By Mathew Goldstein
Transgender medicine is engulfed in a cesspit of misinformation and bad arguments. Unfortunately, sources of misinformation on this topic include Friendly Atheist, Science-Based Medicine, Freedom From Religion Foundation, and other fellow secularists that we generally agree with and support. Where there is misinformation there is a concomitant need to discuss and clarify.
Recently, FFRF welcomed, then erased, a reasonable post on their internet forum explaining and defending the concept of animal and vascular plant biological sex by biologist Jerry Coyne “Biology is not Bigotry” in reaction to a post that concluded the proper definition of a women is anyone who declares themself to be a women. That initial post was retained. Professor emeritus Coyne then resigned as an Honorary Board member. Richard Dawkins and Richard Pinker then also resigned in solidarity.
Some of the content of Coyne’s post sounds questionable. In particular, I am not convinced that transwomen should be disqualified from being rape counselors for women or from working in women’s shelters as he asserts. Transwomen should not be disqualified from any employment opportunities that employs men. In the U.S. some rape counselors, about 15%, are men, and about 10% of rape victims are male. I am not aware that the male rape counselors are restricted to having only male clients. If FFRF had removed those claims but otherwise retained the post, or if they had disputed those claims, instead of completely removing the post, which otherwise has merit, there may have been no recriminations.
Hemant Mehta labeled the three people who resigned from the FFRF Honorary Board bigots and also claimed that the Cass Review had been debunked. He is wrong on both counts.
There is a distinction between the biological definition of sex, rooted in the empirically verified phenomena that there are two different types of gametes, one smaller (male) and the other larger (female), that merge to instantiate a new animal or vascular plant and gender. Gender identity is probably shaped by a complex interaction of genetic, hormonal and social influences. Some, but not all, transgender activists are loathe to acknowledge that gender identity and biological sex sometimes conflict. They mistakenly assume if there is a conflict then the validity of transgender identity becomes suspect. They then reject, and attack, the biological definition of sex. Religiously motivated opponents of transgender medical procedures also refuse to recognize a distinction between biological sex and gender, insisting the latter must always match the former, thus denying gender is a distinct cognitive trait. The result is activism that is counter-factual, inconsistent, and counter-productive on both sides. That is a tragic mistake.
So let’s start with a few basics: That there are exactly two different gametes does not defame the biological definition of sex as being bigoted. People who defend the biological definition of sex are not thereby exhibiting or promoting bigotry. Human gender dysphoria coexists with there being exactly two different types of gametes. Transgender medical procedures as treatments for gender dysphoria are fully compatible with there being exactly two types of gametes. The three secularist former FFRF Honorary Board members who recently resigned favor granting adults the freedom to undergo transgender medical procedures. A birth certificate identifies biological sex, it does not identify gender. Biological sex is, unsurprisingly, positively correlated with gender identity, yet biology is complex and can be messy. An insistence that there must be a one to one mapping from biological sex to gender identity is primarily about defending ideology, it is not about reality, and does not merit being taken seriously.
Both biological sex and gender identity matter. For humans biological sex is about the presence of either testes or ovaries, which are distinct from cognition and psychology, while gender identity is a cognitive/psychological trait. There is some neurobiological evidence for gender identity residing in the hypothalamus and, as such, it may be somewhat immutable. Which one should take priority when there is a conflict depends on the context and potentially on other related factors such as puberty, hormones, functional genitals, chromosomes, various physical traits that have different probability distributions (usually as a result of puberty), etc. There are privacy, time, effort, and cost/benefit tradeoffs to take into account. This complexity should not be denied or ignored. Both transgender activists who deny the reality of the role of conflicting biological sex, and religious conservatives who deny the reality of the role of conflicting gender identity, cannot be trusted to advocate for realistic and ethical transgender policies.
For example, Hemant Mehta says “if simply saying you’re trans gives you a competitive advantage, it’s downright bizarre we haven’t seen trans athletes winning every women’s sport in which they can play.” Notice how centering the “simply saying you׳re trans” disregards the underlying complexity of the conflicting biological sex component that is a common trait among transgender people, as if biological sex has no role, while also falsely asserting that merely because some athletic women routinely beat some athletic men there can be no competitive advantage for men, all in one sentence. Here is a list of over 100 transwomen winners. The number of transwomen medal winners are increasing every year.
