Contra deBoer on transgender issues

I don't think you're merely asking us to be "kind"

I’ve long been a great fan of Freddie deBoer. He’s a consistently thought-provoking and engaging writer, courageous in his willingness to step on toes and slaughter sacred cows, worth reading even when I (often) disagree with him.

One of many areas on which I disagree with Freddie is in our respective stances on trans issues. Some years back, he posted that he was sick of people in the comments of his articles bringing up trans issues even though the article itself had nothing to do with the topic, and announced a blanket ban on this specific behaviour.¹ He subsequently posted about the subject in more detail, explaining why (in contrast to his more iconoclastic opinions on progressive issues like racism, policing and mental health) he supports the standard “trans-inclusive” paradigm more or less uncritically. In March of last year, he posted an article titled “And Now I Will Again Ponderously Explain Why I Am Trans-Affirming”.

To be frank, I found the article staggeringly shoddy and poorly argued, especially for such a typically perceptive writer: it was a profound shame to see him fall victim to exactly the same errors in reasoning and appeals to emotion he so loudly decries when progressives use them in other political contexts. I intended to write a response to that article but never got around to it, and then the moment had passed. Last week he published not one but two new articles on the topic, so now I have a second chance to strike while the iron is hot. In some cases I will respond to Freddie’s arguments directly; in other cases I think it will be illuminating to contrast what Freddie wrote on this topic with what he has written on other controversial political issues in the past, to illustrate how flagrantly he is failing to live up to his own standards and committing precisely the same infractions he has complained about at length in other contexts.

“No one is saying” and what a strawman is

Freddie repeatedly asserts that various complaints that gender-critical people might have about trans activists are completely unfounded and invented from whole cloth, that no trans activists are saying what gender-critical people accuse them of having said, and that if any trans activists are saying these things then they’re only a small radical fringe and they don’t matter.

They’re trying to obliterate the distinction between male and female, between men and women, altogether!

Who? Where?… No one wants you stop calling your kids boys or girls and no one wants you to stop being a man or woman.

Terms like “birthing person” and “chestfeeding” are stupid and alienating to a lot of people!

Well… yeah… Again, though, plenty of trans people don’t use this language, and it’s mostly confined to the parts of our culture that have aggressive HR departments. I have been around LGBTQ people generally, and activists specifically, for most of my life. No one has ever scolded me for saying “ladies and gentlemen” or “breastfeeding” or “dad.” Not once have I ever been confronted about using language that suggests a gender binary. Not once!

In 2021, Freddie wrote an article titled “"NO ONE SAYS" & What a Strawman Is”, describing a rhetorical trick in which a person opposing him on some political issue will insist that “NO ONE SAYS” a thing Freddie disagrees with, Freddie will cite examples of people saying that exact thing - but rather than concede the point, the person will simply move the goalposts:

You know what the “no one is saying” crowd do when you show them incontrovertible evidence that someone is saying it? They say “oh that person doesn’t matter,” and roll right along. “No one is saying” morphs easily into “no one important is saying.”

Freddie might claim that no one is trying to obliterate the distinction between men and women; no less than a once-august publication like Scientific American argues that sex is a “spectrum” and that the idea of there being “only” two sexes is “simplistic”. Freddie might claim that no one in his experience has ever scolded him for saying “mother” rather than “birthing person”, but the latter is the official language advocated for by the UK’s National Health Service. Freddie might insist that no one wants you to stop calling your kids boys or girls, but here’s a fawning article in the New York Times about parents doing exactly that, and another from the BBC.

Note also Freddie’s claim that linguistic prescriptions like “birthing person” and “chestfeeder” are largely confined to “the parts of our culture that have aggressive HR departments”. This might come as a surprise to Freddie, but some of us actually have to work in companies with aggressive HR departments - we aren’t all lucky enough to be self-employed freelancers pulling down six figures a year, beholden to no one but ourselves. It’s very strange for a self-identified Marxist who expresses such profound outrage about the capitalist exploitation of the proletariat to be so blasé about the obnoxious ideological hoops that ordinary working people are made to jump through as a condition of continued employment in a precarious economy.

For emphasis: Freddie, someone is in fact saying! And in many cases these “someones” are far more powerful and have far more influence on our culture than you or anyone in your circle of like-minded Brooklyn activists. When the fifth-largest employer in the entire world is urging its staff to use “birthing person” in place of “mother”, what some Brooklyn activist believes is beside the point. [EDIT: This sentence originally read: ‘When the fifth-largest employer in the entire world is demanding that its staff exclusively use “birthing person” in place of “mother”, what some Brooklyn activist believes is beside the point.’ In retrospect, as several readers pointed out, this was a significant exaggeration and I’ve revised the wording accordingly.]

