GENDER Q & A
Looking for solid, evidence-based responses to the standard-issue questions posed by those still clinging to their misconceptions about "gender medicine?" Not sure which resources to provide and how to avoid the "gender-affirming care" lecture series? We've got you covered.
No. The “affirmation model” wrongly requires doctors and therapists to affirm any claims of a “trans” or “nonbinary” identity, without taking into consideration developmental stage, online influences, or comorbidities such as depression/anxiety or autism. There is no proven protocol for determining who, if anyone, will benefit from the medical interventions offered—puberty blockers, opposite-sex hormones, and surgeries—and no credible evidence that they are safe or effective. For those over 18 or minors with parent permission, no psychological or medical evaluation is required to access hormones. Planned Parenthood, one of the largest purveyors of opposite-sex hormones in the U.S., has a “no barriers” policy: “We follow the Informed Consent model so patients do not need a mental health referral to receive services.” In blue states, most gender clinics and Planned Parenthood will dispense testosterone or estrogen to minors starting at age 16 after one short visit. At age 18, no parental notification or approval is required and in some cases, opposite-sex hormones have been prescribed after a phone or video consultation as short as 15 minutes, with no prior in-person meeting and no mental health evaluation or health history taken.
Resources:
“By Any Other Name. The story of my transition and detransition,” Helena, February 19, 2022
No. Suicide rates among trans-identifying youth are comparable to those with similar mental health and developmental conditions, such as anxiety, depression, OCD, autism, and ADHD. Fortunately, suicide is rare in both groups. Comprehensive mental health evaluation and treatment should be the first step in addressing gender-related distress.
Studies examining gender medicine and suicide rates have found no statistically significant link between "gender affirming care" and suicide prevention. According to suicide prevention experts, suicide isn't caused by just one thing, but is the result of many factors. Even so, too many clinicians and advocacy organizations—including the Trevor Project, a suicide prevention organization—claim “untreated gender distress,” or mistreatment and stigmatization, as a single cause of suicidality. Despite the recommendations from the federally-funded Suicide Prevention Resource Center, messaging from activists and others advocating for medical interventions promotes the idea that suicide is an expected or reasonable response to not receiving “gender-affirming care.”
Furthermore, the claim that “gender-affirming care” prevents suicide is not supported by the NIH-funded study, Psychosocial Functioning in Transgender Youth after Two Years of Hormones. Despite the authors’ conclusions that these interventions improve psychosocial functioning, two of the young study participants committed suicide within the first year after starting opposite-sex hormones in a highly affirming environment, with affirming parents, and therapeutic support, and despite prescreening participants for suicidal ideation and significant distress.
In Sweden, the longest (40-year) study of sex-reassigned adults found that compared to others of the same sex, completed suicides were 19.1 times higher, suicide attempts 4.9 times higher, and psychiatric inpatient care 2.8 times higher.
See di-ag.org/suicide-risk for more information.
No. There is no medical diagnosis for “trans.” It is not possible to be “born in the wrong body”—we are not “in our bodies,” we ARE our bodies. Despite decades of research, no brain differences between trans-identifying individuals and others have been found. The Diagnostic and Statistical Manual Of Mental Disorders, Fifth Edition (DSM 5), a publication of the American Psychiatric Association, includes a mental-health diagnosis called “gender dysphoria.” According to DSM 5, “gender dysphoria” is when a person has been uncomfortable with their birth sex for at least six months. This distress can be (and until the 21st century largely was) treated through non-medical interventions and resolves with time. There is no credible evidence that hormonal and surgical interventions actually help a person feel better about their sex in the long term—or improve their mental health or quality of life. Despite what we have been told, “gender-affirming care” is not medically necessary.
When a child or adolescent tries to be perceived as a member of the opposite sex by changing their name, asking others to use opposite-sex pronouns, and wearing sex-atypical clothing, hairstyle, and make-up (aka ”social transition”) they are embarking upon a pathway that can lead to lifelong medicalization. Social transition is an intervention with serious ramifications. Adults in positions of authority (parent, teacher, therapist, doctor) who encourage social transition can interrupt the natural process of identity formation, introduce or reinforce ideas of "wrongness," and push a young person down a path towards ever more extreme measures to appear as the opposite sex. Social transition also falsely presents identity as fixed, locking youth into a rigid sense of self and limiting future choices. According to the The Cass Review (England, April 2024), “‘Social transition’ is not a neutral act but a major psychosocial intervention that may affect whether a child’s gender distress disappears or becomes long-lasting." Given time and space to explore and mature, most children outgrow gender distress. Adults in positions of authority should aim to be neutral.
