Last year Jeanette Jennings, as part of the reality-TV show I Am Jazz, threw her 17-year-old child, Jazz, a “farewell-to-penis party.” Guests cheered as the teenager hacked at a phallus-shaped cake with a knife, shouting, “Let’s cut it off.” The party may have been a bit contrived even by reality-show standards, but the subsequent operation was all too real.
In any other context, we might consider the drug-induced stunting of a child’s penis, followed by its surgical removal, to be mutilation. But in an era of culturally and legally enshrined transgenderism, it’s not just permissible; it’s entertainment.
In February, Representatives Jackie Speier (D., Calif.) and Angie Craig (D., Minn.) participated in the “Jazz and Friends National Day of Community and School Readings,” sponsored by the Human Rights Campaign (a well-funded gay and transgender lobby group) and the National Education Association (a teachers’ union). They read aloud celebratory and euphemistic stories of transgender children (such as Jazz, with the amputated penis) on the House floor. But the mainstreaming of youth transgenderism goes way beyond Congress. In schools nationwide, children as young as five are being taught that they may have been born in the wrong body.
Transgenderism is the theory that each person has an innate gender identity that is distinct from that person’s sex. Theories about gender identity were pioneered by sexologists and academics in the mid 20th century, and they remain widely contested and poorly understood. Despite this, they are being applied in a radical and experimental way to children worldwide. Parents and professionals agonize over the fear that young people will suffer physical and psychological harm from the application of transgender theory, but all too often they are cowed into submission.
Some American girls have had double mastectomies as young as 13. Planned Parenthood operates on an “informed consent” basis — meaning that young people are briefed on “both the risks and the benefits” of cross-sex hormones and do not require a letter of referral from a therapist. The organization’s website states: “If you are eligible, Planned Parenthood staff may be able to start hormone therapy as early as the first visit.” Meanwhile, in 2015 the National Institutes of Health (NIH) awarded a $5.7 million taxpayer-funded grant for a five-year study on “the impact of early medical treatment in transgender youth.” According to a progress report, the minimum age for the cross-sex-hormones cohort was decreased from 13 to eight.
The claims of prominent clinicians justifying such interventions are baffling. Diane Ehrensaft, a developmental psychologist and founding member of the Child and Adolescent Gender Center clinic in San Francisco, claimed that toddlers can send a pre-verbal “gender message” by tearing barrettes out of their hair and saying things such as “I. Boy.”
In a presentation at the United States Professional Association for Transgender Health’s 2017 conference, Johanna Olson-Kennedy, the medical director of the largest transgender-youth clinic in the U.S. (and one of the doctors leading the NIH study), explained how she had interacted with an eight-year-old girl brought in by her mother.
According to her own account, Olson-Kennedy asked the girl, “Do you think that you’re a girl or a boy?” The child looked confused and answered, “I’m a girl because I have this body.” Olson-Kennedy then made up an analogy about Pop-Tarts being put in the wrong box, which prompted the girl to turn to her mother and say, “I think I’m a boy and the girl is covering me up.” After audience laughter, Olson-Kennedy remarked that this was an “amazing experience.”
In medical literature this new approach is called by the euphemism “gender affirmation.” It has three stages: socio-psychological treatment, which involves using a name, pronouns, clothes, etc. appropriate for the opposite sex; endocrinological treatment, using puberty-blocking drugs and then cross-sex hormones; and surgical treatment, removing or manipulating the minor’s sex organs. The latter stages are irreversible and can lead to sterility and sexual dysfunction. But the earlier measures can be harmful, too, as they make it less likely that the child will grow to accept his or her body.
Discomfort with one’s sex and development is a normal part of adolescence. In 1980, the psychiatric profession recognized the small minority of young children for whom these feelings are intense and described what they suffered from as “gender-identity disorder.” This was a rare condition that generally manifested in early childhood. Researchers found that by the end of adolescence, around 80 percent of these cases resolved themselves naturally with therapies such as “watchful waiting” and counseling. Children were not treated with drugs or surgery.
In 2013, however, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders replaced “gender-identity disorder” with the more neutral name “gender dysphoria.” Today it is far more commonly reported and mainly affects adolescents. Transgender activists argue that this new diagnosis proves their theory that a gender-dysphoric girl is really a boy, and that the correct treatment is not to change the patient’s thoughts but to change the patient’s body — and everyone else’s thoughts.
In the 1990s, researchers in the Netherlands developed a way for children with very acute gender dysphoria to delay puberty. Designed as a “pause button” — with the rationale that developing sex characteristics could cause distress — these “puberty-blocking” drugs were intended to be reversible. Yet now, under the “gender affirmation” model, almost all young patients proceed from puberty blockers to cross-sex hormones.
