How high the cost for transgender ideology?

“I tried to steer them. I gave up.” Those were the damning words of Erica Anderson, former head of the U.S. branch of the World Professional Association for Transgender Health (WPATH), as quoted in the New York Sun. The article assesses the fallout from a comprehensive new report containing pages of shocking leaked internal communications among WPATH members. This report runs about 240 pages total, mostly consisting of the leaks themselves, plus an illuminating 70-page analysis by British journalist Mia Hughes. Hughes was commissioned to prepare the report by author Michael Shellenberger for his think tank Environmental Progress, which covers a variety of issues ranging from pro-human environmentalism to homelessness, crime, and mental illness.

There are too many revelations to list in a short article, but Shellenberger has provided a helpful overview of just some of them. A major running thread is the fact that these professionals realize they’re recommending irreversible treatments to patients who are too young or too ill to give informed consent. In one training video, a doctor admits that trying to explain how treatment could affect the future fertility of a 14-year-old is like “talking to a blank wall.” Worse, that same doctor says he’s known patients who regretted the treatment when they reached their 20s and wanted children. “I’m always like, oh, the dog isn’t doing it for you, right?” It does “bother” him, he confesses, but then again, maybe it’s better for the kids to be “happier in the moment.”

If that sounds insane, the report also reveals that puberty blockers are being pushed on mentally handicapped adolescents. When a clinician asks how to proceed with a 13-year-old girl, a law professor chimes in with a paper explaining that even a developmentally delayed young person experiencing dysphoria is better positioned than her parents to “make complex medical decisions that will have life-long consequences.” That same logic governs various exchanges about prescribing hormones and surgery to the severely mentally ill. In one especially jaw-dropping exchange, somebody asks about the protocol for a patient with dissociative identity disorder, and another professional merely cautions that consent must be obtained from all the patient’s “alters” (alter-egos). 

Sane people read a sentence like that and wonder in what world such glib “professional” back-and-forth constitutes an exchange of medical insight. But as one therapist explicitly underscores to another, in their minds “harm reduction” is their “primary lens.” Therefore, they conclude it’s “discriminatory” to withhold such “treatment” from the young, the ill, and the vulnerable, just as it would be to deny cancer treatment. This particular therapist cheerfully says she’s recommended genital surgery for people with a range of psychological problems, even homeless people, all of whom “are living (presumably) happy ever after.” Not that she would know, because she never bothered to follow up.

Conservatives will recognize this as another variation on a common theme for the radical left. Once you are so ideologically possessed that you believe “reproductive care,” “gender-affirming care,” or even “assistance in dying” are absolute goods, then you will insist on making them as widely available as possible. Of course, you will also insist that this is all about giving people the right to “choose” these things for themselves. But when choice begins to devour itself, you won’t be available for comment.

Many WPATH members identify as transgender themselves, and the files even include some frank discussion of their own post-surgical complications. But no doubt none of them would say they “regret” their choices. The much-touted supposedly low regret rate is discussed in one of the report’s most insightful passages, where Hughes states the obvious: Many people claiming “no regrets” are almost certainly protesting too much, because they simply can’t cope with the thought that they’ve made a terrible mistake. 

Here again, we see a parallel to abortion. How many interviews have we watched where a public figure insists that she’s glad she aborted her child, while her body language subtly tells another story? Naturally, the radical left is eager to turn any supposedly “happy” post-abortive woman into a statistic, and they are similarly eager for those who supposedly have “no regrets” about permanently altering their bodies. 

Of course, to many of us, the truth was never unclear. As Flannery O’Connor once wrote, famously and presciently, when “tenderness” is detached from its source, “its logical outcome is terror. It ends in forced-labor camps and in the fumes of the gas chamber.” 

Or, as the case may be, in well-lit operating rooms and the cut of a scalpel.