A Brief Summary of an Essay-series Exploring the Transgender Dilemma Through the Lenses of Critical, Scientific, Economic, Ideological, Ethical, Psychological and Pharmacological Perspectives:

Introduction

Over the past few decades, the conversation surrounding LGBT rights has undergone a dramatic transformation. What began as a fight for equal rights for gays and lesbians—centered on sexual orientation as an immutable characteristic—has shifted towards a movement advocating for self-defined gender identity, often at the expense of biological reality. This shift has introduced new legal, medical, and ideological challenges, raising ethical concerns, scientific contradictions, and financial incentives that demand scrutiny.

This comprehensive analysis explores the key distinctions between gay rights and gender ideology, the scientific and medical implications of gender dysphoria, the socio-psychological factors driving the trans identification surge, and the multi-billion-dollar industry profiting from the medicalization of gender identity. It also examines the ideological roots of gender theory, shaped by postmodernism’s rejection of objective reality and neo-Marxism’s focus on identity as a political struggle. Additionally, research highlights a strong correlation between autism and gender dysphoria, raising concerns that individuals with cognitive rigidity and social difficulties may be particularly vulnerable to gender ideology’s influence. Through well-researched data, expert insights, and critical analysis, this paper aims to separate fact from ideology, ensuring that compassion does not come at the cost of truth.


Part 1 – Rights vs. Gender Ideology: A Research-Backed Analysis


Summary:

1. Scientific Basis: Sexual Orientation vs. Gender Identity

  • Sexual orientation (LGB) is strongly biologically influenced, with evidence from brain structure differences, twin studies, and the fraternal birth-order effect.
  • Neuroscientists like Debra Soh argue sexual orientation is largely innate and not socially constructed.
  • Gender identity (T/Q), however, lacks definitive biological evidence; studies show some brain differences in transgender individuals, but these are confounded by hormonal treatment and other factors.
  • High desistance rates (60–90%) in gender-dysphoric children suggest social and developmental influences.
  • The phenomenon of rapid-onset gender dysphoria (ROGD), particularly among adolescent girls, implies social contagion effects.
  • Gender identity appears more fluid and influenced by social/psychological factors than sexual orientation.

2. Impact on Gay and Lesbian Communities

  • Surge in female-to-male (FtM) transitions, particularly among adolescent girls, suggests many who would have been lesbian are now identifying as trans men.
  • Tavistock gender clinic in the UK saw a 5,000% increase in trans-identifying teen girls from 2009 to 2016.
  • Lesbian identity is declining as more women adopt fluid labels like ”queer” (from 69% identifying as lesbian in 2014 to 38% in 2024, per Australian SWASH survey).
  • Social pressures in LGBT spaces encourage same-sex attracted individuals to accept trans partners; lesbians rejecting trans women (biological males) as partners face accusations of bigotry.
  • Stonewall UK now defines sexual orientation by gender identity rather than biological sex, causing tension within the community.
  • Rising concerns that gender ideology is eroding lesbian identity and redefining same-sex attraction in a way that marginalizes LGB individuals.

3. LGBTQ+ Movement Shift: From LGB Rights to Emphasizing Gender Identity

  • Post-legalization of same-sex marriage (2015, U.S.), major LGBT organizations pivoted to gender identity activism.
  • Trans rights have taken center stage, shifting the focus from biological sex-based sexual orientation.
  • Organizations like Stonewall redefined ”gay” and ”lesbian” to include trans individuals, sidelining those who believe orientation is based on sex.
  • This shift has created internal fractures, with groups like the LGB Alliance advocating for separating LGB and T issues.
  • Some argue that scientific contradictions exist: gender identity is claimed to be ”innate” while sexual orientation is now seen as ”fluid.”

Conclusion: Sociopolitical Trends and Policy Responses

  • Many liberal democracies adopted gender self-identification (self-ID) laws, allowing legal gender changes without medical requirements.
  • Critics argue self-ID undermines women’s and lesbian rights, allowing biological males access to female-only spaces and categories.
  • Institutional changes in education, media, and corporate policies promote gender ideology, often prioritizing trans inclusivity over LGB concerns.
  • Media initially embraced trans narratives uncritically but has since become more nuanced, with outlets like BBC and The Economist reporting on lesbian and feminist pushback.
  • Countries like Sweden and Finland have begun restricting youth medical transitions, prioritizing psychotherapy over immediate medical interventions.
  • Policy shifts highlight a growing re-evaluation of gender ideology, balancing trans rights with concerns over medical ethics, childhood development, and the integrity of sex-based identities.

This essay suggests that the rise of gender ideology has significantly altered the LGBTQ+ landscape, leading to tensions between gender activists and same-sex attracted individuals. While trans rights have gained mainstream institutional support, concerns persist about the erosion of biological sex-based identities, the impact on lesbian and gay communities, and the long-term consequences of youth medical transitions. The challenge ahead is crafting policies that respect both transgender rights and the distinct realities of sexual orientation without conflating the two.


Part 2 – Gender Dysphoria, Autism, and Trauma: Science, Ideology, and the Ethics of Affirmation Therapy


Summary:

1. Scientific Correlations: Autism, Trauma, and Mental Health

  • Autism and Gender Dysphoria:
    • Large-scale studies show that transgender-identifying individuals are 3–6 times more likely to be autistic than the general population.
    • Around 24% of trans/gender-diverse individuals in one study were autistic, compared to 5% of cisgender individuals.
    • Hypotheses for this overlap include sensory sensitivities, rigid thinking, and reduced influence by social norms among autistic individuals.
    • The “extreme male brain” theory suggests cognitive patterns in autism may correlate with gender variance, particularly in females.
  • Childhood Trauma and Gender Dysphoria:
    • Studies consistently report high rates of early sexual abuse, emotional neglect, and adverse childhood experiences (ACEs) among gender-dysphoric individuals.
    • One study found 55% of trans individuals had experienced sexual abuse before age 18.
    • Some clinicians theorize gender dysphoria can serve as a dissociative defense mechanism against trauma (e.g., escaping an identity associated with abuse).
    • Case studies suggest some transitions may be attempts to escape past abuse or bullying, particularly among same-sex attracted youth.
  • Mental Health Comorbidities:
    • Trans-identifying individuals have significantly higher rates of anxiety, depression, PTSD, eating disorders, ADHD, and personality disorders than the general population.
    • One survey found 53.2% of gender-dysphoric individuals had a history of at least one major psychiatric condition.
    • Lisa Littman’s research on Rapid-Onset Gender Dysphoria (ROGD) found that 62.5% of trans-identifying youth had pre-existing mental health conditions.
    • Critics argue that transition-focused therapy often overlooks underlying psychological issues, reinforcing gender dysphoria instead of treating its root causes.

2. Biology vs. Ideology: Is Gender Identity Innate or Socially Constructed?

  • Brain Studies and Gender Identity:
    • Some brain imaging studies report that trans individuals have neuroanatomical traits that differ slightly from their birth sex, though not conclusively matching their identified gender.
    • However, sample sizes are small, and confounding factors (hormone therapy, neuroplasticity) complicate conclusions.
    • Critics like Debra Soh argue that the belief in an “innate transgender brain” is not well-supported by science and has become politically driven rather than evidence-based.
  • Social Contagion and the Surge in Trans Identification:
    • Historically, most trans-identifying individuals were adult males who had long-standing dysphoria from childhood.
    • In the last decade, there has been a 4,400% increase in teen female referrals to gender clinics, suggesting social and cultural influences.
    • Lisa Littman’s ROGD study found clusters of teenage girls in friend groups simultaneously identifying as trans after social media exposure.
    • Abigail Shrier argues that many of these girls are gender-nonconforming lesbians who, in previous generations, might have simply been comfortable in their bodies.
    • Critics suggest that social pressures and activist messaging are pushing gender questioning among vulnerable youth, rather than revealing innate identities.
  • Debra Soh and the Critique of Gender Ideology:
    • Soh critiques the politicization of gender science, arguing that dissenting researchers face suppression.
    • She emphasizes that most gender-dysphoric children (80%) desist by puberty if not socially transitioned early.
    • She warns that gender identity is being treated as untouchable ”dogma” rather than an area for open scientific debate.

3. Ethical Concerns: Gender-Affirming Therapy vs. Reality-Based Therapy

  • Affirmation vs. Exploration in Therapy:
    • Affirmative therapy immediately validates a trans identity and facilitates medical transition.
    • Reality-based therapy explores underlying causes of gender distress before affirming transition.
    • Critics liken affirming dysphoria without exploration to affirming an anorexic’s belief that they are overweight—validating a false self-perception rather than treating the underlying issue.
    • The push to classify gender-exploratory therapy as ”conversion therapy” has created a chilling effect, discouraging therapists from questioning trans identities.
  • Comparison with Other Psychiatric Conditions:
    • If a schizophrenic patient claims the TV is sending them messages, a therapist does not confirm their delusion.
    • If a BDD (body dysmorphic disorder) patient demands surgery for a minor flaw, doctors typically refuse because the issue is psychological.
    • Yet, for gender dysphoria, many clinicians now affirm the identity immediately, despite parallels with other identity-related conditions.

4. Medical Ethics and the Treatment of Minors

  • Puberty Blockers: “Pause Button” or Path to Sterilization?
    • Puberty blockers are often presented as reversible, but long-term effects on bone density, brain development, and fertility are unknown.
    • One study found 98% of youth who take blockers proceed to cross-sex hormones, making it effectively a transition path rather than a “pause”.
    • Sweden, Finland, and the UK have recently reversed course, now prioritizing psychotherapy over blockers due to insufficient evidence of benefits and serious risks.
  • Surgical Interventions in Adolescents:
    • Some clinics perform double mastectomies on girls as young as 13, raising ethical concerns about informed consent.
    • Detransitioners report regret and permanent medical consequences, such as sterility, loss of sexual function, and irreversible bodily changes.
    • The principle of ”first, do no harm” is being ignored in some gender clinics, where medical transition is fast-tracked without considering alternatives.
  • Legal and Parental Rights Issues:
    • Some policies allow minors to transition without parental consent, framing parental skepticism as abusive.
    • In Canada and parts of the U.S., misgendering someone can be considered discrimination, raising free speech concerns.
    • Legal definitions of “woman” and “man” are being rewritten, allowing self-identification to override biological sex in areas like prisons, sports, and scholarships.

5. Philosophical and Societal Implications

  • Blurring the Lines Between Identity and Reality:
    • Critics argue gender ideology promotes subjective identity over objective biological facts.
    • Some see the push for trans self-ID as part of a broader postmodern movement that prioritizes feelings over material reality.
    • Analogies to transracial, trans-species, and trans-abled identities raise the question: If gender is self-declared, why not race or disability status?
  • Impact on Women’s Rights and Free Speech:
    • The redefinition of ”woman” to include trans women (biological males) has created conflicts in women’s sports, prisons, and shelters.
    • Lesbians who refuse to date trans women are sometimes labeled ”transphobic”, raising concerns about coerced attraction.
    • Some laws now criminalize ”misgendering”, leading to legal and social consequences for refusing to use preferred pronouns.
  • Should Therapists Affirm Every Identity Claim?
    • The role of therapists has shifted from challenging distorted beliefs to validating all identity claims without question.
    • This shift undermines the core principles of psychotherapy, where reality-testing is essential for mental health.
    • Some clinicians fear they are being forced into ideological compliance rather than practicing science-based medicine.

Conclusion: Balancing Science, Ethics, and Identity

The debate over gender dysphoria and transgender identity sits at the crossroads of science, ethics, and philosophy.

  • The scientific evidence highlights strong correlations with autism, trauma, and mental health conditions, raising questions about whether transition always addresses the root cause of distress.
  • The social contagion hypothesis and rapid increase in teenage trans identification suggest that ideology, not just biology, is at play.
  • The ethics of affirmation-only therapy remain highly contested, with concerns about rushed medicalization and long-term consequences.
  • The legal and societal shifts driven by gender ideology challenge established norms about sex, free speech, and medical ethics.

This essay suggests that a rational, evidence-based approach would prioritize open scientific inquiry, individualized care, and patient well-being over ideological mandates. Without this, the medicalization of gender identity may become one of the most significant ethical missteps of our time.


Part 3 – From Reality to Rhetoric: A Critical Exploration of the Postmodern and Neo-Marxist Foundations of Gender Ideology


Summary:

1. Introduction:

  • LGBT activism has shifted from advocating for sexual orientation rights (LGB) to focusing on gender identity.
  • The essay critiques the ideological foundation of modern gender discourse and its departure from biological reality.
  • It explores scientific research, postmodern philosophy, neo-Marxist influences, and sociopolitical impacts.

2. Distinction Between Gay Rights and Gender Ideology

  • Gay rights are based on biological sex and sexual orientation, with evidence suggesting a biological basis.
  • Gender identity is a subjective belief system with no conclusive scientific evidence of an innate “gender identity.”
  • Many LGB individuals reject gender ideology, as it demands societal affirmation rather than simple legal equality.
  • The shift from LGB to LGBTQIA+ has led to internal conflicts, with some arguing gender ideology erodes same-sex attraction by redefining “woman” and “lesbian.”
  • Gender ideology often forces people to accept subjective identities as objective reality, turning into an ideological movement rather than a rights-based one.

3. Scientific and Psychological Insights on Gender Identity

  • Unlike sexual orientation, no genetic or neurological basis for gender identity has been conclusively found.
  • Rapid Onset Gender Dysphoria (ROGD) is observed in teenage girls, suggesting social contagion rather than an innate trait.
  • Studies indicate that many transgender-identifying youths have high rates of autism, trauma, and other psychological conditions.
  • Historically, most gender-dysphoric children desisted after puberty if not socially or medically transitioned.

4. Postmodernism and Neo-Marxism in Gender Activism

  • Postmodernism rejects objective reality, promoting the idea that gender is entirely a social construct.
  • Judith Butler and queer theorists argue that gender is performative, not biologically rooted.
  • Neo-Marxist critical theory frames gender identity as a struggle between ”cisgender oppressors” and transgender ”oppressed.”
  • Intersectionality positions trans identities as more marginalized than others, leading to an “Oppression Olympics.”
  • Institutions and academia have absorbed these ideologies, enforcing language changes and policy shifts based on identity rather than empirical data.

5. Ethical and Medical Concerns Over Affirmation Therapy

  • Affirmation therapy accepts a child’s self-identification without exploring underlying mental health issues.
  • Puberty blockers are often falsely presented as reversible, despite evidence of negative long-term effects.
  • Cross-sex hormones cause permanent changes, often leading to infertility, bone loss, and other medical complications.
  • Some European countries (Sweden, Finland, UK) have reversed course, moving away from gender-affirming treatments for minors due to a lack of long-term benefits.
  • Detransitioners are increasing, with lawsuits emerging against gender clinics for rushing medical interventions.

6. Sociopolitical and Legal Ramifications

  • Redefining “woman” in law has led to conflicts in sports, prisons, and shelters, raising safety and fairness concerns.
  • Compelled speech laws require individuals to use preferred pronouns, leading to legal penalties for misgendering.
  • Expanding hate speech laws has criminalized disagreement with gender ideology, with people being fined or arrested for expressing biological truths.
  • Corporate and academic institutions enforce gender ideology through DEI policies, punishing dissenters.
  • Cultural shifts have led to nonbinary identities becoming trendy, often adopted for social status rather than dysphoria.

Conclusion: Seeking a Middle Ground

  • The transition from a rights-based movement (LGB) to an ideological movement (gender identity) has led to internal conflicts and social tensions.
  • While transgender individuals should be treated with dignity, policies must balance rights without overriding biological reality.
  • Science, ethics, and free speech should guide policies rather than ideological dogma.
  • Future discussions should focus on protecting vulnerable individuals without enforcing gender ideology as unquestionable truth.

This essay provides a thorough critique of the ideological, medical, and sociopolitical implications of modern gender identity discourse, arguing for a more balanced, evidence-based approach.


Part 4 – A Lucrative Industry: Big Pharma’s Financial Incentives Behind the Permanent Medicalization of Troubled Youths


Summary:

1. Introduction

  • Gender-affirming treatments (puberty blockers, cross-sex hormones, surgeries) have become a booming industry.
  • The essay examines how financial incentives, medical institutions, and activist organizations influence the promotion of these treatments.
  • Ethical concerns arise as youth transitions are fast-tracked despite increasing evidence of harm.
  • Investigative journalism and whistleblower accounts reveal conflicts of interest among researchers, doctors, and policymakers.

2. The Pharmaceutical Industry’s Role

  • The U.S. market for sex reassignment hormone therapy was valued at $1.6 billion in 2022, with rapid growth expected.
  • Pharmaceutical companies profit by repurposing drugs like Lupron and Supprelin as puberty blockers, despite their original uses being for prostate cancer or precocious puberty.
  • High pricing strategies (e.g., Endo’s puberty blocker for kids costing 8x more than the adult version) maximize profits.
  • Once transitioned, individuals become lifelong medical patients, requiring continuous hormone treatments, surgeries, and follow-ups.
  • Gender-affirming procedures often require multiple corrections, further benefiting the medical industry.

3. Gender Clinics and Medical Institutions

  • The number of pediatric gender clinics in the U.S. has skyrocketed from nearly zero to over 100.
  • Institutions promote gender-affirming care as a profitable business, with hospitals like Vanderbilt openly describing surgeries as “huge money makers.”
  • Pediatric gender programs attract long-term patients, ensuring recurring revenue through hormone treatments and surgeries.
  • Clinics fast-track minors into medical interventions, often prescribing puberty blockers or hormones after just one or two visits.
  • Fear of being labeled transphobic pressures doctors to quickly affirm gender dysphoria rather than explore underlying issues.

4. Conflicts of Interest in Research and Policy

  • The World Professional Association for Transgender Health (WPATH) sets international guidelines while its members profit from gender-affirming care.
  • WPATH leaders admitted under oath that most contributors to their standards had financial ties to transgender medicine.
  • Pharma companies like AbbVie fund LGBTQ+ activist organizations that advocate for puberty blocker coverage, aligning industry and activist interests.
  • Texas has launched investigations into potential deceptive marketing practices by drug manufacturers promoting puberty blockers for children.
  • Efforts to suppress unfavorable research have been documented, with WPATH allegedly pressuring researchers to alter findings that cast doubt on youth transitions.

5. Media, Activism, and Corporate Influence

  • Media outlets downplay detransitioners’ stories and negative outcomes due to advertising and sponsorship ties to pharmaceutical companies.
  • Activist groups silence dissent through social media censorship, legal threats, and professional ostracization of researchers who challenge affirmation-only models.
  • Whistleblowers describe medical professionals being pressured to affirm all cases of gender dysphoria, sidelining mental health assessments.
  • Social media platforms flag critical content as “misinformation,” ensuring ideological conformity.
  • Only recently have investigative reports from Reuters, The New York Times, and BBC started questioning the prevailing gender-affirming model.

6. Real-World Cases & Whistleblower Testimonies

  • Tavistock Gender Clinic Scandal (UK): The UK’s only pediatric gender clinic shut down after reports of over-diagnosing and fast-tracking minors into hormone treatments.
  • Vanderbilt University Medical Center (USA): Leaked video revealed hospital administrators calling gender surgeries a major revenue stream, triggering government scrutiny.
  • Whistleblower Jamie Reed (USA): A case manager at a trans clinic exposed unethical fast-tracking of minors into hormone treatments, leading to state investigations.
  • Detransitioners’ Lawsuits: Young adults who regret their medical transitions are suing hospitals and doctors for malpractice, citing inadequate informed consent and misdiagnosis.
  • Investigative Journalism: Reports from major media outlets (Reuters, BBC, NYT) confirm concerns over the lack of long-term studies and rushed medical transitions for minors.

Conclusion: Ethics vs. Profit

  • Gender-affirming care has evolved into a highly profitable industry, with financial incentives driving medical decisions.
  • The combination of corporate funding, ideological activism, and fast-tracked medicalization raises serious ethical concerns.
  • The emerging backlash—whistleblower reports, lawsuits, and increasing scrutiny—suggests a growing recognition of the need for more cautious, evidence-based approaches.
  • Future policies should prioritize patient well-being over institutional profits, ensuring that youth receive thorough psychological assessments before irreversible treatments.

This essay provides a critical examination of the financial motives behind gender-affirming care, revealing how corporate interests, medical institutions, and activist groups have created a system that prioritizes profit over patient safety.

The Trans Ideology Dilemma, Part 4 – A Lucrative Industry: Big Pharma’s Financial Incentives Behind the Permanent Medicalization of Troubled Youths

This section includes:

  • The pharmaceutical industry’s role in pushing puberty blockers, cross-sex hormones, and surgeries as lifelong medical treatments.
  • How psychiatric institutions and gender clinics fast-track youth transitions, incentivized by financial gain.
  • The conflicts of interest among researchers, doctors, and policymakers who promote gender-affirming care despite growing evidence of harm.
  • How activist organizations and media benefit from ideological conformity and corporate funding incentives.
  • Citable examples, including lawsuits, whistleblower reports, and investigative journalism on these corrupt practices.

Profiting from Gender-Affirming Treatments for Youth

Financial Incentives & Market Growth

(U.S. Sex Reassignment Hormone Therapy Market Report, 2030) U.S. sex reassignment hormone therapy market has grown rapidly in recent years, reaching an estimated $1.6 billion in 2022 (U.S. Sex Reassignment Hormone Therapy Market Report, 2030).
Gender-affirming medical care has become a lucrative and fast-growing sector. The U.S. market for sex reassignment hormone therapies (puberty blockers, estrogen, and testosterone) was about $1.6 billion in 2022, with steady growth projected (U.S. Sex Reassignment Hormone Therapy Market Report, 2030). Likewise, the U.S. market for gender-related surgeries (mastectomy, genital reconstruction, etc.) reached $2.1 billion in 2022 and is forecasted to grow ~11% annually through 2030 (U.S. Sex Reassignment Surgery Market Size Report, 2030). Globally, sex-reassignment surgeries were valued around $4 billion in 2022 and climbing (Объясни как работает гравитация, почему тела притягиваются к …). This surge reflects a significant rise in demand, particularly among youth, and strong financial incentives for providers and drug makers.

Pharmaceutical companies have profited by repurposing existing drugs as puberty blockers for transgender minors. GnRH analogues like leuprolide (brand name Lupron) and histrelin (Supprelin LA) were originally developed for other conditions (prostate cancer or precocious puberty) but are used off-label to halt puberty in gender-dysphoric youth. AbbVie Inc. and Endo International “dominate the U.S. market for puberty blockers” (As children line up at gender clinics, families confront many unknowns). AbbVie’s Lupron franchise alone earned about $752 million in revenue in 2020 (across all uses) (How AbbVie Makes its Money). Endo’s Supprelin LA is extremely costly – a single yearly implant for children has a list price around $37,300, compared to just $4,400 for a nearly identical adult version of the drug ( Hormone Blocker Shocker: Drug Costs 8 Times More When Used For Kids – KFF Health News ). By discontinuing cheaper alternatives and marketing the high-priced version, Endo boosted its profits; its CEO told investors that sales of Supprelin were “doing particularly well” as use grew ( Hormone Blocker Shocker: Drug Costs 8 Times More When Used For Kids – KFF Health News ). These medications require ongoing administration, meaning each new patient represents a long-term revenue stream for pharma companies.

Lifelong medical dependency: Importantly, medical transition often creates a patient for life, generating ongoing income for the medical industry. Once adolescents undergo sex reassignment, they typically must stay on hormones indefinitely to maintain their transitioned characteristics. For example, a natal female who has her ovaries removed to transition will need lifelong testosterone; a natal male who removes testes will require estrogen for life. Even without surgery, using blockers and cross-sex hormones in youth can permanently compromise fertility or endocrine function, making continued hormone therapy necessary. Gender-related surgeries also frequently entail follow-up care or revisions. For instance, phalloplasty (construction of a penis) is known to have “a high rate of complications” and often requires multiple follow-up surgeries (Masculinizing surgery – Mayo Clinic). Vaginal reconstructions can likewise need further interventions for strictures or other issues (PD31-08 COMPLICATIONS AFTER GENDER AFFIRMING …) (Masculinizing surgery – Mayo Clinic). Each complication or revision means additional procedures, clinic visits, and prescriptions. In sum, early medical transition can lock patients into decades of hormone purchases, lab tests, specialist appointments, and surgical tune-ups, a fact not lost on industry stakeholders.

