Category: sex and gender issues

The Atlantic takes on “affirmative care”

July 2, 2025 • 11:02 am

One sign that there has been a sea change in America’s gung-ho enthusiasm for “affirmative care” of minors with gender dysphoria is the mainstream media’s recent critiques (or just objective analyses) of the problems with such care. These critiques have exposed the lies promulgated about such care, largely by the “progressive” Left. The new article in The Atlantic by staff writer Helen Lewis is one such journalistic corrective (read it by clicking on the screenshot below or by reading it archived here). And you should read it.

One of the factors prompting the article appears to have been the Supreme Court case The United States v. Skrmetti, which upheld a Tennessee law banning the use of hormones or puberty blockers for “gender affirming care” in cases of gender dysphoria in minors. Such care was allowed, however, if modification of sexual traits was necessary to allow an individual with a disorder of sex determination to “conform to their sex assigned at birth” (Wikipedia’s words, not mine).  The case was decided along ideological lines by a 6-3 vote, but in general I agreed with the decision, having felt that medical treatment for transition should be permitted only if a person with gender dysphoria was old enough to have mental maturity to decide. (I waffle between 16 and 18 on this one, but it’s 18 in Tennessee).

Author Lewis, in fact, was willing to allow medical transitioning to begin in younger children with dysphoria, but changed her mind after seeing WPATH, progressives, doctors, and government officials repeatedly lie about the condition and how to fix it. To quote her (all the article’s quotes are indented):

I have always argued against straightforward bans on medical transition for adolescents. In practice, the way these have been enacted in red states has been uncaring and punitive. Parents are threatened with child-abuse investigations for pursuing treatments that medical professionals have assured them are safe. Children with severe mental-health troubles suddenly lose therapeutic support. Clinics nationwide, including Olson-Kennedy’s, are now abruptly closing because of the political atmosphere. Writing about the subject in 2023, I argued that the only way out of the culture war was for the American medical associations to commission reviews and carefully consider the evidence.

However, the revelations from Skrmetti and the Alabama case have made me more sympathetic to commentators such as Leor Sapir, of the conservative Manhattan Institute, who supports the bans because American medicine cannot be trusted to police itself. “Are these bans the perfect solution? Probably not,” he told me in 2023. “But at the end of the day, if it’s between banning gender-affirming care and leaving it unregulated, I think we can minimize the amount of harm by banning it.” Once you know that WPATH wanted to publish a review only if it came to the group’s preferred conclusion, Sapir’s case becomes more compelling.

Here are three of the issues that Lewis raises:

1.) Lying or misleading people about gender dysphoria and its treatment.

ACLU lawyer Chase Strangio was guilty of promulgating the lie that failure to effect gender transition in dysphoric children would lead to their suicide. He in fact made this statement when he argued Skrmetti before the Supreme Court, and had to admit under questioning that there was acxtuallyno evidence for this assertion:

“We often ask parents, ‘Would you rather have a dead son than a live daughter?’” Johanna Olson-Kennedy of Children’s Hospital Los Angeles once explained to ABC News. Variations on the phrase crop up in innumerable media articles and public statements by influencers, activists, and LGBTQ groups. The same idea—that the choice is transition or death—appeared in the arguments made by Elizabeth Prelogar, the Biden administration’s solicitor general, before the Supreme Court last year. Tennessee’s law prohibiting the use of puberty blockers and cross-sex hormones to treat minors with gender dysphoria would, she said, “increase the risk of suicide.”

. . . But there is a huge problem with this emotive formulation: It isn’t true. When Justice Samuel Alito challenged the ACLU lawyer Chase Strangio on such claims during oral arguments, Strangio made a startling admission. He conceded that there is no evidence to support the idea that medical transition reduces adolescent suicide rates.

At first, Strangio dodged the question, saying that research shows that blockers and hormones reduce “depression, anxiety, and suicidality”—that is, suicidal thoughts. (Even that is debatable, according to reviews of the research literature.) But when Alito referenced a systematic review conducted for the Cass report in England, Strangio conceded the point. “There is no evidence in some—in the studies that this treatment reduces completed suicide,” he said. “And the reason for that is completed suicide, thankfully and admittedly, is rare, and we’re talking about a very small population of individuals with studies that don’t necessarily have completed suicides within them.”

Here was the trans-rights movement’s greatest legal brain, speaking in front of the nation’s highest court. And what he was saying was that the strongest argument for a hotly debated treatment was, in fact, not supported by the evidence.

Strangio is one of the biggest proponents of affirmative care, and even took to Twitter advocating censoring Abigail Shrier’s book on gender dysphoria, Irreversible Damage. (Strangio is a trans-identified female.) Imagine an ACLU lawyer advocating censorship!

The “Dutch Protocol” (see below) was often cited by American organizations like the World Professional Association for Transgender Health (WPATH) or by physicians to justify affirmative care of minors. But the Dutch Protocol (affirmative care with medical intervention in children of younger ages) is basically without convincing clinical evidence:

Perhaps the greatest piece of misinformation believed by liberals, however, is that the American standards of care in this area are strongly evidence-based. In fact, at this point, the fairest thing to say about the evidence surrounding medical transition for adolescents—the so-called Dutch protocol, as opposed to talk therapy and other support—is that it is weak and inconclusive. (A further complication is that American child gender medicine has deviated significantly from this original protocol, in terms of length of assessments and the number and demographics of minors being treated.) Yes, as activists are keen to point out, most major American medical associations support the Dutch protocol. But consensus is not the same as evidence. And that consensus is politically influenced.

There’s an article at the site of Our Duty that discusses the shortcomings of the Dutch protocol, and is accompanied by a video of Dr. Patrick Hunter  testifying before the Florida Board of Medicine; it’s a summary of the flaws of that protocol, which was applied to children much younger than 18. Here’s the video, which is short (9 minutes):

2.) Demoniziong those who question “affirmative care”.

There’s Strangio, of course, who tweeted this (and later removed it):

And this:

Marci Bowers, the former head of the World Professional Association for Transgender Health (WPATH), the most prominent organization for gender-medicine providers, has likened skepticism of child gender medicine to Holocaust denial. “There are not two sides to this issue,” she once said, according to a recent episode of The Protocol, a New York Times podcast.

Boasting about your unwillingness to listen to your opponents probably plays well in some crowds. But it left Strangio badly exposed in front of the Supreme Court, where it became clear that the conservative justices had read the most convincing critiques of hormones and blockers—and had some questions as a result.

. . .Trans-rights activists like to accuse skeptics of youth gender medicine—and publications that dare to report their views—of fomenting a “moral panic.” But the movement has spent the past decade telling gender-nonconforming children that anyone who tries to restrict access to puberty blockers and hormones is, effectively, trying to kill them. This was false, as Strangio’s answer tacitly conceded. It was also irresponsible.

Questioning affirmative care has been something that marks you as “transphobic” (I myself have been called that), but when all the facts are in, I suspect that this demonization of people who want to know the scientific and medical truth will be seen as oppressive and, given its medical results, even barbaric. As Lewis notes, the British Cass Review that resulted in closing all but one gender clinic in the UK has been falsely demonized as being discredited. It has not been discredited.

3.) Withholdiong research that doesn’t support “affirmative care”.

This is the other side of the Dutch Study coin. First you promulgate bad research that supports your side, then you are slow to publish better studies that do not support your side. The author notes that WPATH comissioned reviews of the flawed Dutch protocols and, apparently because the protocols were weak, tried to block their publication.