Female sporting events

I also find it hard to square Freddie’s claim that “no one” is trying to obliterate the distinction between male and female altogether with his apparent belief that trans women competing in female sporting events is entirely fair and legitimate. How can such a policy possibly be justified without ignoring the indisputable biological reality, consistent across time and space, that the average male person is stronger, faster and more resilient than 99% of female people? No less of a once-respectable institution than the American Civil Liberties Union describes the claim that “Trans athletes’ physiological characteristics provide an unfair advantage over cis athletes” as a “myth”. When a respected organisation like the ACLU, with an annual budget exceeding $300 million, asserts that male people are collectively no stronger than female people - the only way I can describe the claim that “no one” is trying to obliterate the distinction between male and female people is that it is a shameless insult to the reader’s intelligence.

Scepticism for me, but not for thee

A recurrent problem throughout the article is Freddie assuming that any criticism of trans-inclusive policies is a criticism of trans people themselves. No matter how many times a gender-critical person might assert “I’m not worried about trans people using this policy to hurt people - I’m worried about bad actors who are not themselves trans or suffering from gender dysphoria taking advantage of this policy to hurt people”, Freddie continually insists that criticising policies intended to be trans-inclusive is functionally the same as criticising trans people as a group. This is precisely the same kind of facile reasoning he’s so elegantly skewered in other political domains - the notion that opposition to this or that policy necessarily implies hatred of black people, or the mentally ill, or what have you. But he’s guilty of it himself, admitting elsewhere in the article that certain trans-inclusive policies pursued by the radical fringe of the trans activist lobby are short-sighted and counterproductive. So we find ourselves in the curious position in which Freddie can criticise this trans-inclusive policy without that bringing his support for trans rights into question - but if gender-critical people are sceptical or uneasy about that trans-inclusive policy, the only reasonable explanation is that they’re crypto-conservative fundamentalist Christians motivated solely by disgust and hatred of trans people.

For example, Freddie admits to scepticism about outré neogenders (“I suspect a lot of those people will probably adopt a more conventional gender identity as they age”), that a lot of the linguistic prescriptions trans activists make are preposterous and counterproductive (“I think making people believe that you want to get rid of the term “mother” is about as politically wise as punching a baby on camera”), that it’s wrong to act like medically transitioning will solve all of a trans person’s problems (“And I worry, for young trans people, that they’ll find transitioning to be just another of these human disappointments - things will be better, no doubt, but as we all tend to do they’ll have idealized the next stage of their lives and then may experience that sudden comedown when they realize that they’re still just humans with human problems”) and even that some medical practitioners are being overly aggressive about pushing minors to transition (“Can I see understand [sic] some concerns with overly-aggressive medical providers pushing care on trans-identifying minors too quickly? I guess so.”) These topics, apparently, reside within the Overton window: one is entitled to raise concerns about them without being accused of being motivated by malicious hatred of trans people as a group. Why are these concerns legitimate to express, and not: the unintended consequences of abolishing single-sex bathrooms and changing rooms; male rapists with intact genitalia being incarcerated in female prisons; convicted sex offenders coming out as trans and changing their names in order to evade child safeguarding policies - or any other of the litany of reasonable-sounding objections gender-critical people have raised over the last decade or so? No idea.

The bathroom question

A large chunk of both articles is dedicated to the question of whether it is appropriate to allow trans women to use women’s bathrooms:

They’re gonna rape the girls in the bathrooms!

Please, help me understand this, because it’s never made an ounce of sense to me. The claim is that, if you allow transwomen into women’s bathrooms, they’ll rape the women in there, right? Here’s my question: do you think that a sign on a door is gonna keep a rapist from raping? Like, there’s a sexual predator who wants to commit a rape, and he’s about to follow a woman into the bathroom to do so, but then he sees that it’s a women’s bathroom and says “ah shucks, I guess no rape for me today”? I simply do not understand this. If physical proximity is by itself sufficient incitement to sexual assault, then we have much, much bigger problems on our hands. How does legally allowing a transwoman into a girl’s bathroom create any greater threat than a cisgender man’s practical ability to simply walk into that bathroom and assault someone?

I personally am not a diehard advocate for sex-segregated bathrooms, and can see the merit in making all bathrooms gender-neutral. Of all the components of trans activism going, gender-neutral bathrooms is perhaps the one I find least objectionable. That being said, I find the argument for sex-segregated bathrooms easy to understand (even if I don’t necessarily share it), and admit to being surprised that Freddie doesn’t get it, so I will try to aid him in understanding it.

