The Dangers of Gender-Affirmative Care

The Biden administration recently announced a plan to ban “conversion therapy” and dismantle barriers to “gender-affirming care” for transgender-identifying children and adolescents. A few days later, Congresswoman Pramila Jayapal introduced the  “Transgender Bill of Rights” on Capitol Hill which sought to legislate what the Biden Administration proposed to impose by executive order.

On this issue, the Democratic Party assumes the mantle of righteousness. Who could oppose “life-saving” “gender-affirming care”? Who supports “conversion therapy”, which the Biden administration described as “a discredited and dangerous practice that seeks to suppress or change the sexual orientation or gender identity of LGBTQI+ people”?

The reality diverges sharply from the loaded language the Biden Administration deploys, lifting terms directly from the most radical trans activists occupying positions at the outermost extreme of an ongoing debate between different factions of gender clinicians.

The dispute over how best to treat gender-questioning children that the Biden Administration seeks to resolve by enshrining “gender-affirming care” and stigmatising “conversion therapy” boils down to whether or not clinicians regard the children in their care as exceptions to everything we know about child development, human biology, sexual orientation, and more. Attending closely to the language of the activists with whom the Biden Administration has sided provides a masterclass in how to manipulate language to normalise risky and invasive medical intervention on a class of people — children — who are widely understood to be unable to provide consent in other contexts.

What’s changed are the ideas and expectations that we’ve raised children on and the way we’ve turned them loose in an online world whose terrain no one has mapped. Many of these children have grown up with extended experiences of online disembodiment. They may not be free to run around outside with their friends but they’re free to roam the darkest corners of the Internet. Who knows what strangers and strange ideas they encounter there.

These children have grown up hearing a very new and confusing set of fairy tales about gendered souls that can end up in the ‘wrong bodies’. Adults who should know better — adults who do know better — have made these children impossible promises.

Children who identify as trans aren’t sages. They aren’t sacred. They haven’t been endowed with wisdom beyond their years. It’s not fair to treat them as exceptions to the safeguards we place around children, so that when they grow up and change their minds and ask why we let them do this, we say: You wanted it. You asked for it. You were so sure. What else could we have done? 

There’s a way in which everything that touches trans must be exceptional — the children, the stakes, the feelings, the possibility of knowing anything for sure — because if these kids aren’t exceptional, then we threw everything we knew out the window. We didn’t ‘help’ exceptional children but harmed ordinary ones, struggling with ordinary challenges of development, sexual orientation, identity, meaning, and direction.

[emphasis added]