Glimpsing the human cost of getting nature wrong
In February of the year, Ohio parents lost custody of their 17-year-old daughter because a judge ruled she should be allowed to receive therapy to identify as a boy.
Americans will see more cases like this as government officials align with transgender activists to promote a radical view of the human person and endorse entirely experimental medical procedures. At stake are not only parental rights, but the well-being of children who suffer from gender dysphoria.
Transgender activists maintain that when a child identifies as the opposite sex in a manner that is “consistent, persistent, and insistent,” the appropriate response is to support that identification. This requires a four-part protocol, as I painstakingly detail in my new book, When Harry Became Sally: Responding to the Transgender Moment.
First, a social transition: giving a child as young as three a new wardrobe, new name, new pronouns, and treating the child as a member of the opposite sex.
Second, puberty blockers to prevent the normal process of maturation and development. This means there is no progression of the pubertal stage, and a regression of sex characteristics that have already developed.
Third, around age 16, comes the administration of cross-sex hormones: Boys are given feminizing hormones such as estrogen, and girls are given masculinizing hormones such as testosterone. The purpose is to mimic the puberty process that would occur in the opposite sex.
Finally, at age 18, these individuals may undergo sex-reassignment surgery: amputation of primary and secondary sex characteristics and plastic surgery to create new sex characteristics.
Starting a young child on a process of “social transitioning” followed by puberty-blocking drugs was unthinkable not long ago, and treatment is still experimental. Puberty- blocking drugs are not FDA-approved for gender dysphoria, but physicians use them off-label for this purpose. No laws in the U.S. prohibit use of puberty blockers or cross-sex hormones for children, or regulate age at which they may be administered.
Normally, 80 to 95 percent of children will naturally grow out of any gender- identity conflicted stage. But all the children placed on puberty blockers in the Dutch clinic that pioneered their use persisted in a transgender identity, and went on to begin cross-sex hormone treatment.
This treatment protocol can interfere with the resolution of a gender- identity conflict. The rush of sex hormones and the natural bodily development during puberty may be the very things that help an adolescent actually identify with his or her biological sex.
And sadly, the medical evidence suggests that “transitioning” does not adequately address the mental health problems suffered by those identifying as transgender. Even when procedures are successful technically and cosmetically, and even in cultures relatively “trans-friendly,” people still face poor psychosocial outcomes.
A more cautious therapeutic approach begins by acknowledging the vast majority of children with a gender-identity conflict will outgrow it. An effective therapy looks into reasons for the child’s mistaken gender beliefs, and addresses the problems the child believes will be solved if his body is altered.
As I document in When Harry Became Sally, mental health professionals liken gender dysphoria to other dysphorias (serious discomfort with one’s body) such as anorexia. These tend to involve false assumptions or feelings that solidify into mistaken beliefs about oneself.
As a result, some mistakenly believe that a drastic body change will solve or minimize their psychosocial problems. But altering the body through hormones and surgery doesn’t fix the real problem, any more than liposuction cures anorexia nervosa.
The most helpful therapies do not try to remake the body to conform to misguided thoughts and feelings—which is impossible—but rather help people move toward accepting the reality of their bodily selves.
Biology isn’t bigotry. And there are human costs to getting human nature wrong.
RYAN T. ANDERSON, PH.D. (@ RyanTAnd) was a featured speaker at the Legatus 2018 Summit. He is the William E. Simon Senior Research Fellow at The Heritage Foundation and author of the book Truth Overruled: The Future of Marriage and Religious Freedom, and of the recently released When Harry Became Sally: Responding to the Transgender Moment.