Activism, Biology, Culture Wars, Feminism, Health, Identity, Regressive Left, Sex, Top Stories, Women
Published on December 18, 2020

Like It Or Not, Keira Bell Has Opened Up a Real Conversation About Gender Dysphoria

written by Quillette Magazine

“I look back with a lot of sadness,” says Keira Bell. “There was nothing wrong with my body. I was just lost and without proper support. Transition gave me the facility to hide from myself even more than before. It was a temporary fix.”

In the debate about transitioning children who experience gender dysphoria, Ms. Bell’s case represents an important turning point. Ms. Bell, now 23, was 16 years old when she presented to the Tavistock Centre in London, which runs Britain’s Gender Identity Development Service. In a landmark ruling delivered earlier this month, a British court upheld her claim that she’d been rushed through gender reassignment without proper safeguards. In addition to receiving treatments that left her with facial hair and a deep voice, Ms. Bell had a double mastectomy at age 20, and now faces a host of possible long-term side-effects, including infertility. As a result of the court’s judgment, Tavistock has suspended referrals for puberty blockers and cross-sex hormones for young patients. Treatment will remain available, but new cases now will be subject to court authorization.

In a separate development, it’s been revealed that Tavistock has spent the last nine years sitting on 2011 study results that appear to contradict some of its oft-stated claims about sex reassignment. The puberty-blocking drugs often administered to dysphoric children—Gonadotrophin-releasing hormone agonists (GnRHa)—were developed in the 1980s for anti-cancer applications, and received scant medical scrutiny before being widely prescribed on an off-label basis to transitioning children. It is gratifying to see that prominent media are now calling for a broader inquiry into the clinics that have been rushing children through these often irreversible life-altering regimens.

As the data belatedly released by Tavistock itself show, blocking puberty is associated with a variety of adverse medical outcomes. This is hardly surprising, since puberty is a critical development period for many parts of the body, from the reproductive organs and skeletal system to the brain. In particular, puberty is a critical period for the development of strong bones that help prevent fractures and osteoporosis in adulthood. From a medical point of view, artificially halting puberty is a dangerous shot in the dark. Yet endocrinologists and other medical experts who’ve raised the alarm about puberty blockers in recent years have routinely been smeared as transphobic. We know of no other area of health policy in which alerting the public to clear and well-established health risks (among children, no less) is stigmatized in this way. Indeed, the British court’s judgment regarding Ms. Bell has itself been assailed as transphobic—including in an error-riddled piece that appeared in, of all places, Foreign Policy.

The policy reckoning we are now beginning to observe has been a long time coming. And Ms. Bell’s role is an important one, as trans activists have long sought to discredit or ignore the growing ranks of desisters—those, such as Ms. Bell, who once presented sincerely as trans, but later reverted to an identity consistent with their real biological sex. Even media that formerly had toed the progressive line on the issue of gender dysphoria are now finding the courage to run articles about vulnerable girls—many of them autistic, depressed, or socially insecure—who suffer regret after a period of trans self-identification.

“Early last year, my teenage daughter told me she was trans and wished to transition to being male,” wrote an Australian mother earlier this week, describing a daughter who’d showed “absolutely no sign of being unhappy with her gender until her early teens.”

“I am not conservative—in fact, I despise most of the items on the right-wing wish list,” she added, (correctly) anticipating the claim that her expression of concern on this issue would mark her as a presumptive transphobe. “But I believe that it is too easy to get medical treatment for children to change gender. In our experiences with healthcare professionals in this field, it seems the current approach is to assume that all patients are genuinely transgender and the only path for them is to physically transition… Transgenderism has now become fashionable to young people. I work with teenagers, and know them very well. It is normal now for 14-year-olds to say they are non-binary, gender fluid or pansexual. At that age, it’s often not really possible to understand what those things mean, and all the complexities involved.”

Needless to say, this article, which appeared in the Sydney Morning Herald and affiliated publications, was attacked on social media as not only transphobic, but also “appalling,” “harmful,” and even “violent.” Such scathing hyperbole has become the norm in the face of so-called “gender critical” dissent. (Twitter, in particular, has become the central rallying station for those who seek to suppress debate in this area.) And in many cases, “gender crits”—or “TERFs,” in the jargon of the truly woke—have been deplatformed and physically threatened.

Until recently, this phenomenon attracted little in the way of critical attention in mainstream media and politics—even from feminists who, one might think, would oppose what amounts to a program of female-to-male conversion therapy for adolescent girls (many of whom, upon desistance, turn out to be lesbians). This is largely because influential gender activists have successfully promoted the claim that any critique of their movement amounts to a form of potentially deadly psychic injury upon trans people, and so must be suppressed. In 2019, a Guardian employee who quit after the newspaper published ideologically diverse voices on transgender issues claimed that remaining on the job would require sharing a workplace “with people who are denying my humanity.” More recently, staff at Penguin Random House Canada objected to the publication of Jordan Peterson’s new book on the dubious claim that he’s “an icon of hate speech and transphobia.” Similar campaigns have been launched against Joe Rogan and Abigail Shrier, invariably under the conceit that the very lives of gender dysphoric individuals hang in the balance.

