At the age of 13, my daughter, following some stressful social changes in her life and a large amount of time spent on the internet, joined a wave of teens that feel discomfort with their sex or gender role and believe they are “trans”. As part of this identity and her conclusion that she is really a boy, she believes she needs to “transition” to find happiness. This phenomenon in teenagers, who had no childhood gender distress, has been dubbed “Rapid Onset Gender Dysphoria” (ROGD). 

Inherent to the gender ideology that my daughter has adopted, is a belief that early, unquestioned gender transition is warranted for pretty much anyone who declares that they are *actually* the opposite of the sex of their biological body. And, the prevailing current view in the US and many other countries around the world, is that, if I want to be a good parent, I must support my daughter’s Gender Identity, and treat her Gender Dysphoria by affirming it (ie, agreeing that she is male), allowing social transition (ie, allowing her to pretend to be a male at school and home, including changing to a male name and pronouns), and encouraging her to medically transition (by administering puberty blockers, injecting testosterone, and amputating her breasts), as soon as possible, in order to allow her to be her true self. 

This is a big problem for me. I don’t believe that there is such a thing as a Gender Identity, I don’t think the best treatment for Gender Dysphoria is chemical and surgical alteration of the body, and I don’t think anyone becomes their true self by modifying their body. I am also horrified by the mental and physical side-effects and long-term risk of all that transition entails. In essence, I question all of the tenets of gender ideology. 

As a lawyer, I tend to boil things down to pro and con arguments, researching the facts and then debating the merits of each argument. I use logic as my guiding principle, and I do my own research. 

What my research revealed was that there is no scientific basis for the claim that “affirming” a young person’s new Gender Identity, and giving them synthetic hormones and surgeries to remove and alter body parts actually benefits those affected by this condition or feeling. No research demonstrates that these treatments decrease the suicide rate—which is supposedly extremely high among those with Gender Dysphoria —and no research says that better mental health results from these treatments. 

My own daughter echoed common themes when I asked her what it meant to feel “male” when she was biologically female. As with most ROGD kids (I’ve spoken to many parents with ROGD kids over the last two years), I was met with a blank stare; she had no answer and said it was too difficult a question for her to answer. I explained that I was not going to encourage her to medically alter her body and risk her health because of a feeling that could not be explained, but she still had no answer. Since then, I have read and listened to everything I can get my hands on, both by advocates of gender ideology and critics, and I have never once seen or heard a definition for “male” or “female” in terms of Gender Identity. 

Given the lack of science and evidence, what is the argument for medically risky treatments and telling vulnerable young people (including young children) that they are the opposite sex just because they think they are? There must be a pretty strong argument in favor of what I will call “early transition” as the preferred form of treatment for young people complaining of Gender Dysphoria. Otherwise, it would not be the new standard of care by medical institutions, and it would not be promoted in schools and in the media. 

After thinking about this for over two years now, and reading and listening to everything I could find on the topic, I have come to an understanding of what the arguments are in favor of early transition. I have also come to my own conclusions about the lack of merit to such arguments, and I have heard from many professionals (both therapists and at least one endocrinologist) who agree with me.

From what I can tell, the best argument is that these treatments are both psychologically and medically necessary to avoid misery and suicide. The two components to Gender Ideology used to justify recommending these risky treatments that permanently alter young people’s bodies (in sharp contrast to rules regarding things like tattoos, alcohol consumption or cigarette smoking, all of which are prohibited until an individual reaches a threshold age, ranging from 18 to 21) are Gender Identity and Gender Dysphoria. 

Here are the arguments in favor of and against early transition:

Arguments in Favor of Early Transition as the Preferred Form of Treatment for Young People Complaining of Gender Dysphoria

