisha
Mosley, Keira Bell and Ritchie
Herron. Listening to their stories, one notices common threads in
the lives of many who have undergone gender transition: heavy consumption of
social media, past trauma, and comorbidities such as autism, anxiety, and
depression. Given the uptick in lawsuits being brought by young
detransitioners, is it a stretch to conclude that this population is falling
victim to misdiagnosis at best or malpractice at worst?
Concerns to Ponder
Another question that ought to
be asked in connection with the detransition movement centers around the mental
and emotional status of individuals who have undergone gender-affirming
treatment, then later desist from their new identities. Once someone has
renounced his or her birth gender and identity as a cosmic mistake, wouldn’t it
be logical for that person to feel very adrift upon renouncing the identity that
was adopted to replace the original one? If both the old and new identities
have proven unsatisfactory, wouldn’t it make sense to conclude
there’s no hope?
Statistics would seem to confirm
this conclusion. Sadly, this population is at greater risk of the ultimate
expression of self-harm – which includes a higher than average percentage of suicide
attempts and completed suicide.
On that somber
note, Lois
Cardinal, a natal male who gender transitioned, is
fighting for the right to receive “medical assistance in dying” due to
unhappiness following transition. Although this scenario is playing out in
Canadian courts, it’s important to realize that in the United States physician assisted suicide is currently
legal in ten states and the District of Columbia. It wouldn’t be a far stretch
geographically or philosophically for our country to emulate the scenario that
is playing out with our northern neighbors. We must also remember that a transitioner
in Belgium obtained assisted suicide “after a botched sex
change operation… left him a ‘monster.’” I mention these stories at the risk of
muddying the waters because assisted suicide is another outgrowth of the
already tragically high self-harm statistics among the trans population.
It also makes sense to
consider a seeming inconsistency being propagated by no less an authority than
the National
Institutes of Health (NIH), which
is the source of the suicide statistics and definition of gender dysphoria linked
above. This organization’s self-proclaimed mission is “to seek fundamental
knowledge about the nature and behavior of living systems and the application
of that knowledge to enhance health, lengthen life, and reduce illness and
disability.” This agency, an arm of the U.S. Department of Health and Human
Services, condemns female
circumcision as mutilation, yet endorses
mastectomies and hysterectomies on healthy dysphoric women as gender-affirming
care. The incongruity in these two positions seems obvious, yet many physicians
who would never consider performing female circumcision are irreparably
damaging young women’s bodies in accordance with the NIH’s misguided gender
policy.
Physicians and Experts
Question Gender-Affirming Care Among Minors
Thankfully, a broad group
of physicians
representing various specialties and not a few countries is sounding
an alarm on the gender-affirming care model for treating dysphoria in young
people. These entities cite a dearth of long-term evidence to support current
protocols, particularly among minors. Dr.
Armand Antommaria, “a professor at Cincinnati
Children’s Hospital Medical Center, who serves as an expert witness for the
LGBT groups… concedes that of the 28 recommendations in the Endocrine Society’s
guidelines [for transgender care], ‘three are backed by moderate-quality evidence,
fourteen are backed by low-quality evidence, five are backed by very
low-quality evidence, and six are backed by no evidence at all.’”
Is it
any wonder that psychiatrist Miriam Grossman urges
the medical establishment to pump the brakes on hormones and surgery, and
instead probe underlying issues and root causes behind a desire to
change gender? Similarly, Dr.
Lisa Littman’s research into the disturbing trend of “rapid
onset gender dysphoria” among youth (most notably young girls) suggests a
social contagion factor; this possibility ought to spur practitioners to
thoroughly investigate young would-be transitioners’ full mental health profiles,
as opposed to fast
tracking minors into hormones and surgery.
On an interesting side
note, Dr. Littman draws a comparison between the socializing tendencies of
young people with gender dysphoria and those suffering from eating disorders.
She describes a ranking component (those with the most extreme conditions are
awarded hero status, while those with less pronounced behaviors draw less
recognition) as well as a teaching and modeling phenomenon (sufferers with more
experience coach neophytes on ways to persist in the behavior instead of complying
with treatment interventions).
Given these similar
patterns, one might ask if it is any kinder to affirm gender confused
individuals than it is to agree with those experiencing eating disorders.
Since both conditions can cause irreversible harm to patients, why are the
treatment models so far apart? No reputable doctor would assist an anorexic
patient with weight loss strategies, yet many whisk out drugs and scalpels when
dealing with gender dysphoria. The difference seems to be the credence afforded
to a patient’s self-diagnosis: with eating disorders, an objective standard
(healthy weight guidelines) is contrasted with a patient’s self-perception of
being overweight, and objectivity prevails when rendering treatment; with
gender dysphoria, a person’s self-perception of having been born in the wrong
body is accepted as fact, despite millennia of scientific understanding
regarding gender being a fixed chromosomal reality.
When did the scientific
community start subjugating objective health data to patients’ subjective
beliefs about their bodies?
More
Voices
Dr. Jennifer Bauwens, a clinician
who specializes in providing care for trauma survivors and teaches on this
subject in several graduate programs, has also raised concerns about assisting young people to gender transition. Bauwens, who holds a PhD in clinical social
work from NYU, testified before Congress this past July, stating that “compared to
other psychological disorders found in the DSM V-TR, gender-affirming care is
the most invasive and unnecessary physiological intervention connected to a
psychological issue. Gender-affirming care is also in direct opposition to the
basic practices of good mental health treatment.” Bauwens went on to cite the
findings of UCLA’s Williams Institute on Sexual Orientation and Gender Identity
Law and Public Policy that “45 percent of
transgender-identifying people reported childhood sexual abuse… 44 percent of
transgender-identifying people reported childhood physical abuse… 75 percent of
transgender-identifying people reported childhood emotional abuse.” Such soaring
numbers ought to prod practitioners to probe and treat underlying factors that
may contribute to a young person’s desire to change gender, as opposed to offering
a one-size-fits-all gender-affirming protocol.
