About six weeks ago, I started a four-part think-aloud here on Hepzibah about the transgender issue, knowing I was risking being a fool by rushing in (on Aug. 7, 9, 11 and 15) and pretending I could both view it from a neutral position and take a stand at the same time. I still hold those dual views - that transgender people need our support on a personal level and the question of medical intervention on the human body should not be left to people who go through life saying "whatever!"
After four attempts to shed light on the topic I decided I'd had my say (my "think-aloud") and it was time to face my limitations and shut up and listen a while before saying any more. So I put it on the back burner, along with my concern over whether American democracy is in real danger or merely facing another bump in the road, whether I should take my love of animals more seriously and become a vegetarian, whether the U.S. should continue to support Ukraine (I'm not really on the fence on that one; I say yes.), and all the other "eat your peas and think of the starving children in Africa" issues that cross my path.
The response to my discussion of the transgender issue was disappointing. One friend asked me, "Why do you care? It's such a trivial issue in the greater scheme of things. And it affects so few people!" I didn't argue with him, but my mind went to the several videos I had watched by people who had come to regret their choices to undergo breast and penis removal. I have no trouble imagining myself in other people's shoes, normally. I like to think I can imagine being Jewish, being black, emigrating to another country. But for the life of me I can't get my head around the idea of having my penis lopped off. And back in the early 70s one of my closest friends took his own life, and for years afterward, I had dreams of shouting at him, "Why didn't you wait! Just a few years. Life for gay people will get better. Much better!" I have become obsessed with the idea of preventing young people from making decisions they come to regret - or would if they were still alive. So in some indirect way this issue has become personal for me.
And then there's the fact that the place where I normally sit - on the left of the political spectrum, with democrats and LGBT people, doesn't quite feel at home anymore. Just as the Republicans have usurped American democracy, I have the sinking feeling that the trans activists are taking more of the LGBT space than is justified, and perhaps the people who like to label the extreme left "woke" are not just the Marjorie Taylor Greene idiots the left like to think they are. Maybe we ought to think more about lock-step support of some of our inclinations to do the right thing and come down on the right side of history. Hate speech, for example. I can't get a handle on that issue, either. In Germany, you can't say anything good about Hitler and the Nazis. They've shut down free speech on that issue and everything in me wants to shout, "Hallelujah, good on ya, Deutschland! Way to go!" But then where do I go with that other voice in my head that insists, "the only way to counter bad speech is with more speech, not with censorship." My head goes with that one. I understand, in principle, how the attempt at a cure can sometimes be worse than the disease.
So here's Part V of my thoughts on the transgender issue. What are we to make of the folk now claiming in ever-increasing numbers that they made a mistake by medically intervening their way out of gender dysphoria? I know the numbers are still small, but not so small they can be ignored. On the one hand, anecdotal evidence is quite often misleading and potentially worthless. On the other hand, if you listen to the collective testimony of individuals now filling the internet with their claims they made a mistake, if you've got a conscience, you have to let that testimony in. At least give the issue a serious hearing.
Of all the articles and videos I've come across on the issue of detransitioning, one in particular stands out. I am drawn to it because it comes from a place I normally run from. Two Christian doctors talking about the issue and insisting it has not only a social, a legal and a medical dimension, but a spiritual one. "Aaaargh" as they say in the comics. Gag me with a spoon. But my life experience has demonstrated that all sorts of b.s.ers and bloviators (if there's a difference) can sometimes come out with gems of wisdom. Nobody should be rejected out of hand until they've had their say. And the more I listened, the more I concluded they had a great deal of information I needed to consider. Here I am, in bed with anti-gay homophobes, I said to myself. Just what I need to check the strength of my convictions.
I'm talking about Sean McDowell talking to Paul Rhodes Eddy, in an hour-long piece from three months ago. Sean McDowell is a professor of theology at Biola University, a Christian college near Anaheim in the greater Los Angeles area. He is the author/editor of around fifteen books on Christian apologetics. He has a PhD in Christian apologetics from a Southern Baptist theological seminary. I'm familiar with him as an opponent of same-sex marriage of the "hate the sin and love the sinner" school of thought. Nice guy, from what I can see.
