Alex Byrne holds a chair in philosophy at MIT, and has done considerable research on gender issues. This has resulted not only in several papers but also in an estimable book, Trouble With Gender: Sex Facts, Gender Fictions. I read the book and liked it, and eventually became convinced of its thesis that the idea of “gender” is so slippery that it really shouldn’t be used at all. “Sex roles” would do as well, but somehow even I continue to use the g-word.
Luana sent me this new development in the Byrne saga. Because Alex contributed to the writing of a Health and Human Services Review of treatments for pediatric gender dysphoria, he is in the process of being demonized by a group of academics. It’s not that there’s anything wrong with the HHS review, really; the demonization came because it was issued by an HHS whose head was appointed by Trump, and also because it goes along with the increasing evidence that treating childhood dysphoria with “affirmative care” is deeply problematic, leading to premature dispensations of hormones and surgery to adolescents and children who, without that “care,” would mostly come out as gay.
But the pre-puberty treatments, often given before any reasonable age of consent, deprive those children of any chance of a meaningful sex life—including one without orgasms—forever. And the mutilation involved in sex-role-altering surgery surely requires consent of someone who understands the consequences—someone who’s mature. (I waffle between the ages of 18 and 21.) But if you deviate from the “progressive” party line that “gender-affirming therapy”—the one-way escalator from dysphoria to hormones and often to surgery—is the essential cure for gender dysphoria, then what is happening to Alex will happen to you, too.
Finally, Alex is getting dogpiled because his critics aver that, because he’s a philosopher, he has no expertise to weigh in on issues involving gender, even if he’s written about them repeatedly in scholarly venues. That’s rich because, as you’ll see, most of his critics don’t even approach Alex’s level of expertise.
The whole brouhaha serves to demonstrate that “cancel culture”—the attempt to ruin someone’s career if they transgress “progressive” ideological stands—is alive and well.
The announcement of the dogpile was tweeted by Jesse Singal, who has suffered his own accusations of “transphobia” for taking positions similar to Alex’s:
A new open letter recently came out https://t.co/iLz95mPcQR
— Jesse Singal (@jessesingal) June 29, 2025
Here’s the letter, with the link in the heading:
It was alleged in May that you were among the anonymous authors of the HHS report on pediatric trans care. The report, among other things, issues the alarming recommendation that trans youth should not have access to gender-affirming care, despite the leading pediatric medical body in the country supporting the efficacy and life-saving potential of these treatments. [1]
In light of your recent confirmation [2] of these allegations, we as your colleagues at MIT, in philosophy, and in higher-education feel it necessary to speak out.
While we are not here calling for official or unofficial sanctions, we the undersigned believe that your behavior (a) perpetuates harm toward the trans community; (b) constitutes a failure to uphold your responsibilities as an academic; (c) is the result of an extremely misguided decision to collaborate with the Trump administration.
Marginalization of Trans Communities. While you claim to support the right of trans people to live freely, in practice your behavior does not support this right. Since 2020 you have published a number of academic articles, as well as one book, arguing against trans inclusivity. And there can be no doubt that such rhetoric, along with the new HHS report, further marginalizes and stigmatizes trans people, both within and outside of philosophy. [3]
But your contribution to the HHS report raises serious issues well beyond this particular issue about marginalization. Indeed, we submit that the allegations against you should be a cause for significant concern, even for those who share your views about trans people.
Let us explain.
Academic Professional Ethics. We are happy to grant that your participation in the authoring of the report is an exercise of your academic freedom. Per the 1940 Statement of Principles on Academic Freedom and Tenure, jointly agreed upon by the AAUP and AAC, academic freedom entitles professors to freedom in research and publication of results. [4]
But since 1966, the AAUP has also agreed on a Statement on Professional Ethics. [5] Per this 1966 Statement, professors are obligated to “exercise critical self-discipline and judgment in using, extending, and transmitting knowledge” and to “practice intellectual honesty”. We take this to mean that as academics, we also have a responsibility to the public to not misconstrue the scope of our expertise, nor comment in our capacity as academics on issues where we lack the requisite expertise. It is, of course, compatible with professional academic ethics to express one’s views publicly, even when one is not an expert, i.e., one might lobby for a particular candidate or write an op-ed in a newspaper. But contributing to a document as an expert in an area in which one is not an expert is contrary to professional standards.
The HHS cites contributors to their report on pediatric trans care as including medical doctors, medical ethicists, and a methodologist. [6] While you are a highly regarded philosopher of mind and have recently written on the philosophy of gender, you are not a medical ethicist by training. Moreover, to our knowledge, you do not have medical or scientific training, nor have you published any peer-reviewed pieces in medical journals.
Given your lack of the requisite expertise, we believe it is inappropriate for you to engage in the shaping of national medical policy on gender-affirming care for trans youth. Familiarity with theories of gender made from the armchair does not equip one to make expert judgments about the quality of medical studies, nor about the lived experiences and needs of trans youth and their families.
In contributing to a medical report that will have significant negative impacts on the lives of trans youth across this country, we believe that you have failed to uphold your responsibility as an academic to provide expert testimony only on matters included in your domain of expertise.
Collaboration with the Current Presidential Administration. The past few months have witnessed the Trump administration engage in the kidnapping of international graduate students from the streets, the deportation of innocent people to dangerous foreign prisons without due process, the cutting of lifesaving aid to millions across the world, and the undermining of the independence of colleges and universities across the country. We find these actions appalling, unethical, and undemocratic.
