The Worst Argument for Youth Transition

In a recent protect story for New York publication, Chu uses the most controversial justification in the field: that minors should be permitted to possess mastectomies and another gender surgeries simply because they want them. As entire members of society who want to change their sex, Chu writes,” We will never be able to defend the rights of transgender children until we understand them solely on their own words.” ” It does not matter where this wish comes from”.

Counterpoint: Yes.

The most compelling argument for a medical transition is that a small percentage of people have a psychological condition ( gender dysphoria ) that causes them to feel unhappy ( because their sexed bodies feel alien ) and that doctors have treatments ( hormones and surgery ) that can help them.

In making the case for youngsters transition, activists have tended to emphasize the second part of that story—the distress of gender- nonbinary children—to support treatments that would otherwise appear serious. Yet Marci Bowers, the leader of the World Professional Association for Transgender Health, has pointed out that stopping puberty shortly means that some people may not experience adult sex or reproduction. A physically male child’s ability to have natural children and not grow an Adam’s apple or have his voice break could be the price of giving up orgasms.

Put simply, this is not something that most parents would believe to—unless the solution was worse. And therefore medical-transition advocates have emphasized the possibility of death for gender-conforming minors: Would you rather have a living daughter or a dead son? ( Thankfully, adolescent suicides for any reason are uncommon, though rates have increased in the past ten years. )

Treating gender dysphoria as a medical treatment with a medical remedy, Chu argues, has “hung transgender rights on the narrow peg of gender identity “—the thought of a male or female nature ( or something in between ) that resides inside all of us. She cites a passage from the marriage- equality fight, in which activists argued that being gay was an inherent and unchangeable state, never a a phenotype, a pathology, or a trait that could be ingrained into a person’s ability to be sexy or seduced. Chu writes that we “won moderate benefits at the level of social approval” by adopting a similar “born this approach” argument for clinical transition.

She does n’t think this is enough. Otherwise, she makes an argument for full-fledged individualism, though never using the word. She opposes awkward allowances and delicate right. She wants people like her—born man and living as women—to have unrestricted access to adult sports and services, based solely on their self- recognition. Additionally, she wants all people of any age to have the proper to” change sex,” a word she seems to identify specifically in terms of medical physique modification.

When the puberty-blocker model was developed, a few hundred minors sought care every year; in 2011 the main office in England had just 210 referrals, and the majority of the patients were natal men who had experienced sex dysphoria since early childhood and had not displayed any other mental health issues. What kicked off the current debate was a steep rise in the number of children seeking care, and the changing demographics of those children. Most of the patients in recent years have been genetically female, and many of them have issues such as autism, eating disorders, anxiety, or previous trauma.

These children need undoubtedly parental guidance, counseling, and appropriate medical care. The “affirmative” model departed from this assertion, though, characterizing extensive psychological assessments as transphobic gatekeeping. According to supporters, removing barriers to the medical transition was a “life-saving” strategy.

However, there is little evidence to support the claim that adolescent medical transition prevents suicide. As early as 2018, the Gender Identity Development Service—Britain’s leading child gender clinic, staffed by doctors involved with transition- related care—criticized a television drama called Butterfly that showed a gender- nonconforming 11- year- old attempting suicide. The clinic stated in a statement,” It is not helpful to suggest that suicidality is an inevitable part of this condition.” ” Suicide attempts by younger children referred to the service would be very uncommon,” he said. Last month, a Finnish study concluded that suicide was rare among minors seeking help at gender clinics, and when deaths occurred, they reflected overall mental- health challenges rather than being specifically linked to gender dysphoria.

Chu is unconcerned by this new evidence because she views it as a real downer. She criticizes the 2018 Atlantic cover story on child transition by author Jesse Singal, which included interviews with doctors and patients with diverse viewpoints on the subject, and asserts that it ushered in a welcome new phase of the transgender debate. ” The story provided a template for the coverage that would follow it”, she writes. It then quietly suggested that since the evidence was debatable, the rights were the same as it was when it turned what was threatening to turn into a social issue, leading to a question of rights.

The primacy of rights, in Chu’s opinion, leaves the question of whether or not evidence is relevant in medical decisions, even when children are involved. This view has two logical implications: The first is that, if we are now just letting kids do whatever they want with their bodies, why not let them get married at 12, or drink alcohol at 13, or consent to sex at 14 with an adult partner? The political adage” Toddlers have the right to get tattoos” might be the worst I’ve ever heard.

Alternate argument: Whether you think of gender as being significant or unique enough to justify total bodily autonomy for minors.

Whenever I read Chu’s work, I get the sense that she’s mocking the strand of feminism for which I have argued all my adult life. From Mary Wollstonecraft onward, the focus of the feminist project has been to dissociate notions of femininity and passivity from the material reality of being a woman. However, Chu enthusiastically discusses” sissy porn” in her book, Females, where it states that being “fucked is what a female is.” ( Call me old- fashioned, but I prefer the more standard definition of XX chromosomes and the body type evolved to produce large gametes. ) The quote’s author, who lacks any personal information, might be mistaken as an old-school misogynist rather than a favorite of the progressive left.

