For instance, in 2015 Michelle Forcier, MD, professor at Brown University Medical School and Director of Gender and Sexual Health Services at the Lifespan Physician Group in Providence, Rhode Island, was interviewed on NBC. Asked about whether children as young as three or four could possibly know what they want, Forcier replied, ‘To say three- and four-year-olds don’t understand gender doesn’t give our kids a lot of credit.’ When asked what harm could be done by waiting before transitioning she said, ‘The biggest harm is not to do anything.’ But what was the risk of waiting, she was asked. Her reply: ‘The risk of waiting is suicide. The risk of waiting is running away. The risk of waiting is substance abuse. The risk of waiting is bullying and violence. The risk of waiting is depression and anxiety.’49 Joel Baum, who is Senior Director at the campaign group Gender Spectrum, has put this even more starkly. To parents worried about consenting to their children going on hormones he has said, ‘You can either have grandchildren or not have a kid any more, either because they’ve ended the relationship with you or in some cases because they have chosen a more dangerous path for themselves.’50
The problem with the choice being presented this way – in the most catastrophizing light possible – is that it leaves no room for discussion or dissent. Instead, the moment that a child says they think they may be of the opposite sex, they must be greeted only with acceptance and from then on only with a set of life-changing steps which an increasing body of professionals appear to want to encourage with as little pushback as possible.
Yet stories like James’s and also that of Sarah’s daughter are filled with suggestive turns. Just as James says he might never have considered trying to become a woman if he hadn’t been in a milieu in which drag and trans were common, so Sarah’s daughter admits that she might never have considered the possibility that she was actually a boy if there had not been other pupils at the same school who were making the same claims. All of which brings us to the crux of the issue. Even if there are some people who actually suffer from gender dysphoria, and even if for some of them life-changing surgery is the best possible option, how might they be differentiated from people who have such ideas suggested to them but who later turn out to have made the wrong decision for themselves?
Among the most hard-nosed but likely arguments for an eventual slowing of the current trans stampede is the growing possibility of an avalanche of lawsuits. Although the UK, including the NHS, has opened itself up to this eventuality, the potential in Britain for successful future legal actions is nothing compared to the US. Whereas Britain’s health service is struggling to satisfy the increased demand for gender reassignment surgery, in the US there is not merely a movement but a business incentive for pushing this. Just one of the signs that trans is an area where social demands are starting to attract business opportunities lies in the extraordinary levity with which trans activists – including some surgeons – are now talking about life-changing surgery. Some of this requires a strong stomach.
The Profession
Take for example Dr Johanna Olson-Kennedy. Regarded as a leader in her field, she is at present the medical director of the Center for Transyouth Health and Development at the Children’s Hospital Los Angeles. This is the largest transgender youth clinic in the US and is one of four recipients of a taxpayer-funded National Institutes of Health grant for a five-year study on the impact of puberty blockers and hormones on children. A study for which, as it happens, there is no control group.
In her career Dr Olson-Kennedy has, by her own admission, regularly issued hormones to children as young as 12. And in an article in the Journal of the American Medical Association titled ‘Chest Reconstruction and Chest Dysphoria in Transmasculine Minors and Young Adults: Comparisons of Nonsurgical and Postsurgical Cohorts’51 she says that a number of girls as young as 13 had been put on cross-sex hormones for fewer than six months before they were given surgery. This means that girls as young as 12 have been given these life-changing drugs. Furthermore, progress reports show that as of 2017 children as young as eight have become eligible for such treatments.
Dr Olson-Kennedy’s public statements are remarkable in their insistence, assurance and, one might say, dogmatism. She has been publicly critical of the idea of mental-health assessments for children who say that they want to change sex. In comparing children who say they want to change sex with children suffering from diabetes she has in the past said, ‘I don’t send someone to a therapist when I’m going to start them on insulin.’52 She is a leading proponent of the idea that any challenge to the decision that a child has arrived at risks jeopardizing the relationship between the professional and the patient. As she has written: ‘Establishing a therapeutic relationship entails honesty and a sense of safety that can be compromised if young people believe that what they need and deserve (potentially blockers, hormones, or surgery) can be denied them according to the information they provide to the therapist.’53 Olson-Kennedy is sceptical about the idea that some 12- or 13-year-olds might not be in a position to make an informed and irreversible decision. She has said that ‘I have never had anyone who was put on blockers that did not want to pursue cross-sex hormone transition at a later point.’ In making this point she has emphasized that:
When we make a decision to move forward with medical intervention, either puberty suppressants, or cross-sex hormones, the most important person we consider in that decision making is the child – the young person. There are some centers that use much more technical, psychometric testing, that looks at various and assorted factors in children’s psychiatric development. We don’t practice that model in our clinic.54
Yet elsewhere she has said that she has seen a small number of patients who have stopped treatment or have come to regret transitioning, but added that this should not influence attitudes to other people who wish to transition. One problem – in her view – is that such important decisions have sometimes been taken by ‘professionals (usually cisgender) who determine if the young people are ready or not’. Olson-Kennedy believes that this is ‘a broken model’.55
