Notes on the Journey

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Transgenderism Is Depopulation

The North Pole Is On Fire


Massive fires are burning out of control in the Arctic Circle. Global Warming is accelerating exponentially. Human civilization is about to end. We will very likely all be dead by 2026 when the planet will no longer be able to support life as the atmosphere becomes Venus-like and plants are unable to sprout.

Chemical corporations and their close cousins, Big Pharma and Big Medical, have dreamed up a solution that they believe will reduce population while it keeps us all distracted from the fact that we are in the process of committing mass murder/suicide of all life on Earth.


I live in Iowa City. This spring the floods were so intense that farmers were unable to plant crops. Iowa City is home to Gender Enforcement Clinics, one for adults and one especially for children.

This upset me for awhile because I couldn’t understand why doctors would want to de-sex children. I did get caught up in trying to warn people about it. I wrote to various agencies – that had originally been developed to help women cope with male violence and male privilege – to ask them why they now believe that males and females are completely interchangeable and why it is that doctors are the only ones with the authority to determine what constitutes appropriate sex role stereotypes which are then enforced with cross sex steroids.

I was concerned that women were losing our right to have bodily privacy and that men would be invading our private spaces and taking away the Title IX protections we fought for by claiming that feeling like a woman literally makes you a woman, even if you have a penis. Of course they always answered me in terms that showed they believe that I am a bigoted imbecile. How ridiculous of me to get in the way of the mass sterilization project!

I follow climate data, which takes some diligence, since the United States government is officially closing it’s Arctic monitoring stations and sending all it’s climatologists packing. Yesterday I saw the headline The North Pole Is On Fire and it hit me, like a proverbial hot kiss at the end of a wet fist: TRANSGENDERISM IS DEPOPULATION. Our Corporate Chemical Fathers found a way to get people to flock to “gender clinics” to have themselves chemically sterilized under the ruse of “changing sex.” Because there is no actual sex change taking place. No chromosomes are being altered. Every cell in a person’s body remains their natal sex, no matter what kind of chemically-induced deformities develop that make a person APPEAR to be the opposite sex.


What is taking place at a gender clinic is that men and women, boys and girls, who are uncomfortable with our sex slavery gender role system and who have been led to believe will escape their pain by poisoning and mutilating themselves, are being DE-SEXED. Their ability to develop sexual gametes inside their testes and ovaries is being destroyed by synthetic corporate steroids. Planned Parenthood, which now has banned the use of the word WOMAN when referring to women’s healthcare issues,  is selling cross sex steroids to children because cross sex steroids are BIRTH CONTROL. Every medically transgendered person you see has been sterilized, neutered, rendered unable to bear children. (Except of course for the AGP perverts who get sexual thrills from dressing women’s clothes and going out in public to get a rush from the shock and disgust they see in people’s faces. It’s a sex addiction and they keep their intact penises while gaslighting everyone.)

People are flocking to these clinics to have themselves chemically neutered and paying to have themselves and THEIR CHILDREN sterilized. And any person, but especially any woman, who questions the wisdom of this sadomasochistic crap is subjected to severe sanctions.  

Every time I see a rainbow flag or the baby shower colors of the “tranz” flag, all I can see now are the mastectomy scars on a 12 year old girl.


And now I understand why this has happened and why it will continue and I am no longer going to actively oppose this lemming-like self-destruction. Transgenderism is a big distraction from the fact that we are now in the process of going extinct from carbon pollution. And it really is better if all the “tranz’ victims of the corporate medical system DON’T reproduce. More for me and my own grandkids as we all starve as the entire system collapses.







Today In Female Mindrape: Your Body is What Men And Self-Harming Women Say It Is. No Backtalk, Bitch.

Transgender man who gave birth loses high court privacy ruling

Guardian journalist loses right to anonymity in legal action seeking to be registered as father

Fred McConnell
 When Fred McConnell asked to be registered as the father of the child, the registrar said he could only be registered as the mother. Photograph: Eleni Stefanou

The first transgender man to give birth and seek to be called the child’s father has lost a high court case to protect his privacy despite warning that he and his child could be victimised and bullied as a result.

Fred McConnell, 32, a Guardian multimedia journalist who transitioned from female to male before giving birth in 2018, can now be named as the first person to give birth who wants to be registered as the child’s father.

McConnell had been living as a male for several years, including taking testosterone from the age of 25 and undergoing chest reshaping surgery in Florida, before he sought to get pregnant, which required him to stop taking testosterone.

Prior to attending a fertility clinic he applied for a gender recognition certificate, which was granted before he gave birth. This meant he was legally male when his child was born. But when he went to register the birth and insisted he should be registered as the father, the registrar said he could only be registered as the child’s mother.

McConnell sought a judicial review in the family division of the high court of that decision and during the case, which has yet to conclude, his identity and that of his child were protected by an anonymity order.

However, media organisations requested that order was lifted, arguing that McConnell had been cooperating with a documentary about the conception, pregnancy and birth of his child, using his real name, and that he had been interviewed about his experiences in the Guardian.

The judgment on whether he should be allowed to be called the child’s father is expected later this week.

Lawyers for the Telegraph Media Group, Associated Newspapers, News Group Newspapers and Reach PLC said McConnell had “put himself at the forefront of the debate on transgender rights” and it was legitimate for them to want to name him as claiming the right to be called the child’s father.

They said there was public interest in the question of how the law should recognise transgender parenthood and that it was artificial for the public not to make the link between the man in the documentary exploring the reality of giving birth and the man in court challenging the law.

McConnell’s lawyers had argued that linking his name to the case was unfair given the amount of adverse comment including “insensitive and sarcastic” reporting in Mail Online’s coverage of the anonymised hearings. They warned that he would be the subject of online trolling, doorstepping by the media and other distressing behaviour.

Lawyers representing his child also argued that if the father’s name was known the potential for the child to “be the target of playground bullies was all too plain” and that reporting about the case would not benefit from naming McConnell, while the consequences for the child would be “extreme”.

Responding to the ruling, McConnell said: “Protecting my child has always been and will always be my number one concern. This was the purpose of the anonymity order. Now that my anonymity has been lifted, I embrace the opportunity to draw focus on to the need for equality in this area of the law. All children should be able to have their legal parents correctly and accurately recorded on their birth certificates.”

His legal team said the UK’s system of birth registration does not treat families equally and that unless it is changed McConnell is being forced to register as “mother” on his child’s birth certificate. They said this was the case for all transgender fathers, whether or not they carry their babies, and for transgender women, who are forced to register as “father” in all circumstances.

His lawyer, Karen Holden, said: “Having an accurate birth certificate is vital as it stays with someone for their entire life and forms part of their identity. We took on this case to support changing a part of UK law that denies equality, creates inaccurate documentation and fails to serve multiple groups with the LGBTQ+ community”.

When McConnell was born, his registered gender was female. He realised he was trans in 2010, aged 23, and lived as a male, starting testosterone treatment in April 2013. In 2016, he sought advice from a fertility clinic about getting pregnant and his hormone treatment was suspended, his menstrual cycle restarted and he became pregnant in 2017 through artificial insemination using sperm from a donor.

His case demanding to be registered as the child’s father was heard at the high court in February, but the court reconvened in May after it emerged that McConnell was co-operating with the documentary Seahorse, about the conception, pregnancy and birth, which had been shown at film festivals and is set to be broadcast later this year by the BBC. Throughout he is openly named, but there was no reference to his claim to be registered as the child’s father.


The Cracks in the Edifice of Transgender Totalitarianism

The Cracks in the Edifice of Transgender Totalitarianism



“What we live through, in any age, is the effect on us of mass emotions and of social conditions from which it is almost impossible to detach ourselves. Often the mass emotions are those which seem the noblest, best and most beautiful. And yet, inside a year, five years, a decade, five decades, people will be asking, ‘How could they have believed that?’ because events will have taken place that will have banished the said mass emotions to the dustbin of history.”

–Doris Lessing, Prisons We Choose to Live Inside (1987)

The epidemic of supposed gender dysphoria among children and adolescents—“transgenderism”—has often been described as a cult. The designation is in some ways apt. Though lacking a charismatic leader usually found in such movements, other expert descriptions of cults certainly apply: “designed to destabilize an individual’s sense of self by undermining his or her basic consciousness, reality awareness, beliefs and worldview, [and] emotional control.” Cults also lead the target to believe that “anxiety, uncertainty, and self-doubt can be reduced by adopting the concepts put forth by the group.” The promise is a “new identity” that will solve all problems, even as it separates one from family and previous life.

This is especially true in cases of so-called Rapid Onset Gender Dysphoria, in which previously normal teenagers (usually girls) suddenly announce their desire to transition to the opposite sex. It is readily apparent how a teenager struggling with severe or even common adolescent angst could be lured into such a group.

Perhaps transgenderism is better described as a form of “social contagion.” This term refers to “the spread of ideas, feelings and, some think, neuroses through a community or group by suggestion, gossip, imitation, etc.” The explosion of cases of gender dysphoria, previously an exceedingly rare condition, over the last few years has coincided with a meteoric increase in sympathetic attention to the topic in regular and social media—thus suggesting social contagion. Parents whose children “come out” as transgender when their friends do certainly agree with this explanation.

Individuals who have been ensnared in but escaped from the transgender movement describe it as an ideology, with elements of both the political and the religious. The devotion to the ideology is so deep that, as one psychiatrist describes the mindset, “[a]nyone who hesitates in supporting transition and [sex-reassignment surgery] is a dinosaur committed to an outgrown, inherently discriminatory understanding of trans persons and needs to be defeated in court or in the public arena.”

And yet these descriptions—cult, social contagion, ideology—fail to capture the uniqueness and enormity of what is happening with the transgender movement. Past and current cults have seduced their victims into losing all sense of reality and embracing bizarre and dangerous beliefs; social contagions and mass crazes have affected large groups of seemingly intelligent individuals; ideologies have taken hold that have altered societies and cost lives. But now we are facing something different.

Previous cultish or similar social phenomena have generally been limited to some degree by time, space, or eventual return of the senses. But Western civilization is now gripped by a cultural cyclone that is blowing through such limitations with totalitarian force. Transgenderism has shaken the foundations of all we know to be true. Scientific knowledge is rejected and medical practice co-opted in service of a new “reality”—that “gender” is independent of sex, that males and females of any age, even young children, are entitled to their own transgender self-identification based only on their feelings, and that literally every individual and every segment of society must bow to their chosen identity at risk of losing reputation, livelihood, and even freedom itself.

Remarkably, this revolution is happening without any credible scientific evidence to support it. The concept of changing one’s biological sex is, of course, nonsense, as sex is determined by unalterable chromosomes. An individual can change his hormone levels and undergo surgery to better imitate the opposite sex, but a male on the day of his conception will remain a male on the day of his death. And as discussed below, the idea that there is a real personal trait called “gender” that challenges or invalidates the identity significance of biological sex is equally fallacious. But the absence of genuine evidence is simply ignored, and faux “evidence” is created to validate the mania.

So far. But there are signs of cracks in the grand edifice of transgenderism. As Dr. Malcolm warned in Jurassic Park, “Life finds a way.” So does reality. At some point it will reassert itself, and we will ask how this ever could have happened.

The Science of Sex and Gender Identity

Before exploring the revolution, it is necessary to outline briefly the science in the area of sex and gender identity. According to guidelines of the National Institutes of Health (which itself is currently funding ethically dubious studies related to the treatment of gender-dysphoric patients), grant applicants for health studies must consider sex as a biological variable “defined by characteristics encoded in DNA, such as reproductive organs and other physiological and functional characteristics.” Human sex “is a binary, biologically determined, and immutable trait from conception forward.”

Although certain rare congenital disorders of sexual development (“intersex” disorders) can result in ambiguity about biological sex, there is no “spectrum” of sex along which human beings can be found. Biological sex is binary. According to University of California–Santa Barbara evolutionary biologist Dr. Colin Wright, “The claim that classifying people’s sex upon anatomy and genetics ‘has no basis in science’ has itself no basis in reality, as any method exhibiting a predictive accuracy of over 99.98 percent would place it among the most precise methods in all the life sciences.”

By contrast, “gender identity” is a psychological phenomenon, not an immutable characteristic, and not found anywhere in the body, brain, or DNA. There is no medical test that can detect it. Because twin studies show the infrequency of both genetically identical twins’ suffering gender dysphoria, the condition clearly is not genetic. Nor is there any evidence to support the common claim that a patient has a “girl’s brain in a boy’s body,” or vice versa, as repeated in media sensations such as I Am Jazz. To the contrary, every cell of a male’s brain has a Y chromosome and every cell of a female’s brain has two X chromosomes, which is true regardless of whether the individual “feels like” the opposite sex. Any “evidence” of an innate gender identity is utterly fictitious; to the contrary, there is much unrefuted evidence that various psychological and environmental factors are determinative.

Not only can the feeling change, research shows that it does so in a great majority of cases (at least for child patients). For example, children with gender dysphoria who are allowed to experience natural puberty will come to accept their sex by adulthood in 61 to 98 percent of cases. By contrast, children who are subjected to transitioning treatments such as puberty blockers and cross-sex hormones (discussed below) almost always go on to live as transgender adults. Data on the persistence rate of adult patients is unreliable, primarily because so many patients are lost to follow up. But many of those patients are increasingly seeking medical help to reverse the procedures.

There is no evidence that so-called gender-affirming treatment (GAT) has any positive effect on the long-term psychological well-being of individuals who suffer gender dysphoria. Such people do, in fact, have high rates of suicide before treatment (with the rate of suicide attempts nine times the rate of the general population). But a study from Sweden, a highly “affirming” country for citizens who consider themselves transgender, shows that undergoing GAT does not reduce the suicide rate for these patients. In fact, their rate of completed suicide was found to be 19 times the rate for the general population.

The History of “Gender Identity”

In light of the dearth of credible scientific support, where did the concepts of gender identity and transgenderism come from? Origins rest in a group of “sexologists” of the 1950s, prominent among them German-born endocrinologist Dr. Harry Benjamin and PhD psychologist Dr. John Money.