A blanket policy of sex-segregated bathrooms is intended to minimise the risk of female people being raped or sexually assaulted by male people in bathrooms. While a policy of sex-segregated bathrooms is enforced, a person who sees an obviously male person enter a women’s public bathroom could reasonably assume that that person was up to no good, and take appropriate steps to rectify the situation (such as notifying a security guard). Under a trans-inclusive bathroom policy, one is no longer supposed to assume that a male person entering a women’s bathroom is up to no good, because they might identify as a trans woman.

While Freddie is correct that, under a policy of sex-segregated bathrooms, there is nothing stopping a male rapist from simply walking into a women’s bathroom, a trans-inclusive bathroom policy makes it dramatically easier for such people to get away with committing an opportunistic rape, as bystanders will be less likely to intervene if they see a male person entering a women’s bathroom for fear of being accused of being transphobic. The reasoning is similar to regulations in which adults are not permitted to enter public playgrounds unless they are the parent or guardian of a child: obviously a child molester can simply ignore the regulation, but the regulation is designed to make bad actors more obvious to bystanders.

If a woman is in a public bathroom and an obviously male person walks in, there is no reliable way for her to tell if that person is a harmless trans woman just minding her own business, or a rapist exploiting well-meaning inclusive policies for malicious ends. The fact that the person has a penis is not dispositive in one direction or the other (as Freddie acknowledges not all trans people may wish to medically transition); nor that they are bearded and wearing jeans and a T-shirt (because “trans women don’t owe you femininity”, and a trans woman presenting as male does not in any way undermine her trans identity).

Source.

For the reasons outlined above, there is no way to reliably distinguish between trans women and cis men on sight². Hence, there is functionally no difference between “bathrooms intended for women and trans women” and “gender-neutral bathrooms”. Like Freddie, I am not aware of any hard evidence that making bathrooms gender-neutral in a particular area resulted in an increase in the rate of rape or sexual assault. I understand the gender-critical opposition to gender-neutral bathrooms without necessarily sharing or endorsing it. Even if the concerns about how this policy might be exploited by bad actors are in fact unfounded, I don’t think it’s fair to accuse everyone expressing those concerns of being transphobic. I think it’s especially unfair to accuse a gender-critical person of saying they think all trans women are rapists when, in my experience, gender-critical people go to great lengths to emphasise that they are concerned about bad actors who aren’t trans taking advantage of these policies for malicious ends, rather than trans women doing so.

Overstating the importance of the issue

In his second article from last week, Freddie complains that gender-critical people have vastly overstated the significance of the trans issue, elevating it to the status of “the most important social divide of our time, apparently beating out crime and education and the collapse of the family etc” when trans/NB people make up at most 2-3% of the American population. I agree that, in the scheme of things, trans issues receive a vastly disproportionate share of column inches relative to their import. Where I differ from Freddie is placing the blame for this state of affairs solely at the feet of gender-critical people.

As noted by Wesley Yang, there are 39 separate days³ in the American political calendar specifically dedicated to celebrating trans people (and an additional 77 days dedicated to celebrating trans people as a subset of LGBTQ+) - in contrast to Black History Month, which famously falls on the shortest month in the Gregorian calendar, despite black Americans making up 13-14% of the US population. President Joe Biden gave a statement on Transgender Day of Remembrance, while Democratic candidate Elizabeth Warren made the frankly bizarre campaign promise that her pick for education secretary would have to be personally vetted by a transgender child. There has hardly been a single political issue in the last ten years that hasn’t been framed as “how might this affect trans people?” or “what does this mean for the struggle for trans rights?” in the popular media, no matter how tangential the connection - everything from Black Lives Matter to the war in the Ukraine to gun violence in schools to the cost-of-living crisis to Covid to AI to the Israel-Palestine conflict to Brexit and even climate change (“[exposure to secondhand smoke] can exacerbate the respiratory stress that LGBTQI+ populations may experience from air pollution and chest binding, which is a common practice among transgender men to achieve a flat chest”).

It’s a bit rich to demand that Americans spend more than one-tenth of the calendar year celebrating trans people, “centring their voices” and putting their trials and tribulations at the forefront of their consciousness - only to then turn around and say “umm why do you even care about this, it’s such a tiny issue lol” when some of them offer even the mildest pushback. You brought it up.

Medical transition of minors

Social contagion via social media

On the controversy over underage trans people discovering a transgender identity and/or undergoing medical transition, Freddie writes:

Children are routinely getting permanently-disfiguring medical treatment!

