Five years ago, awash in naivety, I wrote something for The New York Times (though not the headline!) about how people assumed my stereotypically masculine daughter was trans. Why, I asked, when so many kids looked like her when I was little, and when we’d spent so much effort in the 1970s trying to open up boys’ worlds to girls, would we assume a girl partaking of boys’ worlds was a boy? I expressed full support for trans kids, but also for not making assumptions about a kid’s identity based on adherence, or not, to stereotypes.
I had no idea there was a culture war about trans kids brewing, or that I had stepped into the center of it. There was a lot of backlash and a prominent lawyer wrote a piece to counter mine, which was widely circulated. I then reached out to him and asked him to sit down and talk with me about what he thought I’d gotten wrong. He agreed, and explained to me that we couldn’t afford to be nuanced about anything to do with trans kids because it gave fodder to the Republicans trying to hurt them. Nuance was the enemy.
I wrote my subsequent book very, very carefully, considering his warning. I sure as hell didn’t want to be responsible for hurting kids! But it’s five years later, and I now understand that nuance is not the problem. Partisanship, and an unwillingness to evolve positions in the face of new evidence—those things are hurting kids. These cruel Republican bills are extreme responses on the right to extreme ideologies on the left, but it’s very hard for people who adhere to either extreme to see that. (I’m sure there’s plenty I’m not seeing clearly from where I’m sitting, somewhere in the middle.)
A couple of days ago, this lawyer and a well-known doctor went on the radio to talk about the truly barbaric policy in Texas, accusing parents partaking of gender-affirming medical interventions for their gender-dysphoric kids of child abuse and calling CPS on them (as parents not partaking of those interventions have also endured, let’s not forget). I waited on hold for 45 minutes to ask what we should learn from Sweden, France and the recently released Cass Interim Report in the UK, each urging caution in medicalizing and suggesting that the affirmative model had fissures. I never got on, so I tweeted the question to the host and the two guests.
The lawyer then DMed me to say he wish he’d never sat down with me, and assured me he’d read the Cass Report.
What did you think of the report, I asked him. And why do you regret sitting down with me?
He added nothing about the Cass report but said that, like me, he supported parents having all the information—that’s what the informed consent model provided. “But go have your discourse,” he said. (I don’t really know what this means.) And he said it’s normal for the media to not report about healthcare in other countries because our systems are so different that it’s just not relevant. He’s good at constructing arguments! And quickly! Thinking back I might have noted that we’re often drawing on gender diversity in other cultures to explain what’s going on here, even if there’s really no parallel because gender and sexuality are understood so differently.
He said that my latest op-eds showing “both sides” of the story fueled what’s happening in Texas and Idaho. Nuance, and journalists doing their job, are the problem, and not an unregulated approach to an unprecedented epidemic of gender dysphoria, which many countries are now reconsidering. Isn’t it interesting that much of the evidence being used to support medical interventions for gender dysphoria here is being used to put the yellow light on those medical interventions elsewhere? No wonder he doesn’t want us to report on it! And the media has complied with his wishes.
Anyhoo, I sent one final note:
I support you 100% in fighting this truly abusive bill in Texas, but the honest to god truth is that there really are kids and families getting hurt, not just by the model of care but the ideology that goes with it. Would you be willing to talk to some of the detransitioners who should have been more carefully evaluated, or the families that have had CPS called on them for *not* medicalizing? I can imagine that, given the environment that you transitioned in, it's really hard to imagine how different it is for some people. I believe it's because groups like the AAP are refusing to acknowledge these people that the Republicans are responding so violently (though I know you think it's because of nuance). I think acknowledging that there are problems will ultimately be the only way to save these medical options, and that's why some trans people are speaking out. Maybe you'd also like to speak with those trans folks trying to complicate the narrative? I can put you in touch. I am not at all trying to provoke you. I understand your job is to win an argument and not to consider all sides—but that is my job, and I have listened to those that have reached out to me, just as I listened to you. As much as you have compassion for those struggling to access this care, I imagine you would have compassion for those who hurt themselves by accessing it all too easily. A recent study showed a 10% detransition rate, but we truly have absolutely no idea who's being helped and who's getting hurt. There's no follow-up at these clinics. I was just thinking how great it would be for you to just listen to one or two of these folks. I think it can strengthen your argument.
No response. (Also, yeah, I see a few typos in there but you can’t edit DMs!)
I can think of no topic that is more worthy of nuance than gender, and medicating kids with gender dysphoria. There are so many angles, so many stories, so much to learn. But then again, I’m not trying to win an argument. I’m trying to tell the whole truth.
One of your most salient lines, I think, is linking the AAP’s refusal to look seriously at detransitioners and the Republican legislative blowback. It gets at the heart of this, that the evidence is complicated and often times poor; that the US medical community seems uniquely averse to admitting this; the way that ends up sounding like a lunatic conspiracy theory; the way it explains that in light of the entire American medical community (and media) ignoring this, what options do concerned people have but to introduce over-the-top legislation?
Give it to him Lisa! He is a lawyer, not a doctor or a scientist, just like the therapists who assess aren't either. It's all smoke and mirrors - like doublespeak. All the while I sit here with my 14 year old thinking I am cruel for denying what she thinks will make her feel better. And I am not a Republican but I sure will vote for them as soon as I can. Keep up the good conversation.