For these reasons, we believe it is deeply myopic for any academic to collaborate with the Trump administration in this moment, regardless of one’s particular views about gender. However misguided one may think “gender ideology” is, it is simply unconscionable to for that reason, make common cause with an administration so engaged. Indeed, were the Trump administration to suddenly decide tomorrow to support gender-affirming care for minors, we hold that it would be equally shortsighted and reprehensible if trans advocates were to then overlook everything else the administration is doing and join them as collaborators.
There is already a term of criticism for when a government appeals to pro-LGBTQ+ policies so people turn a blind eye to its other, harmful actions: that term is ‘pinkwashing.’ In this moment, we need a similar term of criticism for gender-critical theorists who overlook the rest of a government’s appalling behavior, merely because that government shares one’s views on gender. One can think that trans politics is misguided and also refuse to collaborate with such an administration.
By contributing to the HHS report, we believe you have not only misconstrued the extent of your academic expertise, but have also badly misjudged the gravity of the current administration’s actions.
As of yesterday, the letter was signed by (according to my count) 211 people, 31 of whom who refused to give their names and appear as “anonymous”, 65 who say they are graduate students, and 57 who say they are undergraduates. (See the signers by clicking on this link.) While there is some overlap between these groups, it’s fair to say that about half the signers lack either the courage or the expertise to call out Byrne for “lack of expertise”. What kind of person would refuse to give their names when engaging in such a dogpile?
And note that the “expertise” of those judging Byrne’s expertise (probably without having read his book or the rest of his work) include students or professors in mathematics, mechanical engineering, women’s history, urban studies and planning, aerospace engineering, computer science, chemical engineering, bioengineering and a even “Anonymous (Staff)”. (I didn’t bother to look up some of the others whose fields weren’t specified.)
What is clear about these critics are several things (characterization and bolding below are mine):
a.) Many of them have not read Byrne’s work on gender and transitioning, as judging from their signing a letter that mischaracterizes his views (see his response below).
b.) His real crime is almost Soviet-style in its nature: “Collaboration with the Current Presidential Administration.” Because the report came out as an HHS document, it can be traced to Trump, ergo to Satan, and ergo Byrne is an agent of Satan. It’s Trump, Jake! Read this again and weep (from the letter):
Collaboration with the Current Presidential Administration. The past few months have witnessed the Trump administration engage in the kidnapping of international graduate students from the streets, the deportation of innocent people to dangerous foreign prisons without due process, the cutting of lifesaving aid to millions across the world, and the undermining of the independence of colleges and universities across the country. We find these actions appalling, unethical, and undemocratic.
For these reasons, we believe it is deeply myopic for any academic to collaborate with the Trump administration in this moment, regardless of one’s particular views about gender. However misguided one may think “gender ideology” is, it is simply unconscionable to for that reason, make common cause with an administration so engaged.
Whatever else the administration has done, and I’ve made it clear that I deplore nearly all of it, it’s crazy to say that you shouldn’t try to help it provide more salubrious forms of gender care given Trump’s EO on the issue. Kids are being mistreated, and you shouldn’t help them because in so doing you’re co-signing an HHS document?
c.) The collaboration of Byrne on a public document is characterized as a breach of professional ethics, since he’s a philosopher and therefore lacks “expertise”. From the “Dear Professor Alex Byrne” letter:
Given your lack of the requisite expertise, we believe it is inappropriate for you to engage in the shaping of national medical policy on gender-affirming care for trans youth. Familiarity with theories of gender made from the armchair does not equip one to make expert judgments about the quality of medical studies, nor about the lived experiences and needs of trans youth and their families.
Byrne answers this in his response (see links and excerpts below).
d.) These people who decry Byrne for lack of “expertise” are apparently themselves unaware of the increasing evidence against “affirmative” pediatric gender care, especially the use of “blockers”. They cite American organizations ideologically determined to support “affirmative care”, but don’t even mention Britain’s Cass Review, which led to the dismantling of all but one of that nation’s gender clinics and a ban on puberty blockers for people younger than 18. Several European countries now allow puberty blockers only as experimental treatments, forbidding them as instruments of general “affirmative care”.
e.) It’s clear that although the letter denies any attempt to ruin Alex’s career, accusing him of professional malfeasance clearly has that end. It will predictably encourage his colleagues—not just at MIT but everywhere—from associating with him, and will drive away students who would otherwise seek his mentorship. As Byrne says in a Washington Post op-ed noting why he co-authored the HHS report:
The hostile response to the review by medical groups and practitioners underscores why it was necessary. Medicalized treatment for pediatric gender dysphoria needs to be dispassionately scrutinized like any other area of medicine, no matter which side of the aisle is cheering it on. But in the United States, it has not been.
I was familiar with the other authors — there are nine of us in all — and I was confident that we could produce a rigorous, well-argued document that could do some good. Collectively, we had all the bases covered, with experts in endocrinology, the methodology of evidence-based medicine, medical ethics, psychiatry, health policy and social science, and general medicine. I am a philosopher, not a physician. Philosophy overlaps with medical ethics and, when properly applied, increases understanding across the board. Philosophers prize clear language and love unravelling muddled arguments, and the writings of pediatric gender specialists serve up plenty of obscurity and confusion.
f.) Finally, and perhaps most important, nowhere in the letter do the signers engage in the claims of the HHS report. The proper way to engage something like the report is with rational counterargument and data, not with accusations of “lack of expertise” or of being on “the wrong side of the aisle.” This is implied in these tweets, two by Byrne’s wife Carole Hooven, who suffered her own demonization on the basis of sex and gender—to the extent that she had to leave her department at Harvard:
Robert P. George, a political philosopher at Princeton, also notes the letter’s failure to engage the recommendations of the HHS report:
Byrne’s reply is a document of unusual rationality, calmness, and maturity, and simply dismantles the dogpile letter above. I don’t have space to reproduce it all, but I will give the first bit:
Dear colleagues and others,
Thank you for your open letter (reproduced below), concerning my involvement in the recent Department of Health and Human Services Review of treatments for pediatric gender dysphoria, which I discussed in a June 26 Opinion for the Washington Post.
