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Jesse says at the end of the interview that once the right wing came in hard against this stuff it became a huge culture war.

I think that prior to a couple years ago conservatives were not engaged much on this issue, but it was a simmering culture war within liberal spaces. And the trans activists were mopping the floor with us. We were effectively silenced. I was afraid of talking about this IRL with the local political groups I was a part of.

I have been commenting mildly and politely and anonymously on trans articles in NYT and WAPO since 2013. I have had TRA's calling me a murderer, terrorist and Terf for years. I have been told ( in comments only, thank God) to suck their lady dick.

The only opponents to the trans ideology I knew of were politically moderate feminist people like myself.

So you had one side saying "Hey, lets look at this issue with some nuance" and the other side saying "That is literal violence you cunts!"

The small, mean part of me doesn't mind that the TRA's are getting forceful pushback in the same style they have employed for years.

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It doesn’t bring me any joy but I do feel a sense of, “I told you so.”

Well before I did enough reading and conversation to land where I am, I was just an extremely socially liberal woman often referred to as a “feminazi” with a large circle of gay and lesbian friends and acquaintances. And when I developed questions after working with some trans adults and teens, I developed questions.

I got pilloried, obviously. But one of the questions I remember asking is: If I, being who you know I am, have these questions--what in god’s name do you think conservatives will do when they catch wind of this?

If you can’t in good faith wrestle with these questions now, with me, what do you think will happen later?

Just...silence and blocks and admonitions to “educate” myself.

So here we are.

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I was grateful to hear Hannah Barnes interviewed in On Point on NPR. It was better than I'd expected from NPR, being a formerly-devoted listener that hasn't been able to stomach their coverage in recent years. Jesse is more steeped in the issue and does a more thorough interview for sure, but I'm glad I was able to share the NPR interview to my remaining lukewarm friends, because they've probably never listened to Jesse but judge him as harshly, and without just cause, as they do JKR.

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In a few years, after the dust has settled, it's going to be interesting to find out why and how the activists managed to get away with their absolutely vile behaviour. I can't recall any other movement acting this way to general approval.

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The antisemitic movement that wraps itself in "we just want peace for the Palestinians" gets away with everything from murdering athletes at the Olympics, to throwing old people off of cruise ships (and get honored for that with an Opera produced by the Met!) down to stopping Jewish kids from running for student government at UCLA.

And they get general approval from people ranging from [m]Alice Walker to Jimmy Carter to Ben & Jerry's to "The Women's March"

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`murdering athletes at the Olympics'

1972

`throwing old people off of cruise ships'

1985

`stopping Jewish kids from running for student government at UCLA.'

In no way could you connect this to terrorist incidents carried out decades ago. Those operations, by the way, were carried out by different groups and roundly condemned by pro-Palestinian/anti-Zionist groups.

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I was going to mention the murder of Bobby Kennedy, too! I should have.

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1968, perpetrated by a crazy person.

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So should we simply attrubitue the law students (_Stanford_ law students!) who screech at a talk by Judge Kyle Duncan (https://www.nationalreview.com/bench-memos/stanford-president-and-law-school-dean-apologize-to-judge-duncan/) as "crazy people"?

Or for the people who say that J.K. Rowling is "literally killing them" (see https://www.change.org/p/policy-makers-and-leadership-transphobia-kills-kids ) some of whom make actionable threats against her. Are they just "crazy people?" too, to be ignored?

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Likely perpetrated by tools of the American oligarchy. Evidence for crazy person is actually really weak.

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Not exactly what happened. Who condemned the Achille Lauro murder and the 1972 Olympic massacre of Israeli athletes?

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As is pointed out elsewhere in the interview, the medicalization of kids was wildly abnormal with respect to the rest of medical practice (which is hardly flawless!). So yes, it seems strange that he did a "republicans pounce" here. Anyone who actually "believed science" would have been agitating against all of this stuff from the beginning, and some were.

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My sister and I have had our hair on fire ( or at least smoking) since around 2012.

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People who theoretically believe science believe the strangest stuff.

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"The small, mean part of me doesn't mind that the TRA's are getting forceful pushback in the same style they have employed for years." Same.

I've said it before but I've been likened to a Nazi by my actual friends for suggesting maybe it's not so awesome to put men-with-dicks in women's prisons, as well as online accusations of wanting children to die because I think caution is wise when doing treatments on children that may cause them to lose future fertility.

I'm not ashamed of the small, mean part of myself for enjoying watching them squirm as it becomes clear a lot of these treatments aren't backed up by the evidence. They should be ashamed of blindly supporting serious medical interventions on people too young to consent.

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`to put men-with-dicks in women's prisons'

I don't support putting men with dicks in women's prisons, either. What is being advocated for is that transgender women, who have an established, longstanding history of receiving at least HRT (or similar medical intervention) and living as women, and without conviction of a sexual offense against women, not be subjected to the inherently dangerous situation of being imprisoned with men.

Men impersonating trans women are a threat to women (both cis and trans). This is unacceptable and we should be discussing how to protect all women from their predation, instead of singling out certain women (or persons if you prefer) for abuse.

`I think caution is wise'

The bills I am discussing (AL, TN, and IA) don't allow for caution or incremental approaches. After July 1, 2023 medical care for under 18 year-olds is illegal in those states (I think that this is true for MS and SD, as well).

`medical interventions on people too young to consent.'

Some young people know who and what they are; some don't and exaggerate or are confused. You're choosing to sacrifice the health of the former for the latter.

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“Men impersonating trans women are a threat to women (both cis and trans). This is unacceptable and we should be discussing how to protect all women from their predation, instead of singling out certain women (or persons if you prefer) for abuse.”

They’re not women, though. Women are adult human females. Which specific characteristics do “trans women” possess which makes them more like natal women than natal men? (Don’t even waste anyone’s time with “ppl who identify as women,” or “ppl who live as women,” because they are circular, meaningless phrases.

There is no reason to include their concerns with women because they aren’t women. It’s not the responsibility of females to protect males from male violence. You are admitting that there’s no way to tell who is faking being trans, therefore the minuscule number of ppl that may benefit from access to female spaces are NOT worth putting each and every female, including my daughters, at risk of playing “Let’s Be Inclusive!” when their safety may be compromised by the males who, again, YOU admit, are lying about being trans-identified.