Resources:
Social Transitions - A Powerful Psychosocial Intervention, Gender: A Wider Lens, Episode 40, Sasha Ayad & Stella O’Malley, September 2021
Independent review of gender identity services for children and young people: Final report, Dr. Hilary Cass, page 31
No. There is no evidence or reason to assume that interrupting a specifically timed, necessary physical maturation process does not irreversibly affect development. Puberty is normal and involves changes to every organ system in the body, including neurodevelopment—not just secondary sex characteristics. Blockers stop neurodevelopment necessary for identity formation, sexuality development, and the ability to accurately assess risk. Without this cognitive maturation, youth cannot comprehend the impacts of the medical pathway.
Puberty blockers exploit a child's anxieties about puberty and cement the pathologizing of normal development, essentially guaranteeing that children continue on to opposite-sex hormones, as data shows. Children should be reassured and helped to tolerate the discomforts of a changing body, not told it is possible to flip a switch to shut down a crucial developmental phase. Children do not have the life experience to meaningfully consent to drugs that compromise future sexual function and fertility.
The Cass Review (England, April 2024) concluded that no high-quality evidence supports using puberty blockers (or hormones) to treat young people with gender dysphoria: puberty blockers have never been approved to treat this condition. In June 2025, results from a multi-million dollar U.S. government-funded study were published which found that puberty blockers do not improve mental health.
Resources:
Protecting Puberty, Genspect campaign launched June 2025
Puberty blockers for gender dysphoria: the science is far from settled, William Malone et al., The Lancet, September 2021
Puberty Blockers Can Powerfully TRANSFORM a Body, Genspect Conference, Zhenya Abbruzzese, December 2023
“Off-label, on meds: What does America's Food and Drug Administration know about the risks of transgender puberty blockers?,” Gender Clinic News, Bernard Lane, March 16, 2023
Puberty Blockers for Children: Can They Consent?, The New Bioethics, Antony Latham, June 22, 2022
No. There is no credible long-term evidence on the safety of opposite-sex hormones provided for the purpose of altering sex traits. Extended use results in vaginal atrophy, eventually leading to hysterectomy because testosterone shrinks the uterus and causes pain. Boys and men taking opposite-sex hormones face an increased risk of heart attack, stroke, and dangerous blood clots. Boys given blockers early in puberty who progress to opposite-sex hormones will be permanently sterile and unable to orgasm. In the 1970s, athletes in East Germany were administered testosterone (then recognized as illegal “doping”) and about 800 of them developed serious health problems. Opposite-sex hormones create an endocrine disorder in otherwise healthy bodies, increasing risk of serious illness while providing only cosmetic changes.
Resources:
The effects of gender-affirming hormone therapy on cardiovascular and skeletal health: A literature review, Nyein Chan Swe et al., March 2022
“Brandt Files #4: Side Effects? Haven’t Seen ‘Em: A Cheery Endocrinologist Testifies About Everything and Nothing,” BROADview, Lisa Selin Davis and Unyielding Bicyclist, September 7, 2023
No. There are no credible long-term studies on regret. We know from detransitioner accounts that regret often doesn't set in until 2 to 10 or more years after beginning medical interventions, but all the studies on regret are short term, spanning no longer than a few years. Gender clinics are not required to follow up with patients who stop treatment and data show that 75% of those experiencing regret don’t report this to their physicians. While we have no quality evidence, the Reddit/detrans discussion forum created in 2017 has grown to 57,000 members as of June 2025, indicating significant regret. According to the Society for Evidence Based Gender Medicine, “A new study (now available in English) from Germany poses a formidable challenge to the presumption of permanence of gender dysphoria in adolescents and young adults. German insurance data, containing medical claims for about 14 million insured persons aged 5-24, indicate that over 60% of young people diagnosed with ‘Gender Identity Disorder’ (F64) no longer have the diagnosis 5 years later, indicating low diagnostic stability.”