Medical Institutions & Fast-Tracking Gender-Affirming Care

Major medical centers and clinics have identified gender-affirming care as a profitable service line. In the United States, the number of pediatric gender clinics exploded from essentially zero 15 years ago to over 100 clinics today (As children line up at gender clinics, families confront many unknowns), often with long waiting lists of families seeking treatment. This rapid growth has been driven in part by financial motives. A notable example is Vanderbilt University Medical Center’s transgender clinic, where an administrator was caught on video in 2018 touting that “these types of surgeries bring in a lot of money,” calling female-to-male chest and genital surgeries “huge money makers” for the hospital (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida). Another Vanderbilt staffer warned that any employees with moral objections to providing gender transitions “probably shouldn’t work at Vanderbilt” – non-compliance would have “consequences” (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida). The message was clear: the institution prioritized the revenue from these procedures and expected staff to fall in line. After these videos became public in 2022, Vanderbilt came under political scrutiny (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida). Critics noted that a double mastectomy (“top surgery”) can cost $10,000 or more, while complex genital surgeries can cost $25,000–$50,000 each, yielding significant billable income for surgeons and hospitals. Pediatric gender clinics also attract lucrative referrals and follow-on care; one children’s hospital was described as opening its gender program “because it was profitable” (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida).

Beyond surgeries, diagnosing and treating gender dysphoria brings financial benefits to clinics. Initial consultations, psychological assessments, hormone prescriptions, and ongoing monitoring all generate fees. In many U.S. states, Medicaid or private insurance will cover these services, funneling public and private dollars into gender clinics. Some institutions have been accused of fast-tracking minors into medical treatment to maximize throughput. Reuters interviewed staff at 18 youth gender clinics across the U.S. and found that many will prescribe puberty blockers or hormones after just one or two visits if no obvious mental health “red flags” appear (As children line up at gender clinics, families confront many unknowns). Seven clinics said they were comfortable offering hormone therapy on the first visit for qualified adolescents (As children line up at gender clinics, families confront many unknowns). “For those kids, there’s not a value of stretching it out for six months to do assessments,” explained one gender program physician, noting that if a teen and their parents have done research and consent, the team moves quickly (As children line up at gender clinics, families confront many unknowns). This approach contrasts with the more cautious, months-long evaluations that early gender clinicians (like the pioneering Dutch team) once recommended (As children line up at gender clinics, families confront many unknowns) (As children line up at gender clinics, families confront many unknowns). Fast-tracking means more patients can start treatment sooner, benefiting clinic volume. However, it raises ethical questions if financial incentives are implicitly encouraging minimal psychological evaluation before irreversible interventions.

Institutions also benefit from aligning with influential guidelines. Organizations like the World Professional Association for Transgender Health (WPATH) issue internationally followed Standards of Care that increasingly support early intervention. Clinics that adopt WPATH’s “affirmative” model may gain reputational prestige and fend off liability by claiming adherence to prevailing standards. However, WPATH itself has been critiqued for possible bias (as discussed below). In practice, once a clinic positions itself as “affirming,” the internal culture often pushes toward quickly validating a young patient’s trans identity and proceeding to treatment. This can translate to more prescriptions and procedures (and thus more billing). Some clinicians have admitted feeling pressure to “over-diagnose” and medicalize children rapidly – for example, at the UK’s Tavistock youth gender clinic, staff feared being labeled “transphobic” if they did not unquestioningly affirm every case (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News). A former Tavistock psychologist said there was effectively “only one pathway… a medical one” for patients, with little time to thoroughly explore other mental health factors (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News). In summary, financial and institutional incentives (in concert with activist pressure) have fostered an environment where quick affirmation and treatment are the norm, to the benefit of clinics’ bottom lines but potentially at the expense of due diligence.

Conflicts of Interest & Industry Corruption

Significant conflicts of interest have been documented among the professionals and organizations setting the standards for gender-affirming care. The WPATH, which publishes the leading medical guidelines in this field, is led and staffed by many individuals who personally profit from transition services. According to court documents from a recent Alabama trial, WPATH President Dr. Marci Bowers (a gender surgeon) acknowledged earning over $1 million in a single year from performing transgender surgeries, and stated it is “absolutely” important that those writing the guidelines be advocates for these procedures (WPATH medical guidelines plagued by conflicts of interest  – UnHerd). In the same case, Dr. Eli Coleman – lead author of WPATH’s Standards of Care version 8 – admitted under oath that “most participants” involved in drafting the new guidelines had financial or personal conflicts of interest in this area (WPATH medical guidelines plagued by conflicts of interest  – UnHerd). In other words, the very doctors declaring these treatments safe and necessary for minors were often the same people profiting from increasing their use. Despite this, WPATH claimed no conflict was “significant” enough to affect the outcome, even as they removed minimum age recommendations for hormones and surgeries in their latest standards (WPATH medical guidelines plagued by conflicts of interest  – UnHerd) (WPATH medical guidelines plagued by conflicts of interest  – UnHerd). This raises serious ethical questions. As one investigative report dryly noted, “Transgender medicine for minors is a lucrative industry” (WPATH medical guidelines plagued by conflicts of interest  – UnHerd), and those writing the playbook had a direct stake in its expansion.

Beyond guideline-setters, pharmaceutical ties to advocacy groups also present conflicts. For example, pharma companies that manufacture puberty blockers and hormones have sponsored LGBT organizations and medical societies. AbbVie, maker of Lupron, has been a prominent corporate sponsor of the Human Rights Campaign (HRC) ([PDF] AbbVie – 1792 Exchange) ([PDF] SKADDEN, ARPS, SLATE, MEAGHER & FLOM LLP – SEC.gov). HRC in turn advocates strongly for insurance coverage of puberty blockers and cross-sex hormones for minors, even incorporating this as a criterion in their Corporate Equality Index. (Notably, to earn a perfect HRC score, companies must cover puberty blockers for employees’ children ().) This cozy relationship means that corporate interests and activist agendas can align: drug companies gain a larger customer base, while activist groups receive funding and political support. There have even been allegations (under investigation by the Texas Attorney General) that drug makers may have promoted puberty blockers off-label to parents without adequate disclosure of risks (Texas demands drug companies turn over documents on ’puberty blocking’ drugs for children | Reuters) (Texas demands drug companies turn over documents on ’puberty blocking’ drugs for children | Reuters). While companies deny wrongdoing, the fact that Texas felt compelled to probe AbbVie and Endo for potentially deceptive marketing highlights the level of concern about industry influence in this area (Texas demands drug companies turn over documents on ’puberty blocking’ drugs for children | Reuters) (Texas demands drug companies turn over documents on ’puberty blocking’ drugs for children | Reuters).

Another element of potential corruption is the suppression of negative evidence. When the scientific evidence has not aligned perfectly with an affirmative approach, some stakeholders appear to have tried to bury or spin it. In 2021, WPATH commissioned an independent systematic evidence review from researchers at Johns Hopkins University as it prepared new guidelines. Emails later revealed that WPATH executives pressured the researchers to withhold or alter findings that were not favorable (The BMJ investigates dispute over US group’s involvement in WHO’s trans health guideline – BMJ Group) (The BMJ investigates dispute over US group’s involvement in WHO’s trans health guideline – BMJ Group). The Hopkins team complained of “this sponsor trying to restrict our ability to publish” and noted WPATH was worried that fully transparent evidence would put them “in an untenable position” in defending pediatric treatments (The BMJ investigates dispute over US group’s involvement in WHO’s trans health guideline – BMJ Group). Despite these revelations (published by The BMJ), WPATH leaders who interfered remained on a World Health Organization panel developing trans care guidelines (The BMJ investigates dispute over US group’s involvement in WHO’s trans health guideline – BMJ Group) (The BMJ investigates dispute over US group’s involvement in WHO’s trans health guideline – BMJ Group). Such incidents suggest a willingness among some experts to prioritize ideology or profit over scientific rigor, effectively sidelining data on harms. Indeed, long-term, high-quality studies on puberty blockers and adolescent hormone use are still lacking. Reuters found that these life-altering treatments have “little scientific evidence of their long-term safety and efficacy” (As children line up at gender clinics, families confront many unknowns). Internal discussions among clinicians (later made public) show many are acutely aware of the weak evidence base and potential for “a medical scandal” (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News). Yet the treatments continue to be pushed, raising concerns that financial and reputational interests have eclipsed the precautionary principle that normally guides pediatric care.

Media & Activist Influence

Media outlets and activist organizations have played a key role in shaping the public narrative – often in ways that protect the financial interests in gender medicine. Major medical centers and pharma companies contribute significant advertising revenue and sponsorships to media and nonprofits, which can create a friendly bias. For instance, some of the largest funders of U.S. news advertising are pharmaceutical companies, and many news programs (even those covering healthcare controversies) are sponsored by drug ads. Advocacy groups similarly receive corporate donations: as noted, companies like AbbVie have openly partnered with LGBTQ+ advocacy campaigns ([PDF] AbbVie – 1792 Exchange). This financial entanglement may help explain why critical coverage of gender-affirming treatments has been muted until recently. Publications that eagerly profile the success stories of transgender youth often hesitate to report on complications, regrets, or industry profiteering. According to two trans-identified academics writing in The Atlantic, mainstream outlets and LGBTQ activists tend to “downplay… the reality of detransition” and gloss over negative outcomes (Take Detransitioners Seriously – The Atlantic). They observed that when a famous detransitioner (former Navy SEAL Chris Beck) spoke out about feeling misled, “most of the outlets” that had celebrated his transition “have yet to cover” his reversal (Take Detransitioners Seriously – The Atlantic). In their view, media silence on such stories is driven by political correctness and fear of aiding “anti-trans” narratives (Take Detransitioners Seriously – The Atlantic). The result is a skewed information environment where only the positive or profitable side of youth transitions is amplified.

Activist organizations have also employed strategies to silence dissenting voices in medical and academic communities. Professionals who question the prevailing “affirmation-only” approach risk public vilification and career consequences. As mentioned, clinicians at the UK GIDS clinic felt unable to openly challenge protocols for fear of being labeled transphobic and jeopardizing their jobs (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News) (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News). In academia, researchers who publish findings that complicate the affirmative narrative have faced intense backlash. A notable example is Dr. Lisa Littman, who in 2018 published a study on rapid-onset gender dysphoria. Activists mounted campaigns against her and pressured Brown University to remove a press release about the study. The journal was forced into a review process (which ultimately upheld Littman’s work with minor corrections), but the chilling effect was clear. Likewise, when a prominent Toronto gender clinician, Dr. Kenneth Zucker, took a cautious therapeutic approach for youth, activists accused him of “conversion therapy.” He was fired in 2015 amid the controversy, even though an external review later found the allegations were unfounded and he eventually won a settlement. These cases show how internal and external critics are often discredited or muzzled before their concerns can gain traction. In the U.S., a recent whistleblower described how even center-left media seemed more interested in questioning her motives than investigating her claims about poor practices at a trans clinic (Whistleblower Jamie Reed: The Courage to Admit You’re Wrong) (Whistleblower Jamie Reed: The Courage to Admit You’re Wrong). Institutions sometimes directly intervene to quash dissent: for example, internal forums of WPATH revealed leaders discouraging discussion of rising detransition rates, and a children’s hospital reportedly told staff not to publicly question its gender care model. Such suppression not only harms scientific debate but may also protect the financial and ideological investments that powerful groups have made in gender medicine.

Nonetheless, cracks in the silence are starting to appear. Some journalists and outlets have begun publishing in-depth investigations, despite activist pushback. In late 2022, The New York Times ran a feature on the unknowns and risks of puberty blockers, and Reuters published a multi-part investigative series highlighting the scant evidence behind pediatric transition and the stories of families who felt misled (As children line up at gender clinics, families confront many unknowns). These pieces faced criticism from trans advocacy groups, yet they represent a shift toward more balanced reporting. Whistleblowers and patient testimonies, often amplified by independent or conservative media, have forced mainstream outlets to acknowledge controversies they once ignored. Still, advocates for cautious care argue that a “truth deficit” persists in popular media – with well-funded activist campaigns branding almost any critique as hate, many professionals and reporters self-censor. Dissenting viewpoints are frequently marginalized on social media as well: users who share detransitioner stories or question drug safety may find themselves dogpiled or even banned for “hate speech.” Behind the scenes, Big Tech companies partner with LGBTQ organizations to flag “misinformation,” which can include medically accurate but critical content. All these factors contribute to an atmosphere in which challenging the affirmative model is professionally and socially perilous. In effect, ideology and corporate interest have aligned to suppress scrutiny, ensuring that the public hears far more about the supposed benefits of gender-affirming treatments than the risks or conflicts of interest that accompany them.

Real-World Cases & Whistleblower Reports

A growing number of lawsuits, whistleblower accounts, and investigative reports have begun to expose unethical practices and profit-driven motives in gender-affirming medicine. These real-world cases illustrate the human cost of an industry that, according to critics, puts business and ideology ahead of patient well-being. Below are several notable examples, documented by reputable sources:

  • Tavistock Gender Clinic Scandal (UK) – The NHS’s only youth gender clinic, Tavistock GIDS in London, became the subject of intense scrutiny after dozens of clinicians resigned in protest. At least 35 psychologists quit in a three-year span, warning that children were being “over-diagnosed and then over-medicalised” without proper oversight (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News) (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News). One departing clinician said they felt they had had “front row seats to a medical scandal.” Internal reports (e.g. by Dr. David Bell in 2018) detailed how gender-dysphoric youths were fast-tracked to hormones despite complex mental health issues, and staff felt unable to challenge the aggressive approach. This culminated in a lawsuit by Keira Bell, a former patient who regretted her teenage transition. Bell testified she was put on puberty blockers at 16 after only a short evaluation and later suffered irreversible changes (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News). In 2020, the High Court initially ruled in her favor that minors likely cannot give truly informed consent to such treatments. Although that decision was overturned on appeal, the independent Cass Review subsequently found Tavistock’s model unsafe – citing “insufficient evidence” for puberty blockers and cross-sex hormones – and the NHS shut down Tavistock in 2023-24 (Cass Review – Wikipedia) (Cass Review – Wikipedia). This case exposed how a trusted institution allowed potentially harmful, experimental treatments on minors to continue unabated, raising alarms about medical ethics and oversight.
  • Vanderbilt “Money Maker” Video (USA) – In 2022, leaked videos from a 2018 session at Vanderbilt University Medical Center’s transgender clinic showed an administrator openly emphasizing the financial rewards of gender surgeries. She explained to colleagues that “these surgeries bring in a lot of money,” noting that a phalloplasty (creation of a penis) could net $100,000 and that chest surgeries are “huge money makers” (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida). The video also captured a warning that any conscientious objectors would face “consequences” (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida). After these revelations, Vanderbilt’s pediatric gender program faced public outcry and a government inquiry (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida). Vanderbilt announced a pause on adolescent gender surgeries, and officials demanded to know if profit motives were clouding clinical judgment. The incident provided stark evidence of profit-driven decision making – effectively confirming that some hospitals see transitioning minors as a lucrative business opportunity. It also raised ethical questions about patient consent (were families aware that they were viewed as revenue sources?) and the internal culture at such clinics.
  • Whistleblower Jamie Reed (USA) – In early 2023, Jamie Reed, a former case manager at the Washington University Transgender Center (St. Louis Children’s Hospital), went public with a detailed account of ethically troubling practices at her clinic. In a sworn affidavit and a published expose, Reed – who describes herself as a queer liberal – said she witnessed children receiving drastic treatments with minimal assessment. According to her, every patient who came to the center “was quickly put on hormones,” even those with serious psychiatric issues or a history of trauma, without adequate therapy or scrutiny. She described clinicians cheerleading transition and downplaying the risks, and instances of parental consent being bypassed or coerced. For example, Reed recounted one case where a minor with severe autism was started on hormones despite clear inability to consent. Her reports also noted that the side effects of puberty blockers and hormones (such as sterilization, sexual dysfunction, bone loss) were not properly explained to families. Reed’s allegations were significant enough to trigger investigations by the Missouri Attorney General and health authorities (Therapists, social workers face scrutiny in Missouri AG investigation of transgender care • Missouri Independent). In fact, her testimony and documentation helped lawmakers in Missouri push through stricter regulations on youth gender medicine (Whistleblower Jamie Reed: The Courage to Admit You’re Wrong) (Whistleblower Jamie Reed: The Courage to Admit You’re Wrong). Reed’s claims were largely corroborated by The New York Times in an August 2023 follow-up (the Times spoke with patients and clinic records that supported her story) (Whistleblower Jamie Reed: The Courage to Admit You’re Wrong). Her courageous whistleblowing, at great personal cost, suggests that behind closed doors, some gender clinics have been operating with shockingly poor safeguards, essentially rushing minors into life-altering medical decisions – and that staff felt they had to leak information to force accountability.
  • Detransitioners’ Lawsuits and Testimonies – An increasing number of young adults – often biological females in their teens – are coming forward to say that they regret the medical transitions they underwent as minors and that medical professionals failed them by pushing affirmation without caution. One high-profile example is Chloe Cole, a California girl who was put on puberty blockers and testosterone at 13 and had a double mastectomy (breast removal) at age 15, before ultimately discontinuing male identification. Now 19, Chloe has filed a malpractice lawsuit against the doctors and hospital (Kaiser Permanente) that facilitated her transition (’Detransitioner’ sues doctors after being given irreversible gender …) (’Detransitioner’ sues doctors after being given irreversible gender treatments as child). Her legal complaint states the providers “blindly ramrodded” her through treatment without proper mental health evaluation or informed consent (’Detransitioner’ sues doctors after being given irreversible gender treatments as child). Medical records show Chloe had autism, ADHD, and body image issues – red flags that were never meaningfully addressed (’Detransitioner’ sues doctors after being given irreversible gender treatments as child). She alleges that alternatives to medical transition (like talk therapy) were not offered, and that as a vulnerable adolescent she simply trusted the doctors’ advice that transitioning was the only solution. Chloe’s story is unfortunately not unique. Others, such as Layla Jane (who is suing medical providers in California for approving a double mastectomy at age 13), and several anonymous young adults in Canada and the UK, have also taken legal action after detransitioning. Their testimonies often echo the same themes: perfunctory assessments, pressure to transition quickly, and failure to disclose the permanence and risks of treatment. These cases put a human face on what can happen when profit and ideology eclipse prudent medicine. They also pose a looming financial risk to the industry itself – if courts begin to find clinics liable for negligence or lack of informed consent, the “gender-affirming” business model may face a wave of costly litigation.

Major investigative journalism efforts have also bolstered these accounts with hard evidence. Aside from Reuters and the NYT, BBC’s Newsnight and the BBC podcast “File on 4” have uncovered internal concerns at Tavistock and highlighted stories of regretful young patients. Swedish and Finnish television documentaries in 2021–2022 featured whistleblowers and detransitioners, which contributed to those countries reversing course on pediatric hormone treatments. Even some medical journals are now publishing more critical analyses of the affirmation-only approach. All of this accumulating evidence – from insider leaks, to patient lawsuits, to international health authorities reversing policy – points to a pattern of systemic problems and possible corruption in how gender-affirming care for youth has been sold and implemented. While transgender advocacy groups and industry-backed experts continue to defend the prevailing model, these real-world cases and investigations are forcing a reevaluation of practices that, until recently, were portrayed as unassailably compassionate and safe. The tension between the big money involved and the unresolved medical uncertainties is now at the center of a heated public debate. Going forward, the hope of whistleblowers and reformers is that greater transparency and accountability will protect vulnerable youth – even if it means certain powerful interests in the “gender industry” must sacrifice some profits and prestige for the sake of ethics and evidence-based care.

Sources: Investigative reports and testimony from Reuters (As children line up at gender clinics, families confront many unknowns) (As children line up at gender clinics, families confront many unknowns), The Associated Press (Governor wants probe of Vandy hospital after doctor touts trans procedures are ’money makers’ | Health News Florida), KFF Health News ( Hormone Blocker Shocker: Drug Costs 8 Times More When Used For Kids – KFF Health News ), Sky News (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News) (NHS ’over-diagnosing’ children having transgender treatment, former staff warn | UK News | Sky News), The BMJ (The BMJ investigates dispute over US group’s involvement in WHO’s trans health guideline – BMJ Group), UnHerd (WPATH medical guidelines plagued by conflicts of interest  – UnHerd) (WPATH medical guidelines plagued by conflicts of interest  – UnHerd), and other reputable outlets have been used to compile the above information. These sources include on-record statements, court documents, and whistleblower accounts that shed light on how financial incentives and institutional dynamics intersect with the treatment of gender-dysphoric youth.

The Trans Ideology Dilemma, Part 3 – From Reality to Rhetoric: A Critical Exploration of the Postmodern and Neo-Marxist Foundations of Gender Ideology

  • How postmodernism’s rejection of objective reality plays into the concept of gender fluidity.
  • How neo-Marxism reframes identity as a class struggle, influencing transgender activism and institutional policies.
  • The broader cultural, academic, and institutional shifts that align with these ideological frameworks.

Introduction

Over the past few decades, the landscape of LGBT activism and gender discourse has shifted dramatically. What began as a fight for gay, lesbian, and bisexual rights – rooted largely in sexual orientation – has increasingly been overtaken by debates over gender identity and “gender ideology.” This research paper critically examines this shift and its implications. We explore the distinction between biologically-based gay rights and the more ideologically driven concept of gender identity, review scientific and psychological findings on gender dysphoria, analyze the influence of postmodern and neo-Marxist thought on gender activism, discuss ethical and medical concerns about affirming versus treating gender dysphoria, and survey the sociopolitical ramifications of gender ideology on law and culture. Throughout, we draw on expert commentary and data – with a dose of humor and irony – to illuminate how an originally liberatory movement for sexual minorities has in some ways transformed into an ideological crusade that even many within the LGB community question.

Distinction Between Gay Rights and Gender Ideology

(The End of Gender | Book by Debra Soh | Official Publisher Page | Simon & Schuster) Cover of Debra Soh’s “The End of Gender,” which challenges popular gender myths with scientific evidence. Sexual orientation and gender identity are often lumped together under the LGBTQ+ umbrella, but they are fundamentally different in nature. Sexual orientation refers to whom one is attracted – a trait which research suggests has biological underpinnings (e.g. genetics, prenatal hormones) and is not a choice. Gender identity, on the other hand, refers to an inner sense of being male, female, or something else – a concept that has become highly ideological. Unlike sexual orientation, there is no robust scientific evidence that an innate “gender identity” exists independent of biological sex (Sexual orientation and gender identity: what does the science say? | Catholic News Agency) (The binary nature of sex: a column by Deborah Soh – Why Evolution Is True). As neuroscientist Debra Soh bluntly put it, “I see no evidence that ‘gender identity’ exists, either in humans or animals. All observed phenomena can be explained by innate sex differences and, in rare cases, gender dysphoria” (The binary nature of sex: a column by Deborah Soh – Why Evolution Is True). In short, being gay is about who you love, whereas being transgender is about what you believe yourself to be – a belief often asserted despite one’s physical sex.