The topic of pediatric gender medicine is emotionally fraught, and some people understandably feel vulnerable, angry, and frustrated. However, an open letter of this sort is not a constructive way to express one’s view that a colleague has committed professional ethical lapses and errors of judgement. Formal university channels as well as more collegial options are available, including writing opinion pieces. Encouraging individuals on social media to join a public condemnation of a colleague is inimical to the mission of the university.
The letter makes two main complaints:
(A): I have breached “professional standards” in contributing to the Review because of my “lack of the requisite expertise”; this “constitutes a failure to uphold [my] responsibilities as an academic.”
(B): Given the actions and policies of the current administration, my decision to take part in writing the Review was “extremely misguided” and “unconscionable.”
Framing the letter, you write that “since 2020 [I] have published a number of academic articles, as well as one book, arguing against trans inclusivity.” Despite referring to my “rhetoric,” you give no quotations or citations in support. People interpret “trans inclusivity” differently, but on an ordinary understanding of that phrase I haven’t argued against it. For example, from the preface of my book, Trouble with Gender:
[N]o one’s pursuit of a dignifying and fulfilling human life is impeded by anything in the pages that follow–neither transgender people, nor women, nor gay people, nor any other relevant constituency. If there is any doubt about that at the start, I hope it will vanish by the end.
You also accuse me of producing work that “further marginalizes and stigmatizes trans people.” Indeed, you have “no doubt” that this is the case. Since you provide no evidence for this claim, I will not address it here, except to say that I disagree.
The last 2+ pages of Byrne’s letter take up the claims (A) and (B) that he says his critics make, and simply demolishes them. But he ends on a conciliatory note:
Our “Ethos, Diversity, & Outreach” webpage says that “the Philosophy Section aims to create a vibrant and tolerant intellectual community with heterogeneity in backgrounds and opinions, and where the overriding norms are those of civilized rational argument.” I endorse these aims and commend them to you. As some of you know, I enjoy talking to people with very different perspectives from my own. My office door is always open if any of you would like to discuss the issues raised by your letter in person.
The misguided, erroneous, and hamhanded letter of the critics above shows the extent to which science and medicine have been politicized in America, injected with ideology to the extent that if you collaborate on an endeavor coming from the “wrong side of the aisle,” people on the “right side of history” (or so they think themselves) will try to ruin your career. This is a reprehensible endeavor from people infused ideology, hate, and anger.
The issue is not that he’s “only” a philosopher; its that they are not.
Aristotle:
Existence/Identity:
“It is impossible for the same thing to be and not to be at the same time in the same respect” (Metaphysics, 1006b).
Non-contradiction:
“The same attribute cannot at the same time belong and not belong to the same subject in the same respect” (Metaphysics, 1005b19-20).
+1
Allow me to introduce Aristotle to Queer Theory.
It’s been done. They go wild over some passages of Aristotle’s Physics, which can be read with the most hilariously sexualised notions of ‘motion’ and ‘empty space’. Real bodice-ripping stuff.
Given the ideological basis of gender theory, it would seem like a philosophy is exactly the right academic discipline for investigating it.
I’m not sure what the “ideological basis” of gender theory might be, especially since the psychological phenomenon of “gender” has been around for over a century. In one of my disciplines, it was examined in interesting detail by Margaret Mead’s “Sex and Temperament in Three Primitive Societies”, (1935) which compared and contrasted gender roles in closely related communities in New Guinea. (She followed this up in 1949 with her book “Male and Female” that looked at changing gender roles.)
Prof. Byrne may be right, that “gender” is too ambiguous a term to hang much on, but so is “personality,” and most of have no trouble believing that individual human — even our pets — have personalities.
1908 – The Kybalion :
https://en.m.wikisource.org/wiki/The_Kybalion/Chapter_13
Gender in Mystical and Occult Thought – Behmenism and its Development in England
B. J. Gibbons
Cambridge U. Press
1996
A common mystification against exposure of “gender” as a mystical occult / Hermetic religious principle that Mead used is that genetics – genes – the word origins – are the same as for “gender”, something like “giving rise”, “race”, or “birth”.
Deliberate use of vague/confusing concepts/words is how cult religions operate – the meaning must be sought by the Outer School from the Inner School. See Cultish – The Language of Fanaticism by Amanda Montell 2021.
BTW take a look at publications by Robert J. Stoller and John Money to see how “gender” was picked up and practiced further – apparently, directly connected to Mead’s publication.
The analogy with personalities isn’t quite on point. ~Everyone agrees there is a wide and continuous range of personalities that vary on many axes. Genderists argue that gender is categorical not continuous, that there are two categories (woman or man), and that a “trans” person of one gender (woman) can be born in the sexed body of people typically with the other gender (male). This is not like personality.
Genderists also argue that gender is continuous and this is why it’s possible for a male to be a kind of female.
