Panic Attack

by Robby Soave

  What does it even mean to be transgender? The terminology and definitions have rapidly changed, keeping pace with medical innovations that give people a much greater ability to change their physical appearance to match how they feel inside. Fundamentally, to identify as trans is to have an internal sense of your gender that does not match your biological sex at birth.

  Relatedly, many of the issues most important to the trans community have to do with physical and mental health: hormone therapy, surgery, at what age teenagers should be able to make decisions without parental approval, and more. There are also the increasingly fraught subjects of public restrooms, high school locker rooms and sports teams, what box to check on government identification cards, and whether other people should be compelled to use a trans individual’s pronoun of choice.

  In many cases, trans goals are perfectly reasonable and will likely come to pass as the country becomes more sympathetic toward them. But, as the incident at Reed shows, there’s an illiberal streak within trans activism that might make the movement’s goals seem less reasonable to the average person. The tendency of some trans activist leaders to make hyperbolic statements could be undermining a worthy cause—and putting them at odds with potential allies. Many of the loudest trans voices, particularly on social media, routinely decry all criticism of their activism as not just wrong but a form of assault. Nowhere else has the distinction between words and actions been so thoroughly eroded; people who criticize the trans community are accused of literal violence.

  This strain of illiberalism occasionally puts radical trans activists in tension with other members of the LGBT acceptance movement. During the June 2017 gay pride march in Washington, D.C., a group of protesters chained themselves together and blocked the path of the parade. They were made up of members of the LGBT community who were “black, brown, queer, trans, gender nonconforming, bisexual, indigenous, two-spirit, formerly incarcerated, and disabled, and white allies.”3 They circulated a list of intersectional demands: an end to police involvement in the D.C. pride march, denunciation of corporate sponsors Wells Fargo and Lockheed Martin, and assurances that “trans women of color play a central role in decision-making processes.” Gay people who languish under just one form of oppression are increasingly seen as relatively privileged and are thus in some danger of losing control of the LGBT movement to the multi-marginalized.

  Or consider what happened to Katie Herzog, a writer for the Seattle newspaper The Stranger. Herzog is a progressive member of the left. She’s no social conservative—she’s a lesbian, in fact. In the summer of 2017, she wrote an article titled “The Detransitioners,” about people who thought they were transgender but later changed their minds (more on detransitioning in a bit). Herzog was not claiming that transgender people are wrong or delusional—she very carefully pointed out that trans people wanting to revert to their previous sex is a rare occurrence, though it does happen. But for daring to question the idea that transitioning is always and automatically the right answer for all people who aren’t feeling comfortable in their own skin, Herzog was subjected to a torrent of harassment.

  “It was a total shit show,” Herzog told me in an interview. “There were flyers up in my neighborhood, in coffee shops, calling me transphobic.”

  Activists burned stacks of the issue of The Stranger that had the piece in it, according to Herzog. She was asked to attend a “powwow with self-appointed members of the trans community.”

  “What started out as an awkward but collegial meeting quickly turned into fifteen trans women yelling at me and snapping and being incredibly hostile,” she said. “People in the community wanted me to apologize, and they wanted the paper to invalidate the piece.”

  Again, I bring up these incidents not to suggest that trans people are particularly crazy—they aren’t—but to point out the damage done by extremists.

  Some of my criticisms even resonated with Parker Molloy, a trans woman and well-known writer on trans issues who is generally in good standing with the activist community. When I asked to interview her for this book, she sent me a two-thousand-word response decrying the lack of nuance in the things I had written about the trans community dating as far back as 2014. (I have no doubt that she will find plenty to disagree with here as well, though I learned a lot from speaking with her.)

  “Most trans people aren’t the militant caricatures you see on Tumblr or Twitter,” she told me. “Most of them understand that there are nuances to these issues. It’s just a lot of people, unfortunately, they’re screaming so loudly that I think it distorts the perception of trans people entirely. They seem completely unwilling to listen to reason, which is not true of the trans population as a whole.”

  Scions of Stonewall

  Broad awareness of trans issues is a relatively recent phenomenon, but trans people have always existed. They occasionally occupied prominent places in the gay rights movement; the 1969 Stonewall riots, one of the first notable pro-gay demonstrations, involved several trans women. At the time, they called themselves drag queens or transvestites, as the term “transgender” was not yet in use.

  The riots were prompted by a police raid of the Stonewall Inn, a popular gay bar in New York City, in which thirteen people were arrested. According to historical accounts, a cop shoved one transvestite, who responded by hitting him with her purse.4 At least two gender-nonconforming individuals, Marsha Johnson and Sylvia Rivera, were involved in post-Stonewall activism. They cofounded the Street Transvestite Action Revolutionaries, a group that worked primarily on behalf of homeless drag queens.5 (Johnson died under mysterious circumstances in 1992—her body was found floating in the Hudson River—and Rivera died in 2002.)

  “Some people wrongly think that trans people just appeared later, but they were always part of this movement,” Molloy told me.

