Do Not Allow Them to Medically Transition
Childhood is a time of play and discovery. It is a time to try things on, and try things out. Humans have the longest childhoods of any species that has ever evolved on this planet— a powerful indicator that we have much to learn as children in order to become highly capable adults. Children explore and experiment with belief and identity. Childhood should not be a time in which any given experiment seals your fate.
In our lineage, we have had two sexes, with endocrinological systems that regulate our form, function, and development, for hundreds of millions of years. It is a system that is both ancient and complex. But hormones are now being pushed by doctors and drug companies—and assented to by parents—as if we have no history with them at all. These hormones include puberty blockers, notably GnRH (Gonadotropin Releasing Hormone), which are often begun in the early teen years. This may then be followed, in the mid-teen years, by cross-sex hormones, specifically estrogen and testosterone. Our history with these hormones is long, and their effects on us complex and cascading, interwoven with myriad systems. Yet we are experimenting on our children as if puberty is a matter of choice. Having mustard or mayo on your sandwich is a choice. Wearing pants or a skirt is a choice. Playing soccer or basketball with friends is a choice. Puberty is not a choice.
Puberty is critical, and messing with ancient hormonal systems has serious downstream effects that will never go away. Much of the research on the effects of hyper-novel medical intervention is written by people who are already invested in disrupting children’s development, but even so, we find that bone mass is negatively affected, as are several physiological parameters, including blood volume, cholesterol and several other hormones. Furthermore, giving GnRH at onset of puberty affects cognitive function in an animal model (sheep), impairing spatial memory.
It is also true that many young people who medically transition later detransition, or desist, citing reasons as varied as becoming more comfortable identifying as their natal sex; coming to understand themselves as lesbian, gay or bisexual; and having concerns about potential medical complications from transitioning (see especially Littman 2021 and references therein, and also the Pique Resilience Project). Many desistors also report that they “did not receive an adequate evaluation from a doctor or mental health professional before starting transition.” For those young people who identify as trans, and later desist, given the irreversible effects of puberty blockers and cross-sex hormones, certain doors will have permanently shut for them: they can never become what they might have been.
Some state legislatures are trying to stop the experimental drugging of children, but they are swiftly called “transphobic” and “anti-science” for doing so, by the media and by politicians eager to score points. Even professional organizations have fallen prey to this blindness. Consider, for instance, the recent statement from the Society for Research in Child Development, in which they argue for medical interventions for transgender children, without ever mentioning the effects that such interventions will have on the non-transgender children who would thus be altered forever. They would seem to be thinking only of the vocal minority, never considering the less visible children who stand to be permanently damaged by such policies.
The “affirmative care” model proclaims that if a child says they are trans, then they are trans, and any discussion or pushback is considered damaging to the child. This model is increasingly the norm, even mandated in many health care settings. The affirmative care model not only woefully misunderstands childhood, but also puts a much larger fraction of children at risk. Allow me to explain.
We are told that people who turn out to be trans as adults—a tiny but real fraction of humanity—tend to know this of themselves when they are young, and to say so. This is no doubt true.
But what of the vast numbers of children who say similar things when they are young, but do not turn out to be trans? There will be no data on this, but all parents know that children say things that are impossible. They are exploring, they are fantasizing, sometimes they are testing the adult waters to see what works, what gets a rise out of the parents, what gets them attention. This is to say nothing of the abused children who are even more likely to retreat to fantasy in order to create a stable identity, and who will be further harmed by the affirmative care model.
A child may declare herself a unicorn one day, and a turtle the next. Unlike hormones, preferences from foods to colors to friends are transient, and can easily be exchanged as the child tries out new ways of being. It’s as if, as a society, we have forgotten the distinction between simile and metaphor, or perhaps we are pretending that children knew the difference all along, and are ever precise in their language. But until yesterday, we all knew that “I feel like a boy” is not the same as “I am a boy.”
Given what childhood is, and how many fantastical and untrue things come out of children’s mouths, “everything children say is literally true” is an absurd and dangerous premise on which to base medical care.
Furthermore, we are told that failing to intervene, hormonally and medically, for those children who declare themselves trans, puts them at risk of failing to become their true selves. This, we are told, would be a grievous error.
But what of the other possible error?
Intervening at an early age with experimental and disruptive medical practices for all the children who declare themselves trans, risks harm to a large number of non-trans people for life.