This distinction helps explain why many gay and lesbian individuals are uneasy with modern gender ideology. The gay rights movement historically fought to remove stigma from same-sex attraction and to secure equal rights – allowing people to love whom they love without discrimination. That struggle was grounded in material reality (biological sex) – e.g. two men or two women in a relationship – and demanded others not persecute them for it. In contrast, gender ideology demands affirmation of a subjective identity and often insists that others participate in that identity (through language, access to sex-specific spaces, etc.), effectively requiring a redefinition of reality. As journalist Helen Joyce observes, there is a key difference between traditional “trans rights” (freedom from unfair abuse or discrimination, which almost everyone supports) and the current agenda of “gender-identity ideology.” The latter demands that “trans people be treated in every circumstance as members of the sex they identify with, rather than the sex they actually are”, even when it infringes on others’ rights (On Helen Joyce’s “Trans” – Why Evolution Is True). For example, gender ideology asserts that a person born male who identifies as female is female in every legal and social sense – a far-reaching claim that goes well beyond the principle of “live and let live.” Joyce notes this is “not a human right at all” but rather “a demand that everyone else lose their rights to single-sex spaces…and accept trans people’s subjective beliefs as objective reality, akin to a new state religion, complete with blasphemy laws.” (On Helen Joyce’s “Trans” – Why Evolution Is True). That sharp analysis encapsulates why many gay and lesbian activists feel gender ideology has diverged from – and even undermines – the original gay rights cause.

Indeed, veteran gay rights campaigners have described the rise of the broad LGBTQIA+ coalition as “a hostile takeover of a homosexual-rights movement by straight people” (How trans ideology hijacked the gay-rights movement – spiked). This may sound ironic, but consider: under the ever-expanding LGBTQIA+ umbrella, the category “T” (transgender) often includes individuals who are heterosexual (for instance, a biological male who identifies as a woman and is attracted to women would count as a “lesbian” in gender ideology terms, despite being, from a biological perspective, an straight male). As one commentator wryly noted, “This is how a collective identity for homosexuals came to include lots of straight men who wanted to be seen as anything but straight men.” (How trans ideology hijacked the gay-rights movement – spiked) In the 1980s it was LGB (Lesbian, Gay, Bisexual) – all orientations defined by attraction to the same sex. By the 2010s, the acronym had ballooned to LGBTQIA+, grouping together causes as disparate as sexual orientation and gender identity (plus Queer, Intersex, Asexual, etc.), sometimes with divergent or even opposing interests (How trans ideology hijacked the gay-rights movement – spiked) (How trans ideology hijacked the gay-rights movement – spiked). For many gays and lesbians, this “forced teaming” has been troubling. The LGB Alliance, a group founded by lesbians and gay men in the UK, argues that the right of same-sex attracted people to define themselves based on biological sex is being threatened by attempts to confuse sex with gender (LGB Alliance – Wikipedia). In their view, if “male” and “female” become subjective terms detached from anatomy, then the very meaning of “same-sex attraction” is obscured. A lesbian, for example, could be told she is bigoted for not being attracted to a transwoman (biological male), since gender ideology would label that transwoman a “female.” Thus, what was once the gay rights movement’s core assertion – that sexual orientation is valid and innate – is paradoxically undermined by an ideology claiming “gender is fluid and sex is irrelevant.” It’s no surprise, then, that there’s a growing schism: many LGB individuals support equal rights for transgender people to live free of harassment, yet reject the notion that gender self-identification should trump biological sex in law and culture.

The historical shift is stark. The gay liberation movement and fight for same-sex marriage were about expanding freedoms – allowing everyone the rights that straight people had, such as marriage and open service in the military (On Helen Joyce’s “Trans” – Why Evolution Is True). In contrast, the contemporary gender identity movement often demands not just freedom from discrimination, but affirmation and accommodation from others. Where gays once asked “please leave us alone and let us have equal rights,” gender ideologues now often insist “celebrate and believe what I say I am – or face consequences.” This represents a profound change in tone and approach. As we’ll see, it’s a change driven less by empirical science and more by ideology – one that many gay activists feel has hijacked their movement (How trans ideology hijacked the gay-rights movement – spiked) and even turned it into something “regressive” (How trans ideology hijacked the gay-rights movement – spiked) rather than progressive.

Scientific and Psychological Insights on Gender Identity

While “born this way” has strong scientific backing in the context of sexual orientation, the same cannot be said for gender identity. Decades of research in genetics, endocrinology, and neuroscience have found no conclusive biological marker for a mismatched gender identity – no “female brain in a male body” or vice versa, as popular rhetoric suggests. In fact, a major review of the science noted a “lack of scientific evidence that gender identity is an innate, fixed property of human beings independent of biological sex” (Sexual orientation and gender identity: what does the science say? | Catholic News Agency). The notion that a person could be literally born in the “wrong” body is not supported by robust evidence (Sexual orientation and gender identity: what does the science say? | Catholic News Agency). By contrast, sexual orientation does show some biological correlations (e.g. modest genetic influences, differences in brain structure, etc.), although it too is complex. The key point is that gender identity remains an ideological concept: an internal feeling that one’s gender is at odds with one’s sex, for which science has yet to find a clear, inherent basis. As one skeptical clinician quipped, if gender identity were truly innate and immutable, we wouldn’t see entire friend groups of teenagers coming out as trans in the span of months – something that is happening with startling frequency today.

And yet, that is exactly what’s being observed. In clinics and schools, there has been an “explosion” in adolescents (especially females) identifying as transgender in recent years. For example, the UK’s main gender clinic saw a 4,400% increase in teen girls seeking gender treatments over the past decade (Gender detransition: a case study – PMC). This rapid surge cannot be explained by genetics or prenatal biology; it points instead to social and psychological factors. Dr. Lisa Littman in 2018 coined the term Rapid Onset Gender Dysphoria (ROGD) to describe the phenomenon of groups of teen girls suddenly declaring transgender identities during adolescence, often after intense immersion in social media and YouTube transition videos (Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria | PLOS One) (Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria | PLOS One). Her survey of parents documented a pattern: 65% of these teens had one or more friends become trans around the same time, and most had increased their social media use just prior to coming out (Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria | PLOS One). In many cases, whole clusters of friends (sometimes every girl in a friend group) began identifying as trans together – a statistically unlikely coincidence (Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria | PLOS One) (Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria | PLOS One). These findings suggest a social contagion effect may be at work, wherein vulnerable adolescents, particularly girls, latch onto a transgender identity due to peer influence or a desire to make sense of feelings of angst. (One might say being trans is the new “emo”). It’s telling that historically, gender dysphoria was exceedingly rare in females, yet now teen girls are the predominant demographic in youth gender clinics ( RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases – PMC ) ( RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases – PMC ).

So who are these girls (and some boys) coming out as trans in droves? Far from being well-adjusted kids who simply “knew from toddler age” they were born wrong, many have underlying mental health challenges. Multiple studies and clinic reports show high rates of autism, anxiety, depression, trauma, and other issues among gender-dysphoric youth. For instance, one British gender clinic report found about 35% of referred adolescents scored in the range of autism spectrum disorder (Children referred to the UK’s largest gender clinic were vastly more likely than average to present with autistic traits. – Stats For Gender) – vastly higher than autism rates in the general population (around 1–2%). At the Tavistock GIDS clinic in London, internal data revealed that 97.5% of children seeking gender transition had at least one other psychological/neurological issue such as autism, depression, self-harm or a history of trauma (Tavistock clinic ‘ignored’ link between autism and transgender children). A staggering 70% of these young patients had five or more such co-occurring problems (e.g. abuse, bullying, eating disorders) in their backgrounds (Tavistock clinic ‘ignored’ link between autism and transgender children). In other words, the majority of these youths were highly vulnerable adolescents for whom gender dysphoria may have been a symptom or coping mechanism for other distress. One whistleblower from Tavistock said clinicians were so set on affirming trans identities that they ignored these red flags – treating complex cases as simple “born trans” narratives and thus doing a disservice to kids who might have been better helped by addressing their autism or trauma first (Tavistock clinic ‘ignored’ link between autism and transgender children) (Tavistock clinic ‘ignored’ link between autism and transgender children).

The correlation with neurodevelopmental and psychiatric conditions is particularly striking. Gender dysphoria in adolescents shows overlap with autism at rates many times the norm (Children referred to the UK’s largest gender clinic were vastly more likely than average to present with autistic traits. – Stats For Gender), suggesting that some autistic youth may fixate on gender as an explanation for why they feel “different.” Likewise, trauma and social isolation can lead a teen to seek a new identity for escape or a sense of belonging. As journalist Abigail Shrier documented in Irreversible Damage, peer influence and affirmation online can provide a social high. Trans-identification becomes “a peer contagion” in some teen circles: coming out as trans is celebrated, garnering instant attention and praise (and sometimes more compassionate treatment from parents and teachers) (Parent reports of adolescents and young adults perceived to show signs of a rapid onset of gender dysphoria | PLOS One). It’s not that teens consciously choose to be trans for kicks – but in an environment where it’s trendy and grants entry into an “oppressed” community, it unconsciously pulls a subset of troubled teens. Notably, Shrier found that many of the girls caught up in this craze had no signs of gender dysphoria in childhood and often were lesbian or bisexual in orientation before deciding they were actually trans boys (Irreversible Damage eBook by Abigail Shrier | Official Publisher Page | Simon & Schuster) (Irreversible Damage eBook by Abigail Shrier | Official Publisher Page | Simon & Schuster). This raises a provocative question: Are we medicalizing away some young lesbians? Some lesbians and feminists worry that today’s gender ideology, with its rigid ideas (“if you’re a masculine girl, maybe you’re really a boy”), is a new form of conversion therapy – pushing tomboys to become trans men, and thus effectively “straightening” their future, since a transitioned trans man dating men is now in a heterosexual relationship. It’s an ironic twist: in the name of inclusivity, we might be erasing the very diversity (butch girls, sensitive boys) that gay and lesbian activists once championed.

(Irreversible Damage: The Transgender Craze Seducing Our Daughters) Cover of Abigail Shrier’s book Irreversible Damage (2020), which investigates the surge of transgender identification among teen girls. The concept of ROGD remains controversial – major professional organizations (under pressure from activists) officially dismiss it – but clinicians in the field privately acknowledge seeing exactly this pattern (A gender imbalance emerges among trans teens seeking treatment). Even some mainstream outlets like Reuters have noted the “outsized proportion of adolescents assigned female at birth” seeking transition and questioned “whether peer groups and online media may be influencing some of these patients” (A gender imbalance emerges among trans teens seeking treatment). The data bear out that concern: when one or two friends in a group come out as trans, suddenly several others do too, almost like a domino effect. This doesn’t happen with, say, sexual orientation (friend groups don’t typically all turn gay simultaneously), which again underscores the ideological and social nature of gender identity. Additionally, pre-existing mental health issues are very common among these youth. One large parent survey reported that nearly half of their trans-identifying teens had diagnoses like depression or anxiety before developing gender dysphoria, and those teens were more likely to pursue medical transition ( RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases – PMC ). Parents often felt that therapists and doctors “rubber-stamped” their child’s self-diagnosis of being trans, “pressured [them] to affirm”, and fast-tracked them to medical interventions ( RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases – PMC ) ( RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases – PMC ). Disturbingly, according to these parents, their kids’ mental health often deteriorated after starting transition ( RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases – PMC ) – contrary to the “transition saves lives” mantra. Of course, these are parent-reported data, which come with bias, but they align with what European health authorities are now acknowledging: many young people presenting as trans today have complex issues and might not find long-term relief from simply changing gender.

Finally, it’s important to highlight a key scientific insight: most children with gender dysphoria will not remain dysphoric after puberty. Decades of studies (even from gender-affirming clinics) have shown that the majority of gender-questioning kids eventually desist – typically growing up to be gay or bisexual adults, not transgender (Sexual orientation and gender identity: what does the science say? | Catholic News Agency) (Sexual orientation and gender identity: what does the science say? | Catholic News Agency). Estimates vary, but roughly 61–98% of dysphoric children outgrow those feelings by adulthood if not socially or medically transitioned in youth ([PDF] No. 21-2875 – ACLU of Arkansas). In other words, nature often “corrects” course for kids with cross-gender feelings, especially once puberty hits and their identity solidifies. This fact was widely accepted in the field until recently. Now, activists downplay desistance, but it remains a crucial consideration: prematurely labeling a young child as trans and affirming that identity might actually cement a transient dysphoria into a persistent one. Many gay adults recall that as gender-nonconforming kids they might have said “I want to be a girl” or similar – today, those kids might be put on a transition track when in fact they were simply future gay men or lesbian women. This is why a growing number of LGB individuals are speaking out that “affirmation” protocols can inadvertently harm gay youth by medicalizing identities that would have resolved as healthy homosexuality. As we move to the ethical and medical section, keep in mind this data-backed reality: most dysphoric children would be okay if we did nothing drastic. That begs the question – why are we doing something drastic?

The Influence of Postmodern and Neo-Marxist Ideology on Gender Activism

To understand how gender ideology gained such traction, one must venture into the halls of academia, where certain postmodern and neo-Marxist ideas incubated and then seeped into activist movements. This might sound abstract, but bear with it – it’s the philosophy that underpins a lot of what we see today (and it comes with plenty of irony).

Postmodernism (particularly as applied in gender studies and queer theory) challenges the very notion of objective truth and biological essentialism. In the postmodern view, reality is socially constructed, language defines truth, and categories like male/female are fluid, arbitrary and “performative.” The poster child here is philosopher Judith Butler, who in 1990 famously argued that “gender is in no way a stable identity” – rather, it’s a repeated performance, something one does rather than is (“Gender,” Marxism, and the Search for Power | The Heritage Foundation). Butler and other queer theorists sought to “detach ‘gender’ from biology”, asserting that male and female are mere myths imposed by society (“Gender,” Marxism, and the Search for Power | The Heritage Foundation). They delighted in deconstructing binaries and norms – a fundamentally postmodern approach that holds that all identities (gender, sexuality, even sex itself) are fluid and subject to personal interpretation. Pushing this to its extreme, you get claims like “some women have penises and some men have vulvas,” or that asking for someone’s biological sex is a form of violence. In a postmodern lens, identity is self-defined narrative, and anyone who insists on a material basis (like chromosomes) is seen as oppressively “essentialist.” This ethos has trickled out of academia into activism: hence slogans like “Trans women are women” and the insistence that one’s stated identity outweighs any biological or empirical evidence to the contrary. It’s why a statement such as “only women can get pregnant” can be deemed transphobic – because postmodern gender ideology considers “woman” a subjective identity, not a biological category tied to wombs. The influence of this thinking leads to often surreal outcomes (the satire writes itself – e.g., forms asking for one’s “sex assigned at birth” as if it were arbitrary, or attempts to introduce pronouns like “ze/hir” to escape the he/she binary). While some find this liberating, others view it as a rejection of reality – the emperor’s new clothes with a gender studies degree.

Layered atop postmodernism is a hefty dose of Neo-Marxist or “critical” theory. Classical Marxism focused on class struggle (proletariat vs. bourgeoisie). Neo-Marxism, especially through the Frankfurt School and later critical theorists, expanded the idea of oppressed vs oppressor to culture and identity groups (“Gender,” Marxism, and the Search for Power | The Heritage Foundation). Critical Race Theory, for instance, frames society as structurally racist (whites oppressing people of color). In the gender realm, Critical Gender Theory (or queer theory) frames the world as a power struggle between cisgender “oppressors” and transgender (and gender-nonconforming) “oppressed” (“Gender,” Marxism, and the Search for Power | The Heritage Foundation) (“Gender,” Marxism, and the Search for Power | The Heritage Foundation). In this view, gender identity is politicized as an oppressed class. A trans woman (even if a wealthy, white, biological male) is deemed more marginalized than, say, a working-class lesbian, because in the identity hierarchy “trans” is considered more victimized in the current power structure. This intersectional mindset was articulated by theorist Kimberlé Crenshaw, who introduced intersectionality to describe overlapping systems of oppression – e.g. how a black trans woman might be oppressed on account of race and gender identity (“Gender,” Marxism, and the Search for Power | The Heritage Foundation). The result is a kind of “Oppression Olympics” in which gender identity has been grafted onto the civil rights framework. Gender activists often explicitly compare themselves to the gay rights movement or even black civil rights – with slogans like “Trans rights are human rights” – even though, as we’ve discussed, the demands often differ in kind (it’s one thing to demand not to be fired for being trans, quite another to demand society at large say “men can get pregnant”). Still, by casting trans people as an oppressed class and anyone who dissents from gender ideology as an oppressor, the movement gains moral leverage and urgency. It effectively weaponizes compassion: who wants to be the bigot yelling “there are only two genders” if that’s equated with being on par with racists or homophobes?

This neo-Marxist framing also leads to a quasi-religious fervor in enforcement of the ideology. Because if everything is a power struggle, no dissent can be tolerated (to dissent is to side with oppression). Thus, in some academic and activist circles, we see tactics like deplatforming speakers who question gender self-ID, branding feminists who uphold sex-based rights as “TERFs” (trans-exclusionary radical feminists) – essentially heretics – and even advocating the punishment of “misgendering” as hate speech. The ideology took on the zealousness of a revolutionary movement: it wasn’t enough to let people transition; society must be “re-educated” to affirm that trans women are women in every sense, that gender non-conformity means “you might be trans,” and that any skepticism is literal violence. If this sounds a bit Orwellian – compelling others to speak untruths (e.g. call a 250-pound bearded inmate “Ma’am” or face disciplinary action) – that’s because it is. The intellectual lineage here includes not just Marx but also Foucault (who saw everything as power relations) and Marcuse (who argued tolerance should not be extended to the intolerant – a rationale used to shut down “transphobic” speech). In short, gender activism absorbed critical theory’s tendency to view the world as oppressors vs oppressed, and postmodernism’s denial of an objective reality, yielding a potent doctrine: “My subjective identity is my truth, and if you don’t validate it, you are harming/oppressing me.”

It’s worth noting how institutions and academia have aligned with these ideologies. University gender studies departments have long been dominated by postmodern queer theory. From there, the language of “gender as a social construct” and the notion of infinite genders leaked into mainstream culture and policy. Organizations like WPATH (World Professional Association for Transgender Health) and the American Psychological Association have adopted affirming stances that echo ideological commitments (sometimes despite shaky evidence). The institutional capture can be seen in bizarre moments like medical journals suggesting that the words “mother” or “breastfeeding” be replaced with gender-neutral terms so as not to offend – an effort to rewrite language reminiscent of Newspeak. Laws and corporate policies increasingly reflect these ideas (more on that in the next section). The neo-Marxist influence is also evident in training materials that treat cisgender privilege as a concept analogous to white privilege, and that encourage folks to “ally” with trans people by memorizing new pronouns and challenging the gender binary at every turn.

One could inject some humor here by noting that in some circles this ideology has basically created a new class system: at the top of the virtue hierarchy is the non-binary queer person of color with neurodiversity (oppression points galore), and at the bottom is the cis straight white male (the dreaded oppressor). It sounds like a sketch, but in seriousness, we do see identity politics sometimes descend into self-parody – e.g., privileged students claiming exotic gender labels to avoid being seen as oppressors themselves. (In one comedic instance, an entire student group declared themselves “queer and nonbinary” so they wouldn’t be labeled cis, despite presenting entirely typical for their sex – truly a Marxist class consciousness twist!).

In summary, postmodern ideology provided the rationale to deny biological reality (“everything’s a construct”) and neo-Marxist critical theory provided the moral imperative to fight for gender identity as the next grand liberation movement (“we must smash the cis-heteronormative power structure!”). These influences help explain why gender activism became, at times, intolerant of debate and scornful of science – because it sees itself as a righteous struggle against an oppressive system of “cisnormativity” that must be dismantled. The result is that some activists indeed behave as if following a religion – reciting dogmas (“Trans women are women” like a creed) and excommunicating heretics (shutting down discussion by calling anyone who questions them a bigot). When Joyce quipped that it’s akin to a “new state religion, complete with blasphemy laws” (On Helen Joyce’s “Trans” – Why Evolution Is True), she wasn’t far off the mark. In the next section, we’ll see how these ideological currents have influenced medical practice and ethics – with real-life consequences for children and patients.

Ethical and Medical Concerns Regarding Affirmation Therapy and Medical Transition

Perhaps nowhere do the tensions between ideology and reality come into sharper relief than in the medical treatment of gender dysphoria, especially in children and teenagers. The prevailing approach in much of the Western world today is “affirmation therapy.” In practice, this means that if a person (even a minor) says they are transgender, the role of therapists, doctors, and parents is to immediately affirm that stated identity. No challenging, no probing into possible underlying causes – affirmation is treated as an end in itself, even the first step toward medical intervention. This stands in stark contrast to a more traditional “reality-based” or exploratory therapy, which would involve examining the reasons for the dysphoria (Is the child on the autism spectrum? Is the teen girl struggling with her body image or trauma? Might the boy simply be gay and feeling pressure because of homophobia or gender norms?) before jumping to the conclusion that altering the body is the solution. The ethical dilemma is clear: Should therapists treat the mind to fit the body, or alter the body to fit the mind’s perception? Affirmation therapy has overwhelmingly chosen the latter route – essentially saying the patient’s self-diagnosis is unquestionable. As one psychologist quipped, it’s the only field where “the customer is always right” has become clinical protocol. Imagine if every anorexic teen who “feels fat” were affirmed – “yes, you are overweight” – and put on diet pills; that, we recognize, would be absurd and harmful. Yet when a teen boy says “I feel like a girl,” many therapists rush to affirm and set him on a path of hormones and even surgeries. Critics call this “unquestioning affirmation” dangerous, and some trans activists ironically agree that not every dysphoric youth is actually trans – but the current climate often treats them as if they are, by default (A gender imbalance emerges among trans teens seeking treatment).

The dangers of one-size-fits-all affirmation are manifold. First, it can lock in a transient identity. As noted, most young children with gender dysphoria would desist if allowed to go through puberty normally (Sexual orientation and gender identity: what does the science say? | Catholic News Agency). However, if such a child is socially transitioned (new name, pronouns, treated as the opposite sex), the act of affirmation itself can alter the course – the child gets psychologically invested in the new identity, and everyone around them reinforces it. Desistance rates plummet once a child is socially transitioned, because it’s hard to go back when you’ve been effectively told “Yes, you really are a boy in a girl’s body” (the child feels they must have been right all along, and now has an identity and sometimes community built around it). This is why some clinicians argue that affirmation for young kids is itself an irreversible psychosocial intervention. And then comes the medical transition: puberty blockers, cross-sex hormones, surgeries. Here we must get very concrete about the effects on the body. Puberty blockers, like GnRH agonists, are drugs that halt the normal puberty process. They are often described as a harmless “pause button,” but the reality is more complicated. There is weak evidence for their long-term safety or efficacy in gender dysphoria (Final Report – Cass Review). These drugs are being used off-label (originally intended for precocious puberty or prostate cancer), and no randomized controlled trials have proven that blocked puberty improves mental health outcomes for trans-identifying youth in the long run. What we do know is that blockers suppress hormones needed not just for development of sex characteristics, but for bone density and brain maturation. Pubertal hormones are critical for the adolescent growth spurt and achieving peak bone mass; blocking them for years can lead to osteoporosis or stunted development. Indeed, the French National Academy of Medicine recently warned of potential side effects including weakened bones and sterility from aggressive youth gender treatments (The real story on Europe’s transgender debate – POLITICO). And almost invariably, kids put on blockers do not go back – between 95% to 100% of children on blockers proceed to cross-sex hormones (On Helen Joyce’s “Trans” – Why Evolution Is True). In essence, the drug touted as a “pause to think” often becomes a one-way ticket to further transition.

Cross-sex hormones (estrogen for natal males, testosterone for natal females) cause permanent changes. For teenage girls, taking high-dose testosterone will deepen the voice (usually irreversibly), cause facial hair growth, change body fat distribution, stop menstrual cycles, and frequently lead to infertility (especially if given after puberty blockers, as eggs may not mature properly) (Number of transgender children seeking treatment surges in U.S.). For boys on estrogen, breasts will develop (often requiring surgery to remove if they later detransition), testicles may atrophy, sexual function can be lost, and fertility is usually compromised as well (Number of transgender children seeking treatment surges in U.S.). These are major, life-altering medical outcomes being introduced to minors who cannot vote, drink alcohol, or get a tattoo. In many places, a 13-year-old cannot legally consent to having her ears pierced without parental permission – yet 13-year-old girls have had their healthy breasts surgically removed in the name of gender affirmation. It sounds hyperbolic, but it’s true: in the United States, hundreds of girls aged 13–17 have undergone “top surgery” (double mastectomy) in recent years (Number of transgender children seeking treatment surges in U.S.). A Reuters investigation found at least 776 mastectomies on minors from 2019–2021 in the U.S. alone (and that’s likely an undercount, not including private pay cases) (Number of transgender children seeking treatment surges in U.S.). These surgeries, along with interventions like facial feminization or genital surgeries (which, while rarer in minors, have indeed occurred in 16–17-year-olds in some instances), raise profound ethical questions. Can an adolescent truly grasp the impact of losing fertility or sexual function for life? Many detransitioners (people who later regret and revert after transitioning) say absolutely not – they feel they were not in a position to understand what they were agreeing to as teenagers. Some have likened the rush to affirm and medically transition distressed youth to the “medical scandal of our time.” We allow youth feeling distress with their bodies to self-diagnose and effectively direct clinicians to administer high-risk treatments – a practice virtually unheard of elsewhere in medicine.

