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To Escape the Body: A Review of Helen Joyce’s Trans: When Ideology Meets Reality, pt. 3 – How Transgenderism Harms Women And Children

Part 1 – The History of Transgenderism: r/theschism, r/BlockedAndReported, themotte.org

Part 2 – the Causes and Rationalization of Transgenderism: r/theschism, r/BlockedAndReported, themotte.org

Part 3 – How Transgenderism Harms Women And Children: r/theschism, r/BlockedAndReported, themotte.org

Part 4 – How Transgenderism Took Over Institutions And How Some Women Are Fighting Back: r/theschism, r/BlockedAndReported, themotte.org

Part 5 – Conclusion and Discussion: r/theschism, r/BlockedAndReported, themotte.org

Last time, we discussed what Joyce thinks are the causes of transgenderism, how they render many or even most trans people as not really trans in the first place, and what gender-identity ideology (GII) says in the first place.

This time, we’ll go over what Joyce sees as the harms of transgenderism.

Think Of The Kids!

Joyce starts by reminding us that there is a fairly high desistance rate among cross-sex identifying kids and this was known since the 70s and 80s. But this is obviously an inconvenient fact for GII, Joyce asserts, so it gets ignored.

I don’t think this is a good start, I think the modern argument TRAs would offer are that you should not stand in your child’s way of deciding their identity, even if they would desist later. Jesse Singal’s famous (or infamous) 2018 Atlantic article highlights the alarming rhetoric aimed at parents skeptical of transition (“Would you rather have a live daughter or a dead son?”), but I don’t know of cases where desistance has been ignored. I do, however, see serious debate between pro-trans and anti-trans advocates on how many desist in the first place.

Anyways, let’s jump to the 1990s. Clinicians at the time began to wonder what could be done to help the kids who would not desist. It was not clear how to identify them, and if you simply waited until they were older, then you ran into a big problem.

Puberty.

Puberty has strong and lasting effects determined by your sex (really, hormones) that cannot be fully undone by surgery. A trans woman who undergoes male puberty is going to have a deeper voice, certain facial features, and larger body (notably hands and feet). Trans men don’t have as many visible leftovers if they transition (barring breasts). But going through this was obviously discomforting to these kids, so why not try to delay puberty and see who desisted?

Thus, Amsterdam clinicians decided to start injecting small groups of kids with puberty blockers. This was predicted to be a free lunch – the kids who desisted would be taken off the blockers and develop as normal, the ones who persisted could grow up until they were 16 and old enough to consent to the irreversible stuff.

Joyce details a catastrophe as the outcome.

Of the seventy children enrolled in a study between 2000 and 2007, every single one progressed to cross-sex hormones. Almost all had surgery at age eighteen…These children were all highly gender-dysphoric, and had not desisted by the start of puberty.

Joyce admits that it was possible the clinic somehow picked out only persisters, but she is highly skeptical of this. If every other study Joyce cited found major desistance, then the more likely explanation was that puberty blockers had disrupted the body’s process for resolving dysphoria.

But the results were taken up with gusto by others, and Canadian and American clinics began prescribing these blockers not long after. UK’s Tavistock was initially cautious, but began routine assignment in 2014 after, according to Joyce, they were pressed by activists.

All this might have been more acceptable if the criteria for assignment were strict, but Joyce says they’ve been assigned more and more to kids with less severe dysphoria and even those who aren’t transgender, but non-binary or gender-fluid.

I’m not sure how to verify the numbers exactly (even Joyce admits we don’t have clear counts). The number is clearly greatly increasing, but it’s not clear if this just reflects that the right number of kids are getting them, or too many are. I will say that she’s correct on the broadening of who can get blockers. The Mayo Clinic, St. Louis Children’s Hospital, and Cleveland Clinic all say that you don’t have be trans, but just questioning your gender to get it.

But is the broadening of the accepted reasons really a problem? Assume for a moment that puberty blockers worked as advertised (no interference with normal desistance processes). Is there something inherently wrong with offering kids who are experiencing discomfort with their gender puberty blockers? One might argue that categories like non-binary or genderqueer don’t exist and are artificially created for ideological reasons, but if they do, I’m not sure what the issue is.