There are multiple examples of men performing within mid-range when competing against other men who promptly win a medal for the first time after declaring themselves to be a women and qualifying to compete instead in the women’s division where they invariably rank higher than they did when they competed against men. Look on the internet at the female and male results for various athletic competitions that list the rank and performance numbers. Merge the male and female lists and recalculate the rankings. Here is my prediction: At least nine times out of ten, for the combined list the male rankings as a percentage of the total population will go up and the female rankings will go down. This is an almost inevitable result of redefining a woman (or a man) as any person who declares themself to be a woman (or a man), full stop, as if biological sex has no relevance at all, which is fictional nonsense in the sports competition context. Biology, like the universe more generally, is unfortunately amoral, it does not always operate in harmony with social justice criteria and our ability to change its operation is limited.
Hemant Mehta tends towards being a one-sided, pugilistic, partisan who starts with his conclusions, searches for any information that he can cite to argue in support of those conclusions, systematically and selectively tosses out the information that contradicts his preferred conclusion, and exhibits few scruples with regard to whether his arguments represent the truth, the whole truth, and nothing but the truth. He is a propagandist for particular conclusions regardless of whether or not the overall available evidence actually favors those conclusions. Having said that, it also needs to be said that his blog is a good source of current event information. His blog is a welcome presence, I just wish the commentary on some topics, or at least this topic, was more thoughtful and more balanced.
Regarding the Cass Review supposedly being “debunked”, I recommend reading all three parts of Jessie Singal’s thorough debunking of the attempted but failed debunking of the Cass Review: “Yale’s “Integrity Project” Is Spreading Misinformation About The Cass Review And Youth Gender Medicine: Part 3”. Please keep in mind that the controversy among the experts here is confined to the treatment of minors. Here is his conclusion (which I agree with):
Maybe I spent too much time on this, but “An Evidence-Based Critique of ‘The Cass Review’ on Gender-affirming Care for Adolescent Gender Dysphoria” is a calumnious 30-car pileup of scientific misinformation. It offers an ugly, remarkably messy case study on what happens when highly credentialed, trusted experts simply stop caring about the truth, when they let the pull of political righteousness guide them instead. Legitimate disagreement is one thing, but a paper this flawed and this dishonest should leave a mark on any institution or scientist who promotes it. It’s really that bad. Yale Law School should be exceptionally careful about promoting the work of “The Integrity Project” going forward.
It does no good to cover up, deny, and try to censor inconvenient arguments by declaring people who advance such arguments to be bigots. Ditto for accusing people who dare to try to unselectively and impartially side with the facts, regardless of who the facts favors or disfavors, as being guilty of siding with the enemy which is then somehow translated, via a leap over logic, all the way into their actually being the enemy. Nor should adults be given a veto over critical responses to their favored arguments for merely asserting that such criticism harms them, as if they are entitled to being coddled like immature children who are incapable of accepting criticism.
We should be willing to acknowledge that while all religion is ideology, it does not automatically follow that all of the more secular opponents of religiously motivated social conservatism are automatically reliable advocates for best fit with the overall available relevant evidence conclusions. That can be a complex and difficult goal to achieve. It has a dependency on debate from a broad range of different perspectives. When a damaging anti-intellectual narrowness, intolerance, and reliance on censorship prevails the result is that bad arguments, ignorance, and misinformation are protected and proliferate.
My speculation is that transgender practitioners are understandably afraid of liability lawsuits. We know too little to accurately identify who will benefit and who will not benefit from transgender treatments in advance. IMO, to try to protect themselves, transgender practitioners have adopted a “gender affirming care” mantra, under which they claim their responsibility is limited to treating whoever requests treatment, in part as a way of escaping responsibility for carefully diagnosing and skeptically evaluating their patients need for the transgender treatments. Holding practitioners responsible for vetting their patients before treating them is not a “double standard”. There is a significant risk that pursuing such a policy of avoiding responsibility for what happens to their patients can eventually back-fire on some practitioners. Practitioners confront difficult choices, they can potentially also be subject to lawsuits for refusing to provide requested treatments.
It appears to be likely that some people will lose out and be harmed by the gender affirming care policy, particularly when the patients include troubled minors. There is substantial evidence that within the cohort of minors who express gender discomfort are minors who exhibit multiple psychological symptoms. Individuals who identify as trans sometimes have wider confounding issues related to identity confusion. Yet I am not hearing any concern whatsoever expressed for vulnerable minors from too many secularists whose approach to this issue is callous tunnel vision indifference. The Science Based Medicine web site withdrew and disavowed a post by one of their regular contributors that reviewed Abigail Shrier’s controversial boook “Irreversivable Damage”, which focused on this important topic, after overwrought complaints by transgender activists. That book’s content has some weaknesses and flaws that should be highlighted and criticized accordingly, but it is still an overall positive contribution to the broader debate and should have been respected for its contribution despite its flaws. Instead, the book and its author were demonized and shunned. As humanists we should be concerned for the welfare of those vulnerable minors, be committed to not demonizing and slandering people we disagree with, and not be equating activism with censorship.
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