And here is the blurb on Dr. Paul Rhodes Eddy from the Center for Faith, Sexuality and Gender, with which he is associated:
Paul Rhodes Eddy (PhD, Marquette University) is Professor of Biblical and Theological Studies at Bethel University in St. Paul, MN. He has authored, co-authored, or co-edited a dozen books, including Understanding Transgender Identities: Four Views (Baker Academic, 2019). He is also a Teaching Pastor at Woodland Hills Church in St. Paul, MN. He lives in White Bear Township, MN with his wife Kelly and their two sons.
As I listened to their discussion, I saw my task as trying to distinguish the parts of what they had to say that I might assume to stem from their bias as anti-LGBT Christian apologists from what they had to say as objective scientists. And when I say "they" I mean chiefly Dr. Eddy, the sex researcher being interviewed by Dr. McDowell. My starting place comes from lived experience as a gay man; Dr. Eddy's starting place is almost certainly colored by the world he lives in of men and women who believe my embrace of homosexuality as a positive thing is misplaced, and transgendered people - perhaps - I can't be sure - are even more in need of corrective thought. That raises the obvious question: can either of us be objective here?
The longer I listened, the more I thought I saw their Christian orientation (not to say bias) leaking through their conclusions, the more I was persuaded that Dr. Eddy is no less sincere in his desire to understand the transgender dilemma than I am. And the more I found a meeting of the minds. We both reach pretty much the same conclusions on transitioning and detransitioning. Tempting as it is to ascribe his conclusions to a Christian ideological bias, how can I explain away the fact that I reach pretty much those same conclusions? I felt that obligated me to give him the same benefit of the doubt that I am inclined to give myself.
I recommend you give them a listen, if you have the time. It's only an hour. But if you want a condensed version, here's my take on what they had to say:
McDowell and Eddy begin their discussion with a Christian liberal admission that the church has not always done the right thing in dealing with sexuality. I am reminded of the times I have observed how readily people can become conciliatory once their ability to bully has been checked. And their claim that they see their goal as "missiological" - wonderful word, that - gives me the creeps. But we're just getting started.
First off, "detransitioning" is defined, simply, and I'd say obviously, as "reversing the transitioning process." Transitioning is divided into three parts: social (taking on attitudes and behavior of the opposite sex), medical (from puberty blockers to hormone therapy to surgery), and legal (taking steps, such as official name change, to reorient the world to one's transgender change). [Please note that I am following the transgender activist practice of using "transgender" to include what was once commonly distinguished as medical-biological (transsexual) as well as social (transgender). I don't like blurring the distinction, but I'm going with the flow here because I don't want to get hung up on the linguistic dilemma.]
Alarm bells went off for me when Eddy observed that Darwinian evolutionary theory opened up the perspective of seeing sex and non-binary and on a spectrum, since embryonic development takes us through the female-to-male journey in the womb. My thought was, "What's he getting at? Is he trying to shade evolution at the same time as the choice to transgender?" They move on before I can get an answer to that question.
Eddy credits the internet with the growth of interest in transgendering. Specifically with the idea that it was something one might consider doing. At the end of the last century there was relatively little interest, but between 2004 and 2007 there was a sudden spike in the number of adolescents reporting gender dysphoria. And, of course, as dysphoria became more prevalent, so did transitioning - and ultimately detransitioning, as well. Eddy cites two studies of adolescents in schools, one in Minnesota in 2016 showing 2.7% of 80,000 students surveyed in grades 9 and 11 reporting "some sort of transgender or gender-diverse identity." A second study, in Pennsylvania in 2021, showed 9.2% of students reporting "gender-diverse identity." If these studies are reliable (a big "if") they suggest a strong increase in dysphoria-consciousness. (And that, of course, opens up the question of whether transgender-consciousness is the same thing as dysphoria. I believe it is not, but that's a question for another time.)
Another question that cannot be ignored is why the sex ratio has changed so remarkably. Where once it was boys/men wanting to be girls/women, these days it is primarily girls/women wanting to be boys/men.
And a third question is what is the explanation for the high correlation between people with gender dysphoria and people with autism.