For Joyce, however, the problem goes beyond just kids on the verge of puberty. Pro-trans messaging has come to include the idea that kids from a very early age can indicate their gender. Diane Ehrensaft, Director of Mental Health and founding member of the Child and Adolescent Gender Center, is quoted as saying that kids as young as three years old can indicate their knowledge of their gender.

This is an inversion of John Money’s ideas, though no less highly unconventional. Where Money had argued that gender was malleable in the first 2.5 years of life and then unchangeable, the modern GII argument seems to be that gender is known from birth.

Both, however, would argue for social transition at an early age. This is unacceptable to Joyce because these are always presented as reversible (both transition and blockers), but part of what she calls the “cascade of interventions”. It does not appear that kids tend to desist even if you just socially transition them. The age at which interventions are happening is lowering as well, with some kids getting cross-sex hormones and even surgery before 16.

If you want to see how nasty activists of any sort can get if you question their views, Joyce points to a controversial figure in this discussion space, the man named Ken Zucker. Zucker is one of the biggest names in gender medicine and has seen at least 1500 gender dysphoric kids. He edits Archives of Sexual Behavior but is known for authoring studies which showed the high desistance rates among kids. Zucker even introduced puberty blockers alongside someone else into Canada in 1999.

I won’t detail the entire controversy, Singal has also covered that here here. Joyce, for her part, argues that the campaign to get Zucker taken down was very much to send a message to anyone else who tried arguing like he did.

Medical Issues With Puberty Blockers

Not only is there a dearth of reliable evidence that kids benefit from taking puberty blockers, Joyce argues that there are other side effects that complicate the matter.

  1. Only your natal hormones can make your ovaries/testicles mature.

  2. There is anecdotal evidence that your sex life may be less-than-fully realized.

  3. Puberty, even if partial, is what makes your penis or vagina develop into an adult’s, blocking it can keep your genitalia child-like, leaving not enough skin to do standard reassignment surgery.

  4. Eggs and sperm cannot be frozen for later if they are never active to start with, and they only activate in puberty.

  5. Trans men and women suffer from higher rates of diseases (not the same ones for both).

The drugs themselves are another issue. Joyce claims that they’ve never been put under clinical trials and aren’t even made for that purpose according to the manufacturers. They’re meant for treating adults for hormone-related conditions or to chemically castrate sex offenders. There are concerns that they may cause a significant IQ drop and prevent calcium from being laid down in bones.

From a cursory glance, I think Joyce is correct. Google Scholar doesn’t list too many studies that actually look at the issue, I only found one meta-review, published in 2020. There was also a piece from 2019 in the BMJ that discussed possible issues with even trying to study it from an ethical perspective. Wikipedia lists some adverse effects.

Progress Is A Circle

But there is another effect in promoting transgenderism, and gender-diversity to a lesser extent, in children – the reinforcement of gender stereotypes. Joyce picks Introducing Teddy: A Gentle Story About Gender and Friendship as her example of this, where the titular Teddy becomes a girl by turning his bow tie into a hair bow.

Such stories of children for children are increasing common, and they do not endorse any explanation of a child’s alienation from their sex other than a discordant gender identity. Joyce argues for familiar explanations: homosexuality or seeking (parental) approval.

Thus, it is damning to Joyce that so many pro-trans or trans-inclusive arguments and lessons to children just enforce gender stereotypes that are the product of the culture. Why are these people acting as if these stereotypes were instead naturally implanted into people?

Parents V. The World

Even more damning is how this divides parents from children. Obviously, transphobic parents would always have a problem with any suggestion of a trans child. But with an increasingly harsh attitude towards anyone who questions their child’s identity or the idea of teaching these ideas to children, there are now stories about kids cutting contact and leaving their homes.