And then there’s the infamous study by Dr.  Johanna Olson-Kennedy on the effect of puberty blockers on mental health (remember, blockers were touted as essential to prevent depression and suicide in children with gender dysphoria). Olson-Kennedy, a big proponent of affirmative care, didn’t find what she hoped for, and so withheld the study for several years!

The Alabama disclosures are not the only example of this reluctance to acknowledge contrary evidence. Last year, Olson-Kennedy said that she had not published her own broad study on mental-health outcomes for youth with gender dysphoria, because she worried about its results being “weaponized.” That raised suspicions that she had found only sketchy evidence to support the treatments that she has been prescribing—and publicly advocating for—over many years.

Last month, her study finally appeared as a preprint, a form of scientific publication where the evidence has not yet been peer-reviewed or finalized. Its participants “demonstrated no significant changes in reported anxious/depressed, withdrawn/depressed, somatic complaints, social problems, thought problems, attention problems, aggressive behavior, internalizing problems or externalizing problems” in the two years after starting puberty blockers. (I have requested comment from Olson-Kennedy via Children’s Hospital Los Angeles but have not yet heard back.)

And note, this is in an unreviewed preprint.

Withholding evidence that doesn’t support your favored hypothesis is scientifically unethical, somewhat akin to falsifying data. That’s because doing this means you’re simply allowing false conclusions to persist when you have evidence for their falsity. And that means that medical practice based on those false conclusions also persists, and, in this case, children were being treated on the basis of untested ideas.

There’s a lot more in this article to chew on, but the important thing is that it was published in a reputable (and left-leaning) magazine. The NYT has had similar articles about the weak evidence for “gender affirming care.”  (In my view, Pamela Paul’s 2024 critique of this care in the NYT was a big factor in her being let go by the paper. They thus lost one of their best heterodox writers.)

To paraphrase Walter Cronkite, an advocate of gender-affirming care might say, “When we’ve lost The Atlantic and the New York Times, we’ve lost America.”

I don’t oppose the use of hormones or blockers when the decision to use them is made by adolescents with sufficient mental maturity. If you’re 18 and want to change, well, go ahead and take the hormones and cut off pieces of your top or bottom. But not in minors—not until we have evidence that that this practice actually helps them—and we don’t. Lewis closes her piece this way:

Some advocates for the Dutch protocol, as it’s applied in the United States, have staked their entire career and reputation on its safety and effectiveness. They have strong incentives not to concede the weakness of the evidence. In 2023, the advocacy group GLAAD drove a truck around the offices of The New York Times to declare that the “science is settled.” Doctors such as Olson-Kennedy and activists such as Strangio are unlikely to revise their opinions.

For everyone else, however, the choice is still open. We can support civil-rights protections for transgender people without having to endorse an experimental and unproven set of medical treatments—or having to repeat emotionally manipulative and now discredited claims about suicide.

An important article by Andrew Sullivan

June 26, 2025 • 10:30 am

Before I leave for the airport, I wanted to call people’s attention to this new, long op-ed piece by Andrew Sullivan in the NYT. Click to read, or find it archived for free here:

Sullivan’s thesis is that extreme trans-activism has not only been inimical for society in several ways, but has also eroded respect for something he fought for over many years: gay rights. I must add that neither Andrew nor I want to “erase” trans people, or take away their rights (save a few like participation of trans-identified women in women’s leagues, or their presence in women’s jails).

That said, Sullivan makes four important points (his writing is in quotes)

1.) Extreme trans activists like Chase Strangio are trying to force American society to conform to their ideology against our will and desires:

And some of the changes (prompted by the movement) are indeed welcome. The greater acceptance of trans people is a huge step forward for all of us. But then, as I told my friends (gay, trans and everyone else), I’d always believed this and always supported trans civil rights. I was glad when, five years ago, the Supreme Court gave transgender people civil rights protection in employment. I’ve also long lived in a gay world that is skewed left, and, along with my fellow gay non-lefties, I’ve long made my peace with it, or tried to.

But this new ideology, I believed, was different. Like many gays and lesbians — and a majority of everybody else — I simply didn’t buy it. I didn’t and don’t believe that being a man or a woman has nothing to do with biology. My sexual orientation is based on a biological distinction between men and women: I’m attracted to the former and not to the latter. And now I was supposed to believe the difference didn’t exist?

I’m more than happy to accept that there are some people — not all that many — who don’t fit in that binary, and want to be protected from discrimination and allowed full access to medical interventions in order to live lives that are true to who they are. And I’m with them all the way. After all, I, too, am a part of a minority — most people live their lives governed by heterosexual desires. Thanks to the gay and lesbian movement, I’m not being asked to.

But abolishing the sex binary for the entire society? That’s a whole other thing entirely. And madness, I believe. What if I redefined what it is to be heterosexual and imposed it on straight people? Or changed what it means to be a man or a woman, for that matter? Then it ceases to be accommodation of a minority and becomes a societywide revolution — an overreach that would soon lead to a potent and sane backlash, against not just trans people, but gay men and lesbians as well.

2.). These changes have eroded gains achieved by the gay rights movement, for “L” and “G” are lumped together in peoples’ minds with “T”:

The gay rights movement, especially in the marriage years, had long asked for simple liberal equality and mutual respect — live and let live. Reform, not revolution. No one’s straight marriage would change if gay marriage arrived, we pledged. You can bring up your children however you like. We will leave you alone. We will leave your children alone.

But in the wake of victory, L.G.B.T.Q.+ groups reneged on that pledge. They demanded the entire society change in a fundamental way so that the sex binary no longer counted. Elementary school children were taught that being a boy or a girl might not have anything to do with their bodies, and that their parents had merely guessed whether they were a boy or a girl when they were born. In fact, sex was no longer to be recognized at birth — it was now merely assigned, penciled in. We got new terms like “chest-feeding” for “breastfeeding” and “birthing parent” for “mother.”

A key leader of this movement, Chase Strangio, informed us that “a penis is not a male body part. It’s just an unusual body part for a woman.” We all were suddenly expected to announce our pronouns as if everyone didn’t already know. Then neopronouns — xe/xem! — were added. The movement came up with a mantra: “TRANS WOMEN ARE WOMEN. TRANS MEN ARE MEN.” It was not an argument, nor a proposition to be explored or debated. It was a theological command. In all caps.

Was there any debate among gays and lesbians about this profound change, a vote taken, or even a poll of gay men and lesbians? None that I can find or recall.

3.). Some of the erosion of the equality gays received comes from trans-activists imposing their views on children, which many of us see as misguided or even unconscionable:

Debate has been all but snuffed out; total uniformity of thought is demanded.

But this illiberalism made a fateful, strategic mistake. In the gay rights movement, there had always been an unspoken golden rule: Leave children out of it. We knew very well that any overreach there could provoke the most ancient blood libel against us: that we groom and abuse kids. You can bring up your children however you like, we promised. We will leave you alone. We will leave your children alone.

So what did the gender revolutionaries go and do? They focused almost entirely on children and minors. Partly because the adult issues had been resolved or close to it, and partly because true cultural revolutions start with the young, it meant overhauling the education not only of children with gender dysphoria, but of every other kid as well.

Kids all over the country were impacted. Your children were taught in elementary school that being a boy or a girl was something they could choose and change at will. Your daughter found herself running against a trans girl (i.e. a biological male) in athletics. Children in elementary school got to pick pronouns, and some children socially transitioned at school without their parents’ knowledge or permission. I suppose there are other ways you can resurrect the ghost of Anita Bryant, and all the homophobic paranoia that followed her, but this will probably do the trick.