Inexplicably, activists appear to be influencing and even dictating medical guidelines. For instance, the American Academy of Pediatrics’ 2016 guidelines were written by Gabe Murchison, a transgender activist with no medical training. In the guidelines, Murchison advises intervening sooner rather than later and baselessly casts aspersions on cautious approaches backed by decades of research proving positive outcomes:
The problem with “delayed transition” is that it limits transition based on a child’s age rather than considering important signs of readiness, particularly the child’s wishes and experiences. A gender-affirmative approach uses this broader range of factors, with particular attention to avoiding stigma and shame.
The AAP’s 2018 policy statement races miles ahead of the current evidence, according to specialists within the field. Yet the AAP seems to have ignored its critics. The Endocrine Society, the American Psychological Association, and the World Professional Association for Transgender Health (WPATH) are also shaping new standards by entertaining endocrinological and surgical intervention for minors with gender dysphoria.
These changes appear to be a result of politicization, rather than solid evidence. Sheila Jeffreys, a feminist and the author of Gender Hurts, recently told National Review that “you need to look at who the funders [of WPATH] are. . . . It’s drug companies.” She added that “the situation with children is . . . very, very profitable for drug companies” because young patients can become dependent on these drugs for life.
Is there a middle ground between this approach and the earlier, more cautious treatment?
In the U.K., the National Health Service has a “gatekeeping” approach to transgender youth in which psychological evaluations are conducted and irreversible treatment is not recommended for under-16s. However, according to the Sunday Times of London, doctors at Britain’s national youth-gender clinic have complained that even this degree of protection for young people is proving “woefully inadequate.” Reportedly, doctors suggested that patients could be subjected to “long-term damage” because of the clinic’s “inability to stand up to the pressure” from “highly politicized” transgender-activist groups. The governor of this clinic recently resigned in protest at its “blinkered” neglect of doctors’ concerns.
An Oxford University sociology professor, Michael Biggs, has accused the clinic of suppressing its own negative findings. Biggs conducted his own research, which found that after a year of treatment at the clinic, there was a “significant increase” in the number of girls who reported self-harming and attempting suicide to the clinic’s staff.
In any case, “gatekeeping” aside, some basic principles are worth considering. First, minors, unlike adults, are unable to give informed consent to experimental treatments to their healthy and fully functioning bodies. Second, minors with acute gender dysphoria ought to be given every opportunity to work through their distress through non-invasive, researched therapies — a method that is proven to help the majority of young patients without permanently altering their bodies. Third, clinicians ought to base all treatment on evidence, not ideology.
What evidence supports “gender affirmation”? In a letter to the editor published last fall in the Journal of Clinical Endocrinology and Metabolism, the Endocrine Society’s leading journal, a group of endocrinologists who specialize in gland and hormone disorders state that “there are no laboratory, imaging, or other objective tests to diagnose a ‘true transgender’ child.” Therefore, they ask, “how can a physician ethically administer GAT [gender-affirmation therapy] knowing that a significant number of patients will be irreversibly harmed?”
Answering this question is urgent because gender dysphoria among youth is increasing at an astonishing rate. In the U.K., where medicine is centralized and highly regulated, the National Health Service’s only gender clinic for children and young people saw 2,519 referrals in the 2017–18 fiscal year. This is an increase of 400 percent in the past four years. In the U.K., girls seem to be disproportionately affected. For instance, Britain’s national youth gender clinic has seen a 45-fold increase in females seeking medical help for gender issues in less than a decade. In 2009–10 there were 40 girls; in 2017–18, there were 1,806.
In the U.S., where medicine is less regulated, numbers are harder to come by, but we have an idea. Last summer The Atlantic reported that there are around 40 youth gender clinics in the United States. (Until 2007 there were none.) This does not account for hospitals and other practices offering treatment, so there may be considerably more. In 2017 the Williams Institute at UCLA School of Law estimated that 150,000 youths between the ages of 13 and 17 identify as transgender. In 2019, the Centers for Disease Control and Prevention estimated that 2 percent of American high-school students, or around 300,000, identify as transgender. Estimates vary, but just about everyone agrees that the youth transgender population is increasing fast.
In the summer of 2018, a preliminary study in the United States by Lisa Littman, a researcher at Brown University, noticed a similar trend among teens experiencing what she described as “rapid onset gender dysphoria.” Littman suggested that “social and peer contagion” could be a factor in transgender self-identification. In response to pressure from activists, Brown removed the study from its website, explaining: “The conclusions of the study could be used to discredit efforts to support transgender youth.” PLOS ONE, the journal that published Littman’s paper, also conducted a highly unusual post-publication review in response to pressure, republishing the paper with a “correction” that issued “additional context” but did not alter the paper’s findings. Littman called for further research, but instead millions of dollars are pouring into studies designed to support transgender theory, including Olson-Kennedy’s study for the NIH.