To begin with, every indication is that the number of trans children receiving hormones remains low, and the number undergoing surgical interventions vanishingly rare. Can I see understand some concerns with overly-aggressive medical providers pushing care on trans-identifying minors too quickly? I guess so. But what I can promise you is that I want medical decisions about children to remain between the children, their parents, and their doctors. That’s who should have a say - the children, the parents, and the doctors. If in fact there are risks or problems identified with the current manner of practicing trans-affirming medicine for children, then we will have to rely on the medical community to change their standard of care as new data comes available. Will this result in perfect outcomes? Of course not. Does pediatric sports medicine or pediatric oncology result in perfect outcomes either? Of course not. What I am certain of is that I don’t want the government getting involved in these medical decisions. Ron Desantis does not get a say, sorry.

It’s fascinating contrasting the passage above with an article Freddie published in 2022 about the recent phenomenon of social media-addicted teenagers suddenly “discovering” that they suffer from dissociative identity disorder (“DID” for short, popularly known as “multiple personality disorder”), an exceptionally rare condition in which a person has multiple distinct personalities (called “alters”). Freddie unequivocally asserted that most or all of these teenagers are either mistaken (honestly confusing the symptoms of some relatively banal personality trait or mental illness for an exotic psychosis dissociative disorder) or actively lying; that this is bad for the teenagers themselves; and that the adults who ought to know better but indulge these teenagers anyway should be ashamed of themselves. He even went so far as to argue that dissociative identity disorder may not even exist, citing as evidence (among other things) that certain people only “discovered” they had it after being charged with a crime. How this observation ties into the transgender debate is left as an exercise to the reader (but here are a few hints).

I really cannot fathom how Freddie can reconcile his position in the DID article with his position on trans teenagers: the cognitive dissonance is simply astounding. Freddie insists that gender-critical people need not be concerned about teenagers receiving hormones or surgical interventions, as the rates at which these are occurring are “low” and “vanishingly rare” respectively - but I would be very surprised if the number of teenagers claiming to suffer from DID (even if they aren’t receiving any medical treatment for same) is greater than the number coming out as trans, which does not in any way alter Freddie’s opinion that the former is a concerning trend. He talks about “a notoriously controversial and historically extremely rare disorder… suddenly bloom[ing] into epidemic proportions among teenagers with smartphones and a burning need to differentiate themselves” and does not accept for a moment the explanation that “expanding public consciousness about such illnesses reduces stigma and empowers more people to get diagnosed with conditions they already had” - but simply refuses to connect the dots with the other thing that awkward teenagers with smartphones and burning need to differentiate themselves started “discovering” about themselves en masse all over the Western world about ten years ago (which resulted in an over 5,000% increase in referrals among female minors to the UK’s centre for transgender children - in the space of less than ten years). And the standard explanation offered for why so many female teenagers are coming out as trans is word-for-word the same as the standard explanation for why so many teenagers are claiming to suffer from DID!

Imagine, if you will, two female teenagers:

• Alice is a socially awkward thirteen-year-old with some autistic tendencies. Having trouble fitting in at school, she retreats into social media, becoming immersed in communities of like-minded individuals on Tumblr and TikTok. Six months later, she announces to her parents that she has dissociative identity disorder and multiple “alters” (having given no indication that she experienced anything like this at any point prior), and demands to be brought to a therapist, and perhaps later to a psychiatrist who will prescribe her powerful antipsychotic medication which comes with a host of side effects.

• Barbara is a socially awkward thirteen-year-old with some autistic tendencies. Having trouble fitting in at school, she retreats into social media, becoming immersed in communities of like-minded individuals on Tumblr and TikTok. Six months later, she announces to her parents that she is a trans boy called Brandon (having given no indication that she was dissatisfied with her gender identity at any point prior), and demands to be brought to a physician who specialises in gender issues who will prescribe her hormones (which come with a host of side effects) and recommend that she undergo top and/or bottom surgery.

Freddie looks at Alice and says: this is concerning, and Alice will suffer as a result - I don’t care that I’m not Alice’s parent or healthcare provider, I still think it’s concerning and I’m entitled to say so. Freddie looks at Barbara/Brandon and says: nothing to see here - it’s a private matter for Brandon, Brandon’s parents and Brandon’s healthcare providers, “I don’t understand why this element of medical science has become everyone’s business to a degree that is simply not true in other fields”, and if you think this is concerning then you’re a bigot. No matter how much a gender-critical person might insist that they are motivated by concern for Barbara/Brandon’s welfare which is just as authentic as Freddie’s for Alice - no, they’re really just a closeted conservative Christian consumed with hatred and disgust for trans people. I truly do not understand why Freddie is entitled to his opinion on Alice (despite not knowing her personally), but no gender-critical person is entitled to their opinion on Barbara/Brandon.

