When medicine is really politics

As 2024 begins, it becomes ever more clear that the question “What does it mean to be a human being?” will continue to be the pressing issue of the moment. It’s also evident that those who put their trust in princes and who look to politicians to play the adults in the room and set things straight will be very disappointed. In an age of televisual and social media, politicians cannot afford to be driven by convictions so much as by focus groups and soundbites.

The latest evidence comes from Ohio’s Republican governor, Mike DeWine, who on Dec. 29 vetoed a House bill designed to ban medical interventions for children suffering from gender dysphoria and also to ensure that biological sex, not gender identity, determines participation in sports. DeWine’s stated motivation is a good one, and he says he wants to uphold parental rights. He does not wish to see such children prevented from receiving the medical care that they need. Only the most callous would wish otherwise. For those children and families affected by gender dysphoria, the toll can be brutal. I have spoken to many parents over the last three years who have a son now claiming to be a daughter or vice versa. Too often the looks in their eyes are like those of someone whose child has a terminal illness or who has died. The agony is real. Such families and children truly need help.

Yet the problem with DeWine’s action is that trans medicine is really politics dressed up in clinical rhetoric. DeWine has since nodded in this direction with a series of executive orders restricting trans surgery for minors, a move made, he said, to protect parental rights. But one cannot play to both sides in this debate. The very nature of gender dysphoria is the point at issue.

The symptoms can be real enough. But whether one believes the problem lies with the body or the brain is a matter of interpretation. Indeed, today it is a matter of political interpretation. Affirmation of the former has become part of the only acceptable political liturgy in progressive circles. It also resonates deeply with the therapeutic culture that has been built around the notion of human beings as autonomous, free-floating selves. And it is rooted in gender theory, scarcely a truly scientific discipline. It is a mystery as to how the least plausible of all branches of critical theory—gender and queer theory—have become so politically powerful but they are indeed so. The only answer can be that a culture in thrall to the idea of human autonomy has no plausible line of resistance to them.

The ambiguity of DeWine’s actions is akin to that of Pope Francis’s legitimation of blessings for gay couples. A desire to help the poor, the weak, and the vulnerable is admirable but one can only do so if there is some normative understanding of what human beings are. Unless there is such an understanding, then we will understand the human condition in terms of the tastes of the day and will offer help only in ways that affirm such tastes. Kindness becomes indulgence of delusion. Care becomes a front for the political ambitions of lobby groups. This is not the first time this has happened. A hundred years ago, lobotomies were considered a kind and caring way to deal with certain mental health conditions. Today society regards them as monstrous.

Tragically, DeWine’s action will have the opposite effect to that which he intends. It will not allow for appropriate medical care of gender-dysphoric children. It will only further the damage being caused by those who have come to see children and their understandably worried parents as easy marks for the furtherance of their political aims. And a hundred years from now he will likely be seen to have been a dupe of one of craziest causes yet to grip the imagination of our cultural and medical commissars.

In recent days Gov. DeWine released administrative actions limiting trans surgeries for minors. The fact remains that the legislation he vetoes is stronger, more comprehensive, and more lasting, than his administrative actions. Leaders in the legislature pledge to override DeWine’s veto. May it be so.