The analogy fails I think partly because while we begin by agreeing that we have a personality, the competing definitions of “gender” means we can’t agree that we have a gender.
The distinction you propose is not relevant to the issue that Alex Byrne is skeptical of “gender” because it is ambiguous — so is “personality”. The possibility — which I will dispute — that “personality” is dimensional and “gender” is categorical is orthogonal to the point.
But most of the gender theorists I know of argue that “gender” is a continuum — i.e. is dimensional. As one infamous social theorist argued, the traditional models for gender draw upon stereotypes of male and female sex, but we now find numerous variations in gender expression (and presumably in gender identity). There have been too few rigorous studies of “gender” to be able to describe it in the same detail as “personality”, but that is a failure of research, not of “gender”.
So washing the dishes is classified as which gender?
Yes agreed some genderists argue that gender is a fluid and continuous trait. But many argue that gender is categorical. The slogan is “Trans women are women!”, not “Trans women are close to women on a continuous scale that varies on many dimensions etc.” One piece of evidence that gender (whatever that means) really is categorical is that gender resolves to sexual preference in a large majority of “trans” youth once they go through puberty and realize they are gay not “trans”. Sexual preference for male or female partners is categorical.
It started with that, but then a laundry list of other “gender identities” started to proliferate.
I remember reading lists of 70 plus “gender identities” and it seemed to be growing weekly.
Interestingly enough, they all seem to have vanished of late and we are only left with “transwoman”, “transman” and “nonbinary.”
Hmm, could it all have been imaginary nonsense ?
It seems to me that it is not really true that the HHS report was a product of the Tr*mp administration. This repeated add-on, to make it extra doubly bad of course, overlooks the point that it came out in the first few months of the current presidency. The body of the report is over 250 pgs long, so likely it was mainly prepared under the Biden administration.
The report says (pp 10-11):
It was clearly produced very quickly since it was published on 1 May (with minor corrections a fortnight later).
“… so likely it was mainly prepared under the Biden administration.” That would be impossible.
Waaait a moment here. Byrne is Prof. Hooven’s spouse? Goodness. I like them more and more – they just jumped to the top of my fantasy dinner party guest list. I’d have invited either – probably her first but only b/c I’ve known her work for longer – but now they come as a set? Perfect. I will call the caterers.
Top notch.
What an intellectually unserious attack on Alex. Even idiot Lena Dunham could have written that vapid mean girls bs better. And I REALLY dislike LD.
D.A.
NYC
“One effect of such letters is to send a clear message to other academics who may be contemplating their own investigations into pediatric gender medicine or other controversial topics. Unless you are confident in advance that you will agree with us, do so at your peril. Only a brave—or foolhardy—untenured faculty member, let alone a graduate student, would take that risk.”
Byrne’s letter is admirably calm and collegial, particularly considering the nature of the attack against him. I was pleased to see him call out the real intent of the authors arrayed against him.
As might have been expected, Byrne took the onslaught in the “open letter” philosophically.
Ha! Well said.
I agree. He’s taken a road so high that I think he might need supplementary oxygen!
Alex’s patient response is brilliant. I wonder how the signatories to the open letter will respond?
Pearls before swine, I expect.
They’ll be furious, as always. The extreme gender ideologues are very intolerant.
Recall Dawkins quip : we’re not supposed to “rock the boat”.
Nothing provokes demoralization as when religion is met with independent thought.
In fact, in the way the Hermetic alchemical formula works – or dialectic – the “demonization” (more accurately might be “demiurgization” – a vessel of false consciousness but I digress..) is used as an opportunity to advance and control religious thought – again, through demoralization.
By the way:
“LGBTQ+” is a dialectically synthetic identity. Nothing more. Has nothing to do with same-sex marriage law. It is used as an epistemic magic spell – a literal spell, not figurative. I think it explains a lot.
Wear it with pride Prof. Byrne – or maybe any of the other Six Deadly Sins!
Excellent, dignified, and principled response by Byrne. He dismantled the plaintiffs assertions in just a few paragraphs. It took his detractors many more paragraphs to emit just enough smoke to distract readers and avoid addressing anything of substance.
Professor Alice Sullivan recently published her second independent report for the UK government, this time on barriers to research around sex and gender. It’s a long read (400+ pages, I’ve got to page 338) and very alarming to see the mistreatment of “gender-critical” academics all collated in a single work. It also includes the responses from academics and students opposed to the gender-critical perspective, who, unlike their counterparts, provide little detail or evidence of their assertions and experiences. https://www.sullivanreview.uk/barriers.pdf
(Report 1 of Prof Sullivan’s review was on the conflation of sex and gender in official policies and practices and the harms, especially in healthcare, arising from this.)
I was reading an interview with her just a couple of days ago:
https://www.spiked-online.com/2025/07/06/how-universities-went-to-war-with-biological-facts/
I just got to page 369, where our host’s criticism of an open letter gets a mention, with the relevant WEIT post cited in the footnotes: https://whyevolutionistrue.com/2023/10/06/group-of-science-savvy-uk-liberals-urge-denial-of-the-sex-binary/
I’ve read essays by Alex Byrne and Carole Hoooven — both of them are impressive, compassionate, clear and careful thinkers. (I had learned they are married — household conversation must range from mundane to exalted.) I have not read his book — yet — it’s on my list. Both of them are, with Helen Joyce, Emma Hilton, Kathleen Stock — and others (JKR!, Sex Matters links) among my source material when I try to engage misguided friends in conversation regarding the gender-crankery that has poisoned our culture and politics.
