Biden’s transgender decree
One way to shut down debate on a contentious subject is to declare there’s no debate on the subject. Everyone, absolutely everyone, agrees with one side, so why are you even trying to argue? It’s settled.
The Biden administration is doing that now on what officials call “gender-affirming care” for young people who believe they’re transgender. “There is no argument among medical professionals — pediatricians, pediatric endocrinologists, adolescent medicine physicians, adolescent psychiatrists, psychologists, etc. — about the value and the importance of genderaffirming care,” Dr. Rachel Levine, who, as U.S. assistant secretary for health, is the highest-ranking transgender person in the administration, told National Public Radio Friday. The next day, Levine made the case in a speech at the “Out for Health” conference at Texas Christian University.
A month earlier, to observe “International Transgender Day of Visibility,” Levine’s agency, the Department of Health and Human Services, released an information sheet on “gender-affirming care” for youth. “For transgender and nonbinary children and adolescents, early gender-affirming care is crucial to overall health and well-being as it allows the child or adolescent to focus on social transitions and can increase their confidence while navigating the health care system,” the department said.
The information sheet included a chart detailing “gender-affirming care.” It listed four specific types of care, with a definition and comment on whether or not it was “reversible.” The first type of care was “social affirmation,” which it defined as “adopting gender-affirming hairstyles, clothing, name, gender pronouns, and restrooms and other facilities.” That can be done “at any age or state,” HHS said, and is “reversible.” Indeed, while there’s debate about the wisdom of such efforts, they are, in fact, reversible.
But the department listed three other approved treatments that aren’t reversible — puberty blockers, hormone therapy and “gender-affirming surgeries.” The chart defined the first as “using certain types of hormones to pause pubertal development,” which it recommended “during puberty.” It called such treatment “reversible,” although there’s great debate about that, and in any event, it’s hard to see how delaying the age at which a child reaches puberty can be reversed, since the child will never be that age again.
HHS defined hormone therapy as “testosterone hormones for those who were assigned female at birth” and “estrogen hormones for those who were assigned male at birth,” recommended from “early adolescence onward” and labeled “partially reversible.”
“Gender-affirming surgeries” were defined as “’top’ surgery — to create male-typical chest shape or enhance breasts,” or “’bottom’ surgery — surgery on genitals or reproductive organs,” or “facial feminization or other procedures.” Such measures are “typically used in adulthood or case-by-case in adolescence” and are obviously “not reversible.”
Levine says there’s “no argument” about the value and importance of these treatments. But in fact, all three of them -- puberty blockers, hormone therapy and “gender-affirming” surgeries — are quite controversial. Just look at some of the commentary from an organization called the Society for Evidence-based Gender Medicine, which is made up of the type of “medical professionals” to whom Levine referred. In the group’s own words, “We are an international group of over 100 clinicians and researchers concerned about the lack of quality evidence for the use of hormonal and surgical interventions as first-line treatment for young people with gender dysphoria.”
You might have seen more about the group, except members’ views are sometimes censored by major medical organizations. For example, last year The Wall Street Journal reported the American Academy of Pediatrics barred the SEGM from setting up a booth at the AAP’S annual conference. The AAP is “working very hard to give an appearance that everything’s been decided and there’s no debate,” a SEGM member, Dr. Julia Mason, told the Journal.
And now, that’s what the Biden administration is trying to do, too. Levine has declared the argument among medical professionals over. The new consensus, amazingly enough, agrees with Levine. The administration now will move to the next step. Since the debate is over, since there’s a scientific consensus in favor of “gender-affirming” treatment, those who are still criticizing aren’t debating the facts. They’re attacking their fellow human beings.
Who would want to do that? Who would want to risk being accused of slander, bigotry and gender-baiting — risk reputation and livelihood — for questioning the wisdom of “gender-affirming care” for minors? Better to just be quiet. After all, Levine says the argument is over, at least as long as Levine and the Biden administration are in power.