On both sides of the Atlantic, many professionals fear reputational destruction if they speak up. For instance, Kenneth Zucker, a global authority on childhood gender dysphoria with over 40 years’ clinical and research experience, was fired by his clinic in Toronto based on libelous claims that the clinic made public after activists launched a smear campaign against him. Zucker — who, incidentally, is open to transition treatments in acute cases of gender dysphoria, though he maintains that congruence between a patient’s gender identity and sex is the ideal outcome — has since been vindicated in a lawsuit.
Intimidation is a common activist tactic. In the United Kingdom, “transphobia” can constitute illegal “hate speech” that warrants police action. A mother of two was arrested and held in a cell for seven hours after she identified a trans woman as a man online. A 74-year-old woman was contacted by British police after she wrote: “Gender’s fashionable nonsense. Sex is real.” And these are not isolated incidents.
Parents who are unimpressed by transgender theory, or who suspect there are other reasons for their child’s gender dysphoria, may not have a choice in the matter. Earlier this year the Daily Mail reported that a British teenage boy with autism had been taken into care because his parents refused to treat him as a girl. And I spoke to the father of Sofia (not her real name), a 15-year-old girl living in Spain. “Our daughter,” he told me,
declared she was a boy when an older boyfriend came on the scene. We found violent and misogynistic pornography on her phone. Later we found out that at least two of this boy’s ex-girlfriends had had double mastectomies. . . . He seemed obsessed with girls getting their breasts cut off [and] advertised on social media where girls could get their breasts removed in Spain. . . . He [the boyfriend] then reported us to the police, . . . but when Sofia threatened suicide, social workers were brought in to help reconcile our family. The social workers turned out to be transgender activists. Now Sofia has been taken into state custody, where she plans to undergo sex-change treatments.
If Sofia had been born a generation earlier, she might have benefited from therapy designed to explore the root issues of her discomfort (which would presumably have exposed the influence of this sadistic young man). But today, transgender activists have made it nearly impossible for parents to get proper help for their children. Therapies designed to reconcile a child with his or her sex are now illegal in more than 15 U.S. states, where they are considered a form of “conversion therapy” (the controversial practice of trying to change a gay person’s sexual orientation). Tried and tested treatments that are designed to reduce the feelings of distress associated with “gender dysphoria” cannot coexist with the dogmatic principle that “gender identity” is innate and immutable.
Under such a grave misapplication of the term “conversion therapy,” therapists may have no choice but to provide “gender affirmation,” which in many cases amounts to an actual conversion: the attempt to turn a female child into a male child or vice versa by mutilating his or her body.
A recent paper in the American Journal of Bioethics goes one step further, arguing that “transgender adolescents” should have “the legal right” to undergo medical treatments without parental approval. Last month a judge in Canada created exactly that right, overruling a father’s attempt to stop his 14-year-old daughter from being injected with testosterone. Similar cases have occurred in the United States.
The justification for taking parental rights away is that when children are deprived of gender affirmation, suicide is supposedly likely. Reports of attempted suicide and self-harm among transgender young people are indeed alarming. The Centers for Disease Control and Prevention estimates that over a third of transgender high-school students reported attempting suicide last year. However, as with just about everything gender-related, the causes of suicidality are complex, and it is irresponsible to suggest otherwise.
Kenneth Zucker, the gender-dysphoria expert, told me: “On average, children and adolescents with gender dysphoria have a variety of behavioral and emotional problems or mental-health diagnoses. And that general vulnerability to psychopathology can also be a risk factor for suicidal feelings.” Zucker added that the suicidality rates of gender-dysphoric youth are not necessarily greater than those of children with non-gender-related mental-health problems.
The Samaritans, a suicide-prevention charity, have pointed out that “research has consistently shown links between certain types of media coverage of suicide and increases in suicidal behavior among vulnerable people.” However, with transgenderism, the complexities of suicidality are simplified and politicized.
For example, in 2014 Joshua Alcorn (a.k.a. Leelah), a transgender 17-year-old, walked in front of oncoming traffic on a highway, leaving behind a suicide note to be published on Tumblr. Alcorn’s death sparked an activist outcry. But a formerly transgender teen said recently in an interview that appeared on the blog 4thWaveNow:
[Alcorn’s] death affected me, along with many others, as it was sensationalized and widely held up as a warning to parents: “This is what happens when you don’t let your kid transition.” This mantra continues to be repeated online and everywhere, and perpetuates the idea that suicide is the “only way out” for kids whose parents will not accept their gender identity — this is a false statement that should under no circumstance be peddled to impressionable young people.
Indeed, parents of young people have told me stories that are eerily similar: Their child spent a lot of time online, wrote down a list of demands related to gender affirmation, texted or emailed it to them, and said that if they did not comply, the child would kill himself or herself. One father said his daughter had been googling “how to fake suicide.”