Until that time, the psychoanalytic professions considered the desire to be a member of the opposite sex as a (rare) disorder to be treated with psychotherapy. Benjamin, however, theorized that this desire indicated “a unique illness distinct from transvestism and homosexuality . . . and not amenable to psychotherapy.” He called this condition “transsexualism” and urged its treatment with “sex reassignment” surgery (a longstanding interest of his, dating back to his early-career fascination with efforts to change surgically the sex of guinea pigs). Perhaps related to his own unsatisfactory personal experience with psychotherapy, “Benjamin forever after deplored psychoanalysis as unscientific.” He thus ignored (according to his own case-history write-ups) blatant signs of psychopathology in the patients whom he treated medically for confusion about their sex.

Like Benjamin, Dr. Money of Johns Hopkins University designated transsexualism a condition to be treated medically rather than psychologically. Money changed the terminology used, co-opting the term “gender” from the realm of grammar (i.e., the classification of nouns by which they are designated masculine, feminine, or neuter, in certain languages), to now mean “the social performance indicative of an internal sexed identity.” In other words, Money decreed that an individual could have a “gender” that differed from his or her biological sex. “Transsexual” thus became “transgender.”

The American College of Pediatricians (ACPeds) describes the linguistic innovation as follows:

From a purely scientific standpoint, human beings possess a biologically determined sex and innate sex differences. No sexologist could actually change a person’s genes through hormones and surgery. Sex change is objectively impossible. [Sexologists’] solution was to hijack the word gender and infuse it with a new meaning that applied to persons.

There is not and never has been any scientific basis for Money’s dichotomy between gender and sex, interpreted as the idea that a person can be born into the “wrong” body. (As pediatric endocrinologist Dr. Quentin Van Meter puts it, “There is zero point zero zero” science behind the concept.) Yet Money’s social–political construct now dominates medicine, psychiatry, academia, and the culture at large.

Money’s enthusiasm for administering irreversible medical treatments to transgender patients led Johns Hopkins to establish one of the earliest programs for that purpose, enlisting psychiatrists, psychologists, endocrinologists, and surgeons. Under their ministrations, patients underwent hormone treatments and surgery to amputate healthy organs and create faux new ones. Despite ethical objections from psychoanalysts and many surgeons (“it is one thing to remove diseased tissue and quite another to amputate healthy organs because emotionally disturbed patients request it”), Johns Hopkins forged ahead with the experimental practice.

Not until 1979 was Johns Hopkins Chief of Psychiatry Paul McHugh―a physician who recognizes the psychological basis of gender dysphoria and who characterizes the possibility of sex change as “starkly, nakedly false”―able to shut down the program. But McHugh is no longer the chief of psychiatry, and the zeitgeist barrels ahead; so “in solidarity with the LGBT community” (note the political language), the program has recently been revived.

Other surgeons and hospitals lacked the scruples of Dr. McHugh. By the early 1970s, so-called sex-reassignment surgery (SRS) was becoming routine, leading the director of the gender-identity clinic at UCLA to declare that “the critical question is no longer whether sex reassignment for adults should be performed, but rather for whom?” Medical institutions have scrambled to add to the proliferation of gender clinics in response to, as admitted by a Dallas endocrinologist, “patient demand” rather than medical necessity.

With respect to what used to be classified as “gender identity disorder” (GID), medical associations have bent to the prevailing political winds. In 2013 the American Psychiatric Association (APA) changed the DSM-5 to replace GID with “gender dysphoria,” a term that now focuses not on the psychological basis for a patient’s rejection of his sex but rather on the distress produced by that rejection. If there is no distress, reasons the APA, there is no problem—it is perfectly normal, and certainly not a “disorder,” for a person to refuse to acknowledge the significance of his or her body. The “stigma” supposedly disappears.

(The APA has so far resisted the demands of some transgender activists to “de-pathologize” the condition completely. The absence of a recognized diagnosis means the absence of insurance coverage. So in the professional literature, transgenderism occupies an uneasy limbo between a psychiatric condition and a normal state of human identity. Someone has to pay for these expensive “re-assignment” procedures.)

The American Psychological Association’s guidelines acknowledge that not all clinicians believe in affirming the beliefs of gender-confused patients (at least when those patients are children), but they largely adopt the agenda of the transgender radicals. The organization states flatly that “gender is a nonbinary construct that allows for a range of gender identities, and that a person’s gender identity may not align with sex assigned at birth.” Having adopted this manifestly unscientific foundation, they go on to build their house of cards around a political rather than medical scaffold.

The political reclassification of gender dysphoria has gone global, with the World Health Organization’s (WHO) May 2019 decision to remove the condition from the list of mental disorders and refer to it as “gender incongruence.” WHO explained this move as necessary to remove discrimination against dysphoric individuals and declared that their right to GAT should be guaranteed.

Transgender Totalitarianism

Transgender orthodoxy (or ideology or theology) has thus seized Western society with absolutely no basis in fact. It is difficult to identify any comparable cultural phenomenon at any point in history. Nations have been engulfed by political movements such as National Socialism, based on fabricated science about racial identities, but those movements were different in kind from the transgender revolution. Even totalitarian political systems are built less on broad citizen acceptance than on the naked power of the armed State. By contrast, transgenderism is defeating reality without firing a shot.

At various points in history, the field of medicine has embraced evidence-free practices, such as lobotomies in the early twentieth century, as has the field of psychotherapy (phrenology, for example). But in none of these cases did the professions as a whole demand absolute acceptance of, and perhaps participation in, the groundless doctrines. Instead, the practices were confined to a narrower group of experimenters who had limited and only temporary success against the reality of science and common sense.

This is not the case with transgenderism. Supposedly sophisticated and highly trained medical professionals across the spectrum now not only ignore the absence of evidence, they deny even facts that have been obvious to every sane human being since creation.

Actual physicians now declare under oath that there is no physical basis for determining whether a human being is male or female. Dr. Deanna Adkins, a professor at Duke University School of Medicine and the director of a new Duke-affiliated gender clinic, testified in a North Carolina court, “From a medical perspective, the appropriate determinant of sex is gender identity. . . . It is counter to medical science to use chromosomes, hormones, internal reproductive organs, external genitalia, or secondary sex characteristics to override gender identity for purposes of classifying someone as male or female.” This would come as a surprise to the millions of doctors and billions of other normal people who have been classifying individuals that way since the beginning of time.

This politically based insistence that black is white has enshrined treatments that are extraordinarily damaging to patient health, both physical and mental. Pediatricians refer dysphoric children to complicit endocrinologists, who administer hormones with harmful and often irreversible consequences, who then refer the children to complicit surgeons, who wield the scalpel to remove healthy organs and create pathetic, non-functioning replicas of others. Psychiatrists or psychologists may be involved, but often only to rubber-stamp the patient’s supposed need for the radical treatments. Gender clinics spring up like mushrooms after a shower of acid rain.

Professional medical societies cower before these activists and create guidelines based not on science but on politics. Dissenting physicians are bullied into silence, leading the outside world to believe the lie that the medical profession as a whole supports the “affirmation” of gender identity as incongruent with biological sex. Medical ethicists muse that physicians’ participation in these schemes should be required as a condition of licensure.

Claiming a place among actual medical societies, and presenting itself as the gold standard in transgender treatment, is the World Professional Association for Transgender Health (WPATH). WPATH purports to be the voice of medical experts on this issue but operates more as a political-advocacy organization―no professional degree of any kind is required for membership. Despite the “all comers” approach to membership, WPATH’s guidelines for treatment are considered gospel in some parts of the medical profession.

A noteworthy aspect of WPATH’s 2011 revision of its Standards of Care was its encouragement of a new paradigm for obtaining informed consent from patients. As described by Dr. Stephen Levine, a psychiatrist at Case Western Reserve University School of Medicine:

[The new model] asserted that patients know best what they need to be happy, generally meaning that patient autonomy is the singular ethical consideration for informed consent. . . . This includes children and adolescents. The mental health professionals’ roles in recognition and treatment of the highly prevalent psychiatric co-morbidities and decisions about readiness were de-emphasized, particularly by the pronouncement that there is nothing pathological about any state of gender expression.

According to WPATH, then, doctors are to sublimate their ethical concerns about treatment of dysphoric patients to the current desires of those patients.

WPATH has spawned USPATH, which openly proclaimed the political mission of its 2017 conference: to “stand as a strong statement of support for continuing the rapid developments in trans health in America, and for the community of health providers, researchers, and advocates who are advancing that care.” At that conference, organizers bowed to threats of violence from transgender radicals and cancelled the appearance of Dr. Kenneth Zucker, a psychologist who takes the apparently loathsome position that patients will generally be happier if they can be reconciled with their biological sex. The only concern among these supposedly objective professionals about how to silence Zucker’s lone skeptical voice was how to do it without getting sued.

Transgender activists in the medical profession go a step further: They even support legislative prohibitions on what they call “conversion therapy.” This means psychiatrists and other psychotherapists are banned from even exploring with a patient the underlying psychological basis for the dysphoria. To paraphrase Johns Hopkins psychiatrist Paul McHugh, referring a gender-dysphoric patient for “affirming” therapy is similar to referring an anorexic patient for liposuction. But doctors in the new gender industry collude with the political gender radicals to ban the very psychiatric treatment that could spare a patient a lifetime of warring with his own body.

Just as history offers no parallel for the moral and professional rot in the medical field, it contains nothing comparable in the wider culture:

• The transgender revolution has captured all categories of government, with legislative, executive, and judicial branches rushing to impose policies preferred by the activists.

• It has captured the media, which dutifully present the radical ideology as the new normal and paint opponents with a hostile tinge. Social-media giants such as Twitter routinely censor any content deemed insensitive to dysphoric people, even a simple statement of truth such as “men aren’t women.”

• It has taken over public and some private schools, from preschool through higher education. If a student claims he’s transgender, he is, and all students and personnel must treat him as a member of his newly chosen sex.

• It has taken over American business, with requirements (sometimes self-imposed, and frequently in response to well-funded bullying) for public pledges of allegiance to the new orthodoxy. Corporations are now urged not only to support the concept but to apply pressure in the public square against dissenters.

• It has corrupted religion, especially mainline Protestantism, by replacing Scriptural teachings with the dogma of narcissistic choice and entitlement.

• It has corrupted athletics, with biological males now allowed to compete against smaller, slower, less muscular women and girls to the inevitable detriment of the female athletes.

• It has corrupted the law, with statutes that were enacted without any thought of gender identity now being interpreted to elevate the “rights” of the dysphoric over those of other citizens. Even the federal statute that was enacted to protect girls’ access to meaningful participation in sports (Title IX) has now been inverted to protect the male invaders of girls’ teams.

• It has corrupted research, with the federal government now funding unethical and unprofessional research projects that are designed to support a particular outcome rather than arrive at scientific truth. Further, it has ginned up outrage at any research that reaches conclusions contrary to transgender dogma.

• It has corrupted language, with demands for false and fabricated pronouns to refer to transgender individuals, and with enforced redefinition of basic terms such as “man,” “woman,” “father,” and “mother.” What even radicals referred to ten years ago as “physical sex” or “biological sex” is now routinely deemed “sex assigned at birth,” as though the attending obstetrician recorded whichever sex first came to mind.

• It has trampled religious freedom, including the rights of couples who wish to adopt or foster children and the organizations that help them. Unless these individuals and organizations agree to speak and act in accordance with transgender mandates—to deny their most fundamental beliefs—they will be forced out of these critical childcare and family-formation programs.

Perhaps most seriously, it has bulldozed the ancient, fundamental rights of parents to protect and guide their children. The Obama administration issued guidance recommending that school officials not notify parents whose child is experiencing gender confusion; and though that guidance is no longer in effect, keeping parents in the dark remains the rule in some states. Parents who do know of the problem but reject the notion that their child is trapped in the wrong body are subjected to emotional blackmail directed by the “experts,” who, of course, profit from this new industry. Warned that without hormones and surgery their child will commit suicide, parents are told bluntly that their choice is between a “live daughter and a dead son,” or vice versa. If they still refuse to consent to what they know will harm their child, the government may strip them of custody. When the medical and governmental establishment excludes the natural protector of a child—the person who knows and loves him more than anyone else on earth—from decisions that can literally ruin the child’s life, civilization itself is undermined.

Trans Kids

During the decades after the widely publicized “sex change” of Christine (né George William) Jorgensen in 1952, medical experimentation in this realm was largely confined to adult patients. There was no serious attempt to medicalize children confused about their sex (to the extent there were such children—statistics from 2011 estimated that only 0.2 to 0.3 percent of the adult population suffered gender dysphoria, so presumably the percentage of children was even smaller). But a particularly disturbing feature of the current transgender mania is the insistence that even very young children can “know” they are of the opposite sex, with the resulting conclusion that they are entitled to medical assistance in permanently transforming their bodies to match their feelings.

The modern treatment regimen for gender-dysphoric children originated with Dr. Norman Spack, a pediatric endocrinologist who founded the nation’s first gender clinic at Boston Children’s Hospital. The process includes potentially four steps: “social transition,” in which the confused child is referred to by a new name and new pronouns and is allowed to dress and otherwise act as a member of the opposite sex; suppression of natural puberty by administering puberty-blockers called GnRH agonists, which supposedly will give the child more time to decide on further transitioning steps before his or her body can develop naturally into sexual maturity; “hormonal transition,” the administration of powerful physiology-manipulating, cross-sex hormones; and then “surgical transition.”

The undisputed physical effects of this GAT are shocking. According to massive research compiled by the American College of Pediatricians, administering cross-sex hormones and puberty-blockers carries enormous risks: heart disease, blood clots, strokes, arrested bone growth, osteoporosis, cancer, crippling joint pain, depression, and suicidal ideation. Interference with normal puberty and sexual maturation, which results from both puberty-blockers and cross-sex hormones, will also cause sterility and permanent sexual dysfunction. These are merely the known effects; because this type of treatment is so new, long-term consequences are unknown. GnRH agonists are not FDA-approved to inhibit normal puberty and are used off-label for this purpose.

The surgery (SRS) is gruesome. Female patients may be given hysterectomies, vaginectomies, and double mastectomies—all of the removed organs, of course, perfectly healthy—and some  surgeons are stripping skin from girls’ forearms to create non-functioning replicas of penises. Sex organs (penis, testicles, scrotum) of a male patient are removed, and a faux vagina is created that must be kept openwith a dilator to prevent the wound from collapsing on itself and healing.

In other words, these “affirming” doctors battle against normal systems of the human body, which retaliates by fighting off the intrusions. Patients will be engaged in this war for the rest of their lives.

