Heather, I agree with almost everything you’ve said — but you are making somewhat of a devil’s bargain when you make the claim that trans is real but rare: you want to save this enormous cohort of confused kids at all costs, and believe me, I sympathize. Perhaps you think it’s more palatable to a compassionate audience, and it demonstrates that you’re not just a wicked transphobe, if you concede something along the lines of “there always used to be trans people, and those were the ‘real’ ones, but these kids are different.”

Well, it’s true that these kids are different, and it’s true that for about a century we’ve had people in the West who believed sex change was a real thing that reflected their true inner self, but I wish you were willing to “go all the way” and state the obvious: that there is no physical, medical evidence for the condition currently known in the West as “being trans.”

It’s always been rare, yes. But what is trans? In what way is it “real”?

If you want to make the claim that all cultures throughout history have had gender nonconforming people, yes, I agree. And, since behavioral traits exist on a spectrum, if you want to make the claim that all cultures have a few extreme outliers of very, very gender nonconforming people, I will agree with that too. Absolutely. That’s real.

A few cultures, especially those with rigid gender roles, even have a category for extremely gender nonconforming folks. That’s why a culture like Samoa’s has a category for fa’afafine, but a more egalitarian culture like the Iroquois did not create a special category.

So far, we probably agree. Gender nonconforming people exist. But gender nonconformity does not equal “trans”— if that were true, you and I, both gender nonconforming women, if only because we dare to have unpopular opinions, would be “trans” —and we’re not.

Gender nonconformity exists in all times and places, but it does not equal trans. The specifics of what a culture _does_ with that reality of gender nonconformity are …well, culturally determined.

Gender nonconformity is universal. What cultures _do_ with gender nonconformity, how they treat it, what they believe it signifies, how they behave toward nonconforming people, that’s all very different across time and place.

Throughout history and different cultures, what people _didn’t_ universally have is a belief in being “in” the “wrong body” or a belief in being literally the opposite sex, or a belief in a brain-body mismatch. No, those are things specific to our culture, and the “treatment” consists of health-harming cosmetic procedures. We created all of it. I’d say Samoa did a much better job.

We didn’t create gender nonconformity— the universal. We created “trans,” our culturally specific response to it.

So… what is it to “be trans”? The 20th and now the more extreme 21st century Western version of “being trans” is essentially a culture-bound syndrome.

To say that some people “are trans” is to concede that some people really are the opposite sex on the inside. There’s no evidence for this.

If what you’re claiming is simply “some people are so extremely unhappy with their bodies that they are ‘happier’ living as the opposite sex and having these extreme cosmetic procedures” — well, I suppose that’s possibly true.

Even that, though, is not a “universal” — traditionally the fa’afafine know they’re male, don’t experience distress at their bodies, etc. The emotional distress of “being trans,” and the idea that the solution to the distress is to have cosmetic procedures while all of society pretends they’re the opposite sex — that’s all stuff specific to our culture. Some might say our culture’s approach is very unhealthy compared to Samoa’s.

So to call our extremely unhappy gender nonconforming people “trans” as if it’s some real and valid medical condition, in absence of all evidence, is to gloss over the hard reality about what is real versus what is a (very maladaptive) cultural invention.

Think of this too — if we concede that some people are “really trans” then, too, every teenager in the grip of this current cultural mania is going to be sure, absolutely sure, that she’s “one of the rare and real” trans people. Every parent who is horrified to see his pre-school age son play with dresses and dolls is going to be sure, absolutely sure, that his son isn’t proto-gay, but rather “one of the rare and real” trans kids. “Born that way” if you will. But there is nothing at all wrong with any gender nonconforming person’s body or behavior. That’s all in our minds.

No one can be “in” the wrong body because we _are_ our bodies. It’s possible to have a false cultural belief that a few rare people are “in” the wrong body, that they “are” really trans, but that is a statement of belief, not fact. I would argue that it’s a harmful belief that benefits no one and leads to health-destroying interventions.

No one “is trans” in the way 21st century Western people have conceived of it. There is no evidence of such a thing.

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I agree with much of what you have said here, some of which is framed in ways that I have not considered it before.

Elsewhere, I do take pains to distinguish between sex and gender, and I would never agree that “transsexual” is actually a real, possible outcome for a human. Transgender—which, note the change of language in the last few decades—has largely replaced that. The honest, deeply gender dysmorphic people whom I know—whom I recognize as trans—know very well that they cannot actually change their sex.

There is much more to be said on this topic, of course, but for now, I will leave with gratitude for your careful and kind analysis.

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Thank you for taking the time to read a very long comment and to reply, Heather. You have a much bigger platform than I will ever have, and it feels good to share ideas with you and to “be heard” on something that has been troubling me so deeply. I know only a few hundred people and yet I’ve lost count of the number of kids I know in these families who are experiencing this. It saddens me so much, I almost can’t express it.