When they reach the question of why it is that transgendering has become such an issue at this time, I begin to appreciate Eddy's ability to be neutral. He acknowledges the culture war which polarizes us all: him on the Christian "God wants us to marry the opposite sex only and remain in the bodies we were born into" side, and me on the side of those who come up with things like"you don't tell me who I can love and who I can marry - I have the right as a citizen living in a democracy to make that decision on my own" and "seems to me the 'born into' question is up for grabs at the moment." But to his credit (in my view) he suggests we look at these questions from a multivariate perspective, and not assume simple single causes. He advocates a "bio-psycho-social" model to follow. I grit my teeth when he adds that, as a Christian, he'd like to add a spiritual component to that mix and make it a "numa-bio-psycho-social" model, and I immediately want to know how the spiritual differs from the psychological. But that's clearly another rabbit hole we probably need to walk past.
What kinds of issues does the bio-psycho-social model direct us to? The "bio" part leads us to ask whether there are chemicals in the environment, for example, that ought to get us to focus on such things as the intersex question. Sounds to me like asking us whether there's something in the water. But who knows? Maybe there's something there. The "social" aspect is the biggie, as far as I'm concerned. When somebody identifies as transgender, are we doing the right thing by insisting on a gender-affirming approach? Are we seriously doing right by kids by going with their assertion that they are "in the wrong body"? I've come down on that side, so far, and I'm still there. But I recognize it as a legitimate question, mostly because my life has been one discovery after another that I have held firm convictions that I later come to understand as erroneous, and the only proper approach to scientific questions is to assume truth to be "the sum total of all knowledge to date subject to change at any moment with the introduction of new reliable information."
Then comes the troubling possibility that some people have come upon gender dysphoria through interaction with their peers. Adolescents are notoriously susceptible to peer group influence and it's an open secret that a lot of bad ideas get into the heads of kids from television and social media. There's even as word for it: social contagion. Add to that the increasing social acceptance of transgender folk and the fact that insurance companies, some of them, are now willing to pay for medical transitioning, and you've got a whole new ball game, a whole new reason to make the leap. And, of course, from the perspective of somebody who later wants to detransition, a whole new risk one should avoid. Either way, a whole new complexity. Not as dramatic as the possibility that, perhaps not in the immediate future, but eventually, we may see uteruses transplanted into male bodies. But complex for sure.
I'd like to make a brief discursion here to take up two issues McDowell and Eddy do not address. I'm old enough to remember when people went to extremes to hide the fact that they were gay. Old enough to be astonished at how radically the world has changed. Today I can be openly gay and the world I live in, at least, is totally supportive. Positive images are everywhere. The most popular movie on Netflix recently has been Red, White and Royal Blue, a wonderful fantasy in which two drop-dead gorgeous men, one the second in line to the British throne and one the son of America's first female president fall in love and even get portrayed having anal sex in one scene. How's that for a switch? And the world roars its approval. Given this reality, it will surprise no one that all sorts of young men and women who probably would have been too inhibited to explore same-sex sex only recently are now giving it a go. I celebrate this. I think it's good for young people to get drunk a few times. It's the only way one can learn what drink does to you. Do you become a silly drunk? An obnoxious drunk? A morose drunk? You need to know yourself and know what the risks are. Similarly, I think you should know yourself sexually. Young people experiment with sex and if they discover they are essentially heterosexual after a couple gay trysts, all the better. Self-knowledge is essential to a good life.
But what about experimenting with switching sex and gender? Socially, I'd say the situation is the same as experimenting with same-sex behavior. No harm done, except possibly to your dignity and loss of standing in your old social circles. Do it, if you feel like it, I say. If nothing else, it will put you in the shoes of more serious-minded gender dysphoric people. You will experience the difficulties they go through. But again, I draw the line at medical intervention. Cut off your breasts or your penis and you don't get to go back again. Not something to mess with. Not a parallel with experimenting with being gay.
The other issues is a big one, in my mind. There is a glaring inconsistency, as I see it, in the transgender claim, from guru Judith Butler on down, that gender (and sex!) are fluid, that there are any number of ways of being a man or a woman, that being non-binary is the way to go. But at the same time people who believe they were born into the wrong body and want to change their gender seem to go for the stereotypes of the opposite sex. Male to female candidates want to be Marilyn Monroe, not Angela Merkel. Female to male often go for the lumberjack or tough guy image, not the self-effacing polite gentleman who gives his seat to a lady. What's that all about, other than calling the "multiple gender" notion into doubt?
