Thoughts on Transgenderism......Am I A Bigot?

In a newsletter from several months ago, the journalist Nick Catoggio introduced me to a recent poll on attitudes toward gay marriage. While support for gay marriage has held steady among Democrats and Independents, support among Republicans has dropped by ten points in the last three years. The decline is significant given the dramatic upward trajectory of support that we’ve seen over the last three decades, including among Republicans.

I’m a good example of how this sudden and huge shift took place. Despite the fact that my favorite high school teacher, Ken Rucker, was gay and the fact that I had a few gay friends in high school, I, like the overwhelming majority of Americans, believed that marriage was an institution between a man and a woman. Back in 2000, I agreed with the likes of Hillary Clinton, who made that point many times during her New York Senate race.

There is no getting around the embarrassing fact that I was wrong. In addition to personal conversations with Ken Rucker and others, I was influenced by Andrew Sullivan’s essay titled “Here Comes the Groom: A (Conservative) Case for Gay Marriage," which was published in The New Republic, and Jonathan Rauch’s “Gay Marriage: Why It Is Good for Gays, Good for Straights, and Good for America.” These two gay writers argued that marriage is a stabilizing institution and that extending it to same-sex couples would strengthen society. Truth be told, I had no good answers to key questions: Why would two people of the same sex marrying and potentially adopting children leave society worse off rather than better? Why shouldn’t we want to replace a culture of promiscuity with a culture of lifelong partnership?

Just as the issue of gay marriage won support among Americans with its libertarian-ish “live and let live” argument, so too has the transgender movement seen its acceptance grow over the last decade. As Nick Catoggio writes, “Just as same-sex unions imposed no burden on straight ones, men transforming themselves surgically into women and vice versa imposed no burden on the general population.” But something shifted in 2021 and 2022. According to Catoggio, “2022 was the year social conservatives finally gained indisputable evidence that greater LGBT rights had led to certain pernicious policy outcomes.” I agree with his analysis. I believe the recent dip in support for gay marriage is connected to the growing cultural conflict over transgender ideology.

So what happened in 2021 and 2022?

First and most important, we saw major headlines about transgender women competing in women’s sports. While there are many examples, the most famous is of Lia Thomas. Here was a mediocre swimmer on the University of Pennsylvania’s men’s swim team who began transitioning in 2019. Even though she lost muscle mass and strength through testosterone suppression (it’s important to note that her swimming times were slower than her personal bests before medically transitioning), Lia became a national champion in NCAA women’s competition.

In addition to the issue of who gets to play in women’s sports, 2022 saw increasing news reports of public schools introducing transgender concepts to young children. Most famously, this occurred in Montgomery County, Maryland. Initially, some principals and teachers allowed parents to pull their children out of classrooms when the controversial books were read aloud. But then the school system banned the opt-out policy. (The Supreme Court will rule on this soon.) Obviously it’s important that America’s youth learn to be tolerant of different types of people, but is it necessary that six year olds learn in tax-payer-funded schools to question whether they are truly a boy or a girl? My point isn’t to litigate all these debates. It is simply to give examples for why there was a dip in support for the LGBT+ community over the last few years.

My own window onto the world of name changes, pronoun changes, and transitioning was working as a substitute teacher in Charlottesville, VA. In my experience, the high school and middle school environments felt like places where it was considered cool to experiment with these things. What I observed firsthand mirrored broader societal trends, as reflected from the data collected in CDC’s Behavior Risk Factor Surveillance System and Youth Risk Behavior surveys. The steep rise in trans-identifying is not just taking place in America. In Ottawa, the gender diversity clinic at the Children’s Hospital of Eastern Ontario went from a few patients a year to over 400 a year. From 2009 to 2018, the United Kingdom gender clinic saw gender treatments increase at an astronomical rate as well.

Has the growing acceptance of transgender identities simply enabled those with genuine gender dysphoria to come forward? Or are children and teens being shaped by peer dynamics and social media?

On the one hand, based on what I observed in the school system, I believe social contagion plays some role in the rising numbers. On the other hand, I fully accept that, for a small number of people, distress over their biological sex can be so severe that it impairs their social and psychological functioning. Gender dysphoria is a very real phenomenon. Period.

I think of a former colleague of mine from the Heritage Foundation. A few months ago, this budget expert transitioned. Jessica writes, “I knew I was transgender since the age of four” and that “medical scans and examinations have since confirmed my predominantly female brain biology.” Riedl writes, “Too many adults still cling to their 10^th grade biology teacher’s over-simplified summary that XX versus XY chromosomes cleanly determine all subsequent male or female biological and gender development. While the vast majority of humans still develop consistently male or female in the womb, approximately one percent of people trigger genes, chromosomes, hormones, and/or physical/brain developments that cross between the two sexes.” Indeed, Jessica was bullied so badly that her family had to sell their house and move to a new school district.

