Chloe Cole’s Fight for Evidence-Based Medicine Deserves Respect

The Los Angeles Times published a hit piece on detransitioner Chloe Cole last week, attempting to paint her as a political operative eager for fame and attention. Yet in her zeal to dismiss Cole’s efforts, writer Mackenzie Mays brushes over a key fact: that Cole was failed by her medical providers and misdiagnosed as transgender.

Cole’s story should trigger concern about how such an event could occur, and what steps can be taken to prevent other patients from enduring similar pain. Regardless of Cole’s politics, the pursuit of ethical medical treatment should be a nonpartisan cause, and Cole’s misdiagnosis should offend people of all ideological persuasions.

But Mays never seriously grapples with that fact, opting instead to whitewash legitimate questions about medical ethics and Cole’s own tragic experience as parts of a larger political agenda. She suggests that it is Cole’s own need for acceptance, rather than an effort to prevent other patients from suffering like she did, that propels her advocacy.

Mays glosses over how Cole, who now realizes she was never transgender, came to have her healthy breasts removed at age fifteen. 

Mays dubs the emergence of detransitioners dealing with the aftermath of medical and surgical “gender-affirming” care a “movement,” rather than what they often really are – misdiagnosed, physically-altered, and sterile patients realizing they had other reasons for their emotional distress when they were diagnosed with gender incongruence. 

Detransitioners are no more a “movement” than vegetative lobotomy patients or flipper-armed thalidomide babies. The existence of these patients should spark a closer examination of the system that allowed these mistakes to happen, rather than tossing them aside as political operatives.

As Dr. Hilary Cass and her team report in the Cass Review, the largest systematic review of gender research to date, there is no sure way to determine which children will maintain a lasting transgender identity. Studies show that if children with gender distress are allowed to progress through natural puberty, most will come to accept their biological gender, and many will identify as non-heterosexual.

Contrary to Mays’ claims that detransition is rare, there is no reliable way to measure the detransition rate, and it remains a black box. One study revealed that about three-quarters of detransitioners did not notify their gender clinician of their detransition, casting doubt on reports detransition is uncommon, while another study suggested the rate may be as high as thirty percent. While there are diagnosis codes to track and study gender transition, none exist for detransition, essentially nullifying this patient cohort and rendering them invisible in the electronic depository of codes used for research.

Mays owes Chloe Cole and patients like her an apology. Safe, evidence-based medicine is not a political agenda – it’s what all patients deserve, regardless of gender identity.