There is a far greater risk to a far greater number of girls & women than there is to trans-identifying biological males. I don’t feel the need to apologize for this. Third spaces are the ONLY way forward if safety is paramount. I’m not putting females, including my daughters, at risk by supporting policies for ppl who want validation of their “identities.”

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Also, cis is a term I don’t use. It’s as unnecessary to have a term for ppl that aren’t trans as it is to have a word for people who don’t collect stamps.

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This argument originates from atheist circles (so far as I am aware); even they have stopped using it.

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I could care less what the atheists say. It's an unnecessary word. I see no need to use it in reference to myself to make others feel better about themselves.

It's as dumb as in ADHD circles, which I used to pay attention to more since I'm diagnosed, when they refer to people without ADHD as "neurotypicals" or NTs. I used to use it for a while but then I realized it had a bit of an edge to it, it was setting up a binary (should I have put a trigger warning in for that?), an Us vs. Them scenario. When no, ADHD isn't something I WANT to identify with. It's just something that complicates my day-to-day, but lingering on it & resenting people who don't have it, when I wouldn't mind NOT having it (because who WANTS difficulties with working memory & executive function?). When I heard from the doctor that prescribes my meds about more people being diagnosed w/ADHD, I wasn't happy about it. I wasn't saying "look there, it's just being more accepted now, just like when society accepted left-handed people!" I get the feeling it's being over diagnosed. Getting back to my point here, there's no need to set up the foil of "neurotypicals." People without ADHD are just normal healthy people without this annoying neurobiological condition I happen to have.

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`Women are adult human females'

Please define `adult' and `female' and describe how your definitions can be used to identify and thereby exclude (passing) trans women from many public women-only spaces, e.g., a bathroom that correspond with gender identity?

I've heard of trans men, and known NB people (adult female, in your view), who have attempted to use the women's bathroom and have caused a commotion. As an example, if you didn't know of either person, who would you want walking into the women's bathroom after you at an empty rest stop on the interstate: Blair White or Buck Angel?

`You are admitting that there’s no way to tell who is faking being trans'

I admitted no such thing. It's very easy for me to tell that the Wi Spa flasher is not trans: they don't live as a trans women and have never tried to. It's very easy for me to tell that `Karen' White is not trans (or that it's immaterial): they started `transition' shortly before being sent to prison and don't have a history of living as a trans woman.

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Adult: a person who achieved maturity or legal age.

Female: the sex of the species that produces the large gamete (though females unable to produce said gamete due to life stage or medical conditions are still female). For an organism to be female it needs to have developed along the evolved pathway associated with large gametes - eggs.

" they don't live as a trans women and have never tried to"

What does it mean to "live as a trans woman," and when policies have been initiated by Democrats under pressure from activists that give people no ability to second guess someone's self-ID in the moment, how is anyone given a moment to question whether that person over there is actually "living as a trans woman"?

Also, "passing" is irrelevant. They should use third spaces. "Passing" as an ideal only means "successfully deceiving others about who they are."

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`Adult: a person who achieved maturity or legal age.

Female: the sex of the species that produces the large gamete.'

So far as I am aware production of a `large gamete' or the once ability to produce them is not a prerequisite for entering the women's bathroom. How do you infer these characteristics?

`Also, "passing" is irrelevant.'

Buck or Blair at the interstate restroom?

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Sometimes self ID is advocated for when it comes to prisons which is one of the big issues many have a problem with.

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People self-IDing as trans to escape consequences or to gain entry to women's spaces is a problem! That guy behind the Wi Spa incident shouldn't have been allowed to enter, `Karen' White shouldn't have been in a female prison, and...

Unfortunately the people who seem to be advocating the most loudly for reform see trans people as the problem, per se, instead of the individuals donning a trans identity or non-representative trans people (there are criminals in every demographic, after all).

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There IS no way to exclude Wi Spa guy, for example, by following the rules set forth by trans activists & those who dictate what this is all about. The whole idea of “gender” is that there’s no way to challenge it! This is what Michael Knowles was unartfully getting at: the entire concept is Swiss cheese, incoherent, changed at whims to suit an argument, but malleable enough to take another form when it’s not right.

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`There IS no way to exclude Wi Spa guy'

He claimed a female identity but there is no evidence whatsoever that he was undergoing/underwent transition. Seems like a legitimate reason not to issue him an official form of documentation that states he's female. Also maybe previous convictions should be taken into account?

Maybe self-ID is the problem here but that doesn't mean there's no way to stop people from abusing the system.

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That's certainly not all that is being advocated, as men (or TW if you buy self ID) who began IDing as "women" when arrested or after, often for sex crimes, seem to end up in various women's prisons and the TRAs get mad if you mention this, let alone say it is bad, and the ACLU keeps fighting for this to happen.

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Such people are not trans women, by and large.

If they are earnestly transitioning then I think a few years in a male prison, to ensure a continued and enduring commitment to transition, would be appropriate. Transition can take time many forms and the use of, e.g., HRT wouldn't put them at too much of a greater risk. Continuous monitoring of hormone levels should also be required if they are moved to a female prison.

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The problem with that argument is that being for gatekeeping is considered just as bad as being anti transition these days according to TRAs. If we could (a) go back to earlier and more reasonable gatekeeping, and (b) move away from an affirmation only model for kids, especially girls with rapid onset and autistic kids and kids with various co-morbidities, and not claim that other treatment, including watch and wait and therapy to explore what's going on = "conversion therapy," then there would not be the current disagreement. That Jesse is enemy number one among the TRAs speaks to me of a lack of seriousness in addressing these issues.

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You have to wait to be 18 for loads of things, I don't see the harm here, whereas I see enormous harm from premature transition.

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`I don't see the harm here'

Might that be do to the fact that you're not trans and haven't experienced gender dysphoria to the point that transition is the only treatment that makes sense?

There are probably not a lot of minors with such high degrees of persistent dysphoria that medical transition before majority should seriously be considered but there are some. These laws say that they must continue to suffer until they're 18 because of non-trans minors `playing' with gender identity or being confused about it.

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founding

Hi! 👋🏼 I’ve been over here similarly commenting on the NYT articles since about 2015. We’ve probably “recommended” each others comments many times. Well met!

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I remember starting to notice things were odd in 2014. Every time I tried to look into trans issues, any discussions IMMEDIATELY jumped to how anyone who didn’t 100% agree with them was evil, with no allowance for the slightest discussion. At the time it felt like it was an acceptable way to attack feminists, but then feminists were joining in as well! It was really confusing and I got quite depressed when Stonewall (who at the time I still considered a reasonable LGB organisation) aggressively stated that anyone who didn’t support the TWAW mantra weren’t welcome in the LGB community. I mean it was so bad I was feeling sad when seeing ACTUAL rainbows, and then told myself to get a grip.