And then most radical of all: gender-affirming care for minors, which can lead to irreversible sex changes for children. The “care” included off-label “blockers” to arrest puberty, almost always followed with cross-sex hormones. To begin with, gays and lesbians, including me, empathized with kids with gender dysphoria, and trusted the medical profession with the rest. If this helped kids or even saved their lives, as was often emphasized, what business was it of mine? If transitioning this young in life would helped some pass better as adults, good for them.

Sullivan adds this, and it’s something we all should realize:

. .  . there are many more [gender-dysphoric children] who will grow up to be gay and lesbian than who will grow up to be trans. When adolescents referred to a British gender clinic were asked about their sexuality in 2012, some 90 percent of females and 80 percent of males said they were same-sex attracted or bisexual.

Ergo, parents, psychologists, and doctors should not, under the guise of “gender-affirming care”, be so eager to inject kids with hormones or cut off parts of their bodies.

4.) The extreme political polarization of America, and widespread hatred of Trump, have blinded liberals to the view that, in putting brakes on gender-affirming care, the Trump administration might be doing the right thing:

If Mr. Trump is against childhood sex reassignment, then we must be for it. If Mr. Trump says there are two sexes, we must insist that there is a spectrum. It will be very hard to break this dynamic in such a tribal atmosphere, especially when there is genuine transphobia among some on the right. But it would be incredibly healthy if we were to allow an actual debate in the community about the direction we are headed in, and treat dissenters less like bigots and traitors. Representative Sarah McBride, the first openly trans member of Congress, echoed this sentiment on Ezra Klein’s podcast last week. But she was condemned on social media as a traitor to trans people.

This intransigence matters because, left on its current trajectory, the L.G.B.T.Q.+ gender movement carries significant risks for gay, lesbian and trans equality. Gallup found that satisfaction with the acceptance of gay and lesbian people peaked at 62 percent in 2022 but dropped to 51 percent by January of this year. The center and right — whom some of us spent a lifetime engaging — are being lost. Gallup showed Republican support for gay marriage dropping from 55 to 46 percent between 2022 and 2025.

In my view, this kind of intransigence works against true liberalism and against the Democratic Party. It is a maladaptive manifestation of Trump Derangement Syndrome, which is a real thing. We cannot simply oppose everything the Republican administration does simply because it’s Republican. And some of the things we need more inter-party comity about are issues of gender and sex.

h/t Luana for calling my attention to this article.

Evolution meetings include an ideologically-based symposium on “teaching sex and gender”. It’s a spectrum, Jake!

June 20, 2025 • 11:00 am

A while back, the Presidents of the Society for the Study of Evolution (SSE), the American Society of Naturalists (ASN) and the Society of Systematic Biologists (SSB) posted this letter on the SSE website (click title to see archived version):

The letter was a response to Trump’s Executive order on sex, which gave the biological definition of sex: a binary based on the physiological apparatus for producing gametes of different size, of which there are two forms.  This is how the “Tri-Societies Letter” (henceforth “TSL”) started:

As scientists, we write to express our concerns about the Executive Order “Defending Women From Gender Ideology Extremism And Restoring Biological Truth To The Federal Government”. That Order states first, that “there are two sexes…[which] are not changeable”. The Order goes on to state that sex is determined at conception and is based on the size of the gamete that the resulting individual will produce. These statements are contradicted by extensive scientific evidence.

The TSL, posted on the SSE webpage, asserts that sex is a multivariate trait, is not binary but a spectrum, and that this spectrum occurs in all biological species. It adds this (bolding is mine):

Scientific consensus defines sex in humans as a biological construct that relies on a combination of chromosomes, hormonal balances, and the resulting expression of gonads, external genitalia and secondary sex characteristics. There is variation in all these biological attributes that make up sex. Accordingly, sex (and gendered expression) is not a binary trait. While some aspects of sex are bimodal, variation along the continuum of male to female is well documented in humans through hundreds of scientific articles. Such variation is observed at both the genetic level and at the individual level (including hormone levels, secondary sexual characteristics, as well as genital morphology). Beyond the incorrect claim that science backs up a simple binary definition of sex, the lived experience of people clearly demonstrates that the genetic composition at conception does not define one’s identity. Rather, sex and gender result from the interplay of genetics and environment. Such diversity is a hallmark of biological species, including humans.

Note that it gives no way to determine whether an organism, including a human, is male or female! And how many sexes are there? This gives us no clue.

The letter went on to imply that all the members of the society, or at least nearly all of them, agreed with the Presidents’ views in the TSL:

Our three scientific societies represent over 3500 scientists, many of whom are experts on the variability that is found in sexual expression throughout the plant and animal kingdoms. More information explaining why sex lies along a continuum can be found here. If you wish to speak to one of our scientists, please contact any of the societies listed below.

It turned out that this was a distortion: the Societies had never polled their membership to see how many people agreed with their letter.

The result was considerable pushback against the TSL from scientists, 125 of whom wrote a letter to the Societies saying they didn’t agree with the TSL’s characterization of sex. Luana Maroja was the driving force behind this pushback, and the letter included this (I signed it, of course):

However, we do not see sex as a “construct” and we do not see other mentioned human-specific characteristics, such as “lived experiences” or “[phenotypic] variation along the continuum of male to female”, as having anything to do with the biological definition of sex. While we humans might be unique in having gender identities and certain types of sexual dimorphism, sex applies to us just as it applies to dragonflies, butterflies, or fish – there is no human exceptionalism.   Yes, there are developmental pathologies that cause sterility and there are variations in phenotypic traits related to sexual dimorphism. However, the existence of this variation does not make sex any less binary or more complex, because what defines sex is not a combination of chromosomes or hormonal balances or external genitalia and secondary sex characteristics. The universal biological definition of sex is gamete size.

You can see my other posts about this kerfuffle here.

The response from the Societies can’t be posted as we were refused permission to do so, but I characterized it this way:

. . . . this time we asked for a response and got one, signed by all three Presidents.  I can’t reprint it because we didn’t ask for permission [we later did but were refused], but some of its gist is in the response below from Luana [Maroja]. I will say that they admitted that they think they’re in close agreement with us (I am not so sure!), that their letter wasn’t properly phrased, that some of our differences come from different semantic interpretations of words like “binary” and “continuum”(nope), and that they didn’t send the letter anyway because a federal judge changed the Executive Order on sex (this didn’t affect our criticisms). At any rate, the tri-societies letter is on hold because the organizations are now concerned with more serious threats from the Trump Administration, like science funding.

The upshot was that the Societies eventually decided to remove the letter from the SSE website. What remains on the the original page is this, “This letter was originally posted on February 5th. A revised version is in progress and will be posted shortly.”

We are still waiting. I’m betting that no revision will ever appear. And it shouldn’t, for it’s not good for the premier evolution societies to pretend that biologists see sex as a spectrum.

What I’m leading up to is that, at the SSE’s annual conference taking place this month, the Society is sponsoring a three-hour symposium with four lecturers, a symposium that seems designed to reiterate the premises of the now-vanished letter. You can see the summary of this symposium by clicking on the link below to see synopses of the four lectures; then click on the bottom symposium, which looks like this:

If you go through the written summaries of the talks, you will see two themes reiterated:

1.) Biological sex is not binary but multifaceted, a “complex suite of traits across multiple organizational levels”.  No definition of biological sex appears to be given.

2.) Teaching that sex is binary harms those people who feel they’re not part of the binary, presumably nonbinary people, genderfluid people, some trans people, and the like. An important goal of teaching about sex and gender is to avoid harming people, and this form of teaching must be designed to avoid that harm.