There is evidence to support this indirectly, at least one school district in the US said that its staff were not permitted to reveal a trans kid’s status to their parents. This was picked up last year by right-wing media, which is presumably why the district removed the document from their site.

Schools are not the only intervening institution; the government is in on it as well. Joyce refers to a 2019 British Columbia court case involving a 14-year-old trans boy named Max and his father.

In 2016, aged twelve, she was referred to the school counsellor. Unbeknownst to her parents at the time, she mentioned feeling a commonality with the transboy protagonist of a film she had seen online. The counsellor concluded that Max was trans, arranged for a change of name and pronouns in school records, and referred Max to a psychologist, who recommended testosterone and made a further referral to a paediatric endocrinologist.

A consent form was sent to the Jacksons; the father refused to sign…But under British Columbia’s Infants Act, a child of any age has the right to medical treatment that is opposed by parents if the doctor thinks it is in the child’s best interests, and that the child is ‘mature enough’ to decide. In 2019, the supreme court of British Columbia ruled that Max could consent to medical transition independently of the father’s wishes (his ex-wife was no longer opposed). His refusal to refer to his child as a boy, and continued opposition to transition, were ruled ‘family violence’, and he was banned from speaking to the press.

Tangentially, I will note my confusion over this case. The Guardian reported the following:

“I will be stranded between looking and sounding feminine and looking and sounding masculine. I would feel like a freak,” the teenager wrote in an affidavit which was read out in court on Tuesday.

But I don’t know what would cause this. This may just be a teenager not able to speak clearly, but w/o drugs or surgery, how would you be stuck in such a manner? I would understand if Max was upset about looking/sounding feminine while trying to be masculine, but the wording is…odd.

A Threat To (Cis) Women

The elephant in the room for who stands to lose, according to Joyce, is cis women. They stand to lose many things they had once relied upon, not the least of which include single-sex spaces.

You may remember the name Jessica Yaniv if you’re more online. Yaniv is a trans women and trans activist who, in 2018, began asking wax salons if they would wax her genitals. The reporting I find from this time suggests that Yaniv hadn’t had surgery, meaning she still had her penis and testicles. This doesn’t work for Brazilian waxing; testicles are simply too sensitive to some of the techniques. When she was refused, she brought anti-discrimination cases in British Columbia against the women who refused.

Joyce says it was unclear which way the case would be decided. In the end, however, the court ruled that Yaniv was in the wrong and described her as a vexatious litigant who was acting in bad faith and motivated by money over actual discrimination.

Sounds like a victory for cis women, right? No, unfortunately. The court did not decide against Yaniv on the basis of the defendants having a religious right to refuse service, but on the basis that she had made self-admitted racist remarks against them. The defendants were South and East Asian women, you see.

What I don’t quite understand is where Joyce actually falls on this idea of religious freedom to not accept the tenets of GII. Does she greatly support religious freedom in all cases, or just strategically in this one because it happens to support her view that trans women are a threat to cis women?

The more classic problem, of course, is the bathroom question – is it okay to ban trans women from women’s restrooms? Here, I’ll point to there being no evidence that it’s problematic, but this may be because the culture hasn’t really caught up yet. I don’t think we can really extrapolate from the present to the near future.

Joyce, however, goes a different route – crime statistics.

The little evidence that exists shows that at least some of the males who identify as women are very dangerous indeed. Of the 125 transgender prisoners known to be in English prisons in late 2017, sixty were transwomen who had committed sexual offences, a share far higher than in the general male prison population, let alone in the female one.

So either transwomen are more likely than other males to be sexual predators, or – more probable in my view – gender self-identification provides sexual predators with a marvellous loophole. Whichever is true, allowing males to self-identify into women’s spaces makes women less safe.

Of course, prisoners are perhaps not representative of the overall trans population. But I would agree that self-ID is a dangerous thing and shouldn't be the basis by which we decided transgenderism. I would say that it specifically applies to spaces like women's restrooms, but I don't know of any practical way to allow for people to critically evaluate whether someone is trans that also accommodates self-ID.

There’s then a really uncharitable attempt at showing TRA hypocrisy.