The aforementioned Australian mother—who stands accused of serving up “a slew of damaging, baseless, and utterly transphobic declarations,” and “a horrifying reminder of the often covert transphobia that still operates within our society”—offers a typical case study. On Twitter, a La Trobe University lecturer named Yves Rees specifically called out Gay Alcorn, the editor of Melbourne’s the Age newspaper, which had been among the outlets that had published the article in question. On that very thread, Ms. Alcorn agreed to delete the article from her site—not on the basis that anything in the article is factually incorrect or libelous, but rather on the basis that it causes “harm.”

The precedent that the Age sets is a damaging one. As this case shows, terms such as “harm” have become so misused in this debate that they now have become meaningless. Indeed, applying similarly vague definitions and apocalyptic rhetoric, one could equally discredit any published opinion, on any controversial subject—as all arguments, to some extent, are intended to support one side of an issue and argue down (or “harm”) another.

As the case of Keira Bell shows, the real harm at issue—the kind exacted by a scalpel, not words—very much serves to buttress the gender-critical side of the ledger. And the emerging data is staggering. Sweden’s Board of Health and Welfare has confirmed a 1,500 percent rise between 2008 and 2018 in gender-dysphoria diagnoses among teenage minors, a phenomenon that has caused even this ultra-liberal Scandinavian country to shelve plans to lower the age of sex-reassignment surgery. In the United Kingdom and Australia, demand for gender reassignment services is also surging. And the fact that the pattern is most pronounced among American girls, not boys, is consistent with Brown University researcher Lisa Littman’s published research on the effects of peer contagion within adolescent female social networks.

While Prof. Littman’s research into what’s now termed Rapid Onset Gender Dysphoria (ROGD) has been published in a peer-reviewed journal, there remains a lingering sense in progressive (and even centrist) media that ROGD isn’t something polite people are allowed to talk about. Rather, gender identity is cast as something akin to a soul-like essence, whose nature cannot be challenged. This helps explain why many desisters, including Ms. Bell herself, have become loathed Judas figures­­­ within radicalized portions of the trans activist community: Their desistance testimonials completely demolish the conceit that social and psychological factors aren’t at play in a child’s construction of identity. It’s notable, for instance, that the CBC, Canada’s national public broadcaster, hasn’t run a single story on Ms. Bell, while somehow finding plenty of space to lecture Canadians on the dangers of “deadnaming” a Hollywood celebrity.

Make no mistake: Gender dysphoria is a very real condition, albeit one that affects a small share of the population. And in some cases, dysphoric patients who go through a proper regimen of mental-health screening really do go on to benefit from transition. Here at Quillette, we are fully aware of this, as we often feature trans individuals on our podcast, and publish their own detailed accounts of transition. We also acknowledge that trans individuals deserve to be treated with dignity and compassion, and should be heard when they raise concern over incidents that genuinely may be described as transphobic. But the idea that children are never mistaken in their own self-diagnoses, including in regard to gender, has always been preposterous—especially in the case of children who experience trauma, depression, an autism spectrum disorder, or any of the other conditions that are comorbid with dysphoria.

Exactly five years ago, the Centre for Addiction and Mental Health (CAMH) in Toronto announced it was “winding down” its gender-identity services unit on the grounds that the presiding psychologist, Dr. Ken Zucker, was failing to adequately affirm the gender identity of children who claimed to be trans. His ouster was lauded by local activists, one of whom claimed in the Toronto Star that Zucker’s moderate approach was linked to a “staggering rate of suicidal behaviour,” and was “inconsistent with provincial and international human rights guidelines.” Such claims turned out to be outrageous smears, as Jesse Singal richly documented in a 2016 New York magazine article. And in 2018, Dr. Zucker won a US$450,000 judgment against CAMH, which “apologize[d] without reservation.” Dr. Zucker also sued the Toronto Star—along with Jake Pyne, the activist who’d libelled him in its pages—and settled with them on undisclosed terms.

But Dr. Zucker’s legal win wasn’t nearly as widely reported as his original termination, since few public figures were eager to admit that his clinical methods, which emphasized “watchful waiting” instead of instant affirmation, hadn’t actually been discredited. And to this day, many activists reflexively denounce any form of medical “gatekeeping” that keeps dysphoric children from easy access to pills and the operating table; and instead advocate for a model of care that casts children as “clients” who should be allowed to “access hormone treatments and surgical interventions without undergoing mental health evaluation or referral from a mental health specialist.”

If such views were expressed in regard to any other serious medical or psychological issue that involved children being prescribed powerful drugs on an off-label basis—depression, ADHD, anorexia, anxiety—journalists would rightly be raising hell. Instead, most just stare at their shoes.

In a democratic society, adults generally are free to do with their bodies as they please. But minors have always been another matter. We typically do not allow those under the age of 18 to consent to vote, or to receive a gun license, or even to get a tattoo. And years from now, when this period of gender-based social panic has receded, academics and reporters will seek to examine how, on this one very specific issue, we allowed public policy to be hijacked by those who seek to rush children into risky and often dubious medical interventions that many later regret. When that happens, it will not only be doctors and politicians whose actions will be judged, but also the journalists, at the Age and elsewhere, who chose to prioritize ideological fashion over journalistic integrity and the well-being of vulnerable children.

Featured image: Keira Bell, childhood photo, screenshot from video.