Trans people and detransitioners are valid: a response to “Speaking up for female eunuchs” Dana Pham Follow Feb 2 · 13 min read

Illustration by Ellie Foreman-Peck. Source: https://standpointmag.co.uk/issues/february-2020/speaking-up-for-female-eunuchs/?fbclid=IwAR3zJlQ_ZjAhLaVU6as0HukOiKAQu5SXG5N4OJujLVmFC59GOk-VJCTIqkg

A few days ago, Helen Joyce had an opinion piece of hers published in STANDPOINT. titled “Speaking up for female eunuchs”. Essentially, she argued that “the woes of “detransitioners” are a warning: treating children with gender dysphoria is riskier than zealots admit”. She’s right in pointing out that the zealots should pay proper attention to the detransition phenomenon, but I don’t believe her claim that treating gender dysphoric children is “riskier” stands up to scrutiny.

It’s sad to see that Britons are slowly losing their freedom of speech, and protests, a form of free speech, have been used to erode other people’s free speech. Trans zealots are notorious for this (see Helen’s Michfest reference), and attempt to drown out the detransition phenomenon out of the transgender discourse because according to them, detransitioners “are not supposed to exist… who were once “transgender”. These zealots harm the community they supposedly represent, because as far as I can tell, the facts about detransition are on their side, yet they choose shut down debate instead. That is not the way to win debate — all it does is help the Helen Joyces of the world win through misinformation.

Gender identity is not a “supposedly innate sense of which sex you are” as Helen simplistically puts it. Humans are created following a male-female dimorphic template, a blueprint of instructions contained within DNA and genetics. Syncopated development in utero of the fetal sex and fetal brain gender can lead to miswirings, which originate in entropy and the mutations that drive species-level evolution. Hormonal profiles, namely testosterone and estrogen, are generated according to the gonadal development in utero, ie the sexing of the fetus yields hormone engines.

Hormone receptors are populated 6–8 weeks following fetal sexual differentiation. When hormone receptors differ from those expected by the gonad-driven hormonal profile, gender dysphoria arises. Gender stereotypes are the natural expectation or average response of estrogen acting on a ‘normal’ female and testosterone acting on a ‘normal’ male. Gender roles are a post-hoc analysis of observed gender stereotypes, and are used to discourage divergence in gender identity. This manifests when society, unintentional or not, reinforces gender roles, which are ironically defined by naturally-occurring gender stereotypes.

Transgender people are a natural consequence of living in a world governed by entropy, evolution, and mutation. Sex does not define gender; we are more than just chromosomes. So here’s the gender ‘chicken and egg’ riddle: are gender-stereotyped behaviors reinforced by society simply because they are the expectation/norm of the dimorphic human template, based merely on the way testosterone acts on the ‘normal’ male brain and the way estrogen acts on the ‘normal’ female brain? Or do they become the norm through the reinforcement of gender roles that are subconsciously created from our observations of naturally-occurring gender stereotypes? Feminists fought to abolish the latter, and rightfully so. The zealots are wrong to treat detransitioners, especially natal female detransitioners, as apostates.

There’s a difference in the manifestation of similar characteristics in women that are driven by estrogen acting on the female brain (gender stereotypes), and a woman being pressured into behaving in accordance with expected gender roles, defined by society through the projection of determinism onto gender stereotypes. The only reason people are forcing themselves into norms to begin with is out of the fear of society’s response, which ironically results from their misunderstanding of the natural, biochemical origin of human gender identity. Nature ‘chose’ to rebel by proxy through entropy — it can’t be helped. Transwomen are a type of women, just like tall women are a type of women, athletic women are a type of women etc.

Helen mentioned that “The Tavistock Centre… treats young people with gender dysphoria. A decade ago it saw fewer than 100 under-18s annually. Last year it saw nearly 2,600”. As time goes by, more and more people in our society figure out that they’re genuinely gay, yet no one complains about that? The same principle should apply to gender transitions, unless of course if you have a problem with adults and children figuring out who they really are, and being true to themselves.

In any case, Helen framed the trans children debate in the UK as follows:

“On one side are activists and clinicians who press for “affirmation”: an immediate change of name, dress and pronouns, with the expectation of proceeding to medical treatment. On the other are feminists who dismiss gender as sex stereotypes and object to the medicalisation of nonconformity, and parents who fear that children who are merely confused will be turned into lifelong medical patients.”