1. Gender Identity is Innate and Immutable:Gender Identity is a thought or feeling that exists within all of us, although we are not all aware of it. Gender Identity is the sense of one’s “gender,” which is either “male,” “female,” both or neither (or, some would argue, many more genders). Gender Identity has nothing to do with masculinity or femininity. Gender Identity has nothing to do with sexual attraction. Stereotypical behaviors or preferences are simply not part of Gender Identity. Thus, by way of example, a twelve-year-old girl (someone with a female body) who feels that she is male has a male Gender Identity. It doesn’t matter if she is feminine, gender conforming, and never had body issues until puberty started. Her sense of her male identity is what matters. Gender Identity can be realized by us at any point in life, and, once realized, never changes—or might change, but it’s not likely. Nobody, regardless of age or circumstance, is ever confused about their Gender Identity, as it is an internal knowledge that is beyond challenge. Because of the relative stability and reliability of Gender Identity, it can be the basis for serious actions.
2. Gender Identity Mismatches Cause Distress:If the Gender Identity, which is separate from biological sex, does not match the biological sex of the individual, this causes Gender Dysphoria—the distressing feeling that one’s Gender Identity does not match one’s biological sex. In the example above, the twelve-year-old girl who realizes her Gender Identity is male, has a mismatch between her Gender Identity and her biological sex. This invariably causes her great distress. Gender Dysphoria is not a psychological ailment, but is instead a normal response to the mismatch. Although some have called the huge increase in the number of people complaining of Gender Dysphoria, a social contagion in actuallity, it is the result of more readily available information and a more welcoming climate today, that allows people the freedom to express their Gender Dysphoria where they previously did not feel comfortable doing so, or didn’t know how to label their discomfort, and were forced to suffer in silence. Presumably many of these people committed suicide.
3. Gender Distress Must Be Remedied:Gender Dysphoria likely will drive the person to suicide if left unchecked, or, in the best case scenario, will lead to a life of complete misery. Because of this, the distress is unsustainable as a state of being and must be remedied, as soon as possible. To hesitate is to court disaster. 
4. Gender Distress Can Only Be Remedied By Transition:Because Gender Identity is innate and unchanging, and mismatches with the body cause unlivable distress, it is harmful to attempt to convince or assist the person with Gender Dysphoria to accept biological reality. Any attempt to help the person to come to terms with their biological sex is really an attempt to change the Gender Identity, and any such attempt to change the Gender Identity is improper conversion therapy, similar to attempts to force gay people to be attracted to the opposite sex. Notably, Gender Identity is one’s “true” sex, and is more important than one’s biological sex because one’s thoughts and feelings are all that matter.Since it is inappropriate to take a psychological approach, in addition to everyone uniformly treating the affected person as though they were the opposite sex in society to protect their fragile mental state, the body must also be modified as much as possible (ie., making the body appear as the opposite sex). It is wholly necessary to administer dangerous chemicals and perform risky surgeries on young people who suffer from it, sterilizing most. To do otherwise will lead to the person’s suicide since other’s don’t perceive them as the sex they feel they are on the inside. Society is obligated to affirm an individual by using pronouns and a name that match the Gender Identity. 

Arguments Against Early Transition as the Preferred Form of Treatment for Young People Complaining of Gender Dysphoria