I recall going to a Pride day where Ruth Hunt (head of Stonewall at the time) was talking and my brother compared her loud speech on stage berating everyone who didn’t believe TWAW (supported by a vocal group bellowing TWAW nonstop at the front) to a speech by Hitler, which sounds a bit extreme, but you had to be there!

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I can't wait to watch the documentary about all this.

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founding

The bathroom bill drama goes back at least to 2015, which was definitely framed as RW conservatives engaging.

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Bathroom bill stuff was when I started paying attention but I took a pretty normal liberal stance bc... who knows? On the surface I just thought it was more conservative fear mongering. I didn't really get what was going on until a couple years ago

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Mar 14, 2023·edited Mar 14, 2023

> On the surface I just thought it was more conservative fear mongering.

Me too. I feel like conservatives constantly shot themselves in the foot because they're just like "ew trans" rather than understanding actual safeguarding concerns. Why focus on bathrooms when they could have focused on changing rooms, prisons, and seeing a medical provider of your same sex? It would have been way harder for Democrats to fight that.

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It was already pretty toxic back in 2007, when Catherine Crouch's film "The Gendercator" was pulled from the San Francisco Lesbian and Gay Film Festival.

https://www.ebar.com/story.php?ch=news&sc=&id=238433

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And how does the `politically moderate feminist' part of you react to the anti-feminist, conservative Republicans of AL, TN, and IA (likely) stopping, and preventing, the treatment of under 18 year old children who say they are trans?

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I'm also a mother, and a pediatric nurse, and those play a large part in how I see the world.

I don't believe that those bills stop or prevent treatment of dysphoric kids. They stop and prevent experimental treatments that are harming them.

There are always patients who come to doctors, insisting on specific medications and treatments for conditions which they have diagnosed themselves. The most common one is demanding antibiotics for viral infections. Some doctors give in, because these patients can be a real hassle. The good ones don't.

Doctors will tell their patients to avoid going online and diagnosing themselves with things. And yet we have tweens and teens doing just that. They come to clinics having diagnosed themselves and already decided on a treatment. This "treatment" is all about using medication and surgery to make cosmetic changes to the body. They aren't medically necessary, and in fact they hurt the body. There is not one instance where taking cross sex hormones benefits the body. They may cause some cosmetic changes that the patient initially likes, but all the while they are throwing the endocrine system into dysfunction and disorder. Every part of the body is crying out for the chemicals it is supposed to be getting, and instead it's getting hormones that are entirely unsuited for it. It causes a cascade of medical problems that just keep compounding as time goes by.

So the politically moderate feminist part of me reacts with enormous relief to the conservatives of AL, TN, and maybe IA stopping these terrible ill-thought out "treatments".

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Mar 12, 2023·edited Mar 12, 2023

Transgender persons under 18 exist: we know this definitely. Perhaps (most likely) non-transgender persons under 18 are inappropriately seeking treatment in greater numbers now. However, the bills being endorsed by some people on this board will sacrifice the health and dignity of actual, living, thriving trans persons under 18 so as to reduce the number of non-transgender under 18 year-olds receiving inappropriate treatment.

`There is not one instance where taking cross sex hormones benefits the body.'

I don't know how you define beneficial. Taking cross sex hormones can certainly give female competitors an advantage, which seems like a benefit those who engage in this practice. I'm also not sure how alleviation from gender dysphoria, such that a trans person can function and their mental health is improved, wouldn't be considered `beneficial'. There are side effects to the hormones, sure, but it's better than the alternative for a lot of us.

I'm really starting to believe that all of the `think of the children' rhetoric on this issue is really just obscuring the actual intent of those saying it: to prevent medical transition of any person, regardless of age. See, for example, the proposed OK bill that would prohibit insurance coverage of transition-related services. It's certainly the intent, if you read what they say/think, of the legislators writing, and governors who sign, these bills.

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"Transgender persons under 18 exist: we know this definitely."

When you say it like that it implies that these kids are locked in as requiring transition. In other areas we hear people on the Left say that people centered language is more humane, so "people experiencing homelessness" instead of "homeless people." But here we see the opposite. They're not "children experiencing gender dysphoria," we must lock them in as Trans Kids™️, or the much weirder way you phrased it so as to avoid using the word "child" or "minor."

The research that much of the world uses to justify these treatments is based on an entirely different cohort of children, and under entirely different methods of assessment. The Dutch had very long assessments, the kids were more often males (and now it's far more often females), who had experienced distress at their gender from a very early age (the current pool not showing unease until adolescence), and the pool that got treatments then did not have the smorgasbord of coexisting morbidities that the kids seeking treatment today are experiencing. (As Jesse or Hannah notes, people are beginning to question how rock solid the Dutch studies were, for reasons better explained by them).

I'm curious why people like you are so casual about pushing treatments on kids based on evidence that is from a different cohort of kids, which the UK clinicians were unable to replicate in their own studies (2015, I think Barnes said).

We have a whistleblower that the Left is scrambling to defame before the Missouri AG completes his investigation.

We have captured US medical organizations that should be the ones looking to see that the treatments they're using on minors are safe & effective. For any other health condition they would be using much higher standards (like Jesse says, we have activists pointing to reports of increased well-being based on self-selected online surveys as proof puberty blockers work, and we'd never do that with heart medication or cancer treatments).

If the medical organizations were doing their jobs, and doctors weren't either (1) grifter activists like Jack Turban or that odd Florida surgeon that "deletes the yeets" and directly markets to kids on TikTok, or (2) risk-averse normie doctors too scared to question the narrative... we wouldn't have state legislators feeling they have no choice but to put the brakes on.

Reading what you wrote again & I see what this is really about: "There are side effects to the hormones, sure, but it's better than the alternative for a lot of us." Us. Aha. Are you a trans-identified adult? If so, you probably did suffer in childhood. No one suggests you didn't. Your experiences are informative, but they do not justify forgetting everything we know about child development, about how kids aren't able to make these kids of decisions because their brains aren't fully formed until after they're 18. Your experiences don't justify activists using emotional manipulation by bringing up suicide anytime the words "child" and "gender dysphoria" come up in conversation.