This is not surprising. Debates surrounding trans issues have become so polarising today, especially in North America and the UK, that it’s no longer as simple as a Google search for determining what the nuanced truth is. I am very disappointed in both sides of the debate. Fortunately the debates aren’t as polarising here in Australia, but I am still very disappointed in the polarisation, which pretends nuances doesn’t exist. I can only write from an Australian perspective about the nuances, so here goes:

Transition treatment for trans children is not as radical as it seems. The first step for a child, if they want to, is to let them wear whatever clothes fit their gender, and pick a name that feels right for them. It doesn’t sound like much, but it can go a long way for these children, and at any point they feel that such simple things are not right for them, then they can just simply drop it. Genuinely gender dysphoric children who socially transition will generally find that their mental health is almost as good as their peers. This is not conditioning “children to accept a life of chemical and surgical impersonation of the opposite sex as normal and healthful”, as conjectured by the discredited American College of Pediatricians.

Helen makes the interesting point that “no clinic is researching what distinguishes children who persist in cross-sex identities from those who desist… Detransitioners’ testimony suggests plenty of possibilities: eating disorders; past sexual abuse; rejection of same-sex orientation; or autistic spectrum disorders, which cause rigid categorical thinking”. More research of this kind wouldn’t hurt, however, at the end of the day it’s the role of the psychologist/psychiatrist to figure out if a trans patient has comorbidity, and if the patient does, ensure the patient’s condition/s are well managed, and not driving apparent gender dysphoria, especially if the dysphoria is not insistent, persistent and consistent. If your child’s psych is not doing this, go find another psych. Perhaps the problem isn’t transgender healthcare, perhaps the problem is bad apples in the psych profession.

Nevertheless, Helen went from making an interesting point to reframing unreliable research as reliable: “Anyone who ventures onto such forbidden territory risks being accused of transphobia; their reputation, even their livelihood, can be on the line… In 2018 Lisa Littman… surveyed parents of trans-identified teenagers whom she found on websites critical of the affirmative approach”. Dr Littman, who coined the term Rapid Onset Gender Dysphoria based on her 2018 survey, delivered a study that was not even a testable hypothesis, let alone a phenomenon: no long-term follow up, no cross-checking with the trans children themselves involved. Unfortunately Helen didn’t stop there.

It’s simply not true that “every study of pre-pubescent children with gender dysphoria has found that the great majority become comfortable with their birth sex before reaching adulthood. Many turn out to be gay”. The studies that I think Helen is referring to are studies that randomly take a group of children from gender clinics and follow them, only to seemingly find that most aren’t trans when they grow up. But what does that mean?

It means that a lot of these studies are just studying children, at random, that attend these gender clinics, without differentiating between those who have a gender dysphoria diagnosis, those who identify as trans, with or without diagnosis, and those who don’t identify as trans at all. All these children attended these gender clinics for a wide range of reasons, not just for gender dysphoria diagnosis. So the next time you hear the argument that “60–90% of children will naturally grow out of it”, it’s because that 60–90% weren’t trans to begin with. In fact, many of these 60–90% are LGB(-T)QIA in some way, shape or form, just not T. But unfortunately Helen again didn’t stop there.

Helen referenced sexologist Ray Blanchard, who classified transwomen into “two broad groups, according to their sexual orientation. The homosexual ones had generally been feminine in behaviour and appearance from a young age, and transitioned in their 20s to fit in better — and perhaps to have better luck finding sexual partners”. What a terrible reason for a feminine gay man to transition. Sexual orientation is separate to gender identity, which I gather from Helen’s writings that she would agree on the separation, so what gives Helen?

Helen continued: “The heterosexual ones were far more numerous. They had generally been conventionally masculine… Most had cross-dressed in private since puberty, while fantasising about mundane or stereotypical aspects of being female… Blanchard hypothesised that they experienced… “autogynephilia”: sexual desire for themselves in the form of a woman”. As a transwoman myself, I can attest that Blanchard’s autogynephilia is more accurately a pre-transition transwoman’s desperate desire to transition due to long-term repression of gender dysphoria.