Despite the fact that the guidelines of the Endocrine Society (the world’s oldest and leading organization in the field of endocrinology and the study of metabolism) state that there is ‘minimal published experience’ about hormone treatment for people ‘prior to 13.5 to 14 years of age’,56 Olson-Kennedy and other colleagues seem extraordinarily confident about what they are doing, for example in her extraordinary dismissal not just of her opponents but of the irreversibility of the actions she is encouraging children to take. In one presentation, recorded undercover, she rails about something which she says she feels she’s ‘just got to say’. This is an answer to any critics who think that children do not have the ability to make such fundamental and life-altering choices. Waving her arms and losing her temper with such intransigent points of view, Olson-Kennedy points out that people get married when they are under 20 and choose colleges to go to, and that these are also ‘life-altering choices’ made in adolescence that mostly work out. We spend too much time focusing on the bad stuff, she says. ‘What we do know is that adolescents actually have the capacity to make a reasoned logical decision.’ So far so indisputable. But it is the casualness with which she makes the follow-on point that is vaguely staggering. ‘Here’s the thing about chest surgery,’ she says. ‘If you want breasts at a later point in your life you can go and get them.’57
Really? Where? How? Are people like blocks of Lego onto which new pieces can be stuck, taken off and replaced again at will? Is surgery so painless, bloodless, seamless and scarless today that anyone can just have breasts stuck on them at any point and live happily ever after, enjoying their new acquisitions? A fairly typical male-to-female transformation does not only involve operations to change the genitals and breasts but also operations to shave bone off the chin, nose and forehead which involves procedures where the skin is peeled off the face. And then there are the hair implants, speech therapy and much more.58 A woman who see
ks to become a man must have an approximation of a penis constructed from skin elsewhere on the body. The subject’s arms are often flayed to build this, with no assurance of success. And all at the cost of tens – often hundreds – of thousands of dollars. It requires a specific level of mendacity to describe all this as an absolute doozy.
It gets worse. In February 2017 an organization called WPATH held its inaugural USPATH conference in Los Angeles. WPATH stands for ‘World Professional Association for Transgender Health’. But this was the ‘Inaugural United States Professional Association for Transgender Health Scientific Conference’.59 One part of the symposium was called ‘Outside of the binary – care for non-binary adolescents and young adults’. In this session Dr Olson-Kennedy addressed a room full of people who clearly already agreed with her. But as well as some of her presumptions that they obviously agreed with, it also became clear just how young the ‘adolescents and young adults’ of the title actually are.
For example, Olson-Kennedy described how she once had to deal with an eight-year-old child who had (clearly laughably to her) been ‘assigned female at birth’. As Olson-Kennedy describes it, ‘So this kid comes into my practice’ and her parents were confused. Their daughter was ‘completely presenting male’, which means, ‘short haircut, boy’s clothes. But what was happening is this kid went to a very religious school. And in the girls’ bathroom – which was where this kid was going – people were like “Why is there a boy in the girls’ bathroom, that’s a real problem.” So this kid was like “So that’s not super working for me, so I want to figure out like, I think I wanna enrol in school as a boy.”’ Olson-Kennedy rattles on with this story in the style of a hilarious anecdote, including impressions of the confused parents and the crazy attitudes of those around them, who clearly don’t understand what the doctor and her audience on this occasion see as the bleeding obvious.
Some ‘kids’ who come to her apparently have great ‘clarity’ and ‘great articulation’ about their gender and are just ‘endorsing it’. This ‘kid’ had apparently not ‘really organized or thought about all these different possibilities’. Although Olson-Kennedy tells the story of a three-year-old girl apparently telling her mother how she felt like a boy, which the doctor now says the child didn’t say, the crowd all laughs along knowingly. At one point Olson-Kennedy recounts how when she asked the ‘kid’ (from the previous example) whether she was a boy or a girl and saw ‘confusion’ on the kid’s face, the kid replied, ‘I’m a girl cos I have this body.’ To which Olson-Kennedy adds, ‘This is how this kid had learned to talk about their gender, based on their body.’ She then recounts a brilliant idea, ‘completely made this up on the spot, by the way’. She asks the child whether she likes pop tarts. The eight-year-old says yes. And so Olson-Kennedy recounts that she asked the child what she would do if she came across a strawberry pop tart in a foil packet in a box that contained ‘cinnamon pop tarts’. Is it a strawberry pop tart or a cinnamon pop tart? ‘The kid’s like “Duh, it’s a strawberry pop tart.” And I was like, sooooo . . .’. At which point the audience all laugh knowingly and begin to clap. Olson-Kennedy continues, ‘And the kid turned to the mom and said “I think I’m a boy and the girl’s covering me up.”’ At this the audience all ‘coo’ and ‘aww’ with appreciation for the moment. As Olson-Kennedy concludes, ‘The best thing was that the mum was like “Awww” and just got up and gave the kid this big hug. It was an amazing experience.’ Before other members of the audience can get up and recount their own heart-warming stories, she goes on: ‘I worry about when we say things like “I am a” versus “I wish I were a” because I think that there’s so many things that contextually happen for people around the way they understand and language gender. So, I don’t think I made this kid a boy.’ At which the audience laugh appreciatively at the very idea of such a thing. ‘I think that giving this kid the language to talk about his gender was really important.’60
Just one of the strange things about all of this, from the audience reaction at the USPATH conference, is that Olson-Kennedy is not speaking at a meeting of ‘professionals’ but to a congregation. A fixed set of ideas are being discussed. A fixed set of virtues are being celebrated. And a fixed set of propositions are being set up, laughed at and dismissed. The audience does not sit, listen and then ask questions as at an academic or professional conference. They cheer, laugh, snort and applaud in a manner which more than anything else resembles a Christian revival meeting.