The first point simply reiterates what was in the now-disappeared letter.  It makes the argument that many “progressive” biologists make: sex involves a combination of different traits.  This of course neglects the universality of the gametic definition, for no other definition holds for all animals and vascular plants. That’s why the definition (really a post facto observation) is used. In fact, many of those who hold to the “multifactoral” definition never even give a definition of sex, so I don’t know how they can tell that, say, a rabbit is male or female.

The second point turns biology teaching into a form of social engineering or propaganda: we must teach about sex in a way that does not harm people (i.e., offend them). I see this as distortion of biological truth in the interests of social justice, something that Luana and I discussed in our paper “The Ideological Subversion of Biology.” In fact, of course, teaching that biological sex is binary should not make anybody feel worthless or demeaned, for the dignity and rights of people depend not on biology but on morality, which is a social construct.  I have made this point endlessly and won’t repeat it here; see the end of the paper linked just above.

Some quotes from the summary and the abstracts:

Symposium summary at the beginning:

This symposium will explore the current science behind sex and gender, explore how educators can move their instruction beyond simple binary XX/XY paradigms, and provide educational materials for teaching this nuanced and difficult subject.

The non-binary nature of sex:

However, “biological sex” can describe a complex suite of traits across multiple organizational levels, including chromosomal inheritance, physiology, morphology, behavior, etc. To capture the full range of sex variability and diversity, we must critically assess our research approaches for studying sex associated traits. In this talk, I will provide practical guidance for conceptual frameworks, experimental designs, and analytical methods for studying and teaching the biology of sex. I invite fellow scientists and educators to conscientiously apply these inclusive approaches, to advance our biological understanding of sex and to encourage academically and socially responsible outcomes of our research.

. . . . Biology is the study of the diversity of life, which includes diversity in sex, gender, sexual behavior, and sexual and romantic orientations. However, the few existing studies of biology textbooks and classrooms suggest that many textbook authors and classroom instructors represent only a narrow swath of this diversity which can lead to an over emphasis on binary sex, conflation of sex and gender, and reinforcement of essentialisms.

Biological sex is a complex and highly variable trait; however, overly simplistic explanations are common in undergraduate biology classrooms. Here we test the impact of an accurate approach to teaching about the diversity of biological sex in organismal biology (‘treatment’ lecture) and compare this approach to a ‘traditional’ lecture section of the same introductory biology course.

The harm of teaching sex “wrongly”.

Although science is thought to be objective and free of emotion, many people are uncomfortable talking about the biology of sex. That discomfort and fear leaves room for hostile attacks on the science of sex to easily propagate through political and social channels. This creates unique challenges for educators in this area. In this presentation, I will discuss the biological basis of sex and sexual diversity from the perspective of a developmental biologist. The hierarchical nature of development connects genetics to phenotypes. Development dictates how sexual diversity emerges within species. The evolution of development dictates how sexual diversity arises among species. I will use development to demonstrate how biologists can distill complexity down into understandable chunks to address the most pervasive misconceptions about sex, especially those actively being used to take away
people’s rights.

. . . To more fully characterize the current range of narratives about sex, gender, sexual behavior, and orientation (SGBO narratives) present in undergraduate biology courses, we interviewed a national sample of 53 biology majors whose genders do not align with the sex they were assigned at birth (i.e., trans-spectrum students) about the SGBO narratives they encountered in biology courses.

We analyzed interviews using reflexive thematic analysis with the goal of identifying SGBO narrative in biology content and how these narratives supported or harmed these students’ sense of belonging in biology classrooms.  We found five SGBO narratives that harmed trans-spectrum students’ sense of belonging.  We also found three narratives that supported trans-spectrum students’ belonging.  These narratives could manifest in the classroom in multiple ways ranging from short disclaimers to elaborate case studies. The ways the narratives manifested influenced their impact on at least some students. These narratives and how they manifest provide potential teaching suggestions to both support trans-spectrum in STEM classrooms and more accurately teach the diversity of biology of sex, gender, sexual behavior, and orientation.

(Continuing the last quote in the section just above):

. . . We show that (1) the treatment lecture has a positive impact on feelings of inclusion for LGBTQIA+ students, (2) the treatment lecture had a positive impact on LGBTQIA+ and TGNC (transgender and gender nonconforming) student experiences in the course compared to other students. . .

This is not a huge deal, but I don’t think that one should distort the most widely accepted definition of sex to avoid offending people who don’t think they adhere to it.  I can’t see any other reason for this symposium. And yes, sex is binary, and that’s universal: there are only two types of gametes, and this holds across all animals and vascular plants. It’s not only universal but useful, for the binary enables us to understand one of the most important phenomena in biology: sexual selection, a form of selection that leads to differences between males and females. Of course teachers should be sensitive to their audience and not denigrate those who feel non-binary, but they should also teach the conventional wisdom about sex, which is apparently not going to happen at this symposium.

U. S. Supreme Court affirms Tennessee’s ban on medical “gender-affirming care”

June 19, 2025 • 9:35 am

In 2023, Tennessee passed a bill to restrict access of minors to “affirmative care”, though only minors who wanted blockers or hormones to assume the identity of his/her non-natal sex or to relieve gender dysphoria. Tennessee is now one of 15 states that has passed laws restricting affirmative care.  Note, though, that hormones and blockers may, under that law, be used to treat other disorders (also called “differences”) of sex determination {DSDs).

Click title to read the bill. In it, “minor” refers to “an individual under 18 years of age”

From the bill:

The legislature determines that medical procedures that alter a minor’s hormonal balance, remove a minor’s sex organs, or otherwise change a minor’s physical appearance are harmful to a minor when these medical procedures are performed for the purpose of enabling a minor to identify with, or live as, a purported identity inconsistent with the minor’s sex or treating purported discomfort or distress from a discordance between the minor’s sex and asserted identity. These procedures can lead to the minor becoming irreversibly sterile, having increased risk of disease and illness, or suffering from adverse and sometimes fatal psychological consequences. Moreover, the legislature finds it likely that not all harmful effects associated with these types of medical procedures when performed on a minor are yet fully known, as many of these procedures, when performed on a minor for such purposes, are experimental in nature and not supported by high-quality, long-term medical studies.

The bill does not ban that aspect of “affirmative care” that involves psychological affirmation of a minor’s desires; what is banned is solely medical treatment given to minors. (I do think that good psychological treatment doesn’t have an aim at the outset, though, so “affirmative psychology” seems counterproductive).

But when you turn 18 in Tennessee, you can have all the hormones you want, though puberty blockers are by that point superfluous.

Yesterday,  the U.S. Supreme Court upheld the law by a vote of 6-3—the ideological vote that we liberals are used to.  There are long concurrences by Judges Alito (22 pages), Barrett (11 pages) and Thomas (23 pages), and dissents by Sotomayor (31 pages) and Kagan (2 pages). Click to see the decision:

And the end of the decision:

The Supreme Court decision reprised the Tennesse law:

In 2023, Tennessee joined the growing number of States restricting sex transition treatments for minors by enacting the Prohibition on Medical Procedures Performed on Minors Related to Sexual Identity, Senate Bill 1 (SB1). SB1 prohibits healthcare providers from prescribing, administering, or dispensing puberty blockers or hormones to any minor for the purpose of (1) enabling the minor to identify with, or live as, a purported identity inconsistent with the minor’s biological sex, or (2) treating purported discomfort or distress from a discordance between the minor’s biological sex and asserted identity. At the same time, SB1 permits a healthcare provider to administer puberty blockers or hormones to treat a minor’s congenital defect, precocious puberty, disease, or physical injury.

