Nothing is what it seems at the Trans Wellness Conference down at Philadelphia’s Pennsylvania Convention Center.

Someone brushing past in the hall sports a beard on an angular chin, but also a handbag and heels. A lecturer refers to himself as “they” throughout his (or was it her?) talk on chest “binding.” The brochure says “Wellness,” but no one looks well here. All around are misshapen and untoned bodies; faces marked with dissipation; studied dress that is a couturial assault on the eyes. Scarcely one in the 700 looks appealing.

“Conference” is a misnomer too, if to “confer” is to exchange opinions. There is one allowed opinion in this place, as I would test on Day Two, and receive incontrovertible proof of on Day Three. No workshop discusses the ethics of turning males into females and females into males; that cow’s long out of the barn. The Enlightenment is presumed, and the devil has moved to the details—legal strategies; insurance end runs; school infiltration; post-surgical therapies.

The legal and medical professions are heavily represented. (“Where there is carrion there the vultures will gather.”) A curriculum sampling:

“State and Local Advocacy for TGNC [Trans/Gender Non-Conforming] Youth in Schools”; “Parents of Trans Youth Ages 12 and Under”; “Facial Feminization”; “Tips to Work with Your Health Insurance Company”; “Intersections Between Fashion, Mental and Sexual Health”; “Top and Bottom Surgery”; “Combating Dysphoria Through Fitness”; “Care of the Aging Transgender Person”; “TGNC Youth and Homelessness”; “Self-Massage Techniques for Chronic Pain”; “Packers, STPs, Masturbators, and Sex Toys”; “Becoming an Activist for Trans Rights in School”; “Self-Care Strategies for Trauma and Anxiety in Trans and Non-Binary Bodies”; “Cross Hormone Therapy”; “Hormones and Handcuffs”; “Trans Porn.”

Sex play paraphernalia to make ancient Pompeii blush is openly displayed on some of the scores of tables in the vast lobby. Around the corner is the children’s room, where someone blowing soap bubbles into the air reminds me of the Pied Piper, who lured the town of Hamelin’s children from their parents. A flamboyant drag queen reads Red: A Crayon’s Story to enthralled children donning knit rainbow caps and sitting in a circle with their beaming mothers.

You, like I, might have thought that gender “transitioning” was a once-and-done thing. Not so. What an outsider is most surprised to learn is the extent of lifelong negative health impacts and medical complications on the other side of transgender surgeries. One session I attend is devoted solely to post-op pelvic issues. As a “body worker” presenter admits, “everything’s connected to everything else.”

What an outsider is most surprised to learn is the extent of lifelong negative health impacts and medical complications on the other side of transgender surgeries.

So when bits of the forearm are mined for the construction of a penis, nature is not flouted with impunity. Girls “binding” their breasts to minimize them, girls undergoing breast removal, end up with chronic neck pain, scoliosis, loss of range of arm motion, and secondary muscles struggling to perform functions they were never designed for. The “neo-vagina” must be continually kept open or it will reclose. I cannot scratch the surface of issues here.

During the presentation by a New York librarian, kindergarten teacher, and author of children’s illustrated trans books, I raise my hand at the back of the room: “Aren’t you concerned that you are not so much responding to 5-year-olds’ felt needs as creating them by planting suggestions? Now that ‘trans’ is becoming cool, don’t you worry about a bandwagon effect?” The room is collectively appalled. His smile fades and he says, “No. Next question,” and moves on.

Two questioners later, evidently still piqued, he comes out with the most revealing statement of the three-day circus: “As for the concern that a child might decide to become a trans in imitation of another child, … SO WHAT?”

On Day Three I mosey over to a table where I might find common ground: United Methodist Church. A middle-aged man and woman smile and offer me literature. I smile back and ask if they have heard of John Wesley. This begins a conversation whose ensuing half hour must be condensed for purposes of this column, but in short I find myself being pursued down the crowded hallway by two security agents, accused of homophobia, transphobia, and racism, and escorted to the exit.

I stop outside and breathe fresh air.