Jamie Reed, former case manager at Washington University’s
Transgender Center at St. Louis Children’s Hospital, also advises against
pediatric gender transitioning. Reed echoes the concerns about fast tracking
treatment and ignoring comorbidities already mentioned. After four years in her
position, Reed left the gender clinic, and now speaks out against
gender-affirming care for minors.
The aforementioned list of practitioners calling
peers to rethink the current model of gender care among minors is far from
exhaustive. The Society for Evidence Based Gender Medicine (SEGM) describes itself
as “an international group of over 100 clinicians and researchers
concerned about the lack of quality evidence for the use of hormonal and
surgical interventions as first-line treatment for young people with gender
dysphoria.”
Lest
the assertion be made that this issue is only troubling to conservatives, let
the record show that many who question the wisdom of performing these
procedures on children hold more progressive beliefs. Jamie Reed describes
herself as “left of Bernie Sanders.” Dr. Julia Mason, pediatrician and cofounder
of SEGM, is a “lifelong democrat.” Two parental groups that are “critical of the
dominant paradigm regarding transgender politics and treatment” – Transgender
Trend and 4thwavenow – refer to themselves as
“left-leaning and liberal.” Gays Against Groomers, who identify themselves as “a nonprofit
organization of gay people and others within the community” have joined the
chorus of voices opposing “the sexualization, indoctrination and medicalization
of children under the guise of LGBTQIA+.”
Clearly,
critics of gender-affirming protocols for children fall on both sides of the
political aisle.
Final Thoughts
The turmoil that must
precede a decision to alter one’s body chemistry and appearance in an effort to
conform to a perceived gender identity is beyond my comprehension – yet it is
not beyond my compassion. As I have stated elsewhere, I
believe many who are providing gender-affirming treatment do so out of a desire
to help those suffering from the anguish of dysphoria. Nevertheless, it
behooves us as a society to consider the long-term consequences of such
well-meaning “care” and to heed the warnings of the many voices urging
caution in this largely uncharted area.
That said, many contend
that gender-affirming care for minors is intellectually dishonest and morally
indefensible.
Let’s take these one at a
time.
A skilled physician may be
able to alter a patient’s body and make it appear like
that of the opposite sex, but no procedure can change the person’s
chromosomal makeup. Since most of us aren’t geneticists, let’s compare this to
something to which we can all relate – food. Suppose I declare a stalk
of celery a mozzarella stick, and even make it look like one by encasing the
vegetable in cheese. However, one bite will alert the eater that he is, in
fact, gnawing on a crunchy, stringy veggie that is only dressed up to look like
a gooey cheese stick. Also, the two foods contain different vitamins and
minerals and metabolize in the body differently; regardless of appearance, the essence
of the edible remains unchanged.
Is it any more accurate to assert that
biological realities of gender can be changed than that celery can morph into
mozzarella?
Secondly, gender treatment
for minors is morally indefensible because of the immaturity of young minds. A
case could be made that no one under age 25 should be a candidate for gender-affirming
care, which would give the brain a chance to fully develop before making a
decision of such magnitude; it might be an easier sell to pair the legal age
for gender transitioning with the legal age for consuming alcohol (21),
which would still be an improvement over the current state of affairs. At the
very least, this risky treatment should be denied to minors.
The NIH, which we have
referenced frequently throughout this discussion, combines these final points
well. The NIH’s chromosome fact
sheet asks, “Do males have different chromosomes than females?” The
publication answers that question by stating that humans “differ in a pair of
chromosomes known as the sex chromosomes. Females have two X chromosomes in
their cells, while males have one X and one Y chromosome.” The piece goes on to
explain that “serious problems” such as “mental disability… impaired fertility… [or] kidney or heart
problems” arise when variations occur in the numbers of sex chromosomes people
inherit. Furthermore, in the NIH’s paper on benefits and risks
of genetic therapies, the organization declares it “does not perform or fund studies on genome editing targeting
sperm, eggs, or embryos in humans. These changes would be passed on to the
patient’s children and could have unanticipated effects.”
In other
words, the NIH acknowledges that underlying chromosomal differences exist
between males and females, and in an abundance of caution veers away from
attempts to alter those differences as they manifest themselves in reproduction.
Bottom Line
In a previous
article on this topic, I stood with Martin Luther. Now I cast
my lot with the brave detransitioners who are speaking out against the harm
done to them by the silence and complicity of adults. These young people aren’t
hiding behind pseudonyms as I once wished to do; they are facing the issue square
in the face and speaking the truth.
If adults won’t ally themselves with
these young people, where can they turn?
There’s a reason the
silent majority is so named. There are precious few things in life that require
individuals to rouse themselves and fight for what they believe is right. When
such issues beckon, too many of us stand alone with our principles conveniently
obscured by daily chores and obligations. I submit that few responsibilities
are more pressing than pushing back against the gender identity movement which
is threatening the minds, bodies, and futures of our kids. There is definitely
a “Children’s
Crusade” component to this fight, as so many young people who have
suffered as a result of gender-affirming procedures are taking action to
prevent the same thing from happening to their peers.
Will we leave them to battle alone, or will we sideline our fears and enter the fray alongside them? If
we turn our backs on our youth who are looking to us for support, future
generations will judge us just as they have other historical figures. Surely,
we are called off the sidelines for such a time as
this.
“Open your mouth for the mute, for the rights of all who are
destitute. Open your
mouth, judge righteously, defend the rights of the poor and needy.” – Proverbs
31:8-9