The National Law Review summarizes the decision and discusses its basis and what it did not address (click to read):

An excerpt:

In a 6-3 opinion authored by Chief Justice John Roberts, the Court in Skrmetti affirmed the U.S. Court of Appeals for the Sixth Circuit,[1] which held in September 2023 that (1) the Tennessee law does not discriminate on the basis of sex for purposes of equal protection, and (2) that it was subject only to rational basis review.

“SB1 does not classify on any bases that warrant heightened review,” the Supreme Court wrote. It concluded that the Tennessee law incorporates only two classifications: (1) age (allowing certain medical treatments for adults but not minors), and (2) medical use (allowing puberty blockers for minors for some conditions but not others). These two classifications warranted only rational basis review, the Court said.

And the Court dodged the question of whether transgender status should be considered a protected class equivalent to race or gender. “This case, in any event, does not raise that question because SB1 does not classify on transgender status.”

That’s a serious issue, for if transgender status is a protected class, the whole game changes. That doesn’t mean, though, that gender-dyphoric minors will immediately be allowed medical “affirmative care.” It goes on:

. . . The decision marks the first time the Supreme Court considered the application of the Equal Protection Clause to transgender youth, despite the decision skirting the question of whether transgender status should be considered a protected class.

The decision has broad implications, although many legal issues in this area remain unresolved.

Those unresolved issues are said to involve the right to privacy, parents’ rights, statutory discrimination analysis, impact of state constitutional arguments, and tension with state laws on gender identity.  The upshot, it seems to me, is that the Court decided that the Tennessee law, because it didn’t discriminate on the basis of sex (both male and females with gender dysphoria are equally subject to Tennessee’s ban), was constitutional on those grounds. But that still leaves the issue of whether “transgender status” or “having gender dysphoria” counts as being a member of a protected class. If that proves to be the case in further legal wrangling, then affirmative medical care may be permitted.

I am not sure how this affects the 25 other states that do not have laws against medical affirmative care; those states have not passed bills banning it (or, presumably, allowing it) that can be adjudicated at the nation’s highest court. (I may be wrong here, so readers who know are welcome to correct me.)

Some of the mainstream media are couching this as a “setback for transgender rights”, but some of us would argue that there is not a “right” for minor who wishes to have surgery and/or hormone treatments aimed at making them resemble members of their non-natal sex should be able to freely get such treatments.

Here are two articles explicitly endorsing such a “right”:

From the Associated Press:

There was an NPR article called “Battle over rights of trans children is up at the Supreme Court,” but it has now changed the title (!). It does still assert the “rights” in one paragraph:

Front and center at the Supreme Court on Wednesday is the battle over the rights of transgender children. At issue is a state law in Tennessee that blocks minors from accessing gender-affirming care in the state.

I don’t want to scour all the news for similar statements, though, because I don’t believe there’s any “right” of minors to affirmative medical care beyond psychological treatment; there’s certainly no right in the Constitution or—in my view—ethics to have parts of your body cut off or hormones injected into you, particularly when the vast majority of minors experiencing gender dysphoria will resolve as being gay children who don’t need this kind of medical care (especially unproven blockers, who are banned for minors in some European countries).

Emily Yoffe, whose writings I’ve always found pretty sensible, agrees with me, and published the article below in the Free Press (archived here):

Some excerpts from Yoffe’s piece (bolding is mine):

The Court’s ruling is narrow; it says that a state has the right to regulate the practice. States, mostly blue, that still allow youth gender transition aren’t affected. But the decision will likely lend weight to the arguments of people who want to end the practice nationwide. And it will likely help the legal efforts by “detransitioners”—that is, young people who say they were pressured into life-altering treatments they now regret—to get compensation. Surely more such lawsuits will now be filed. Gender transition clinics will likely be under far more scrutiny: This Free Press story describes the cases of two such young women who were given prescriptions for testosterone after about a 30-minute appointment at Planned Parenthood.

Children who express gender distress often suffer from a host of other medical and psychological issues, such as autism, ADHD, depression, or anxiety, or have experienced various traumas. But to the gender doctors in their lucrative new clinics, there was only one answer to such childhood troubles: gender transition. This usually meant medically blocking a child’s normal puberty, then putting that patient on opposite-sex hormones: testosterone for girls, estrogen for boys. Sometimes complicated and painful surgeries were undertaken to try to create new genitals. Thousands of teenage girls, and some not even teenagers, have received double mastectomies, known euphemistically as “top surgery”—a surgical intervention normally reserved to treat breast cancer.

In the U.S., gender-distressed children and their parents were told that without the swift intervention of these radical treatments, the children were likely to commit suicide. It became a cliché for the reluctant parents of girls seeking to transition to be asked by the gender provider, “Would you rather have a live son or a dead daughter?” (And vice versa for parents of boys.)

The clinicians assured parents there was robust evidence underlying their interventions, but this was false. During the oral argument in the case, Chase Strangio, the lawyer for the ACLU, arguing to overturn Tennessee’s ban, was forced to acknowledge to Justice Samuel Alito that “completed suicide, thankfully and admittedly, is rare.”

I would have guessed that Strangio would be in there argue for surgery and hormones; he was, after all, the ACLU lawyer who argued for banning Abigail Shrier’s book on rapid-onset gender dyphoria, often triggered by social pressure. (Strangio is also a trans-identified female.) In the end, Shrier was right. Shame on Strangio and the ACLU:

More from Yoffe:

. . . . The Court’s ruling notwithstanding, the U.S. medical establishment remains firmly behind the practice. Compare that to England, where a rigorous and independent report, the Cass Review, concluded that the evidence for pediatric transition is “remarkably weak.” Finland, Norway, and Sweden are among the other Western nations that have joined the UK in moving away from this treatment.

It is widely observed that the vast majority of young people with gender dysphoria—even those whose distress is “consistent, insistent, and persistent”—when allowed to go through normal puberty, come to accept their biological sex. (And there is no way to identify the very small number of children who will go on to experience lifelong gender distress.) Many of these children turn out to be gay, which is why a rising number of gay adults and gay-rights advocates have become alarmed that the transgender movement is medically transitioning gay kids. They argue that this movement has, intentionally or not, reified homophobic tropes.

I especially agree with the last paragraph below. In the future, I think medical gender-affirmative cafe will, along with our poor treatment of farm animals, be seen as practicers that were immoral in their time, but widely practiced:

Critics of the Supreme Court decision will argue that our major medical associations, from the American Academy of Pediatrics, to the American Medical Association, to the Endocrine Society, have all given support to this new branch of medicine. This is true. It is also true that these organizations or similar ones once supported lobotomies and eugenics. Just as that is a source of shame today, it is to be hoped that their vehement support of medically transitioning vulnerable young people will be a source of shame in the future. These medical societies have failed in their most basic duty of care to their patients by embracing a model that has so little evidence and such profound lifetime consequences.

When the history of this era is written, historians will have to explain how transgender activists so quickly took over institutions, and were able to so successfully threaten the social and work lives of those who objected. We are confident that historians will also remember those courageous individuals who, at the risk of professional and personal ruin, did so anyway.

