The first time I read To Kill a Mockingbird, I loved Scout because I was Scout. I, too, had an attorney father who taught me to read in his broad lap, penciling out words on a page of yellow foolscap. I, too, preferred the rough-and-tumble games of boys to the orderly domestic dramas of girls. I had been a “tomboy,” too.
This is “gender,” the behavioral manifestation of our sex. In the last decade, gender has vaulted in the popular imagination from something we might dismiss as a dispensable collection of stereotypes to a matter of “identity”—humankind’s signal trait. Our current obsession with gender identity has led us to treat the pronouncements of four-year-olds (“No, Mommy, I’m not a boy”) with the reverence once reserved for oracles.
In her new book, The End of Gender: Debunking the Myths About Sex and Identity in Our Society, the neuroscientist and sex researcher Debra Soh provides an indispensable cultural sanity check. Today’s educated lay public might not dare proffer an opinion on the measured value of the Hubble constant or the likelihood that protons ultimately decay. But we seem to have a lot of fervent opinions about sex, sexuality, and gender, many of them gleaned from pop culture—many of them dead wrong. In Soh’s telling, gender is neither purely a “social construct” nor is it everything—more important than biology itself. No, she explains, gender proceeds from biology. The masculinity or femininity we exhibit may be closely tied to the testosterone level to which we were exposed as babies in utero, for example.
One of The End of Gender’s bravest themes comes in Soh’s discussion of childhood gender dysphoria. “There is no such thing as a transgender child,” Soh declares. Her pronouncement hit me like cold water; “transgender child” is a phrase I have used myself. Children afflicted by severe discomfort with their biological sex may be “gender-dysphoric children.” But “transgender” is a social designation and, like “gay” or “Republican,” something we once took to be the province of adults.
“Children, and particularly prepubescent children, do not possess the emotional maturity to identify this way,” she writes. Scout Finch may turn out, one day, to be gay, or trans, or Republican. But the point is that this is something she would be in adulthood. In eras past, we wouldn’t have burdened a child with the demand that she define her identity. As my own Democratic parents admonished me in 10th grade, “You’re not yet a Democrat; you’re not registered to vote!”
But in 2020, young gender-non-conforming children are encouraged to do exactly that. They are often invited to pick a new name and begin a course of hormonal blockers to inhibit puberty until they can be started on cross-sex hormones, which will give them the appearance of the opposite sex at the cost of their future fertility. Soh argues, convincingly, that this is a grave mistake.
For one thing, she points out that “gender dysphoria” is often itself the symptom of another comorbidity, the one that ought to be treated first—anxiety, autism, or body-dysmorphic disorder. For another, the vast majority of children with gender dysphoria—if left alone and not socially or medically transitioned—will outgrow it. (Many, but not all, will emerge as gay adults.) Scientists have, as yet, no way of predicting which children will outgrow it on their own. And even a severe case of gender dysphoria “isn’t necessarily predictive of a child’s dysphoria persisting,” Soh writes. “As one study showed, even children who were severe in their gender dysphoria desisted.” The oft-cited claim that without medical transition, 41 percent of gender dysphoric children are destined for suicide is patently untrue; it is based on a study of transgender adults.
Given all this, one might ask: What on earth are we doing? Why are we administering powerful and experimental medications for a condition children are likely to outgrow? Why are we allowing 11-year-olds to “assent” to puberty blockers—a first step in a medical course that will conclude with the loss of all future fertility? Physicians don’t “even allow adult women to make a decision about tying their tubes or having a hysterectomy until they are in their thirties,” Soh points out.
In fact, the treatment of gender-dysphoric children has become so politicized that capable psychologists and physicians choose to avoid the minefield entirely. This makes these children yet another victim of cancel culture, in which decent and competent people are removed from the arenas where they’re needed most, leaving only the unabashedly agenda-driven in place. “Since legitimate experts now avoid anything to do with treating gender dysphoria in children,” Soh notes, “activists have stepped in, taking their place.” Many doctors and scientists now think of themselves primarily as activists. Their medical conclusions are driven by their politics. They toss out disconfirming evidence like so much biohazardous waste. Soh writes that “things have gotten so bad, scientific papers can’t be trusted.”
How does the lay person know what studies to believe? “Be wary of cross-disciplinary authorship with departments like philosophy, English, and education,” she warns. “If what you are looking for is basic, foundational information, anything older than ten years old is probably safe. Anything published in the last few years is questionable.”
Matters are not hopeless, Soh wants us to know. We don’t have the luxury of hand-wringing despair. We have a job to do—every one of us. We must reject cancellation. We have to hunt out apolitical studies that exist and reject efforts to politicize good research. We should challenge our assumptions and trust not our intuitions but the dispassionate inquiry of actual science. At stake is nothing less than the future of science itself. Scout may win our hearts, but real girls like her deserve the benefit of sound medicine. Political correctness may help us save our own skin in the workplace or classroom, but it has proven a rotten guide in the more critical quest for knowledge and truth. Be brave like Debra Soh—brave like Scout.
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