(image) Sweden, Finland, and the UK have begun reversing course on pediatric gender medicine after reviewing the evidence (or lack thereof) for long-term benefits. Europe is already tapping the brakes. Sweden, often seen as a progressive haven, conducted systematic reviews and found the evidence for youth gender transition was shaky and the risk of harm significant. In 2021, the renowned Karolinska Hospital in Stockholm announced it would no longer prescribe puberty blockers or hormones to minors outside of strict research settings (The real story on Europe’s transgender debate – POLITICO). The Swedish National Board of Health and Welfare in 2022 updated its guidelines to state that hormone treatment for minors should only occur in exceptional cases, as the risks likely outweigh the benefits (The real story on Europe’s transgender debate – POLITICO). Finland’s health authority reached a similar conclusion in 2020: their guidelines now prioritize psychotherapy and mental health support as first-line treatment for youth gender dysphoria, reserving hormones only for the most severe persistent cases, and banning gender surgeries for under-18s (Finland Issues Strict Guidelines for Treating Gender Dysphoria – CANADIAN GENDER REPORT) (Finland Issues Strict Guidelines for Treating Gender Dysphoria – CANADIAN GENDER REPORT). Finnish experts openly worried that many teen girls claiming trans identities were actually suffering from other issues (like trauma or internalized homophobia) and that invasive treatment would harm rather than help in most cases. In the UK, an independent review by Dr. Hilary Cass in 2022 found the current affirm-and-refer model “unsustainable” and driven by ideology rather than evidence (On Helen Joyce’s “Trans” – Why Evolution Is True) (On Helen Joyce’s “Trans” – Why Evolution Is True). The NHS is shutting down the singular Tavistock gender clinic and moving to a more cautious approach: new regional centers with multidisciplinary teams (including mental health and autism specialists) to fully assess each case (The real story on Europe’s transgender debate – POLITICO) (The real story on Europe’s transgender debate – POLITICO). The NHS has even proposed that puberty blockers be used only in research trials going forward, given the uncertainties (The real story on Europe’s transgender debate – POLITICO). France’s medical academy likewise urged great caution, emphasizing psychological support over hormones for youth. In all these countries, the pendulum is swinging back toward “first do no harm” and acknowledging that the explosion in trans-identifying youth may have cultural drivers.

Yet in North America, “gender-affirming care” for minors continues to be promoted as the only valid approach, and dissent is often silenced by accusations of transphobia. This despite the fact that no long-term randomized studies have proven that affirming and transitioning kids reduces suicide in the long run (the oft-cited stat “untreated trans kids suicide” is misleading – the data actually show suicidality is elevated in trans-identifying youth regardless of treatment, and while some short-term mental health gains occur after transition, these often level off or reverse later ( RETRACTED ARTICLE: Rapid Onset Gender Dysphoria: Parent Reports on 1655 Possible Cases – PMC )). The ethical principle of informed consent is stretched to a breaking point: how informed can a distressed 14-year-old be about the decision to render themselves sterile, with unknown impacts on brain development? Moreover, parents in some jurisdictions are put in a bind – affirm your child’s new identity or risk being seen as abusive. There have been cases of parents losing custody for refusing to call their child by a new name and pronouns or for seeking a second (more cautious) medical opinion. This climate is driven partly by an ideological certainty (“better a live trans child than a dead child” is the emotionally charged mantra) that leaves no room for nuance – even though common sense and emerging evidence beg for nuance.

In reality, a thoughtful “watchful waiting” or exploratory therapy approach for youth – one that acknowledges the mind-body incongruence but tries to help the child become comfortable in their own body, or at least waits until they are adults to make irreversible decisions – might lead to far fewer medical transitions and likely better overall outcomes. Therapists like Dr. Kenneth Zucker (a pioneer in gender dysphoria treatment) practiced this more cautious method, helping many kids reconcile with their bodies (and often grow up to be gay). But such clinicians have been vilified in recent years, bizarrely labeled “conversion therapists” for not immediately affirming trans identity (even though helping a boy accept being a feminine gay male instead of becoming a trans woman is arguably preventing conversion of a sort!). The ethical conundrum is that affirmation therapy, in its zeal to be kind and supportive, may actually lead to medical harm – what one UK whistleblower called treating kids as “collateral damage” in service of an ideology (Tavistock clinic ‘ignored’ link between autism and transgender children). Future generations may look back and ask: why did the medical establishment go along with this so readily? Already, lawsuits are beginning – detransitioned young adults suing clinics for rushing them through life-altering procedures without adequate evaluation. One detransitioned woman in the UK told the High Court that at 16 she was fast-tracked to hormones after just a brief consultation; by 21 she regretted it deeply. These stories are mounting, and while proponents of affirmation try to downplay them, they pose a serious ethical wake-up call.

In summary, the medicalization of gender-questioning youth is a case study in how ideology can steer clinical practice away from scientific rigor. Compassion for transgender people is essential, but compassion without truth – without acknowledging biological reality and the complexity of identity formation – can become reckless. A more balanced approach would be “affirmation of the individual, but exploration of the dysphoria.” Love the child, but investigate why they hate their body; offer support, but not necessarily irreversible drugs and surgeries as a first resort. Encouragingly, some countries are moving back in that direction, prioritizing long-term well-being over political expedience. In doing so, they echo the age-old medical ethic: Primum non nocere – first, do no harm. It is an irony that a movement positioning itself as saving lives may in some cases be inflicting harms that won’t fully manifest until years later.

Sociopolitical and Legal Ramifications of Gender Ideology

The influence of gender ideology has extended far beyond clinics and college campuses – it is reshaping laws, policies, language, and social norms in profound ways. Proponents argue these changes are necessary for transgender acceptance, while critics contend they sometimes conflict with sex-based rights, free speech, and truth. Let’s examine a few key areas:

  • Redefinition of “Woman” (and “Man”): Perhaps the most consequential shift is the legal and social redefinition of basic sex terms. In places that have adopted gender self-identification, the word “woman” is no longer tied to biological females; it legally includes anyone who identifies as a woman. This has led to conflicts in women’s sports – for example, transgender athletes born male breaking women’s records and winning championships, raising questions of fairness given male puberty confers advantages in size, strength, and speed. It’s not mere hypotheticals: from weightlifting to swimming, we’ve seen cases of transwomen outperforming top female competitors by significant margins. Likewise, in women’s prisons, self-ID policies have allowed male-bodied inmates (including violent offenders) to transfer into female facilities. In the UK, the notorious case of Karen White – a male prisoner who identified as female – resulted in sexual assaults of female inmates after being placed in a women’s prison (Isla Bryson case – Wikipedia). Similar incidents and safety concerns have arisen in women’s shelters and domestic violence refuges when biological males are admitted on the basis of gender identity. For many feminists (and indeed ordinary women), these scenarios are alarming: hard-won sex-segregated spaces meant to ensure female safety or fair competition are being eroded. They argue that “trans-inclusive” policies sometimes amount to excluding women – from their own sports, or compromising their safety in private spaces. Even some liberal countries are responding: after the high-profile case of a trans-identified rapist in Scotland, authorities reversed a policy and barred such individuals from women’s prisons, acknowledging the obvious risks.
  • Compelled Speech and Pronoun Laws: Another ramification is the rise of laws and directives that enforce compelled speech in the form of preferred pronouns and gender terminology. In New York City, for instance, guidelines were introduced that threaten fines up to $250,000 for employers or landlords who “intentionally” use the wrong pronouns for someone (NYC: Huge fines for not using preferred trans pronouns – The Christian Institute) (NYC: Huge fines for not using preferred trans pronouns – The Christian Institute). Under these rules, if an employee born male requests to be called “she” or even “ze/zir,” persistent failure to comply can be deemed harassment punishable by exorbitant fines. This is an unprecedented move – traditionally, human rights laws punish actions, not words. Requiring one to say something one does not believe (e.g. that a biologically male colleague is “her”) is a form of compelled speech that raises First Amendment issues in the U.S. and free expression concerns elsewhere (Preferred Pronoun Laws and the First Amendment). Canada’s Bill C-16 similarly added “gender identity or expression” to anti-discrimination law; while the law itself doesn’t explicitly compel pronouns, official human rights commissions have interpreted misgendering as a violation. In some jurisdictions, misgendering or “deadnaming” (using someone’s former name) is now treated as a hate crime or civil offense. This has a chilling effect on open discussion, to say the least. People fear that even an accidental misuse of pronoun could cost them their job. Comedy sketch shows have lampooned this (imagining cops arresting someone for calling a person “Sir” when they identify as “Madam”), but it’s only slight exaggeration. When the New York City Human Rights Commissioner says they will “aggressively enforce” these pronoun rules (NYC: Huge fines for not using preferred trans pronouns – The Christian Institute), it’s not far-fetched to imagine a store owner getting a hefty fine because an employee innocently said “Have a nice day, sir” to a gender-nonconforming customer who took offense. Beyond legal penalties, social media platforms enforce these norms by banning users for “misgendering” – Twitter famously locked accounts, including a congressman’s, for referring to a trans woman (born male) as “him.” Thus, gender ideology has led to a new speech code where certain factual statements (e.g. “Bruce Jenner fathered children” or calling Ellen Page “she” after Page declared a new identity as Elliot) are treated as taboo or hateful. This raises profound free speech questions. Even some ardent trans supporters admit forcing language is counter-productive, giving credence to critics’ claims of authoritarian overreach.
  • Expansion of Hate Speech and Discrimination Concepts: Relatedly, there’s been a widening of what counts as “hate” or illegal discrimination. Using the wrong pronoun or questioning someone’s self-identified gender can be interpreted as violence in the rhetorical frame of gender ideology. Activists successfully lobby for “gender identity” to be included in non-discrimination laws, which on its face is reasonable (no one should be denied housing or a job simply for being transgender). But in application, it sometimes means that single-sex services or organizations come under fire. For example, a rape crisis center for female survivors may face lawsuits or loss of funding if it cannot, in good conscience, admit a bearded trans-identifying individual into women’s counseling groups – even though female survivors may be traumatized by male presence. Similarly, religious women’s groups or lesbian networking groups that wish to limit to biological women run afoul of these broad laws and risk being branded hate groups. The definition of “transphobic hate” can become so broad that any dissent from gender ideology is labeled hate. There have been instances of police in the UK knocking on doors to warn citizens about transphobic tweets (one man was told he committed a “non-crime hate incident” for retweeting a limerick about transgender people – you can’t make this up). This policing of thought and speech is justified by authorities as protecting a vulnerable group, but critics see it as the thin end of a totalitarian wedge. When stating biological facts or advocating women-only spaces can result in public shaming or even legal trouble, we have drifted far from liberal principles.
  • Cultural and Media Climate: Culturally, gender ideology’s influence means that media, academia, and corporations vigorously enforce in-group terminology and viewpoints. Major news organizations now write of pregnant people or “individuals with cervixes” instead of women, to be inclusive of trans and nonbinary individuals – at the cost of making language convoluted and erasing the common word for half the population. Schools introduce children to the concept of being born in the wrong body at young ages, sometimes without parental knowledge, in pursuit of affirming trans kids – even though this may confuse a lot of kids who would never have thought of themselves as anything but their birth sex. Stories abound (some perhaps exaggerated) of schools asking teachers to hide a child’s new gender identity from parents, or of children being encouraged to use alternate pronouns as an experiment. While inclusion is laudable, parents argue that some curricula veer into indoctrination, presenting gender identity as something everyone has to figure out, rather than a rare condition. The result can be kids who are simply going through normal puberty discomfort being led to believe they are transgender. Culturally we’ve also seen a sharp uptick in young adults identifying as nonbinary or genderqueer – not undergoing medical transition, but adopting the labels and sometimes expecting special accommodations (like colleges creating “all-gender” dorm floors, or workplaces adding third-gender options on forms). This can be seen as either a delightful expansion of freedom, or an indication of social contagion combined with the cachet of a trendy identity. A bit of irony: declaring oneself nonbinary (neither male nor female) has become particularly popular among a subset of youth, which some cynics describe as “the new goth” – a way to stand out and rebel. Except unlike wearing black lipstick, this trend has institutional support and can get you a pat on the back from the establishment.

The broad enforcement of gender ideology in media/politics means that even well-intentioned discussion is often shut down. A mainstream author who writes about the importance of biological sex (like J.K. Rowling did) is swiftly villainized; Rowling received mountains of abuse (some of it extremely misogynistic) and calls for boycott merely for saying “sex is real and important for defining women’s experiences.” Politicians who question aspects of the trans agenda are likewise attacked. In some cases, policy decisions are made out of fear of seeming transphobic rather than evidence – for instance, some state prison systems initially let inmates self-declare gender without much safeguard, only to reverse after incidents. The net effect is that public policy is often reactive and ideologically driven instead of calmly balancing competing rights. We see this in the U.S. debate over whether transwomen (biological males) should compete in women’s sports – those raising concerns are shouted down as bigots, when a year or two later even sports authorities concede there’s an issue and scramble for a compromise (like World Rugby banning transwomen from elite women’s matches for safety). One gets the sense that reality keeps reasserting itself – you can change the words on paper, but if a 6’2” 200 lb trans woman knocks out a 5’5” female opponent in an MMA fight, people notice the discrepancy regardless of pronouns. Gender ideology’s demand that everyone ignore the “man behind the curtain” can only go so far before the curtain gets yanked.

On the positive side, increased visibility of transgender issues has led to greater societal empathy for a minority that has long been marginalized. Discrimination in jobs, housing, healthcare against transgender individuals is now rightly condemned and often illegal. That is genuine progress. The challenge is ensuring that protecting one group’s rights doesn’t inadvertently infringe upon another’s. Striking that balance requires honest dialogue – something that’s hard to come by when any deviation from the “party line” invites outrage. As gender-critical feminist Megan Murphy famously quipped after being banned from Twitter, “We’re at a point where saying ‘men aren’t women’ can get you banned – that’s literal insanity.” She has a point: when truthful statements become unsayable, democracy suffers.

In conclusion, the sociopolitical ramifications of gender ideology are a mixed bag. We’re updating laws and norms to be more inclusive, which is admirable in intention. But some changes are proving contentious and destabilizing, especially where they collide with material reality or other important values like free speech and women’s rights. A nuanced approach would protect transgender individuals from discrimination and violence without demanding that all of society rewrite its entire rulebook of language, sports, privacy, and discourse. The current climate, however, often feels like an all-or-nothing zero-sum game – which is why the backlash (from gender-critical feminists, from conservative legislators, from ordinary parents) has been mounting. Ideally, we find a path that allows a transgender person to live their life in dignity and safety, and allows people to acknowledge biological sex where relevant and speak openly about sensitive issues without fear. In a pluralistic society, that compromise should be possible: respect people’s chosen lives, but don’t require everyone else to deny reality or silence themselves in the process.

Conclusion

The journey from the gay rights movement to the current gender ideology movement has been anything but linear. What started as a fight for the right to be (to love who one loves openly) has, in parts, morphed into a fight for the right to define reality (“I am what I say I am – and you must say so too”). We have examined how sexual orientation and gender identity, though often mentioned in the same breath, rest on very different foundations – one grounded in biological truths, the other in subjective self-perception. We have seen how scientific evidence for innate gender identities is scant, even as social evidence mounts that peer and cultural factors are driving a surge in transgender identification among youth. We’ve pulled back the curtain on how postmodern philosophy and neo-Marxist theory seeded the ground for an ideology that asks us to reject basic binaries and view gender through a prism of power and identity, sometimes to illogical extremes. We’ve raised ethical red flags about the rush to medically alter young bodies in the name of affirmation – a trend some countries are now reversing upon sober reflection of the data. And we’ve highlighted the broad societal changes underway, from the law to language, and the importance of finding balance so that one group’s rights don’t nullify another’s.

It’s an awful lot to untangle – fitting, perhaps, for such a tangled acronym (LGBTQIA+… sometimes jokingly extended with every letter in the alphabet). In navigating these issues, critical thinking and compassion are both needed. Compassion, because at the heart of this are real individuals with real distress who deserve respect and understanding. Critical thinking, because good intentions alone do not guarantee good outcomes – policies and treatments must be grounded in reality and evidence, not just ideology or fervor. A sharp but humorous observation sums it up: “Remember when we fought to break gender stereotypes? Now we enforce them with scalpels and lawsuits.” The irony isn’t lost on many old-school liberals and feminists who feel the gender ideology movement, in some ways, turned left at absurdity. Yet, these conversations are often drowned out by shouting matches between extreme ends. One end envisions a dystopia of forced gender conformity and erasure of LGBT people (which no one sane wants); the other end evokes a nightmare of all boundaries gone – hairy-chested “women” in every women’s locker room and compelled chants of newspeak pronouns (equally hyperbolic as a universal outcome). The reality will likely carve a saner middle path, if we let reason and evidence back into the room.

There are signs of a corrective course: European health authorities prioritizing therapy over hormones for kids, courts grappling with balancing trans rights and women’s rights, and more detransitioned voices coming forward to tell cautionary tales. Even within the transgender community, there are moderates urging a pullback from the extremist edge – worried that the radical ideologues are spurring a backlash that will hurt trans people most of all. After all, it’s possible to support trans individuals’ dignity and acknowledge biology; indeed, for long-term acceptance, that may be the only sustainable route. Many trans adults themselves do not subscribe to some of the militant dogmas – they quietly live as the opposite gender with the pragmatic understanding that they are honorary members of that sex, not literally changing chromosomes. Such trans people often get along just fine with their gay and straight peers; they’ve been overshadowed in media by the louder activist voices.

Ultimately, integration of previous research and sharp analysis leads us to one conclusion: biology matters, and so do people’s feelings – the challenge is not choosing one over the other, but accommodating both where possible. Sexual orientation will remain a fact of nature; gender identity will remain a facet of human experience (for some, not all). Striking the right balance between respecting individual identities and respecting empirical reality is the crux of the matter. As this paper has shown, when ideology swings too far (in either direction), problems ensue – whether it was the old ideology that being gay was a disorder to be “cured,” or the new ideology that every dissenter is a transphobic sinner to be shamed. We would do well to approach these issues with a mix of humility and humor. Humility, to admit we as a society are still learning and that the science of gender dysphoria is far from settled. And humor, because some of the scenarios are so absurd that if we don’t laugh occasionally, we’ll only rage – and laughter can diffuse tension and open minds more effectively than moralizing.

In the end, what most people want is actually not so different: a society that is kind but grounded, neither cruel nor crazy. Achieving that means pushing back against the excesses of gender ideology while avoiding a regression into intolerance. It means protecting the gay youth who might be mislabeled and medicalized, protecting the trans individual from unfair discrimination, protecting the woman who wants her safety and identity respected, and yes, protecting the truth so that our language and laws reflect reality and not just wishful thinking. Walking this tightrope isn’t easy, but it’s necessary. As the dust settles on this era of fervent activism, we can hope that the sharp analyses of thinkers like Debra Soh, Abigail Shrier, Helen Joyce and others are heeded – not to engender fear, but to inject sanity and science into the discourse. Only then will we be able to truly support everyone under the rainbow and keep our feet on solid ground.

Sources:

The Trans Ideology Dilemma, Part 2: Gender Dysphoria, Autism, and Trauma – Science, Ideology, and the Ethics of Affirmation Therapy

This section includes:

  • Gender Dysphoria and Autism Correlation – Explores a strong link between autism and gender dysphoria.
  • Childhood Trauma and Gender Identity – Research suggests a high prevalence of childhood trauma, including sexual abuse, among individuals with gender dysphoria.
  • Mental Health Comorbidities – Trans-identifying individuals have significantly higher rates of anxiety, depression, ADHD, and other psychological conditions.
  • Biology vs. Ideology – Explores the legitimacy of some brain studies suggesting structural differences in transgender individuals, where critics argue that gender identity is shaped more by social and psychological influences
  • Ethical Concerns in Therapy – The debate over affirmation therapy vs. reality-based therapy highlights concerns about whether immediate affirmation is the best approach, especially given high rates of desistance among gender-dysphoric youth if left untreated.
  • Medicalization and Minors – Questions the use (and necessity) of puberty blockers, hormones, and surgeries for minors, with growing international pushback and restrictions of pediatric medical transitions due to the lack of long-term safety data.
  • Philosophical and Social Ramifications – The legal and cultural enforcement of gender identity over biological sex raises concerns about free speech, women’s rights, and medical ethics.
  • Balancing Science and Compassion – A sustainable approach requires acknowledging biological realities while ensuring gender-dysphoric individuals receive ethical and evidence-based care, free from ideological pressure.

Introduction:
Gender dysphoria – the distress arising from a mismatch between one’s experienced gender and birth sex – lies at the intersection of science, psychology, and ideology. It raises complex questions: What factors correlate with identifying as transgender? Is gender identity “hard-wired” in the brain or shaped by culture? How should therapists balance affirming a patient’s identity with objective reality? And what are the broader implications when personal identity is treated as a medically and legally enforceable fact? This analysis delves into each of these areas, drawing on empirical data, case studies, and expert commentary to provide a comprehensive understanding.

1. Scientific Correlations

Autism Spectrum Overlap with Gender Dysphoria

A striking body of research has uncovered elevated rates of autism spectrum disorders (ASD) among transgender-identifying individuals. In the largest study to date (over 640,000 participants), transgender and gender-diverse people were three to six times more likely to be autistic than cisgender people ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ) ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ). About 24% of transgender/gender-diverse respondents were autistic, compared to 5% of cisgender participants (Study finds higher rates of gender diversity among autistic individuals | Autism Speaks) (Study finds higher rates of gender diversity among autistic individuals | Autism Speaks) – a nearly quadruple to quintuple prevalence. This overlap appears bidirectional: autistic people are also more likely to identify as gender-diverse than neurotypical peers ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ).

Several potential explanations have been proposed for this correlation. One idea is that certain autistic traits – such as sensory sensitivities, atypical social cognition, intense focus on specific interests, and lower empathy – might predispose individuals to question gender norms or feel discomfort with their bodies ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ). For example, sensory issues could make the physical changes of puberty especially distressing, or a cognitively rigid focus on “being one of the boys/girls” might lead an autistic youth to identify intensely with the opposite sex. Another hypothesis is that autistic individuals are less swayed by social conventions, so they may express gender variance more freely. Neurologically, the “extreme male brain” theory (which posits that autism involves cognitive patterns more common in males) has been floated to explain why autistic traits and gender variance co-occur, especially in birth-assigned females. Ultimately, researchers note the overlap is real, but caution against assuming causationautism does not necessarily cause gender dysphoria, nor vice versa (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria). Instead, clinicians are urged to support autistic transgender people holistically: being both autistic and gender-diverse can compound minority stress and mental health struggles ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ) ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ). Notably, one study found nearly 70% of autistic youth with gender dysphoria desired medical transition care, underscoring the need for sensitive, case-by-case treatment rather than blanket skepticism ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ).