An objective observer would assume that doctors who participate in GAT are pushing or overstepping the boundaries of acceptable medical practice, risking discipline from the governing authorities. In the current political environment, not so. In 2017 the Endocrine Society issued guidelines that allow treatment of dysphoric children and adolescents with puberty-blockers and cross-sex hormones despite the known and as yet unknown health risks.

Though the guidelines are replete with admonitions to “monitor” various aspects of the patient’s health during GAT and to involve mental-health professionals in largely unspecified ways, the only thing they advise an endocrinologist not to do is administer puberty-blockers and cross-sex hormones to pre-pubertal children. Otherwise, all bets are off. Even age limits for receiving irreversible cross-sex hormones are flexible, since there may be “compelling reasons” to do this to teenagers younger than sixteen. As long as there is a “multi-disciplinary team” in place to “monitor” the increase in heart attacks and strokes and bone deterioration and malignancies and crippling depression, all should be well.

One of the more disturbing aspects of the Endocrine Society’s subordination of sound medical practice to political demands is its treatment of the permanent sterility that will result if the GAT is fully implemented. The guidelines take a casual approach: “Clinicians should inform pubertal children, adolescents, and adults seeking gender-confirming treatment of their options for fertility preservation.” Nothing about serious counseling to explain the enormity of this decision. No recognition that children and adolescents cannot be expected to grasp it anyway. No, just tell the kids—for whom having children of their own is at this point beyond their imaginations—about “options for fertility preservation.”

The American Society of Plastic Surgeons has not issued ethical guidelines about participating in GAT, but the worldview of this professional organization is evident from its description of these surgical procedures as “gender confirmation” surgery. The Society’s website advertises facial “feminization” or “masculinization” surgery as well as “transfeminization” and “transmasculine” “top” and “bottom” surgery.

As suggested by the Endocrine Society’s guidelines, until recently puberty-blockers were not used before the patient reached age 11, cross-sex hormones before age 16, and surgery before late adolescence or adulthood. But the industry is lowering the ages of administration regardless of what any guidelines recommend. Dr. Johanna Olson-Kennedy, a California pediatrician gaining notoriety for pushing the envelope in this area, altered the protocol for a federal study she is performing to allow administration of cross-sex hormones to children as young as age 8. Double mastectomies are being performed on girls as young as age 13. Stanford University pediatric endocrinologist Dr. Tandy Aye is urging legislative changes to allow adolescent minors to undergo sterilizing surgery, even though the idea that a minor can fully understand the ramifications of sterility is, to say the least, inconsistent with what is known about adolescent brain development. Some surgeons are already performing mutilating surgery on minor boys, arguing that “age is arbitrary” and that teens are better off having the grotesque and painful procedures while they are still at home where their parents can supervise post-operative care. These surgeons claim to perform these permanent, life-altering procedures only on “mature” adolescents. Maturity, of course, is determined by the ideologically driven doctor, and apparently with little or no recognition of the obvious emotional problems of a boy who wants to be castrated.

Presumably medical guidelines will be modified to accommodate the experiments these pioneering practitioners want to perform. As it is, elite transgender doctors such as Olson-Kennedy simply flout the guidelines at will and do whatever they want. One could conclude that the guidelines that do exist are there for appearances only—to help direct inexperienced physicians how to handle these patients in politically correct ways, and to present a veneer of sober reflection to ward off intervention by some professional or governmental body that might actually shut down some of the horrors.

The insistence that children’s feelings be honored, even unto inflicting irreversible treatments and surgeries, is alarming and unprecedented. For good reason children are not allowed to drink, smoke, gamble, vote, drive a car, sign a contract, or access certain entertainment. Nor are they allowed to obtain other medical treatments without parental consent. But powerful adults are arguing that the feelings of children who are too young to buy cough syrup should override all contrary considerations.

Dissent is not tolerated. Anyone—whether parent, physician, teacher, classmate, or other—who questions their decisions is labeled a transphobe, a bigot, and must be silenced.

Why Now?

Why is this happening? Why has a fog of lies descended on entire societies such that even children are being sacrificed to this voracious leviathan?

Volumes will be written about the underpinnings of the mass transgender hysteria. A few considerations:

• The transgender mania naturally results from the relentless march of the sexual revolution. The denial of human nature began with the birth-control pill’s decoupling of sex from reproduction. That led to the separation of sex from marriage, which dissolved restraints on non-marital sexual activity and non-marital childbearing. A family of mother and father was no longer considered necessary for creating children, which meant there was nothing special about the maleness and femaleness of romantic partners. Enter Obergefell, which by discovering homosexual marriage as a constitutional right obliterated even physical, biological distinctions between the sexes. And if there is no meaningful distinction, a human being should not be confined to one sex but rather should be inherently capable of moving between the sexes or stopping somewhere in the middle.

• The mania results from the elevation of the narcissistic autonomous Self, which is entitled to whatever choice it deems desirable at the moment—even a choice that violates physical reality.

• The mania results from the developing concept that patient desire should be the primary if not sole determinant of medical treatment. The WPATH guidelines make clear that the demands of the patient trump the ethical concerns of the physician. Carrying this concept to its logical conclusion, one dysphoric man argued in a chilling essay in The New York Timesthat a doctor should be obligated to provide the mutilating surgery the patient wants to better resemble a woman—even if the patient knows and admits that the surgery will cause great physical harm and will fail to relieve, and perhaps will even increase, his emotional distress. Under such a standard, the physician ceases to be a healer and becomes merely a tool for fulfilling the fevered desires of a troubled patient. And unlike a healer, a tool has no right of conscience, no legitimate basis for refusing to participate in the requested procedures.

• The mania results from the cult of experts. Parents whose every instinct screams that their children need psychotherapy, not GAT, yield to professionals who claim to know better. If the expert says the appropriate treatment is X, then every non-expert is expected to submit without question—even if the folly of the recommended course is a flashing red light.

• The mania results from hubris. One GAT physician describes the heady adulation from desperate patients and families: “Every single encounter is so rewarding. They tell us, ‘You are my hero. You are saving my kid’s life. We don’t know what we would do without you.’” According to researchers who interviewed surgeons involved in the early phases of SRS, the surgery appealed to some physicians’ desire “to prove to themselves that there was nothing they were surgically incapable of performing.” Change a man into a woman or a woman into a man, and ye shall be as gods.

• The mania ultimately results from the decline of religious faith. None of the cultural evolution described above could have happened in a society that still recognized the reality of God, and of biblical and natural law. And to paraphrase Chesterton, the person who does not believe in God believes not in nothing, but rather in anything.

Of course, one should never dismiss the lure of one of the oldest temptations known to humanity: greed. Some professionals in this expanding area of practice no doubt desire to ease the suffering of confused patients. But the health care professionals who have uncritically accepted the quackery of the unholy Money–Benjamin alliance, as well as the pharmaceutical industry that will churn out drugs and hormones which hapless patients must take for a lifetime, will reap the benefits that are projected to hit almost $1 billion by 2024. This kind of reward can go a long way toward easing the twinges of conscience.

Cracks in the Edifice

This bleak picture suggests that humanity has been infected by a monstrous virus that so far has resisted all remedies. But scientific and moral truths can be buried for only so long, and there are signs of their revival.

One encouraging development is the increasing number of physicians publicly proclaiming the nakedness of the transgender emperor. Indeed, that analogy first came from Dr. Paul McHugh writing here in Public Discourse, who has been outspoken against the fallacies and the harm of the transgender revolution.

Other physicians have joined his chorus. From the American College of Pediatricians (established in reaction to the increasingly politicized American Academy of Pediatricians) to individual physicians who speak the truth at no small risk to their careers—see two events hosted by Ryan Anderson at The Heritage Foundation here and here—resistance is growing.

An example is a letter written by five physicians (Drs. Michael Laidlaw, Quentin Van Meter, Paul Hruz, Andre Van Mol, and William Malone) and published in The Journal of Clinical Endocrinology & Metabolism. These physicians challenged the emerging orthodoxy among providers that gender-dsyphoric young patients should be administered GAT, presenting undisputed evidence of our inability to scientifically diagnose the condition, the manifest medical risks of puberty-blockers and cross-sex hormones, and the scientific research supporting alternative treatments. The fact that the Journal was even willing to publish the letter suggests that medical sanity has retreated but not surrendered.

Professionals who are challenging the transgender narrative span the political spectrum. A group called Youth Trans Critical Professionals defines itself as “psychologists, social workers, doctors, medical ethicists, and academics” who “tend to be left-leaning, open-minded, and pro-gay rights.” However, they declare, “we are concerned about the current trend to quickly diagnose and affirm young people as transgender, often setting them down a path toward medical transition.”

Some mental-health professionals are also challenging the legal restrictions on their ability to provide the best care for dysphoric patients. An Orthodox Jewish psychotherapist relies on the First Amendment rights to freedom of speech and religion in his lawsuit to overturn New York’s ban on “conversion therapy.” In Tampa, Florida, a federal magistrate ruled in favor of a similar suit filed by two psychotherapists. Such legal challenges are an encouraging sign that some professionals are willing to do the right thing for patients regardless of the potential harm to their careers.

The credibility of these physicians and other mental-health professionals is bolstered by the witness of doctors who do not necessarily reject the transgender concept outright, but who are troubled by the prevailing ethic that evidence should be replaced by feelings. Physicians such as Case Western Reserve University School of Medicine psychiatrist Dr. Stephen Levine think medical treatment may be helpful in some situations but resist the more radical claims of the gender industry and its allied activists.

Another promising development is the advent of networking groups for parents who have seen the gender madness harm their own children and families. These parents are unwilling to have “experts” tell them things about their children they know are untrue, and rush the kids into medical interventions they know will ruin their children’s lives. Groups such as Transgender Trend4thWaveNow,  and the Kelsey Coalition  (named for the FDA pharmacologist who refused to authorize thalidomide for the market) have organized to help parents resist and defeat the abuse that is being perpetrated on their children. You can read the stories of five such parents here at Public Discourse.

Many of these parents are reacting to the most cult-like aspect of the mania—so-called Rapid Onset Gender Dysphoria, which has gripped their adolescent girls. The parents tell sadly similar stories: The daughter, perhaps struggling with depression or another mental problem, is exposed to transgender ideology through either other individuals or the Internet; she spends hours watching Internet videos about transgenderism and the magical power of GAT to sweep away anxiety; she suddenly decides, perhaps along with friends, that she is transgender; she insists on being evaluated by a “gender specialist,” who agrees with her self-diagnosis and quickly starts her on either puberty-blockers or cross-sex hormones; the specialist ignores information from the parents about other aspects of their daughter’s experience that may be contributing to her delusion; and both the daughter and the specialist warn the parents that she will kill herself if they stand in her way.

But the new networking organizations have enabled parents to understand the scam in its full malevolence and to realize they have allies in their resistance. Like the professionals mentioned above, many of them are not politically conservative. What they all have in common is a recognition of truth, a rejection of lies even when offered by experts, and a fierce determination to protect their kids.

Some government entities have begun to question the skyrocketing numbers of children denying their natal sex. In Great Britain, the Minister for Women and Equalities recently ordered an investigation into why the number of children requesting gender transition increased 4,000 percent in eight years. Even laypeople—even bureaucrats—understand that such a startling surge in dysphoria cannot be occurring naturally. The willingness to examine the issue is another welcome sign that the mania may in some ways be releasing its grip.

In the United States, many government entities have embraced the transgender movement without serious study. But there is at least some sign of a correction there as well. For example, the Trump administration has taken several steps to restore the rule of law in this arena.

One was the February 2017 rescission of the Obama administration’s school “guidance” that expanded the interpretation of “sex” in Title IX to include gender identity. A related development was the Justice Department’s October 2017 announcement that Title VII, which prohibits employment discrimination on the basis of sex, would not be interpreted to apply to actions based on gender identity. Since Congress clearly intended the 1972 (Title IX) and 1964 (Title VII) statutes to cover only biological sex, these steps demonstrated a welcome return to the norms of self-governance.

In May 2019,  the Department of Health & Human Services (HHS) moved toward a scientific definition of  “sex” in federally funded health programs. While the Obama administration had decreed that statutorily prohibited discrimination on the basis of “sex” should encompass discrimination on the basis of “gender identity,” HHS recently issued a proposed rule reversing that expansive and unlawful interpretation. “Sex,” the proposed rule clarifies, will be given its scientific meaning, referring only to demonstrable biological sex rather than to amorphous, changeable feelings of gender identity.

Finally, HHS strengthened enforcement of pre-existing conscience protections for individuals involved in healthcare provision or research. This means these professionals cannot be forced to violate their consciences by participating in GAT or related research.

Although governmental policy could change as soon as the administration does (for example, the so-called Equality Act would cement extraordinarily damaging and totalitarian policy with respect to gender identity), this pushback holds out hope for a future restoration of reality-based policy-making.

Another example of resistance comes from the world of sports. While boys and men who “identify” as female are handily defeating girls and women, notable personalities are taking exception. Tennis legend Martina Navratilova, herself a lesbian and vocal supporter of “gay rights,” called male participation in women’s sports what it is: cheating. The recently organized group Fair Play For Women publicly advocates for the rights of women and girls to meaningful participation in athletics—which means restricting their sports to biologically female athletes.  Every photograph of a bigger and stronger male defeating a girl, and maybe eliminating her opportunity for advancement and scholarships, develops the public understanding that transgenderism incorporates a significant degree of narcissism and unfair entitlement.

Feminists are beginning to recognize the threat of transgenderism not only to fair competition in athletics but to women as a whole (see herehere, and here). If a male is allowed to join the female sex simply by declaring he feels like a woman, is there really such a thing as women? Is there any basis for protecting women in private spaces (such as restrooms and locker rooms), colleges, dormitories, even prisons? Is there any way to ensure that programs designed to help women, such as dedicated loans or set-asides in government contracting, are restricted to actual women?

Transgender radicals are so concerned about the resistance from feminists, especially lesbians, that they have created their own slur to describe the leftist dissidents: Trans-Exclusionary Radical Feminists, or TERFS. The name-calling, however, has not deterred these feminists, who recognize that enshrining legal rights based on gender identity rather than sex “would eliminate women and girls as a coherent legal category, worthy of civil rights protection.”

Perhaps the most powerful voice leading to a restoration of sanity will come from “detransitioners” —individuals who underwent medical transition, realized they had made a tragic mistake, and are now speaking out to warn other victims of the gender industry.