Let’s take it a step further:

• Alice is a socially awkward thirteen-year-old with some autistic tendencies. Having trouble fitting in at school, she retreats into social media, becoming immersed in communities of like-minded individuals on Tumblr and TikTok. Six months later, she announces to her parents that she has dissociative identity disorder and multiple “alters”, and also that her “primary” persona is that of a trans boy named Alan (having given no indication that she suffered from dissociative identity disorder or any discomfort with her gender identity prior to installing TikTok on her phone). Alice/Alan demands to be brought to a therapist, and perhaps later to a psychiatrist who will prescribe her powerful antipsychotic medication which comes with a host of side effects; and also to a physician who specialises in gender issues who will prescribe her hormones (which come with a host of side effects) and recommend that she undergo top and/or bottom surgery.

What reasonable person would look at the scenario described above and not immediately conclude “Alice has erroneously come to believe both that she is trans and suffers from DID because of her social media consumption”? But Freddie would have us believe that the two phenomena are entirely unrelated. The fact that Alice discovered that she was transgender and had DID at exactly the same time, that she did so immediately after spending far too much time in online communities in which both DID and being trans are glamorised - this is all just a big coincidence. Freddie absolutely reserves the right to say that Alice will suffer as a result of her erroneous belief that she has DID, but anyone (outside of Alice’s parents and healthcare providers) who does the same of her belief that she is a trans boy has outed themselves as a cruel, malicious bigot.

Some of the passages from Freddie’s DID article are almost painfully on-the-nose:

You might very well ask how it could possibly be the case that a notoriously controversial and historically extremely rare disorder would suddenly bloom into epidemic proportions among teenagers with smartphones and a burning need to differentiate themselves. How could that happen? The standard line on these things is that expanding public consciousness about such illnesses reduces stigma and empowers more people to get diagnosed with conditions they already had. [emphasis mine]

And the core point here is that the people who are being hurt by this are these kids themselves. Sucking up scarce mental health resources with fictitious conditions is irresponsible, yes, and pretending to be sick for clout is untoward. But setting that aside, self-diagnosis is dangerous. Playacting a serious mental illness is harmful to your actual mental health. Fixating on the most broken part of yourself is contrary to best medical practices and to living a fulfilled life. Defining yourself by dysfunction is a great way to stay dysfunctional. And everything about mental illness that seems cool and deep and intense when you’re 18 becomes sad and pathetic and self-destructive and ugly by the time you’re 40. Take it from me. These kids are hurting themselves. I don’t want to ridicule them. I’m not even angry at them. I’m angry at their adult enablers. That includes the vast edifice of woowoo self-help bullshit Instagram self-actualization yoga winemom feel-good consumerist tell-me-I’m-special psychiatric medicine, and a media that loves the prurient thrills of multiple personalities and never saw a vulnerability that it couldn’t exploit.

Most of these young people will probably just move on as they get older, realizing that keeping up this pretense is exhausting and pointless, and go on to live (I hope) normal healthy lives. But some of them are no doubt using these popular and trendy diagnoses as a way to avoid what’s really wrong with them, far more prosaic and thus unsexy personal problems, whether mental illnesses or not. And all of this, the enabling and the humoring and the patronizing, will really hurt them in the long run. Adults who play into it should be ashamed. [emphasis mine]

Incidentally, the scenario described above (in which Alice comes to believe that she is both trans and has DID) is not an armchair hypothetical. I took a quick scan of the #dissociativeidentitydisorder tag on TikTok and noticed that many of the individuals posting content under that tag describe themselves as transgender in addition to claiming to have multiple alters. Transgender patients who also claim to suffer from DID is apparently a sufficiently common scenario that it was discussed at the World Professional Association for Transgender Health in September 2022. What to do in the event that there is disagreement among the “alters” about whether or not to undergo medical transition? WPATH’s elegant solution: use a smartphone app to allow the alters to vote in turn and come to a collective decision.

Self-regulation of medical bodies

Stories like the above are precisely why so many gender-critical people don’t share Freddie’s optimism in the ability or willingness of the “medical community to change their standard of care as new data comes available”. By asserting that “I am certain… that I don’t want the government getting involved in these medical decisions. Ron Desantis does not get a say, sorry”, Freddie is committing himself to a position in which the medical bodies governing transition for minors will always be able to effectively self-regulate and will never require outside interference from governmental bodies.

That’s a remarkably high level of confidence to have in any medical body governing any kind of medical treatment. Of course we would all love to live in a world in which medical bodies can self-regulate and no outside interference is necessary, but - well, medical scandals happen, and sometimes the government getting involved is an act of last resort after self-regulation fails. I’m not saying that the bodies governing healthcare for trans minors are any worse at self-regulation and course-correction than the average medical body (whether in oncology or orthopaedics or whatever); but I’m definitely saying I don’t think I have any good reason to believe that these medical bodies are better than average, and certainly not so much better that Freddie’s unshakeable confidence in them can be rationally justified.

