Gender-identity wars

Published: Saturday, October 17, 2020, 8:50 pm |   Author: Rory Leishman

For the past three years, every federal and provincial jurisdiction in Canada has prohibited discrimination on the basis of gender identity, yet none of our legislators, lawyers and judges can have any clear idea about precisely what this wide-ranging legislation entails.

In an attempt to clear up the confusion, the Ontario Human Rights Commission has issued a policy statement on “preventing discrimination because of gender identity and gender expression,” which defines gender identity as “a person’s sense of being a woman, a man, both, neither, or anywhere along the gender spectrum.” The statement also stipulates that trans people whose “gender identity or gender expression is different from their birth-assigned sex” must be “recognized and treated as the gender they live in, whether or not they have undergone surgery.”

For greater clarity, the document specifically states: “Trans people should have access to washrooms, change rooms and other gender specific services and facilities based on their lived gender identity.”

On this basis, it is clear that a biological male who identifies as a trans woman, is entitled to use the girl’s washroom in a high school or any other public facility, even if he has not been subjected to any hormonal or surgical treatments. What, though, about a trans person with one of the more ambiguous gender identities recognized by the Commission, such as a biological male with a sense of being both a man and a woman? Which washroom, male or female, is he/she entitled to use?

The Commission does not address such conundrums.

Note that the Commission refers to a person’s “birth-assigned sex.” Some physicians have also taken to using this term. In a recent article in the Canadian Medical Association Journal, Andrew Pinto, assistant professor of Medicine at the University of Toronto and staff physician at St. Michael’s Hospital, stated that a “person’s gender identity may be the same as or different from their sex assigned at birth.”

What exactly is the meaning of “sex-assigned at birth”? Can a newborn have a different sex at birth from what he or she had at six months in the womb? Or can a person’s sex change at ages one, ten, or 20 years after birth?

Dr. Paul McHugh, University Distinguished Service Professor of Psychiatry at the Johns Hopkins University School of Medicine, has addressed this issue in his recent submission to the Supreme Court of the United States in the Bostock case on transgender discrimination. “Sex is innate, fixed, and binary,” McHugh testified. Except in rare intersex anomalies, a human being is biologically either a male or female from fertilization to natural death.

“Sex is not and cannot be ‘assigned at birth,’” McHugh emphasized. “The language of ‘assigned at birth’ is purposefully misleading and would be identical to an assertion that blood type is assigned at birth.”

In contrast, gender identity is not innate, fixed or binary. What, then, should a mother do if her son comes home from school and announces that he feels like a little girl trapped in a boy’s body?

Many physicians would counsel the mother to start dressing and treating her son like a girl. McHugh emphatically disagrees. In his Court testimony, he points out that by treating her son as a girl and fostering his gender delusion, the mother increases the risk that the boy will eventually undergo dangerous, cross-sex hormone treatments and sex-reassignment surgery that will leave him permanently sterile and grievously mutilated.

That is fine with trans activists and their medical supporters. They maintain that hormone therapy and sex-reassignment surgery (otherwise known as gender-affirming surgery) are effective in alleviating gender dysphoria.

However, as McHugh points out, there is no compelling medical evidence to support such claims. In an article published last year in the American Journal of Psychiatry, John E. Pachankis, director of the LGBTQ Mental Health Initiative at Yale University School of Medicine, and Richard Bränström, a transgender researcher in Sweden’s Karolinska Institutet, frankly acknowledged: “Despite professional recommendations to consider gender-affirming hormone and surgical interventions for transgender individuals experiencing gender incongruence, the long-term effect of such interventions on mental health is largely unknown.”

To cast more light on this issue, Pachankis and Bränström studied the extensive experience in Sweden with gender-affirming surgeries and came to the conclusion that these surgeries had reduced the likelihood that patients would need additional mental health treatment to an extent that “lends support to the decision to provide gender-affirming surgeries to transgender individuals who seek them.”

While transgender activists hailed this sensational conclusion, McHugh and several other authorities took a closer look at the authors’ paper and subjected it to devastating methodological criticism. As a result, on August 1, the American Journal of Psychiatry published a “correction,” which disclosed that upon re-examination of the Swedish data, Bränström and Pachankis have now concluded that they “demonstrated no advantage of (“gender-affirming”) surgery in relation to subsequent mood or anxiety disorder-related health care visits or prescriptions or hospitalizations following suicide attempts.”

Given the lack of evidence of any benefit to trans persons from social conditioning, cross-gender hormones and surgical treatments, why do these practices have such ardent support from the American Medical Association, the American Psychiatric Association and their Canadian counterparts?

McHugh explains: “Unfortunately, ideology rather than science is driving the support.” Not so long ago, it was likewise ideology rather than science that prompted psychiatrists to embrace the recovered memory syndrome, a now discredited theory that caused many innocent people to end up in jail.

In 2013, the American Psychiatric Association resolved under pressure from transgender activists to replace “gender identity disorder” in the Diagnostic & Statistical Manual of Mental Disorders with “gender dysphoria.” As a result, most psychiatrists will now no longer treat a patient for a gender disorder unless the patient is distressed by the incongruity between the reality of his biological sex and the delusion of his gender identity.

Regardless, is there any approach to treating trans children that has proven effective? Indeed, there is. McHugh reports that “when treatment is focused on helping patients align their subjective gender identity with their objective biological sex by use of normal counseling methods such as talk therapy, gender dysphoria has proven to be significantly reduced.”

As evidence, McHugh cites the success of Dr. Kenneth Zucker in treating trans children. Given the malleability of gender identity in children, Zucker maintains that in most cases, it is best for parents and others to help trans youngsters to “feel comfortable in their own bodies.”

In an article in the peer-reviewed journal Developmental Psychology, researchers report that a systematic follow-up study of 25 girls treated by Zucker at the Child Youth and Family Gender Identity Clinic in Toronto found that only three (12 per cent) were troubled by gender dysphoria as adults.

Regardless, trans activists have denounced Zucker as a transphobe for failing to encourage trans children to maintain their gender delusions. And in 2015, trans zealots also managed to browbeat the supine directors of the Centre for Addictions and Mental Health in Toronto into firing Zucker as head of its gender identity clinic and shutting the facility down.

Still, Zucker maintains his status as a professor of psychiatry at the University of Toronto and continues to treat gender dysphoria in children at a clinic in downtown Toronto. Nonetheless, concerned parents of trans children should beware: On March 19, federal Justice Minister David Lametti introduced a bill into Parliament to criminalize so-called conversion therapy.

Under terms of this pernicious legislation, any parent who causes a minor child to undergo conversion therapy that “seeks to change an individual’s gender identity to match the sex they were assigned at birth” will have committed a criminal offence punishable by up to five years imprisonment.

When will this madness end?

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