As people are transitioning younger, autogynephilia is losing its relevance. One should be careful in assuming that one understands transwomen’s experiences, which can vary greatly. This is why there is little to no “sexual motive for transitioning is central to understanding why activists are so wedded to the gender-identity narrative”. It’s also why the accusation that gender dysphoric children are interpreted as trans “in order to prop up the insistence of trans adults that they are motivated by an innate gender identity that does not match their body” is false.

Nevertheless, Helen contended that “almost every child who has ever taken such “puberty blockers” has progressed to cross-sex hormones… skipping natal puberty may permanently harm brain development, and probably causes brittle bones. Worst, it means certain sterility”. Correlation is not causation — adolescents who take puberty blockers to treat gender dysphoria eventually progress to hormone replacement therapy (HRT) to continue to treat gender dysphoria, not because blockers causes them to progress to HRT. Helen’s speculation on permanent harm to brain development and brittle bones is even less helpful, and even if the speculation is entirely true, it’s not as psychologically harmful as gender dysphoria. All medical treatments have their benefits and risks, even Panadol, which is so easily available and accessible. Perhaps we should get hysterical about Panadol as well?

The 10–40% (along with the 60–90%) don’t deserve to be forgotten — they deserve gender identity presentation alignment as appropriate, not denial of transition treatment. During the child’s formative years, the most rapid cognitive and emotional growth occurs. Children’s physical and emotional environments dramatically impact the development of their nervous system. This is especially true of the brain and has profound implications for their psychological health as adults. Let’s get it right for the 10–40% Helen has paid little regard for here, because this does not have to be a zero-sum game. Fertility does not take priority over mental health. We’re all God’s children: there is nothing wrong with adoption or fostering.

The only way to draw clear conclusions about the identity persistence of trans children is to conduct prospective studies of children with gender dysphoria diagnosis. No muddying the waters. Said prospective studies are ongoing, and they indicate that the Royal Children’s Hospital Gender Service in Melbourne is on the right track, along with the Australian Standards of Care and Treatment Guidelines they’ve come out with. This is why the gender transition regret rate is consistently less than 1%, irrespective of when the transition started. That failure rate is lower than many medical treatments available out there. Note that gender transition in any form is not cure, that’s why it’s called treatment, not cure. But that hasn’t convinced Helen due to “flimsy evidence”, but she then goes on to misinterpret more credible evidence.

Helen quoted the infamously misinterpreted 2011 Swedish study by Dhejne et al that tracked 324 transsexuals between 1973 and 2003 in Sweden, which found that “persons with transsexualism, after sex reassignment, have considerably higher risks for mortality, suicidal behaviour, and psychiatric morbidity than the general population”. However, the “results should not be interpreted such as sex reassignment per se increases morbidity and mortality. Things might have been even worse without sex reassignment… Medical transition alone won’t resolve the effects of crushing social oppression: social anxiety, depression and post-traumatic stress”. One of the authors of the study further clarified that:

“The risk of suicide was increased 19 times compared to the general population, but that is because gender dysphoria is a distressing condition in itself. Our study does not inform us whether sex reassignment decreases (which is likely) or increases (which is unlikely) that risk… We have known for a long time that it is associated with other psychiatric disorders (such as depression) and increased rate of suicide attempts. Sex reassignment is the preferred treatment and outcome studies suggest that gender dysphoria (the main symptom) decreases. But it goes without saying that the procedure is a stressful life event. And that the surgery and medical treatment is not perfect. It is thus not surprising that this group of patients will continue to suffer from stress-related psychiatric disorders. There might be lingering professional and relational problems. It is also possible (but unproven) that gender dysphoria is somehow etiologically related to depression. In that case, fixing the first with a cure would not automatically fix the latter.”

Detransitions and regrets do rarely happen. A 2018 survey of WPATH (World Professional Association for Transgender Health) surgeons found that approximately 0.3% of patients who underwent transition-related surgery later requested detransition-related surgical care. I want the very best healthcare for detransitioners, but their detransitions should not be used maximise harm against people whose gender transitions are right for them. Whilst some people detransition because transitioning genders wasn’t right for them, others detransitioned not because it wasn’t right for them, but because of reasons such as financial barriers to transition, social rejection in transition, and detransitioning temporarily in order to have biologically-related children.

