Published November 29, 2022
The transgender movement has a science problem. Trans activists and their allies are trying to silence their critics by accusing them of “science denialism,” but they are inadvertently illustrating the anti-science nature of transgender dogmas. For example, a recent opinion piece in the New England Journal of Medicine (NEJM) — titled “Protecting Transgender Health and Challenging Science Denialism in Policy” actually demonstrates that rejecting transgender ideology is the best way to protect health and defend scientific integrity.
Of course, the authors, a couple of Yale professors plus a student, set out to prove the opposite. They open by asserting:
A virulent brand of science denialism is emerging in the U.S. legal system, as states enact bans on gender-affirming health care. Misused clinical research and disinformation have provided legal cover for bans on essential treatments for transgender and gender-expansive (TGE) people. Many of these bans restrict Medicaid reimbursement of gender-affirming care for people of all ages or prohibit gender-affirming care for minors. The recent end of federal protection for abortion and the lifting of Covid-19 protections such as mask mandates may signal an expansion of this dangerous force in health policy.
Yes, the complaints about the Dobbs decision and the ending of mask mandates are real and not a parody of upscale liberal white women. The rest is just loudly repeating transgender orthodoxies, with imprecations for doubters. And despite its apologists’ accusations of misused research and disinformation on the part of critics, transgenderism is indeed a dogmatic form of mysticism. Science has nothing to do with it.
Transgenderism denigrates the reality of bodily sex in order to exalt a non-corporeal sense of gender identity. It does not make a scientific claim, but a spiritual or metaphysical claim — that we have something like a gendered soul in a sexed body and that mismatches are possible and are best resolved by modifying the body into a facsimile of the other sex.
This extraordinary claim cannot be proven and must be taken on faith. Consequently, transgender advocates and allies, such as those writing in the New England Journal of Medicine, do not even attempt to provide a scientific explanation for transgenderism. Rather, because there is no physical need for medical transition, transgenderism has to be self-authenticating, proving itself by whatever mental health benefits can be attributed to it. This is why trans advocates are constantly (and falsely) telling parents that the alternative to transition is suicide — it’s the only argument they have; the only physical harm that can result from not transitioning is self-harm.
As this demonstrates, so-called gender-affirming care is abnormal medicine. It hugely disrupts healthy bodily functions for dubious mental benefits. It is like using intense chemotherapy to treat anxiety. Thus, the case for transition, especially for children, needs to meet an extremely high standard of evidence.
Predictably, the authors of the NEJM article fail to do this. They argue that the case for transition is robust and accuse their opponents of disinformation and cherry-picking data, but tracing their citations back through their own previous work provides more assertion than evidence. The studies they cite cannot escape the usual weaknesses plaguing this area of study: poor response rates, bad sampling methods, small sample sizes, short time-frames, and a reliance on patient self-evaluation.
Even less convincing are their attempts to dismiss the side effects of medical transition, which undermine the claims of any benefits. For example, the NEJM writers suggest that the use of puberty blockers in cases of precocious puberty means they are also safe to use in transition — but the former use simply delays a natural, healthy puberty until the appropriate age, while the latter prevents it from ever happening. Even the New York Times has noticed that using puberty blockers for gender-confused children may have major downsides.
Of course, the elephant in the room is that studies on transition, and especially transitioning children, are overwhelmingly conducted by those whose careers depend upon proving the benefits of transition. The doctors who are chemically castrating teenage boys, or amputating the healthy breasts of adolescent girls, are all-in. To admit that these procedures are a mistake would be a confession of horrific, possibly even criminal, medical malpractice that would end their careers.
Likewise, many of the formerly respectable gatekeepers of medicine and scientific research have been deeply compromised by transgender ideology. From medical associations to hospitals, there is a multitude of people who are in too deep to admit error, even as transgender ideology collapses.
The fact-free nature of transgender ideology is apparent in the latest standards of care issued by WPATH (World Professional Association of Transgender Health), a pro-trans group that is treated as the leading authority on transgender medicine. The organization eliminated many of its recommended age restrictions for medical transition in order to protect from malpractice claims physicians who were transitioning children younger than the previous standards — after all, doctors can’t violate a standard of care that doesn’t exist. And bizarrely, WPATH declared “eunuch” to be a valid gender identity, a decision reached, in part, by relying on online forums filled with violent fantasies of child sexual abuse.
These cranks and creeps have captured the establishment, from medicine to academia to the Democratic Party. And they intend to use their power to intimidate and silence critics. They do not care that their attempts are dishonest and incoherent. For instance, the NEJM writers admit that the scientific “consensus is ever evolving,” yet they posit this as a reason to shut down debate and deregulate transitioning children.
They are not perturbed by the inconsistency, for they are engaged in the exercise of power, not reason. They do not care about winning the argument but about intimidating people into compliance. And so they rely on credentialism and cries of “science denialism” and “misinformation” — following the same approach used to suppress the Hunter Biden laptop story, the lab-leak theory of Covid-19’s origins, and skepticism about extended school closures and masking toddlers — to protect their faith in gender identity and the pediatric transitions it demands.
But try though they might, they cannot alter biological reality. They may live by the lie of gender ideology, but they cannot make it true.
Nathanael Blake, Ph.D. is a Postdoctoral Fellow at the Ethics and Public Policy Center. His primary research interests are American political theory, Christian political thought, and the intersection of natural law and philosophical hermeneutics. His published scholarship has included work on Jean-Jacques Rousseau, Hans-Georg Gadamer, Alasdair MacIntyre, Russell Kirk and J.R.R. Tolkien. He is currently working on a study of Kierkegaard and labor. As a cultural observer and commentator, he is also fascinated at how our secularizing culture develops substitutes for the loss of religious symbols, meaning and order.