Walt Heyer endured years of gender dysphoria that he now understands was influenced by mistreatment from his grandmother and childhood sexual abuse. As an adult he underwent hormone therapy and surgery and lived for eight years as a woman before de-transitioning. A regular contributor to Public Discourse, Heyer is now in his late 70s and devotes his life to helping other victims recover their authentic lives as he did. His website,, has been accessed by hundreds of thousands of users from 180 countries, and he reports enormously increased traffic as the transgender virus has proliferated.

Other adult detransitioners are similarly outspoken about the folly of “sex change” (see Hacsi Horvath’s scholarly work on transgenderism and Rene Jax’s harrowing account of his experience in Don’t Get on the Plane.) But with some victims, the realization of the truth comes much earlier. More and more adolescents and young adults are speaking out about the mistake they made in transitioning and warning other young people not to be sucked into the cult (see herehere, and here, for example). Although reliable information on the level of regret about GAT is unavailable because so many patients are lost to follow-up (perhaps some to suicide), the more detransitioners speak out, the more will feel comfortable doing so.

The lucky ones are those who got out before surgery or other irreversible treatment. As for the others, perhaps the legal system will eventually provide recompense via malpractice suits. Just as legal liabilitydissuaded psychotherapists from pushing the “recovered memory” theory with troubled patients, the prospect of substantial payout to GAT victims may cause practitioners to think twice.

Is This Time Different?

Every time the forces of the sexual revolution claim another victory—dismantling the norms of sexual morality, or achieving acceptance of homosexual behavior, or imposing same-sex marriage, or coercing third parties to celebrate the latest milestone—individuals of more traditional values think that this time, the radicals have gone too far. Surely this will be the development that swings the pendulum back to basic decency and common sense. But instead, the revolutionaries have pocketed the victory and advanced relentlessly on to the next goal.

But perhaps the transgender movement is different. The damage inflicted by the previous campaigns was real and profound, but it was not immediately obvious. It has taken decades, for example, for the consequences of “anything goes” sexual behavior to become apparent—family disintegration, fatherless and broken children, increased substance abuse and other cultural pathologies—and even now ideologues resist the conclusion that these trends resulted from the cultural shifts they advocated.

By contrast, the damage of transgender affirmation is immediate and apparent. The medical harm alone is undeniable, and the mental anguish festers and grows. The affected children and adolescents, especially, become the walking wounded whose shattered lives testify to the abuse inflicted by “experts” who profit from their misery. The voices of detransitioners penetrate the politically correct chatter to warn that what’s happening is destroying lives, here and now.

Hacsi Horvath, an adjunct Lecturer in the Department of Epidemiology and Biostatistics at the University of California at San Francisco, has written at length on the bizarre acceptance of the fantastical concept of gender identity:

In my opinion—which is based upon extensive research, as well as  my own 13-year-long experience in pretending to be a woman—GD  is only superficially concerned with one’s sex. It’s more a disturbance of identity . . . . There is absolutely no good reason why gender dysphoria has essentially been excluded from 15 years of research in new “transdiagnostic” approaches to treating people with depression and anxiety disorders. . . . GD is not sui generis, unique, super-special! It is well within the spectrum of conditions efficaciously treated with transdiagnostic approaches. It is as though the “transition” promoters of mainstream transgenderism had some kind of racket going on.

Fellow survivor Walt Heyer pulls no punches in describing the enablers of the transgender mania. Especially with respect to affirming the false beliefs of minors, he says:

This is child abuse. . . . We are manufacturing transgender kids. We are manufacturing their depression, their anxiety, and it’s turned into a huge industry that people are profiting from after kids’ lives are completely torn apart.

He concludes: “There is absolutely nothing good about affirming somebody in a cross-gender identity because it destroys their life. . . . It’s insanity.”

The transgender castle that radicals have constructed by sheer force of will is built on shifting sand without supports of any kind. The wave that will sweep it away is gaining strength. May the time come soon when we will all say, with observers of past hysterias, “How could we have believed that?”

The Hormone Health Crisis | with Endocrinologist William Malone, MD


The Hormone Health Crisis | with Endocrinologist William Malone, MD

This is about the ethical concerns that doctors are confronting in the corporate push to medicalize  the emotional pain caused by our sadistic gender role hierarchy. If the SHOE (sex role stereotypes) doesn’t fit, capitalist medicine wants you to maim the FOOT to fit.


I’m a Pediatrician. How Transgender Ideology Has Infiltrated My Field and Produced Large-Scale Child Abuse.

trans_childrenI’m a Pediatrician. How Transgender Ideology Has Infiltrated My Field and Produced Large-Scale Child Abuse.

Professionals who question the unscientific party line of supporting gender transition therapy could find themselves out of a job.

Michelle Cretella | July 5, 2017

Transgender politics have taken Americans by surprise, and caught some lawmakers off guard.

Just a few short years ago, not many could have imagined a high-profile showdown over transgender men and women’s access to single-sex bathrooms in North Carolina.

But transgender ideology is not just infecting our laws. It is intruding into the lives of the most innocent among us—children—and with the apparent growing support of the professional medical community.

As explained in my 2016 peer reviewed article, “Gender Dysphoria in Children and Suppression of Debate,” professionals who dare to question the unscientific party line of supporting gender transition therapy will find themselves maligned and out of a job.

I speak as someone intimately familiar with the pediatric and behavioral health communities and their practices. I am a mother of four who served 17 years as a board certified general pediatrician with a focus in child behavioral health prior to leaving clinical practice in 2012.

For the last 12 years, I have been a board member and researcher for the American College of Pediatricians, and for the last three years I have served as its president.

I also sat on the board of directors for the Alliance for Therapeutic Choice and Scientific Integrity from 2010 to 2015. This organization of physicians and mental health professionals defends the right of patients to receive psychotherapy for sexual identity conflicts that is in line with their deeply held values based upon science and medical ethics.

I have witnessed an upending of the medical consensus on the nature of gender identity. What doctors once treated as a mental illness, the medical community now largely affirms and even promotes as normal.

Here’s a look at some of the changes.

The New Normal

Pediatric “gender clinics” are considered elite centers for affirming children who are distressed by their biological sex. This distressful condition, once dubbed gender identity disorder, was renamed “gender dysphoria” in 2013.

In 2014, there were 24 of these gender clinics, clustered chiefly along the east coast and in California. One year later, there were 40 across the nation.

With 215 pediatric residency programs now training future pediatricians in a transition-affirming protocol and treating gender-dysphoric children accordingly, gender clinics are bound to proliferate further.

Last summer, the federal government stated that it would not require Medicare and Medicaid to cover transition-affirming procedures for children or adults because medical experts at the Department of Health and Human Services found the risks were often too high, and the benefits too unclear.

Undeterred by these findings, the World Professional Association for Transgender Health has pressed ahead, claiming—without any evidence—that these procedures are “safe.”

Two leading pediatric associations—the American Academy of Pediatrics and the Pediatric Endocrine Society—have followed in lockstep, endorsing the transition affirmation approach even as the latter organization concedes within its own guidelines that the transition-affirming protocol is based on low evidence.

They even admit that the only strong evidence regarding this approach is its potential health risks to children.

The transition-affirming view holds that children who “consistently and persistently insist” that they are not the gender associated with their biological sex are innately transgender.

(The fact that in normal life and in psychiatry, anyone who “consistently and persistently insists” on anything else contrary to physical reality is considered either confused or delusional is conveniently ignored.)

The transition-affirming protocol tells parents to treat their children as the gender they desire, and to place them on puberty blockers around age 11 or 12 if they are gender dysphoric.

If by age 16, the children still insist that they are trapped in the wrong body, they are placed on cross-sex hormones, and biological girls may obtain a double mastectomy.

So-called “bottom surgeries,” or genital reassignment surgeries, are not recommended before age 18, though some surgeons have recently argued against this restriction.

The transition-affirming approach has been embraced by public institutions in media, education, and our legal system, and is now recommended by most national medical organizations.

There are exceptions to this movement, however, in addition to the American College of Pediatricians and the Alliance for Therapeutic Choice. These include the Association of American Physicians and Surgeons, the Christian Medical & Dental Associations, the Catholic Medical Association, and the LGBT-affirming Youth Gender Professionals.

The transgender movement has gained legs in the medical community and in our culture by offering a deeply flawed narrative. The scientific research and facts tell a different story.

Here are some of those basic facts.

1. Twin studies prove no one is born “trapped in the body of the wrong sex.”

Some brain studies have suggested that some are born with a transgendered brain. But these studies are seriously flawedand prove no such thing.

Virtually everything about human beings is influenced by our DNA, but very few traits are hardwired from birth. All human behavior is a composite of varying degrees for nature and nurture.

Researchers routinely conduct twin studies to discern which factors (biological or nonbiological) contribute more to the expression of a particular trait. The best designed twin studies are those with the greatest number of subjects.

Identical twins contain 100 percent of the same DNA from conception and are exposed to the same prenatal hormones. So if genes and/or prenatal hormones contributed significantly to transgenderism, we should expect both twins to identify as transgender close to 100 percent of the time.

Skin color, for example, is determined by genes alone. Therefore, identical twins have the same skin color 100 percent of the time.

But in the largest study of twin transgender adults, published by Dr. Milton Diamond in 2013, only 28 percent of the identical twins both identified as transgender. Seventy-two percent of the time, they differed. (Diamond’s study reported 20 percent identifying as transgender, but his actual data demonstrate a 28 percent figure, as I note here in footnote 19.)

That 28 percent of identical twins both identified as transgender suggests a minimal biological predisposition, which means transgenderism will not manifest itself without outside nonbiological factors also impacting the individual during his lifetime.

The fact that the identical twins differed 72 percent of the time is highly significant because it means that at least 72 percent of what contributes to transgenderism in one twin consists of nonshared experiences after birth—that is, factors not rooted in biology.

Studies like this one prove that the belief in “innate gender identity”—the idea that “feminized” or “masculinized” brains can be trapped in the wrong body from before birth—is a myth that has no basis in science.

2. Gender identity is malleable, especially in young children.

Even the American Psychological Association’s Handbook of Sexuality and Psychology admits that prior to the widespread promotion of transition affirmation, 75 to 95 percent of pre-pubertal children who were distressed by their biological sex eventually outgrew that distress. The vast majority came to accept their biological sex by late adolescence after passing naturally through puberty.

But with transition affirmation now increasing in Western society, the number of children claiming distress over their gender—and their persistence over time—has dramatically increased. For example, the Gender Identity Development Service in the United Kingdom alone has seen a 2,000 percent increase in referrals since 2009.

3. Puberty blockers for gender dysphoria have not been proven safe.

Puberty blockers have been studied and found safe for the treatment of a medical disorder in children called precocious puberty (caused by the abnormal and unhealthy early secretion of a child’s pubertal hormones).

However, as a groundbreaking paper in The New Atlantis points out, we cannot infer from these studies whether or not these blockers are safe in physiologically normal children with gender dysphoria.

The authors note that there is some evidence for decreased bone mineralization, meaning an increased risk of bone fractures as young adults, potential increased risk of obesity and testicular cancer in boys, and an unknown impact upon psychological and cognitive development.

With regard to the latter, while we currently don’t have any extensive, long-term studies of children placed on blockers for gender dysphoria, studies conducted on adults from the past decade give cause for concern.

For example, in 2006 and 2007, the journal Psychoneuroendocrinology reported brain abnormalities in the area of memory and executive functioning among adult women who received blockers for gynecologic reasons. Similarly, many studies of men treated for prostate cancer with blockers also suggest the possibility of significant cognitive decline.

4. There are no cases in the scientific literature of gender-dysphoric children discontinuing blockers.

Most, if not all, children on puberty blockers go on to take cross-sex hormones (estrogen for biological boys, testosterone for biological girls). The only study to date to have followed pre-pubertal children who were socially affirmed and placed on blockers at a young age found that 100 percent of them claimed a transgender identity and chose cross-sex hormones.

This suggests that the medical protocol itself may lead children to identify as transgender.

There is an obvious self-fulfilling effect in helping children impersonate the opposite sex both biologically and socially. This is far from benign, since taking puberty blockers at age 12 or younger, followed by cross-sex hormones, sterilizes a child.

5. Cross-sex hormones are associated with dangerous health risks.

From studies of adults we know that the risks of cross-sex hormones include, but are not limited to, cardiac disease, high blood pressure, blood clots, strokes, diabetes, and cancers.

6. Neuroscience shows that adolescents lack the adult capacity needed for risk assessment.

Scientific data show that people under the age of 21 have less capacity to assess risks. There is a serious ethical problem in allowing irreversible, life-changing procedures to be performed on minors who are too young themselves to give valid consent.

7. There is no proof that affirmation prevents suicide in children.

Advocates of the transition-affirming protocol allege that suicide is the direct and inevitable consequence of withholding social affirmation and biological alterations from a gender-dysphoric child. In other words, those who do not endorse the transition-affirming protocol are essentially condemning gender-dysphoric children to suicide.

Yet as noted earlier, prior to the widespread promotion of transition affirmation, 75 to 95 percent of gender-dysphoric youth ended up happy with their biological sex after simply passing through puberty.

In addition, contrary to the claim of activists, there is no evidence that harassment and discrimination, let alone lack of affirmation, are the primary cause of suicide among any minority group. In fact, at least one study from 2008 found perceived discrimination by LGBT-identified individuals not to be causative.

Over 90 percent of people who commit suicide have a diagnosed mental disorder, and there is no evidence that gender-dysphoric children who commit suicide are any different. Many gender dysphoric children simply need therapy to get to the root of their depression, which very well may be the same problem triggering the gender dysphoria.

8. Transition-affirming protocol has not solved the problem of transgender suicide.

Adults who undergo sex reassignment—even in Sweden, which is among the most LGBT-affirming countries—have a suicide rate nearly 20 times greater than that of the general population. Clearly, sex reassignment is not the solution to gender dysphoria.

Bottom Line: Transition-Affirming Protocol Is Child Abuse

The crux of the matter is that while the transition-affirming movement purports to help children, it is inflicting a grave injustice on them and their nondysphoric peers.

These professionals are using the myth that people are born transgender to justify engaging in massive, uncontrolled, and unconsented experimentation on children who have a psychological condition that would otherwise resolve after puberty in the vast majority of cases.

