This year "The International Day Against Homophobia, Transphobia and Biphobia" stirred up a bit of Fordphobia on Twitter. Allegations that Doug Ford’s Ontario government has “quietly” put a cap on sex reassignment surgery (SRS) received over three thousand upvotes and retweets.

It was fake news.

The follow-up tweet the next day with correction admitting that there are no quotas, was only “liked” by twenty-five.

The word came this afternoon. The Ford govt quietly limited sex reassignment surgery thru OHIP. Many Surgeons have now met their quota till 2022. All scheduled consultations are cancelled or delayed 18 months. Many transgender patients got bad news this week. @PrideToronto — Tracey Kent ? ???? (@TraceyKent) May 17, 2019

So the Min can correctly say there’s no provincial quota. But slowing down the negotiation process to fund clinics into new year, extends wait times, saves the govt $. Trans patients already have a ridiculously long wait. The govt is muddling the process to cut their budget. — Tracey Kent ? ???? (@TraceyKent) May 18, 2019

The allegation was adjusted to claim that delays in clinic appointments were a result of funding cutbacks that had the effect of capping how many surgeries could be performed. But it was not quiet or secret that Ford’s government was looking to reduce the health care costs in Ontario through a variety of cutbacks to OHIP back in April.

While trans activists have injected “transphobia” into the situation, other services being affected have no similar pejorative to inflame the conversation. For example, suggested cutbacks to anesthesia during colonoscopies weren’t denounced as colonoscophobia. Reduction of MRI scans on knee injuries was not called ambulatoriphobia.

Of course in the wake of multiple high profile bannings from Facebook and Twitter, the fastest growing fear could be called transphobiaphobia: the fear of being called transphobic.

Significant changes to improve SRS coverage by OHIP took place in November 2015, when the government moved from CAMH as a single referral clinic to allow more healthcare providers to provide assessments. The goal was to reduce waiting times for those who qualified.

That was the same time period in which Kenneth Zucker was accused of practicing “conversion therapy” and the CAMH youth gender identity clinic was shut down. Zucker has since received an apology from CAMH and a substantial financial settlement. Terminology is part of the ongoing problem blocking discussion about transgender treatment.

For example, Rainbow Health Ontario offers the following information regarding discussion of SRS:

* Transition-related surgery, also known as TRS, refers to a range of surgical options people may require for gender transition. This is also known as sex-reassignment surgery (SRS), gender-confirming surgery (GCS) or gender-affirming surgery (GAS).

The constantly shifting terminology is almost enough to create serious case of languagephobia.

Psychologist Dr. Oren Amitay is one of those people permanently banned from Twitter for alleged transgender infractions. In an interview with The Post Millennial, Amitay explained some of the issues infecting attempts at dialogue with the current wave of trans activists.

One of the conflicts in accessing surgery covered by health plans is that the patient’s condition needs to be listed as an illness in the DSM but activists want to destigmatize the trans community, denying that being transgender is a mental health disorder. Amitay said that “any trans diagnosis, it’s mostly politics. It’s mostly trying not to pathologize, trying to placate people’s concerns and feelings as opposed to science.”

He said the inherent contradiction comes into play when advocates say “even though [gender dysphoria] is not a pathology, if we don’t get [surgery or cross hormones] we’re going to kill ourselves.”

In a recent scandal, Dr Wallace Wong, who claims to be treating 500 trans children through the BC Ministry of Children and Family, instructed parents to “pull a stunt” and falsely claim their child threatened suicide in order to get treatment. The lecture was recorded and posted online along with a transcript.

While suicide rates within the transgender population are extremely alarming, it is shocking that a physician would muddy the statistical waters by advising clients to intentionally misrepresent their mental conditions. It is this kind of dishonesty that creates public mistrust in the controversial treatment of children who are given a gender dysphoria diagnosis.

I asked Dr. Amitay, if pathology is removed from a gender dysphoria condition, what the difference is between gender confirming surgery and plastic surgery like the cosmetic breast augmentations purchased by many women every year. He replied that there are two differences:

“One is you look at the consequences [of plastic surgery] whereas many of these vulnerable people from a young age are being told that this is the way to go.” The second is that “if you were thinking of having breast augmentation at [the age of] fourteen they would have said ‘no you need your parents’ permission’” and doctors would encourage you to wait.

We discussed the fact that women in their late twenties who’ve asked for tubal ligation to avoid further pregnancies are routinely denied surgery on the basis that they are too young to make that decision. Amitay said he’s had numerous female clients say that happened and they were thankful later on when they changed their minds.

In 2017, CTV reported a growing trend in Canada in which women were having cosmetic breast implants removed and no one denounced the report as mammophobic. But attempts to publicly discuss detransitioning are politically dangerous.

Dr. Amitay said that people have assumed there would be “medical safeguards” in place but that many of these gatekeepers seem to have “caved and joined the club.”

Given that careers, like Kenneth Zucker’s, have been destroyed for reluctance to accept self identification as the sole criteria for diagnosis, it’s hard to blame those who choose to remain silent. And yet, as doctors, they have a presumed duty to first do no harm.

In terms of how this all happened, Amitay said “a woman who wants larger breasts, she can’t claim ‘it’s in my brain’ ‘it’s in my genes’ or ‘some biological reason I want larger breasts’” and that’s part of the conspiracy to use the DSM to access surgery without also accepting gender dysphoria as an illness.

While the majority of the public would likely agree that people who sincerely suffer from gender dysphoria should have access to medical care, the concern for accurate diagnosis and carefully designed treatment plans is based on sound ethical grounds. And we should not be intimidated for trying to engage in rational, legitimate research or discussion.

After decades of being told that gender is a social construct, one of the logical questions to which I’ve sought an answer is why so many trans people define themselves with stereotypes about gender.

In his meandering presentation, Dr Wong discussed the problems, as a therapist, with the DSM criteria for gender dysphoria. His admission is rather telling: “I fit all eight of [the criteria] when I was a kid, but I’m not transgender; I just happen to be gay.”

And that is, to me, part of the irony of “The International Day Against Homophobia, Transphobia and Biphobia." Dr. Wong accepts the guideline that 80% of trans kids will desist and many are actually just gender non-conforming or homosexual. As a consequence, becoming transgender may sometimes be a form of homophobia. Additionally, biphobia is largely a problem within the LGBT community itself.

When Wong congratulated himself in the audio tape, saying how lucky he is that all of his clients fall within that magical 20% of legitimate transgender cases, it raises questions about how statistics and data are being used by professionals.

In his lecture Dr. Wong declared “I’m so blessed that I’m seeing all the 20 percent. I am just so lucky. Just so lucky.” But it raises questions as to whether or not these children are “lucky” to have him as their therapist. If Wong has all the 20% of real cases, which therapists have the other 80%?

Perhaps one of the best things that trans advocates could do to further their cause is to allow for open, honest, and difficult conversations. What they might find is that the only fear towards the trans community is being generated by their own rabid and radical activists.

Wanting to protect children is a natural, human impulse. No one should be shamed or unpersoned for demanding that children not be used as experiments for pharmaceutical companies. Doctors and academics should not be fired for asking uncomfortable questions or presenting research that doesn’t conform to a particular ideology.

If there is transphobia at play in the fields of the internet, it won’t be overcome by silencing and threats from trans advocates. Afterall, disagreement is not “hate speech.”

