Florida Judge Overstates the Case for Child Transition

A federal judge in Florida has sided with the families of three minors seeking medicalized gender transition. On Tuesday, U.S. District Judge Robert Hinkle blocked Florida’s ban of puberty blockers and hormonal treatment from applying to the specific minors in the lawsuit. He gave several justifications for this decision.

Judge Hinkle began with the assertion that “gender identity is real.” He provided a definition of gender identity: “a deeply felt internal sense of being male or female,” which is distinct from (and sometimes at odds with) sex. Those for whom sex and gender identity are aligned are “cisgender.” Those for whom they aren’t aligned are “transgender.”

The concept of “gender identity” originated in the mid 20th century in the context of mental disorders. It was entered into the Diagnostic and Statistical Manual of Mental Disorders in 1980 as “gender identity disorder,” which later became “gender dysphoria.” The belief that we all have a “gender identity”— which Hinkle subscribes to — is a more recent development.

Here’s how Ray Blanchard, an American-Canadian sexologist with 40 years’ worth of experience in “paraphilias, gender-identity disorders, and sexual orientation,” described the concept of “gender identity” in a 2019 interview with National Review:

Back in the days when I was writing a lot on that topic, which is quite a while ago now, I tended to avoid the phrase “gender identity” because I think that it’s a trivial concept when it’s applied to normal people. I mean normal men and normal women know what sex they are, and they respond to that automatically, like when looking for a washroom. But I think it’s only at very unusual moments that a normal man or woman has a conscious awareness of “I’m a woman” or “I’m a man,” and this is often a highly emotional situation.

So I don’t find the concept of “gender identity” useful for normal people, and the concept of cross-gender identity is really not a normal gender identity which has found itself lodged in the wrong body. Cross-gender identity is a constant preoccupation with, and unhappiness about, the individual’s gender. So I guess you could say I believe in cross-gender identity, but I don’t much believe in gender identity.

Gender identity began as an oversimplified shorthand, used to categorize those who felt at odds with their sex without necessarily getting into why it was they felt that way. But in its expanded form, it is little more than a rhetorical decoy. The more reliable concept is sex, which is not only real, but objective and demonstrable — and which cannot be changed, either by feelings or by medical intervention.

Judge Hinkle wrote that “the overwhelming weight of medical authority supports treatment of transgender patients with GnRH agonists and cross-sex hormones in appropriate circumstances.”

Note the word “authority,” rather than “evidence.” It is true that the governing groups of major health associations in the United States have indicated their support for medicalized gender transition. But as for “appropriate circumstances,” health authorities in Europe are beginning to draw the line at children.

An independent review into Britain’s gender youth clinic by a former head of the Royal College of Pediatrics found that the clinic (which is conservative in its approach by American standards) was “not a safe” option for young patients. A Finnish review concluded that “gender affirming” treatment was “experimental.” Swedish health authorities have advised that the risks of medical transition for minors “currently outweigh the benefits.” France and Norway have followed suit.

In the ruling, Judge Hinkle asserted that the ban on puberty blockers and hormonal treatment was not a “legitimate state interest” and that the families that sued the state are “likely to prevail on their claim that the prohibition is unconstitutional.”

But again, this is mere assertion. In principle, it’s indisputable that the state has a legitimate interest in prohibiting dangerous medical procedures. And in practice, experimental child transitions meet that threshold.

For now, except for the three minors in the lawsuit, the Florida law remains in effect. Future litigation is indeed to be expected. But Judge Hinkle overstates the case for child transition.