Resources:
“The Gender Dysphoria Diagnosis in Young People Has a “Low Diagnostic Stability,” Finds a New German Study,” Society for Evidence Based Gender Medicine, July 2024
The Detransition Rate Is Unknown, Archives of Sexual Behavior, J. Cohn et al., June 2023
Detransition and Desistance Among Previously Trans-Identified Young Adults, Archives of Sexual Behavior, Lisa Littman et al., December 2023
“Surge of detransition lawsuits pose threat to booming gender-transition business,” The Washington Times, Valerie Richardson, December 5, 2023
“Better, after: A group of detransitioners deliver a message of hope,” Gender Clinic News, Bernard Lane, December 7, 2023
“Loss to Follow-Up and Transition Regret, Examining 27 studies used in a 2021 meta-analysis on post-surgical regret,” Michelle Alleva, Some Nuance Please, May 3, 2023
In the last 15 years, the number of children, adolescents, and adults identifying as transgender has skyrocketed across the Western world. In the U.S., according to a study from the Annals of Plastic Surgery, there was a 13-fold increase in double mastectomies performed on 12 to 17-year-olds from January 1, 2013 to July 31, 2020. Data from a study by researchers at the University of California, Los Angeles (UCLA) Williams Institute, show that more than 2.8 million people now identify as transgender in the US, including an estimated 724,000 youth. A 2021 analysis by Reuters tallied over 42,000 minors in the U.S. diagnosed with gender dysphoria, about triple the number diagnosed in 2017. This analysis was based on insurance records and is therefore an undercount. The Cass Review also documented the rise in trans identification among youth.
Gender-related medical interventions are irreversible and damaging, and because sex is immutable, they are purely cosmetic—no one changes sex. Puberty blockers followed by opposite-sex hormones lead to sterility and sexual dysfunction. Genital surgeries are high risk, often requiring multiple revisions and leaving patients with permanent physical impairments. Even one person harmed in this way is too many.
Resources:
“Putting numbers on the rise in children seeking gender care,” Reuters, Robin Respaut and Chad Terhune, October 6, 2022
Gender-Affirming Mastectomy Trends and Surgical Outcomes in Adolescents, Annals of Plastic Surgery, Annie Tang MD et al., May 2022
“Headline: When a quarter of the class identifies as trans,” Parents With Inconvenient Truths About Trans, July 7, 2022
“Where is the line? A reflective essay,” Ritchie @TullipR, December 7, 2023
No. Human beings come in two sexes: male and female. Male bodies are genetically programmed for the ability to produce small gametes (sperm) and female bodies are genetically programmed for the ability to produce large gametes (eggs). There is no third type of sex cell, no spectrum of gametes, and therefore no additional sexes. Sex is binary. Those with exceptionally rare genetic variations are still classified as either male or female (see “What about intersex people?” below). Humans do, however, vary in how their secondary sex characteristics (height, lung size and capacity, bone density, skull shape, and so on) develop and overlap. For example, though males typically are taller than females, there are some females that are taller than many men. And of course, there is great variation in the way people respond to culturally-imposed, sex-based stereotypes.
Resources:
There Are Two and Only Two Sexes, Genspect Conference, Heather Heying, January 2024
“Debunking Pseudoscience: ‘Multimodal Models of Animal Sex’,” Reality’s Last Stand, Colin Wright, March 2023
“Is Sex a Spectrum?,” Inspecting Gender, May 6, 2024
Why is Sex Binary, Paradox Institute, May 18, 2020
No. Intersex people prove that genetic mutations sometimes occur that result in changes in the appearance of sex traits and reproductive function of some males and females. The term “intersex” refers to people born with differences of sex development (or DSDs). The term is misleading since it infers that there is a type of sex that is in between male and female, which is not true. Almost all people with DSDs are unambiguously male or female. A tiny minority, 0.018% of all births, are born with ambiguous genitalia. DSDs do not represent a third sex and are not proof that sex is a spectrum. Many people with DSDs object to being included in the “LGBTQIA+ community” because a DSD is a physical condition, not an identity. The vast majority of people who want to be seen as the opposite sex do not have a DSD.