Today’s institutions that promote transition affirmation are pushing children to impersonate the opposite sex, sending many of them down the path of puberty blockers, sterilization, the removal of healthy body parts, and untold psychological damage.

These harms constitute nothing less than institutionalized child abuse. Sound ethics demand an immediate end to the use of pubertal suppression, cross-sex hormones, and sex reassignment surgeries in children and adolescents, as well as an end to promoting gender ideology via school curricula and legislative policies.

It is time for our nation’s leaders and the silent majority of health professionals to learn exactly what is happening to our children, and unite to take action.

Tips for raising a transgender child

52676600_606372733167830_2444819067056422912_oI took a break from monitoring the expansion of the sadomasochistc gender cult in Iowa City, but I picked up an issue of the trans rag, The Real Mainstream, that is published here and distributed in kiosks and the library and this story reached out and slugged me in the jaw. Fuck this shit. This is eugenic child abuse. Why won’t people wake up and see what these monsters are selling to the public?


“When I grow up, I want to be a girl.”

Genevieve Carter (not her real name) is, in many ways, a typical nine-year-oldthird-grader. She loves gymnastics and math, and is the embodiment of childhood enthusiasm. Her thick brown hair falls below her shoulders, and her bright smile frequently lights up her face.

She is also transgender.

“She used to say she wanted to be a builder,” her mom, Louisa, says. “Then she started saying she wanted to be a girl when she grew up.”

This was three years ago, while Genevieve was in Kindergarten. That summer, Genevieve’s parents started letting her choose whether to dress as a boy or a girl. She always picked to be a girl, and has been known as one ever since.

“Children as young as 2-4 likely have a concept of their gender identity.” Says Dr. Katie Imborek, medical director of the University of Iowa Health Care Offsite Primary Care and co-director of the UI Health Care LGBTQ Clinic. “It is not uncommon to see children this young displaying gender non-conforming behaviors. However, they may be somewhat older before they have dysphoria related to the way that they wish to express or practice their gender.”

“I never felt perfect.” Genevieve said. “I always felt that something was wrong, that something was missing.”

After attending kindergarten as a boy, Genevieve started first grade as a girl. Louisa met with the school over the summer and later with the teachers to make sure they understood and to answer any questions they might have.

“Public schools cannot discriminate against your child for being transgender.” Says Max Mowitz, Program Coordinator at One Iowa. “In Iowa, they are protected under the Civil Rights Act.”

If your family lives in a very non-affirming town, Mowitz says, ask the child what he/she/they wants. Most would rather be out, even knowing the backlash they might face.

The first thing to do when your child has told you he/she/they might be transgender is to start going to therapy/counseling. Not because it is a mental health issue, but so the child can talk about it with a professional. Make sure the mental health professional is LGBTQ affirming. Family therapy is a good first step to deciding how to support your transgender child.

Louisa explains that it is important for the parents to see a therapist as well. “Many parents feel a sense of loss. It is a valid feeling, but you need to make sure not to show it to your child, but to deal with it with a therapist instead.”

She also says parents may need to work on coming to terms with the fact that their child is looking and sounding different. “Make sure not to misgender them.” She adds.

“Discuss it with your pediatrician or family medicine provider.” Says Imborek. “You want a referral to a pediatric endocrinologist who can discuss options of puberty blocking medications, usually around the age of 9-14.”

Genevieve has an appointment every year to discuss how things are going for her. Her family is on the lookout for signs of puberty so she can get the hormone blocking shots.

Some adults worry a child might believe they are transgender, then change their mind after taking the puberty blocking medications. There is a small number of children to whom this does happen, but the hormone shots are not permanent changes.

The puberty-blocking medications prevent the child from the traumatic experience of going through puberty as the gender with which they do not identify. Experts agree that kids who grow up in the gender with which they identify have fewer mental health challenges than those who grow up as the wrong gender.

In the early stages of your child expressing their gender identity, parents may struggle with allowing them to express themselves. If your son starts painting his nails, you may worry they may be bullied because of it and want them to stop. “It is difficult to risk your child getting bullied.” Mowitz told me. “But it is more difficult for your child not to do it.”

“I got teased in Kindergarten for having girly stuff.” Genevieve explained. “I had a My Little Pony lunchbox and backpack. But I told a teacher and the girl was told to stop.”

“Your child will experience bullying from internalized homophobia and transphobia.” Mowitz explained. “The best thing you can do for them is to be supportive and affirming of who they are.”

As a parent, you may be LGBTQ-affirming in a general sense, yet still struggle with a transgender child. “You need to understand your own stance and then be their ally.” Mowitz says. “Speak up if you hear transphobic comments, and hold family and friends accountable.”

Genevieve’s only worries right now, as a nine-year-old transgender girl, are that she can’t “make a baby,” and that when she gets to dating age, people might “freak.”

But Genevieve also says she knows she has a good support system, and they will help her through it.

“I feel better than I did [when I was a boy]. Some days I actually feel perfect; I don’t feel like anything is missing.”



“JAZZ” after his castration surgery to cxreate a fake vagina



Of course they will never allow my comment to be viewed, but this is the comment that I left: ” In a short time, this androcratic sado-religious practice will be revealed for what it is, eugenic sterilization and mutilation of gender non-conforming children. For the sake of profits for the medical cartel. Expect massive lawsuits. This insane practice does absolutely NOTHING to break down the sexual power hierarchy that creates the hallucination we call gender, in fact, it forces gender conformity through mutilation of healthy children’s sexual organs, along with experimental poisoning with drugs that have never been tested for safety in kids. These kids are the guinea pigs. Shame on all of you for promoting this horror.”


No child should ever have this done to them. What the hell is wrong with people?



The Corporate Takeover of The Gay Rights Movement


FOLLOW THE MONEY. Who benefits from the medical eugenic abuse of children?

Michael Biggs, Department of Sociology, University of Oxford

Focus of British organizations: StonewallEquality NetworkLGBT Youth Scotland
Focus of U.S. organizations: Human Rights CampaignGLAAD
British grants: Big Lottery FundBBC Children in Need
Revenue of British organizations: Mermaids.


Source: Stonewall’s annual reports to the Charity Commission.
Method: Adobe’s advanced search used to count the number of whole words in each pdf document: (1) lesbian, lesbians; (2) gay; (3) bi, bisexual, bisexuals; (4) trans, transgender, transsexual, transsexuals.
Source: Equality Network’s annual reports to Companies House.
Method: A Scottish feminist counted the number of words in each document: (1) lesbian, lesbians; (2) gay; (3) bi, bisexual, bisexuals; (4) trans, transgender, transsexual, transsexuals.
Source: HRC’s annual reports.
Method: Adobe’s advanced search used to count the number of whole words in each pdf document: (1) lesbian, lesbians; (2) gay; (3) bi, bisexual, bisexuals; (4) trans, transgender, transsexual, transsexuals.
LGBT_wordsDCprotest (1).png
ource: GLAAD’s annual performance reports.
Method: Adobe’s advanced search used to count the number of whole words in each pdf document: (1) lesbian, lesbians; (2) gay; (3) bi, bisexual, bisexuals; (4) trans, transgender, transsexual, transsexuals.

Source: Database on 360 Giving. All grants from Big Lottery Fund whose title or description includes: lesbian OR gay OR bisexual OR transgender OR transsexual OR LGBT OR LGBTQ.
Method: Sum of the value for grants whose description contains the specified text string. Description missing for some grants in 2014 and earlier years.


Source: BBC Children in Need, Grant Funded Projects … as at November 2017.
Method: Grants identified by searching each document for the following words: lesbian, gay, bisexual, trans.


Source: Mermaids’ annual reports to the Charity Commission; reports for previous incarnation (charity number 1073991) obtained from the Charity Commission under Freedom of Information.
Method: Income deflated by Consumer price inflation time series.

Michael Biggs, Department of Sociology, University of Oxford

Caveat Magister: Even Medical Professors Must Not Say Politically Incorrect Things

Caveat Magister: Even Medical Professors Must Not Say Politically Incorrect Things


How far has the United States gone down the road of punishing people for uttering politically incorrect thoughts? Very far indeed, as an incident at the University of Louisville shows. Yes, we know that faculty in the “soft” fields of the social sciences endanger their careers if they happen to say something that upsets someone of “progressive” sensibilities, but the Louisville case involves a (formerly) esteemed medical school professor.

Evidently, no one is safe from the PC enforcers.

Dr. Allan Josephson has been in medical practice since 1976, specializing in childhood psychology.  In 2003, has was chosen to be the chief of the University of Louisville Medical School’s Division of Child and Adolescent Psychiatry and Psychology. Over the years, he greatly improved the reputation of the Division, enlarging its faculty, securing grants, expanding programs, and serving more patients. He published extensively and his annual reviews were flawless.

But in the autumn of 2017, the university’s previously cordial relationship with Josephson took a U-turn when medical school officials learned that he had spoken about gender dysphoria in youth at an event hosted by the Heritage Foundation.

Josephson was one of three panelists. In his remarks, which are cited in the complaint he has filed against the university, he said that “Gender dysphoria is a socio-cultural, psychological phenomenon and cannot be fully addressed through medicine and surgery,” that the current treatment “neglects the developmental needs of children and relies on ideas that are not true,” that “the notion that gender identity should trump chromosomes, hormones, reproductive organs…when classifying individuals is counter to medical science,” and that “transgender ideology neglects the child’s need for developing coping and problem-solving skills necessary to meet developmental challenges.”

In sum, Josephson, along with the other two panelists, dissented from the idea that children expressing gender dysphoria should be accommodated (such as being allowed to use locker rooms of their preferred rather than their biological sex) and treated with puberty-blocking drugs.

Subsequently, Heritage published a record of the event and it came to the attention of two officials at Louisville’s LGBT Center. While not medical doctors, those individuals strenuously objected to Josephson’s remarks and contacted Christine Brady, an assistant professor in the Division. The two LGBT officials demanded to know what punitive action the Division would take against Josephson.

Now that he was the focus of attention, Josephson’s opponents dug and found that his “offenses” weren’t limited to his remarks at the Heritage event, but that he had also served as an expert witness in some legal cases, arguing against the prevailing ideology about gender dysphoria. That spurred Brady to meet with Josephson in November 2017.

At the meeting, Brady declared that Josephson was “hostile” to treating gender dysphoria and couldn’t be trusted with gender dysphoria patients—even though she had only three years of clinical experience, compared to Josephson’s 35. She further claimed that Josephson was guilty of “discrimination” against children claiming gender dysphoria because of his belief that young children lack the cognitive maturity to say that he or she is “really” a member of the opposite sex.

To the LGBT people, Brady, and several other university officials, Josephson was wrong.  They weren’t interested in understanding why he held the ideas he did and certainly not in respecting his expertise. They regarded him as persona non grata and set about punishing him for holding incorrect views about gender dysphoria. One professor demanded that he apologize to the university for his expert testimony and his Heritage remarks and that he hire a public relations firm to counter the “damage” he had done.

Supposedly erroneous views aren’t countered with reason but are crushed with power.

Late in November, two of the university officials decided to demote Josephson from division chief. A letter was sent to him instructing him to submit his resignation by December 4th. The grounds given for this demand was that “the majority of Division faculty disagrees with your approach to management of children and adolescents with gender dysphoria.”

Science and medicine have always advanced on the basis of evidence, not majority belief, but that has changed in our era of political correctness. Supposedly erroneous views aren’t countered with reason but are crushed with power.

Josephson did submit the forced resignation letter but stayed on to fulfill his contract. For the next year, he suffered repeated disparagement and humiliation at the hands of the defendants. His salary was reduced, his travel budget slashed, he was stripped of all leadership activities in the Division, and his workload increased to a level commensurate with junior faculty status.

Nevertheless, Josephson continued doggedly working in the division until February 25th of this year. On that date, he was summoned to the office of Jennifer Le, who had taken over as division chief. He thought the reason for the meeting was to discuss his 2018 evaluation but instead found that the meeting had a different purpose. He was informed that his contract would not be renewed after it expired on June 30th. When Josephson asked why, he was merely told that the Division had “decided to go in a different direction.”

Never once during Josephson’s career at Louisville had the school refused to renew the contract of a faculty member in the Division. But he had made enemies who were intent on getting rid of him. His medical judgment put him on the wrong side of an ideological divide and therefore his presence on the faculty was no longer tolerable.

In their zeal to punish Josephson, however, the university officials involved forgot to consider the possible legal consequences. A public institution, the University of Louisville is obliged to respect the constitutional rights of individuals. With the aid of the Alliance Defending Freedom (ADF), Josephson has filed suit against the university, arguing that its treatment of him violated his rights under the First and Fourteenth Amendments.

The First Amendment does not allow public officials to take retaliatory action against an employee just because those officials dislike the content of that employee’s speech. Also, by punishing Josephson under vague and overly broad standards, the university has violated his right to due process of law under the Fourteenth Amendment.

Josephson is asking for a renewal of his contract and reinstatement as division chief, that his personnel file be purged of references to his demotion and firing, for compensatory and punitive damages for the violation of his rights, and for his legal fees and costs. ADF has successfully brought many other suits against public universities for violating the rights of students and professors and eagerly took this one.

“Universities are supposed to be a marketplace of ideas, but the University of Louisville is turning itself into an assembly line of one thought,” ADF senior counsel Travis Barham said.

The complaint demands a jury trial, and if the case goes before one, there’s a strong likelihood that the “let’s get rid of this heretic” mentality of several university officials will cost the school a great deal of money.

Teachers shouldn’t have to be wary about what they say, but in America these days, they do.

George Leef is the director of editorial content at the James G. Martin Center for Academic Renewal

“Gender therapy” doctor admits to advising kids to fake being suicidal to get transgender “treatments”

“Gender therapy” doctor admits to advising kids to fake being suicidal to get transgender “treatments”

By Jonathon Van Maren

wallace-960x480Earlier this year, I noted that transgender activists were going to use data on the suicide rate in the transgender community to go after schools they consider insufficiently supportive of their ideological agenda, despite the fact that there is no evidence that physical transition actually reduces suicidal ideation. As it turns out, there are some medical quacks willing to go quite a bit further in their crusade to assist young children in the transition process, including a psychologist from British Columbia, Canada:

Dr. Wallace Wong…is facing calls for an inquiry into the conduct of his practice. On February 28…Wong spoke at an event hosted by Vancouver Public Library. In a tape of the event obtained by Canadian pro-family group Culture Guard, Wong is heard proudly describing the scope of his children-only “gender therapy” practice, noting that his youngest client is not yet three years old and that he has 501 orphans and foster kids in his local practice.

