I am non-confrontational to a degree that I know is unhelpful. That is one of two reasons it’s been difficult for me to write this piece. The other is that I get stupidly star-struck, when the star in question is someone I believe to be famous for being very smart: say for example Chris Hayes, the host of MSNBC’s "All In" With Chris Hayes, and the podcast Why Is This Happening? with Chris Hayes.
Let’s get it over with: this is how I opened my first ever email to Chris Hayes, in response to his interview of trans ACLU attorney/activist Chase Strangio on "All In," March 16, 2021:
“I write this as a longtime FOCHer (Friend of Chis Hayes), across platforms, who once flew from SF to LA just to be in the audience for the live performance of WITH Pod at the Ace Theater. (And I’d do it again!)
Also, I am the mother of a child who identifies as transgender, and who urges you to cover the stories about trans kids that will dominate the news in the months ahead with the same varsity-level curiosity that you bring to your journalism.”
(Reader, I wish I could tell you I was playing the gushing fangirl card for some tactical effect. I wasn’t: this was me, from the heart. Stay with me anyway.)
This is where I risk losing your sympathy, because my daughter’s story doesn’t track with the narrative delivered tonight on "All In" by Mr. Strangio. I don’t doubt that many trans narratives do, and I am in no way a detractor of human rights for anyone, least of all trans people. The problem is that when we view all trans stories as top-line human rights issues, we accede to the burial of critically important information that would force nuance on a subject whose presentation in the U.S. is aggressively opposed to nuance.
You attempted, gingerly, to let Mr. Strangio give the devil’s-advocate argument to prescribing the drug Lupron to children and adolescents. I don’t blame Mr. Strangio for withholding or evading. It would be bizarre to expect him to give closing arguments for the opposition; but this is the problem. In the interest of not writing a book here: Lupron, prescribed off-label to “postpone” puberty in trans-identifying children, leads in about 100% of cases to those children starting a life-long regimen of synthetic cross-sex hormones, the consequences of which need to be understood. The ones that got my attention are: 1) sterility, and 2) inability to experience orgasm when the patient is an adult.
Advocates for this treatment assert that a child will die by suicide if not permitted to transition medically to the sex that feels right. If true, we can surely agree that being a biological parent, and even normal sexual function, while desirable, should be voluntarily sacrificed if the price is life itself.
Data do not support the suicide assertion. Suicide ideation and suicide attempts are higher among people who identify as LGBTQ, but there is no apparent increase in self harm associated with denial of medical transition.
Lupron is an experimental drug, meaning experiments are being done on children. That in itself isn’t necessarily damning, but it damn sure argues for a lot more public conversation, and that is what trans activists are varsity-level skilled at stifling.
Anecdote doesn’t equal data. I know that, and I value my daughter’s privacy, so I won’t exploit her as the star witness for my case, though she would be extremely persuasive in that role. Instead, I recommend the publicly documented case of Keira Bell, a young Englishwoman who sued the NHS for putting her on a course of drugs that would subject her to the irreversible damage done by Lupron. The British court, unencumbered by both political pressures and, more importantly, market forces, did a deep dive into the psychological and medical data, and effectively ruled that minors in the U.K. shall not be given Lupron except on a case-by-case basis requiring a judge to rule that the severe adverse effects of this treatment are necessary for the child’s survival. Child safeguarding advocates predict an effective end in the UK to an experiment that failed — I was about to say spectacularly, but a better word is miserably. This ruling happened in December 2020, and I don’t blame you for having no idea what I’m talking about, since there is an apparent gag rule on such reporting in the U.S.
There is so much more I could write, but if you’re still reading then I might still have a chance to persuade you to dig deeper, to expand the dialog, and to absolutely give the Chase Strangios a platform, but not at the expense of the less-watchable experts — with no personal skin in the game — who have information of existential importance to children and families which is being actively, cynically, disappeared in our public non-debate.