Resources:
“Avoid the ‘Intersex Trap’,” Reality’s Last Stand, Colin Wright, April 11, 2023
“Kids with Intersex Conditions in the Age of Gender Identity,” Part I, BROADview, Lisa Selin Davis, June 9, 2022
Differently Normal, blog by someone “happily living with Complete Androgen Insensitivity Syndrome”
No. Girls deserve their own sports opportunities, as afforded by Title IX (federal civil rights law passed in 1972 that prohibits discrimination on the basis of sex in any federally-funded education program or activity). It is not kind to prioritize the desires of males over the needs of females. Female-only sports exist due to the profound physical differences between the sexes. There is no evidence that taking estrogen or suppressing testosterone overcomes the advantage that males have over females in terms of strength, size, hand grip, twitch muscle fibers, hemoglobin levels, body fat, etc. Some of these advantages exist even before puberty. Arguments in favor of allowing males to compete on female teams are typically and disingenuously framed as allowing “trans kids” to compete. No one is arguing that any boy be prohibited from playing sports, only that they should join the team that matches their sex, or, if a school has one, on a coed team. It is unsafe and unfair to require girls to compete against boys.
See di-ag.org/womens-sports for more information.
No. Males shouldn’t be housed in female prisons because they’re not female. Any male, no matter how they identify, presents a threat to incarcerated women. While most states handle placement of males who claim a woman identity on a case-by-case basis, in other states, any male inmate, even a rapist or murderer, need only claim a "female gender identity," to be placed in a women's prison. There is no requirement of genital surgery or low testosterone levels, and even males who have had genital surgery are a threat to women. Data from 2023 indicate that 47% of trans-identified males in federal U.S. prisons were incarcerated for sex offenses, about 4 times the rate of the general male prison population. Women in prison are highly likely to have suffered from past physical or sexual abuse at the hands of men. Forcing them to share cells, showers, and other facilities with males amounts to cruel and unusual punishment. Males who claim a woman identity may need protection from violent men, but so do other vulnerable men and none are moved to women’s prisons. It is also worth noting that women’s prisons have lower security than men’s prisons, which segregate prisoners by crime (in particular rapists and child murderers). Women's prisons aren't segregated because so few women are rapists and child murderers. Men's prisons can segregate men who think they're women from the general prison population, whereas women's prisons cannot.
Resources:
Women’s Liberation Front, Protecting Single Sex Prisons
Women’s Liberation Front, Chandler vs CDHR (challenging California’s SB 132 which allowed males into female prisons)
Women’s Declaration International, Freedom of Information Act 2023 (state by state analysis)
No. Men, regardless of how they identify, pose a threat to women. The vast majority of sexual violence is committed by men against women. Women have a right to single-sex facilities. Women suffering from the trauma of rape may be fleeing abusive male partners and need the option to recover in a female-only space, cared for by and with other women. This was not controversial until the 21st century when males started demanding access to these women-run safe spaces on the basis of their woman “gender identity.” Instead of placing the desires of males above the safety and well-being of women, men who wish to be perceived as women must seek out or create their own crisis centers.
Resources:
No Longer “Women Only”: How “Gender Identity Ideology” Has Changed Women’s Shelters, a report from Women’s Declaration International, June 2024
“JK Rowling launches support centre for female victims of sexual violence,” The Guardian UK, December 12, 2022
No. While there have always been people who have mannerisms or preferences more common in the opposite sex, the idea that physical appearance should be medically altered to reflect someone’s desire to be seen as the opposite sex is a phenomenon that didn’t occur until the middle of the 20th century. The word “transgender” didn’t exist until the 1960s. Doctors first started experimenting with hormones and surgeries to change appearance in the 1930s.
Trans activists often claim that the fa'afafine in Samoa, the hijira in India, and “two-spirit” people of North America prove that trans identities existed within these indigenous cultures for centuries. In truth, the cultures adopting these concepts were extremely patriarchal and homophobic. Designating homosexual males as a third and separate category or as a type of female enabled these societies to maintain the integrity of the male category, unsullied by insufficiently masculine males. Contrary to activists claims, these categories are proof of misogyny and homophobia rather than ancient wisdom recognizing a non-existent third sex. Coined by both Native and Non-Native participants at the Third Annual Inter-tribal Native American, First Nations, Gay and Lesbian American Conference in 1990, the term “two spirit” was developed to replace a derogatory term for gay males. The term is criticized as a Westernized invention that doesn’t reflect cultural traditions—the idea that a person holds both male and female spirits is not part of Native Americans/First Nations tradition. Using a modern western lens to interpret indigenous culture reeks of colonialism!
