An Excellent Story on the Recent History of the Trans Movement

I just read through this rather lengthy story published today at the NY Times. It’s titled “How the Transgender Rights Movement Bet on the Supreme Court and Lost.” While I don’t agree with everything in the story, I do think this is a very fair and well rounded presentation of how we got where we are now, i.e. to a Supreme Court decision this week upholding a ban on gender affirming care in Tennessee.

The author of this piece is doing his best to stick to the facts in chronological order but a theme emerges in the telling of this story: The far left got way out of touch with most Americans on this issue in ways that completely undermined their initial wins in court. In particular, the ACLU made some dubious choices which they may now regret in private, though publicly they are still claiming this was all a plot by the MAGA-right:

“I didn’t pick this fight around trans rights,” Anthony Romero, the A.C.L.U.’s executive director, told me in an interview not long before the decision. “The right-wing conservatives of the MAGA G.O.P. have made this one of their cause célèbre issues as a way to kind of scapegoat individuals, as a way to score cheap political points.”

That’s their story and they are sticking to it, but almost everything else in this story undermines that self-serving claim. The ACLU was driving this bus from one victory to another until a majority of Americans finally said enough.

Along the road to Skrmetti, some believe, the L.G.B.T.Q. movement drove itself toward a cliff — and took the Democratic Party with it, chaining the Biden administration to one of the most divisive issues in American politics at a moment of shifting medical consensus and fierce polarization. “It’s one of the biggest mistakes in the history of trans activism,” said Brianna Wu, a trans woman who serves on the board of Rebellion PAC, a Democratic political-action committee.

What follows is a long and detailed account of how the “Dutch protocol” was adopted by gender clinics around the world and how along with it came radical redefinitions of basic concepts like sex and gender.

Psychiatrists who helped formulate the idea of “gender identity” originally argued that if sex was biological, gender identity was psychological and subjective — “the sense of knowing to which sex one belongs,” as one early paper put it. For decades, “trans” usually referred to people of one sex who sought medical treatment to help them pass as someone of the opposite sex. Within activist circles, though, that idea began to give way to a concept called self-ID, rooting gender identity in bodily autonomy. Activists argued that all people had the right to determine their own gender, regardless of how they dressed or whether they opted for medical transition. Your self-identified gender — not your physical body — should determine what appeared on your driver’s license and which bathrooms you could access.

In the wider culture, concepts of gender were becoming dizzyingly capacious, even confused. Challenging the idea of a rigid male-female binary, academic theorists detached gender from sex entirely, then reimagined it as an infinite spectrum. By the mid-2010s, when Time magazine declared that America had reached a “transgender tipping point,” a trans person might identify as male, female or neither. The gender of a “gender fluid” person might shift from month to month, or day to day. The phrase “sex assigned at birth” — originally devised to classify babies born with ambiguous genitalia or other rare congenital disorders — was now employed to suggest that biological sex was arbitrary, even a kind of fiction. Gender, not sex, was the inherent quality…

In the relatively small community of pediatric gender medicine, physicians increasingly advocated a “gender-affirming” approach, in which clinicians should generally defer to a child’s self-declared identity. Some doctors, citing the risk of suicidal thoughts and behavior among trans youths, argued that failing to affirm a child’s expressed gender would put their life in danger. “We often ask parents, ‘Would you rather have a dead son than a live daughter?’” Johanna Olson-Kennedy, one of the country’s leading gender physicians, told ABC News. In 2018, the gender-affirming model was endorsed by the American Academy of Pediatrics, one of the country’s most influential medical groups…

Some doctors and activists went further. In a 2019 journal article, the trans bioethicist Florence Ashley argued that trans people, including “older teenagers,” should not require a formal diagnosis of dysphoria before gaining access to cross-sex hormones. Rather than relieving supposed distress, Ashley wrote, patients might be seeking “gender euphoria” or “creative transfiguration,” which “sees the body as a gendered art piece that can be made ours through transition-related interventions.”

I picture the people who go in for “body modification” such as complete body tattoos and even more extreme physical changes (split tongues, devil horns) only apply all of that to the developing sex characteristics of 12-year-olds and that’s basically where the far left was trending on this. One of the people who held these maximalist views was Chase Strangio, the lawyer who joined the ACLU and wound up arguing the Skrmetti case before the Supreme Court.

Back in 2016 when North Carolina passed a “bathroom bill” requiring trans people to use the bathroom of their birth sex, the left responded with a TV ad.

In a spot that first aired on Fox News, the woman is barred from a restaurant bathroom by an angry manager, who backs down after two other women — messaging “validators” the audience could relate to — intercede. “I was born with a male body,” the trans woman says in a voice-over. “But inside, I always knew I was female.”

Strangio found that offensive. It wasn’t radical enough for his taste.