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Thanks so much for this thoughtful reply.

Re “ Such intervention on adults is a matter of choice in a free society, for political and moral reasons. But it is not scientific.

“Body distress is real, and deserves compassion. But it is not evidence that brains float into wrong bodies or that medical science can make right ones.”

Exactly. I agree. And indeed, while I agree that it’s a matter of choice for moral and political reasons, and must remain so, I also happen to believe that all purely cosmetic surgeries are unethical. The benefits (except perhaps arguably in “alleviating emotional distress”) never outweigh the small but real risks of surgery, including death. Would a rational person of any sex really risk their life for a “boob job”? What ethical surgeon agrees to take money for this?

But then you’re sliding down the slippery slope of “what about women who’ve had mastectomies and don’t feel whole?” Etc. So I don’t think we can or should interfere with adults’ autonomy and choice, because then, when you allow interference with other people’s cherished expressions of self, eventually someone will come to interfere with yours.

The next question is, though — suppose the main benefit of cosmetic procedures is the alleviation of “emotional distress.” (Because why else does anyone do it, right? Even people who claim to be perfectly happy, who say they’re undertaking a cosmetic surgery “for themselves” as though it’s a form of self-care, are doing it because they are dissatisfied on some level with their bodies, enough to act on it.)

And I absolutely agree that “body distress is real and deserves compassion.” That raises the question again of what’s universal and what’s cultural. On some level, we probably all have a human desire to be “datable / matable” and to have the highest possible social status we can attain within our group. I’d wager all human societies share that, just as all human societies have gender-nonconforming people.

But where did our particular cultural practices to address this universal human wish come from? Who creates, encourages, promotes, and benefits from _this Western type_ of bodily dissatisfaction in our culture? The type where you can buy your way to happiness and success? The people with something to sell us to “fix it.”

Something as seemingly benign as deodorant or lipstick or hair color is sold to us to decrease our bodily dissatisfaction. Do I, does anyone, want to stink or look washed out and have a lower social status than we might? Nah. So we buy things. That’s our culture at work again.

This phenomenon of trans kids and trans teens—listen to the children! ask no questions, bigot! — seems to me a wild intensification of an already pernicious and damaging cultural view of the body as something we all “should” be displeased with and all “should” strive to improve by whatever means possible— but preferably by means that involve buying things. Even better if we continue to buy those things forever, like deodorant or hormone pills or surgeries to repair the previous failed surgeries.

If your sex is something you can choose, like hair color or a pair of this season’s trendiest shoes, that’s quite a market. That’s quite an opportunity to make money.

Bodily dissatisfaction, and buying things to alleviate it, is part of the water we Western fish swim in. It feels normal and natural.

That’s why we Westerners are so easy to “sell” on this narrative of people who are so deeply unhappy that they can’t live a happy life unless they get what they want, ie, lifelong hormones, surgeries, and everyone supporting their idea of themselves. We naturally empathize with it, because we’ve felt the same things on a smaller scale. It feels human and natural to hate your body in this way.

But it’s not, really. It’s another (very maladaptive) cultural adaptation, and we would do well to point that out, drag it out into the open, and discuss better, more mindful, and more compassionate ways to adapt to our natural human desires.

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Compassion does not require us to deny fundamental reality. No amount of hormone suppressors, cross hormones, plastic surgery, clothing, hair, make up, or belief will turn a boy into a girl or a girl into a boy. This is true even if the child is trans. At best, these children become good fakes...but they live a life pretending to someone they are not and can never be.

You are right to point out the financial incentives. They are legion. Yes, drug companies stand to gain, but so do "gender therapists", surgeons, and medical facilities. There is good money to be made from the pain and confusion of these children and their terrified parents (some of whom may be mentally ill themselves and virtue signaling through their child).

Trans or not, children, especially very young children, engage in magical thinking. How many five-year-olds who declare a different gender really understand that they cannot be what they claim to be, who they claim to be...ever? I suspect none of them do. It's cruel to indulge such fantasies.

With few exceptions (Swyer's, CAIS) were are all born male or female. Nothing can change that reality. How is altering the body to (allegedly) align with the mind more compassionate than helping a child accept the body in which he or she was born? It isn't.

The bigger question for me is why this is happening now. Did this explosion of trans children arise organically from some place of woke compassion or is something else going on?

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Brilliant observations! I agree completely. Please keep writing!! 👏🏽👏🏽👏🏽

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So brand new humans are so helpless and raw that raising them is better accomplished by a team. And teams have to converge upon norms…

If I’m a force that wants to obliterate gender norms, maybe I aim to obsolete a society’s felt need to protect children in the first place.

Beelining for that might look like making “affirmative care” interventions obligate, and injecting live porn into K-12 education.

I don’t think corporate profit as primary driver is satisfying here. The trend is too insane.

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