I was wrong.
I couldn’t take the heat.
“If you can’t stand the heat, get out of the kitchen,” I wrote self-importantly last month, in response to Twitter blow-back to “Act One” of my trilogy of essays on gender identity. “But I’ll stay in this kitchen, for now, no matter how hot it gets.”
But that little flare-up was a summer breeze compared to the white-hot Twitter-rage blasted at me last week by an angry mob of trans activists.
I fled the kitchen: I deactivated my Twitter account, alarmed and demoralized - and frankly a little bit scared.
My "sin" was to issue the tweet below, linked to the third installment of my "Jack and Jill" series, in response to the January 21 National Post headline "Puberty blockers, cross-sex hormones: Canada's family doctors get guidance on treating youth with 'gender dysphoria'.
Let me state this plainly here, if I haven’t been clear enough before now: I am not a “transphobe”. A phobia, defined by the Oxford dictionary, is “an extreme or irrational fear of or aversion to something”. I’m not afraid of or averse to trans individuals or those who struggle with their gender identities. (That’s not one hundred percent true, in a sense, I suppose: I am afraid of trans individuals of the sort who came gunning for me on Twitter. But it’s not their trans-ness I’m afraid of – their ideologically-driven hatred of dissent and the harm and havoc they are generating for families are what frightens me.)
I view gender dysphoria, medically and quite simply, as a departure from the normal order of things; that is, as an example of what we used to be able to call, in less politically-charged times, a “disorder”. As I wrote in Act Two:
“It should go without saying (from a medical viewpoint, at least) that calling something a “disorder” isn’t a moral judgment. Pathology isn’t bigotry: it’s simply a departure from the healthy order of things. If I diagnose someone with diabetes, or appendicitis, or schizophrenia, I don’t think any less of them.
Nor am I in any way “intolerant”. I have the utmost sympathy for those who bear this difficult cross. It’s not their fault that they are conflicted. They deserve respect, compassion and fierce support, not condemnation and discrimination. As I put it previously:
To state what should be obvious, youth struggling with gender dysphoria don’t choose to be afflicted: one might sooner choose waterboarding as a path to serenity.
But the CMA has chosen to ignore the basic science of sex and gender in a rush to embrace the now-popular fiction of gender fluidity. The preamble in CMAJ last week to its suite of transgender articles contains this pronouncement:
“A key shift is from a binary notion of gender as only male or female, with some people moving from one to the other, to seeing gender identity as a spectrum or galaxy.”
The “key shift”, it seems to me, is that Canada’s “voice for doctors” has severed its attachment with scientific reality. Because the gender binary is more than just a “notion”: it’s a fact of our mammalian existence, firmly rooted in the biology of our sex. As I wrote:
There is scant support for the concept of “gender fluidity”. Rather, gender is best understood as “binary, with exceptions”. Boys are boys and girls are girls, each half of the binary represented by a bell curve; and within each bell curve we see a spectrum of expression from feminine to masculine, from Barbie-loving to rough-and-tumble males, from girly-girl to tomboyish females. This is perfectly normal (and desirable – imagine the blandness of a world without it), and the range of expressions within the binary carries, for the most part, through to adulthood. Exceptions to the binary norm, as in some individuals with disorders of sexual development (DSD), serve only to prove that rule.
The most important of the CMA articles (by Joseph Bonifacio and colleagues), entitled "Management of gender dysphoria in adolescents in primary care", closes with this:
“Best management will continue to evolve as new research emerges. However, the hallmark of care will remain a thoughtful, affirming, well-reasoned individualized approach that attempts to maximize support for this vulnerable population, as youth and their caregivers make complex and difficult decisions.”
Who wouldn’t be on board with that? I certainly am. Unfortunately, that closing statement is preceded by a rickety construct of conjecture and ideology, fifty-eight “references” notwithstanding. (The fact that the recently issued, devoid-of-evidence, gender-affirmation policy statement by the American Academy of Pediatrics is supplied as a linchpin citation is instructive.)
It’s difficult to imagine NOT being in support of “affirmation”, it must be said. Except that affirmation in this context is not necessarily a component of prudent love and care.
It is not the role of good parents, after all, to affirm every desire of their children regardless of whether or not its in their best interests. We are their parents, after all, endowed with profound responsibility to provide guidance, leadership, structure, and correction.