But over at the Freedom From Religion Foundation, which now comprises a group of Chase Strangio clones, they’re proclaiming first that affirmative care is in general a salubrious way to address gender dysphoria, but also that affirmative care is “religious dogma.”  That characterization is palpably ridiculous, meant as a way for the FFRF to pretend that its “progressive” politics are fully in line with its mission to keep church and state separate. But many atheists like me object to affirmative care. It is the FFRF’s deliberate conflation of progressive politics with church-state separation that I objected to, and this ultimately wound up with my resigning (along with Richard Dawkins and Steve Pinker) from the FFRF’s honorary board.  Click below to read:

Note that the FFRF again speaks of transgender minors’ “rights”:

The Freedom From Religion Foundation lambastes today’s U.S. Supreme Court ruling upholding Tennessee’s cruel and unconstitutional ban on gender-affirming care for minors. This decision is a major blow to science-based medicine and the rights of parents and transgender youth.

, , , , Despite the hostile narrative surrounding transgender health care that the Supreme Court is furthering in its decision, the gender-affirming-care model is safe, effective and supported by every major medical organization, including the American Medical Association, the American Psychiatric Association, the American Psychological Association, the American Academy of Pediatrics and the American Academy of Child and Adolescent Psychiatry. These secular scientific organizations prioritize the safety and health of patients, not religious dogma.

The Freedom From Religion Foundation stands firmly with the transgender community, with parents, and with the medical professionals who follow science and ethics — not narrow sectarian belief — in providing care. FFRF will continue to educate about the harm these theocratic assaults are doing to civil liberties, bodily autonomy and the wall of separation between religion and government.

When the FFRF proclaims gender-affirming “model” as “safe, effective, and supported by every major medical association,” they of course neglect the fact that gender-affirming care is not seen that way in Europe, where it’s either banned or considered as experimental.  And of course most gender-dysphoric minors who go through normal puberty don’t really need this care, as most turn out to be gay. No hormones or excising of body parts required.  Affirmative treatment, as you may know, usually sterilizes its recipients, and, further, many of them will never have an orgasm after transitioning.

People like those in the FFRF are acting like this is the end of gender-affirmative care in America. I wish it were, and that treatment for dysphoria was limited to those over 18 (on same days I think 21). But in half of our states, hormones and surgery are still allowed, and there are no bans to be overturned.  I think that such states are making a mistake treating youths who haven’t attained maturity as having the ability to make their full medical decisions, like catering to a minor who doesn’t like their left leg and wants it cut off. The “right” to make such decisions should not be given to minors, or even their parents or doctors—not until youths come of age.

This viewpoint may be seen as transphobic, but I firmly reject that adjective. After all, it’s not seen as transphobic in the UK, Sweden, Finland, or Denmark, which have severe restrictions on affirmative care. And in the future, those who defend this rush to cut and inject hormones will, I think, be seen as misguided or even barbaric.

Now the editors of Natural History back the non-binary nature of sex, showing their scientific ignorance

May 3, 2025 • 11:30 am

Yesterday when I criticized Agustín Fuentes’s article in Natural History trying (and failing) to show that sex isn’t binary, I gave the magazine a break. After all, it hasn’t been nearly as bad as Scientific American, and I gave it a break because it published a gazillion essays by Steve Gould (yes, some of them were misguided, touting punctuated equilibrium, but they were all entertaining).

But now I’ve changed my mind, for I’ve learned that the editors actually published a justification in the magazine for publishing Fuentes’s piece. I guess they knew it would be controversial, and it is. It’s just flat wrong, but also misleading in a very annoying way: making points about variation within the sexes that have nothing to do with his thesis (and the title of his book from which the article was taken): “Sex is a Spectrum: Why the Nonbinary View is Problematic.”  His presentation shows that some (but not all) aspects of sexual behavior, sexual dimorphism, and so on are more continuous that the discontinuous existence of the sexes themselves. In all animals there are two reproductive systems, male and females, with exceptions ranging in proportion from 0.00005 to 0.00017.  And that, ladies and gentlemen, friends and comrades, is in all relevant respects a binary.

Fuentes, in other words, was attacking an argument that nobody had made, since we all realize there’s variation in sex-related traits, but his thesis was not about that. It’s about whether there is variation in the types of gametes in plants and animals (especially humans) that are the basis for defining sex (actually it’s really a “recognition” of a binary, not an a priori definition designed to impose a false binary on nature). And Fuentes uses many of the bogus tropes employed to “prove” that sex is nonbinary, even showing a photo of a bluehead wrasse, a fish that forms polygynous groups. When the alpha male dies, one female gets rid of her ovaries and develops testes, taking over the top job.  But there are still only two sexes!  I have to say that you have to be either ignorant or tendentious to use this animal as an argument against the sex binary, and Fuentes isn’t ignorant.

At any rate, the editors’ apologia–or rather “explanation”—is below. What burns my onions about this is their contention that “the science behind Fuentes’s thesis. . . is solid.”  The claim that “the number of mating types (often called “sexes”) has been variable over hundreds of millions of years, ranging from two and sometimes three in most animals, to as many as seven in single-celled animals. . ” is wholly misleading.  Well, Dear Editors, all animals and vascular plants have just two sexes (which ones have three?), though single-celled organisms, algae and fungi can have more “mating type”, which I’m okay with calling “sexes”if you want. But Fuentes and the editors, are defending the thesis that animals, including our own species, have nonbinary sex. This is not true.

Note as well that the editors have been taken in by the claim that the variability of “sexual behavior” and of “sexual activity” within and among species show that there is variability in the number of sexes beyond two.  This is a false argument, as anybody who knows biology and isn’t warped by ideology should know.

What bothers me most about this editorial is the editors’ sanctimonious claim that they are acting “in the public interest” by recognizing the “science” in this debate, but the bogus-ness of that science is all on Fuentes’s side. Shame on you, editors of Natural History? Have you actually followed this debate? How can it be that the Supreme Court of the UK has apprehended and resolved this debate better than do editors of a science magazine.

This is what happens when scientists’ work is distorted by their ideology, and by now I shouldn’t have to tell you what the distorting ideology is.

Here is the editors’ preface:

h/t: Robert

Natural History magazine: Agustín Fuentes rejects the sex binary on ideological grounds, but pretends otherwise

May 2, 2025 • 11:00 am

It looks like Natural History magazine has given an implicit endorsement—or at least a platform—to Princeton anthropology professor Agustín Fuentes.  We’ve met him before, and not under pleasant circumstances, as the man is wont to distort science and mislead his readers in the cause of progressive ideology. To see all the pieces I’ve written about him, go here (and especially these pieces here, here, and here.  And for critiques of Fuentes’s misguided accusations that Darwin was a racist who justified and promoted genocide, go here and here, and also see here for one I published in Science with a bunch of evolutionists. Some of these articles show Fuentes deliberately purveying misleading statements to buttress an ideological position. For that seems to be his modus operandi.

Now Fuentes has put his view that sex is not a binary into a new book, an excerpt of which was published in the latest Natural History, a magazine I always liked. This single bad article won’t change my mind about it (as the multiple bad articles in Scientific American did about that rag), but it makes me question the editors’ judgment. Do they know ANY biology? The reason I ask is that the excerpt is so tedious, dreadful, tendentious, misleading, and convoluted that it wouldn’t pass muster in a real scientific journal, and even a scientifically ignorant editor could see the problem with the arguments (and also correct the bad writing).

You can’t go to the article by clicking on the headline; and I don’t have a link, either. I was sent a pdf by a disaffected reader, and that’s what I’ll quote from. Perhaps you can find a copy if you dig around.

The overweening problem with this article is that it doesn’t show that the binary view is wrong, or that biological sex is really a spectrum. What Fuentes does (and he doesn’t really define biological sex) is to show that within the two constructs he takes to represent sex, there is a lot of variation in various traits.  Men don’t all behave in a way that differs from the way all women behave, development of sex is complicated, people of different sex have different “lived experiences” (yes, he says that), the structure of families vary among cultures, and so on.