Childhood Trauma and Gender Dysphoria

Another correlation explored in the literature is the link between childhood adversity or sexual trauma and later gender dysphoria. Multiple studies have found high rates of early abuse among gender-dysphoric and transgender individuals. For instance, one clinical sample reported that over half (55%) of transsexual participants had experienced unwanted sexual contact before age 18 (Prevalence of Childhood Trauma in a Clinical Population of Transsexual People | CoLab). Similarly, a 2021 analysis noted “increased rates of sexual abuse (>50%) in individuals with GD (Gender Dysphoria)” ( Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study – PMC ). Beyond sexual abuse, gender-dysphoric adults also report elevated levels of physical abuse, emotional neglect, and other forms of childhood trauma. In one study of 95 adults with gender dysphoria, a staggering 56% had suffered four or more types of early traumatic experiences, a much higher poly-victimization rate than in control populations (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria). These adversities often coincided with disrupted attachment patterns – e.g. dysfunctional family dynamics or absent parents – hinting that unstable early environments might play a role in some cases (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria) (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria).

What might explain this link? Some psychologists theorize that gender dysphoria can sometimes emerge as a coping mechanism or dissociative response to trauma. Classic case reports described children who, after abuse or loss, began identifying as another gender as a way to “escape” their reality or identity. Coates and Person (1985), for example, hypothesized that in certain cases a young child might unconsciously adopt an opposite-gender persona as an “extreme dissociative defense” against early relational trauma (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria). In plainer terms, a child who was sexually abused might fantasize “If I were a boy (or girl), this wouldn’t have happened to me,” and that fantasy solidifies into a dysphoric identity. There are also accounts of individuals who report transitioning to flee or erase a source of pain – e.g. a boy bullied or abused for being “effeminate” who later lives as female to feel safer, or a girl who was sexually assaulted and then identifies as male to avoid sexualization. Detransitioned author Walt Heyer has noted anecdotally that “Childhood sexual abuse is an experience common to many… who write me with regret about changing genders”, suggesting unaddressed trauma can fuel a transient transgender identity (Childhood Sexual Abuse, Gender Dysphoria, and Transition Regret: Billy’s Story – Public Discourse). However, it’s critical to emphasize that these are case-based hypotheses; as a 2018 review concluded, “to date, no solid empirical support” confirms that childhood trauma directly causes gender dysphoria in a generalized way (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria). Instead, trauma is best seen as one of many factors that might co-occur with gender dysphoria. Indeed, the high prevalence of adverse experiences is concerning in its own right: childhood maltreatment in trans populations is linked to worse mental health, higher suicide risk, and even greater body dissatisfaction later on ( Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study – PMC ) ( Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study – PMC ). Whether or not trauma triggers dysphoria, those who have endured it clearly need compassionate psychological care alongside any gender-related interventions.

Mental Health Comorbidities and Psychological Factors

Gender dysphoria does not exist in a vacuum; it often intersects with other mental health conditions and psychological vulnerabilities. Research consistently finds that transgender individuals, especially youth, have higher rates of mood disorders, anxiety, self-harm, and neurodevelopmental conditions than the general population ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ) ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ). One campus survey in the U.S. found that gender-minority young adults had 4.3 times higher odds of having at least one mental health problem compared to their cisgender peers (Comorbidity – Stats For Gender). Likewise, a systematic review reported that 53.2% of people diagnosed with gender dysphoria had a history of at least one other mental disorder in their lifetime (Comorbidity – Stats For Gender). These disorders range from depression and anxiety to PTSD, eating disorders, substance abuse, and personality disorders. For example, among gender-dysphoric adolescents in one clinic, 21% had an anxiety disorder, 12% a mood disorder, and 11% a disruptive behavioral disorder – rates markedly above population norms. Autism and ADHD are also overrepresented, as discussed; one study found 15% of trans youth had ADHD (similar to the autism rates) (Comorbidity – Stats For Gender), and children with ADHD were 6.6 times more likely to express gender variance than non-ADHD peers (Comorbidity – Stats For Gender). Taken together, these findings portray a landscape where co-occurring psychological issues are common rather than exception.

It’s important to ask: are these mental health challenges contributing factors, consequences, or merely coincidences? In many cases, it may be a bit of each. Gender dysphoria can certainly cause distress that leads to depression or suicidal ideation (the emotional toll of feeling “in the wrong body” or facing social stigma is heavy). There’s also the minority stress model – the chronic stress of being transgender in an often-hostile society can fuel anxiety, trauma, and self-harm over time ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ). On the flip side, pre-existing mental conditions might make a person more vulnerable to developing gender dysphoria or adopting a transgender identity, especially in today’s climate. For instance, Lisa Littman’s survey of parents of youth with so-called rapid-onset gender dysphoria (ROGD) found 62.5% of these youths had at least one mental or neurodevelopmental issue prior to their gender identity change (Comorbidity – Stats For Gender). Many struggled with processing emotions and had a history of trauma or social difficulty, suggesting their dysphoria “came out of the blue” in a context of other turmoil (Comorbidity – Stats For Gender). Clinicians like Dr. Kenneth Zucker have long observed that a “large percentage of adolescents referred for gender dysphoria have a substantial co-occurring history of psychosocial and psychological vulnerability” (Comorbidity – Stats For Gender). In practice, this could mean a teen girl with undiagnosed autism and depression suddenly believes transitioning to male will fix her unhappiness, or a young person with a history of abuse adopts a trans identity hoping to reinvent themselves. The cause-effect relationship is often tangled. What is clear is that comprehensive assessment is vital – underlying issues (such as trauma, autism, bipolar disorder, or borderline personality traits) should be addressed in tandem with gender feelings, not ignored. Even after medical transition, mental health disparities persist. A long-term Swedish follow-up famously found that post-surgery transsexual individuals had higher rates of psychiatric hospitalization and suicide attempts than the general population, indicating transition wasn’t a cure-all for their deeper psychological needs (Comorbidity – Stats For Gender). All of this underscores that gender dysphoria typically exists as part of a complex psychological picture, not as a simple isolated condition. Effective care must recognize and treat the whole person, not just the gender dysphoria in isolation.

2. Biology vs. Ideology

Innate Identity or Social Construct?

A central tension in the transgender debate is whether gender identity is a biologically innate trait – something essentially hard-wired in the brain – or a socially constructed identity influenced by culture and personal experience. The mainstream narrative in recent years often asserts that “trans people are born that way”, with a gender identity that is fundamentally innate (and sometimes at odds with their anatomy). Indeed, some scientific studies lend credence to an innate component. Brain imaging research has identified subtle neuroanatomical differences in transgender individuals that distinguish them from cisgender controls. For example, a 2022 MRI study of trans women (biological males who identify as female, scanned before any hormone therapy) found their brain structural profile fell in-between that of cisgender males and females – significantly shifted toward the female side, though not identical ( Brain Sex in Transgender Women Is Shifted towards Gender Identity – PMC ). The authors concluded that transgender brains appeared “shifted away from their biological sex towards their gender identity” ( Brain Sex in Transgender Women Is Shifted towards Gender Identity – PMC ). Similarly, earlier studies of specific brain regions (like the BSTc and insula) reported patterns more typical of the experienced gender in trans people. These findings are often cited to argue that transgender identity has a biological basis – possibly rooted in genetic factors or prenatal hormone exposures that influence brain development ( Brain Sex in Transgender Women Is Shifted towards Gender Identity – PMC ). In other words, a transgender woman might literally have a brain that is structurally closer to what we’d expect in a female, which could make her feel female. However, these brain studies are not without limitations: sample sizes are small, differences are averages (there’s overlap), and it’s hard to untangle cause and effect. Are trans brains different because of an innate identity, or do years of identifying/behaving as another gender (and associated experiences or even hormone use) shape the brain? The science is intriguing but not definitive.

On the flip side, a growing chorus of experts and commentators suggest that social and psychological factors play a dominant role in shaping gender identity – especially given the rapid changes in who is identifying as trans. Citing dramatic epidemiological shifts, they argue gender dysphoria can sometimes behave more like a social contagion or cultural phenomenon than a fixed inborn trait. Consider that until roughly 10 years ago, the typical trans patient was either an adult male with longstanding cross-gender feelings or a very young effeminate boy – cases that often began in early childhood. Yet in the last decade, clinics have seen an explosion of adolescents (especially teen girls) suddenly identifying as transgender with no childhood history. In the U.K., the Tavistock gender clinic reported a 4,400% rise in teen female referrals over the previous decade (). The graph below illustrates this surge: referrals to the UK youth gender service skyrocketed from only dozens per year in the early 2000s to over 2,700 in 2019-2020, with adolescent girls comprising the majority of cases.

(Tavistock Gender Identity Development Service Data – Gender Identity Research & Education Society) Annual number of children and adolescents referred to the Tavistock Gender Identity Development Service in the UK, 2003–2020. An exponential rise – especially among birth-registered females (yellow) – is evident beginning around 2015 (Tavistock Gender Identity Development Service Data – Gender Identity Research & Education Society).

Such an exponential increase cannot be explained by genetics (genes don’t change that fast) or even prenatal factors; it strongly suggests cultural influences and changing social norms. Dr. Lisa Littman’s 2018 study coined the term “Rapid Onset Gender Dysphoria” (ROGD) to describe this phenomenon, hypothesizing that peer influence and Internet/social media content are significant drivers (). Indeed, parents reported that many of these teens “experienced this atypical gender dysphoria out of the blue,” often after bingeing on YouTube transition videos or amid a friend group where multiple girls suddenly identified as trans (). Journalist Abigail Shrier, who investigated the trend in her book Irreversible Damage, was struck by how unlike classic transsexualism this new cohort seemed. These were often socially awkward, anxious young women who previously identified as lesbian or simply struggled with puberty, now binding their breasts and demanding testosterone after immersing in online transgender forums. Shrier’s research and interviews led her to conclude that “this was not the typical presentation of gender dysphoria” at all – rather, it bore the hallmarks of a social craze, with peer contagion and psychosocial maladaptation at its core (). In her Senate testimony, Shrier pointed out that clusters of transgender-identification have formed within friend groups and schools, analogous to past spikes in eating disorders or even collective delusions in troubled teens () (). In short, the argument goes, if gender identity were purely innate and biological, we wouldn’t expect it to suddenly surge 20- or 50-fold in certain demographics. Such surges imply that ideology and social messaging (“if you feel uncomfortable as a girl, maybe you’re really a boy”) are playing a powerful role.

Neuroscientist Debra Soh’s Critique of Gender Ideology

Neuroscientist Dr. Debra Soh is one of the outspoken voices challenging the prevailing orthodoxy on gender. Armed with years of sex research, she argues that much of what we’re told about gender identity today is ideologically driven and not backed by solid science. Soh points out that it has become almost taboo in academic and medical circles to question the new dogmas, resulting in a “cult-like” climate where feelings are privileged over facts. In an interview about her book The End of Gender, Soh remarked that “gender has been transformed into a cult-like idea, and Western society seems willing to give up factual knowledge about sex and gender.” She notes that researchers face pressure to only ask “polite questions” that confirm activists’ beliefs, and that “the political left is starting to suppress science” whenever findings counter the narrative (CNE.news). One example she gives is the issue of childhood-onset dysphoria. Decades of studies (from Zucker, Bradley, Green, etc.) showed that the majority of young children with gender dysphoria – typically ~80% – eventually outgrow those feelings by adolescence if not socially transitioned. Most of these kids ended up identifying as gay or lesbian, not transgender, once puberty hit (CNE.news). This is a well-documented outcome in clinical research. Yet, Soh observes, “all the mainstream media [now] proclaim that early transition for a child should be supported,” with little mention of the science that most dysphoric kids will desist (CNE.news). She finds it “disturbing” that politically driven guidelines encourage immediately affirming a child as trans, when “scientifically speaking, the situation is different” (CNE.news). In her view, ignoring the high desistance rates is a triumph of ideology over evidence – an example of “giving up factual knowledge” because it’s deemed insensitive. Soh also takes aim at the trendy claims that gender is purely a social construct or that there are infinite genders. She labels these ideas “myths” and says she wrote her book to “debunk [them] one by one… with scientific facts.” (CNE.news). For instance, while gender expression has cultural aspects, biological sex differences in the brain and behavior are very real – and by extension, transgender individuals likely exist due to atypical biological development (as opposed to being proof that anyone can be whatever gender they feel like). In short, Debra Soh’s stance is that biology matters and today’s gender discourse has veered into ideological zealotry, to the point of suppressing researchers and clinicians who don’t toe the party line.

Abigail Shrier and the “Social contagion” of Trans Identity

Abigail Shrier, though a journalist by profession, has become a prominent voice highlighting the ideological and social influences affecting gender identity in youth. Her focus has been on the sudden rise of trans-identification among teenage girls, which she believes is “a social contagion, not an innate identity unfolding.” Through interviews with families, clinicians, and detransitioned young women, Shrier documented how peer pressure, online communities, and activist counselors have cultivated an environment where troubled teen girls interpret their angst as being “transgender.” She cites cases of entire friend groups coming out as trans within a short span, adolescents who had never shown childhood dysphoria yet abruptly insisted on hormones after marathon Tumblr sessions, and therapists who immediately affirm without probing other issues (). The ideological underpinnings here include the notion (spread on social media and in some schools) that gender is fluid, identity is paramount, and anyone who questions a teen’s self-diagnosis is a bigot. Shrier argues that these ideas have essentially seduced a vulnerable population – namely adolescent girls often grappling with body image, sexuality, or social belonging. In earlier eras, such girls might have fallen into anorexia, self-harm, or goth subcultures; today, they declare a trans identity as a purported solution to their discomfort. One poignant observation she makes is that many of these girls are same-sex attracted (lesbian) or gender-nonconforming in their interests – and in a less ideologically charged world, they would likely just grow up to be healthy gay women. Instead, the current climate may be pathologizing their personalities, telling them that if they don’t fit female stereotypes or hate their bodies, they must actually be boys. Thus, Shrier and others see a form of “conversion” happening under the banner of gender ideology – ironically converting would-be lesbians into straight trans men via hormones and surgeries. While this perspective is hotly contested by trans activists (who deny that social contagion plays any role and view such claims as delegitimizing trans people), it has gained traction as multiple countries report spikes in adolescent gender dysphoria. Supporting Shrier’s alarm, clinicians at the UK Tavistock clinic wrote in 2018 about the need to consider social influence on these late-presenting cases, and a former head of that clinic expressed concern that many teens were “simply caught up in something.” Even Dr. Kenneth Zucker, a veteran in this field, has acknowledged that the sociocultural context in recent years is contributing to more teens declaring trans identities (). In summary, Shrier’s work shines light on the ideological roots of the current transgender youth surge: an environment that normalizes and even glamorizes transitioning, potentially at the expense of treating underlying mental health issues.

Historical Shifts in Classification and Treatment

The understanding and classification of gender dysphoria have evolved markedly over time – a story that itself reflects the push-pull of scientific knowledge and changing social attitudes. In earlier diagnostic manuals (DSM-III and DSM-IV), the condition was termed “Gender Identity Disorder” (GID) and explicitly treated as a psychiatric disorder in which one’s gender identity was at odds with biological sex. The emphasis was on the identity conflict itself as pathological. However, with the publication of DSM-5 in 2013, the diagnosis was renamed “Gender Dysphoria” – a deliberate move to depathologize gender variance while still recognizing the intense distress that can accompany it (Gender dysphoria – Wikipedia). As the APA explained, “diverse gender identities are not in themselves disordered, and disorder solely relates to distress.” In other words, it’s not “being trans” that’s a mental illness, but the dysphoria (distress) that may come with it (What Is Gender Dysphoria? A Critical Systematic Narrative Review). This change was driven in part by advocacy to reduce stigma: labeling someone as having a “disorder” simply for being transgender was seen as unnecessarily pathologizing. The subtyping by sexual orientation was also removed (previously clinicians noted whether a patient was attracted to males, females, both, or neither – reflecting an older theory that there are different types of transsexualism). Now, the focus is just on alleviating dysphoric distress. Similarly, the World Health Organization’s latest ICD-11 in 2019 reclassified “Gender Incongruence” out of the mental disorders chapter, moving it to a sexual health category (Gender dysphoria – Wikipedia). These shifts signify a broader historic reframing of gender dysphoria from a psychiatric abnormality to a medical condition or even simply a human variation.

Accompanying the nosological changes have been treatment philosophy changes. Historically (mid-20th century), someone with gender identity conflict might have been subjected to talk therapy aimed at alignment with birth sex (or worse, aversive therapies to discourage cross-gender feelings). By the late 20th century, however, a “gender-affirmative” approach emerged in specialized gender clinics, where the goal was to help a patient transition socially and physically to relieve dysphoria. Harry Benjamin’s work in the 1960s set the stage for providing hormones and surgeries to transsexuals under strict criteria – typically only adults who had a persistent cross-gender identification and had undergone extensive evaluation. The Standards of Care developed by WPATH (World Professional Association for Transgender Health) initially required things like living full-time in the desired gender for a year (the “real-life test”) and letters from mental health professionals before medical intervention (Gender dysphoria – Wikipedia). Those gatekeeping standards have gradually loosened in many places, moving towards an informed-consent model for adults. In children, the Dutch protocol introduced in the 2000s pioneered puberty blockers to buy time, followed by hormones at 16 and surgery at 18 for those with early-onset dysphoria. This protocol was predicated on careful psychological vetting and the idea that only a small, insistent group would be candidates.

In the 2010s, however, activist pressure and ideological currents pushed the field further towards immediate affirmation. Many mental health practitioners were taught that any attempt to explore or question a transgender client’s self-declared identity was “conversion therapy”. Consequently, the role of psychotherapy shifted in many clinics from probing “why do you feel this way?” to simply facilitating transition. Some clinicians raised concerns that other mental issues were being overlooked in this rush. For example, an internal review at the Tavistock clinic found staff felt unable to challenge young patients for fear of being seen as unsupportive, even when complex trauma or autism was present. Over the last few years, there’s been something of a reassessment in parts of the world. Sweden and Finland, after years of relatively permissive practice, have pulled back on pediatric medical transitions (we’ll detail this in the next section) in light of weak evidence for long-term benefit. The UK’s NHS ordered an independent review (the Cass Review) which in 2022 recommended shutting down Tavistock GIDS in favor of regional centers with more holistic care, emphasizing mental health and calling for research because existing evidence for puberty blocker outcomes was very uncertain (The real story on Europe’s transgender debate – POLITICO) (The real story on Europe’s transgender debate – POLITICO). These developments show how the pendulum can swing: classifications changed to be less stigmatizing and treatments became more affirming in response to social justice concerns – “to reduce the stigma and prejudice experienced by persons with GD” ( Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study – PMC ) – yet now some experts worry that perhaps too much ideology (and too little evidence) influenced those practices. History is essentially being rewritten in real-time, as medicine tries to find an ethical course between acknowledging transgender identities and avoiding harm from premature, ideologically driven interventions.

3. Ethical Concerns in Therapy

Affirmation vs. “Reality-Based” Therapy Approaches

One of the most heated debates in clinical circles is over the appropriate therapeutic approach to gender dysphoria: Gender-affirming therapy versus what some call “reality-based” or exploratory therapy. In a gender-affirming model, the therapist takes the patient’s stated gender identity at face value and supports them in that identity, helping them socially transition and access medical treatments as needed. In contrast, a “reality-based” (or exploratory) approach maintains a degree of clinical skepticism, exploring possible underlying causes for the dysphoria and gently challenging false beliefs – much as a therapist would with any other identity-related conflict or dysmorphic feeling. To its critics, affirmation can look like immediately “rubber-stamping” a patient’s self-diagnosis (for instance, telling a troubled teen, “yes, you’re really a boy” after a single session), whereas reality-focused therapy can look to its critics like denying the patient’s lived reality and causing harm by not affirming.

Proponents of gender-affirming therapy argue that it is cruel and unethical to tell someone their deeply felt identity is not real. They point to high suicide attempt rates among transgender people and suggest that affirming therapy literally saves lives by reducing rejection and self-hatred. Indeed, many major medical organizations have issued statements opposing any therapy that tries to change a person’s gender identity (labeling that as a form of discredited “conversion therapy”) (Gender dysphoria – Wikipedia). The American Psychological Association, for example, advises that affirming a child’s gender exploration is best for mental health, as opposed to pressuring them to conform to their birth sex. Affirmation, in this context, is seen as acceptance and support – analogous to how one would support a gay youth in coming out, rather than trying to make them straight. Importantly, an affirming therapist can still offer psychological help (addressing depression, anxiety, etc.), but they will not directly challenge the core belief of being another gender.

On the other hand, proponents of a more exploratory or reality-oriented therapy raise the question: when is affirmation appropriate and when might it be reinforcing a delusion or misunderstanding? In virtually every other area of mental health, therapists do not automatically affirm a patient’s subjective beliefs about themselves. If a patient with schizophrenia says, “I am King Arthur,” the therapist does not nod and say “Yes your majesty.” If a teenage girl with anorexia insists “I’m fat” when she’s dangerously underweight, we don’t celebrate her insight – we recognize that as a false belief central to her disorder and work to change it. Many clinicians have drawn an analogy between gender dysphoria and other dysmorphias or identity delusions: the person has a fixed belief (“I’m really a man,” or “this limb doesn’t belong to me,” or “I’m hideously ugly”) that conflicts with physical reality. In such cases, the usual therapeutic approach is to use gentle reality-testing and treatment of the mind, rather than to alter the body to fit the belief. A patient with Body Integrity Identity Disorder (who might earnestly want a healthy limb amputated to satisfy an identity as an amputee) is generally not offered surgery but rather psychological care; an anorexic is not given liposuction or dieting tips but rather therapy and nutrition support. By this logic, immediate affirmation of a gender-crossed identity could be seen as colluding with a delusion. As one patient advocate put it bluntly during England’s recent review of youth gender services: “People with mental health conditions need robust mental healthcare. Affirming delusions is not good care. Anorexia is not affirmed, it is treated. Gender disorders are just another type of mental health issue manifested on the physical body.” () (). This perspective holds that a therapist’s job is not to simply validate whatever a client says, but to help them discover the truth about themselves and learn to cope with reality. If the reality is that a 13-year-old female cannot truly become male, a reality-focused therapy might help her come to accept her body or explore why she hates being female (maybe due to trauma or internalized sexism) – rather than immediately putting her on a path to medical transition.

This debate often centers around minors, because with adults there’s at least a presumption of stable identity and autonomy (though even in adults, therapists may encounter those who later regret being affirmed too readily). With children and adolescents, the ethical stakes are higher. Affirmation approach says that if a 10-year-old insists he is a girl, you affirm and perhaps facilitate a social transition (new name, pronouns, presenting as female) and when puberty arrives, consider puberty blockers to prevent the distress of developing the “wrong” sex traits. A more cautious approach notes that children’s identities are fluid and developing, and early social transition can cement a transient idea into a persistent one. As Dr. Soh highlighted, most young kids will revert to identifying with their birth sex by pubertyif they are not reinforced in the opposite identity (CNE.news). Thus, prematurely affirming can become a self-fulfilling prophecy. The ethical question becomes: is it more harmful to potentially reinforce a false self-concept, or to withhold immediate affirmation and risk the child feeling unsupported? Reasonable practitioners can disagree, which is why some clinics favor a middle-ground “watchful waiting” (neither affirming nor actively discouraging, but monitoring the child’s development). Unfortunately, in some jurisdictions, even neutrality is frowned upon – conversion therapy bans have been written so broadly that any therapy not explicitly affirming a child’s trans identity could be interpreted as an illicit attempt to “change” their identity. Shrier warned that proposals like the U.S. Equality Act would make it “impossible for a therapist or psychiatrist to do anything other than immediately affirm a patient’s stated diagnosis of gender dysphoria — no matter the patient’s age or context”, effectively mandating affirmation only by law () (). This raises alarms about therapists’ professional judgment being overridden and about young patients being funneled toward transition without thorough evaluation.