To use an example of how medical bodies’ self-regulation can and does fail, the Irish surgeon Michael Neary conducted unnecessary hysterectomies and other surgical procedures on over a hundred women over a thirty-year period. Several nurses blew the whistle at various points in his career, to no avail; an internal investigation conducted by three consultants found no evidence of wrongdoing and recommended that Neary continue working in the Lourdes Hospital. It was only after a judicial inquiry brought by the ministry for health and children (i.e. the government) that Neary was finally struck off the register, five years after the internal investigation found he’d done nothing wrong. If the government hadn’t gotten involved (as a measure of last resort, the ability of the medical bodies in question having demonstrably failed to self-regulate and course-correct), it’s entirely possible that Neary would have ruined dozens of additional women’s lives before retiring on a tidy pension. Or consider the more recent example of Lucy Letby, a serial killer working as a nurse who murdered at least 7 newborn babies: the NHS Foundation Trust attempted to handle the matter internally (even forcing doctors who’d raised the alarm about Letby to personally apologise to her) and were extremely resistant to involving the police. It was only after alerting the police (i.e. the government) - nearly two full years after members of staff had raised the alarm following Letby’s first confirmed victim - that Letby was finally removed from her position and later arrested, charged and convicted.

To clarify: I’m not saying that governmental intervention into transition for minors is currently necessary. However, the suggestion that we can confidently assert that no such intervention will ever be necessary is preposterous. I don’t think we have any good reason to believe that the medical bodies governing medical transition for minors are invulnerable to the kinds of social dynamics and institutional failures that have afflicted every other kind of medical body,⁴ and doctors as a profession (as the examples above illustrate) are notorious for closing ranks and circling the wagons at the first whiff of a potential scandal. To simply declare by fiat “the medical bodies governing transition for minors will always be able to self-regulate and course-correct, governmental oversight or intervention is not necessary and never will be” is shockingly naïve. He touched on a similar point in his article from March of last year:

For example, it’s entirely possible for clinics that specialize in adolescent transition to be mismanaged or otherwise imperfect. That’s simply the reality of medical care at scale. What I don’t understand is why this would be uniquely disqualifying; there are no doubt dialysis centers and radiology labs and pharmacies that have serious operational problems, but no one thinks that this discredits those kinds of medicine.

All true. The difference being that, in my experience, whistleblowers who call attention to substandard practices at dialysis centres, radiology labs and pharmacies are not generally accused of lying, being right-wing agitators or being bigoted against marginalised members of society - all accusations hurled at Jamie Reed, even well after her claims of misconduct were largely substantiated by no less than the New York Times.

This unqualified confidence in a class of medical practitioners is all the more baffling coming from Freddie, considering he himself found it entirely credible when one of his readers described how her therapist used their sessions as an opportunity to hector and guilt-trip her about her white female privilege in the style of racial grievance politics popularised by Robin diAngelo and Ibram X. Kendi. If therapists are vulnerable to allowing their faddish political opinions override their duty of care to their patients, why not endocrinologists, surgeons and so on?

But I suppose the mere suggestion that endocrinologists who work with trans teenagers are just as fallible and prone to ordinary human error as anyone else makes me a cruel, malicious bigot who hates trans people.

Parental input into their children’s transition is more controversial than Freddie seems to think

As an aside, do you know who besides gender-critical people is a cruel, malicious bigot? If we were to be even a little bit consistent about this, Freddie himself. I’m not the first person to note that perfectly reasonable and level-headed individuals with impeccable progressive bona fides (such as Jesse Singal) have been smeared as bigots by no less an institution than GLAAD simply for arguing, as Freddie does, that the parents of trans children should have some input into what medical treatments their children do or don’t undergo. The official stance of many pro-trans organisations is that “trans kids know who they are” and that any attempts to gatekeep their access to “gender-affirming care” (including by their parents) is denying them lifesaving medical treatment, no different from denying insulin to a diabetic.

If you think I’m exaggerating, consider this bill in the state of California which would make a parent’s decision to “affirm” their child’s gender identity (or not) a factor in custody disputes (at the time of writing, it has passed both houses but not yet been signed into law). In the eyes of the state of California, all other things being equal, a parent who expresses misgivings about their child’s desire to medically transition is a strictly worse parent than a parent who uncritically and enthusiastically endorses that child’s desire. See also the British charity Mermaids, publicly-funded and endorsed by Harry and Meghan, who were caught sending a chest binder to a journalist posing a 14-year-old teenager, even after being explicitly told that the girl’s mother had forbidden her from wearing one.