But of course all of this variation, and the multidimensional definition of sex, neglects the big problem: is biological sex binary?  Yes it is: males have reproductive systems that evolved to produce small mobile gametes (sperm) and females have systems evolved to produce larger immobile gametes (eggs). There are only two types of gametes—no more. Biologists have arrived at this definition for two reasons: it’s universal in all animals and plants, and also because of its utility: the different investment in gametes usually leads to differential investment in offspring,  which explains not only sex differences in behavior, but sexual selection itself, which produces sexual dimorphism in appearance and sexual behavior. The exceptions to a strict binary defined (really “recognized”) this way range from about 1/5600 individuals to 1/20,000, and that’s as close to a binary you can get in biology.

What Fuentes does is throw a lot of sand in the reader’s eyes, showing variation within sexes and across cultures, hoping that at the end the reader will say, “Hey, maybe sex isn’t a binary after all.” But that variation does not touch the thesis he’s trying to depose. The man doesn’t know how to debate, so, like a true ideologue, he changes the ground of argumentation.

First (probably in the nonquoted parts of his book), he defines the sexes in an introductory note as “3Gfemales” and “3Gmales”, referring to “typical biological patterns of association between genetics-gonads-genitals in human bodies.” I presume he means that members of each have has the typical chromosomal constitutions of its type (e.g. XX in females) as well as gonads (that presumably means testes vs. ovaries) and genital morphology. Fuentes adds that “while useful as general categories, not all people fit into the 3G classifications.” So that is his definition, and of course since it involves more than gametes, will naturally be less binary than the biological definition. A male with a tiny penis, for example, perhaps because of a disorder of sex determination, would be called a biological male if he has testes, but is something else according to Fuentes. But Fuentes doesn’t say what such an individual is. How many sexes are there? An infinite number? And is that true of raccoons, Drosophila, and robins?

Okay, here comes the sand, so cover your eyes. I’ll have to use screenshots since I can’t copy and paste from this pdf:

Variation in sexual behavior:

But it is not “human sexuality” that is the binary, but the definition of sex.  Surely Fuentes recognizes that he is deviating from the main issue his book (and this article) is about: the binary nature of defined sex, as seen in every species of animal and plant. That doesn’t mean that sexuality and its expression is binary.  I’m not sure whether there’s a name for this kind of argumentation, but what he’s doing is clear.

He drags in variation in family structure, too:

Again, all this does is refute a binary of families, not of sexes. Why is it in there? What is the sweating professor trying to say?

Fuentes dwells at length on how sex is basically irrelevant in medicine because sexes show variation in their responses to drugs and get diseases at different rates, implying that the binary is all but useless for doctors. I read to my doctor several paragraphs of Fuentes’s screed, and I won’t give his reaction save to say that it was “not positive.” For example, can you even understand this?:

Stable? “Perceived instability”? What is he banging on about? He doesn’t say.

And females are too complicated to deal with in biology, medicine, and health? What is he talking about?  When a patient goes to see a doctor, it’s essential for the doctor to know the patient’s biological sex. Not only are some diseases specific to sexes (prostate cancer, ovarian or uterine cancer) as are some conditions (menopause), but a good doctor will realize that heart disease (and other diseases) can present differently in the sexes, and will investigate further based on that. Females with heart disease, for example, present more often with indigestion-like symptoms than do males. Now of course there are factors other than sex involved in treating a patient (do they drink, smoke, or eat too much?), but saying that sex is pretty much useless when treating patients is simply dumb. It can even be harmful (though he doesn’t say how):

Again, does any doctor pay attention only to sex? I don’t know of one. To be sure, Fuentes grudgingly admits that there are “two sets of reproductive physiologies” that are relevant to medicine, but minimizes the importance of sex. And to be sure, some diseases are recognized and treated identically in males and females, but to ignore biological sex as a doctor is sheer incompetence.

In another example, Fuentes notes that Ambien doesn’t work the way you’d predict in women if you just reduces the male dosage based on a smaller weight of females.  Why doesn’t this work? Because the drug clears from women “3G females” (did the doctors check all the “G”s?) more slowly than from “3G males.”   He uses this difference to attack the sex binary, by saying that we don’t understand why this average difference occurs, saying “asking about the actual physiological response, rather than assuming 3G males and 3G females are different kinds of humans, is a better approach.”

But again, this is irrelevant to the sex binary; it is about the mechanism of a difference between (Fuentes’s) biological sexes.  And, interestingly, one of the mechanisms he suggests is “attention should be focused on the varying levels of acting testosterone in attenuating the effectiveness of [Ambien].”

Testosterone! Well at least that has some connection with biological sex, no? Fuentes then tries to efface the difference in hormone levels by saying this:  “Testosterone is not characterizable as a male or female hormone, but rather by variation in circulating levels among humans, with 3G males usually having much higher levels than 3G males.”

In reality, we’ve long known that both testes and ovaries produce testosterone, but the distribution of salivary testosterone in the sexes is indeed variable in each sex, and there is hardly any overlap between the sexes: Since testosterone prompts the development of secondary sex traits, including behavior, it’s the binary nature of sex that produce an almost nonoverlapping distribution of hormones. But one should not imply, as Fuentes does, that variation of hormone levels in each sex means that the sexes themselves are non-binary.

(From paper): Figure 1. Shown is a depiction of the bimodal distribution of raw, baseline salivary testosterone values (in pg/mL) when including both men (N = 360) and women (N = 407). All saliva samples were collected and assayed by the present author using radioimmunoassay (Schultheiss and Stanton, 2009). The displayed testosterone data were aggregated from several past studies by the author, and for graphical purposes only, exclude eight male participants with testosterone levels between 150 and 230 pg/mL.

I don’t want to go on much longer, but I’ll add that Fuentes conflates sex and gender several times, and uses familiar tropes to dispel the binary, like the existence of hermaphroditic earthworms, which of course produce only two types of gametes, but in one body. He even shows a photo of a bluehead wrasse, which, like the clownfish (but in the other direction), changes sex in social groups (the head of a group of females is male, but if he dies a female changes sex and becomes the alpha-fish).  And like the clownfish, this doesn’t dispel the sex binary because again, there are only two forms, one producing sperm and one producing eggs. Nobody ever claimed that a biological female can gametically transform into a biological male or vice versa. As always, there are only two reproductive systems, classified by their type of gamete. Neither of these animals produces a third type of gamete.

At the end, Fuentes reprises his error of saying that variation within sexes dispels any notion of a sex binary, and even lapses into philosophisizing:

I love the “why and how humans are in the world.” It’s totally meaningless!  But wait! There’s more:

Of course there is intra- and inter-sex diversity in levels of hormones, behavior, sexual behavior, family structure, and so on.  But there is no diversity within a sex about the type of gamete it is set up to produce, either sperm or eggs (or both in the case of hermaphrodites, which Fuentes calls “intersex”).  And that IS a universal truth about being male or female, a truth that was recognized a long time before social justice ideology arose, and a reognition that had nothing to do with that ideology. Now it does, for even a dolt can see that Fuentes’s real aim to to dispel the binary definition of sex in any way he can, for he considers that definition to be harmful to people who don’t identify as either male or female. It isn’t. If the facts get in the way of ideology for people like Fuentes, they either ignore or misrepresent the facts. Here the entire article is a form of misrepresentation.
******************
At my own ending I’ll quote, with permission, part of the email that the reader who sent me this pdf wrote, just because I liked the email:

 

. . . last night, I was flabbergasted to read in the table of contents of the latest issue of Natural History, ‘Sex is a Spectrum: Why the binary view is problematic.”