“Philosophers prize clear language and love unravelling muddled arguments, and the writings of pediatric gender specialists serve up plenty of obscurity and confusion.”
Bravo! I’ve never heard nor read a clear, rational, and evidence-based argument for stereotype-affirming drugs and plastic surgery (aka “gender-affirming care”). There isn’t one.
I’m not sure how to interpret your comment. If a woman requests a breast enhancement – or reduction – from her cosmetic surgeon, what would the “evidence-based argument” for it be? One of my patients had a cyst removed from his forehead recently: completely benign, just a bit unsightly. What would the “evidence-based argument” for that procedure be?
One rationale for biophysical approaches to ‘transgender’ identity is that we are rather poor at changing minds, mental states and traits, but we can change or alter many physical and physiological features and states, and that seems to help transgendered people feel more of a concordance between their body and their psychological identity.
We have a number of transgendered patients in my clinic (one of my colleagues is an endocrinologist who treats transgendered patients as one of his sub-specialties….) , and they genuinely and profoundly feel that their psychological gender identity is not in sync with their bodies. How do you propose to help those patients? I have no good answers, but simply telling them they are wrong is not effective.
The patients aren’t wrong in thinking they feel their sense of self isn’t in sync with their bodies — of course they do. They’re wrong on other counts.
For example, the belief that they cannot change their minds about this is both unlikely and untested. Therapy, time, and getting away from the elements in our culture which both encourage the idea that there’s a “brain sex” that negates biological sex and that mental discomfort should be relieved by cross-sex hormones and surgery hasn’t been given much of a chance.
Pediatric sex trait modification is I think often given by doctors who want to relieve present distress and have grateful patients. That’s not necessarily good medical practice long term.
Maybe they should be presented with the evidence that 90% of people experiencing gender dysphoria are just same sex attracted? Homosexuality remains the leading explanation for gender dysphoria and it’s quite obvious why that would be the case.
Mr. Taylor:
To my surprise I read lately that cosmetic surgery is indeed backed by evidence as being psychologically beneficial to those who get it. (I’d always dismissed it as kinda risky and vain.)
But the risk-return ratio is framed as for cosmetic surgery, with everybody you see – including oneself in the mirror – “enjoying” or appreciating it.
It never pretends to be “life saving”. THAT would be a different risk/reward ratio.
Genital surgery is another matter. Pretty much all the data is obscure but there’s little to suggest it helps in any meaningful way in real cases of “Gender Dysmorphia/Dysphoria” – whose base rate is one in 50K live births, not 1/3rd the incoming female freshman population at Yale. So there are so many confounds here.
Further… if you look at the complications rates of cosmetic (say.. nose or boob job) surgery verses gender surgery there is a LARGE differential. Boob/nose jobs have very low complication rates. Not so genital surgery. Ditto for regret rates I imagine.
EVEN IF people other than sex partners see it, it is wildly dangerous and loaded with all sorts of expected complications and ruin risk. The two surgeries are so not the same.
My final question to you Mr. Taylor and I ask it with genuine curiosity: What do you estimate the base rate of “Gender Dysmorphic Disorder” in the population is?
Because that is relevant and many don’t know. My understanding is one in 100,000 girls and one in 10-20,000 boys have it. THAT is pretty rare. Rarer than the now large number of “Gender Clinics” (where you work?) suggest.
Set me straight (hhaha. No pun intended) on this base rate number please. And how do you tamp down any fears you might have that this is a social contagion, a mania, or displaced anxiety for other comorbid problems like autism or homosexuality?
respectfully,
D.A.
NYC
I’ll address the simplest question first: “What do you estimate the base rate of “Gender Dysmorphic Disorder” in the population is?”
I have no idea. I am a cardiologist, so I can discuss the incidence and prevalence of cardiovascular disease, but I raised a reasonable question about what an “evidence-based argument” for various procedures might be, and frankly, I am unaware of any proposal to deny an adult various forms of trans surgery because the risk of complications may be higher than the complication risk for a nose job.
The point, which you don’t address, is that many patients appear to be happy with their trans-altering surgeries and treatments, and if so, why not? As for social contagion, etc, at my clinic, prospective trans patients undergo extensive psychiatric evaluation before any treatment.
Sorry –duty calls
Dave Taylor, MD, PhD
That “many patients that appear to be happy with their … treatments” is no doubt true, but also incomplete. Will they continue to be satisfied in the coming years and decades? The fact that there are large numbers of desistors and detransitioners, many of whom have been profoundly harmed by their chosen medical interventions, argues that any current satisfaction is fleeting. And we are still in the early stages of what may end up being a tsunami of regret followed by legal action against providers of such services.
Committing to a lifetime of endocrine disruption strikes me as a profoundly stupid–and expensive–patient decision, even allowing for any temporary gender euphoria it may bring. How any knowledgeable physician who understands human biology could think this is ethical care is madness.
I’m sure there are many adults who are happy with the transitions. We hear a LOT from the ones who are happy. They’re adults though. And there might be a self-selection bias. For instance… I couldn’t shout it louder when I passed the bar but if I’d have failed…. I wouldn’t have been so loud. This applies to many areas of human endeavor, particularly when identity is involved. I think (with some evidence) that regreters are pretty quiet.
The gravamen of my concern is that such logic (“If you’re an adult you can do crazy things” – which I support as I am the author of many crazy things, lo these many years as an adult).. doesn’t scale to young people, particularly adolescents. Particularly confused adolescents which seem to be the bulk of those needing “Gender Affirming Care”.
