Lobotomies and pediatric gender interventions have a lot in common. Both treatments were developed to address forms of psychological distress, have resulted in patient harm, and sparked concerns surrounding informed consent from a vulnerable population.
But the medical community abandoned lobotomies without legal restrictions, while pediatric gender interventions are being wrestled away from “gender-affirming” clinicians by twenty-seven state bans, multiple federal executive orders and the threat of Medicare and Medicaid defunding.
Despite the similarities, the two interventions have one important difference: pediatric gender interventions are rooted in ideology while lobotomies were not. The medical establishment was able to self-regulate and stop performing lobotomies without legal prohibitions after an increasing number of patients suffered poor outcomes, likely because doctors were not ideologically invested in the procedures. Compelling clinicians to alter a practice motivated by deeply-held beliefs rather than objective evidence has proven to be difficult. But the adverse complications are becoming too obvious to ignore.
A growing population of patients harmed by pediatric gender interventions are redirecting medicine away from ideology and back to objective facts. Detransitioners who were deemed by their clinicians to be transgender and subsequently underwent irreversible procedures before coming to realize that their gender distress was due to something else are the truth serum restoring medical integrity. Legal prohibitions, restrictions in funding, and now a two million dollar judgement in favor of a harmed patient are the inevitable result of belief-directed medicine that failed to right itself.
Shaking clinicians out of their transgender fever dream has been challenging. Queer theory believers unquestioningly affirm children’s musings of gender nonconformity, sometimes leading to life-altering gender interventions. They assert gender is a social construct untethered to biological sex. Children who struggle with gender distress are treated as if they are expressing a distinct and authentic identity — despite its departure from biological reality — and one that must be affirmed without reservation.
This confident conclusion conflicts with standard clinical practice that requires an objective evaluation of a patient’s symptoms and, especially in children, a careful exploration of the psychosocial factors that often underlie gender distress. Yet, in many contemporary frameworks, questioning a child’s newly-declared gender identity is perceived as pathologizing gender nonconformity itself, and therefore discriminatory to those seeking to express an inner sense of self.
In 2023 the American Psychiatric Association’s publishing house released Gender-Affirming Psychiatric Care (GAPC), an exhaustive guide to gender nonconforming patients. This textbook recommends medical and surgical transition as appropriate treatment options for patients of all ages with gender distress, even when significant co-occurring conditions — such as autism, eating disorders, substance use disorders, and serious mental illness — are present.
According to GAPC, some gender-affirming clinicians believe an investigation of a patient’s reported gender distress that delays medical affirmation — which would be required for a comprehensive evaluation — is a form of gender-identity discrimination, and even conversion therapy.
Detransitioners who were subjected to irreversible medical interventions that damaged healthy organs and bodily functions are the unfortunate result of this detour away from objectivity.
This isn’t the first time patients have suffered from ideology infiltrating medicine. The eugenics movement is one such example that led to the coerced sterilization of as many as seventy thousand people. Eugenicists in the early twentieth century sought to improve the human race by limiting the reproduction of people deemed to be “feebleminded,” convincing even the U.S. Supreme Court justice Oliver Wendell Holmes, who famously quipped in his opinion favoring the forced sterilization of twenty-one-year-old Carrie Buck, “Three generations of imbeciles are enough.”
Detransitioners injured by gender interventions are a reminder of how ideological capture of medical institutions can lead to harm rather than healing.
March 12 is Detransition Awareness Day — an opportunity for the medical community to acknowledge the dangers of ideologically-driven medicine and reaffirm a commitment to objective and compassionate care that limits preventable injury.