If true, this indicates Wong has likely used his relationship with the BC Ministry of Children and Family to diagnose more than 10 to 20 percent of local children in government care as needing his “gender therapy,” according to Culture Guard President Kari Simpson.

In Wong’s own words, his practice began in 2010 with just “four clients at the ministry” but in the course of nine years, there was such an enormous surge of need within that population that he now has “more than 500 kids, [with] just the Ministry alone…. So we can imagine the demand of service is soaring…. The phenomenon is happening a lot faster than – than we expected.”

Simpson expressed outrage at this “soaring” demand, claiming Wong was “gender-jacking” vulnerable children from the Ministry and “profiting” handsomely into the bargain.

Wong also had some startling advice for a parent seeking to get a child referred to his program. Although the questioner had not indicated any particular urgency, Wong explained that parents should exaggerate the severity of their child’s condition to their local health offices.

Wong said a suicide threat was an effective means of accomplishing this goal. While Wong framed the matter as the government’s fault and explained to his audience that it is “up to us as advocates” to change the situation, his message could not have been lost on anyone present.

“So what you need is, you know what? Pull a stunt. Suicide, every time, [then] they will give you what you need,” Wong said, adding that gender-dysphoric kids “learn that. They learn it very fast.”

This is a revealing, although unsurprising, admission, and I’m glad that it was caught on tape. Suicidal ideation has long been a preferred tactic of progressives in the culture wars—not only is it used in the transgender context to achieve their goals, but they also claim that any failure to implement LGBT programming in schools and other institutions is sure to cause suicides amongst gay and lesbian youth. Suicidal ideation has even been used in the abortion fight—Irish courts first permitted abortion in limited circumstances when faced with the hypothetical of women promising to commit suicide if they were refused abortions.

Dr. Wallace Wong is a hero in the transgender community because he helps them get what they want, regardless of whether he has to brazenly lie to do so. He does this while claiming that parents who do not whole-heartedly embrace physical transition for their children pose a threat to their own sons and daughters. These facts appear to indicate that the very opposite is true

Gender Dysphoria and Surgical Abuse

Gender Dysphoria and Surgical Abuse

trans teenIn recent years, the issue of transgender identity in children has leapt from the periphery of public consciousness to centre stage of a cultural drama played out in the media, courts, schools, hospitals, families, and in the minds and bodies of children. It is a kind of utopian religion with committed believers.

The drama is “gender dysphoria” and it is about children believing they belong to the opposite sex[1]. It is about parental anguish and commitment, court battles to instigate some therapies, laws to prevent others, cross-dressing, drugs that will block puberty, others that will transform an adolescent towards the opposite sex, pending feats of surgery that will castrate while turning a penis into an opening like a vagina, or producing a penis from a forearm in a foray into reproduction unrivalled since the days of eugenics. It is no wonder this drama is repeated on the media, especially as its players may be toddlers whose future is in the hands of the audience. Accept the pathways of “medicine”, we are urged. Welcome transgender as but one hue in a natural rainbow. Or the children will kill themselves[2].

But is this massive intrusion into the minds and bodies of children necessary? What will happen if parents do nothing but “watch and wait” while their child muses on its gender? Can the child grow out of it?

The answer astonishes. While proponents argue for massive intervention, scientific studies prove that the vast majority of transgender children will grow out of it through puberty if parents do little more than gently watch and wait. Studies vary but from 70 to 97.8 per cent of gender-dysphoric male and 50 to 88 per cent of gender-dysphoric female children have been reported to “desist” prior to the onset of puberty. This likelihood of “growing out of it” is declared in no less than the current, official Diagnostic and Statistical Manual of Mental Disorders of the American Psychiatric Association[3] (DSM-5), and is supported by a number of independent studies[4][5].

The Western medical profession boasts that it rests on “evidence-based medicine” but the tiny fraction involved with “affirmation” of gender identity in confused children is proceeding without supportive evidence for claims of high incidence, the need and safety of medical and surgical intervention, the avoidance of self-harm, and for the concept that the process will produce a happier human being in a happier society. Faith is needed for affirmation.

During a discussion on these matters, a leading endocrinologist declared to this writer, twice, that the issues of gender dysphoria are “utterly arbitrary … utterly arbitrary”, and that his greatest fear was that a mistake would be made by intervention. If most gender-dysphoric children desist without treatment, the “utterly arbitrary” medical pathways are also utterly unnecessary.

How common is childhood gender dysphoria?

No one really knows because there is “an absence of formal prevalence studies”[6][7] and estimates vary greatly. The leader of Toronto’s Transgender Youth Clinic at the Hospital for Sick Children, Dr Joey Bonifacio, says estimates based on adult dysphoria clinics range from 0.005 to 0.014 per cent for men convinced they are women and 0.002 to 0.003 per cent for women convinced they are men, but believes they are “likely modest underestimates”[8]. Bonifacio’s statistics are the same as those declared in the bible of psychiatry, DSM-5[9].

In Australia, prominence has been given to a cross-sectional questionnaire distributed to 8500 adolescents in New Zealand (“Youth 12”) which reported 1.2 per cent answered “Yes” to the question, “Do you think you are transgender? This is a girl who feels like she should have been a boy, or a boy who feels like he should have been a girl.” 95 per cent denied being transgender, 2.5 per cent replied they were “unsure”, and 1.7 per cent “did not understand” the question. The estimate of 1.2 per cent is promoted by leaders of the gender dysphoria service at Melbourne Children’s Hospital[10], but the progenitors of the “Safe Schools” program appear to have inflated the figure to 4 per cent by adding the unsure 2.5 per cent.[11]

Results of such tick-in-the-box questionnaires are unreliable. According to DSM-5, childhood gender dysphoria can only be diagnosed if there is “a marked incongruence” between natal and perceived gender lasting “at least six months”, “manifested by at least six” features, including “a strong desire … and insistence”, together with a “strong preference” for the company, clothing and toys of the opposite sex and its role in fantasy play, and associated with rejection of the stereotypes of its natal sex, including anatomy. Also, to comply with “dysphoria”, there should be “significant distress or impairment … in functioning”.

The unreliability of such questionnaires is emphasised in the Journal of Homosexuality in its consideration of the prevalence of suicide in sexual minorities[12]. It warns that conclusions are limited because they are based on “retrospective” data, “do not effectively allow cause and effect relationships to be discerned” including “co-occurring mental disorders”, are “restricted” in the number of questions they can ask to elucidate facts and are weakened by the possibility of incomprehension of the questions.

Is it any surprise that reliability of responses from adolescents has been questioned?[13] In the New Zealand survey deemed authoritative by some in Australia, 36.5 per cent of adolescents in this land of the All Blacks declared they did not understand the question: have you ever been “hit or physically harmed by another person?”

It is false to claim 1.2 per cent of the population is transgender on the basis of the survey. That would make its prevalence rival the 1 to 3 per cent of mental retardation. It is wrong to conflate the figure to 4 per cent for the “Safe Schools” program. That would mean one in twenty-five of all children would be transgender.

A straw poll of twenty-eight generalist paediatricians with a cumulative postgraduate experience of 931 years conducted for this article reveals eight children to have been observed with gender dysphoria. Four were remembered to have had severe associated mental disorder, one associated attention deficit/hyperactivity, one had been investigated for neurological disease on the basis of strange fidgetiness, and two had suffered sustained sexual abuse. In reality, childhood gender dysphoria is a rare condition whose prevalence is unknown.

How common are associated mental problems?

There are at least four reasons why a child with gender dysphoria might have associated mental disorder. The first is that transgender is but a symptom of a general disturbance. The second is that mental disorder could be caused by gender dysphoria. The third is it could be caused by external ostracism. The fourth would be a mixture of the above. Though studies reveal mental disorder, the cause remains elusive.

A study of Dutch children with dysphoria aged from four to eleven revealed associated psychiatric disease of at least one type in 52 per cent [14] with diagnoses including anxiety, phobias, mood disorders, depression, attention deficit and oppositional behaviour. A study by school teachers reported significant behavioural and emotional problems in about one third of 554 dysphoric Dutch and Canadian children under twelve[15]. At the first presentation to a US gender clinic of ninety-seven children with mean age of 14.8 years, 44.3 per cent had a history of psychiatric diagnoses, 37.1 per cent were already on psychotropic medications and 21.6 per cent had a history of self-injurious behaviour[16]. In an Australian study of thirty-nine dysphoric children of mean age ten, behavioural disorders were observed in a quarter, and Asperger syndrome in one in seven[17].

Proponents claim psychiatric problems are secondary to ostracism, but the American authors suggested gender dysphoria, itself, might be causal: “psychiatric symptoms might be secondary to a medical incongruence between mind and body”, because the symptoms tended to abate with hormone therapy.

The frequency of autism spectrum disorder in children with gender dysphoria, and the known indifference of those children to the opinion of others, would argue transgender was a symptom of an underlying disorder and not a result of ostracism. Autism has been found in 7.8 per cent of transgender children in a Dutch clinic[18], around 13 per cent in London[19] and 14 per cent in Australia.

The answer to the question of whether dysphoria is primary or secondary is unknown and probably unknowable. This renders optimistic, if not delusional, the concept that massive intervention may secure happiness.

What is the risk of self-harm and suicide?

Risk of self-harm has been reported in gender-dysphoric children and is the argument for “treatment” and against inaction. Is self-harm another manifestation of an underlying disorder, or is it due to frustration from gender dysphoria alone, or due to ostracism? Proponents of affirmative treatment proclaim the latter and declare an “alarmingly high rate” of self-harm and suicide attempts, exemplified by highly publicised and tragic youth suicides in the US[20].

As with most data related to gender dysphoria in children, studies are limited by lack of numbers and methodological bias, and the true rate of self-harm due to external ostracism is unknown. Other factors are very common and very important and seem neglected in the argument.

One London study retrospectively reviewed letters from referring doctors and its own notes regarding 218 gender-dysphoric children with mean age of fourteen. Of forty-one aged from five to eleven, it reported self harm in 14.6 per cent, suicidal ideation in 14.6 per cent and suicidal attempts in 2.4 per cent. Higher rates were reported in adolescents. A similar rate of ideation is reported from Canada[21], though associated with a lower rate of self-harm or attempted suicide (17 per cent as against 6.2 per cent). As in London, rates increased with age. Neither study revealed features of self-harm and attempted suicide.

The study reported high associated rates of psychiatric co-morbidity in children under eleven: autism spectrum disorder from 12.2 to 17.1 per cent, attention deficit hyperactivity in 14.6 per cent, anxiety in 17.1 per cent, depression in 7.3 per cent and psychosis in 2.4 per cent with, on the whole, rates increasing with age. It reports bullying and abuse in almost half to two thirds of all children but does not discuss whether it was provoked by transgender characteristics or those associated with autism, hyperactivity and psychosis.

Furthermore, though detailing living arrangements of the children, the authors do not comment on their influence, though the effect of family chaos on the mood of offspring is well known. The study found only 36.7 per cent were living with both biological parents, and 58.3 per cent “had parents who had separated”. “Domestic violence was indicated” in 9.2 per cent, maternal depression in 19.3 per cent, paternal depression in 5 per cent; and parental alcohol or drug abuse in 7.3 per cent.

Nor does the study consider the significance of autism it found in 12.2 to 17.1 per cent of its children. Elsewhere, 14 per cent of children with autism aged from one to sixteen have been reported to experience suicidal ideation or attempts, suggesting a rate twenty-eight times greater than that for typical children (0.5 per cent)[22].

The New Zealand survey of adolescents (“Youth 12”) deemed authoritative by some in Australia asked about “self-harm” in the previous year. Of non-transgenders 23.4 per cent replied “Yes”, as did 45.5 per cent of “transgenders” but 23.7 per cent reckoned they did not understand the question. When asked about attempted suicide, 4.1 per cent of non-transgenders replied “Yes”, as did 19.8 per cent of “transgenders”, but 13.3 per cent declared incomprehension.

In other studies, between 19[23] and 29 per cent [24] of all adolescents are reported to have a history of suicidal ideation, and between 7 and 13 per cent to have attempted suicide; though what constitutes an attempt is not described in these studies, or in those above from London and New Zealand.

The question, then, is whether transitioning of transgender children will ultimately reduce self-harm. While Dutch experience concludes that “starting cross-sex hormones early … followed by gender reassignment surgery … can be effective and positive for general and mental functioning”[25], other centres report high rates of suicide in the years following reassignment.[26] [27] To be fair, those reassigned in these studies did not have such a developed “pathway” for affirmation as in Holland. Nevertheless, suicide attempts after surgery have been reported to be more common than in the general population in Belgium (5.1 per cent as against 0.15 per cent)[28] and in Sweden[29].

Conversely, regarding suicide by adolescent members of sexual minorities, the Journal of Homosexuality concludes that “very few suicide decedents [sic]” have been identified as having “minority sexual orientation” in studies in North America: three of 120 adolescent suicides in New York, and four of fifty-five in Quebec; and warns conclusions based on “small numbers … must be regarded as tentative”.

The conclusion of the Journal of Homosexuality is valid. Numbers are small and data is obscure. No one knows how often real suicide attempts occur or their relationship with internal and external factors in gender dysphoria. When I raised the issue with one experienced therapist, it was denounced as “bull****”, merely a “weapon used by ideologues”.

What are personality characteristics of parents bringing children to gender dysphoria clinics?

No studies are available on characteristics of parents despite numerous studies on their children. It is supposed that gender confusion in a child must deeply affect its parents, and the phrase common to those seen interviewed on television, “gut wrenching”, is easy to accept. Perhaps, therefore, it is despair that is driving an increasing number of parents to start “social transition” of their child to the opposite gender before seeking medical help, under the guidance of websites and support groups and the encouragement of an enthusiastic media. Toronto’s Dr Bonifacio says many have progressed far into transitioning before attending his clinic: parents are dressing and entertaining the child as the opposite sex, applying new pronouns and a new name. Such commitment, he explains, paves the way for further treatment.

A leading but nameless therapist agrees: about a third of children are already being “socialised”. This therapist worries that they are at risk of being “conditioned” by parents who have become “enmeshed” to the degree of being “cheer leaders”. This could lead to the child becoming “scripted” to repeat phrases that would convince therapists. One example is the declaration of a five-year-old that he was “transgender” when featuring with his mother in a recent documentary on childhood dysphoria by Louis Theroux shown on ABC television.

