Flat White

Gender dysphoria: scientifically baseless

20 October 2017

7:26 AM

20 October 2017

7:26 AM

The challenge we face today is to maintain rigorous discernment and objectivity despite the concern we all feel when greeted by a “girl trapped in a boy’s body”; a claim which we are witnessing in increasing numbers. The dissonance being created demands enquiry into misrepresentations. To assert that “gender is fluid” when we know that XX and XY chromosomes are immutably determined at conception is not only wrong, it is harmful.

When we see Intersex data figures misrepresented through the inclusion of hypospadias in order to overstate the incidence of Intersex (from 1:13000 to 1:100) we must concern ourselves. Hypospadias occurs in males, is a correctable anomaly of the urethral orifice and is unrelated to gender confusion or intersex. True intersex conditions – such as 5-alpha reductase deficiency and Congenital Adrenal Hyperplasia – are extremely rare. It is most ironic that childhood sex assignments to assist with these rare intersex conditions are being actively discouraged from surgical correction, these children are being asked to accept undetermined sexual identity states. By avoiding the risk of “non-consensual surgical procedures” with its litigious implications, such children need to wait till adulthood for corrective surgery; this will have a negative emotional impact.

On the other hand, by acceding to request for biologically normal children to “transition gender,” we affirm their faulty perceptions and create confusion for society at large. The word “transition” is a euphemism for both disfiguration and infertility. In no other condition do we embark on such life-altering interventions, without high-level evidence of efficacy for the proposed treatments. No randomised trial has been conducted to show that suicide rates decrease amongst those who have had early medical treatments. In the same way, that a person suffering anorexia nervosa assumes that they are fat, a gender-confused child thinks that they are of the opposite sex. By analogy, professionals do not buy into a patient’s disordered thinking about body image in cases of anorexia, and so they would never suggest lap band procedures for them.

According to John Whitehall, Professor of Paediatrics at University of Western Sydney, ‘Up to 90 per cent of children who question their sexual identity will orientate to their natal sex by puberty.’ In view of such a high natural remission rate, it incomprehensible that professionals are now recommending chemical castration with LHRH agonists. Furthermore, oestrogens are used for boys (increasing subcutaneous fat and mammary gland growth) and testosterone for girls (permanently deepening voices and promoting facial hair growth), for the purposes of altering their secondary sexual characteristics. Whilst such treatments carry known detrimental effects, the mental and metabolic side effects for children, have yet to be fully elucidated.


Paul McHugh, Professor of Psychiatry at Johns Hopkins University Hospital, states that his hospital “stopped doing the transgender surgery that they themselves had pioneered.” Writing in the Wall Street Journal in 2014, Professor McHugh quotes a 2011 study Karolinska Institute in Sweden:

The long-term study (up to 30 years) followed 324 people who had sex reassignment surgery. The study revealed that beginning about 10 years after having surgery, the transgendered began to experience increasing mental difficulties. Most shockingly, their suicide mortality was 20 times higher compared to non-transgender people.

McHugh states that transgenderism is a “mental disorder” and that sex change is “biologically impossible”. Furthermore, The American Academy of Paediatricians urges healthcare professionals, educators and legislators “to reject all policies that condition children to accept as normal, a life of chemical and surgical impersonation of the opposite sex. Facts – not ideology – determine reality.” Their position statement further declares: “Conditioning children into believing a lifetime of chemical and surgical impersonation of the opposite sex is normal and helpful is child abuse.”

Many educators and other professionals may unwittingly be exposing the vulnerable to develop further doubts about their normality. Such attitudes leave room for grooming and bullying by perpetuating a victim mentality rather than helping children to celebrate their true and evolving sexual identities. According to Professor Whitehall, many children with gender confusion have been emotionally and psychologically traumatised by domestic issues, including in some cases violence and sexual abuse. It is self-evident that surgery is not indicated for what is a psychological condition. They will accept their biological sex within a relatively short period of time and move on emotionally. Society must not interfere with the positive natural history of this condition with unfounded use of hormonal and surgical interventions. The gender dysphoric youth need caring, informed and supportive counselling. They should not be encouraged to transition to a most uncertain future.

We must address the obvious incongruity. If it is no longer appropriate to operate on Intersex children, how is it that we can we justify physically altering normal children prior to adulthood?

The medical profession needs to resume its leadership role by subjecting this critical area to the full rigour of ethical scientific analysis. We cannot fulfil our responsibility to lead by ignoring scientific evidence in favour of unsupported gender theory. Nor can we allow such word and data manipulation to influence social thinking. The imperative to do no harm is paramount.

Christina Christopher is a family physician, surgical assistant and mother of four.

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