Compare the two risks side by side:
fail to intervene at an early age, such that a tiny number of actual trans people begin physical transition later and come to be a less good fit for their internally perceived sex; or
permanently disrupt normal development for children who were merely exploring their identity.
Which error does society prefer to make?
In the language of statistics, we can frame the decision this way: The null hypothesis is that you are not trans. This presumption is based on the fact that a persistent, deeply felt disconnect between your actual sex and your perceived sex is extraordinarily rare in humans. It must be, evolutionarily. No mammals are known to have ever switched sex. Nor any birds, for that matter—birds which also, like us, have sex chromosomes that determine what sex they are. So in those of us who belong to clades whose individuals have never switched sex, a deep-seated sense that you are not the sex that you actually are will be exceedingly rare.
The alternative hypothesis—that you are trans—can only replace the null hypothesis—that you are not—with compelling evidence. And the assertions of a child are simply not sufficient.
Do we, as a society, prefer to bias towards false positives (type-I errors), in which we mistakenly assume that some people are trans even though they are not; or do we prefer to bias towards false negatives (type-II errors), in which we mistakenly take some people for not-trans, even when they are?
To prefer the first is to broadly encourage transition. This means transition even for those who do not turn out to warrant or want it, with all the attendant downstream effects: physical, mental and sexual disfunction across a range of systems, many of which we cannot yet even know. Again, this is the “affirmative care” model.
To prefer the second (false negatives), on the other hand, is to recognize that if we do not intervene early, some trans-adults will be a somewhat less good fit for their internally perceived sex than they might have been. Delay treatment until adulthood, and the adult will bear more of the marks of the sex-specific puberty that is a match for their natal sex.
Type-I errors create false positives, in which people who are not trans are treated as if they are.
Type-II errors create false negatives, in which people who are trans are treated as if they are not.
Given that the background rate of trans people is exceedingly low, it is our human and societal responsibility to minimize type-I errors in this case—to drive as close to zero the number of healthy children harmed by medical intervention. This is for two reasons. First, the sheer numbers of people who will be harmed by making type-I rather than type-II errors is far higher. Second, intervention in a functional, ancient system when no demonstration of the safety of those interventions has been made, and indeed when we already know some of the harms of intervention, goes against all that is right, moral, and just.
The treatments for people who are trans—puberty blockers, cross-sex hormones, and surgery—have permanent costs, make no mistake. For the vast majority of children and youth who are merely exploring identity and belief, doing what children do—those costs are unacceptable. We must protect childhood, and we must protect children.
Finally, I would enjoin the reader to consider the possibility of financial incentives in the rise of puberty blockers and cross-sex hormones. We are told that trans people will suffer harm if access is delayed until maturity. In some cases, this may be true. But who profits from the ever-wider acceptance and prescription of these drugs? The companies who make the drugs are those who profit. If you were such a company, and you had a product that nobody knew they wanted or needed, or even knew existed, how might you go about generating demand for your product? Convince would-be consumers that they were incomplete and miserable without it. Further, convince those would-be consumers of your products that those who would keep them from the drugs are trying to kill them.
Among adolescents, attempted suicide is higher in those who identify as trans than those who do not. The high rate of suicidal ideation and behaviors among trans people has been contorted by activists, some of whom argue that keeping people from transitioning is risking—nay, inviting—their suicides. This is propaganda. If any of the players are getting people killed here, it’s the companies, organizations, and yes, activists who are pushing drugs on children. These children and young adults are being sold a story that allows them to feel seen and embraced for a brief moment, before being abandoned to the downstream effects of having disrupted an ancient system with no plan, and no escape.
One such company advertises that their puberty-blocking-drug provides “Childhood, Uninterrupted.” It’s a Peter Pan fantasy with none of the upside. Children can imagine a carefree life of fairies and no responsibilities, and perhaps parents believe that they will have their little ones with them forever, unchanged.
The children have an excuse: they’re children. We can make no such case for the adults. We will look back on this era in horror, a time when we played God with complex systems that evolved over hundreds of millions of years. We have all the arrogance of Zeus, and none of the wisdom.
I discussed this topic on the DarkHorse podcast with Bret Weinstein, in episode 75, which aired on April 10, 2021. Here is the link to the full video, and here is the clip of the relevant section.
It is difficult to know exactly what the numbers are for various things: How many people have historically identified as trans? How about in the current moment? Does it vary by demographic markers, and if so, which ones? This excellent site, StatsForGender.org, does a fine job of compiling much relevant research.
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.
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?