When I read about Riedl, I think about how I would react if my own child had gender dysphoria. I know that I would do everything in my power to make he or she feel loved. I would want the larger society to accept my child, and I would be angry as hell if he or she faced discriminated. I get very upset when I read about the Trump administration’s effort to remove Bree Fram, who deployed to Iraq and Qatar, from her position in the Space Force. Fram writes in the New York Times, “I came out as transgender the day the military first allowed trans men and women to serve openly, in 2016. When I transitioned, I was leading an Air Force team that took lifesaving counter-drone technology directly from the laboratory to the battlefield. On my first day as my authentic self, my team threw me a party in my office.” She continues: “Serving authentically was transformative—not just for me, but for the people around me. I became a better leader when I no longer had to expend energy hiding who I was. I forged deeper connections with my team and created an environment where others felt safe to share their challenges and perspectives.” The Trump administration wants to turn away highly qualified service members simply because they are transgender.

This is wrong.

While I get uncomfortable when I read about this discrimination against patriots like Fram, I also feel uncomfortable when I read that the American Academy of Pediatrics national conference approved booths for the National Peanut Board to provide information on allergy science and for the Gideon International to hand out its bibles but banned the Society for Evidence-Based Gender Medicine because it promotes a more cautious approach to gender dysphoria treatment. (SEGM objects to the widespread use of “affirmative care,” which mandates that children who claim severe discomfort with their biological sex receive immediate “affirmation” from their physicians and then venture down a path of hormone treatments and surgery.) Likewise, I feel uncomfortable when I read that Amazon banned a book by Ryan Anderson because he questions the wisdom of "gender affirmation" care for minors.

Is there no room debate about whether it is wise to encourage children and adolescents to take hormones that block puberty if they have gender discomfort?

A few years ago, the World Professional Association for Transgender Health issued draft guidelines for treating gender-dysphoric adolescents. The guidelines include a set of minimum ages for medical interventions: 14 for hormones, 15 for mastectomies, 16 for breast augmentation, and 17 for genital surgery. But by the time the final guidelines were issued, the minimum age recommendations had been removed. According to reporting in the New York Times, the Biden administration pressured the group to drop the minimums for fear that age minimums could fuel growing political opposition to such treatments.

The bottom line is that we need answers to important questions: Do these treatments benefit most kids who receive them? If so, by how much? And if only some kids benefit, how can the others be identified before starting life-altering treatments such as hormones and surgery? Do medical interventions help children lead longer, happier lives? Or do these interventions harm in in the name of gender equality?

To get answers to such important questions, the United Kingdom’s National Health Service (NHS) commissioned the “Independent Review of Gender Identity Services for Children and Young People.” Dr. Hilary Cass, the former president of the Royal College of Pediatrics and Child Health, chaired the project. It took three years of research and involved an intense effort to interview clinicians, parents, and patients. The report was released on April 10, 2024 and weighed in at 400 pages. Dr. Cass acknowledges that some young people are in tremendous distress about their gender and doesn’t deny the fact that some may benefit from blockers and/or hormones. Her argument is simply that youth gender medicine “is an area of remarkably weak evidence” and that studies are “exaggerated or misrepresented by people on all sides of the debate to support their viewpoint.” As New York Times columnist David Brooks writes, “Cass’s report is remarkable for its empathy for people on all sides of this issue, for its humility in the face of complex social trends we don’t understand and for its intellectual integrity as we try to figure out which treatments actually work to serve those patients who are in distress.” (Notably, Cass refers to the patients in question as “gender-distressed and gender-questioning children,” rather than as “trans children.”)

Cass’s report has impacted the debate in Europe about the wisdom of “affirmative care” but hasn’t had the same effect in America. As the New York Times reports, the European Academy of Pediatrics acknowledged the concerns about youth gender medicine. By contrast, the American Academy of Pediatrics reaffirmed its endorsement of “affirmative care.”

The same gay writer, Andrew Sullivan, who made me a supporter of gay marriage, distinguishes between transgender individuals and transgenderism ideology. He defends the rights of transgender people to live their life freely and without discrimination, but he objects to an ideology that promotes postmodern conceptions of sex and gender to young children. Sullivan writes, “The debates about gender identity rely on stereotypical ideas of what gender expression means. It implies that a tomboy who loves sports is not a girl interested in stereotypically boyish things, but possibly a boy trapped in a female body. And a boy with a penchant for Barbies and Kens is possibly a trans girl—because, according to stereotypes, he’s behaving as a girl would. So instead of enlarging our understanding of gender expression—and allowing maximal freedom and variety within both sexes—the concept of ‘gender identity’ actually narrows it in more traditional and even regressive ways. If you’re a tomboy or a feminine boy—if your expression or behavior is different from what is ‘typically associated’ with your sex based on ‘traditional expectations’—you’re transgender. No wonder so many young people think they need medical help to 'correct’ their sex.”

I agree that gender is a social construct. But there are lots of social constructs. Rule of law and democracy come to mind. And I would argue that it’s good society has deemed murder to be morally wrong. When I think about whether we should dismantle social constructs, I think of G.K. Chesterton’s “fence parable.”

According to Chesterton, the radical reformer sees a fence in a field and, not knowing its purpose, demands it be torn down. By contrast, the conservative reformer insists that we first understand why the fence was built before we go about removing it. Perhaps the fence—gender norms, in this case—no longer serves a purpose. Perhaps it should be taken down. But we should have humility when making that decision.

So yes, we must protect the dignity of every person, including those who are transgender. But we also must preserve space for open debate about how best to support children and teens in distress.