Affirmation is tossed around these days by trans activists like wild-eyed tent revivalist preachers dispensing baptism. “Dip yourself in the holy waters of affirmation, my child, and you shall be healed, released at last from your old body and awarded a new one.”
“Affirmation” is on track to challenge “tolerance” as the most abused term in the entire human lexicon. ("Social justice” warriors preach “tolerance” for everyone – until, of course, you don’t agree with them: then they are intolerant of you, and militantly so.)
“The youth’s voice is always paramount,” Dr. Bonifacio et al assert in their article. Well, parents, if your idea of domestic utopia is adolescent anarchy, then adopt those six words as creed for your household.
Without a doubt, what should be paramount is attentive and active listening to the voices of your children: always be by their side, never abandon them, don’t let them ever doubt your love for them. No matter what.
But to believe, as per Dr. Bonifacio, that their “voice is always paramount” is to believe that we exist only to do their bidding. And that, as we all know perfectly well, is nonsensical.
Also nonsensical is this claim:
“Medications that suppress puberty — hormone blockers — allow youth time to explore their gender identity and expression without having to worry about ongoing pubertal changes and development of secondary sexual characteristics that may be psychologically disturbing and undesired. This can also allow families time to access resources and support and adjust to changes within the family; it can also be a time in which to explore next steps.”
He simply skips over the enormous risks of using blockers in this manner. Starting a child on these drugs essentially ensures further travel down the troubled road to transition, with its signposts of cross-gender hormones, sex reassignment surgery, permanent infertility, and a lifetime requirement to take powerful drugs with dangerous side effects.
In Archives of Disease in Childhood Drs. Christopher Richards, Julie Maxwell, and Noel McCune point out that the use of puberty blockers leaves young people “in developmental limbo without the benefits of pubertal hormones or secondary sexual characteristic, which would tend to consolidate gender identity.” These drugs, they warn correctly, are being used for gender dysphoria “in the context of profound scientific ignorance.”
So my statement that “I am appalled” by the CMA’s one-sided, ill-informed stance, given the implications for the care of youth who are struggling, is one hundred percent accurate. (The CMA has plenty of company, mind you, chief among them the American Academy of Pediatrics and United Kingdom's National Health Service.)
“Our purpose is to drive meaningful change,” states the CMA on its website. “We do that by launching conversations and debate on today’s most pressing and complex health challenges.
Transgender issues certainly qualify as one of “today’s most pressing and complex health challenges”. And I am, like most conscientious physicians, an ardent supporter of meaningful change that enhances understanding and support of trans individuals.
But why the CMA chose to forgo meaningful conversation and debate prior to drinking the gender fluidity Kool Aid is a question for the ages. “There is plenty of disagreement, as in all other areas of science,” observed Dr. Joe Hebert in Psychology Today. “This is how medicine progresses.“
“No-one blames transgender people for firm and active political activity,” continued Dr. Hebert. “They have been poorly treated in the past. But when debate turns into fanaticism, and reason goes out of the window, it’s time to blow the whistle, however good the cause.”
Hence my tweet last week. It was met, for a couple of days, with unanimous applause and a host of supportive, thoughtful, grateful comments.
And then the trans-activist mob caught wind of my tweet. Judging by the tenor of their comments, I doubt that those freshly agitated Twitterites took time to read one whit of my “Act Wisely” essay before their hatred poured forth: I was immediately labeled a transphobe, a bigot, a homophobe, unprofessional, intolerant, discriminatory, a menace to children, and guilty of malpractice; I was accused of “misgendering”, reported to the Twitter police, and, to summarize the most eloquent offering, invited to “fuck off and die”.
My humble, little-noticed blog got a sudden blaze of activist attention. Little snippets were cut and pasted out of context onto Twitter, my work summarily dismissed as a “bizarro” collection of bigotry and homophobia. Which is a curious descriptor for a collection of amateurish essays dedicated mostly to politics and the joys of living with cancer, with the notable exception of my “Jack and Jill” trilogy and a pair of irreverent articles (presently removed) which I penned in response to British reports of a man giving birth and boys having periods.
The thrust of those latter two essays served only to emphasize what is already known to pretty much everyone: biological males cannot get pregnant, and biological boys cannot menstruate. But the discovery of those “diatribes” on my blog showered rocket fuel on the mob’s collective indignation. And removing them from my site didn’t lower the temperature one bit: techy dumpster-diving activists promptly extracted them from Google’s archives and held them high as smoking evidence of my depraved intolerance.