If the numbers I quote above are correct, (average 1:50,000) and this rare beast “Gender Dysmorphia” is just a socially acceptable version of apotemnophilia (they occur in similar parts of the “space cell” area of the brain, where we self-locate our limbs, extremities and ourselves)… our society has made a terrible mistake. Even more so with the children as – you’ll probably admit – activists have taken over the show for a decade.
(I don’t have kids, just a dog and his neutered gender seems fine. :-))
I think a lot of the controversy lies in these distinctions.
Now back to the hearts for you, Dr. Taylor. You have more important things to do than bicker with me here but thanks for your reply.
best,
D.A.
NYC
As a cardiologist you will be aware of the 1991 CAST study*
https://www.nejm.org/doi/full/10.1056/NEJM199103213241201
which unexpectedly showed that suppression of ventricular premature beats with encainide or flecainide after a heart attack increased the risk of sudden death (instead of reducing it as the authors had hypothesized and was standard CCU practice at the time.) I doubt very much that you would prescribe these drugs to an autonomous adult patient today who was sincerely bothered by palpitations that proved on appropriate investigation to be benign VPBs, no matter how much he pleaded for relief from the sense of his heart turning over in his chest several times a day. “I don’t care if it kills me, Doc, [relative risk 2.64 after myocardial infarction] ya gotta do something about these. They’re driving me crazy!”
(* This is hardly the only treatment that has been shown to be worse, on balance, than no treatment. I’m mentioning it because it’s an old study, was entirely unexpected and counter-intuitive, and is unlikely to cause any current patients to question their modern treatment inappropriately. For lay readers looking up CAST, CAST-II showed in 1992 that the other drug in CAST, morizicine, increased sudden death also.)
According to many detranstioners, if they received any therapy before they were offered hormones and surgery it was to agree with their self diagnosis. It was not in any way extensive. How do you know this is happening? Do you speak to therapists? Do they send letters stating this? Do you know a person can buy a letter which claims they’re a good candidate for surgery online? Why are you, a cardiologist, seeing trans patients?
I have heard of surprisingly high claims of gender dysphoria among today’s teens. A little bit I’ve picked up just now:
“A CDC survey found that 3.3% of US high school students identify as transgender, and an additional 2.2% are questioning their gender identity. This means that over 1 in 20 teenagers are either transgender or questioning, according to a study published by Truthout. ”
So that seems higher than previous claims for gay-ness. I can accept that these %s will vary regionally, and so I’d bet they are higher in far-left concentrated areas.
With apologies for overcommenting:
I think the ~5.5% who are “trans” or “questioning” is really just anxious gay teens who got a lot of “trans” propaganda via social media. That’s the hypothesis against which any competing hypothesis of “born in the wrong body” etc. should be tested. The clinical staff at Tavistock said themselves (somewhat tongue in cheek) that at the rate they were adding clients there would soon be no gay people in Britain.
Treat them as you’re doing, provided they’re adults.
Respect to Leslie again for talking cardiology above. I’m aware there are cardiology implications to “Affirming Care” – none of them beneficial – but I don’t have the stones to go up against a cardiologist given I’m a (successfully!) dropped out of medical school amateur here.
Props Leslie.
I’ve no doubt our cardiologist friend believes he’s doing the right thing. There are no monsters here, just professionals whose judgement is impaired by the “chain of trust” in medicine being corrupted by WPATH, APA etc.
D.A.
NYC
There’s a UK Psychiatrist, Az Hakeem, who deals with sexually-confused clients/patients. He doesn’t tell them there’s no such thing as gender. But he asks them to think about what it is that they believe being the opposite sex consists in. Almost all of them come to recognise that they have no idea… most discover that their oddness (many are autistic) is not due to being really female/male. Some 2% of his patients/clients go on to have a sex change. Some are autogynephiles, some have a sexual fetish, but most are simply gay. He believes the TG craze is like the punk craze that influenced his own teenage years.
Dr. Hakeem is excellent. He’s been on GENSPEC, Stella’s show and numerous others. You clearly have looked at this issue in depth Rosemary.
D.A.
NYC
Breast augmentation and cyst removal as you describe are elective, cosmetic interventions. Patients give informed consent for such interventions because that is the information they are provided.
Compare and contrast to so-called GAC. The patients, or parents in the case of child patients, are misinformed, resulting in coerced consent, not informed consent. They are told such interventions are “medically necessary” and “life saving,” which is simply not the truth. Those claims are based on manufactured consensus and junk science. They are lies.
Telling such lies is a betrayal of the most sacred trust between doctor and patient, and reeks of the odious ethics of consumerism, of marketing medical interventions for psychological distress, of prioritizing lunatic gender/body dualistic identitarian ideology over patient welfare.
Not to over-comment, consider this, from above, and the irony:
Finally, Alex is getting dogpiled because his critics aver that, because he’s a philosopher,
A philosopher! Merciful heaven above, shall we consider Judith Butler & her ilk, spewing out steaming heaps of post-modern obscurantist nonsense that is source material for our new liberated gender-ful world?
Not sure that most professional philosophers count Judith as a philosopher. Isn’t she just an activist? Usually obscurantism is a disqualifier, though perhaps less so these days…?