Becoming a “cheer leader” in therapy for a child is, of course, not uncommon. Many if not most parents become passionate for their children and are on the sidelines at soccer and in advocacy groups for advances in treatment of malignancy. But, unpleasant as it is to raise the matter, every paediatrician knows there is a tragic condition known as Munchausen syndrome in which symptoms are fabricated for some kind of benefit. In Munchausen’s-by-proxy, the benefit accrues to the carer. I asked an experienced therapist whether this ever complicated gender dysphoria? Shoulders were shrugged: there are no studies. But, if mental illness affects 45.5 per cent of all Australians at some point in their lives and 20 per cent of those aged from sixteen to eighty-five will have experienced it in the previous year[30], the relevance of Munchausen’s-by-proxy in carers needs to be considered.

What is the treatment for childhood gender dysphoria?

There are three categories. The first, known as “conversion” or “reparative therapy”, is the attempt to make the child more comfortable in its natal sex and to lead it away from identification with the opposite gender. In the process, the reasons for the gender dysphoria are explored with the child and its parents. The second may be called “waiting and watching” while making the child comfortable in its natal sex until it grows out of it. The third is called “affirmative therapy” and involves supporting transition to the opposite gender.[31]

“Conversion” or “reparative therapy”, in which the child is orientated towards its natal sex, is anathema to transgender activists, and their political campaigns have caused it to be forbidden for minors in some states of North America. Evoking spectres of past brutal medical and societal treatment of transgender and homosexual adults, activists declare that anything less than affirmation in transgender children is inhumane, futile and may provoke suicide: transgender is fixed before and unchangeable after birth, and parents and society must accept the inevitable. The term “reparative therapy”, therefore, has a pejorative, political ring to it. It is wielded more like a weapon than a description of a medical alternative.

The second involves keeping the child as happy as possible within its “own skin” or natal sex, in the expectation it will “grow out of it”. It allows a child to dress and play with toys of the opposite gender but without encouragement and only in the home. It allows that a minority will “persist” into homosexuality but perceives life as a homosexual less complicated than that of transgender.

In practice, this middle option could swing towards dissuasion or affirmation. How much time should a child spend in his mother’s clothes? How much effort into persuading a boy there are other interests than dolls? Depending on emphasis (or perceived emphasis as in the case of Dr Kenneth Zucker below) critics may decry “watchful waiting” as merely another form of “conversion” therapy, while others might fear too much affirmation amounts to “conditioning” towards a role from which the child may find it difficult to escape.

The third option, “affirmation” excludes the first two and commits to a “pathway” that begins with “social transitioning” and progresses to blocking puberty with drugs (Stage 1). Stage 2 follows with stimulation of cross-sex features with administered hormones, in preparation for the possibility of later surgical intervention (Stage 3).

Problems are obvious. How might a child escape the “pathway” when gender re-orientation occurs with puberty? Complications with “second transitioning” after a life as the opposite gender are easily imagined[32]. Worse, what if the child is so intimidated by the fear of coming out again that acceptance of the “pathway” seems the only possibility? Or, what if the child has been so mentally programmed it has no idea how to live as the “opposite” sex? Tragic mistakes are possible.

Stage 1: The blocking of puberty

The induction of puberty begins deep in the brain where it is started by a biological clock and involves a cascade of hormones with various checks and balances. Where and how it starts are unknown, but chemical messengers ultimately influence nerve cells in the hypothalamus to release hormones in pulsatile fashion to initiate a cascade of effects. They stimulate cells in the nearby pituitary gland to secrete other hormones that travel to stimulate the gonads to release yet other hormones that travel to evoke secondary sex characteristics.

The hormones that are secreted by the hypothalamus act on receptors on the surface of the cells in the pituitary. Their pulsatile secretion (every ninety minutes) allows time for the pituitary receptors to reset after they have fatigued themselves sending messages to the nuclei of their cells. If they are continuously stimulated the receptors become exhausted and puberty stalls. Drugs are now available that are similar to the hypothalamic hormones. If injected in slow-release form, these “puberty blockers” will exert a sustained effect, exhausting receptors and blocking puberty.

Since the 1980s these drugs have been used to block puberty when it has begun too early and, so far, no side-effects have been noted. It appears pituitary cells can recover from prolonged suppression and that hypothalamic and other upstream neurons are not damaged by their vain efforts. Activists declare that puberty blockage is “entirely reversible” (and Australian courts echo the conviction) but the international Endocrine Society is cautious, declaring passively that “prolonged pubertal suppression … should not prevent resumption” upon cessation[33]. The Society warns there are no data regarding how long it might take for active sperm and ova to appear after prolonged blockage.

Puberty is associated with psychological changes that reflect hormonal influences throughout the brain. Though used for an abnormal state since the 1980s, blockers have only been used in the presumably normal brain for gender dysphoria since the 1990s and, therefore, in neither case is the effect known in later years of life. The claim they are “completely reversible”, is not yet based on evidence. The trial is too short, the numbers too small, the effect not blinded, and there are no controls.

Puberty is blocked to “give the child more time to consider future options” and, according to Dutch pioneers in treatment of childhood gender dysphoria, should not be initiated before breasts have begun to appear in a girl around ten to eleven years of age, and testes to increase in volume in a boy a year or so later. Distress at the appearance of early signs of puberty is reckoned to indicate likelihood of “persistence” with gender dysphoria, thus aiding diagnosis and the later decision to administer cross-sex hormones. Dysphoria through puberty is believed likely to persist.

There are problems in this process: the blocked child will be left behind by its developing peers and this, by itself, may provoke distress. For example, it will be shorter. More seriously, the blocked child will be asked to approve progression to Stage 2, as if it can comprehend its massive implications. Stage 2 may have irreversible effects on fertility in both sexes, and the ability to breast-feed in a female. Is a blocked and scripted child competent to see that far into the future? Do children ever think differently when their hormones have begun to flow? This competence to understand the implications of treatment is known as Gillick Competence after the decision of an English court[34]. As it appears most children who start Stage 1 continue to Stage 2, the stakes are high for presumed Gillick Competence.

Stage 2: The administration of cross-sex hormones

Cross-sex hormone therapy means giving enough hormones of the opposite sex to evoke and sustain its characteristics. The hormones are given for life and must be monitored for side-effects including cardiovascular and thrombo-embolic disease, cancers of the opposite sex, and worsening of psychiatric disorder. By suppression of gonads, there is a slow process of chemical castration and the possibility of reproduction needs to be assisted by cryopreservation of ova and sperm.

According to international practice, cross-sex hormones may follow and then accompany blocking therapy, and be initiated around sixteen years of age. Some clinics, however, commence therapy as early as fourteen[35].

This “earlier” trend obeys a certain logic: if the parents have already transitioned the child “socially” and, if the child might be distressed by the early signs of puberty and, if delaying puberty is likely to cause its own stress, why wait for early signs of natural puberty? Why not block that natural puberty before it appears and go straight to cross-sex hormones? Affirmation therapy is creeping earlier despite recommendations of the Endocrine Society: “Given the high rate of remission [of gender dysphoria] after the onset of puberty, we recommend against a complete social role change and hormone treatment in prepubertal children.”[36]

Stage 3: Surgery

According to international guidelines, “sex realignment surgery” may be performed from eighteen years, though there are reports of it occurring earlier in private clinics[37]. Mastectomy, however, may be performed at a younger age if developing breasts increase dysphoria.

As the grandeur of realignment surgery may not be appreciated by a lay audience, it may be helpful to consider some details of the fate towards which children on affirmation therapy are headed. There are various components and not all patients progress to the final package, but the project will usually include relatively simple surgical procedures of castration, removal or augmentation of breast tissue, reduction in the size of the Adam’s apple, and alteration of body hair.

Construction of alternate genitals is another matter. These surgeries are difficult, often multi-staged, fraught with complications, and limited in outcome.

Creating ersatz female genitals is easiest: an orifice is created in the perineum, lined with skin from a filleted penis and, sometimes, deepened by transplanted bowel. The scrotum forms labia. The glans is grafted above the orifice and the urethral tube is shortened.

Creating male genitals is harder. One surgeon declared that “the task assumes nearly Herculean dimensions”[38] but this underestimates the ingenuity and range of objectives while exaggerating results. Hercules was always successful: creation of a penis is not. Some patients settle for a clitoris enlarged by male hormones. Others aspire to a penetrative organ, or at least one that can deliver urine when its owner is standing. In these cases, a shaft may be attempted from tissue grafted from thigh or even forearm and stiffened with a length of bone. Reversing the biblical account of the origin of females, bone from a woman’s rib may now turn her into someone with a male phallus. A glans may be fashioned from a graft of inner-skin and the tube that delivers urine may be lined with mucous membranes from the mouth. The appearance of a scrotum may be achieved by creating a sac from the labia and inserting two artificial testicles.

Though techniques are improving with practice, complications are protean. Grafts may die, holes fill in, tubes obstruct, openings appear, bones protrude, bowels perforate and germs invade but, all in all, the result may be “aesthetically and functionally pleasing” to the recipient.

What does the law say in North America?

In California, in September 2012, a law was passed “to prohibit a mental health provider … from engaging in sexual orientation change efforts … with a patient under 18 years of age” which included “lesbian, gay, bisexual and transgender youth”. Such efforts included “efforts to change behaviours or gender expressions” which were deemed “unprofessional conduct and shall subject the provider to discipline”. The Bill cited various national organisations of paediatricians, psychologists and psychiatrists which described such activities as conversion or reparative therapies.[39]

Similar laws have been enacted in New Jersey, Illinois, Oregon and Washington and, in 2015, in Ontario, Canada. Known as “anti-reparative” and “anti-conversion” laws, they oppose any attempts to re-orientate sexuality and to suppress gender identity and expression in order “to save children’s lives”.

In effect, Barack Obama has joined the affirmation team. Responding to a petition for banning “dangerous … conversion therapy” after a prominent suicide by a fifteen-year-old adolescent male who had sought to indentify as a female and allegedly underwent “conversion” therapy at his parents’ church, the White House declared that the “Obama administration supports efforts” to ban conversion therapy for minors “because overwhelming evidence demonstrates” it “is neither medically nor ethically appropriate”[40].

It is hard to gauge the effect of the laws. No charges have yet been laid but many therapists uncommitted to active affirmation are now reported to be unwilling to care for transgender children because they do not want the worry of the medico-legal risk. The result of their withdrawal in the face of increasing public demand is that children and their parents are funnelled towards those willing to continue or initiate the stages of transition.

One definite result of activists’ pressure and the expectation of the law in Ontario was the ultimate sacking of an international leader in management of gender dysphoria, Dr Kenneth Zucker (as discussed below) and the closure of his long-standing clinic in Toronto for allegedly practising “conversion” therapy. In turn, this sacking has brought immeasurable weight to the intimidatory effect of the law.

Ontario Bill 77 or the “Affirming Sexual Orientation and Gender Identity Act, 2015” was passed unanimously and in a “miraculously” short time according to its promoter, parliamentarian the Reverend Cheri DiNovo, who explained, “Bills may take up to years to pass but this one succeeded in only two months”. According to Wikipedia, DiNovo entered Parliament in March 2006, has been prominent in many issues including recognition of the Stalin-imposed famine on Ukraine as “genocide”, has “passed most LGBTQ legislation in Canada”, has conducted a weekly radio program, received literary awards, earned a masters degree in divinity and a doctorate in ministry from the University of Toronto, and has been a minister of the United Church since 1995. In 2001, she officiated over the first same-sex marriage in Canada[41]. Recitation of these educational achievements is relevant to some of the discussion we shared.

DiNovo is smart and at home in her conservative, stylish office in the Toronto parliament. Plainly, she could have been become the leader of her party had not ill-health intervened. Concisely, she declared the object of her law was not punitive but “instructional”: to save children’s lives, gender identity had to be affirmed. “Reparative or conversion” attempts should, therefore, be dissuaded and certainly not remunerated under the Health Insurance Act.

Moving to discussion of one of the clauses in the Act which declares the ban “does not apply if the person is capable with respect to the treatment and consents to the provision of the treatment”, DiNovo was strangely unclear. I asked at what age a child would be deemed capable of consent to treatment. Up to what age would a child be incapable of consent and therefore at the mercy, as it were, of parents and affirmative therapists? DiNovo would not approximate, merely repeating, and now with many words, that the law was “instructional”.

More disturbing was the response of this educated lady to my question as to why active, affirmative, transitioning therapy should be applied when most affected children were going to “grow out of it”? “I did not know that,” she declared. I continued by presenting a book written by Dutch leaders in the field who attest to the majority desisting. She declared she had never heard of them! We went on to theological matters in which she declared her belief in the death and resurrection of Jesus Christ. I left perplexed. Could one so prominent not know most children would desist from transgender confusion? If she knew, could one so theological be so untruthful?

What does the law say in Australia?

In February 2017, a Health Complaints Act will become law in Victoria in which complaints may be raised against fraudulent and negligent practices which will include, according to Health Minister Jill Hennessy, “conversion” therapy. She explained that the Act will:

provide the means to deal with those who profit from the abhorrent practice of “gay conversion therapy” … which inflicts significant emotional trauma and damages the mental health of young members of our community. This bill will enable the new Commissioner to investigate and crack down on anyone making dangerous and unproven claims that they can “convert” gay people.

Though she specified “gay people” and did not define age, Hennessy’s attributed declaration—“any attempts to make people uncomfortable with their own sexuality is completely unacceptable”[42]—suggests a broad intent for the law, in line with North American legislation.

More intimidating than the American laws, the Victorian Act will transfer the onus of proof to the accused, who will need “reasonable excuse” to avoid investigation after a complaint has been laid. In response to whether presumption of guilt would contravene human rights, Hennessy (tortuously) explained:

The reverse onus is required in relation to these offences as the “reasonable excuse” exception relates to matters which are particularly within an accused’s knowledge and introduce additional facts from the subject matter of the offence, which would be unduly onerous for a prosecution to investigate and disprove at first instance. Once the accused has pointed to evidence of a reasonable excuse, which they should have access to if the excuse is applicable, the burden shifts back to the prosecution who must prove the essential elements of the offence to a legal standard. I am of the view that there is a negligible risk that these provisions would allow an innocent person to be convicted of any of these offences. Accordingly, I am of the view that these offence provisions are compatible with the charter[43].