But maybe I'm making too much of that idea. Let me get back to the discussion between McDowell and Eddy. They don't use the word zeitgeist but theyacknowledge that transgendering is so much with us that there are now children as young as three or four being socially transgendered. And it's now clear that once the three-step process starts (from social to blockers and hormones [estrogen or testosterone] to surgery) it's quite likely to continue. And that means that detransitioning will as well. I note, though, that that does not speak to the real issue, which is whether the percentage of those transitioning warrants the calls to stop the process entirely. That, it seems to me, remains very much an open question which McDowell and Eddy, now thirty minutes into their discussion, have not resolved.
Eddy takes up the distinction between regret over transitioning and detransitioning. The three main reasons for the former, regret, are: 1) some medical complications; 2) a less-than-satisfactory functional outcome; and 3) a less-than-satisfactory esthetic/appearance. However, while the statistics on the regret rate run between 1% and 2.2%, the rates for actual detransitioning run between .5% and 1%. But, I suspect, there is an issue of numbers, here. Eddy himself describes the statistics as "dicey."
Once Eddy gets into the think of the discussion on detransitioning, he focuses on the complexity behind the figures. Many of the early studies on transitioning, he points out, were undertaken at a time when transitioning came only after extensive counseling, and an attitude which favored moving slowly and carefully. Thus one should expect lower levels of detransitioning from that early era because more thought went into the decision to transition in the first place. Nowadays, when people launch into medical measures after sometimes as little as thirty minutes of counseling, one supposes the risks of an unwise choice have shot way up. This highlights the dilemma one faces over whether to listen to those who threaten suicide or self-harm if they don't get permission to transition or to those who insist on taking it slow, and call their bluff. No enviable spot to be in, for sure.
But don't miss the point here. The overwhelming majority of those who transition find their lives are better after doing so. Figures go as high as 98%. That too is not an insignificant fact, fuzzy statistics notwithstanding. And both Christian apologists reach that conclusion from the data available. And yet, they also warn that in years to come we may have to reevaluate these conclusions as the almost inevitable increase in testimonies from detransitioners eventually comes in. By the end of their session, I find myself better informed, but no less convinced I should be put off by an overriding approach that favors caution.
At the end of their discussion, Eddy gets into the question of the reliability of psychological research in general, the search for data on the transgender issue being only one subset of that research. The problem, he stresses, is what he calls replication bias, the fact (he asserts) that 1) much psychological research never gets replicated, and 2) some research gets taken early on as authoritative and research that counters its findings gets ignored. Add to that the fact that there is yet to be established a standardization of linguistic terms and of measuring tools and the fact that much of what we claim to know is based on retrospective studies, and there is good reason to push the pause button. Just as self-report data is notoriously unreliable, so is data that comes from recall.
When it comes to detransition studies, there is another huge problem, according to Eddy. Many of the studies deal with people who decide to - or decide not to - transition after a few months or a couple years. But other studies show that most of those who detransition do so only after eight or ten years. So these people's experience is not being captured in most of the current studies on detransitioning. Also, detransitioners are less likely to seek the advice of those medical advisors they transitioned with. I wish I could question Eddy about this, though. What difference does it make where the statistics come from on detransitioning? Wouldn't an individual detransitioner be counted as such no matter whether they went through their original transitioning doctor or another doctor? I'm now beginning to worry that maybe my original suspicion that and understanding of the transgender issue is riddled with bias. But is it, in this case, a pro-Christian bias? Or my inclination to see an ideological pro-Christian bias where there isn't one? I am none the wiser after two careful engagements with this video.
We are left with the impression that we are only at the beginning of a useful understanding of how to proceed rationally with people suffering from gender dysphoria, despite the number of years the problem has been around.
Eddy and McDowell end on the question of where to go from here and how to advise parents faced with children with gender dysphoria. Eddy advocates use of not a gender-affirming model but what he calls a gender-exploratory model. In plain English: more "let's think about this" than "whatever you say, dear." Once again we are confronted with a choice of going with the head or the heart, the head being the exploratory approach where we question and reason, the heart being affirmation as a way to show love to our children by giving them assurance we trust them to know what they need from life.
And - again, no surprise - which way you go will depend on the kind of relationship you have with your kids, how much trust you have established with them, how much freedom you've granted them to try new things and fail, and how much you believe they have acquired the maturity to make wise decisions.
Not something you can get help with from outside. Not something a counselor or therapist can assess with certainty. Something that has to be taken on a case-by-case basis. Welcome to reality, where you have to call the shots with the knowledge you are limited to and accept the consequences they leave you with.
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