Respectfully yours,
Jennifer Poyer Ackerman
I sent that email within hours of the Strangio interview. I was shocked and way too flattered to get a reply from Chris less than 12 hours later. He wrote this:
Hey Jennifer:
Thanks so much for the friendly, thorough and thoughtful note. I've actually followed the contours of this debate fairly closely, (including the Keira Bell case) as I think you intuited in some of my questions to Chase. I think I'd put the bills at issue to the side (which strike me as pretty unambiguously bad though you may disagree) and I think there really are some thorny and difficult questions around hormone suppressants for teenagers. But I'll commit to you to continue to cover with "varsity level curiosity" (a phrase I love.) And I hope your child is doing well amidst the madness of this last year.
Best,
-c
To which I replied, true to cringey, obsequious form:
Dear Chris,
Wow, I’m so grateful for your equally thoughtful reply! If you’ll indulge a last word, it has to be this:
Cable audiences, as you know, are siloed. We treat the received wisdom of your hand-picked messengers as settled law, or settled science, as the case may be. I haven’t read any of those bills, and neither has about 100% of the rest of your audience, but now they “feel informed” (ugh, I’m quoting Roger Ailes) and have already moved on, for the tribe has spoken.
I worry most about the chilling effect on the thousands of would-be Keira Bells in our country. We have a coal mine that could really use some canaries, but the detransitioners (most having literally lost their voices already) are maligned, intimidated and thoroughly marginalized by trans activists who regard them, rightly, as an inconvenient truth.
Few people have the power to right this ship and you’re one of them. Thanks so much for listening.
Cheers,
Jenny
I neither expected nor received another reply, but it won’t surprise you to learn that I did re-read the reply I got, more than once. In this case, it was about content, not fandom. I continued to watch "All In" and listen to every installment of Why Is This Happening?, but with an increasingly uneasy feeling when Chris was interviewing trans-activists. If the topic was trans-adjacent, the guest was invariably a trans-activist, and Chris sounded, to me at least, like the obsequious fanboy.
On May 5, 2021, WITHpod featured an interview titled “Treating Trans Youth with Dr. Izzy Lowell.” Dr. Lowell is a medical entrepreneur who runs a telemedicine company for trans-identifying youth and adults based in Atlanta. Her company, Queer Med, prescribes puberty blockers and cross-sex hormones to patients in ten Southern states. Chris's line of questioning was not that of a journalist who was “following the contours of the debate fairly closely.” In his email to me earlier that year he claimed to be familiar with the Keira Bell case, which means these things must be true at the time of this interview with Queer Med's Dr. Lowell:
1. Chris knows that puberty blocking drugs are an experimental treatment that only began being used off-label to treat psychological ailments in the United States in 2007. Prior to that, they have only been used to treat precocious puberty and only for short periods. The evidentiary base on behalf of the safety and efficacy of this sort of care is remarkably thin.
2. Chris knows that teenagers claiming to know they are transgender can be mistaken, as Keira Bell was, and thus may regret taking medical steps with serious and irreversible consequences such as sterility and loss of sexual function in addition to elevated disease risks.
3. Chris knows that the British High Court examined all the available research and concluded that minors, particularly those with comorbid emotional problems, are likely incapable of accurate risk assessment in these cases, thereby ruling in Keira Bell's favor. (Note: at the time of our email exchange, that ruling was in effect, though it was later appealed successfully for reasons of standing.)
Here’s the podcast intro by Chris Hayes:
“There’s this sort of long and gross obsession with the specifics of the biology of the bodies of trans folks: what exactly is happening in the bodies of trans folks ….there’s this fetishistic and gross and dehumanizing aspect of this. In this program, we’ll ask the good-faith questions:
What is the process— how are decisions made?
What is and isn’t reversible?
How this legislation would affect trans kids and their families.
It’s unclear why Chris finds it fetishistic, gross and dehumanizing for me to express concerns about the future sexual health of my trans-identifying teen, but I find that intro painfully offensive. The interview then proceeds to answer none of the questions he listed as the important, good-faith ones.