According to Wiki, she, correction “they” have degrees in philosophy.
https://en.m.wikipedia.org/wiki/Judith_Butler
Yes, but having any degree in philosophy doesn’t itself entail that your colleagues count you as a philosopher. The label ‘philosopher’ has always had an appeal that people want to claim for themselves — often in ways which distort the term’s meaning. Plato dealt with this problem explicitly, starting in Republic 476a, making a distinction between on the one hand philosophers and on the other hand those he called ‘lovers of sights and sounds’. (The discussion comes not long after the more famous discussion about ‘until philosophers rule as kings or those who are now called kings genuinely philosophise’…).
Today, some academic philosophers do say that if the subject matter isn’t part of the scholarly tradition that runs, pretty straight, from Thales or Plato or Aristotle through to Bertrand Russell…, then it isn’t what they mean by philosophy. There was pushback against that sort of view not long ago in the NYT. Most such pushback concerns the broadest possible meaning of ‘philosophy’ and tends (I think) to focus mainly on the ethical, social, political, fairy-stories side (which all cultures have) while ignoring the scientific side of the discipline. There are some exceptions, and they often turn out to be very interesting.
Here’s the NYT piece:
https://www.nytimes.com/2016/05/11/opinion/if-philosophy-wont-diversify-lets-call-it-what-it-really-is.html
I just thought I’d report what I learned from Wikipedia.
I don’t claim she’s a philosopher.
It does add another data point to my collection of “strange people who go by “they”.”
The “collaboration” argument is terribly anti-science.
In the world that the signatories move in, “the requisite expertise” means full acceptance that TWAW and “young trans children know who they are”.
https://www.theatlantic.com/science/archive/2019/01/young-trans-children-know-who-they-are/580366/
Disappointing from Ed Young whom I very much respect and is a bright cookie.
I note that it is 2019 and a lot of assumptions then turned out to be “not so much” or flat our wrong. You can actually see that in the article and to his credit Young seems aware of the selection bias at work here.
Just how this phenom went from incredibly niche (2012) … then a Big Thing and socially acceptable, running against all logic and scientific rigor, is amazing to me.
In some ways it mimics earlier social manias and moral panics (Repressed Memories for eg) but faster. Which makes sense considering the internet in general and social media in particular speed up social change.
Thx Mike.
D.A.
NYC
The repressed memory therapy craze is one analogue. Another would be the
electrotherapy fad of the Victorian era and early 20th century. In some respects, a close analogue to our fad of “gender affirming care” for children must be the
Children’s Crusade of 1212—with an assortment of modern physicians and publicists playing the roles of Hugh the Iron and William of Posqueres, the clever merchants who profited from ferrying their juvenile clients to their fate.
That’s the Thing, Jon. There are many equivalent situations – some even in current memory of people under, say,…. 54-ish. 🙂
I remember Repressed Memory stuff.
I’m sure if my mother had depression after my birth the “best medical consensus would have been to give her thalidomide or something and my younger sister would have flippers today: good in the pool, bad for life flourishing.
D.A.
NYC
Seems like these so-called philosophers and intellectuals are bending over backward to prove Trump/MAGA’s point about intellectual and moral corruption in the academy. Robert George’s point is spot-on: it’s all intimidation in place of dialectical engagement and basic respect (while, ironically, paying lip service to respecting people).
UP/CRC
I think this is incorrect: “Britain’s Cass Review… led to the dismantling of all but one of that nation’s gender clinics.” It led to the dismantling of the one, big national clinic (Tavistock’s GIDS), which was replaced by smaller, regional clinics.
Some people who claim to be intellectuals can be quite thick at times.
You really don’t need to be a medic, a philosopher, or even have a higher education of any kind, to know that mutilating children who cannot give informed consent to being brain damaged, made incapable of orgasm and medically dependent for life is immoral and abhorrent.
Gender surgeon Marci Bowers, who transitioned as an adult after fathering several children, is on video stating that “every child who was who was blocked at Tanner stage 2 has never experienced orgasm. I mean, it’s really about zero.” He is the surgeon who operated on Jazz Jennings.
How can a child give informed consent to stopping their adult self from ever experiencing an orgasm, when they don’t know what one is?
Below is one of the most powerful statements I have read on this topic. It upsets me every time I read it. Imagine never being stirred by the beauty of a sunrise or prompted to tears by the desolation of sad music.
“One of the things I’ve been thinking about is what puberty blockers do to children. This medication is called a “gonadotropin releasing hormone agonist” and it comes in the form of monthly injections or an implant. And because it simulates the activity of this hormone, it shuts down the activity of the hypothalamus. The hypothalamus is this almond-sized structure in your brain, it’s one of the most primal structures we have, and it controls all the other hormonal structures in your body—your sexual development, your emotions, your fight-or-flight response, everything. But it shouldn’t be described in such cold physiological terms because your hypothalamus is not just a hormone factory. It’s this system that allows you to stand in awe of the beauty of a sunset, or to hear the sounds of orchestral music and to stop whatever you’re doing and want to listen. And I always think that if someone were to ask me, Where is it that you would look for the divine spark in each individual? I would say that it would be somewhere “beneath the inner chamber,” which is the Greek derivation of the term hypothalamus. To shut down that system is to shut down what makes us human.
Source:
https://www.city-journal.org/article/transgender-ideology-and-the-corruption-of-medicine
Marci and her many now infamous quotes may ironically help in the decline and destruction of this social mania which has deranged so many lives.
I hope so anyway. It’d be very cool and ironic.
D.A.
NYC
Several people have made memes out of the video and are sharing his quote. I can’t believe he’s still supporting this barbarism. Then again, he made sexually inappropriate comments to Jazz Jennings as he was inspecting his ‘handiwork’ after mutilating the poor kid, so he sounds like a scumbag anyway.