If you want these treatments to be available in the long-term, you and others in your community should want a robust body of evidence that supports these treatments, not cherry-picked studies but ones that can be replicated. And perhaps a recognition that one kind of treatment may not be the best option for all of the children experiencing gender dysphoria. Some might benefit from physical interventions, others may benefit from other forms of treatment.

As far as the OK bill, seeing as how much of what we're told is "gender affirming care" seems hella close to elective cosmetic procedures (with more complications, perhaps), it's entirely appropriate for insurance companies, and state medical insurances, to pull back on covering it. Plenty of us with chronic conditions requiring on-going care (maintenance meds, invasive screenings, etc.) pay plenty out of pocket for our care. Hearing that taxpayers are footing the bill on transitions for convicted rapists & murderers to get free breast implants, when I had to pay a hospital monthly for a screening colonoscopy for my IBD for two years (which are covered under Obamacare for screening, but once you have a diagnosis that requires them — SURPRISE! — you have to foot the bill). https://reduxx.info/violent-trans-identified-male-in-washington-womens-prison-given-breast-implants/

Fork that.

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`When you say it like that it implies that these kids are locked in as requiring transition.'

I believe that some people, including young minors, would benefit from transition over other therapeutic approaches. This is based not only on my own experience, desperately wanting to avoid transition, but also my reading of the literature, which shows that gender dysphoria is a long standing issue for some people that is resistant to other treatment modalities.

`Are you a trans-identified adult?'

Are you a cis-identified adult? That seems kind of insulting, right? Because you know that you are cis (not trans). I don't identify as trans; I am a transgender woman.

`your experiences don't justify activists using emotional manipulation by bringing up suicide anytime the words "child" and "gender dysphoria" come up in conversation.'

Of course my experiences don't justify this and I've never advocated for this argument (online or IRL) because I don't believe it's true. I made it through childhood and a lot of my adult life without resorting to suicide over gender dysphoria. That doesn't mean that I didn't experience a lot of pain and shame, which I would not like other people to experience, or that others won't harm themselves.

`perhaps a recognition that one kind of treatment may not be the best option for all of the children experiencing gender dysphoria. Some might benefit from physical interventions, others may benefit from other forms of treatment.'

Obviously not all gender dysphoric minors require medical intervention. Desistance is real and different levels of dysphoria require different treatments. The point is that these bills do not allow for a wide array of treatments.

`or the much weirder way you phrased it so as to avoid using the word "child" or "minor."'

I didn't write the bills! They disallow medical treatment for all persons under 18. Certainly I can say minors but I won't say children or child, which is a framing by the authors and supporters of these bills to obscure the extent to which they wish to control the lives of people. I appreciate the cognitive and developmental differences of an 8 vs. 16 year old but these bills certainly don't.

`"gender affirming care" seems hella close to elective cosmetic procedures'

Given that a significant symptom of gender dysphoria involves revulsion at one's own body, cosmetic procedures seem like an appropriate remedy. When you say `elective' procedures you make it sound as though we're just trying to get a free rhinoplasty.

`it's entirely appropriate for insurance companies, and state medical insurances, to pull back on covering it.'

Insurance companies aren't the ones making decisions: the legislature is stipulating what they cannot cover.

`Plenty of us with chronic conditions requiring on-going care pay plenty out of pocket for our care.'

Unfortunately this is true. As a leftist I have supported universal healthcare and/or medicare for all to address this injustice.

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Thank you for writing out your thoughts on this and sharing. I appreciate that it has to be hard because this is very personal for you, and it appears that most of use here have different opinions than you do.

"Given that a significant symptom of gender dysphoria involves revulsion at one's own body, cosmetic procedures seem like an appropriate remedy."

We fully accept that revulsion of one's body in the case of Anorexia means that the mind is disordered. We treat the patient by dealing with the underlying issues that make them hate their body, thinking that it is too fat.

I am not at all sure that there is a "soul", separate from the body. That is a religious belief. And if you don't have this religious belief, that means body dysmorphia is one part of the body hating another part of the body. Which is really fucked up and really, really sad.

I believe the goal of treatment should be to integrate the body and mind to alleviate or eliminate the dysphoria.

I also believe that there are around 4 billion men in the world and so there are 4 billion ways to be a man. Wear whatever you want! Re-name yourself, present yourself however you want.

Insurance companies, as a general rule, do not want to pay for procedures that do not show a robust evidence base of efficacy. And I'm OK with this, even though I know this can be really distressing to patients. This came up a lot for me when I was working with oncology patients who were trying to get into our phase I studies because insurance wouldn't pay for further treatment. It was really heartbreaking, because these people just wanted some hope, some sliver of a chance of surviving. That's a whole other thing I don't want to get into here ( the dubiousness of informed consent in these Phase I trials).

So I think that the bills you mentioned earlier are not good- the legislature should stay out of medical decisions. AND, insurance companies should not be obligated to pay for experimental treatments that are not shown to work. If they do work, fine!

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Treatment of what?

As was raised in this interview, what medical diagnosis is being treated by any of the interventions under discussion in this space?

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Gender dysphoria, which I believe both participants discussed.

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Dysphoria, as such, is an unpleasant psychological state. It is unclear even on a theoretical level that any element of transitioning would actually improve that psychological state. Nor is their any evidence base that supports that it does. Dysphoric mood, when noted in a medical chart, is a symptom of various psychiatric diagnoses (including those related to gender) and is generally treated with psychiatric medication and therapy.

Despite the institutionalization of transgender medicine, the idea that any of it has any actual benefit to the patients is still pure speculation. Obviously, doctors need to have some amount of freedom to offer experimental treatments or the field would never advance, but they should be described as such, and research in this area should have been conducted a long time ago and never really has been. Again, this is not how medical practice normally works.

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I think that most transgender persons vehemently disagree with Dr. Ray Blanchard's explanations for why people transition, but even he has stated and believes that medical transition is helpful.

But thank you for your honesty: you don't appear to believe that medical transition is helpful for anyone, regardless of age, and by embracing these and related bills you're willing to see the government prevent it.

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I don’t know a lot about Ray Blanchard, but if I had to guess I’d say he’s on to something. But whether he believes medical transition is beneficial, or whether you believe it is, are immaterial to the question of whether there is scientific evidence that it is. There are lots of things that non-physicians think are beneficial that are not supported by scientific evidence. In some (I think small) portion of cases, the amateurs are right.