More broadly than Ontario Bill 77 which focuses on therapists receiving National Insurance funding, the Victorian Act will embrace any person or organisation beyond the classical health care providers that offer “general health services” to “maintain or improve … mental or psychological health or status”. Given the antagonism of transgender and other minority sexualities to the Christian church it can be prophesied that, sooner rather than later, a church leader advising “watchful waiting” of a transgender child will be asked for a “reasonable excuse”. The apparent suicide of seventeen-year-old Leelah Alcorn in Ohio in 2014 unleashed ferocity against the parents who had sought help in their Christian church, allegedly forcing their transgender son to undergo conversion therapy. There is the possibility of a similar backlash against pastors in Australia.

By passing these Acts, it is surprising that politicians should be aligning themselves, at least by default, with only one form of management of a medical problem. By banning “conversion/reparative therapy”, they promote affirmative therapy as the single option, despite the fact children will “grow out of it”.

Their punitive bias is not shared by the highest of international organisations. The international Endocrine Society acknowledges a middle path between “complete social role change and hormone treatment” on the “affirmative” end of the spectrum and punitive attempts to dissuade on the other. Implying that the large majority will desist if parents are patient, the Society recommends children should not “be entirely denied to show cross-gender behaviours or should be punished for exhibiting such behaviours”. Given politicians cannot be expected to have full understanding of therapies (even DiNovo claims she has never heard the other side), their commitment must be credited to the lobbying of activists.

Success for activists in Ontario

Transgender activists have had great success in Ontario. After sustained pressure and with Bill 77 in sight, a review was initiated of the management of child and adolescent gender dysphoria by Dr Kenneth Zucker and his colleagues at the Centre for Addiction and Mental Health (CAMH) in Toronto, who have been at the forefront of this discipline for almost four decades. The review was commissioned in February 2015, the law enacted in September, and Zucker and the unit were stood down in December. They were alleged to be performing “conversion-reparative” therapy and were presumed guilty because no evidence could be found that they were not practising in that way. In reality, Zucker was toppled and his unit closed because they were not practising affirmative therapy.

Bill 77 could not have been associated with the toppling of a therapist with greater standing. A psychologist, Zucker is Professor in the Department of Psychiatry at the University of Toronto and is internationally prominent in research, publications, experience and recognition since he began at CAMH in 1975. He has been the editor of Archives of Sexual Behavior since 2002, was a member of the American Psychological Association Task Force on Gender Identity, Gender Variance and Intersex Conditions in 2007 and, in 2008, Chair of the American Psychiatric Association Sexual and Gender Identity Disorders Work Group that developed DSM-5 from DSM-4 (on whose committee he had also served). Zucker was also a member of the committee that revised the standards of care of the World Professional Association for Transgender Health[44]. When he was dismissed, he had just been awarded a grant of close to a million dollars to study brain changes in gender-dysphoric adolescents receiving cross-sex hormones. Internationally, Zucker is almost unrivalled. Only the gender dysphoria clinic at the Vrije Universiteit Medical Center, in Amsterdam, has been as prominent as CAMH. Often, the two units have co-operated in research and publications.

For an Australian perspective on the dismissal of Zucker and his unit, consider a hypothetical sacking of the late cardiac surgeon Dr Victor Chang, and the closure of the Cardiac Unit at St Vincent’s Hospital, Sydney.

Zucker was not available for discussion regarding how he and his clinic handled gender dysphoria but his concepts can be gleaned from his publications and statements attributed to him by his detractors. He described a Developmental, Biopsychosocial Model for treatment of gender dysphoria[45] based on the concept that gender identity was not “fixed” before birth but was “malleable” under the influences of external factors of varying strengths at varying stages of development. Biological factors would include innate chromosomal direction and the effects of antenatal hormones. Psychosocial factors would include attitudes and behaviour of siblings, parents, care-givers and other close associates. All the factors would combine to have particular relevance at varying ages. For example, a four-year-old girl might conclude she was a boy if she wore boys’ clothing and played their games, because until seven years of age gender identity may be confused by “surface expression of gender behaviour”.

Zucker and his colleagues argued that “co-occurring psychopathology” in the child and “psychodynamic mechanisms” in its family influenced gender identity, with the latter sometimes exerting an unrecognised “transfer of unresolved conflict and trauma-related experiences from parent to child”. Examples include “a girl observing her mother as bullied may self-identify as a male, while a boy observing his mother as depressed may self-identify as a female because subconsciously he wants to help his mother”. Conversely, “a mother with unresolved hostility toward men may encourage effeminacy in her son”[46].

Nevertheless, Zucker and his colleagues report that, despite external influences, most transgender children do not persist with that identity after puberty: only 12 per cent of transgender girls and 13.3 per cent of boys. They report:

It has been our experience that a sizable number of children and their families achieve a great deal of change. In these cases, the [gender dysphoria] resolves fully, and nothing in the children’s behaviour or fantasy suggest that the gender identity issues remain problematic … All things considered, we take the position that in such cases a clinician should be optimistic, not nihilistic, about the possibility of helping the children to become more secure in their gender identity.[47]

Perhaps even more disturbing to transgender activists was Zucker’s opinion that parents might be permitted to influence orientation of the child towards its natal gender. Declarations by Zucker that “if the parents are clear in their desire to have their child feel more comfortable in their own skin … [and] would like to reduce their child’s desire to be of the other gender, the therapeutic approach is organised around this goal”[48] became nails in his cross.

CAMH therapy included “open-ended play” to explore “underlying mechanisms” for which “surface behaviours” of gender dysphoria are symptoms, and “which can best be helped” if the reasons are understood. Limitations would be set on cross-sex play and dressing. For example, a boy might be permitted to wear at the home but persuaded against wearing them on trips to the mall. Same-sex “peer relationships” would be encouraged because they are “often the site of gender identity consolidation”. If the boy in question did not like “rough and tumble” play, less physical peers might be sought.

Zucker’s management of childhood dysphoria might be summarised as “minimise stress and maximise comfort” in natal sex, in the expectation most will grow out of it. He fears labelling a child is part of “conditioning” to transgender from which return is more difficult. He cautioned parents to:

resist too much accommodation from [a child’s] teachers. Don’t let the school make him a poster child … don’t let them parade him around for pink assemblies. This is his personal journey and we don’t know where it is going to end up.[49]

The latter advice is relevant for Australia. A spokesperson for the New South Wales Education Department has reported, “We have a four year old who is transitioning to kindergarten next year who has identified as transgender.”[50]

Zucker and his colleagues report that a number of children who “persist” with transgender identity emerge from puberty as homosexuals. They insist, “We have never advocated for the prevention of homosexuality as a treatment goal for [gender dysphoria] in children” and explain to parents, “it will be their job and ours to support the child” whatever the future holds. Some children would desist from gender dysphoria to emerge as bisexual or homosexual. Some would persist with transgender identity and pursue the pathway of hormonal and surgical intervention, but Zucker concludes this to be the least favourable option because “growing up transsexual or transgender may augur a more complicated life”.

Though not anti-gay, and involved in positive transitioning of adolescents to the opposite gender if transgender appeared inevitable, Zucker became Enemy Number One for transgender activists[51]. Their pressure and Bill 77 resulted in Zucker and his unit being dismissed for not being “in step with the latest thinking”.[52] Over 500 colleagues expressed their dismay in a petition of protest which cited Zucker’s contribution to science and medical care. The signatories warned “any clinical researcher who considers working at CAMH: in the event of a conflict with activists for a fashionable cause, CAMH might well sacrifice them [and their patients] for some real or imagined local political gain”.

What do the courts say in Australia?

Decisions of Australian courts have kept pace with the exponential phenomenon of gender dysphoria. As recently as 1992, in Marion’s case, the High Court declared that sterilisation of a fourteen-year-old mentally retarded girl, incompetent to decide for herself, needed the court’s approval as a safeguard because there was a significant risk of making the wrong decision regarding an intervention that was “non-therapeutic, irreversible, invasive and associated with grave consequences”; sterilisation should only be performed “as a last resort”[53]. This conservative attitude was confirmed by the Family Court in 2004 in Re Alex[54] which determined that drug administration to effect transition to the opposite gender in the thirteen-year-old natal girl was a “special medical procedure” associated with “significant risks” of reversible and irreversible nature, and required the court’s authorisation.

In 2013, in Re Lucy [55] , the court relinquished authority over Stage 1 therapy, determining it could be “appropriate” for “preventing, removing or ameliorating … a psychiatric disorder” associated with gender dysphoria. Therefore, departmental guardians (and by inference, parents) could give consent to this therapy on behalf of the thirteen-year-old natal female who was competent to give informed consent with regard to transitioning to a male.

In that case, presiding Justice Murphy laid instructional ground by repeating with emphases the statement of an involved physician that:

It is important to state that the natural course of Gender Dysphoria, untreated, is that psychological stress increases over time, as the person becomes more and more disillusioned with their morphology which does not match their mindset of their assumed appropriate gender. Untreated Gender Dysphoria invariably progresses to immense disillusionment and then, to chronic depression which can often progress to major depression with significant suicidal risk.

In both Re Lucy and the following Re Sam and Terry [56] cases the courts, however, determined their authorisation was needed for implementation of Stage 2 therapy because of the permanence of effects. Deliberation in Re Sam and Terry emphasised the necessary protective authority of the court for two unrelated sixteen-year-olds who were both “Gillick incompetent”.

In 2013, in Re Jamie[57] the Full Court determined court authorisation would be needed for Stage 2 therapy if a child was Gillick incompetent but, if competent, a child could consent to Stage 2 therapy without the need for authorisation. The court declared, however, that a child’s competence needed to be decided by the court “even where parents and treating doctors agree”. These principles were confirmed in Re Shane later that year[58].

In July this year, in Re Quinn [59], the Family Court extended its permission beyond the drug components of Stage 2 into the irreversible surgical components of Grade 3 by approving bilateral mastectomies in a fifteen-year-old natal female committed to male gender. Even more significantly, the court gave its authority despite the adolescent being Gillick incompetent because of associated Asperger syndrome.

Concerns with this symbiotic progress of courts and proponents of affirmation include:

The instructional declaration by Justice Murphy that untreated gender dysphoria invariablyprogresses to immense disillusion is not based on evidence.

Should courts be informed by only those committed to activist therapy?

Should courts rely on statements from a small group already involved with the transition of the patient? Is there no possibility of conflict of interest?

How can Gillick competence regarding future reproductive intent be assumed in an adolescent maintained in a pre-pubertal state? Do adolescents ever think differently when their own hormones flow?

How can irreversible, destructive surgery be permitted on an adolescent judged incompetent to understand the implications? Where is the line between transgender surgery and that for Body Identity Disorder in which the sufferer demands transformation of the physical state to satisfy the mental: for example, the removal of a normal leg in the false belief it is gangrenous?

The not-so-slow march of gender dysphoria through the judicial, medical and political institutions shows little evidence of obstruction. When will any authorisation by the court be declared unnecessary?

Obligation to consult the court rankles activists who consider it: “an expensive, time consuming and ultimately unnecessary intrusion into the complex decision making between the patient, their [sic] parents and the treating medical team [and] a form of institutional discrimination”. The intervention of the court is considered unnecessary by leaders of the gender dysphoria clinic at the Royal Children’s Hospital, Melbourne, because it “almost exclusively” relies on reports from the treating team regarding its client’s competence[60]. They declare change is “urgently” needed given the “increasing acceptance of gender diversity being fuelled by social media and popular culture”. They urge “equitable access” to all chemical blocking and cross-sex hormones and Medicare funding for “gender affirmation surgery”.


The phenomenon of childhood gender dysphoria is exponential. Hundreds of children and their parents are reported to be consulting special clinics in Australia each year. How many undertake transitioning is unknown but the media provides regular confirmation, as do unofficial reports from schools. I attended Fort Street Boys’ High, where at a recent reunion two current student leaders proclaimed the year’s success to be the wearing of a dress to school by a boy, every day including graduation. A teacher from a school near my home reports five children to be undergoing transition.

Yet hardly any paediatricians recall any cases of gender dysphoria in almost 300 cumulative years of practice. Certainly, I have not seen one in fifty years of medicine. I accept cases must exist and consider them tragedies deserving as much compassion and medical care as the three cases of physical intersex I have encountered in my career.

What astonishes me is the lack of evidence to support massive medical intervention in the face of evidence that it is not necessary. I cannot help wonder how the intervention was approved by the various ethics committees in hospitals, health regions and universities when it took some students and me over a year to get approval for a study that merely asked mothers when they introduced solid foods to their children. Ultimately, I had to give my personal phone number to all respondents of the questionnaire lest someone suffer anxiety in the middle of the night.

It is less astonishing these days that laws should be passed to ensure compliance with activists’ wishes. My generation has read the books of George Orwell, and observed the imposition of utopian ideas. Orwell would appreciate many aspects of the phenomenon of gender dysphoria. In Nineteen Eighty-Four obedience was ensured by the watchfulness of Big Brother, whose intimidation continues.

In fifty years of medicine, I have not witnessed such reluctance to express an opinion among my colleagues. For this article, I conducted a straw poll of paediatricians whom I know. Many advised me to be very careful, to appear neutral, and not to quote them despite their strong concerns about the current “fad”, hence my reference to anonymous therapists. One warned I should be prepared for him to “deny me thrice”. When I reminded him that Peter went on to become a martyred follower of Jesus, there was no reply.

My motivation for writing an article is that of another physician, a leading endocrinologist, who declares evidence for intervention in gender dysphoria is “utterly arbitrary”, and his great fear that mistakes would be made in consigning children to transition. I share those fears.

Lastly, I confess a family conundrum. I have a four-year-old grand-daughter who insistently, persistently and consistently declares she is a shark. Worse, she declares her name is “Bruce the Shark”. Reference to DSM-5 dismays: she plays with model sharks, dresses in shark motifs, wears a shark headdress, will take herself to the corner to await fish, loves to sit before the shark ponds in aquaria and thrills to caress their tails in special ponds for children at SeaWorld in California. Not above deriving some benefit from the tragedy, her father coaxes her to finish her meals by suggesting she “eat her fish”. But, dejected, he seeks my private advice: “When should we deliver her to the aquarium?”

John Whitehall is Professor of Paediatrics at Western Sydney University.

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