Leading the charge was Mx. Ya-ya Page:
The gathering mob quickly drew in trans leader Amanda Jette Knox, self-styled “Maven of Mayhem”:
Amanda Knox is a gifted writer and speaker whose middle child came out as trans in 2014. One year later, her husband followed suit and transitioned; and Amanda morphed into a lesbian married to a trans-woman. Her family’s story, aggressively self-promoted and well-publicized, has captured the imagination of many, and is the basis of her upcoming book: “Love Lives Here: A Story of Thriving in a Transgender Family.”
I’m happy that Amanda and her family are thriving. Truly. I have no right, no ability, no desire, to judge their personal situation and their choices. I can’t imagine the difficulty of the journey that brought them to where they are today.
But that doesn’t mean that their solution is the solution for everyone with gender dysphoria; nor does it erase the proven biology of our species, or magically establish that gender “fluidity” is real.
Ms. Knox has accrued almost 30,000 followers (and is openly campaigning for m; predictably, in a matter of minutes the Twitter attack had mutated into a full-on swarming. A sampling:
One enterprising trans-Twitterite discovered a listing for me on RateMDs.com:
Like magic, the following assessment of my abilities immediately cropped up on RateMD: He's a transphobe and supports unscientific, political agenda nonsense that potentially harms children.
I tried, for a bit, to defend myself on Twitter, attempting to rationally debate the wholly irrational.
But when I was doxed by the mob, led by Mx. Ya-ya Page and journalist Siobhan O’Leary uncovering and publishing the place of my work, looping in the Alberta Children’s Hospital Foundation (?!), and vowing to report me to the College of Physicians and Surgeons of Alberta - I had had enough. Rattled, and deeply disturbed, I suspended my account.
Trusted colleagues, witnessing my consternation, suggested I back away and avoid further harm to my psyche. And I was inclined to agree, at first.
But after some extended reflection my over-riding sentiment was this:
How dare you?
How dare you impugn my integrity and professionalism?
How dare you question my dedication to the care of my patients?
How dare you try to damage my clinical practice?
How dare you throttle open, honest debate about the care of our youth?
I couldn’t let this drive-by shooting, this gross smear to my professionalism and character, go unchallenged, I decided: hence this essay.
I returned to the scene of my “crime” under cover of darkness - meaning that I opened a new, anonymous Twitter account and clicked my way back to the relevant threads.
I discovered a gleeful post mortem, akin to a gang of loathsome school-yard bullies high-fiving after beating up on their latest victim:
Correct. Bullies are "extremely powerful".
Is it any wonder, given my experience, that so many physicians are silent? Who can tolerate this? Who is willing to risk their reputation by going toe-to-toe with people like this?
As Dr. Herbert put it: “Medical scientists seek greater understanding of their subject, and better treatments for their patients, not martyrdom.”
I’m not being especially brave in speaking up about this – I got chased off of Twitter, after all. The crude and vulgar manner in which the trans activists “communicate” is telling: they seem unable or unwilling to make their points without hurling F-bombs or insulting their interlocutors in the most vile manner possible.
But I’m speaking up as a physician for what I believe to be correct, based on what I know of science and biology and evidence, and motivated primarily by concern for kids who are struggling.
These kids are the ones who are brave, forced to endure scorn and ridicule and bigotry as they navigate their tortuous paths, while being used as pawns by activist ideologues.
Equally heroic are those parents and clinicians brave enough to stand firm in the face of fanatical gender mysticism and to advocate instead for careful remedies rooted in actual science and genuine empathy.
I’ll reactivate my Twitter account, briefly, long enough to dump this essay into its ravenous maw. Then I shall heed, permanently, Barton Swaim’s recent counsel in The Wall Street Journal: “For sanity’s sake delete your account”.
Twitter, concluded Swaim, is nought but a “vast array of vicious, defamatory and inane utterances. The instantaneous awareness of so much folly is not, I now think, healthy for the human mind... After an hour or so of watching humanity’s stupidities scroll across my screen, I felt I had peeked into some dreadful abyss into which only God can safely look. It was not for me to know the thoughts of man.”
“Spending time on Twitter,” he said, “became, for me, a deeply demoralizing experience.”
Believe me, I can relate.
Farewell, Twitter. Hello, sanity.