Obviously, Freddie, you would be very insulted if you were to be smeared as a bigot for expressing the “standard, not-particularly-interesting progressive” opinion that parents should have some say in what medical treatments their children undergo. Please recognise that this “not-particularly interesting” opinion of yours is in fact very controversial in the trans activist space. Please try to understand how gender-critical people feel when you smear them as bigots for expressing what seem to them “standard, not-particularly interesting progressive” opinions, such as “it’s bad when sex offenders falsely claim to be trans women so as to serve their sentences in women’s prisons”.

Detransition

In his article from March, Freddie had this to say about detransitioners:

Yes, detransitioners exist. (I was close with someone like that in grad school.) This is the human species; people do all kinds of things for all kinds of reasons, including transitioning back to a gender identity that they once transitioned from. And I have no particular opinion on how many of those people there are. What I don’t understand is why the existence of detransitioners should undermine our respect for trans people. Why would the mere existence of people who transition back do anything to challenge our belief in the validity of the majority who transition and then maintain that gender identity permanently?

For the record, the existence of detransitioners does not undermine my respect for trans people. I have trans friends who I respect. If they decided that they wanted to revert to being cis, I would support them in that decision absolutely. The existence of people who transition and then come to regret their decision does not challenge my belief that adults are entitled to transition in the first place, any more than (to use a banal example) the existence of people who undergo tattoo removal challenges my belief that adults can get tattoos if they want to.

The detransition phenomenon is important to highlight in the interests of informed consent. If an adult is considering undergoing an elective medical procedure (or series of medical procedures), their healthcare practitioner should proactively make them informed about the statistical outcomes of that medical procedure, which includes the proportion of people who undergo that procedure and later come to regret it. This goes double for surgical procedures which have a high risk of complications. It goes double-double for highly invasive procedures which will irreversibly change large parts of a person’s body and permanently sterilise them. And it goes double-double-double when you’re proposing to do the above on minors.

If our collective attitude towards medical transition was sensible and depoliticised, the paragraph above would be a complete no-brainer. Instead we find ourselves in a culture in which medical transition is routinely presented as a silver bullet which will erase a trans person’s problems in one fell swoop; in which even the expected downsides of successful transition are downplayed and minimised by healthcare practitioners; and in which distressed parents are browbeaten with emotionally manipulative slogans like “Would you rather have a live daughter or a dead son?” In this environment, it’s perfectly reasonable to push back on the soft-pedalling of medical transition by pointing out that a significant proportion of those who transition later regret their decision, and that prospective transitioners ought to take that fact (among others) into account when making their decision.

If anything, the term “detransition” downplays the severity of the situation. A “detransitioner” has not simply pressed Ctrl-Z and reverted their body to factory settings - the changes they have made to their body are generally irreversible and will completely change the course of their life. Michael Neary’s victims were furious upon realising that they were denied the ability to have further children for no good reason at all - the idea that medical professionals would downplay the magnitude of the decision to transition is unconscionable.

The “Fox News Fallacy”

In his article about multiple personality disorder, Freddie described what he called the “Fox News Fallacy”. I will quote from it at length:

Here’s the problem: under current conditions, there’s no way I can talk about any of this in a way that liberals and leftists will listen to. They’ll see that I’m criticizing Zoomers on TikTok who are engaging under the broad umbrella of “identity” and they’ll declare me a reactionary. No matter how right I am. Ruy Texeira calls it the Fox News Fallacy: “if Fox News (substitute here the conservative bête noire of your choice if you prefer) criticizes the Democrats for X then there must be absolutely nothing to X and the job of Democrats is to assert that loudly and often.”

The specific way that lefties will dismiss this problem will be to say, hey, who cares, it’s just adolescents on TikTok. They won’t affirmatively say that it’s good that thousands of teenagers claim to have spontaneously developed an extremely rare and very punishing mental illness, because that’s stupid, so they’ll say it just doesn’t matter, and really it’s weird that you’re paying attention to this. I’ve already established why I care - I believe that this behavior, and the broader suite of 21st century progressive attitudes towards mental health, are doing immense damage to vulnerable young people. But also we’ve seen this movie before.

People pretend that this never happened, now, but in the early and mid-2010s, the stock lefty response to woke insanity at college was not to say that the kids were right and their politics were good. That was a rarely-encountered defense. No, the sneering and haughty response to complaints about, say, incredibly broad trigger warning policies that would effectively give students the option to skip any material they wanted to was, “hey, it’s just college! They’re crazy kids, who cares? Why are you paying so much attention?” Of course, first it was just elite liberal arts colleges, tiny little places, who cares about what happens there. And then it was just college. And then it was just college and Tumblr, and then college and Tumblr and Twitter, and then it was media and the arts, and then all the think tanks and nonprofits, and when it had reached a certain saturation point the defense changed: now it was good. Just like that, overnight, the “it doesn’t matter if that’s happening” sneering defense switched to the “yes that’s happening and it’s good that is’s [sic] happening” sneering defense. From an argument of irrelevancy to an argument of affirmation in no time at all, and absolutely no acknowledgment that what they were dismissing as meaningless the day before they were now defending on the merits.