Gender ideology is essentially a religious cult, so it’s no surprise that its adherents want to impose blasphemy laws.
Did anyone else have trouble accessing the “open letter” via the links in this post? — I could don’t access the letter or the of signatories via the links provided. Other links worked OK.
On the bright side, more and more highly qualified academics like Dr. Coyne are coming out in support of the core values which are supposed to animate Universities and academic life in general. The current neo-lysenko-ism of enforced agreement with absurdities is wearing thin and losing influence now that it is becoming increasingly clear that it had a large part in the recent election victory of SATAN!!! (er.. ah.. Donald J Trump). 🙂
How can even an adult consent to harmful treatment given by an ethically obligated profession that is granted the privilege of self-regulation? Note that if trans treatment was beneficial, it would be allowed in children with their assent (if possible) and with legal consent from parents or guardians, just as paediatric cancer treatment and vaccination is. Doctors can override (with authority from the Court) parental refusal of some beneficial treatments in children. Yet the Tennessee ban says you can’t submit your children to ritual mutilation, no matter what. Why should doctors be permitted to ritually mutilate consenting adults? We can’t prescribe them recreational narcotics or remove healthy organs, or treat symptoms with drugs that cause sudden death. To give testosterone to a woman or estrogen to a man would be malpractice in any other circumstance, given the predictable consequences. The lawsuits under way, brought by adults, will shed light on this question.
The central fraudulent claim of trans treatment is that using drugs and surgery will correct the dysphoria the sufferer experiences from his sexed body not looking the way he imagines it ought to look. Treatment will bring his body into line with this fantasy, and this will make him attractive to people attracted to the sex he wishes he was. Treatment will rebuild him, a man, into his ideal of what a woman should look like. (Spoiler alert: it won’t. It often leads to more surgery, and disappointment.) This is utterly different from cosmetic surgery which promises only what it says on the tin: bigger breasts or that unsightly cyst on your forehead gone. The surgeon doesn’t promise you a more successful sex life, not even even with people attracted to the sex you actually are. And most everyone accepts that insurance doesn’t (with a few exceptions in children and in reconstructions) pay for treatments that change only cosmetic appearance.
It is a good question, What should doctors do if legislatures or self-regulators tell them not to do these treatments anymore? (In Canada they will be stuck, because the humane attempt to help someone become comfortable in the sexed body he was conceived in is explicitly illegal conversion therapy, with jail time. Gender dysphoria patients will become pariahs.) There are many conditions and sources of angst that we have no good treatments for. At some point the profession has to say, Sorry. Medicine can’t fix this. Learn to live with it. You have to anyway. You may sincerely believe you are a woman trapped in a man’s body. But we can’t give you a woman’s body. We will make you chronically sick from trying, and could even kill you. And no, threatening suicide if we don’t give you your way doesn’t cut any ice. (I will say that allowing euthanasia for this cri de coeur would be a terrible idea, which means that Canada will probably adopt it as a professional obligation.)
An few anecdotes from Substacker Eliza Mondegreen’s social media DEW Line shows the disconnect between disappointment and regret:
https://elizamondegreen.substack.com/p/now-what-70a
“Yet the Tennessee ban says you can’t submit your children to ritual mutilation, no matter what. Why should doctors be permitted to ritually mutilate consenting adults?”
Many excellent points, and this one shows the cognitive dissonance at the heart of so much of gender ideology.
This is another contradiction that shows they make it up as they go along:
TRAs: Gender is fluid so men get to keep their ‘ladydicks’.
Also TRAs: Gender is fixed as a child so little boys need theirs cut off.
Careful, Leslie. People get into trouble for talking too much sense.
The open letter seems to be an example of “Faith vs Fact” (ahem) without the backing of sacred texts.
“Gender is soul, surgery salvation. (Chorus: Create in me some new parts, oh Doc, and renew a right spirit within me.) Embrace the inclusivity of brotherly and sisterly love reimagined; separate sharply the sheep from the goats. When the clerisy rightly replaced the clerics they deemed with great wisdom that the commandments shall be more than ten. Foremost among them (this week): Thou shalt not be a bigot. Not I, because, as for me and my house, we believe in love. And by this thou shalt know that thou love them: if thou honor thy neighbor’s pronouns.
Trump parades across this stage as the anti-Christ of our cataclysmic End Times. During this spell of great tribulation, we must be vigilant lest he deceive even us and the other Elect. Focus on the task before us, brothers and sisters and those who are neither, for the gender gospel must first go forth to the ends of the earth before our heaven is finally here established. But be forewarned that evil men (it is always men) and seducers shall wax worse and worse, deceiving, and being deceived. Thou shall not fall if thou remember always to continue in the things which thou hast learned at school and Drag Queen story hour and hast been assured of on all the feasts of Pride days. And, finally, loved ones, be ye not tempted by the ways of this world, never forgetting that mercy is passe; grace is bourgeois, forgiveness . . .”
. . . is nowhere to be found. There is a reason why it is all so complicated and the truths need to be protected by the properly expert, credentialed, and ordained. Then again, maybe there really is nothing new under the sun.
It’s interesting and revealing that given so many well-trained scholars are so certain that the report is completely misguided, few of them can be bothered to write rebuttals on blogs or Twitter or wherever. If it was really hack work it should be easy enough to dismantle. But they haven’t done so. And yet they confidently sign such letters.
Anybody notice the “pingback” above (#15)? How the world has changed, with one of the “the fainting couch four” agreeing with Jerry.