What Chris said:
[The Right is fixated on] regulating and legislating the lives of trans children in two specific ways: one, a real obsession with sports, barring trans students from participating in sports; and trans healthcare.
What he didn’t say:
I think there really are some thorny and difficult questions around hormone suppressants for teenagers.
Chris asked Dr. Lowell:
What are those consultations like, when you’re talking about 10 or 11 year olds and going on hormone therapy?
Dr. Lowell replied:
“We go through their whole med history, their whole gender history, and in terms of making the diagnosis, quote unquote, even though it’s not a medical problem, in medicine we like to diagnose everything, even if it’s normal. So we quote unquote diagnose gender dysphoria is the medical term for that, for the discomfort of being in the wrong gender. In brief, the components of that are a gender incongruence that’s consistent, persistent and insistent.
[… ] I didn’t know a lot of things when I was 10, or 12, or 20. Um, I didn’t know my sexuality, I didn’t know if I wanted to have kids or not… but I did know what gender I was.
For many of these children, parents bring them in and say, Oh, we’ve known that she was a girl since she was 4. And the child knows that, the parents know that. Everybody knows this child is a girl, she just needs some medical assistance to become a woman. Some cases are a lot more complicated, but in a lot of cases, it’s pretty simple.
Chris doesn’t ask:
How do you go about getting informed consent from child patients? Do you ever feel a patient isn’t developmentally competent to give it?
Or:
Do you believe a male child can literally become a woman, with medical assistance?
Dr. Lowell states:
Puberty blockers, with a few caveats, are almost totally reversible.
Chris doesn’t ask:
What are the caveats? Is “almost totally reversible” maybe not as reversible as we would like?
Finally, on the importance of early sex change, Dr. Lowell offers this observation:
We don’t gender people by their bodies and what parts we have, we gender them by the face. So the face is a major source of having dysphoria and of getting misgendered: it’s dangerous, in fact. If you have someone who is 6-foot-4 and has a really masculine looking face, who is a woman and wants to use the women’s room, they’re gonna get some looks. They might not even be safe.
If you’re wondering: no, Chris Hayes didn’t ask whether there is reason to consider the fears or the safety of any females who might be in the women’s restroom when a 6 foot 4 inch man shows himself in. Nor did he ask what Dr. Lowell imagined this man had to fear from the girls or women he might have encountered there, apart from “some looks.”
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Do you remember how you first became aware of “trans” as an identity label entering into wide circulation? You probably noticed some odd-looking breadcrumbs along the way. Maybe you got to the bottom of a work email and noticed the sender had added “she/her” to her signature. It began happening more often, but you sensed it was best not to think too hard about it.
I remember helping my son move into his campus apartment at USC in 2019. This printed, laminated sign had been affixed to every door in the building complex: hundreds of doors. It was eyebrow-raising for me — thus the snapshot — but, curiously, not for the students I was with (though no one in the building seemed inclined to fill in the pronoun blanks).
Who paid for those laminated signs at USC, and who tacked them up on all those doors?
What made your associate decide to amend her signature, when there was never any ambiguity about her name or sex?
If these small “huh” moments added up, and you became curious enough to try a Google search, you would find that every conceivable result that came back had been carefully curated to help you learn these foundational ideas: transgender Americans were an oppressed minority, plagued by violence and bigotry, highly vulnerable to suicide, struggling for basic human rights and life-saving healthcare against mighty obstacles.
What you wouldn’t learn from Google’s algorithm is that humans cannot change their sex. Or that “gender dysphoria” is a feeling some people say they have, not a medical condition requiring the surgical removal of organs or the chemical prevention of puberty. Or that a whole new cohort of “dysphoric” patients consists of adolescent girls in social distress, being told the problem is their sex, which they can opt out of and then literally start new lives by coming out as transgender — all driven by transgender influencers on Instagram and TikTok and online communities that encourage troubled teenagers to interpret the perennial adolescent issues concerning body image and fitting in as evidence that they are “really” members of the opposite sex in need of pharmaceutical or surgical intervention to become their true selves.