  The marriage of gay activism and trans activism was difficult at best. In the 1970s, some gay and lesbian activists worked tirelessly to exclude trans people, for a variety of reasons. Jean O’Leary, a former nun, lesbian, and second-wave feminist, did not approve of men “impersonating women for reasons of entertainment or profit,” and gave a speech at a 1973 gay pride gala in Greenwich Village, decrying this practice.6 She was interrupted by Rivera, who called her a bitch. The singer Bette Midler attempted to smooth things over with a musical number, to no avail.

  In truth, feminists have not always shown much interest in trans people. Germaine Greer, an Australian-born second-wave feminist and author of the influential book The Female Eunuch, opined in 1997 that a person who had transitioned from male to female should be denied a position at a women’s university, on the grounds that the person was not actually a woman. To this day Greer continues to hold the position that trans women are not really women, saying in 2015 that “just because you lop your dick off and then wear a dress doesn’t make you a fucking woman.”7 Her position makes her a leading trans-exclusionary radical feminist, or TERF for short. (The cleverest acronym I have ever encountered is the one used to describe radical feminists who are both sex worker exclusionary and trans exclusionary: SWERF and TERF, like the entree.)

  Even the forty-four-year-old actress Rose McGowan, an activist in better standing with the feminist community, criticized Glamour magazine’s decision to name Caitlyn Jenner its 2015 Woman of the Year. “Woman of the year? Not by a long fucking shot,” McGowan wrote on Facebook.8

  Clashes between certain radical feminists and radical trans activists have occasionally produced violence. Tara Wolf, a twenty-six-year-old trans woman, hit a sixty-one-year-old feminist, Maria Maclachlan, during a rally in London’s Hyde Park in 2017.9 Prior to the event, Wolf had written on Facebook that she planned to “fuck up some terfs,” because terfs “are no better than fash,” that is, fascists. At trial, Maclachlan pointedly refused to use female pronouns when referring to Wolf. The judge ultimately rejected Wolf’s argument that she had struck the much older woman in self-defense, and fined the trans activist £150.

  This
episode exemplifies the tensions between a second-wave feminism that is worried about people who were born men co-opting their movement and a younger feminism that embraces all people who self-identify as women. The new view has largely won that fight, and this victory has influenced how the broader public discusses trans issues. It used to be said that a man undergoing surgery to become a woman was having a “sex change” operation—but this terminology implied that some underlying truth about the person was being altered. Trans people do not believe they are changing; they are becoming who they were always meant to be, and would have been, if not for random chance. (Indeed, one of the cruelest things you can do to trans people is call them by their birth name instead of the name they chose when they decided to transition—a practice known as “dead-naming.”) “Sex change operation” gave way to “gender reassignment surgery,” but even this terminology left something to be desired, since “reassignment” isn’t really different from “change.” The current, most politically correct way of referring to the procedure is “gender-confirmation surgery”—terminology that clearly tracks with Zillennials’ general hunger for affirmation.

  TERFism is clearly unpopular with Zillennials. It might be right to call this development an intersectional success story: younger activists rejected older activists’ characterization of trans issues as distinct from gay issues, to the benefit of trans people. But the endless growth of the acronym LGBT, which first came into use in the late 1980s, is one side effect of this triumph. It initially stood for “lesbian, gay, bisexual, and transgender.” Then a “Q” was added, which stands for “queer” or “questioning,” depending on whom you ask. Next came “I” for “intersex”—people who possess the characteristics of more than one sex—and “A” for “asexual” (or for “ally,” which could be anyone who supports the movement). And so on.

  Complicating matters is the fact that sex and gender are different things, but often conflated: sex is biological, whereas gender is merely a cultural construct built around sex. Zillennials have made the matter even more complicated—for older Americans, if not for themselves—by subscribing to something called gender fluidity. Many young people—as many as a quarter of teenage Californians, according to one study—think of themselves as neither entirely male nor entirely female, and reserve the right to change how they identify over time.10 Thus Facebook added fifty more options for the what-gender-are-you section of users’ profile pages, including “genderqueer,” “cisgender,” “androgyne,” “gender questioning,” and “gender nonconforming.”

  Media companies’ efforts to cater to the gender-fluid generation occasionally border on the absurd. The Zillennial news site Teen Vogue, for instance, ran a story with the headline “Gigi Hadid and Zayn Malik Are Part of a New Generation Embracing Gender Fluidity.”11 But the pair of teen icons did little more than don some vaguely gender-neutral clothing for a photo shoot.

  Many conservatives are extremely hostile to the idea that sex and gender are mutable. The popular conservative author Ben Shapiro is well known for his invectives against the transgender movement, insisting that they are wrong to pretend that sex is alterable. “It’s not rude to say that someone who is biologically male is a male,” said Shapiro during a noteworthy debate with a trans reporter, Zoey Tur.12 Shapiro thinks trans people should be permitted to live their lives however they see fit, but he has maintained that transgenderism is a mental disorder, and one that surgery does not always cure.

  As a libertarian, I don’t share Shapiro’s view. There’s nothing inherently wrong with wanting to change one’s appearance and using modern technology to do so. Many trans people who feel that they were “born in the wrong body” live much happier lives after transitioning. Moreover, trans activism has played an indispensable role in normalizing the trans experience and helping the broader public to accept trans people as, well, people. Positive portrayals of trans characters in movies and television—Jeffrey Tambor in Transparent (though he was later #MeToo-ed) and Laverne Cox in Orange Is the New Black—were important as well. And of course, earlier films—including Peirce’s Boys Don’t Cry—helped pave the way.

