When Harry Becomes Sally, a review;

Sex is not assigned; it is a bodily reality. Surgery cannot change one sex.

People who undergo sex reassignment procedures do not become the opposite sex. They merely masculinize or feminize their outward appearance.

Gender dysphoria is real.

Transitioning may not resolve gender dysphoria.

Would completing the process help? Not according to the best medical findings. The evidence suggests that sex reassignment does not adequately address the psychosocial difficulties faced by people who identify as transgender. Even when the procedures are successful technically and cosmetically, and even in cultures that are relatively “trans-friendly,” transitioners still face poor outcomes. Even the Obama administration admitted that the best studies do not report improvement after reassignment surgery.

The likelihood of suicide may increase after the transition has begun.

The trans model of medicine amounts to fulfilling the patient’s desires regardless of any medical benefit. The physician does not make changes to improve the patient’s health but rather to fulfill the patient’s wishes. Is wish fulfillment the role of medicine?

Gender dysphoria is real, patients with gender dysphoria need to be treated with compassion. How they are treated, however, is a subject of debate. It may be that dangerous surgery that accomplishes little and often has less than satisfactory outcomes psychologically may not be the best course forward.

Never mind that the best studies of gender dysphoria (studies that even transgender activists cite) show that between 80 and 95 percent of children who express a discordant gender identity will come to identify with their bodily sex if natural development is allowed to proceed.

This “transitioning” treatment has not been shown to reduce the extraordinarily high rate of suicide attempts among people who identify as transgender (41 percent, compared with 4.6 percent of the general population). Individuals who have had transition surgery are nineteen times more likely than average to die by suicide.

Sex is a bodily reality, and gender is a social manifestation of bodily sex. Every human society has been organized around the concept of male and female. In many ways, this is an ideological battle, not a biological or scientific battle.

Among the victims of this ideology are religious liberty, parental authority, and privacy in public safety. Activists tend to be uncompromising in their demands, yet their worldview is fraught with contradictions.

• It holds that the real self is fundamentally separate from the material body yet insists that transforming the body is crucial for personal wholeness.
• It attaches a notion of authentic gender identity to stereotypical activities and dispositions, yet it grows from a philosophy holding that gender is an artificial construct.
• It promotes a radical subjectivity in which individuals should be free to do whatever they wish and to define the truth as they choose. Yet, it calls for enforced conformity of belief in transgender dogma.

The most helpful therapies do not try to remake the body to conform to thoughts and

feelings—which is impossible—but rather to help people find healthy ways to manage this tension and move toward accepting the reality of their bodily selves. This therapeutic approach rests on a sound understanding of physical and mental health and of medicine as a practice aimed at restoring healthy functioning, not simply satisfying the desires of patients.

There are five distinct areas of concern surrounding such policies:

(1) privacy interests when men who identify as women can enter female-only spaces;

(2) safety concerns when predators abuse gender-identity access policies;

(3) equality concerns when biological males can compete against females in sports and other arenas where sex differences are relevant;

(4) liberty interests when people are forced to speak or act in ways contrary to their best judgment and deeply held beliefs; and

(5) ideology concerns the confusing messages that schoolchildren receive when they are taught that gender is fluid, falls along a spectrum, and is essentially detached from bodily sex. Children are especially vulnerable, so we must do everything possible to protect them and provide an environment that fosters healthy development.

We need to insist on telling the truth.