If we were going to construct a test-case for how dysfunctional our politics have become, it would be hard to beat the transgender issue. It profoundly affects a relatively minuscule number of people in the grand scheme of things, and yet galvanizes countless more for culture war purposes. It has become a litmus test for social justice campaigners, who regard anyone proposing even the slightest qualifications on the question as indistinguishable from a Klan member. It has seized the attention of some of the most extreme elements among radical feminists, who in turn regard any smidgen of a compromise on the rights of women as a grotesque enforcement of patriarchy.
Worse, it has now excited the Christianist right, who see the recognition of trans rights as an effort to destroy the sexual binary that is at the core of almost all orthodox faith. And it has become a Twitter phenomenon, where all reasonable arguments go to die. If you are an opinion writer, you really do have to be a masochist to even want to dabble in the debate. And the mainstream media is, at this point, completely unreliable as a source of balance or information. They openly advocate the most extreme critical theory arguments about sex and gender as if they were uncontested facts and as if the debate can be explained entirely as a function of bigotry vs love. (A recent exception to this, though tilted clearly from the start in one direction, is this explainer from the NYT last night.)
Big global stories — for example, a high court case in Britain that found that minors under 16 are not developmentally capable of making the decision to take puberty blockers — are routinely ignored. Check out this video from the Washington Post. It doesn’t even gesture at fairness: no presentation of counter-argument; instant attribution of bigotry for anyone deemed in disagreement.
And the issue has recently become, even more emotively, about children — how they are treated, how the medical world deals with them, amid complicated arguments about specific treatments, their long-term effects, and genuine scientific disputes. And all of this is taking place with far too few reliable, controlled studies on transgender individuals, as children and adults, or on medical interventions. A lot of the time, we’re flying blind.
I’ve been trying to think these things through for the past few years. I used to think trans rights were a no-brainer. Of course I supported them. And I still do. I believe trans people when they tell the stories of their lives; I empathize because I’m human, and the pain and struggle of so many trans people is so real; and perhaps also because being gay helps you see how a subjective feeling can be so deep as to be an integral part (but never the whole) of your identity.
Equally, however, I have some reservations. I trust biology on the core binary sexual reproductive strategy of our species, without which we would not exist, and which does not cease to exist because of a few variations on the theme (I’m one of those variations myself). I do not believe that a trans woman or a trans man is in every way indistinguishable from a woman or a man. If there were no differences, trans women and trans men would not exist as a separate category. I do not buy the idea that biological sex is socially constructed, or a function of “white supremacist” thought, for Pete’s sake. I further believe that no-one should be excluded from this or any debate; and that “lived experience” cannot replace “objective reality”, although it can often help complicate and explain it.
In our current culture, this somewhat complicated stance is anathema. For some trans activists, especially the younger more thoroughly woke ones, I am simply evil, beset by phobias, and determined to persecute and kill trans people, or seek their genocide. I wish this were a caricature of their views, but it isn’t. For some radical feminists, my empathy for trans women, and concern for their welfare, is regarded as a function of my misogyny and hatred of women, often wrapped up in some anti-gay, misandrist bile. I wish I were exaggerating here as well. The proportion of people in this debate who seem psychologically unstable, emotionally volatile and personally vicious seems larger than usual.
But we can no longer avoid the subject. There is now a flood of bills in state legislatures designed to ban medical procedures for minors who appear to be trans, and to ensure fairness between trans girls and girls in school sports, and a few that are even more extreme. Lines have been drawn. The woke establishment — all major corporations, the federal government, the universities, all cultural institutions, the mainstream media and now the medical authorities — are unequivocally on the side of anything the trans activists want. Amazon won’t even sell some books presenting one side of the case, while they still sell Mein Kampf. K thru 12 education now routinely tells children that biological sex is a spectrum (it isn’t) and they can choose where to fit.
I have no illusions that this situation will improve. Sides are dug in. But if we were to find a truce, that gave both sides part of what they want, what could it look like? Here are some principles to go by.
Distinguish between adults and children. In a free society, anyone over the age of 18 should be able to identify as they wish, call themselves what they wish, access full medical treatments to be the gender they believe they are, and be protected by civil rights law. (There should be some measure other than simply a statement by the person to show that the transition is genuine and sustained.) The good news is that this state of affairs has been largely achieved — with the Bostock decision as a crucial breakthrough. Again, some perspective. Trans activists dreamed for years of civil rights protection; now they have it. Bostock was easily the biggest win in trans history, and nothing left to do compares with its breadth and scope.
Treating trans people with dignity is the right thing to do; and most of the “problems” associated with trans people — a non-existent threat of sexual assaults in restrooms, for example — dissipate on inspection.
Defend the rights of both women and trans women. In the overwhelming majority of cases, there is no conflict. In the few where there are, compromise. Women who have been abused by men and need a space free from any inkling of maleness and penises deserve such a space. Some shelters can include both trans women and women, but some shelters solely for women should absolutely have a right to exist.
In prison, when we are dealing with criminals, trans women need to be housed separately to minimize the horrible abuse and rape many currently endure at the hands of men; but by the same token, women should not have to be imprisoned alongside trans women, for the same reason. We’re not talking about regular trans people here; we’re talking about criminals, some sex offenders. Separate facilities for trans people is the sanest and least dangerous option. Laws like California’s, that came into force this year, and allow any man to self-identify as a trans woman and thereby transfer to a women’s jail, are putting women at risk. This is not a hypothetical, like restroom attacks. Rapes have already happened.