Comparisons to Schizophrenia or Body Dysmorphia

To further illustrate the ethical divide, many have drawn analogies between gender dysphoria and conditions like schizophrenia or body dysmorphic disorder (BDD) in terms of therapeutic approach. In schizophrenia, if a patient is experiencing hallucinations or delusions (say, they believe the TV is sending them secret messages), the standard care is antipsychotic medication and therapy to help reality-testing – not to install special antennas in their house to confirm their belief. Affirmation therapy for gender dysphoria can look (to skeptics) like telling a schizophrenic patient “Yes, the voices are real and you should do what they say.” With body dysmorphic disorder, patients obsessively believe a part of their body is grossly flawed (even though it appears normal to others) – for instance, someone might be convinced their nose is hideously deformed. While cosmetic surgery is occasionally sought by BDD patients, ethical surgeons typically proceed with great caution, knowing the issue is psychological and surgery rarely solves it. In fact, BDD patients often remain unhappy post-surgery or shift focus to another body part. The parallel caution in gender dysphoria is that changing the body might not resolve the psychological distress if that distress stems from broader issues. Indeed, post-transition outcome studies show that while many trans people feel better in certain respects, rates of depression and suicide attempts can remain high, suggesting unresolved mental health needs (Comorbidity – Stats For Gender).

Those who favor affirmation bristle at the comparison to mental illness or delusion – they argue that being transgender is not a psychosis; trans people do not lose touch with reality in other domains, and their conviction of identity is not a hallucination but a deeply felt knowledge of self. They often liken gender identity to something like sexual orientation or left-handedness – an innate trait that might be rare or not obvious at birth but is fundamental to the person. Thus, they claim, affirming a trans identity is not like indulging a delusion; it’s like recognizing a truth about the person that isn’t immediately visible. Critics respond that while gender dysphoria is very real suffering (and no one is saying people “choose” it on a whim), the content of the belief (“I am a man in a woman’s body”) could be a misinterpretation of one’s feelings rather than an accurate, immutable fact. For example, a girl who hates puberty and feels uncomfortable as a female might latch onto the idea “I’m really male” as an explanation, but that could be a cognitive distortion influenced by online ideology. If that’s the case, then fully affirming that belief – analogous to affirming an anorexic’s warped self-image – might not ultimately serve the patient’s health.

There is also the analogy of somatic symptom disorders: if a patient with no leg injury insists their leg is in horrible pain and demands an amputation, do we amputate? Generally no; we treat the mind. Yet in gender medicine, perfectly healthy breasts or genitals are sometimes removed because the patient’s mind cannot tolerate them. To some clinicians, this is a necessary trade-off to alleviate extreme dysphoria; to others, it’s a profound ethical violation to mutilate healthy organs without addressing why the patient feels that way. The UK’s interim Cass Review has emphasized that many gender-distressed youth have complex psychosocial issues that need attention, and that a single-minded focus on gender transition may neglect those needs. Echoing this, a Swedish psychiatrist, Dr. Sven Román, quipped that affirming every young person’s self-diagnosis is akin to a psychiatrist affirming a depressed patient’s plan to commit suicide – obviously not something we do, because the patient’s current feelings might be tragically mistaken.

In summary, the ethical tension is between validation and verification: validating a patient’s self-professed identity versus verifying through therapy what underlying reality that identity represents. As one set of consultation comments in the NHS review put it: “The NHS cannot collude in telling lies to children about the fundamental reality of their sex.” () ()From this perspective, telling a natal male child who believes he’s a girl that he really is a girl is seen as a lie that could do harm. Others believe it is a therapeutic truth that honors the child’s inner experience. This dilemma has no easy answer, which is why it remains at the forefront of ethical discussions in gender therapy.

Medical Interventions and Minors: Puberty Blockers, Hormones, Surgeries

Perhaps the most urgent ethical questions surround the use of medical interventions in minors: puberty-blocking drugs, cross-sex hormones (estrogen/testosterone), and surgeries such as mastectomies (top surgery) or gonadectomy. These interventions are life-altering and often irreversible, raising concerns about consent and long-term welfare. An affirmation-only approach tends to favor offering such treatments to youth deemed persistent in their trans identity, while a cautious approach urges delaying or avoiding irreversible steps until adulthood. What does the evidence say, and what are the ethical implications?

Puberty blockers (GnRH analogues like Lupron) are often described by advocates as a harmless “pause button” to give young teens “time to explore gender” without the distress of developing unwanted sex characteristics. However, emerging data and clinical experience have complicated this rosy picture. For one, these blockers are not entirely reversible or benign. They halt the physical maturation of bones, brain, and sex organs during a critical window. Short-term, known side effects include loss of bone density, hot flashes, fatigue, mood changes (Gender dysphoria – Wikipedia) (Gender dysphoria – Wikipedia). Long-term effects on brain development, fertility, and sexual function are largely unknown (since this off-label use is relatively new and experimental in gender dysphoria) (Gender dysphoria – Wikipedia). What is known is that virtually all children put on blockers proceed to cross-sex hormones – in one study, 98% did so, meaning blockers are not really a “pause” for most but the first step of a transition pathway (). Why do almost all continue? Possibly because halting puberty at its earliest stage arrests any further development of identity and body – the young teen remains with a prepubescent body while their peers mature, which can cement the feeling of being “different” and left behind unless they proceed to live as the other sex. Shrier argues that “puberty blockers seem to nearly guarantee a child will proceed to cross-sex hormones, perhaps because of the psychological impact of having had one’s puberty blocked and being entirely out of step with one’s peers.” () In essence, blockers may create the very persistence they are meant to neutrally evaluate. Ethically, giving a 12-year-old a drug that will likely put them on a path to sterilization (since years of subsequent cross-sex hormones will render them infertile) is a grave decision. In girls, blockers plus testosterone can lead to vaginal atrophy and anorgasmia (if they later have genital surgery as adults, sexual function might never fully develop if puberty was blocked). In boys, blockers stop sperm development (no bankable sperm if given early) and cross-sex estrogen can cause irreversible breast growth and infertility. These are adult decisions being made by minors who cannot possibly understand the lifelong consequences – a point raised by the UK’s High Court in the landmark Bell v Tavistock case, which initially ruled that under-16s likely cannot give informed consent to blockers (that ruling was later appealed, but it prompted stricter oversight) (Hormonal Tx of Youth With Gender Dysphoria Stops in Sweden ).

Given these concerns, several European countries have recently shifted to more conservative stances for minors. Sweden’s renowned Karolinska Hospital announced in May 2021 that it would stop prescribing puberty blockers and cross-sex hormones to minors outside of research settings (Hormonal Tx of Youth With Gender Dysphoria Stops in Sweden ) (Hormonal Tx of Youth With Gender Dysphoria Stops in Sweden ). Their new policy permits such treatments only in controlled clinical trials, citing the lack of evidence of long-term benefit and the known risks (Hormonal Tx of Youth With Gender Dysphoria Stops in Sweden ). The policy explicitly referenced the UK’s Keira Bell judgment and the need for caution. Finland’s health authority in 2020 also prioritized psychotherapy over early medical interventions for youth, noting that gender dysphoria in teens is often transient or associated with other issues (like autism or trauma) and that hormones should be a last resort. France’s National Academy of Medicine in 2022 warned of over-diagnosis in youth and urged great caution, recommending psychological support and parental involvement, as well as acknowledging potential side effects like sterility and bone loss from treatments (The real story on Europe’s transgender debate – POLITICO) (The real story on Europe’s transgender debate – POLITICO). These moves reflect a more classic medical-ethics stance: when in doubt, err on the side of “do no harm” and recognize that irreversible interventions require solid evidence, which is currently lacking for pediatric transition.

In contrast, in some places (including parts of the US, Canada, and Australia), affirmative care for minors remains the standard, with even double mastectomies (removal of breasts) being performed on teenagers as young as 13 or 14 in certain private clinics. Defenders of youth transition argue that for carefully selected adolescents, these interventions alleviate suffering and reduce suicide risk. However, the empirical support for the oft-repeated claim that “gender-affirming care prevents suicide” is not as strong as many believe – the studies are usually short-term and without controls, and some population-level analyses actually show higher suicide rates post-transition in youth (perhaps because underlying issues weren’t resolved). Ethically, even if there is a suicide risk, some have likened the situation to blackmail: “approve this radical treatment or the kid will kill themselves.” Normally, serious suicidal ideation would prompt intensive therapy and perhaps medication, not immediate life-altering surgery. The ethical principle of informed consent is also front and center. Can a 15-year-old truly understand what it means to be sterile at 25, or to lose sexual function? Many detransitioners (people who later revert to identifying as their birth sex) say they absolutely did not grasp what they were agreeing to in their youth – they trusted doctors who told them it was the only path forward. This raises questions of whether parents and clinicians, swept up in a one-size-fits-all affirmative model, are failing their duty of care by not fully exploring alternatives and long-term outcomes.

Finally, the role of parents and the law becomes an ethical facet. In some jurisdictions, parental consent can be bypassed for teens seeking hormones; in others, parents are pressured to affirm or risk being seen as abusive. The balance between a minor’s autonomy and parents’ responsibility is tricky. A 16-year-old may be mature in some ways but neuroscientifically, their executive function and foresight are not fully developed. We generally restrict minors from making irrevocable decisions (they can’t get tattoos, sign contracts, or drink alcohol), yet some can consent to removing their breasts or affecting future fertility. Critics call this double standard hypocritical and driven by politics rather than consistent ethics.

In sum, when it comes to minors, the ethical landscape is tilting (at least in more evidence-based systems) toward greater caution. The debate over affirmative vs exploratory therapy is not just academic when irreversible drugs and surgeries are on the table. More clinicians are asking, as Finland did, “what’s the rush?” when perhaps addressing co-occurring issues first could resolve dysphoria without drastic measures. The counterpoint is the genuine anguish of a gender-dysphoric youth; no ethical physician wants to prolong suffering needlessly. The challenge is that our interventions are high-stakes and our predictions of who will benefit in the long run are still uncertain. As one pediatric endocrinologist put it, “We need to figure out how to help young people feel comfortable in their own skin – whether that means transitioning or not – without letting ideology or fear dictate our decisions.” This encapsulates the ethical imperative: prioritize the well-being and reality of the patient over any political or social agenda.

4. Philosophical and Social Implications

Identity Beliefs vs. Medical Reality

At a philosophical level, the transgender phenomenon forces society to grapple with the nature of identity and reality. We are being asked: If someone sincerely believes they are something that their biology contradicts, should that belief be treated as a medical condition warranting physical intervention? This is virtually unprecedented in medicine. Typically, if one’s internal self-image clashes with physical reality, medicine works on the mind, not the body (as discussed with BDD or psychiatric delusions). Treating gender identity beliefs as sacrosanct – to the point of remaking bodies to align with them – raises the risk of committing category errors and harming patients who might have been helped in less invasive ways. The irreversibility of many gender medical interventions adds weight to this concern. If the identity was mistaken or transient, the individual faces lifelong consequences. Detransitioned persons often describe the devastation of realizing their identity-based medical decisions cannot be undone – lost fertility, altered voices, chest or genital scars, etc. Some have likened pediatric transition to a form of “gender eugenics” or experimental surgery on minors, given that a significant number might have outgrown their dysphoria. The philosophical question is how we define “health.” Is health the congruence of mind and body? If so, we have two paths: change the mind (traditional therapy) or change the body (gender medicine). Modern ideology has favored changing the body. But this assumes the mind’s perception (gender identity) is infallible and innate, which is philosophically dubious and scientifically unproven.

Critics warn of a slippery slope: if subjective identity claims must be accepted as reality, where do we draw the line? There are already fringe cases of people identifying as trans-species (“otherkin”), trans-racial, or trans-abled (wanting to be disabled). Society currently views those claims with skepticism, but the logic of self-identification could extend to them. For instance, if one can be “born in the wrong body” regarding sex, could someone be born in the wrong species? Such scenarios sound far-fetched, but philosophically they probe the consistency of the self-ID principle. The risk is that by medicalizing identity, we may be validating personal subjective truths that have no basis in material reality, potentially to the detriment of individuals. As one clinician starkly put it, “We need to acknowledge nobody is actually ‘transgender’; the entire premise is a lie. Let’s celebrate diversity in gender expression while keeping [healthcare] firmly planted in the reality of the sex binary.” (). This view holds that it’s perfectly fine for a man to feel more comfortable in feminine roles or attire (and vice versa), but it doesn’t make him literally female – and trying to medically make him female is chasing an illusion, since at the chromosomal and reproductive level he will remain male. You can alter secondary sex characteristics, but you cannot truly change every cell of someone’s sex. Thus, treating the belief of being the opposite sex as a condition requiring surgery/hormones could be seen as endorsing a fundamental untruth. The counterargument from trans advocates is that sex isn’t as binary as we think (they often point to intersex conditions) and that brain/mind is what ultimately matters for sex identity. Yet, philosophically, that veers into a quasi-dualism – the notion of a gendered “soul” or brain that can be born into the wrong body, which is more a metaphysical claim than a scientific one.

The Therapist’s Role: Affirmation vs. Challenging Delusion

Therapists and medical professionals are in a unique position of trust – they are supposed to help patients navigate reality, not reinforce harmful misconceptions. The role of therapists in the gender identity context has become a contentious ethical minefield. Should a therapist act more like a “mirror,” reflecting back and affirming the patient’s self-declared identity? Or more like a “compass,” helping the patient find a true direction (which might mean gently saying, “perhaps you are not actually what you think you are”)? Traditional psychotherapy training emphasizes techniques like reality testing, cognitive restructuring of false beliefs, and addressing underlying trauma or conflicts. However, many therapists now feel those standard tools are off-limits if a client says “Actually, I’m [of the opposite sex].” They worry that even asking “why do you feel that way?” could be seen as transphobic. Some have compared this to a scenario where a therapist would be expected to agree with a patient’s hallucinations – clearly anathema to their professional ethics. As a result, there is a real concern that therapists are being forced into an affirmation-only corner, effectively abandoning their duty to fully assess and treat.

The affirmation model casts the therapist almost as a cheerleader for the patient’s stated identity, helping them overcome external barriers (unsupportive family, access to hormones, etc.), rather than probing the internal consistency of that identity. But if the identity is a manifestation of something like dissociation or a misguided coping mechanism, the therapist might be abdicating their responsibility. There have been cases (shared by detransitioners) where young patients presented with a laundry list of mental health issues – depression, anxiety, past abuse, eating disorder – yet the therapist zeroed in on gender and quickly affirmed them as transgender, sidelining all other issues. From a “reality-based” perspective, this is backwards: one should treat the other issues first and see if the gender dysphoria persists once those are resolved.

Another angle is the concept of “do no harm.” Therapists must weigh harms: the harm of possibly reinforcing a delusion vs. the harm of denying someone’s professed identity. The middle ground approach for therapists has been to practice “open exploration.” This means creating a safe space for the client to explore their feelings about gender without immediately labeling them or pushing in either direction. For example, if a teen girl says “I think I’m really a boy,” an exploration-oriented therapist might respond, “Okay, let’s talk about that. When did you start feeling this? What does being a boy mean to you? How do you expect things would change if you lived as a boy?” and so on – gently guiding the patient to dig into the reasons and expectations. In an affirmative-only framework, by contrast, many of those questions might be skipped in favor of “coming out” support and a referral to an endocrinologist for puberty blockers. The ethical stance of exploration is that it’s not denying the person’s identity; it’s ensuring the identity is fully understood and not a symptom of something else. If, after thorough therapy, the individual remains convinced and shows consistency, then medical transition might be pursued with more confidence. If not, the therapist might have helped them avoid a serious mistake. Unfortunately, a number of therapists report that even this nuanced approach is often branded as “trans conversion therapy” by activists if it doesn’t affirm from the first session. This has a chilling effect, leading some to practice in secret or refer out cases they feel they can’t ethically just affirm.

Ultimately, the therapist’s role should be to help the patient achieve a healthy reconciliation of mind and body – whether that means changing the body or changing the mind. The ideological climate, however, has put pressure such that only one of those outcomes is considered acceptable (changing the body). The philosophical question is: are we helping patients by going along with potentially delusional beliefs? Or are we harming them by not challenging those beliefs? The answer likely varies by individual case, which is why a one-size-fits-all mandate (affirmation only) is so controversial. A parallel often cited: If a patient insisted on cosmetic surgery that the doctor felt was unwarranted given the patient’s appearance, a responsible doctor might refuse, recognizing body dysmorphia. Should gender-related requests be treated any differently? Many therapists and doctors feel ethical discomfort acquiescing to every demand for hormones or surgery, especially in young patients, but fear professional censure if they hesitate. Restoring a climate where clinicians can exercise judicious skepticism and treat the whole person (and all potential issues) is, some argue, essential for truly ethical practice.

Broader Societal and Legal Ramifications

The implications of treating gender identity as legally and medically enforceable reality extend far beyond individual patients – they ripple through law, education, sports, women’s rights, and societal norms. When identity claims are elevated to protected characteristics that override biological sex, society faces collisions between the rights or safety of different groups. For instance, if a transgender woman (biological male) is legally recognized as a woman in all contexts, this means male-bodied individuals in female spaces – from prisons and shelters to locker rooms and sports teams. We have already seen cases where this policy raised alarm: e.g., in the UK, a trans-identifying male prisoner (who had not had surgery) was housed in a women’s prison and went on to sexually assault female inmates. Data from the UK Ministry of Justice revealed that a plurality of trans prisoners (male-to-female) are incarcerated for sexual offenses at a much higher rate than female prisoners (Transgender women criminality shows male pattern). Critics argue that self-declared identity should not grant access to spaces where physical sex matters for privacy and safety. Similar debates rage in sports: if gender identity alone determines competition category, female athletes may be placed at a gross disadvantage against trans women who retain male physiological advantages (greater lung capacity, muscle mass, bone density, etc.). Many see this as an erosion of Title IX protections and women’s hard-won opportunities, essentially undermining the very category of “female” as a meaningful class. Philosophically, it pits the individual’s asserted identity against collective realities (like the need for fair competition or safe refuge). Society must decide if validating one person’s feelings is worth potential harm to others.

Another societal impact is on language and truth. Laws in some jurisdictions compel the use of preferred pronouns, essentially mandating others to speak as if a person is the sex they claim. For those who believe sex is an immutable reality, being forced to say “she” for a clear biological male (or vice versa) is experienced as a coerced lie – a violation of free conscience and speech. In Canada, for example, misuse of pronouns can be actionable under human rights codes in employment or service contexts. This has raised First Amendment concerns in the US and free speech concerns elsewhere. Even beyond legal compulsion, social enforcement is strong: people fear ostracism or job loss if they openly acknowledge biological realities in conflict with gender identity claims (hence the rise of terms like “TERF” used to vilify those, often women, who assert that trans women are not identical to natal women). The chilling of open discussion is a real societal consequence, making it difficult to even have fact-based conversations about these issues without accusations of “hate.” This dynamic arguably hinders scientific and policy progress, since problems can’t be solved if they can’t be discussed honestly.

There’s also the impact on children and education. Many schools have integrated gender identity ideology into curricula, teaching very young kids that gender is fluid and you might have a boy brain in a girl body, etc. Some parents worry this confuses children about a concept (gender) they wouldn’t otherwise question, potentially sowing seeds of body discontent. Additionally, policies allowing children to change gender at school without parental knowledge (in the name of the child’s rights) drive a wedge between parent and child, raising ethical issues of parental consent and guidance. Legal recognition of self-identified gender can also clash with religious or philosophical beliefs of others. A devout religious person might respectfully disagree with the concept of changing one’s sex; yet laws might label that person discriminatory if they cannot in good conscience affirm someone’s new identity. We are thus navigating a tricky pluralism issue: how to respect transgender individuals and respect the fact that not everyone shares the same view of gender/sex.

From a philosophical vantage, treating personal identity as untouchable and legally supreme can be seen as a form of subjectivism run amok. In a pluralistic society, we generally allow people to believe what they want (“live your truth”), but we do not generally require everyone else to participate in or endorse that personal truth. With gender identity, there’s an expectation not only of tolerance (which is fair) but of compelled affirmation by others (which is more problematic). For comparison, consider religion: one may sincerely identify as a member of a certain faith, and they have the right to practice it. But they cannot force others to observe their religious dictates or to address them by religious titles if others do not share that faith. In the gender identity realm, however, the trend is that if Bob identifies as female Alice, everyone must treat Bob as female in every way – effectively forcing others to comply with Bob’s self-conception or risk being punished for “misgendering.” This elevates subjective identity to a social orthodoxy. Some feminist philosophers like Kathleen Stock have argued that this compromises intellectual honesty and material truth, effectively requiring society to participate in a “pretend” that sex is whatever one says it is, despite every cell in one’s body saying otherwise.

The legal codification of gender self-identification (for example, laws that allow changing sex markers on documents based on declaration, or defining “woman” in law to include anyone who says they are one) can also have downstream effects on data collection, crime statistics, and monitoring of discrimination. If male-bodied individuals are counted as female in, say, crime stats, it can obscure true patterns (e.g., if a male rapist is recorded as female because they identify as such, it falsely boosts “female perpetrator” statistics). It also makes targeted initiatives (like women’s health programs or scholarships for female students in STEM) harder to manage if eligibility can be attained by identity claim.

On the positive side, supporters say that legally recognizing trans identities is simply extending rights and dignity to a marginalized group, akin to how gay rights or racial equality needed laws for protection. The societal impact they seek is the normalization of transgender individuals in public life, free from harassment and discrimination. Those are noble aims. The challenge is ensuring those protections don’t infringe on others’ rights or on empirical reality. As society works through these conflicts, it will likely require nuanced policies – for instance, maybe developing solutions like third spaces or case-by-case accommodations rather than blanket self-ID in all contexts. But at present, the debate is polarized between an “all or nothing” approach: either fully validate and enforce gender self-ID or deny trans people recognition. The real world is more complicated, and a balance must be struck.

In conclusion, gender dysphoria and transgender identity sit at a crossroads of science, ethics, and philosophy. The scientific data reveals significant correlations (with autism, trauma, and mental health factors) that any comprehensive understanding must account for. The question of biology vs. ideology highlights that while there may be innate elements, the current surge in trans identification, especially among youth, has a strong ideological and social component that can’t be ignored. Ethically, the medical and therapeutic community is wrestling with how to best help individuals in distress – by affirming their identities, by exploring deeper issues, or some combination of both – all while ensuring “first, do no harm.” And societally, we are testing the limits of how far subjective identity can or should be affirmed in law and custom. In doing so, we risk blurring lines between compassion and capitulation to untruths, between supporting a minority and undermining commonsense realities. As sharp-witted commentators have noted, the truth has a way of resurfacing even when suppressed – “the truth lasts the longest,” as Debra Soh put it (CNE.news). A sustainable path forward will require acknowledging biological reality while also finding space for individuals to live free of unnecessary suffering or discrimination. That means applying both academic rigor and human empathy – not one in absence of the other. Gender dysphoria is undeniably real and painful; the challenge is to respond in a way that is clinically sound, ethically responsible, and socially sane. Only by candidly examining correlations, questioning dogmas, and prioritizing the well-being of individuals over ideology can we hope to strike that balance.

