It is very early days after Dr Hilary Cass’s review on
gender services provided by the NHS in England. I am not a doctor, but my
initial thought is that it is completely devastating for the transgender
argument.
No one denies that there is such a thing as gender
dysphoria, nor that there are people who wish to live their lives as the
opposite sex or indeed sometimes as non-binary. The issue is how medicine ought
to treat children who present with gender dysphoria.
Up to now the tendency both medically and politically
has been to accept that when a boy or indeed a man claims to be a girl or woman
then he must be believed and that we must all accept that a boy who claims to
be a girl really is a girl.
Dr Cass argues however that a boy presenting as having
gender dysphoria can have a variety of outcomes. Sometimes this child may grow
up to be a transwoman, at other times he may come to accept that he really is a
boy in which case he will grow up to be a man.
If left alone a boy with gender dysphoria may grow up
to be a homosexual man. In this case his nascent attraction to boys will resolve
itself not by his trying to become a girl but by his acceptance of his
homosexuality. It may also be that such a boy finds that he wishes to live as a
heterosexual get married and have children.
Once you accept that a boy with gender dysphoria may
have a variety of outcomes it immediately becomes obvious that the treatment
hitherto offered by the NHS with minimal evidence of its effectiveness amounts
to something close to medical malpractice.
Dr Cass points out that even allowing social
transitioning in a school or home situation might make it more likely that a
boy who claims to be a girl seeks to obtain puberty blockers, hormone treatment
and eventually surgery.
So, we have two boys. One who says he is a girl is told
by friends and family and his school that it isn’t true. He may grow up to be a
happy homosexual or heterosexual man. The other socially transitions, is put on
puberty blockers, hormones and eventually has surgery to remove his male
anatomy. But none of that treatment may have been necessary. He might have
accepted in time that he was a boy.
Worse there is minimal evidence that such treatment is
the correct response to gender dysphoria and lots of evidence that it leads to
unpleasant side effects including infertility and the mutilation of the body.
Once you accept that a boy with gender dysphoria might
decide in time that he really is a boy, then it becomes entirely unclear what
could justify you allowing such a boy to socially transition, take puberty
blockers, have hormones or surgery.
Faced with such a boy claiming to be really a girl,
what evidence could you point to that would demonstrate that he really was a
girl. You can’t point to his body because it is male. You can’t point to his
chromosomes because they are male. But nor can you point to his claim that he
is really a girl, because it is just as likely that such a claim by a nine-year-old
boy that he is a girl will lead to him accepting when twenty that he is man.
Once you accept this then the predictive validity of
the claim made by a boy that “I am a girl” becomes at best doubtful at worse
obviously false. If left alone the boy with gender dysphoria may become a
transwoman, but it is just as likely that he won’t. Given the explosion of
cases of transgender cases in the past decades, it may be that the treatment of
gender dysphoria by means of social transitioning, puberty blockers, hormones
and surgery has itself been the cause of the explosion and has led to multiple
cases of male genital mutilation.
Worse still once you accept that the claim that “I am
a girl” may not be true because the person may change their mind, then it
becomes clear that the mantra “transwomen are women” cannot be true either. If
a boy may feel that he is a girl, but not really be a girl, because later he
becomes a man, then this obviously applies to a transwoman also.
Once you accept that a boy’s feeling that he is a girl
may be mistaken, then the very idea that we determine whether we are boys or
girls by means of feelings collapses. We return to determining such things by
bodies and anatomy.
In that case it is hard to imagine a case where
healthy tissue should be amputated because of a feeling that might change. It
would be better by far to treat gender dysphoria with therapy rather than
surgery.
There is a long way to go. Transgender ideology has
captured much of the Western world to such an extent that Dr Cass’s review will
change things only slowly. But this is quite devastating for those who argued
that people with gender dysphoria should be treated with untried treatments and
surgery, and it is also devastating for those who argued that people with male
bodies should be allowed into women’s spaces or to compete as women.
Once you accept that the subjective feeling of a boy
that he is really a girl is not decisive in determining whether he really is a
girl and you have to accept this if you accept that he may change his mind,
then the trans argument collapses. There is no more reason to suppose that
someone’s feeling that he is a girl is decisive in determining that he really
is a girl than the bumps on his head are decisive in determining his
personality.
Transgender has become phrenology. Any doctor or politician
that assumes that it is literally possible to change sex is a pseudoscientist
and must be careful in case they are prosecuted in the future for malpractice.
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