  Some of the most radical members of the trans community, though, are somewhat at odds with currently accepted science relating to transitioning. Indeed, the most contentious debate concerning trans issues has nothing to do with pronouns or bathrooms (though we’ll get to those in a bit) but rather involves something called “desistance.”

  Desistance Debates

  “Gender dysphoria” is the clinical term for the trans experience: the feeling that one’s internal sense of gender does not match one’s biological reality. It was known as “gender associative disorder” or “gender identity disorder” until 2013, but the trans community complained that it was wrong to think of the issue as a “disorder” at all, and the terminology shifted to accommodate them.

  For a trans person, the process of transitioning can involve hormone therapy—estrogen for trans women, androgen for trans men—and surgery. The process is life-affirming for most trans people. But a small number of people who transition later change their mind, no longer identifying as the sex and gender to which they transitioned. People who undergo therapy and medical procedures to revert to their original sex are said to have “detransitioned.” This was the subject of Herzog’s article—she spoke with several people who had detransitioned about their experience.

  No one could credibly claim that the detransitioners represent a particularly large contingent: Herzog’s article notes that just 2.2 percent of people who transitioned later experienced regret, according to a Swedish study.13

  A somewhat larger number of people, though, experience gender dysphoria but never actually transition. Later in life, their gender dysphoria ends, and they come to recognize their birth sex as the one to which they feel they belong. For these people, transitioning would have been a mistake. This is called desistance. The science here is far from settled, but some mainstream research suggests that, on the upper end, as many as 80 percent of young people diagnosed with gender dysphoria—who identify as a gender other than their birth gender—eventually desist.

  “All else being equal, this research suggests that the most likely outcome for a child with gender dysphoria is that they will grow up to be cisgender and gay or bisexual,” wrote New York magazine’s Jesse Singal.14

  Might this figure be substantially off? Certainly. Studies that arrived at it may have included too many subjects who were incorrectly diagnosed as gender dysphoric. Of course, in order to suss out the truly gender dysphoric, fairly invasive psychological questioning is probably necessary, which runs counter to the activists’ desires. Young people, increasingly experimenting with gender fluidity and living outside the gender binary, are in some sense contributing to the confusion here—they may seem dysphoric to the casual eye, but they are really just interested in transgressing gender norms, not in changing their underlying sex. But pointing out this tension does not make one a proper intersectional ally.

  One of the leading defenders of the 80 percent figure, the psychologist Kenneth Zucker, has been endlessly attacked for it—in fact, zealots in the trans community successfully got his clinic shut down after lodging a series of complaints that he was harming patients.15 Zucker’s Child Youth and Family Gender Identity Clinic in Toronto had taken a somewhat different approach to treating gender-dysphoric kids than the activists would have liked. Instead of practicing gender-affirming techniques—that is, presuming that his young patients were sincerely dysphoric and recommending a series of treatments to prepare them to transition—Zucker preferred to scrutinize his patients and see if it was possible to make them feel comfortable in their current bodies before proceeding down the path to transitioning. The activists claimed that Zucker was traumatizing the young people who entered his clinic—how dare medical professionals scrutinize their patients—in a manner akin to gay conversion therapy: the odious, immoral, and completely ineffective practice of trying to turn
gay kids straight. Gay people virtually never desist from having same-sex attractions, but the fact is that gender dysphoria is different, and the best research we have suggests that some number of people who feel a desire to transition—possibly a very large number—change their minds.

  Desistance has policy implications. If a large number of people diagnosed with gender dysphoria are eventually going to feel perfectly comfortable in their own skin (or at least no less comfortable than the average person), then it’s important not to push serious medical intervention onto kids at an early age. Doctors need to be very, very sure the individual in question is actually interested in living as a different sex and not just experimenting with less rigorous gender definitions.

  The World Professional Association for Transgender Health does not recommend gender confirmation surgery for anyone under the age of eighteen. But there are other options for gender-dysphoric teens. They can take puberty blockers, which delay the onset of puberty, giving them more time to decide whether they would like to eventually transition. This is ideal in cases where the individual is actually going to transition—it delays or disrupts certain permanent changes that are more difficult to reverse. Between ages fourteen and sixteen, they can begin hormone therapy, resulting in body changes that are semi-permanent. In some cases, teens who take puberty blockers and cross-sex hormones can become infertile. For the truly gender dysphoric, these are trade-offs well worth making—but the consequences underscore the need to be absolutely certain. Thus the relevance of desistance statistics.

  Alice Dreger, a former Northwestern University bioethics professor who writes about gender issues, told me we are starting to see more people talk openly about detransitioning and desistance.

  “The gatekeeping has become pretty permeable, and the consequence of that is you’re seeing people who probably shouldn’t have transitioned and are detransitioning,” said Dreger. “These are not people who are angry and anti-trans, but they wish that they had had better screening and better care for their mental health issues.”