Today, you can search "autogynephelia" to understand the condition that animates many trans-identifying males. Men who call themselves "trans women" sit atop the trans power pyramid, directing the political activities, providing the funding and policing the discourse around "trans rights." I can't prove that the invention of the "trans child" was the brainchild of these men, but I do think "trans kids'" emergence at scale was welcomed as a great gift, in part because the "trans child" serves as a dramatically more sympathetic poster child for the movement than middle-aged men seeking access to women's spaces.
"Gender" has no historical meaning other than as a stand-in for “sex.” The trans movement’s forefathers capitalized on this underemployed word which for centuries had no meaningful work to do, and remade it into a pseudo-spiritual essence. How else to convince a jaded society to accept this audacious premise: that some among us share a feeling so strong and so special that we require a team of doctors, a mandated lexicon all must adhere to, and unfettered access to the private spaces and competitive arenas of all other groups? And while we're at it: anyone who objects will be accused of promoting a genocide.
The gender framework — legal, medical and political — did its initial groundwork in stealth fashion, beginning as early as 1960 and gaining significant ground in the '90s. By the time mainstream America began to notice, around 2016, T had been securely welded onto LGB. Rules and statutes had been “updated” to give “gender identity” legal footing interchangeable with sex; and a whole new medical specialty, “pediatric gender medicine,” had been invented, its mother ship christened in Boston in 2007 to little if any national fanfare.
This scaffolding extended to the targeted lobbying and even infiltration of major medical societies by a brand new advocacy group "identifying" as august experts with the self-granted authority to hand down treatment guidelines for a bespoke condition only they could define. They reserved the right to continuously redefine it as they went along, like proprietary intellectual property. This group's moniker is WPATH: World Professional Society for Transgender Health.
Major funding for all this human progress flowed through a pipeline largely controlled by a handful of well-connected men, including Jennifer (born James) Pritzker and Jon Stryker, scions of vast family fortunes with outsized political influence, and, in Stryker's case, a medical-devices company whose fortunes multiply in proportion to the number of extant gender patients.
The movement's leaders received important strategic advice from the Denton Law Firm (“the world’s largest”) which I’ll paraphrase from a famously leaked memo:
Don’t seek headline-making wins for trans people in case law; rather, find boring, uncontroversial measures such as anti-bullying legislation and work in a minor edit to include “gender minorities” etc. in the protected class. Each time you pull this off, you’ll compound the legal payoff.
This tactic worked like a charm, again and again.
What I am describing is not a conspiracy theory but a complicity theory. First, a niche cadre of True Believers with power and influence (plus astonishing marketing instincts) set about reinventing the human social order to accommodate a shared fetish. An ambitious plan, to be sure, but more group project than conspiracy.
Still, success at scale would require an army of dedicated allies, wearing lipstick or beards but not both, who wouldn’t seek a detailed grasp of the project’s origin or even its precise objectives. They would be driven by one thing: the need to be recognized as a member of Team Kindness. Others would understand their zeal as Kindness Manifested. Skeptics could then be cast as Unkind, even as Right Wing Bigots – why not just say Nazis? – and the movement would flourish.
As Dr. Lowell has likely discovered, “gender affirming care” offers unique rewards and incentives to providers. Gender dysphoria is a novel presentation with no physiological basis, removing pressure on the provider to “cure” anything. It offers high profit margins and imposes no meaningful regulation or government oversight. American gender clinics aren’t even required to report their data to any public health body: the CDC and NIH are not interested, apparently. Activist pressure has led private insurance companies to provide coverage for hormones and surgeries in a large number of cases, making payment predictable and stable. Because “gender medicine” purports to treat a condition that can’t be located in the body, patients tend to be young and healthy when they walk in, reducing exposure to life-threatening complications from treatment. Body modification surgeries, when they go well, might be one-and-done, but hormones are forever.
Given all this upside with no downside permitted to be spoken of, youth gender clinics have proliferated, with medical and surgical sex change services for children and adults generating $1.9 billion in 2021 and projected to grow at an annul rate of 11.2 percent through 2030.