However, Chu’s preferred style when writing about gender is such trollishness. ( Her literary criticism is more straightforward. ) She claimed that she made the transition to experience “benevolent chauvinism” and to wear hot pants, and that “my new vagina wo n’t make me happy, and it should n’t have to.” The contemporary trans movement has largely dissuaded the notion that transition is related to sexuality, and particularly the sexual fetish known as autogynephilia, where men become aroused by the idea of themselves as women. Yet Chu has steamrolled through that taboo too, wondering aloud whether sissy porn made her trans. I occasionally believe that only her ideological adversaries read her work. Liberals are undoubtedly uneasy when you quote from it because they are aware that this is not the trans-rights narrative that GLAAD and the Human Rights Campaign have approved. You have to argue against her with one hand tied behind your back, politely overlooking her actual, published statements, including her claim that the anus is” a kind of universal vagina through which femaleness can always be accessed”.

Anyway, it turns out that I was n’t mistaken to believe Chu was making fun of me because she actually uses her name. Along with Singal, Matthew Yglesias, Matt Taibbi, Andrew Sullivan, Meghan Daum, and Bari Weiss, her New York article lists me on a list of alleged gender-critical “militants.” ” Many of these writers live in self- imposed exile on Substack, the newsletter platform, where they present themselves as brave survivors of cancellation by the woke elites”, she writes. Never mind that my European center-left views make me a woke elite to the majority of America. I find it offensive that radical activists “preach the science denial” by placing a priori a priori to rational standards of care. Yes, I do think doctors should have a good evidence base before giving out drugs used for chemical castration. As advertised, guilty as charged!

Chu describes my fellow militants as an obscene force opposed to the affirmative gender-care model. The queer theorist Judith Butler believes that only fascists—and trans- exclusionary radical feminists, or TERFs, whom Butler sees as fascists in disguise—have questions about the new orthodoxy on gender. However, Chu is willing to grant us access to a third category. We are trans-agnostic reactionary liberals or TARLs. ( To my ears, this does n’t sound as catchy as TERF, but then, I have n’t yet had the newer term screamed at me through a megaphone by a six- foot figure in a balaclava. ) According to her,” the TARL’s primary concern, to hear him tell it, lies in protecting free speech and civil society from the illiberal forces of the woke left.” The TARL claims to have no position in relation to trans people other than showing his general sympathy for those who are suffering from psychological distress or civil rights violations. Again, guilty as charged.

The essay begins with a review of Butler’s new book, which serves as the ostensible hook for Chu’s argument. However, I have a negative perception of Chu finding Butler’s prose dull ( relatable ) and their persona drab. She clearly prefers her own rhetorical fireworks and provocative poses to Butler’s pioneering work in the field of impenetrable subclauses.

Chu’s real motivation, surely, is a sense that her side is losing. In Europe, where the” Dutch protocol” for puberty blockers was created in the 1990s, many nations are turning to talk therapy as a first-line treatment in place. England’s National Health Service announced shortly after Chu’s essay was published that it no longer routinely prescribes puberty blockers for dysphoria, claiming that the evidence for their safety and effectiveness was insufficient. France, Sweden, Finland, Norway, and even the Netherlands have also pulled back—hardly a roster of countries that you’d describe as being to the right of the United States. In contrast to the case in the U.S., where the debate is incredibly polarized and the most prominent Republicans ‘ opponents of youth transition are Republican governors, these decisions have been led by doctors rather than politicians.

The debate is raging even in America. Quite a bit of Chu’s essay is devoted to complaints about media organizations that have not sufficiently echoed the activist line—that puberty blockers are safe and reversible, and that the “science is settled”. The New York Times is regarded as having fallen into the hands of barbarians, or at least failed to prevent them from scurrying through the affirmative gates. ( The publication of more sceptical articles recently caused staff uprisings. ) ” The paper consistently refuses to treat transition- related care the way it would any other health- care matter … as an issue of access”, Chu laments, ignoring the fact that if rates of women seeking abortions, say, rose by thousands of percent in a decade, the Times probably would write about the phenomenon.

The absence of the Times as a trustworthy ally is significant because the American model of youth transition best describes itself as consensus-based rather than evidence-based, which is to say, it relies more on the opinions of credentialed experts than on the conclusions of highly rigorous studies. What is left is ideology when the clinical justification for the transition from underage to adulthood disappears. ” The belief that we have a moral duty to accept reality just because it is real is, I think, a fine definition of nihilism”, Chu writes. Let anyone change their sex, she would prefer to make a radical claim for unrestricted personal freedom, even for minors. Let anyone alter their gender. Let anyone change their sex again. Let trans girls play sports, regardless of their sex status. This only implies that some girls are better at sports than others if they excel. ( It does n’t, of course—it means that male puberty and higher male testosterone levels confer significant sporting advantages, but that’s me being a reality- accepting nihilist again. )

We should treat children’s statements about their identity with unquestioned reverence, Chu contends, because it would be impossible to make” thoughtfulness” a prerequisite for any universal right by turning it into an exclusive privilege. It is a inescapable fact of how our society views children, whether or not, that in the majority of cases, parents or legal guardians will veer off of the child’s path to care. For now, parents must learn to treat their kids as what they are: human beings capable of freedom”.

Making a case in this manner irritates many people who share her political objectives and demonstrates a titillating disdain for respectable politics. For those who are used to fighting against those who claim that any overreach in gender medicine is untrue, that too few patients are involved in it are worth caring, or that we should be writing about something else more important—all the riotous flavors of denial and whataboutism—Chu’s case for unlimited agency for teenagers is refreshing. She said everything out loud, and her argument is logical, coherent, and forcefully delivered. You wo n’t hear it made very frequently because it’s about as well-known as the one that allows 9-year-olds to get nose jobs.