And I’m fairly certain that’s what will happen with all of this “alters” shit and various other bits of identity madness. If you think we won’t have mainstream media liberals rabidly defending these self-diagnoses as “valid” and the “personal truth” of a generation of internet-addled kids, wait awhile. Wait. You’ll see. The cool types may not feel great about what’s happening, but they’re doggedly attached to never seeming to echo conservative complaints and are very invested in a self-conception of being above it all. So they won’t rock the boat and this ideology will bubble along in the background and eventually questioning it will result in instant excommunication. Meanwhile a lot of kids will get hurt.

I will inevitably be accused of a lack of sympathy for those with mental illnesses. But I have very deep sympathy for everyone who genuinely struggles with the human devastation of mental illness. What I have always demanded is that this sympathy be extended with an unsparing and viciously honest dedication to grasping their true, ugly, and profoundly unsexy reality. None of this stuff is honest, and none of it is healthy, and I think the cul de sac of rigidly-enforced identity politics is a ruinous development for psychiatric medicine. I am truly worried for online youth culture, and for that I’ll be called a reactionary.

And what does Freddie have to say about gender-critical people who are (among other things) concerned about trans teenagers for many of the same reasons that Freddie is concerned about teenagers claiming to have DID? Well, he

• refuses to say it’s good that tens of thousands of teenagers are claiming to suffer from what was previously an extremely rare medical condition (gender dysphoria) and in many cases requesting drastic and irreversible medical and surgical interventions for same (because it would be stupid to say such a state of affairs is “good”)

• says it doesn’t matter that it’s happening (“To begin with, every indication is that the number of trans children receiving hormones remains low, and the number undergoing surgical interventions vanishingly rare.”)

• suggests that it’s weird that gender-critical people are paying attention to this at all (“I don’t understand why this element of medical science has become everyone’s business to a degree that is simply not true in other fields”) and

• calls all gender-critical people reactionaries (“[Complaining about trans issues] would have made more sense under the old terms of straightforward appeals to public morality and Christian doctrine. The older school of conservative Christians would have simply denounced trans people as wicked, against God’s plan, where now those who agitate against trans rights have to jury-rig these bizarre justifications for restricting them. I would like to put it to those who insist that they don’t hate trans people but who spend endless hours agitating against them… maybe you do hate trans people? Or, at least, feel revulsion towards them, want never to have to encounter them in public?”).

One might think the breadth of criticisms directed towards trans activism and the range of people expressing them might give Freddie pause - surely not all of these people are just bigoted lapsed Christians motivated by animalistic revulsion of trans people? But no - no matter how many people express reservations about this or that component of transgender activism; no matter how measured, restrained and thoroughly researched their criticisms might be; no matter what point on the political spectrum they may reside on (including no less than the Communist Party of Great Britain, who in another world Freddie might consider fellow travellers); even if they are atheist materialists who object to gender ideology specifically because they consider its quasi-mystical dualistic character something of a cultural regression - everyone who is even a little bit more sceptical on the trans issue than Freddie must in fact be a closeted Christian who thinks that trans people are “wicked” and “against God’s plan”. There’s no other possible explanation that merits serious consideration, apparently.

1. For the record, I don’t blame him for finding this behaviour tiresome, I think the people melodramatically accusing him of hypocrisy for “censoring” them should chill out, and as it’s his Substack, the moderation decisions he enforces on it are entirely his prerogative. To anyone who says that my only beef with Freddie is that he won’t let me talk about this stuff in the comments of his articles about something unrelated, I would like here to reiterate: I have never complained about him forbidding people from bringing up trans issues in the comments of his articles, and completely respect his decision to ban people from doing so.

2. To better disambiguate between genuine trans women and cis bad actors was the root of my proposal to make incarcerating trans women in women’s prisons conditional on their being first assessed by a psychiatrist experienced in gender issues. Freddie doesn’t even touch on the prison issue at all, I suspect because he recognises a losing battle when he sees one.

3. Not including the unofficial “Trans Day of Vengeance”, which coincides with April Fool’s Day.

4. To bring it back to another of Freddie’s older posts: medical bodies are institutions, which means they are exactly as subject to the Iron Law of Institutions as any other institution.