Published on March 19, 2021
Imagine feeling so alienated from your body that you would consider taking cross-sex hormones and removing your genitals. That’s the tragic situation that many people with gender dysphoria experience. They aren’t faking it, and they didn’t actively choose it.
But they aren’t getting the care they deserve — and, even worse, Big Government and Big Tech are working to deny or conceal the truth in service of a new transgender orthodoxy. I’ve tried to sound the alarm about the real harms that would result, but the activists have a lot of corporate and political power on their side — as I was reminded recently when Amazon canceled my book.
Some activists and self-proclaimed gender experts say the best solution to gender dysphoria lies in hormonal and surgical transition, a claim my book disputes.
Get the full story about surgery
For instance, media outlets trumpeted a 2019 study that claimed to offer evidence in support of such interventions. But last August, the American Journal of Psychiatry was forced to issue a correction, acknowledging that “the results demonstrated no advantage of surgery in relation to subsequent mood or anxiety disorder-related health care.” In fact, the study’s authors also admitted that those who surgically transitioned “were more likely to be treated for anxiety disorders” than those who had not.
But media outlets seemed to all but totally ignore the correction. Just as they ignored what the health experts in the Obama administration had to say.
In August 2016, the Centers for Medicare and Medicaid wrote that “the four best designed and conducted studies that assessed quality of life before and after surgery … did not demonstrate clinically significant changes … after (gender reassignment surgery).”
What does that mean in plain English? A population of patients is suffering so much that they go through radical surgeries, and the best research the Obama administration could find suggests that these surgeries bring them no meaningful improvements in their quality of life.
Things are even worse for children. Right now an experimental medical regime is being pushed — the off-label use of puberty blocking drugs to indefinitely block biologically appropriate puberty, administration of cross-sex hormones, and even double mastectomies on teens. Don’t believe that last claim? In a study published in 2018, mastectomies were even performed on two 13-year-old girls with gender dysphoria.
Most people recognize that children are too young to know what it even means to be a man or a woman, let alone to consent to such procedures. Indeed, for many of today’s genderfluid teens, something other than historic gender dysphoria may be at issue.
Learning the stakes
From 2009 to 2018, the United Kingdom gender clinic saw a 4,400% increase in the number of girls being referred for gender treatment. This suggests to some researchers that there is a social contagion aspect to these teens’ experience and we should not rush to pharmacological solutions.
On Dec. 1, three High Court judges in the United Kingdom ruled on behalf of a 23-year-old woman who at age 16 had been placed on puberty blocking drugs and testosterone, and at age 20 had a double mastectomy. She thought it would bring her happiness. It didn’t. Now, before treatments like this may be performed on a minor in the UK, they’ll usually require permission from the court.
In the United States, there are no such protections. But the reality is that so-called “gender affirmation” procedures violate sound medical ethics.
It is profoundly unethical to intervene in the normal physical development of a child as part of “affirming” a “gender identity” at odds with bodily sex. While puberty-blocking drugs may be an appropriate treatment for precocious puberty — the early onset of puberty — in order to delay puberty to a biologically appropriate age, the use of puberty blockers to delay or permanently block natural biological puberty is unethical and violates the bodily integrity of a child. So, too, is administering cross-sex hormones and surgically removing anatomy or secondary sex-characteristics as part of “gender affirmation.”
Amazon wants to end the debate
In response to a question from lawmakers, Amazon eventually claimed it has “chosen not to sell books that frame LGBTQ+ identity as a mental illness.” My book, of course, does nothing of the sort. It acknowledges what everyone agrees on: that gender dysphoria is a serious condition that can cause great suffering. The only disagreement is how best to treat patients who experience gender dysphoria. That’s the debate Amazon is shutting down.
We shouldn’t be naïve about the long-term impacts of a move like this. My book is still sold by other retailers (for now) but Amazon’s deplatforming will harm the entire culture of book authoring, publishing and reading — as it will have a chilling effect on all aspects of the book market. How many authors will think twice before telling the truth on controversial issues? How many publishers will simply decline to publish books they’re afraid will be barred from Amazon? How many readers will never even hear of the banned books?
Likewise, book delisting cuts off vital political and cultural discussion about important matters when we need it most. The timing of Amazon’s move is suspicious, coming the weekend before the House of Representatives passed the so-called “Equality Act,” of which I am one of the most outspoken critics.
We must all recognize that both Big Government and Big Tech can be threats to our freedom and our flourishing. And if both insist on imposing a new orthodoxy, the future is bleak — not only in terms of the new civil “rights” for men identifying as women to spend the night in women’s shelters, disrobe in women’s locker rooms, and compete in women’s athletics, but also in terms of what medicine would be mandated and which therapies would be prohibited.
It doesn’t take much effort to see how the Biden administration will argue that any therapy to help someone feel comfortable with his or her own body should be prohibited as discrimination.
But rather than attempting to reassign bodies to line up with misguided thoughts and feelings, we should at least attempt what is possible: helping people to align their thoughts and feelings with the reality of the body. That’s what the research in my book reveals. I pray that more people will not be harmed because Amazon refuses to let its customers read it.
Ryan T. Anderson is the president of the Ethics and Public Policy Center and the author of “When Harry Became Sally: Responding to the Transgender Moment.” Follow him on Twitter: @RyanTAnd