Or some kind of comedy club. The next person up to the microphone gets asked by Olson-Kennedy, ‘Are you a medical provider?’ There is an ‘Uh-huh’. ‘OK,’ she says, apparently unwilling to give up the mike: ‘here’s something I learned from being married to a mental-health person.’ At which point the medical provider says in a husky voice, ‘Tell me more about that.’ There is a wild burst of applause, whoops and appreciative laughter at what appears to be some kind of hilarious innuendo. After this has finally died down the medical provider (who turns out to be from Iowa) says, ‘So I was just going to share that in my practice what I do when I first meet someone is just tell them – if you had a magic wand or one of those Star Trek things that you can do whatever you want, what would you like to see happen? What can I do? So that way I know where they want to go and see what the tools might be.’ Ordinarily if a child says that they would like to wave a wand and change something they then open their eyes to realize that the wand, and whatever spell they have intoned, does not work. Only in the world of trans ideology do the adults tell the children that the wand can be waved, the wishes can be granted and that if they want to be something enough then the adults can make the magic happen.
As it turns out, the joke that this participant took part in with Dr Olson-Kennedy isn’t even as funny as the USPATH conference participants seemed to think. Because the ‘mental-health person’ to whom she is married has some pretty extraordinary practices of his own.
Aydin Olson-Kennedy works at the Los Angeles Gender Center. His biography there explains that as well as being a ‘licensed clinical social worker’, a ‘mental health professional’, and also somebody involved in ‘advocacy work’, Aydin Olson-Kennedy has transitioned himself. And as the centre says, he ‘brings a unique perspective to his career as a transgender man who at one time needed similar mental health and medical services for himself’. In such a situation the question of where medicine, care, social work and advocacy cross over is a very pertinent one.
As part of her transition to a ‘him’, Aydin underwent a double mastectomy – an operation which very rarely leaves no scarring at all. But perhaps Aydin’s choice to undergo this operation is one reason why he seems happy to recommend it to others. The known cases include that of a 14-year-old girl with a history of psychological problems. More shocking still is the case of an American child who suffered from Down’s Syndrome. This girl – who was known as Melissa – suffered from a range of physical and mental-health problems and had reportedly also suffered from leukaemia. For complicated reasons the mother of the child appeared to be shopping around for other diagnoses for her daughter. One conclusion that she came to – with help – was that her daughter was in fact trans. Among those who supported this claim and the resulting call for the girl to transition was Aydin Olson-Kennedy. Indeed, he asked for other trans people to donate funds in order that the Down’s Syndrome child could have a double mastectomy.61 As though the whole business could not get any more complex, both Olson-Kennedys are also registered consultants with Endo Pharmaceuticals, which – among other things – are makers of testosterone.
Where does this go?
If L and G and B are uncertain elements in the LGBT alphabet, then the last of those letters is the least certain and most destabilizing of all. If gay, lesbian and bi are unclear, trans is still very close to a mystery and the one with the most extreme consequences. It is not that there are demands for equal rights – few people think anyone should be denied equal rights. Instead, the preconceptions and
assumptions are what cause the problems. The demand that everyone should agree to use new gender pronouns and get used to people of the opposite sex being in the same bathrooms is at the relatively frivolous end of the spectrum of demands. Far more serious is the demand that children be encouraged towards medical intervention over a matter that is so incredibly unclear – and the age at which such children will be encouraged in this way will only keep going down. At the end of 2018 a private gender clinician in Wales was convicted in court of illegally providing healthcare services. Her clinic was providing sex-change hormones to children as young as 12.62
Moreover, why would their ages not keep going down, when the claims being made are backed up by so much threatening rhetoric, blackmail and catastrophism? Anyone mentioning the drawbacks or concerns about going trans is said to be hateful and either encouraging violence against trans people or encouraging them to do themselves harm. This suggests that the only thing that non-trans people can do is stay silent on the issue and never speak about it unless what they have to say is affirming. This stance has already led to the invention of new concepts which flow out from parts of the feminist and trans movements – such as the idea that some people are ‘non-binary’ and ‘gender-fluid’. A BBC film called Things Not to Say to a Non-Binary Person features some young people talking about how ‘restrictive’ the idea of being male and female is – and simplistic. As one of them says, ‘I mean, what is a man and what is a woman?’63 The overwhelming feeling from watching the young people in the film, and others who make the same claims, is that what they are actually saying is ‘Look at me!’
The Madness of Crowds Page 28