As social media became ubiquitous among children and teens, the adolescent "trans" population expanded quickly, feeding the "affirmative care" pie until it grew big enough for all providers to enjoy a hearty slice, even Planned Parenthood: in states where laws permit it, their clinics dispense cross-sex hormones to both minors and adults on the basis of informed consent. Their multi-page fundraising letters now scrupulously avoid the words "women" and "girls," in deference to the Transgender Style Guide, so as not to offend any pregnant men.
The irony of this, given Planned Parenthood's raison d'etre – empowering women by making them the agents of their reproductive lives, promoting intentional families and thus professional inroads for women– might seem amusing, sometime in the future.
Again, the marketing chops required to make this vision a reality are awe-inspiring: major insurance companies and America’s best hospitals are invested in $1.9 billion worth of procedures annually to alleviate a feeling described by these same doctors as normal, with no disease present. For child patients, the consequences of this medical care include future sterility and lack of sexual function, compromised bone and heart health, lowered cognitive function, and elevated cancer risks, among others. To suggest that maybe this normal feeling could be survived, as it plainly has been for all human history, without experimental high-risk medical interventions, is to reveal transphobic hate, for this is the new definition of “conversion therapy.” Literally arguing to preserve healthy young bodies in favor of rearranging them to simulate a sort of human hybrid, at staggering cost: this inverted definition of conversion is swallowed whole by an unblinking nation murmuring "kindness.".
Sometimes a big new idea feels revolutionary and inspires so much excitement that it takes on a life of its own. History offers examples we can be proud of: the movements for universal suffrage; sustained student protest of the war in Vietnam, the fight for an HIV cure, and for marriage equality. Imagine yourself as someone so dedicated to the struggle that you’ve made it your life’s work, the source of your income on which your family depends. How would it feel to be confronted with evidence of corruption and malfeasance at the struggle’s core — problems so grave that you grapple with going public, as a whistleblower? It’s hard to conceive of a more fraught, no-win situation, and yet it could be made even worse. How? Well, what if a nationally-known television journalist amplified a Twitter mob’s attempt to discredit you?
That is what happened to Jamie Reed, a case worker at Washington University’s youth gender clinic who blew the whistle on harmful, dishonest and unethical practices she said characterized the clinic’s approach to its vulnerable young patients – mirroring, by the way, practices that had recently brought an end to Britain's Pediatric Gender Identity Services. (Something you would know if you followed the contours of the debate closely.)
It would be tricky for activists to malign Jamie Reed as transphobic, given her marriage to a trans-identifying person. Attacks on her professional or personal biography also proved frustrating, for lack of dirt. The Twitter mob was thus reduced to arguing that Jamie Reed must be lying because some parents had written letters proclaiming their satisfaction with their children's care at this very clinic. Unburdened by the facile unseriousness of this attack, Chris Hayes bestowed upon it his blue-check imprimatur.
"Meanwhile, multiple other outlets have conducted dozens and dozens of interviews with parents, employees, and patients and found no corroboration for the very disconcerting and specific allegations in the first report."
2:05 PM · May 17, 2023·77.6K Views
Two things stand out here. First: "multiple other outlets" can't be found. The St. Louis Post-Dispatch published a story attempting to counter Reed's allegations, and then the Missouri Independent published a piece that quoted four parents (two of them officers of an advocacy group for "trans families") and one patient, who all said they were very happy with the Center. So that's two outlets, neither of which proved any of Reed's allegations false — one of which inadvertently published a lot of stuff that looks more like confirmation than it does debunking. Moreover, Jamie Reed never alleged that every family who came to the clinic felt badly served.
Second and more fundamentally: a "whistleblower " is by definition someone who is uniquely willing to come forward, at grave personal risk, when others will not. These "others" may lack the relevant information, or they may lack integrity, or courage. In any case, they all stand to lose something if the claims are borne out. Operating from purely rational self-interest, who would stick his or her neck out when someone else's neck was already exposed?