I happen to think that there probably is such a thing as a “true transgender person”, which is to say someone who has an intersex condition that causes some aspect of brain development to essentially switch the person’s brain from developing as one sex to the other. Some people say there’s imaging in support of this, but what I’ve seen is unconvincing. However, I think that technology may enable us to elucidate this phenomenon within the near future.

I also think that it’s at least possible that some aspects of social or medical transition are beneficial for some people, who may have a variety of underlying reasons for transition not limited to the above.

I just don’t think it’s normal or appropriate for an entire industry of specialty clinics to be rapidly performing medical and surgical interventions before any good quality research on the conditions or the interventions has been done. I also point out with regards to these bills that receiving non-evidence-based medical and surgical treatments is not a right, nor is performing them. Physicians are empowered by the people through their elected legislators to practice medicine. If the people through those legislators wish to restrict or rescind that power, it’s their call. As a profession, I don’t think getting regulated in this way reflects well on doctors, but it’s on us to regulate ourselves first and we haven’t done that.

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I realise this is likely a painful and very personal topic for you, but if you genuinely think we are talking about just not treating children with gender dysphoria you should probably read Barnes’ book.

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Mar 12, 2023·edited Mar 12, 2023

It is a painful and personal topic for me: I grew up not knowing what I was (not a lot of trans-awareness in rural IA in the 80s/90s) but knew that I was different enough to feel deeply ashamed and that I had to keep it secret.

These bills single out, ostracize, and shame under 18 year-old transgender patients. You may believe it's for the best but do not dismiss or forget the very real pain you are allowing these people to experience. There is a cost to denying a trans person access to bathrooms and to arbitrarily stopping their doctor recommended, longstanding treatment.

I am familiar with the content of Barnes' book, and I will read it, just as I read Shrier's `Irreversible Damage'. I'm very aware of what's being debated: whether or not medical interventions, and which ones, are suitable for dealing with under 18 year-olds' purported gender dysphoria.

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I appreciate your perspective. I don’t know what to think about the bills, as I’m unfamiliar with the details, but I appreciate another perspective on this thread.

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I think this personalization of an abstract issue is where you're going wrong. I'm not trans, but I am a chronic pain patient. When I see policy measures that crack down on opioid prescriptions, I think many of them are misguided and even potentially harmful. But I also acknowledge the legitimacy of the processes used to enact them, and I don't think that anyone is doing it to personally demean me.

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This is the first time I can recall that I have been moved to tears by this podcast (well, maybe tears of laughter on occasion). And it wasn't anything that Jesse or Hannah said during the interview. It was Jesse's earnest appeal in place of the usually silly signoff: Journalists, please do your job and start asking questions. Clearly he's tired of being the only one doing this important work (one of very few anyway) and taking all the heat for it. "Come on, guys!"

P.S. "Too nerdy for the podcast"? Is that even a thing?

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"Too nerdy for the podcast?"-tees in the merch store now!

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I'm too nerdy for my shirt...

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Mar 10, 2023·edited Mar 10, 2023

Since it's relevant but not in the notes (because I imagine this episode was recorded earlier), here is the link to Hannah Barnes' interview on WBUR's On Point, which seems like a pretty significant crack in the dam of denial at NPR:

https://www.wbur.org/onpoint/2023/03/09/the-inside-story-of-the-collapse-of-the-tavistock-gender-service-for-children

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Yes! I was so surprised to see Hannah Barnes mentioned in my NPR feed, and it was pretty good episode of On Point! I sent a nice email Megna Chakrabarti to thank her for her coverage.

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Thank you. I was looking for that yesterday.

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I’m literally shocked that this was aired.

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In regards to whether the increase in people saying they are trans - if it were solely due to an increase in acceptance and visibility, we would see a lot more men and women in their 40s and 50s. There would be an increase in all ages. That has not happened. Though for sure the increase in acceptance plays a role

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I feel like I’ve seen a small but noticeable uptick in my 30-40 something friends. Mostly men.

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I've seen a huge increase in the number of nerdy, often autistic and/or ADHD men in their 20s and 30s self-identifying as transgender. I know that in discussions about ROGD teen girls are often the focus but when you look at groups of young men who like things like anime, coding, and gaming there seems to be something very similar going on.

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Yep! My on-the-spectrum, coding cousin in his late 20's is identifying as female now. My whole liberal family is hoping this goes away.

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Interesting. But even in that. If you compare the demographics of gay people to trans people - there are huge differences. Like gay people, the younger you get, the more gay people there are but they exist in every demographic in equal numbers for men and women. Not so for trans people. Like there are way more female trans teens than make ones. Way more male 35 year old trans people than female. It is odd

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I posted more about this in this week’s open thread, for privacy reasons.

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Autogynephilia

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Really?! Do you live in NY or SF? I don’t see that, even in Portland, OR

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I have lived in both those places and have an extensive network of ultra-leftist friends.

Many of the real leftists and activists who have been long time organizers and political operatives privately admit that identity politics and gender reimagining is way out of hand. But the younger crowd and the urban progressives who’ve been radicalized in the last 5-10 years are very caught up in it.

There’s more I could say about this, but this is as much as I’m willing to publicly.

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Former DSA member here. I concur. In my local chapter people without some flavor of queer identity were few and far between.

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I have friends who have gone "the Soviets were the good guys in the Cold War" leftist and trans issues are definitely big in those circles. My friends are Xennials but very much into the gender reimagining and identity politics and I now I am very curious about how much of that has to do with the influx of younger activists bringing these beliefs into the movement.

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The pattern over the past 10 years seems to be way more middle aged mtf and way more teenaged ftm. The number of very young kids is going up too but I think it’s still primarily boys as it used to be.

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founding

In addition-- if, in the past, all of the now-trans people were just closeted, why don’t we have an epidemic of suicide in the past that slowly improves as more people come out? Supposedly, hiding one’s transness can lead to suicide, right? And yet we see over the last several years, at least among young people, that both trans identification *and* suicide have increased.

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Jumped the gun on listening to the whole episode, as I've now read the book, and been following Barnes and colleagues excellent work for Newsnight on this and I would hope that this is now a turning point. arguably it should have been this a couple of years ago when they were initially reporting on issues covered in this book.

But reading the whole story, from inception to closure of GIDS in such excellent detail really does illustrate how badly things went wrong. They should never have allowed themselves to get won over so easily by 'the dutch model', Nor ever allowed pressure groups such as Mermaids to apply the whole 'appeal to emotion' on them because all of this arguably contributed a hell of a lot to the rest of the discourse in an incredibly negative way. The road to hell is paved with good intentions and all that.