Treatment of minors should be safe, limited and rare. A blanket ban on all medical treatment for trans kids is a crude invasion of an intensely personal decision rightly placed in the hands of doctors, parents and children. Asa Hutchinson is right. No government should have that power. And there are many cases when early intervention has been shown to help kids enormously in handling their gender dysphoria, leading to good outcomes and happier trans lives. Too many people have been helped and too many good doctors have been involved to ignore this truth.
At the same time, the use of off-label puberty blockers should not be portrayed, as it too often is, as an easily reversible pause in development while the child figures things out. These drugs have unknown long-term effects on healthy children, have no good studies behind them, affect bone density and mental and neurological development, and are, in fact, almost never reversed. They are an experiment. On children. It seems to me you need a very good reason to use them.
What’s needed is much more comprehensive, wide-ranging psychological evaluation to assess all the factors that are correlated with a child’s or teen’s desire to be the opposite sex. We are told this is already happening, but you only have to see the insane increase in numbers seeking transition, and take a brief look at the countless stories emerging of hormones and blockers being handed out like candy, especially in the private sector, to realize this isn’t the case.
Is the origin for this desire rooted in family dynamics, autism, mental illness, social contagion, or fear of being lesbian or gay, rather than a real, sustained trans identity? Many of these factors can come into play — but they are far more time-consuming than making a quick affirmative diagnosis and going straight to blockers and/or hormones. Our medical system wants to medicate first. But when the consequences for a medical decision can last a lifetime, and the person is too young to vote, all the more reason to examine all the factors that could be a part of it.
If you think nothing bad is happening in this sudden explosion of child and teen trans care, check out this rather moving essay by Keira Bell, who had absent, negligent parents, and far too little counseling and was fast-tracked into becoming a man by experts she was wrong to trust. (Britain’s high court sided with her — a story you cannot find in the NYT or WaPo.)
Or absorb this essay on having a double-mastectomy the author now deeply regrets. Or the reddit detrans message board with 19,000 members. There are many successes in treating trans kids, which is why a blanket ban is bad and cruel. (A ban that would end treatment for kids already taking hormones, as in Arkansas, is unconscionable.) But there are failures too. And notice the poison and bullying directed at these de-transitioned souls by so many trans activists. It’s a sign of a highly insecure movement, when it doesn’t seek to examine where it has gone wrong, but ostracizes the victims of its over-reach.
It should not be hard to make a minor’s transition with puberty blockers and hormones possible when he or she needs it, but with many more safeguards: much more thorough psych evaluations, permission from both parents, the child and a doctor — with a second opinion also mandatory. I would favor a ban on any surgical treatments and hormones until the age of 18 and 16, respectively. I don’t believe in altering a human body permanently in childhood or adolescence. We treat minors differently from adults for a reason. The pre-pubescent mind is not ideal, to put it mildly, for making permanent changes to your body.
Protect gay and gender-non-conforming kids. Children and teens experiment with identities — and this is a good thing. Tomboy girls and feminine boys are threats to no one. Many will turn out to be gay or lesbian; many straight. And yet they are now pressured both ways: to conform to rigid gender stereotypes by reactionaries or to see their atypical behavior as a sign they were born in the wrong body by woke progressives. Why not just leave them alone? The North Carolina bill that will have schools monitoring kids for atypical behavior and reporting them to their parents for it is horrifying.
Equally, the way in which trans ideology doesn’t only seek to protect trans kids, but to abolish the idea of biological sex altogether and to teach kids they have a choice over whether to be a boy or girl, should be kept out of the classroom. It takes the experience of less than one percent of humanity and tries to make it explain the 99 percent of their peers. It’s nuts; and it will confuse children, particularly gay kids.
If I had been told by my parents or teachers that my fear of contact sports or my love of theater as a child suggested I was actually a girl inside, I don’t know how my 8-year-old self would have responded. But it is not unimaginable I would have believed them. My worry is that gay kids in particular could be swept up in this, and mistakenly make irreversible decisions they will later regret, as so many young lesbians have.
The increase among teens seeking treatment is a good thing if it means more awareness and understanding. But the scale of it, especially among girls, seems completely out of whack with a natural development. In 2009/10, at Britain’s Tavistock Center for transgender minors, for example, 32 girls and 40 boys were referred for treatment. By 2018/19, those numbers were 1,740 girls and 624 boys. Sudden high increases are everywhere — tenfold in Sweden in three years; quadrupling in New Zealand in the same time. And in almost every teen trans story, there is a pattern: obsessive Internet use. Can we really be sure this isn’t a craze or a fad for many? And can we have that discussion without accusations of callousness and bigotry?
I doubt these recommendations will have any appeal to the trans rights radicals or the Fox News right. But they’re sane, rooted in caution about experimental treatments, allow maximal freedom for all parties, and ensure more safety for kids and dignity for adults. They are not transphobic. And they are not trans-radical. Part of me doesn’t think they have a chance. But part of me also remembers that movements for social change often over-reach at first, and then, after a pushback, find some balance.
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