Also: if there is a safe space on earth for whistleblowers, one would expect to find it at MSNBC, where brave truth tellers are valorized and defended against the bullying and threats of the powerful bad actors they've exposed – for the benefit of all of us! But not this particular whistleblower. Huh.
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My age is a number that starts with F. I've lived most of those years in the Bay Area, and I’m a lifelong Democrat. I can’t condemn people for their casual, reflexive fealty to a cause that is both so weirdly novel and so darkly manipulative as Gender Identity Ideology. If it hadn’t come for my child; if I hadn’t felt the urgency of what would become a compulsive seven-year interrogation, who knows? There but for the grace of Bernie, or whatever. A lot of people I know are devoted to Team Kindness, and not one has a detailed grasp of its objectives, but I still like some of them.
Then again, none of those people is Chris Hayes. While I can suspend judgment for now on a casual friend who chooses not to engage seriously with this topic, I can’t get there with a nationally-prominent journalist who speaks with authority to an audience of millions. I know what he knows because he told me, and I see him repeatedly tell a stylized version of half the story. I can make no sense of this, given the urgency and the consequence of the story he’s not telling.
Which is what I wrestled with in my head for almost two years after our email exchange. During that time, I watched the New York Times tiptoe haltingly back to its former self-perception as a merchant of fact, even facts at which Team Kindness might aim its withering side-eye. I watched 60 Minutes turn stunning and brave by introducing America to the concept of detransition and daringly pulling back the curtain on pediatric sex reassignment surgeries — which “never happen.”
Meanwhile, the stack of inconvenient truths grew so tall in country after European country that a remarkable thing happened – some of the grownups over there looked at the evidence, and the evidence revealed this:
Kids are being treated medically for a condition they contracted online.
Doctors are harming them with experimental treatments.
Kids who aren't medicalized do not become suicidal.
Kids who are medicalized do not show lasting improvements in their mental health.
Trans-identified adults go on to have vastly higher rates of suicide than the general population after transition.
Thus, the evidence base recommending pediatric gender medicine is not there. What to do about this?
Europe did what America will be forced to do, kicking and screaming, eventually. England, Sweden and Finland halted medical sex change for children, or pressed pause as a face-saving gesture that amounts to the same thing. Even at the point of origin, the OG lab that spawned the first Trans Child, the Amsterdam Clinic of “Dutch Protocol” renown, two doctors signed a letter of apology for standing by while the objectively terrible outcomes of their groundbreaking clinical trials were translated to English-speaking audiences as the Next Big Revenue Stream in human evolution. Or assisted de-evolution, as the case may be. (Listen to the whole WITHpod episode for Dr. Lowell's quixotic take on the Dutch Protocol if you're not sufficiently alarmed.)
Not here! Not yet! We don’t give up that easily in America. However many more effeminate little boys in the Heartland who have yet to be affirmatively castrated to suit the aesthetic preference of homophobic parents; however many socially awkward daughters of the Coastal Elite who won’t be mothers because You Tube delivered a trendier, glitterier fix for their punishing self-regard; and however many would-be successful female athletes who worked harder than most of us can conceive of for scholarships and Olympic potential they’ll soon be expected to serve, as if on a platter, to men who aren’t worthy to wash their towels: I don’t only blame Chris Hayes. There is far too much ignominy to go around. Too much reckless abandonment of our duty to think critically, too much reflexive cowering at the idea of moral courage, because what if somebody gets mad? Too much collective shame to think about who will have to account for what share of the damage still to be done. Accountability is for street criminals, not media stars – unless they harass women. I don't think Chris would do that.
Here is the final letter I sent Chris Hayes, after my nearly two-year pause-and-reflect interlude:
This was long so I didn’t read it all but read your exchange with Chris Hayes and his lousy follow up. This is why I stopped watching MSNBC years ago. He doesn’t deserve your respect. Does he ever have a detranser on. ?
This is a great piece, thank you. Life long democrat and I will do my best to hold their feet to the fire.