What is most staggering though that you could have all the evidence in the world and you'll still have people continue to deny anyone has been adversely affected by the 'affirm first something something second' model. Even after GIDS was closed, a British council spent thousands to create 'trans flag' road crossings as a dedication to them. Please, America, catch up, if only to stop providing the idiots in the UK with 'proof' that Hillary Cass is wrong.

As an aside, here's the latest copy of the British Medical Journal - "transgender medicine for young people - too far too fast?" - 'no debate' is over.

https://www.bmj.com/content/380/8374

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People also deny that there’s an “affirmation first” model in practice or an “affirmation-only” one.

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As a pediatrician I’m embarrassed by the idiocy of my colleagues and their utter lack of critical thinking skills. The diagnostic overshadowing is such a huge issue. With the overlap of autistic spectrum disorder and other issues with claiming a trans identity it’s time to really evaluate what’s going on.

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I’m a HS teacher and I have multiple autistic kids identifying as trans, as well as kids with learning disabilities who have experienced recent trauma like the death of a parent, other kids with unrelated chronic health problems. These are troubled kids.

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For sure. The identification as ‘trans’ or ‘No binary’ is most often a symptom of great distress. Not a true identity. This has been a huge embarrassment for my field of pediatrics. So much harm has been done

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I'm grateful to hear from pediatricians, even anonymously, that feel this way. Please know that many parents are eager to see more from your field stepping forward. We are desperate for signs that we can count on the professionals we've looked to for guidance since our children were born. It's been most unsettling to realize in recent years, especially in a blue state, that I'm not sure I can trust pediatricians on this issue. (I know many of you are probably just trying to do your jobs, feed your families, etc.)

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A few thoughts: I thought it was funny that Jesse said, mid-interview: “Would you say it’s complicated?” And by the end, Barnes was saying: “It’s complicated.”

I read the book last week and some of the stories are heartbreaking. One young (gay) man was so severely mentally ill with OCD that he saw imaginary bugs crawling on the walls. He was petrified of leaving his room. The GIDS was so hellbent on transitioning him, they traveled to his home to start the process. Shockingly bad sense. A long-time gender doctor in Scotland said kids like this were common: kids who hadn’t left their rooms in years on hormones. It seems insane.

I also wonder why insurance companies in the US are agreeing to pay for medical procedures and drugs with long-term side effects and complications that someone will also have to pay for, with no good evidence any of it helps patients. That can’t roll on powered by ideological fumes forever.

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It’s incredible. It’s also the only logical move if you believe all or most comorbidities flow from the gender dysphoria. Treat that and everything else should melt away.

That some clinicians believe that--without evidence!!!--is one thing. But if they believe it, they’re doing what they believe is the right thing to help. Which is the really discomfiting part.

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Yeah, I agree that it makes sense in their framing. But! Such severe mental illness? It does beggar belief.

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"[R]oll on powered by ideological fumes" is brilliant!

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Listening to this is the freshest breath of air, really enjoyed this perspective, and I think you both made the moving parts very accessible to the audience.

I was surprised to hear Jesse say in a couple different ways a version of "in any other field, this level of evidence would never be used as evidence to allow for treatment". Indeed "In any other field this wouldn't fly" was a recurring theme and a huge part of the reason why I think the current social milleu plays a bigger part in how the treatment got to where it is than is being let on or is acceptable.

Again, a great listen.

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I don't think the "in any other field..." statement is true, though. A LOT of medical practices have weak evidentiary bases, but many of them are not associated with this level of potential harm. The opioid overprescription "epidemic" was an example that is interesting to look at for the parallels with (and differences from) youth gender medicine.

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It happens a lot in women's health. Doctors still put pregnant women on bedrest for a variety of conditions even though it has not been shown to improve outcomes. They figure it may not help but it can't hurt. Unfortunately, bed rest increases the risk of things like blood clots which are very bad during pregnancy. Not to mention the psychological risks of putting a woman on bed rest when she's pregnant.

For some reason, there are areas of medicine that don't get proper scientific evaluation and scrutiny.

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Women’s health is at the odds and terrifying intersection of “we don’t know because we’ve never bothered to think about it” and “the baby is most important so let’s make you suffer a lot for marginal gains in baby safety that the research doesn’t real bear out.”

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A friend was telling me that her doctor said she could not take any painkillers for migraines when she was pregnant. Even aspirin, even though they use low dose aspirin to prevent preeclampsia and the pain from a migraine can raise blood pressure. I guess aspirin magically becomes dangerous if its use only benefits the pregnant woman and not the fetus.

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Excellent example!

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Gynecology is full of these horror stories- Dalkon Shield, Vaginal Mesh, the push for vaginal births at all costs. It’s like there’s collective amnesia that the medical profession isn’t infallible.

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founding

Yes. I’d also say some psychiatric medicine, specifically antidepressants, falls into this camp as well.

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True that a lot of medical practice doesn't have a sound evidence base, but not like this. There are many cases where studies can't be done for a clinical question that's too specific, or because it's too expensive, or because it's unethical to do the study. We use clinical judgement instead, which we are empowered to do by the laws that grant us our licenses. Medicine came before evidence.

But the medical practice in this area is completely outside of professional norms. We don't even have a sound theoretical basis for most of this work. The basic questions of how to define "trans" clinically haven't been addressed. As the interview points out, it isn't even clear what the indication is for these treatments, or what the theoretical rationale is for doing them.

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Agreed. This is a totally politicized aspect of medical care. If you don’t agree you are a bigot.

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True, and also worth noting that it is perfectly normal for surgeons to decline to do procedures requested by a patient. In the OB/GYN community, there is a debate on tubal ligation and they will refuse to do it in younger women, even those who are legal adults. Apparently the transgender folks have ignored this ethical quandary.

I was once at an ethics conference where a patient was experiencing terrible arm pain, but every test in the book had been done and no cause could be found. He was requesting that the arm be amputated. Even after psychiatric evaluation, the surgeons weren't comfortable amputating a healthy limb because the patient told them to, which is totally understandable from their point of view. Again, the transgender medicine people don't seem to think there is an issue in amputating healthy tissue at patient request.

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Hypocrisy abounds. That insurance will cover hair removal treatment for transwomen but not for women with PCOS is something I've seen mentioned in comment forums.