1. Gender Identity is undefinable, its existence cannot be demonstratedGender Identity rests on the assumption that “male” or “female” have a definition independent of biology and of socially created stereotypes. What does it mean to be “male” or “female?” One could speculate that biological boys and men feel different than biological girls and women, but in what ways, and are any of those ways not related to their bodies? Surely, every female or male experiences being a female or male differently, so there are billions of ways to feel like a girl, a woman, a boy or a man. Thus, the idea that one can feel “male” or “female,” separate and apart from biology and from stereotypical male or female preferences and behaviors, is nonsensical.
2. The concept of Gender Identity is over reliant on gender stereotypes:If the feeling of being male or female is really related to social expectations of femininity or masculinity (essentially stereotypes), so that the feeling that one is in the wrong body is really just a fear of being gender non-conforming (e.g., if many men who desire to be women and go through the painful medical procedures to make them appear like women, do so because this is the only way they feel comfortable expressing their feminine side), this is a cultural issue, not a biological/medical issue. Transition is inappropriately risky to remedy social distaste with cultural stereotype non-conformity in attire, social roles, and personality. It is ironic that society calls itself accepting and progressive for encouraging people to medically alter their bodies and create the false appearance that they are biologically the opposite sex, when society could instead simply accept gender non-conforming behavior. 
3. If Gender Identity does not exist, separate and apart from both biology and stereotypes, there is no reason that early transition is necessary to prevent a mismatch between Gender Identity and biological sex. If Gender Identity is not real, then Gender Dysphoria is not a normal response to a mismatch between GI and biology, but is instead a psychological ailment in which one is uncomfortable with one’s body. There is no precedent in medicine for medically altering a healthy body as a treatment for a psychological disorder.
4. Even assuming arguendo that Gender Identity is a real thing, because it is separate from biology, there is no compelling argument that it needs to match biological reality:Why can’t someone have a male Gender Identity and be in a female body, and why can’t someone have a female Gender Identity and be in a male body? Can’t society simply be more accepting of people whose Gender Identity is different than the sex of their body? If the mismatch is not inherently a bad thing, Gender Dysphoria is not a normal response to a mismatch between Gender Identity and biology, but is instead a psychological ailment in which one is uncomfortable with the mismatch. There is no precedent in medicine for medically altering a healthy body as a treatment for a psychological disorder.
5. There is substantial evidence that Gender Identity (if it exists at all), is NOT stable and early intervention actually causes medical transition where it would likely have been unnecessary:Detransitioners and desisters are emerging in droves. These are individuals that held a trans Gender Identity at one time, but now do not. Desisters changed their minds about trans before medical transition. Detransitioners are those who medically transitioned and then reverted back to identifying as their natal sex. This indicates that Gender Identity, if it exists at all, is not stable. Further, it is common knowledge – that children and adolescents are exploring their identities and changing their preferences and opinions constantly. Even as adults, we still change our minds, although the stability of one’s “identity” increases over time. It is known that the brain is not fully mature until around age 25. Given this basic human knowledge, it is irrational to make permanent bodily changes – with negative health risks – based solely on the feelings of a 13 year old child. It is similarly irrational to socially transition a four-year-old based on that child’s self-described feeling of being “male” or “female”, terms which, as I have already stated, are devoid of meaning when it comes to Gender Identity. To do so with a young child is tantamount to gaslighting — in this case, making the child think that his or her current fanciful thinking is stable, unchanging reality. Studies reliably show that around 80% of all children who complain of Gender Dysphoria ultimately outgrow it—if left alone to mature naturally. By contrast, around 96% of children put on puberty blockers go on to synthetic wrong-sex hormones. It would seem that early intervention is actually causing children to medically transition when they otherwise would have gone on to be comfortable in their healthy bodies. Thus, there is every reason not to apply early transition. This would be jumping the gun and actively interfering, likely preventing a favorable natural outcome.
6. If un-remedied Gender Dysphoria will likely will drive a person to suicide, and if the increase in the percentage of people suffering from Gender Dysphoria was always about the same, where are the astronomical numbers of suicides by the silently suffering from Gender Dysphoria in the past? There should literally be many thousands of such suicides. Yet, from everything I have read and heard on the subject, I have not seen a single indication that such a mass extinction of the historic dysphorics exists. Conversely, despite the claim that those who do not receive affirmation and transition interventions will surely kill themselves, the few studies on this topic have not shown a decrease in suicide rates for those who are given the recommended transition treatments. Further, there is almost no suicide among four and five-year-olds that would warrant social transition for these children. 
7. Gender Dysphoria complaints are not rapidly rising due to increased modern acceptance of trans; instead they are on the rise due to the belief system in a Gender Identity, homophobia, rampant sexism, and social contagion.Telling people that they have a Gender Identity, and they need to determine what it is, and it’s possible that it doesn’t match their body, fosters confusion, particularly in gender-stereotype non-conforming young people, and people with issues of body dissociation. If a young person does not feel particularly female, in a stereotypical way, or has non-stereotypical interests, and/or same-sex attraction, but has a female body, that person may conclude that they have a male Gender Identity and must be “transgender.” After introducing the idea that it is possible to be born “in the wrong body”, and if one is gender non-stereotypical, one should consider that this might apply to you, the impacted individual may obsess over the mismatch between their nebulous Gender Identity and their body… actually creating Gender Dysphoria. Add on normal teenage angst and social struggles, and it is not surprising to see a huge increase in Gender Dysphoria. Since many of the young people with Gender Dysphoria today are on the autism spectrum or suffer from anxiety or other mental health issues, this explanation becomes even more plausible. For very young children, gender non-conformity is most often cited as evidence that a child is trans. As in, if a boy child likes girl fashion, or dolls. Or, a girl prefers short hair and toy trucks. This is clearly a form of homophobia on the part of the parents, who push their child to become the opposite sex because they happen to have non-gender-stereotypical interests. Once the child declares that they are the opposite sex, if the parent gaslights the child, there is little hope for the child to accept themselves as they are—a gender non-conforming boy or girl. Strangely, our society encourages the creation of trans identified children. 

Conclusion

I have examined the pros and cons of early transition, and I have concluded that there is no basis for a rush to pump young people full of powerful drugs and narrow their vision of themselves. The arguments in favor of early transition have an excessive burden on belief and faith, rather than evidence. I hope anyone reading this will weigh the pros and cons and make their own choice.

Originally published at https://pitt.substack.com/p/early-transition-arguments-pro-and reproduced by kind permission.