No. Gays and lesbians were discriminated against because people were uncomfortable with the idea of same-sex attraction. As a result, homosexual behavior was criminalized and homosexuality was considered a mental disorder. Physicians used therapeutic and medical interventions to attempt to convert homosexuals to heterosexuals. There is tremendous shame and resentment about these practices. The fight for gay rights was about decriminalizing sexual relations between consenting adults, depathologizing same-sex attraction, and giving homosexuals the same rights as heterosexuals.
People with a “transgender identity” demand that others perceive them as members of the opposite sex. This requires that others must believe that people can change sex and/or accept that the words “woman,” “man,” “girl,” and “boy” no longer relate to the sex of adults or children. Rendering these words essentially meaningless results in the homophobic erasure of same-sex attraction—a female in a relationship with a trans-identified male becomes a lesbian, making that term and concept now equally meaningless.The fight for “trans rights” is about allowing “trans-identified” people access to the spaces, opportunities, and honors afforded to those of the opposite sex and providing tax-payer funded access to harmful medical interventions. Activists' demands extend to controlling speech by requiring others to use preferred pronouns, an idea incompatible with the First Amendment. Though often framed as the newest frontier in civil rights, 21st century trans activism is authoritarian, regressive, and seeks rights granted to no other groups of people. Same-sex attracted people don’t demand that others hold particular beliefs. And of course gays and lesbians don’t lobby for taxpayer-funded cosmetic surgeries.
Resources:
No. “Exploratory therapy” (the therapy previously known as therapy) is the time-tested first step to resolving mental distress. Clinicians who don’t explore the reasons for a patient’s distress are abdicating their duty. This is particularly true for people who may want medical interventions with serious consequences including, for trans-identifying clients, irreversible physical changes, lifelong medication that introduces dysfunction and illness, and high-risk surgeries. By referring to any psychotherapy as “conversion therapy,” transactivists are invoking the shameful and throroughly discredited practice of gay conversion therapy inflicted in the 20th century which consisted of horrific practices ranging from electroconvulsive shock to lobotomy to corrective rape. Grouping exploratory talk therapy with these barbaric practices is a profound category error and is manipulative to the extreme.
Resources:
“Affirmation OR Assessment,” Genspect, February 2025
Yes. The U.S. has many urgent problems. But central to a healthy, functional society is the common belief in objective truth. Those promoting the denial of binary sex and the elevation of personal truth—including the belief in “gender identity”—over objective evidence have stifled debate and exacerbated the divisiveness and polarization that interferes with our nation’s ability to solve priority problems. This subordination requires censoring speech to facilitate implementing unpopular policies and practices, like allowing males into female spaces or categorizing references to someone’s sex (aka “misgendering”) as discrimination.
Our major institutions—schools and universities, medical associations, political parties, courts, and media—have adopted and promoted this ideology and the associated medical pathway. As a result, trust in these institutions has declined. We need strong and trusted institutions to advance our understanding of, and ability to mitigate, climate change; to tackle income inequality; to improve health insurance; to get big money out of politics; and to address the many other issues that are important to liberals. Institutional trust declines (and the Democrats bleed voters) when:
people lose their jobs (and in some cases, custody of their children) by refusing to agree that there are more than two sexes or that people can actually change sex
parents discover that their young children are being taught that their bodies are irrelevant to their sex, or that their child’s school has hidden an opposite-sex identity
formerly top-tier science magazines and journals try to burnish ideological claims that sex is more complicated than gamete size or publish poor-quality, easily-refuted studies that support the medical pathway while not publishing rebuttals
women’s sports are open to any male that claims to be female despite the well-documented advantages of males starting even before, but accelerating quickly after, puberty.
To reestablish institutional trust, preserve our liberal principles, and advance liberal policies in the U.S., we must abandon all support for gender ideology.