Sources:

  1. Warrier et al., Nature Communications (2020) – Large-scale study on autism and gender diversity ( Largest study to date confirms overlap between autism and gender diversity | The Transmitter: Neuroscience News and Perspectives ) (Study finds higher rates of gender diversity among autistic individuals | Autism Speaks)
  2. Giovanardi et al., Front. Psychology (2018) – Study on attachment, trauma, and gender dysphoria (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria) (Frontiers | Attachment Patterns and Complex Trauma in a Sample of Adults Diagnosed with Gender Dysphoria)
  3. Oliveira et al., BMC Psychiatry (2021) – Findings on high rates of childhood maltreatment in trans individuals ( Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study – PMC ) ( Gender dysphoria: prejudice from childhood to adulthood, but no impact on inflammation. A cross-sectional controlled study – PMC )
  4. Autism Speaks summary of Nature Comm. study (2020) – Autism 24% in trans vs 5% in cis sample (Study finds higher rates of gender diversity among autistic individuals | Autism Speaks) (Study finds higher rates of gender diversity among autistic individuals | Autism Speaks)
  5. StatsForGender.org – Review of mental health comorbidities in gender dysphoria (various studies summarized) (Comorbidity – Stats For Gender) (Comorbidity – Stats For Gender)
  6. Debra Soh interview, CNE News (2022) – Critique of gender ideology in academia and mention of desistance in children (CNE.news) (CNE.news)
  7. Abigail Shrier, Senate Q&A (2021) – On rapid-onset dysphoria and social contagion among teen girls () ()
  8. NHS England Consultation Report (2023) – Public and expert comments on gender services (quotes on not “telling lies” to children and not affirming delusions) () ()
  9. Medscape Medical News (Nainggolan, 2021) – Sweden’s Karolinska Hospital ends routine youth hormone treatments, citing lack of evidence and U.K. court case (Hormonal Tx of Youth With Gender Dysphoria Stops in Sweden ) (Hormonal Tx of Youth With Gender Dysphoria Stops in Sweden )
  10. France24 / AFP News (2022) – French National Academy of Medicine warning on over-diagnosis, need for caution with youth treatments (bone fragility, fertility risks) (The real story on Europe’s transgender debate – POLITICO)

The Trans Ideology Dilemma, Part 1 – Gay Rights vs. Gender Ideology: A Research-Backed Analysis


This section includes:

  • Scientific Distinction Between Sexual Orientation and Gender Identity – Sexual orientation has a strong biological basis, while gender identity lacks clear scientific evidence and is influenced by social and psychological factors.
  • Impact on Gay and Lesbian Communities – The rise of gender ideology has contributed to a surge in female-to-male transitions, disproportionately affecting same-sex attracted girls. Lesbians face pressure to accept trans women as partners, challenging the concept of same-sex attraction.
  • LGBTQ+ Movement Shift – The focus of LGBT activism has shifted from securing rights for LGB individuals to emphasizing gender identity, often at the expense of sex-based rights and biological reality.
  • Sociopolitical Trends and Policy Responses – Laws and policies increasingly favor gender self-identification, reshaping legal definitions of sex and complicating same-sex attraction. Some countries are reversing course, prioritizing cautious, evidence-based approaches to gender dysphoria treatment.
  • Cultural and Institutional Influence – Schools, media, and corporations have adopted gender ideology, often sidelining discussions on biological sex and its relevance to same-sex attraction.

1. Scientific Basis: Sexual Orientation vs. Gender Identity

Sexual Orientation (LGB). Decades of research indicate that sexual orientation (being gay, lesbian, or bisexual) has a strong biological foundation. Studies suggest people are “born with a certain sexual attraction,” not taught it. For example, neuroscientist Debra Soh notes that sexual attraction is likely rooted in biology – potentially influenced by prenatal factors like hormones or immune responses – rather than social upbringing. Scientists have found physiological evidence: male and female brains show sex-specific structures, and gay individuals sometimes exhibit brain anatomy or responses intermediate between heterosexual males and females. These findings align with the idea that being gay/lesbian is an innate trait. Indeed, multiple lines of evidence (twin studies, the fraternal birth-order effect in males, etc.) point to biological correlates of homosexuality, meaning one’s sexual orientation is largely not a choice or social construct but an intrinsic aspect of identity. This contrasts with unfounded claims of “sexual fluidity for anyone,” which Soh calls a “bizarre strain of thinking” – she argues orientation is fixed for most people. In short, sexual orientation is empirically understood as an innate, biologically influenced trait.

Gender Identity (T/Q). The concept of gender identity – one’s internal sense of being male, female, or something else – is newer to scientific inquiry, and evidence for a purely biological basis is less conclusive. Some neurological studies have reported subtle brain differences in transgender individuals (for instance, trans women showing certain brain features shifted toward a female-typical pattern). However, experts caution that these findings are preliminary and often confounded by factors like hormonal treatments. “It remains unclear whether [observed] brain differences are a reflection of gender identity,” Soh notes, meaning science has not definitively shown an inborn “female brain in a male body” or vice versa. In fact, a large proportion of youth with gender dysphoria have other mental health diagnoses (one survey found 75% had co-occurring disorders), suggesting dysphoria may sometimes arise from psychosocial factors. Moreover, gender identity displays notable social patterns: the vast majority of gender-dysphoric children (60–90%) outgrow their dysphoria by puberty if not affirmed as trans. This high “desistance” rate implies that for many kids, feelings about gender are fluid and tied to developmental or social context. Recent phenomena like “rapid-onset gender dysphoria” in peer clusters (especially teen girls) further point to social influence. Researchers like Dr. Lisa Littman found that 87% of youth in her parent-survey had friend groups where multiple peers became transgender-identifying around the same time, and 41% of those youths had first identified as lesbian, gay, or bisexual before coming out as trans. These patterns underscore that gender identity may be more malleable and influenced by social environment than sexual orientation. In summary, unlike sexual orientation, which is strongly rooted in biology, gender identity’s origins appear to be a complex mix of some biological predispositions (still under study) and significant social/psychological factors.

2. Impact on Gay and Lesbian Communities

Transition Trends Among Lesbians. A striking shift has occurred in the demographics of those pursuing gender transition, with implications for lesbian and gay communities. Historically, most transgender individuals were male-to-female, but in the last decade there’s been an explosion of female-to-male (FtM) transitions, often involving adolescents who would likely have identified as lesbians in the past. For example, the UK’s Tavistock youth gender clinic saw an unprecedented surge in adolescent girls referred for gender dysphoria. Female patients, once a small fraction of cases, swelled to 70% of referrals by 2016-2017 – jumping from only 32 girls in 2009 to 1,265 in 2016. This over 5,000% increase in trans-identifying teen girls over seven years suggests many youths who might have grown up to be lesbian women are instead transitioning to live as straight trans men. Clinicians observed that a “new kind of patient – distressed, same-sex attracted girls with complex problems – was being funnelled…towards medical transition” at Tavistock. Similar spikes are reported internationally. Researchers and writers like Abigail Shrier have voiced concern that social pressures and homophobia (e.g. bullying of “butch” girls in puberty) are influencing some lesbian teens to see transition as the answer. In essence, the data show a notable decline in the lesbian population as more young women adopt a trans male identity, a trend some have controversially dubbed “lesbian extinction” or a form of inadvertent gay conversion (since early transition can permanently sterilize youth who might have simply been gay adults).

Trend in youth gender dysphoria referrals. The number of children and adolescents referred to the UK’s NHS Gender Identity Development Service skyrocketed in the 2010s, especially among birth-assigned females. Many of these girls were gender-nonconforming and same-sex attracted, highlighting a new demographic of transgender youth.

Changing Identity Labels. Concurrently, within lesbian communities there’s evidence of changing self-identification, likely influenced by broader “queer” and gender-expansive ideologies. Traditional lesbian identity has somewhat declined as more women embrace fluid labels. For example, an Australian survey (SWASH) found that the percentage of non-heterosexual women who identified exclusively as “lesbian” dropped from 69% in 2014 to just 38% in 2024. Many younger women now prefer labels like “queer” or multi-label identities, reflecting a trend away from fixed sexual orientation categories. The table below illustrates this shift:

Year% of non-hetero women identifying only as lesbian
201469%
202051%
202438% (preliminary)

Table: Percentage of non-heterosexual women in a community survey choosing “lesbian” as their sole label (University of Sydney SWASH survey data). Many women now opt for broader labels (queer, bi, etc.), indicating a more complex view of sexuality.

Researchers note that some of this change comes from women adopting inclusive identities that accommodate gender-diverse partners or a more fluid self-concept. However, lesbian advocates worry that gender ideology may be eroding lesbian identity. If “lesbian” is redefined to include trans women (biological males), some women feel their orientation (attraction to female bodies) is being invalidated. The above trends – both the rise in FtM transitions and the decline in the use of “lesbian” label – highlight how the transgender movement’s rise has uniquely impacted lesbians as a group.

Same-Sex Dating and Social Pressures. The convergence of gender ideology with LGBT spaces has introduced new dynamics in dating for gay men and lesbians. One contentious issue is pressure on same-sex attracted people to accept trans partners as a test of inclusivity. Some activists now define sexual orientation by gender identity rather than biological sex – effectively saying lesbians can be attracted to trans women (male-bodied individuals) if they identify as women. Major LGBT organizations have adopted this language; notably, the UK’s Stonewall charity now states “gay” and “lesbian” mean attraction to the same gender, not same sex. This shift implies that a lesbian woman who exclusively dates natal females could be deemed exclusionary if she is unwilling to date a trans woman who has male anatomy. According to journalist Helen Joyce, under these new definitions “anyone who declares themselves exclusively attracted to people of the same sex has become a bigot” in the eyes of radical activists. This rhetoric has translated into real-world pressure. A 2021 BBC investigation reported cases of lesbians being ostracized or accused of “transphobia” for refusing sex with trans women. In one survey (albeit with a small sample) cited by the BBC, 56% of lesbian respondents felt pressured or coerced to accept trans women as partners. Similarly, some gay men have been told that not considering trans men (who are biologically female) as dating prospects is prejudiced – challenging the very concept of same-sex orientation. These social pressures, often amplified on dating apps and within LGBT circles, have created a rift: many lesbians and gay men feel that their boundaries of attraction are being politicized. As one lesbian interviewee put it, “No one should be shamed for sticking to their sexual orientation, yet I’ve been called hateful for saying I’m only into women (natal females)”. While many trans people and allies do respect individuals’ personal preferences, the fact that some in the community experience such coercion is a source of growing tension. It underscores a fundamental conflict between gay rights (based on sex) and gender ideology (focused on self-identified gender). In summary, gender ideology’s rise has led some gay and lesbian individuals to feel marginalized within their own community – pressured to conform to new norms that sometimes conflict with their sexual orientation and dating autonomy.

3. LGBTQ+ Movement Shift: From LGB Rights to Emphasizing Gender Identity

Over the past decade, the focus of the LGBTQ+ movement has noticeably shifted from primarily LGB (sexual orientation) issues to those centered on T (transgender/gender identity) issues. Activist and political priorities have been reoriented in messaging, often to the frustration of some gay and lesbian veterans of the movement. Researchers and commentators point to the period after major LGB victories – for instance, the legalization of same-sex marriage (2015 in the U.S.) – as an inflection point. Rather than winding down, large LGBT advocacy organizations “simply redirected staff, fundraising and rhetoric” toward gender identity causes. In a short span, the relatively simple goals of gay rights (e.g. marriage equality, anti-discrimination) merged with more complex “gender politics” originating in academia and queer theory. This fusion gave rise to the now-common umbrella initialism “LGBTQ+”, which encompasses a broad spectrum of identities (trans, non-binary, genderqueer, etc.) beyond sexual orientation. As journalist Brad Polumbo observes, “the simple moral logic of non-discrimination [for gays] has been transformed into a… soup of invented identities.” The once-unifying rainbow flag has evolved with added stripes and colors to represent transgender and other gender-diverse groups, symbolizing this expansive shift.

Critics argue that this expanded agenda has at times subordinated LGB interests. A vivid example came from the UK’s largest LGBT charity, Stonewall. Stonewall embraced an “all in for gender self-ID” approach around 2015–2018, even changing definitions: it began describing biological sex as merely “assigned at birth” and redefined lesbian/gay in terms of gender identity. Under this doctrine, a gay man attracted only to male anatomy or a lesbian only to female anatomy could be seen as prejudiced. Prominent gay and lesbian activists – including Stonewall co-founder Simon Fanshawe and the newer LGB Alliance group – publicly accused Stonewall of “replacing sex with gender” as the movement’s focus. They argue that the hard-won understanding that sexual orientation is based on biological sex is being eroded by an agenda that says gender identity can override sex in defining who is gay or lesbian. This internal rift has led to what Polumbo calls a “growing estrangement” between parts of the LGB community and the trans activist wing. By 2019, the conflict was out in the open: essays and open letters circulated declaring it was time for “LGB and T to go their separate ways,” citing irreconcilable differences in goals.

From a political perspective, transgender rights issues began to dominate headlines and policy fights that previously centered on LGB rights. Campaigns around bathroom access, pronoun laws, medical coverage for transition, and gender self-identification laws took center stage, often backed by the same organizations that had championed gay rights. Governments and media that had allied with the gay rights cause moved swiftly to endorse transgender inclusion as the next civil rights frontier. Many activists who cut their teeth on gay rights applied the “born this way” framework to gender identity – even though, as discussed, the scientific backing for gender identity’s innateness is far weaker. This has occasionally led to logical tensions: for instance, some campaigns simultaneously insisted that gender identity is fixed and innate while sexual orientation can be fluid, a contradiction noted by Soh. Nonetheless, the activist narrative unified around the concept of LGBTQ+ as one movement, emphasizing that “trans rights are human rights” just as gay rights are.

It’s important to note that not all LGB individuals agree with this pivot. While many do support full equality for transgender people, they express concern that resources and attention have shifted away from issues still affecting gay men and lesbians (such as anti-gay hate crimes, or the specific health and social needs of LGB youth). There is also discomfort that the public perception of the LGBTQ+ movement is now heavily influenced by debates over gender identity – which can be more divisive – potentially jeopardizing the broad public support that gay rights achieved. For example, within some Pride organizations and charities, lesbians who wanted to discuss sex-based concerns (like ensuring lesbian-only spaces) have felt sidelined or even silenced in favor of the prevailing gender-inclusive line. This activist-driven change in priorities is evident in the language used by institutions, the allocation of funding, and the content of educational programs, which increasingly center on gender identity. In summary, the LGBTQ+ movement’s focus has undeniably expanded: what was once primarily about sexual orientation equality has become equally (or more) about gender self-expression and identity. This evolution has been driven by political strategy (keeping the movement active post-marriage equality), the rise of queer theory in academia, and advocacy by trans activists – resulting in a new movement landscape where tensions between “LGB” and “T” communities sometimes flare, even as all parties ostensibly share the same LGBTQ+ banner.

4. Sociopolitical Trends and Policy Responses

The shift toward gender ideology has elicited significant responses from governments, media, and institutions. Broadly, many liberal democracies moved rapidly to enshrine gender identity into law and policy, often paralleling protections long afforded to sexual orientation. At the same time, a cultural change has taken place in education and media representation, normalizing the concepts of gender self-identification and fluidity – sometimes outpacing the scientific consensus. Here we examine key trends:

  • Legal Recognition and Self-ID Laws: A number of countries have adopted gender self-identification (self-ID) laws, allowing individuals to change their legal gender by simple declaration, without surgical or medical requirements. As of 2023, at least 17 countries had nationwide self-ID policies, including nations in Europe (e.g. Ireland, Denmark, Spain, Germany) and the Americas (Argentina was the pioneer in 2012). These laws were often implemented as part of broader LGBTQ+ inclusion efforts, treating gender identity as analogous to sexual orientation. Advocates argue that removing medical gatekeeping is a matter of dignity and human rights for trans people. However, opponents – among them some feminists and LGB activists – have raised concerns about unintended impacts on sex-based rights. For example, gender self-ID could allow biological males who identify as women to access female-only spaces (changing rooms, shelters, prisons) or to compete in women’s sports, raising safety and fairness issues. Governments have been split on these issues: the UK, for instance, saw heated public debate over reforming its Gender Recognition Act. Scotland passed a self-ID law in 2022, but it was controversially blocked by the UK government in 2023 amid concerns over its impact on women-only services. This tug-of-war shows how gender ideology has become a politicized topic, with progressive administrations tending to back self-ID, and more conservative or gender-critical voices urging caution to protect sex-based categories. Importantly, the impact on same-sex attracted individuals can be indirect but profound. Under self-ID laws, a heterosexual male who transitions can legally become “female” and even be counted as a lesbian woman in some contexts, which many lesbians find disquieting. Lesbian advocates have voiced fears that self-ID effectively erases the meaning of “lesbian” as female homosexual, since any trans woman attracted to women is now classed as a lesbian too. Thus, policies like self-ID, while intended to advance trans rights, have sometimes left gay and lesbian individuals navigating new complexities in language and legal definitions of their identities.
  • Institutional Adoption and Education: Educational and corporate institutions have swiftly incorporated gender ideology into their policies and training. Schools in several countries now teach children that gender is on a spectrum and separate from biological sex, often as part of anti-bullying or inclusivity curricula. However, experts question the scientific accuracy of some materials. Dr. Debra Soh recounts that her friend’s 8th-grade son’s health class was taught “gender is a spectrum with little or no relation to biology,” a claim she labels unscientific. Nonetheless, such teaching has become common, reflecting how thoroughly gender identity concepts have penetrated mainstream education. Many schools allow students to choose their gender identities and names, sometimes without parental consent, following the principle of affirming a child’s declared identity. Proponents say this creates a supportive environment for transgender and nonbinary youth; critics worry it may reinforce transient identities or confuse kids, especially those who might simply grow up to be gay. Beyond schools, workplaces and media have adopted new norms: pronoun declarations, gender-neutral facilities, and style guides that favor gender identity over sex (e.g. saying “pregnant people” instead of women, to include trans men). While these changes aim to include trans and nonbinary people, they have sparked debate about free expression and truthfulness in description. Some lesbian and gay commentators feel that institutions are now more focused on gender inclusivity training than on combating homophobia. For example, a company may celebrate “International Pronouns Day” but pay less attention to ongoing discrimination faced by LGB employees. This institutional emphasis on gender can inadvertently sideline same-sex attraction issues – a subtle but notable shift in diversity and inclusion programs.
  • Media and Public Discourse: The media initially embraced gender identity narratives with few questions, often highlighting uplifting stories of transition and adopting the mantra “trans women are women.” In recent years, however, coverage has become more nuanced as data and dissenting voices emerged. Major outlets like the BBC and The Economist have run pieces investigating the surge in teenage transitions and the conflicts within the LGBT community. One BBC article (2021) broke a taboo by reporting that some lesbians felt pressured into intimacy with trans women and dared to discuss the “cotton ceiling” issue. The fact that this piece caused a furor – with activists demanding retraction – illustrates how polarized the media environment is around gender ideology. Still, the very appearance of such articles shows that the impact on gay and lesbian individuals is becoming part of the public conversation. In social media, battles rage between trans rights advocates and “gender-critical” feminists or gay activists. Governments and tech companies have sometimes policed speech on these matters (e.g. Twitter briefly suspending accounts for statements like “only females are women”), framing it as anti-hate enforcement. The sociopolitical trend, therefore, has been a rapid institutional embrace of gender identity frameworks, followed by a period of public debate and reevaluation as the real-world impacts become apparent.
  • Policy Reversals and Nuanced Approaches: Notably, some countries renowned for LGBTQ+ support have begun tapping the brakes on aspects of gender ideology, especially in healthcare, in a data-driven manner. Sweden and Finland, for instance, have revised clinical guidelines for youth gender dysphoria, prioritizing psychotherapy over immediate hormonal treatment after reviewing evidence of outcomes. These moves came amid concern that an overzealous “affirmation-only” approach (which was partly driven by activist pressure) lacked solid evidence and could harm some children – many of whom were same-sex attracted and might desist in time. In the UK, the National Health Service ordered the closure of the Tavistock youth gender clinic in 2022 after an independent review (Cass Review) found that the standard of evidence for pediatric transitions was low and that “one size fits all” affirmative care left young people at risk. Such developments hint at a calibration in institutional response: a move from uncritical acceptance of gender ideology toward a more evidence-based approach that considers multiple factors (mental health, developmental maturity, possible homophobic influences on identity). Governments are trying to balance transgender individuals’ rights with protecting minors and safeguarding sex-based rights – a tricky sociopolitical tightrope.

In summary, the sociopolitical landscape has been transformed by the rise of gender ideology. Laws and policies in many jurisdictions now recognize gender self-identification, reflecting a broader commitment to transgender inclusion on par with gay rights. Media and educational institutions have largely aligned with this perspective, though a more nuanced discussion is now emerging. These shifts have unquestionably improved visibility and legal standing for transgender people. Yet they have also introduced tensions and unintended consequences – particularly for women and same-sex attracted groups – that society is currently grappling with. As researcher Julie Bindel noted, we are in the midst of a grand social experiment: expanding the definition of gender and orientation and seeing how it impacts everyone from vulnerable teens to the established gay and lesbian community. The challenge going forward will be crafting policies that uphold the rights of all individuals, considers the plausible psychiatric conditions in tandem with trans-identifying youths, while also respecting the realities of biological sex and the integrity of sexual orientation. Achieving this balance will require continued empirical research, open dialogue (without fear of cancellation), and nuanced, compassionate policymaking rather than one-size-fits-all ideological approaches.

Sources:

  1. Soh, D. (2020). The End of Gender – as summarized in review .
  2. Littman, L. (2018). PLOS ONE study on rapid-onset gender dysphoria .
  3. Shrier, A. (2020). Irreversible Damage – trends in female teen transitions .
  4. Mooney-Somers, J. & Kean, J. (2024). University of Sydney/ACON research on lesbian identity labels .
  5. Polumbo, B. (2019). “LGB vs T” analysis in Quillette .
  6. BBC News (2021). Report on lesbians and trans dating pressure .
  7. Thomson Reuters Foundation (2024). Context article on global self-ID laws .
  8. Cass Review Interim Report (2022) via BBC News .

Separate Issues

Gay rights and gender ideology are not the same thing. They get lumped together in political and activist discourse, but they address completely different issues. Below, I’m going to break it down logically and from the perspective of different groups.



Why Gay Rights and Gender Ideology Are Separate Issues

Sexual Orientation vs. Gender Identity:

  • Gay rights are about who you are attracted to (same-sex attraction).
  • Gender ideology is about how you perceive your identity in relation to your biological sex (e.g., transgenderism, non-binary, etc.).

Gay People Do Not Challenge the Existence of Biological Sex:

  • Gay men are male and are attracted to other males.
  • Lesbians are female and are attracted to other females.
  • This entire framework depends on biological sex being real—otherwise, what does ”gay” even mean?

Transgender Ideology Can Undermine Gay Identity:

  • Trans activism often promotes the idea that gender is fluid and independent of biological sex.
  • This leads to cases where lesbians are told they are ”transphobic” for refusing to date biological males who identify as women.
  • Gay men are also pressured to accept ”trans men” (biological females) as potential partners.

Legal and Social Rights Are Different:

  • Gay rights fights for equal marriage, anti-discrimination laws, and the right to adopt.
  • Gender ideology fights for self-ID laws, access to opposite-sex spaces, and medical interventions.

Gay Perspectives on the Trans Movement

Not all gay people align with the LGBTQ+ movement, and many are openly critical of gender ideology. Here’s why:

1. The ”LGB Without the T” Movement

Many gay people feel that the trans movement has hijacked the original fight for gay rights. The movement used to be about sexual orientation, but now, it’s more focused on pronouns, gender identity, and allowing biological males into women’s spaces.

2. The Erasure of Gay People

  • If a boy likes to wear dresses or play with dolls, many activists now push gender transition instead of just accepting that he might be a gay man.
  • Many gender clinics have seen a disproportionate number of young lesbians transitioning to male, often due to social pressure.

3. Forced Dating and ”Genital Preferences” Shaming

  • Lesbians are now being told they are ”bigots” if they won’t sleep with trans women (biological males).
  • Gay men face similar pressure to consider dating trans men (biological females).

4. The Destruction of Safe Spaces

  • Gay bars and clubs, which used to be safe spaces for same-sex attracted people, are now expected to accommodate anyone who ”identifies” as the opposite sex.
  • Women’s sports and shelters have also been affected, impacting lesbians more than gay men.

What Trans People Think About Gays

The trans community is divided on this issue:

  • Some trans people support LGB rights but respect that sexual orientation is based on biology.
  • Others, especially extreme activists, see sexual orientation as ”transphobic” and demand that people date them regardless of biology.

Many radical trans activists view gender as more important than sex, which directly conflicts with the reality of same-sex attraction.


Final Thoughts

  • Gay rights are about being attracted to the same sex.
  • Gender ideology is about redefining what sex and gender mean.
  • Many gay people feel that their movement was taken over by something completely unrelated.
  • The push for gender ideology can actually harm gay people, especially by confusing young lesbians and pressuring them into medical transition.

This is why many gay people reject the LGBTQ+ label and prefer to focus on LGB rights without the TQ+.

This is an important basis for an essay I’m putting together that deals with the ideology-driven fundamentals that gender theory builds upon, as well as scientific research detailing the issues in ignoring the immense wealth of correlations between trans youths and autism, trauma, sociopolitical factors and much more!