That rumbling you just heard was SJG [Stephen Jay Gould] and his biologist forebears from this magazine spinning in their graves. Or so I infer.

OK, I am not a biologist and wouldn’t even try to play one on TV, and so wouldn’t claim the credentials or background to properly critique this. But I do have to wonder at the author’s writing in pretzel knots to avoid, for example, using the term “women” (preferred: “Humans with uteri” [p. 23]), or writing things I find hard to swallow (“the number of mating types (often called “sexes”) per kind of species…[is] two and sometimes three in most animals…”). I’d really like to know the animals that have three sexes (and what the third kind is called, and who it mates with).

h/t: Alex, Robert

Misguided branch of British Medical Association rejects UK’s Supreme Court decision that “woman” is defined by biological sex

April 30, 2025 • 10:00 am

As I reported two weeks ago, the Supreme Court of the United Kingdom voted unanimously to affirm that the term “woman” under the legal Equality Act refers only to biological women and not trans-identified men. That means that a biological male holding a gender reassignment certificate would not have the same legal status as a biological women.  I added this:

In all the stuff I was able to read this morning, I was unable to find the definition of a “biological woman”, save that it refers to one’s natal sex, though they don’t mention gametes. The ruling does refer to the binary nature of sex (see below). And the ruling implies as well that the word “man” can mean in law only a “biological man”

That would seem to settle things, at least as far as the Equality Act is concerned, and the ruling was celebrated by those who favor the existence of “women’s spaces,” including sports competition, locker rooms, and jails.

But some members of the British Medical Association (BMA), as reported by the Times of London and other venues, have taken issue with the Supreme Court’s decision, implying that rrans-identified men are also women.  The subgroup of the BMA that voted against the Supreme Court Decision was the group of “resident doctors,” previously known as “junior doctors,” and so represent younger physicians. Note that the BMA is a registered trade union and does not regulate doctors; that role is given to the General Medical Council.

Click below to see an archive of the Times report:

A précis:

Doctors at the British Medical Association have voted to condemn the Supreme Court ruling on biological sex as “scientifically illiterate” and “biologically nonsensical”.

The union’s wing of resident doctors — formerly known as junior doctors — passed a motion at a conference on Saturday criticising the ruling that a woman is defined by biological sex.

The doctors claimed that a binary divide between sex and gender “has no basis in science or medicine while being actively harmful to transgender and gender-diverse people”.

The branch of the British Medical Association (BMA) — representing about 50,000 younger doctors — said it “condemns scientifically illiterate rulings from the Supreme Court, made without consulting relevant experts and stakeholders, that will cause real-world harm to the trans, non-binary and intersex communities in this country”.

The BMA’s stance is likely to raise concerns that the medical profession may seek to obstruct attempts at implementing new NHS guidance on trans patients, being drawn up after the Supreme Court ruling. It follows the union’s decision last summer to lobby against the Cass Review and to call for an end to the ban on puberty blockers for children identifying as transgender.

Lobbying against the Cass Review—a sensible report that banned the use of puberty blockers on individuals under 18 and dismantled the dysfunctional Tavistock Clinic that hustled gender-dysphoric children into “affirmative therapy”—shows where the ideology of this group lies. Although the Cass Review was widely applauded by doctors, these “resident doctors” are clearly infected with the mantra that anyone can claim to be any sex they want. As the yahoo! article below notes, “Last year, the BMA became the only medical organisation in the UK to reject the findings of the Cass Review into the provision of gender identity services for young people.”

And their ideology is clear:

The BMA motion, responding to the ruling, said: “This meeting condemns the Supreme Court ruling defining the term ‘woman’ with respect to the Equality Act as being based on ‘biological sex’, which they refer to as a person who was at birth of the female sex, as reductive, trans and intersex-exclusionary and biologically nonsensical.

“We recognise as doctors that sex and gender are complex and multifaceted aspects of the human condition and attempting to impose a rigid binary has no basis in science or medicine while being actively harmful to transgender and gender diverse people.”

It added that the BMA is committed to “affirming the rights of transgender and non-binary individuals to live their lives with dignity, having their identity respected”.

Of course we all respect the rights of transgender individuals–as transgender individuals. But those rights clearly clashed with the rights of other groups, most notably biological women, and the court adjudicated that clash in its definition of “woman”. Nobody of good will wants “erasure” of trans people, but we have to recognize that the claim that “trans women are women” leads to a clash of rights whose solution was taken up by the UK Court.

Note the “sex and gender are complex” assertion often used by ideologues or the benighted to claim that sex is not binary. (Yes, there are a very, very few exceptions., as I mention below, but for all practical purposes biological sex is binary.)  And, of course, it is binary in nearly all transsexual individuals, who even recognize the binary by wanting to adopt the role of their non-natal sex.

A bit more:

Sex Matters, the campaign group, accused the doctors of being an “embarrassment to their profession” and said it is “terrifying” that people who have undergone years of medical training can claim there is “no basis” for biological sex.

Indeed; for the doctors are redefining sex (and gender) as some multifactorial, “multifaceted aspect of the human condition”.  Perhaps gender roles fit that definition, but the Supreme Court was defining sex, not gender, and stayed away from gender, which is not part of the Equality Act.  This clearly shows the ideological nature of the resident doctors’ efforts and their unwarranted conflation of sex and gender.  Sex is a biological issue; gender a social one, also mixed to some degree with biology.  Don’t these doctors know that? Yes, of course they do, but pretend otherwise. If they’re not pretending, they are witless and don’t deserve to be doctors.

Yahoo News! (click below) gives the text of the resident doctors’ resolution:

Here’s the text of the resolution:

“This meeting condemns the Supreme Court ruling defining the term ‘woman’ with respect to the Equality Act as being based on ‘biological sex’, which they refer to as a person who ‘was at birth of the female sex’, as reductive, trans and intersex-exclusionary and biologically nonsensical.

“We recognize as doctors that sex and gender are complex and multifaceted aspects of the human condition and attempting to impose a rigid binary has no basis in science or medicine while being actively harmful to transgender and gender diverse people. As such this meeting:

“i: Reiterates the BMA’s position on affirming the rights of transgender and non-binary individuals to live their lives with dignity, having their identity respected.

“ii. Reminds the Supreme Court of the existence of intersex people and reaffirms their right to exist in the gender identity that matches their sense of self, regardless of whether this matches any identity assigned to them at birth.

“iii. Condemns scientifically illiterate rulings from the Supreme Court, made without consulting relevant experts and stakeholders, that will cause real-world harm to the trans, non-binary and intersex communities in this country.

“iv. Commits to strive for better access to necessary health services for trans, non-binary and gender-diverse people.”

The deeming of the Supreme Court’s ruling as “trans and intersex-exclusionary” is confusing.  Most trans people do indeed fit into the Court’s categorization of “man” or “woman.” The exception, the “true” intersex people, range in frequency from 1/5600 to 1/20,000, and so are very rare, making biological sex as binary as you can get. (In contrast, the frequency of people born with extra fingers or toes is about 1/2500 to 1/800, and yet we refer to humans as having “ten fingers and toes”.) It’s clear that this controversy is really not about the rare “true intersex” individuals, but about individuals who fit the biological definition of “man” or “woman” but identify otherwise—as either “nonbinary” or “transsexual”.

h/t: cesar, nick