Desistance can be a form of survival mode, rather than being genuine desistance. Indeed, the 2015 US Transgender Survey found that 8% of respondents who had transitioned reported having ever detransitioned, and 62% of that group had later returned to living in a transgender role. Given how more complicated detransition and desistance is than what both sides of the polarising debate have made it out to be, it’s no surprise that the recent political attention paid to detransitioners has elicited in them mixed feelings of both exploitation and support. We can do better than this.

WPATH’s Standards of Care (SOC) doesn’t reference detransition, although the majority of WPATH surgeons support the inclusion of detransition guidelines in the next (eighth) edition of the SOC. Helen mentioned the “changing caseload at paediatric gender clinics around the world, which used to see mostly prepubescent boys but now mostly see teenage girls. These young women have been indelibly marked by their quest for manhood”. Perhaps in the detransition context, the next SOC edition should emphasise the gender ‘chicken and egg’ riddle: are gender-stereotyped behaviors reinforced by society simply because they are the expectation/norm of the dimorphic human template, based merely on the way testosterone acts on the ‘normal’ male brain and the way estrogen acts on the ‘normal’ female brain? Or do they become the norm through the reinforcement of gender roles that are subconsciously created from our observations of naturally-occurring gender stereotypes? The pie doesn’t need redistribution, it just needs to grow to benefit both trans people and detransitioners.

As someone who leans libertarian, I do share Helen’s concerns about the state getting involved in the parenting of children, when it’s the children’s parents who should be doing the parenting. I should point out however that those who criticise parents for supporting their gender dysphoric children transitioning should also not be surprised over the criticism of parents who don’t support their gender dysphoric children transitioning. Respecting parents’ rights is a two-way street. I can also see where Helen is coming from on the issue of gender self-identification.

Gender identity and pronouns are socially negotiable, because there are two parts to gender identity. The first part relates to self-identification, and this may be driven or not driven by gender dysphoria. What may not be as self-explanatory is the other part: identification perceived by others, which gives rise to social negotiation.

There’s an interview clip on YouTube that shows Ben Shapiro initially using transgender actress Laverne Cox’s proper pronoun (female) on Joe Rogan‘s show. He did so without thinking, then ‘corrected’ himself when he realised his façade cracked. His façade is his belief in ‘biological pronouns’, but sex chromosomes were only discovered in 1905, and ‘he’ is Old English, ‘she’ is Middle English. Ben usually doesn’t look silly, but in this case, he did, especially given that he would not have access to Laverne’s chromosomal sex test results, if they do exist.

Because there’s no such thing as ‘biological pronouns’, Ben gendered her female (initially) because irrespective of whether Laverne passes as a woman or not, or whether she proclaims her gender identity or not, she presents as a woman. Her gender presentation, with the help of any HRT and SRS, signals to everyone’s brains that she is a woman, cisgender or trans.

Since our brains prefer categorisation, if you saw someone in the local shopping centre presenting as a woman, regardless of any less conspicuous manly imperfections or knowledge of her history, she would register as female in your mind because she falls within the broad female category accordingly. To illustrate this point further, if you knew that the person you saw at the shopping centre is a transwoman, bumped into her then decided to have lunch together, using male pronouns when referring to her would only serve to confuse the waitress taking your orders, who is even less interested in her history.

Now if you came across a pre-transition transwoman who doesn’t present as a woman, ie looks like a ‘man’, and they asked you to use female pronouns, you shouldn’t be forced into using the requested pronouns, but I think it would be polite to use female pronouns in this case. This is social negotiation, and it appears that a lot of trans activists, especially on the Internet, deny the reality thereof. I guess hiding behind a computer/smartphone screen is bliss.

Gender identity and pronouns are tools of social negotiation. Trans activists however have used them as emotional tools of self-identification, and this has not helped societal acceptance of ordinary trans folks who just want to get on with their lives without worrying about trans politics.

Finally, Helen makes some interesting points about transwomen’s participation in women’s sports. My question to her however, is that if one opposes transitioned transwomen, who’ve been through male puberty, participating in women’s sports, why would one also oppose transgirls from transitioning to prevent themselves from going through the same male puberty? You can’t have cake and eat it too. I’d imagine however that as trans people are transitioning younger, the issue of “larger, stronger” trans sportswomen will too pass.