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And HRT is only prescribed for women until they are in their early 50s, and then it’s stopped due to cancer risk. Transwomen will take it for their entire lives though - so no-one worries about their cancer risk?

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And testosterone is a controlled substance that a lot of regular men would like for “low T” (to be fair, testosterone levels are declining across the population and it certainly can be a problem).

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#notall <3

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I read an article recently, which I currently can't find (I'm still looking) that said that the number needed to treat for gender dysphoric children/youth (or maybe it was adults) was 45. So out of 46 people, 45 would be harmed by the treatment and one would be helped.

https://en.wikipedia.org/wiki/Number_needed_to_treat

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Found it! https://www.thepublicdiscourse.com/2019/11/58371/. It was gender surgeries on adults.

As Regnerus put it, “the beneficial effect of surgery is so small that a clinic may have to perform 49 gender-affirming surgeries before they could expect to prevent one additional person from seeking subsequent mental health assistance.” From https://www.heritage.org/gender/commentary/transitioning-procedures-dont-help-mental-health-largest-dataset-shows

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Jesse,

Thank you for your continued work on this topic. I admire your willingness to speak out against other journalists and activists that have no interest in science.

You and Hannah Barnes are exactly the kind of journalists we need to continue to report on this.

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It would not surprise me if in 5 or 10 years Jesse won some kind of award for his work on this (unless Twitter eventually breaks his brain). I'm convinced the self-ID/radical affirmation model is not only not going to survive, but will be considered an embarrassing scourge relatively soon. The kids will outgrow it/think it's uncool, and evidence will keep piling up that at best, it solved nothing, and at worst, it made things drastically worse. Somewhere in the middle will be just what an exhausting pain in the ass it all was.

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Mar 10, 2023·edited Mar 10, 2023

I appreciated the author's dispassionate (but analytical) take on this issue that I'm, frankly, *very very very and maybe too* passionate about? It's very important for mouth-frothers like me to hear takes like hers, where the reporter tries hard not to jump to conclusions or go into rant mode, but still, you know...tells you what happened LOL? Like, Wesley Yang sometimes gives me that righteous anger feeling but I don't think I can even *have* this conversation in public if I take his tack, or emulate his tone when I do.

I am trying to get to the point where I can talk about this stuff with fellow media liberals without just making them lose their minds with anger and panic, and I think this episode was a good resource for talking points, but also a terrific model for an aspirational tone to take if you're in discussion with rational people who won't bite you LOL.

Worth noting, I think the way to approach this topic generally, when discussing it with "steeped libs," is approaching it from the strategic standpoint: if there's no good evidence to support medical transition for youth, we need it pronto. And if we continue to pursue it as a cause without that evidence, we are placing bets on the reputation of trans people, who will be the recipients of the cultural backlash if the trans wave rolls back next year. The argument that the brand of allyship being peddled right now, particularly by the young, *is potentially harmful to trans people* is not hard to make, and an argument that I think can be made (at least in the real world) with the steeped. What do you think, though? What are some good ways to introduce this topic among the steeped, tacks we can take, that will not necessarily win someone over right away, but plant the seed of taking a closer look at this issue after the conversation is done? And without convincing them you are a Literal Nazi?

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"Mouth-frother" like me, too! How did that happen? How did I go from assuming this was all fine, except for some outlying cases, to wanting to burn the whole thing down? Yes, it's great that Hannah Barnes can maintain a dispassionate and even sympathetic view of the people who did all this, but sometimes I just need to hear Wesley Yang. Yes, I also really want guidance on how to sound gentle and thoughtful instead of enraged and insane when this comes up with normies who don't know anything about it.

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Genuine lol at “sometimes I just need to hear Wesley Yang.” I feel you.

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Lately I’ve been living for Wesley Yang’s Tweets. I still think it’s so weird the TRAs who are always in Jesse’s replies don’t go after him.

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Good question! Wesley tangles with some people but you're right, I don't recall seeing these long back and forths like what Jesse goes through. Possibilities: maybe Wesley has been considered a non-tribe member for so long that they ignore him? maybe Wesley fights back so much more aggressively that they don't want to tangle with him?

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Ooh you hit on something that I see as both "boo-ya" and maddening as hell--I think it's precisely because Jesse can be taken seriously that he is more threatening to TRAs.

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I think you should recommend those you are trying to reach out to, listen to Best Science in Medicine podcast. The podcast has nothing to do with gender health or politics, but it does discuss more mundane medical treatments (like statins and muscle pain issues).

If you listen long enough, you realize that even for the most quotidian health issue, the research and findings are very limited in scope, time and effect.

It may convince some people that medical studies have significant limits.

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Agree totally on all points. Frankly I think what you suggest--"if there's no good evidence to support medical transition for youth, we need it pronto. And if we continue to pursue it as a cause without that evidence, we are placing bets on the reputation of trans people, who will be the recipients of the cultural backlash if the trans wave rolls back next year"--sounds great. I could say that and mean it.

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founding

I really liked her comment near the end about it isn't rational that these people who work at these clinics, don't know each other and represent a range of genders and viewpoints would be motivated in their criticism by transphobia.

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Look at a Slate article by Evan Urquart who is FTM trans and the comments. Most ‘pro medicalization’ don’t even know about Tavistock. Others are in denial. The superficiality of the comments against any kind of deeper analysis is consistent. It’s generally that. 1) the right wing does this so you are right wing, 2) Lia Thomas doesn’t matter becusse you didn’t care about women’s sports before Lia, 3) tjr doctors know what they are doing, and 4) you are just a hater anyway.

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2) Is always funny to me. I didn't care about women's sports before cause I didn't have to, your bullshit forced me to care. I was blissfully ignorant until a UFC male was allowed to crack the skull of a female fighter cause of their self-ID & I thought, "this might be a disturbing trend I need to look into...".

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Yeah, so shallow,. It really all boils down to (4), and that shuts down any rational discourse with theybes.

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I didn't care about the Uighurs before 2019, either.

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It was interesting to hear that internal alarms were ringing, and being ignored, in 2015. I also happened to listen to a podcast of "You Must Be Some Kind of Therapist" today, in which she interviews a Jungian analyst who has been treating de-transitioners for many years. It's not like there wasn't already evidence that long-term outcomes for transsexual patients were not great. How was this ignored, too?

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Just listened to this. Very interesting conversation and I thoroughly recommend.

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Mar 10, 2023·edited Jun 13

Jesse, starting the episode with, “How do you pronounce Hannah Barnes?” was goofy as hell.