The thing about abortion

I’m well aware of the fact that abortion has their circumstances where they are necessary, and that it will always exist and should therefore be performed as safely as possible without risk towards the mother, as with unregulated back alley or coat hanger abortions. The problem I have, however, is against the inconsistencies and disingenuous attitude towards abortion itself, as with how we deal with the ”concept of conception”. Fundamentally, the abortion issue is about the fact that we’re choosing to terminate a person in order to make our lives easier. But we won’t admit it to ourselves, so we rationalize it in order to convince us that it’s ok;

We go to health and empathy”It would be ’easier’ or ’better’ for the child if it didn’t live, so it wouldn’t have to deal with the hardships that comes with having down’s syndrome, a poor upbringing, unfit parents or growing up in foster care.” But this argument fails when these dispositions are in no legitimate way deciding the child’s inherent right to a chance for a full and developing life. We cannot decide that, it’s borderline eugenics disguised as a health problem. What we’re really doing is implying that it would be better if children or adults who’s had these dispositions, which includes, me, alot of my friends and family, never actually deserved the chance to live from the start. That it would be better had we died before we could succeed and that the world doesn’t deserve the love and unique ideas and perspectives this child could’ve shared with the rest of the world had it been given the chance;

We go to technicalities”There’s a point when life actually becomes life, so life hasn’t begun yet by the time of the abortion.” But that argument fails when our definition of ”life” varies from moment to moment. We cannot call an embryo or a fetus under development (which is a human person’s first developmental stage followed by infant, toddler, teenager, adult, senior etc) ”a lump of cells” while refer to bacteria on Mars as life. Life is just that, organic potential, and we cannot choose to define life based on convenience. What we’re really doing is lying to ourselves to make our decisions easier to cope with, by convincing ourselves that it’s a medical procedure so we don’t feel any guilt for terminating children or responsibility for having unsafe sex. This doesn’t make anyone a bad person, it just makes them a normal person that’s being lied to or manipulated by semantics;

We go to rights”It’s about the woman’s right to her own body, and therefore it is her choice, and it stands to reason that obviously a woman should have full control of her own body.” No one in their right mind would oppose this. But that argument fails when the child’s body isn’t the same as the mother’s body. In no other animal kingdom or any biological sense do we view a fetus as the same individual animal as the carrier. It is its own, seperate, individual lifeform. What we’re really doing is actively associating pro-life sentiments with anti-women sentiments to make it political, when they aren’t the least bit related to eachother, not by any stretch of the imagination.

We then deprive the world of a person who would’ve affected hundreds, if not thousands or millions of lives, directly or indirectly, with their light and presence… because it would be ”better for the child”. Excuse me, but that’s not up to you and either of us have no right deciding the child’s right to live. It’s not about women’s rights, it’s not about what’s best for the child and it’s not about how we define life… it’s about the lack of responsibility, the easiest way out and normalized dehumanization for political gain.

It’s about some of your closest friends, who grew up in shit home circumstances and with medical difficulties, and grew up to become some of the funniest, most sincere, loving and honest people you’ve ever known. The unwanteds. You know… that one or two loveable friends of yours whom you believe never deserved the chance to live?

My dad has Alzheimers

He got the diagnose just under a week ago. This is the kind of thing that makes me think that nuh-uh… I only have one life. And a chance that life might be shorter thant others, and basically be over a few years before my heart even stops beating. So I cannot afford to not see every day as a gift. And for once in my life actually focus on myself for real and just not so much focus on what people think of me or my decisions. Because let’s face it, you only have the time you have, and your freedom to explore this rock and its wonders. And Marcus, my beloved Husky that I’m getting home in three weeks, will follow me everywhere. So whenever I do get Alzheimers, if ever, I’m just gonna sit and stare at my hexabytes of storage with memories from between 2004 to 2050 and just remind myself that everything is fine and I have no regrets.

But this post isn’t really about that. I’ve already accepted that I’m going to die. We all are. And I’ve accepted my dad’s diagnose, not that it was surprising from the start but… one could still hope, right? That being said, unless it hasn’t been too obvious as of late, I did try psilocybin in Amsterdam about a month ago. A lot of the insights I’ve had about my perspectives around life and what I value in life, especially after everything that’s been happening, and how most of it has actually been my own fault, came from that trip. I have always been interested in its potential therapeutic capabilities, like opening up new perspectives and treating people, especially soldiers with PTSD, or the terminally ill with death anxiety. Never in my life did I suspect that it would change my life this profoundly. This is legit the absolute first time I’m really trying to take care of my own shit, because I’ve always been focused on others. I mean, if everyone else is fine, I’m good. Right? But to actually enjoy one’s own company like this because you’ve finally stopped lying to yourself about what’s ok and what’s not, and treating yourself like you actually gave a fuck? Not about what I want, but what I need?

I have always had a pretty decent self-image, like how I feel about myself as a person. I’ve always been good at rationalizing stuff. But I’ve always had absolute shit confidence. At least not sober. And if you’re good at rationalizing, it’s very easy to manipulate yourself. And a lot of the things I’ve learned about myself lately has made much of it make sense, and that maybe I haven’t been as crazy about certain things in the world as I first might have thought myself to be. Everyone makes mistake, and you learn, accept and move forward. I haven’t talked alot about all of this, but I can definitely say that this year started out as the absolute worst year of my life. Especially the past spring and summer. But after everything that’s happened lately, after finally feeling like I have a direction, a purpose, after my decision to get Marcus and after everyone who has helped me so much that I’ve gained a genuine love for humanities’ potential for goodness after everything I’ve experienced… and what I’ve been able to prove to myself, this year hasn’t only turned into my life’s best, but also my life’s most important. And I’ll do whatever it takes to not have to bend to someone else’s will if they don’t have my best interests at heart, like I’ve done my entire fucking life, and try to make every day count!

I’m still, to this day, processing stuff from my trip. It’s hard to explain… you know when you have like a revelation and four things in your life suddenly make sense? I’ve had like five of those, each explaining their own four scenarios in my life. Like domino bricks, one thing being explained, which then explains one other thing, which then explains another thing and everything just falls into place. And I realised that the reason I’ve felt stuck is because I’ve been stuck in my own rationalizations… instead of just experiencing. And accepting each day as a gift for me to experience. And just not have toxic people in my life, and not have to rationalize why someone’s toxic because some people you can just know when they’re being disingenuous… I just don’t have time for that. But that has nothing to do with accepting people’s flaws. Because God knows that I’ve been toxic too. God knows I’ve made mistakes. We have to accept that none of us are perfect, and we can’t expect others to be. So I’m done passing judgement. We’re all learning as we go, and that’s ok.

We’re gonna be ok! 🙂

Project Veritas Exposing Pfizer (COVID-19)

This is something I’ve been meaning to talk about for a while but I’ve just haven’t had the energy to put down because the entire subject and all the lies that we’ve been bombarded with month after month since this whole pandemic started is giving me a migraine. But I can’t shut up when it comes to the simplifications and ignorance surrounding the vaccine debate.

Here’s some of the statements made by a few Pfizer scientists that got leaked thanks to the under cover reporting of Project Veritas journalists, you can see the video further down in this entry:

  • Nick Karl, Pfizer Scientist: “When somebody is naturally immune — like they got COVID — they probably have more antibodies against the virus…When you actually get the virus, you’re going to start producing antibodies against multiple pieces of the virus…So, your antibodies are probably better at that point than the [COVID] vaccination.”
  • Chris Croce, Pfizer Senior Associate Scientist: “You’re protected for longer” if you have natural COVID antibodies compared to the COVID vaccine.
  • Croce: “I work for an evil corporation…Our organization is run on COVID money.”
  • Rahul Khandke, Pfizer Scientist: “If you have [COVID] antibodies built up, you should be able to prove that you have those built up.”

I’ve always been for vaccines. This whole situation isn’t about vaxx vs. antivaxx. Vaccines are good and we should be thankful to the medical industry for putting out vaccines that saves millions if not billions of lives throughout the years. However… anyone trying to label criticisms against the COVID vaccine, or the mandates as if it equals to being ”anti-vaxx”, run from them. They have no clue what they’re talking about and aren’t ready to ask the hard questions. The right questions.

I’m still for vaccines, and I always will be. But I’m specifically not getting the COVID vaccine, and I have my reasons. And that is my choice, and it doesn’t affect others in the slightest. I stay away from people, I wear the mask at the airport when asked by security, I have no problem with that (even though wearing it within the gates or on the plane makes no sense… why are masks necessary if you HAVE to have a negative test result to fly? What’s the mask for?). I’ll go along with the theater, well aware of it. But I am my own autonomous individual. And I have the right to say ”suck my fucking dick” to anyone who thinks they’re above me.

The third Pfizer scientist, Rahul Khandke, admitted his company demands that its employees keep information from the public.

“We’re bred and taught to be like, ‘vaccine is safer than actually getting COVID.’ Honestly, we had to do so many seminars on this. You have no idea. Like, we have to sit there for hours and hours and listen to like — be like, ‘you cannot talk about this in public,’” Khandke said.

Khandke also signaled that proof of antibodies is on par with proof of vaccination.

“If you have [COVID] antibodies built up, you should be able to prove that you have those built up,” he said.

I also don’t go out of my way to provide every source of information I have for my opinions or conclusions because it is not up to me to lecture people on something they’re too lazy (or simply too busy with life/family/work) to look up for themselves. And doing a few hours of google searching isn’t research. If it were that easy, we wouldn’t be in this situation. For someone to actually open their eyes, regardless of subject, they have to at least start considering the possibility that they’ve been lied to, or that their logic is flawed and DARE to challenge the narrative. But people generally don’t like leaving their comfort zone where they don’t get ostracized by their just as indoctrinated loved ones. So if you’re arguing with someone who labels you as a conspiracy theorist… that’s actually on you. You don’t have to cast them aside. Most people aren’t malicious, they’re just confused. Just, don’t start those arguments at all. When people are ready to listen – when more of this shit comes up and they find it by themselves – they will let you know, one way or another.

Veritas Journalist: “So, I am well-protected [with antibodies]?”
Chris Croce, Pfizer Senior Associate Scientist: “Yeah.”

Veritas Journalist: “Like as much as the vaccine?”

Croce: “Probably more.”

Veritas Journalist: “How so? Like, how much more?”

Croce: “You’re protected most likely for longer since there was a natural response.”

Croce expressed dismay with his company’s direction and moral compass:

Veritas Journalist: “So, what happened to the monoclonal antibody treatments?”

Croce: “[It got] pushed to the side.”

Veritas Journalist: “Why?”

Croce: “Money. It’s disgusting.”

Croce: “I still feel like I work for an evil corporation because it comes down to profits in the end. I mean, I’m there to help people, not to make millions and millions of dollars. So, I mean, that’s the moral dilemma.”

Veritas Journalist: “Isn’t it billions and billions?”

Croce: “I’m trying to be nice.”

Veritas Journalist: “No, I hear you. I hear you. I do. I mean, I’ll still give you a hard time about it.”

Croce: “Basically, our organization is run on COVID money now.”

All that being said, if you want the vaccine, go get it. If you’re in a risk group, you probably should. But if you feel like you don’t need it, or want it, that’s entirely up to you.

If you don’t vaccinate, you’re exposing yourself to risk, not others. Don’t let anyone else try to tell you otherwise because it’s simply not true. Who would you expose? The vaccinated? Aren’t they protected? How about the unvaccinated? Isn’t that their responsibility?

While at the same time, let’s say you’re young and healthy and you DO vaccinate, you’re still exposing yourself to risk. They aren’t complication free and the fact that the massmedia doesn’t cover it should tell you enough to at least ask a few questions.

You can’t just follow the science if you’re not also following the money… 🙂

Source: https://www.projectveritas.com/news/pfizer-scientist-your-antibodies-are-probably-better-than-the-vaccination/

About Project Veritas

James O’Keefe established Project Veritas in 2010 as a non-profit journalism enterprise to continue his undercover reporting work. Today, Project Veritas investigates and exposes corruption, dishonesty, self-dealing, waste, fraud, and other misconduct in both public and private institutions to achieve a more ethical and transparent society and to engage in litigation to: protect, defend and expand human and civil rights secured by law, specifically First Amendment rights including promoting the free exchange of ideas in a digital world; combat and defeat censorship of any ideology; promote truthful reporting; and defend freedom of speech and association issues including the right to anonymity. O’Keefe serves as the CEO and Chairman of the Board so that he can continue to lead and teach his fellow journalists, as well as protect and nurture the Project Veritas culture.

RELATED:

”HOW COOL ARE CLOUDS??!” – Isak, 2021

Honestly… I don’t know where to start. There is sooo much to tell, and I’ve been trying to find the right words to describe my experiences in Amsterdam but I just can’t seem to find them. I feel changed in a way. It somehow felt like home. The connection I experienced, with both people and the universe at large was indescribable. Profound and intense I guess would be somewhat close.

Clouds, bananas, vines, drums, laughs, tears, smiles, more smiles, love, oneness, bliss, peace, epiphanies, realizations, home, earth, space, dimensions, purpose, meaning, calling, metamorphosis, changeling, evolution, awakening, life, release, surrender, admire, elevate, inspire…

Life.

I will struggle to come to terms with what all of it means for a long time moving forward. What life means to me. What living means to me. And how I should orient myself in the world. I feel like I opened up the gates to the entire cosmos and just slipped my toe across the threshold.

But one thing is for damn sure. I haven’t smiled this much and felt at ease in a way such as this, in such a short period of time ever before. Everything was just perfect. And I understand now what I have to do. I have to understand. I have to. I have to do something. I have to get out.

This is the first day of the rest of my life 🙂

I keep expecting something to go wrong. That I screw something vital up or I miss something of great importance necessary for me to be able to travel abroad. But today is the day! I’m leaving this country for the first time in 12 years (Åland doesn’t count obviously, it’s basically a Swedish island that belongs to Finland) and I’m just as excited as I’m nervous. I rarely show it outwards, but I guess my nervous neuroticism manifests itself as this hidden aint-gonna-happen-mode I fall into as soon as I’m excited about something. I believe that thinking about it has made me realize that its a mode I’ve been dealing with thoughts like these for as long as I can remember. What does it mean though? Always expecting shit to go wrong, or not happen, especially if it’s something I look forward to. I suspect that it has to do with me learning to settle for disappointment and low expectations. If I already accept and expect that shit will go wrong, it sort of becomes less difficult to get over it. Especially if I already have accepted it. That can turn into a positive surprise over and over again. But it can also set you up for failure and depression. If you always expect things to go wrong, or not happen at all, I don’t see much of a future to look forward to.

All that being said, I truly believe that I will find what I need in the future, even if I don’t necessarily know what that might entail during this moment of writing. So the expectations for my life is high, because my expectations for my future self is high and I intend to make myself proud. However, when it comes to shorter-range planning like trips, events, amicable meetings… in other words, plans for certain happenings in your life that are objectively replaceable (since life itself isn’t), my expectations leave a lot of room in my psyche for marginal error. When shit goes well, it goes well. If it doesn’t, try again next time and usually it goes well. This time, I just really, really hope everything goes well and that tonight, I will end the day documenting my arrival at the Amsterdam airport, carrying nothing but a backpack with emergency rations for three days and spare clothes. Going minimalist af on this trip.

What I have to do before then?

  • Go to the clinic and do the antigen test, which is in about an hour
  • Get to Arlanda with my antigen result and fill in my health form for travelling
  • gtfo of Sweden

And of course… this whole thing hinges upon the result being negative. Also, I’ve spent like 1 400 SEK total on the plane ticked and already rescheduled it once and would like my money to not just go down the drain, lol.

I will be documenting as much as I can. I will also be posting lots on my Instagram. I love taking pictures, and seeing new shit. Hey, maybe that can be my thing? I’ve always wanted to travel and take picture, and make videos, start a YouTube channel. I’ve been thinking about it a lot. But it’s been hard to put something out that even I find interesting when absolutely nothing of interest occurs. This trip, being out of the country for the first time in 12 years but this time all by myself? Now that is something my 9-4 years younger me would love myself for. Because I’ve been meaning to get the hell out of here since like 2012, when I started talking about actually going to Japan, but it never happened. And then COVID-19 had to fuck everything up. Now when the plans seem to creep closer to reality, what are my plans? At least for when the restrictions gets loosened up?

  • South Korea
  • Japan (Okinawa)
  • Indonesia
  • Bangladesh
  • New Zealand
  • The US
  • Iceland
  • Scotland
  • Croatia
  • Rome
  • Kurdistan
  • Abu Dhabi

So as you can see, I do have plans. And I intend to visit at least most of these places. It’s not listen in any kind of prioritized order, but there are priorities (like The US, SK, JP and NZ). And to be honest? I would really like to visit Patong in Thailand again. I was there with my brother and our then-girlfriends, mainly to see how much I remember. We were there for two weeks. We did so much and spent so much time outside that two weeks felt like four. That was 2009. A month after that I went to Turkey with my childhood bro. You know what, I might actually post some of those pictures when I’m posting about my Amsterdam trip when I get back! Now, I gotta scram.

I got a plane to catch 🙂

Language is amazing, but words are inert

I’ve been experimenting alot with lucid dreaming throughout my years, which has made the concept of sleep something I on occasion look forward too, for other reasons than rest or tiredness. I’m not there yet, but I’m working on creating another part of my life. That’s where your REAL house is. You just gotta find the key. Then everything you thought you never needed will be found and things will make sense. At least, that would be nice. I believe we can understand ourselves so much better if we learn to understand and control our dreams. Mastering the art of lucid dreaming gives you an unprecedented possibility to actually directly AND consciously talk to your subconscious, while also realizing how much your subconscious affects you despite feeling ”fine”.

There is a movie called Waking Life that deals with this very subject. However, that’s not really what I wanted to talk about right now – despite it being one of my favourite conversational subjects as of late! In the movie, however, there’s a scene discussing the concept of language. I like the scene because I find the entire concept of language fascinating! The fact that some guy from Italy, and another from Sweden or whatever can speak English for example and understand eachother is amazing. And of course I’m not talking about specifically only english per say, but language overall. How two different people who grow up with entirely different ways and words and grammar and cultural expressions, can learn eachothers’ or other languages with completely different grammatical structures and sometimes even different alphabets and letters, and thus be able to communicate? The fact that we as homo sapiens sapiens have that capacity and ability to learn like tens of languages if we put work into it, is absolutely amazing.

They talk a bit about this in Waking Life, what language really is and how all of our understanding towards eachother are all about our subjective associations to words and symbols that we use to represent abstract concepts like anger or love. Because how can we ever be sure about how someone else feels or understands when everything you feel or think about (associate to) the word ”love” is based on your own subjective experiences (or lack there of) about the word and concept itself?

https://www.youtube.com/watch?v=iDGMS_tjRxU

She explains it better. But I was walking downtown the other day and it came to mind when I was going to meet my friend from South Korea, who’s begun learning swedish after having only conversed with me in english. We’re literally from two opposite sides of the world, but we have the capability to meet, converse and share complex thoughts and ideas thanks to the concept of language. This fascinates me.

Language fascinates me! 🙂

I’m feeling better.

This past month has really been something else. I feel like I’ve escaped the grasp of a pool of quicksand. Using my own strength coupled with the aid of people close to me, I’ve managed to not only avoid unnecessary misery, but I’ve managed to create a clear path towards reclaiming the lost aspects of my personality. I’m slowly getting to where I’m meant to be. And I choose to not regret a single moment of anything that has happened. Because Lord knows who I would’ve been and what epiphanies and such I would’ve missed unless I got where I am today. I believe things could’ve gone better. But I also know things could’ve been a hell of a lot worse. And right now, I’m confident. I’m dedicated and excited. I have SO many things planned for when this summer is over.

I have a new apartment that’s getting ready for a move in in August. I have travel plans that I’m aiming to put into motion the coming fall. I have reconnected with old friends, connected with some new yet not totally unfamiliar individuals, and my sense of self-worth has slowly been showing its wretched face again. I’m feeling better.

All I can see right now are opportunities and possibilities. And to actually utilize them I have decided to stay away from anything regarding romantic feelings for about a year. I think I need to be my own company for a while, to find myself back to myself. Who I’ve become. Because I need to first know where I am, to figure out where to go and how to get there.

Just a little quick update. Most of my thinking have been quite internal, hence the lack of posts here. I’ve been meaning to write about stuff, but I’ve had so much going on with both work and stuff that I’m reading. But I won’t neglect this page. Sorry for not making today’s entry more interesting, but I figured it was time for at least a somewhat short update, especially since the last few posts has been so melancholic.

But it is what it is, and it’s getting better 🙂

Sinking.

I somehow happen to distract myself from reality. I piss on the teams I end up with on League. Like usual. I jam to my playlists while cookin’. Per usual. I talk shit and laugh my ass off to Gaki no Tsukai with friends. As usual.

But then it hits me. That sinking feeling. How lonely I feel. And that the one person I’ve been able to call and say I love you too, the one person I could hug, kiss and who loved me back the way she did, despite all my flaws, despite all my mistakes and despite… Everything… I can’t anymore. The one person I depended on to know that I could have that. The one person I’ve told countless things I have never told another soul and probably never will. The one person who taught me to love again. The one person who has inspired me so by the way she’s kept going despite everything she’s had to desl with. And to also remember that I was that very same thing to her. And I just cut it off.

I’m still having trouble loving myself for how much pain the breakup caused her. Or even how much pain I’ve caused myself because of everything. And how I let it affect her.

Suddenly I just remember that she’s not there anymore. And how I fucked up handling it the way I did. I don’t hate myself for ending it with her. I hate myself for how I did it. I can’t change that. I could’ve done it better. Should’ve… It just reminds me of how weak I really am. I may present as strong, hell, in some circumstances I might as well be. But never in my fucking life have the limit to my strength hurt this much.

The way I ended things, how fast it all went, how unjustly I treated the situation is the very thing that makes me fear losing her forever. And reading her notebook just put fuel to the flames.

I just want all of this to end. I just want to be able to forgive myself. But I feel like I can’t. How could I, if she wouldn’t? Since she’s the one I hurt. Would she? Should she? Could I forgive myself even if she did it?

I have had abandonment issues all my life. I’ve always felt out of place in a way. But I keep being reminded of how many I have in my life that genuinely care for me, as I do for them… but when it comes to relationship, she was the only one that I’ve loved this much who also didn’t get sick of me after a couple of years. Who stuck with me. I guess she would probably felt the same way, even though her issues caused her to occasionally doubt her worth, and thus my reasons for staying. I told her that at some point in the future I wanted her to become my wife. And she was looking at rings for fucks sake. I… Fuck I don’t know anymore. I’m just typing… Thinking…

Does it mean we weren’t meant to be? That there is someone out there better for her, who has his shit together? Someone for me? Who will understand her better than I ever did? I always wanted to. It took some time for me to begin to. Ironically, it became easier when I myself started to feel like shit without even realizing it. Which is why people around me saw it way before I did. That I needed to get my shit together. I could read all the self help books in the world, watch every Peterson lecture, study every philosophy, but I still would have to admit to myself why I was doing it. It wasn’t because I was fascinated by the concepts. Even if that’s partly why. It’s because I started feeling lost. Meaningless. And everything I read helped a bit. But it also showed me how much I have to work on. Otherwise I feel like I would’ve cracked long ago and it wouldn’t have been a damn thing Bea could do about it. And it probably would’ve been way worse. So I feel like we we’re fucked anyway.

I don’t blame her for anything. We’ve both had our issues, some worse than others. But she’s good hearted, intelligent, kind, adventerous and spontaneous when not hindered by her social anxiety, filled with empathy, absolutely hilarious and can spot ingenuity from miles away. That’s what I saw and that’s what made me love her. I tried so hard to be the one she needed. I know I didn’t always succeed. But somehow along the way I forgot to be what I needed, despite the fact she kept reminding me.

I feel more organized. I still feel lonely… But I will get through this. But every now and then I get the reminder of what I did. How I handled it. And that sinking feelings comes back…