According to two people present for the discussion, Strangio disputed that a trans woman could be “born with a male body” or “born male”; in his view, a trans woman was born a woman just like any other woman. There was no such thing as a “male body,” Strangio told his colleagues: “A penis is not a male body part. It’s just an unusual body part for a woman.” Before the advertisement aired, Strangio elaborated on his critique in an article in Slate. “Many advocates defend the use of the ‘born male’ or ‘born with a male body’ narrative as being easier for nontransgender people to understand,” Strangio wrote. “Of course it is easier to understand, since it reinforces deeply entrenched views about what makes a man and what makes a woman. But it is precisely these views that we must change.”

The left won the battle in North Carolina and the bathroom bill was overturned. By 2021 when Joe Biden came into office they were on a winning streak and ready to take the next step.

On his first day in office, Biden signed an order mandating that executive agencies interpret the word “sex” in all federal antidiscrimination laws to include “gender identity” — a term that Gorsuch’s reasoning had carefully avoided. A slew of other orders and proposed rules would follow, instructing prisons, schools, the State Department and other institutions to recognize a person’s gender identity without condition — even a child’s. More or less by fiat, the administration had deemed self-ID the law of the land.

And this is around the time the pushback really started in earnest. It turned out many voters weren’t upset about trans adults using a bathroom but they drew the line when it came to children.

By 2021, dozens of states were moving to bar trans athletes from competing in girls’ and women’s sports. At around the same time, Republican lawmakers began taking aim at pediatric gender medicine. “There wasn’t much of a difference in where people were on sports than where they were on sex changes for minors,” said Terry Schilling, the president of the American Principles Project, a conservative advocacy group. “But we couldn’t get politicians to talk about sex changes for kids until the fight around sports got started.”

In response to this backlash, groups like WPATH began making transparently political decisions, writing their guidelines in such a way that they could be held up in court to defeat state bans. But some people inside the organization saw what was happening and called it out.

In October 2021, two prominent WPATH members — Marci Bowers, a surgeon and WPATH’s president-elect, and Erica Anderson, a psychologist and former president of WPATH’s U.S. affiliate, both of them trans women — went public with concerns about the rigor of pediatric gender care and the potential impact of puberty blockers on later sexual function. Soon after, the two groups released a letter to their members opposing “the use of the lay press” as “a forum for the scientific debate of these issues.”

Nevertheless, WPATH continued down the same path, even allowing Rachel Levine to push them into deleting age limits from their 2022 guidelines. The Biden administration apparently didn’t know this was happening at the time and wasn’t thrilled when they found out.

After seeing an early copy of SOC-8, Levine and her staff began pressuring WPATH to drop the new age minimums, arguing that “specific listings of ages, under 18, will result in devastating legislation for trans care,” as the group’s president relayed to colleagues in July 2022. That September, the American Academy of Pediatrics — which had also been provided a preview — followed suit, threatening to publicly oppose SOC-8 if the age minimums were not deleted…

White House officials were blindsided, several told me. Though Levine would later tell Biden aides that she had been trying to protect the president, the West Wing saw it differently: Her request could suggest that the administration thought there should be no minimum ages at all. “Everyone was like, holy cow — did Rachel Levine really go out and lobby for 9-year-olds to get surgery?” one former Biden aide told me.

Meanwhile, the ACLU had decided to take the Tennessee case to the Supreme Court. By the time they got to oral arguments last December, Chase Strangio was backtracking so fast he was practically moonwalking.

Pressed on the longstanding claim that gender-affirming care prevented dysphoric teenagers from killing themselves, Strangio conceded the point. “There is no evidence,” he told the court, “that this treatment reduces completed suicide,” adding that “completed suicide, thankfully and admittedly, is rare.” Engaging with the conservative Justice Clarence Thomas, Strangio even uttered the phrase he considered anathema: “born male.” When Prelogar was asked whether the Biden administration had overstated the scientific evidence in its original petition to the court, she, too, retreated to more cautious terms. Gender-affirming treatments, she said, “can be” necessary for “some adolescents.”

The loss in Skrmetti has some trans people wondering if it isn’t time to abandon Strangio-style extremism. That brand of trans politics is looking more like a dead end these days as polls show solid majorities are against the more extreme manifestations of these ideas. But even now, anyone who takes a different view has to contend with the far left dead-enders who see any compromise as unacceptable.

In any case, it’s good to see the NY Times chronicling this story in a way that admits a few key points. One, it wasn’t the right that started this push, it was the left. They pushed and won for years in court until, just as happened with the adoption of “defund the police,” people decided they had gone too far. 

Two, the Biden administration played a major role in advancing the most extreme views and that helped trigger a backlash. Three, the people pushing these views at WPATH and other groups were intentionally political and partisan in how they approached it. They deny it of course but their behind the scenes emails tells the real story. The whole thing is worth reading if you have time.