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Awwww, he's trying to make up for Katie's absence by mimicking her endearing inability to pronounce anything properly.

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It's pronounced "Hannahnikole"

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An interview with Masha Gessen on trans issues:

https://www.newyorker.com/news/the-new-yorker-interview/what-we-talk-about-when-we-talk-about-trans-rights

What do you think?

I have read a lit of her writing, including some books, and I like her work a lot, but this is weak imo. She hits all the talking points, but without any insight. She references people with DSDs and says you can’t tell their sex, which is wrong. She uses a few examples of cross-dressing women as evidence that trans people have existed throughout human history just as gay people have. I am wholly unconvinced by this point, because those women lived in sexist societies where they HAD to live as men if they wanted careers or the freedom to travel freely, etc. And she makes the strange claim that the gender of a female infant and an old woman are not the same. OK, but they are both female.

Anyway, disappointing and unconvincing.

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My lord. Another reader pointed out that Gessen had her breasts removed because of cancer risk. Here is Gessen in 2008, talking about her mastectomy, saying she hated the thought of removing “healthy tissue” but did it because of cancer risk. https://www.theguardian.com/lifeandstyle/2008/jul/05/familyandrelationships.family

Now she says it was “top surgery” because she is trans. I am so disappointed in her.

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Masha Gessen became myopic and unwilling to see beyond her own ideological circle long ago.

The point where that became obvious to me was when her book The Future of History came out in 2017. It's about Russia and doesn't have much to do with trans issues (though she does manage to shoehorn them in there too). The book was pitched, promoted and lauded as shedding light on the evolution of "homo sovieticus", explaining the grip authoritarianism has on the nation's psyche, how ordinary Russians came to accept their country's slide back into dictatorship and how Putin was able to cement his totalitarian regime. Essential analysis, right? Alas, that book was a window into Masha's own isolation and inability to reach beyond her immediate identitarian bubble. She employed the classic documentary tool of building an analysis on the narrative arcs of several real people serving as dramatis personae. Except that to understand "Russians", you'd probably need to connect with a mix of people from all walks of life (especially those working class Russians we now see embracing Putin even at the funerals of their own sons, those sacrificed to his imperial ambitions) and Masha's protagonists were all well educated, middle class, LGBT, Muscovite children of wealthy apparatchiks and the politically connected upper class. Not only was it obvious that she lazily reached only as far as her own social circle extended but what struck me was that the alternative never seemed to occur to her - because, as she does in this article, why bother leaving your bubble and speaking to those whose motivations you analyse? Be they Russian Putinists or transphobic Republicans, the activists opposing them can tell you all about what's going through those thick heads. Plus, that approach has the added bonus that Masha doesn't have to get anywhere near the deplorables.

It doesn't negate all of her conclusions because she's pretty smart and a good writer but she's sadly incapable of engaging with anyone whose experience of the world differs from her own and that makes her perspective on a lot of issues very personal, subjective and narrow. My point being that it's not fair to be disappointed in her because this is the way Masha Gessen has been thinking and writing about everything for a while now.

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Wow. Beautifully put. I was trying to articulate this yesterday, but gave up and you said it perfectly. Her lazy opinions are so obviously the result of being steeped in her NY queer subculture.

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Just an aside, it never ceases to amaze me how many different insightful conversation offshoots will break out on a given BARpod thread. There's truly a kind of alchemy drawing people here.

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This is very interesting! It really does point to a significant blind spot on Gessen’s part and explains quite a bit

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I read Gessen's memoir about being a carrier of a deleterious BRCA1 mutation and it was pretty interesting. I agree with you that this is weak. She makes a number of arguments that are incredibly weak and doesn't seem to have thought them through very thoroughly. What makes it even more frustrating is that in parts of the interview (like about medical transition) she clearly has thought through it and isn't just repeating the standard line so she is totally capable of thinking about all of this rigorously.

This interview also has another feature I find incredibly frustrating. If I want to know the motivation of Republicans who are trying to ban certain types of healthcare for trans kids, I would not ask an activist who is fighting those bills because the activist is not in their opponents' heads. Activists are likely to ignore what their opponents say and create motivations for their opponents that make them seem irrational and overall bad people. This reminds me of the whole "9/11 happened because they hate our freedom" line. No, 9/11 happened because they were angry at American policy in the Middle East and yes some of the anger may have been because their despotic governments blamed their failures on US policy, but they were very clear about why they did it. You're not going to persuade people or fix the problem if you keep misstating why people disagree with you.

ETA: I wonder how much her treatment for the BRCA1 mutation influenced her ideas. The treatments are removal of the breasts and ovaries along with anti-estrogen drugs. The interviewer didn't really go into that.

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Very thoughtFul reply. I agree with you regarding Gessen’s thoughts on Republican motives. And I have not read her work on the breast cancer gene. Thank you for pointing that out. She says explicitly that she got “top surgery “ for which she paid out of pocket. She never mentions cancer risk. She is strongly implying that she got the surgery because she is trans. But is this a new framing? The lying and reframing I see from some trans activists doesn’t make me trust their self-reported experience.

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"...[M]akes a number of arguments that are incredibly weak and doesn't seem to have thought them through very thoroughly. What makes it even more frustrating is that in parts of the interview...she clearly has thought through"--kind of sounds like Alex Murdaugh's trial testimony.

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Also. Yes. It is possible those women would have lived as women IF they had the same opportunities it is also possible they preferred living as men. But that does not mean they BELIEVED they were men or were in fact men .

I do believe there probably always were trans people. But this increase now makes no sense

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Yes, that’s the recent part that is illogical.

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She (they? whatever) lost credibility with me quite a while ago, maybe it was when she (they?) declared she (they?) was nonbinary. Too bad--I used to think she was thoughtful. Lisa Selin Davis has good commentary on the piece: https://twitter.com/LisaSelinDavis/status/1634722107287388161

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"And she makes the strange claim that the gender of a female infant and an old woman are not the same." Except all old women were once female infants.

I found it weak, too. I think her writing has been better.

She mentioned having a child, and yet if she was a child now & transitioned -- that might not be possible because of the harm done to her fertility.

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I read it. Very silly actually.

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Great interview. I am halfway through the book, but Barnes strikes me the same in person as she does through her writing; that is, not an advocate but an investigator.

I haven't heard of her being smeared on Twitter as a bigot, transphobe, whatever, but I imagine that if that hasn't started it soon will. Argh.

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