One of the greatest compliments of Thomas Aquinas was that he was often better and more persuasively able to explain his opponents’ arguments than the opponents themselves. In his new book, When Harry Became Sally, Ryan Anderson seems to have a similar Thomistic capacity for explaining the Transgender Movement.

Anderson dedicates large sections of the book to quoting and summarizing what the activists are saying. He even clarifies some points transgender activists make. For example, he notes that the claim, “People are the gender they prefer to be” (p. 28), is an ontological claim; that is, a claim about being, not just preferences. Clarifying this point removes the argument from the realm of preference to ontology. At the same time, by showing this argument clearly, he makes it more refutable: we cannot argue preferences (subjective, pizza vs. tacos), but we can argue ontology (objective, what really exists).

This ontological claim brings up a very important distinction in this discussion, namely, the difference between individuals who suffer from gender dysphoria (aka gender identity disorder) and activists pushing an agenda. The activists want to replace objective ontological reality, claiming that mere opinions are more real than reality. Those who suffer these conditions just want relief.

Trans Kids vs. Trans Adults

Among those who suffer from thinking they are not their biological gender, Anderson rightly distinguishes between kids and adults. Kids have a very high remission rate (80%+) if puberty progresses in a normal way. If a therapist helps, remission rates move even higher.

Anderson notes that these kids’ perceptions are out of accord with reality, but in every other situation where there is discord between perception and reality, we try to change the young person’s perception, not reality. In other bodily disorders like anorexia, we don’t help teens starve themselves; we help them accept a reasonable weight. Anderson states, “Why do our feelings determine reality on the question of sex, but on little else? Our feelings don’t determine our age or height” (p. 47).

For adults, the book seems to offer no effective treatment for gender dysphoria. Hormones and sex reassignment surgery are 98% successful at producing altered physical characteristics, but they do not seem to resolve wider issues of body image, depression, and suicide: in fact, some studies suggest these treatments may make these problems worse. If a medical procedure with many negative side effects produces no better results – and possibly worse – than no treatment at all, why do it? There may be better tests in the future to indicate when such treatments would actually help a person, but so far they seem clearly to be a net negative for those treated.

Some adults seem to find relief in discovering and dealing with issues causing gender dysphoria. In the section on “detransitioners” – i.e., those returning to their original gender after trying to adopt an alternative gender – he gives examples of some who discover more fundamental causes such as dissociative disorder and family issues. Once these people resolved the underlying issue, they no longer had gender dysphoria.

I asked Anderson about the seeming lack of treatment for adults with persistent gender dysphoria that does not come from an underlying issue. He said that oftentimes all that can be offered are strategies for coping and for mitigating issues as is done with many other untreatable psychological conditions.

Policy Prescriptions

Nonetheless, today eight states have bans on any treatment for transgender individuals other than helping them to “transition” from one gender to another. This is a total capitulation to activists. Many who later detransitioned complained that no other options were offered. They feel like they were not given a chance to investigate underlying causes or other therapeutic options but were pushed toward hormones and surgery.

In such an environment, when transgender activists push everyone toward transitioning, we have to ask if they are really showing compassion. True compassion would be attempting to help all those suffering from gender dysphoria to find a way to live their lives in peace. When a five-year-old thinks he or she is the opposite gender, what is true compassion for that child? Is it compassionate to force life-altering treatments with serious negative side effects for something that the vast majority of young people will grow out of? I doubt it.

Toward the end of the book, Anderson comments on the issues regarding policy and culture. The fundamental problem with what transgender activists are asking, he says, is that their concerns only take into account the trans individual and no one else.

He notes, for example, the problems with allowing people to go into a bathroom based on their preferred gender identity without any checks and balances. First, this puts many people in uncomfortable situations because it violates privacy, which is the whole purpose of gender separation in the first place. Second, it makes it much hard to prosecute disreputable individuals using public bathrooms. In established law, a man shows his ill intention simply by entering a women’s bathroom. It is not that a transgender person will necessarily commit such crimes; rather, these norms let weird, seedy individuals hide under the cover of “gender identity” and associated misunderstandings, which are hard to disprove. While this may sound theoretical, it is a documented fact that creeps like this have tried to use the gender identity defense over 130 times in American courts. Finally, the law of preferences discriminates against people whose gender identity matches their biological sex: they have to go into one restroom while transgender individuals can go into either.

Anderson’s Methodology

Anderson is cautious with the sources he cites and the claims he makes. For example, he notes that only 5-20% of kids with gender dysphoria continue with it irreversibly into adulthood. However, a quick search of the literature on the NIH website finds a review article with a stronger statement. “Only 2.5% to 20% of all cases of GID in childhood and adolescence are the initial manifestation of irreversible transsexualism.”

When Harry Becomes Sally is not above critique, however. Anderson relies heavily on Mayer and McHugh’s special report, “Sexuality and Gender”, from The New Atlantis in 2016. If you have read and understood these scholars, you can probably skip significant parts of this book. Nonetheless, Anderson does a service in making this information more accessible to the general public and adding a philosophical layer. The only other criticisms of the book are minor: there are a few obvious typos, and he presents some information more than once as if it were new information.

Overall, Anderson presents a formidable primer on the Transgender Movement. It shows how the claims of activists and actual science are miles apart. I have given a rough summary here, but if you are interested in the topic, read the book.