Helen Lewis: The Tide is Going Out on Gender Affirming Care

Helen Lewis has a story at the Atlantic offering her take on the recent trend of news about gender affirming care. As she sees it, the tide of certainty is going out for a number of reasons starting with the recent announcements by medical associations that they were backing away from their maximalist stances on this issue.

“Doctors Agree,” proclaimed the American Civil Liberties Union: “Gender-Affirming Care Is Life-Saving Care.” GLAAD declared that “every major medical association and leading world health authority supports health care for transgender people and youth.” Fired up by the Republican “war on trans kids,” and naturally deferential to institutional authority, Democrats have tended to echo this line…

Today, though, the future of medical transition for minors is up for debate. On February 3, the American Society of Plastic Surgeons recommended that “surgeons delay gender-related breast/chest, genital, and facial surgery until a patient is at least 19 years old.” The next day, the American Medical Association, the country’s largest organization representing doctors, endorsed that view: “In the absence of clear evidence, the A.M.A. agrees with A.S.P.S. that surgical interventions in minors should be generally deferred to adulthood.” These statements echo what skeptics of American youth gender medicine have been saying for years…

The actual change here is relatively small because the number of actual surgeries wasn’t that great in the first place. Still, what has changed is the left’s ability to characterize this as a settled issue. No longer can they mention medical associations in this debate without admitting that there is some hesitation to accept the most extreme version of gender affirming care being promoted by Tumblr activists.

The other change which Lewis mentions is the recent win in court by a detransitioner named Fox Varian:

Varian asserted, according to the reporter Benjamin Ryan, who attended the trial, that her doctor “served as an enabler, repeatedly assuring her that the mastectomy she desired would greatly improve her well-being.” Varian told the court that she regretted the surgery instantly, and detransitioned three years later. She was awarded $2 million in damages.

And finally, there was the admission by trans attorney Chase Strangio before the Supreme Court that there was no evidence to support the frequently repeated claim that gender affirming care was “lifesaving.”

In front of the Supreme Court, the ACLU’s Chase Strangio conceded that there was no evidence to support the assertion that transition prevents suicide, because “completed suicide, thankfully and admittedly, is rare.” He argued that instead it reduced suicidal thoughts—a significant climbdown from the once-popular assertion that parents had to choose between “a dead son and a living daughter,” and vice versa. His concession helped expose this rhetoric as the emotional blackmail that it always was.

As these bogus arguments have been knocked down, elected Democrats have retreated to “the basis of individual freedom rather than the effectiveness of the treatments themselves.” But the libertarian case for trans identity has its limits. The problem for trans activists and elected Democrats is that personal freedom has always had guardrails when it comes to children. Kids can do a lot of things but they can’t smoke, drink, drive a car or get a tattoo. Society has long recognized that some choices are life-altering, dangerous and should only be made by adults. But let’s face it, the activists wanted to threaten or ignore the wishes of parents and they used these bogus arguments and appeals to expertise to do that in schools, in debates and in medical clinics. 

Now that some of that is falling away, parents have a chance to reassert themselves as the primary caregivers for their own kids, not a speed bump on the road to the latest body modification fad that’s popular with other teens. Hopefully some upcoming Supreme Court decisions will further delineate where children (and adults) are free to express themselves and where they are not.

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