In 2014 Time magazine published a cover story titled “The Transgender Tipping Point: America’s next civil rights frontier.” In the U.S., this framing has been rhetorically effective to the point where, by hijacking the language and legacy of civil rights, two completely distinct causes have been lumped together and many fearful of being “on the wrong side of history” are deciding to keep their doubts to themselves.
In the U.K., where there is a lively debate around transgender-policy issues and accurate reporting from mainstream outlets, the civil-rights Trojan horse has been less effective. Feminists, gay-rights advocates, and transsexuals have been speaking out. Debbie Hayton, a trans woman (i.e., a natal male) who is a science teacher, told me that “gender identity” is meaningless and that sex — not gender — ought to be the basis of law. Hayton believes that transgender extremism is counterproductive and will harm the relationship of trust and mutual respect between trans people and wider society.
According to a 2017 Pew Research poll, 54 percent of Americans believe that whether someone is male or female depends on his or her birth sex (and 44 percent do not). But the reluctance of Americans to stand up for this belief — and the silence of the American mainstream media — has allowed congressional lobbyists to promote a radical gender-identity policy agenda virtually unchallenged.
Earlier this year, after relentless lobbying by the Human Rights Campaign, the Equality Act was introduced in the House and Senate. It has the support of hundreds of Democrats and a handful of Republicans. Framed as an extension of anti-discrimination protections, the act, if passed, would require all federally funded entities to interpret “sex” to include “gender identity.” In other words, they would have to recognize — for the purpose of public spaces, accommodation, sports, etc. — a transgender woman (a biological male) as a female, and a transgender man as a male.
Kara Dansky of the Women’s Liberation Front, a self-described “radical feminist” organization, wishes both the Left and the Right would wake up to what this will mean for sex-based rights and protections. “This issue affects everyone,” Dansky told National Review. Indeed, forced transgender acceptance is one of the rare issues that can bring together partisans from both ends of the political spectrum.
After a bipartisan event at the Heritage Foundation in January 2019 — “The Inequality of the Equality Act: Concerns from the Left” — hosted by social conservatives and delivered by a panel of radical feminists, Andrew Sullivan suggested in New York magazine that cooperation between two camps that have long been sworn enemies “might be a sign of the end-times.” Sullivan is correct that opposition to transgender orthodoxy unites some gay-rights advocates (who seek to legitimize same-sex attraction), women’s-rights campaigners (who seek sex-based protections and rights), social conservatives (who oppose dangerous cultural revolutions, sexual or otherwise), and clinicians and medical researchers (who care about the integrity of their field). But, politics aside, the greatest victims in all this are the children.
Hair-raising stories from parents were read aloud by the panel. The event was organized by a “lifelong Democrat” and “progressive mom” whose autistic 13-year-old started thinking she was a boy after a school presentation, whereupon a “gender therapist” recommended a breast binder and drugs without any evaluation. One story from the event particularly stood out:
At age sixteen, my daughter ran away and reported to the Department of Child Services that she felt unsafe living with me because I refused to refer to her using male pronouns or her chosen male name. Although the Department investigated and found she was well cared for, they forced me to meet with a trans-identified person to “educate” me on these issues. Soon after, without my knowledge, a pediatric endocrinologist taught my daughter — a minor — to inject herself with testosterone. My daughter then ran away to Oregon, where state law allowed her — at the age of seventeen, without my knowledge or consent — to change her name and legal gender in court, and to undergo a double mastectomy and a radical hysterectomy.
My once beautiful daughter is now nineteen years old, homeless, bearded, in extreme poverty, sterilized, not receiving mental health services, extremely mentally ill, and planning a radial forearm phalloplasty [a surgical procedure that removes part of her arm to construct a fake penis].
What will future generations make of all this? I recently interviewed three formerly transgender teens of the Pique Resilience project for NationalReview.com. One by one, they told me how they’d been drawn into the transgender fad after spending huge amounts of time online. They were drawn in because it seemed like “the in thing to do,” and because — when struggling with anxiety, depression, exclusion, bullying, and their sexualities — “every problem that I had I just felt that it was automatically answered, explained by this trans thing. And not only was it explained but it also offered me a solution.”
Now these young women are infinitely grateful that their parents put the brakes on gender affirmation. Though one of them went on to have cross-sex hormones as an 18-year-old, she now regrets this decision and thinks “it’s messed up” that young people like her with “glaringly obvious” underlying reasons for not liking their bodies are being harmed. Luckily, these young women saw the light before it was too late. The heartbreaking part is that there are many thousands more for whom there will be no going back.
This article appears as “The Youngest Guinea Pigs” in the April 22, 2019, print edition of National Review.