Arguing that vulnerable males must be allowed to identify out of male spaces because males are so dangerous undermines any argument that males should be admitted to female spaces on demand.

Obviously, she and her opponents disagree on many things. But it’s not a contradiction if your opponents believe that sex is malleable like gender to also believe that trans women and women should therefore be kept in the same space, segregated away from cis men.

There are more arguments Joyce makes for the preservation of single-sex (basically only women’s) and the dangers of allowing trans women to enter those spaces, but they’re not very interesting or worth expounding on. If you understand the argument that males tend to be more violent, especially sexually, towards females, you’ve read about a dozen or so pages in this book already.

Mods are mean and limit me to 20k characters, check the comments for the rest of this post.

That's all for this part. Next time, we'll go over some more modern history and how some cis women are fighting back against this. Thanks for reading, I hope you enjoyed!

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But is the broadening of the accepted reasons really a problem? Assume for a moment that puberty blockers worked as advertised (no interference with normal desistance processes). Is there something inherently wrong with offering kids who are experiencing discomfort with their gender puberty blockers? One might argue that categories like non-binary or genderqueer don’t exist and are artificially created for ideological reasons, but if they do, I’m not sure what the issue is.

Whats the scenario here? So you have kids who have some sort of gender problem but dont want to transition, and you give them puberty blockers. If nothing changes about their gender situation, what then? Do they just keep taking blockers permanently? I mean, progressivism making people literally not grow up is funny as an idea, but probably not so funny if it actually happens.

And if you dont start out with the idea that normal development is the "good outcome", why would it be a problem if they interfere with desistance? At most you can say that trans people end up less happy. But hypothetically that could change, and the interference remain the same.

The simpler explanation would be that trans women attracted more scrutiny, so of course people who declared themselves to be pro-trans focused on touching women and female-related terms. Trans men don’t seriously threaten men in the same way, and good luck trying to start a mens-rights movement which might be threatened by them.

There are more arguments Joyce makes for the preservation of single-sex (basically only women’s) and the dangers of allowing trans women to enter those spaces, but they’re not very interesting or worth expounding on. If you understand the argument that males tend to be more violent, especially sexually, towards females, you’ve read about a dozen or so pages in this book already.

The feminism is getting in the way of the analysis here: Men dont worry about transmen because whatever they could do was already done by normal women. They demanded to be included in previously male-only spaces, and that those change to accomodate them. But this goes back to "The only allowed reason to not like someone is that hes evil", and so she has to claim this is about violence.

Whats the scenario here? So you have kids who have some sort of gender problem but dont want to transition, and you give them puberty blockers. If nothing changes about their gender situation, what then? Do they just keep taking blockers permanently? I mean, progressivism making people literally not grow up is funny as an idea, but probably not so funny if it actually happens.

I think the idea is that you give them time to make a decision. Perhaps in 6 months, they make a decision and it's now permanent, no buyer's remorse accepted. I have no idea how long you'd assign them.

The feminism is getting in the way of the analysis here: Men dont worry about transmen because whatever they could do was already done by normal women

Why there wasn't really a fight over trans men joining isn't really the point, I think. I'm arguing that trans men don't get any privileges by acting like cis men. The use of the men's restroom is, to use a bit of hyperbole, like a deer entering a wolves den. The only ones at risk I can see are boys who female predators may go after, but that's not nearly as common as the reverse.

Why there wasn't really a fight over trans men joining isn't really the point, I think. I'm arguing that trans men don't get any privileges by acting like cis men.

Those are the same point. They dont get any privileges that way because they already had them as women. If theres any advantages to being a man, weve gotten outraged about and tried to eliminate them a while ago.

They're related, but not the same. I'm arguing about what is, you're arguing about why that is. We're both mostly in agreement over why there's no privileges to be gained by being a trans man.

There's no legal privileges, but I suspect jumping out of the social competition between women is at least a small factor for many trans men. Some people will just never do beauty, femininity, etc. well, and so it saves them some emotional turmoil and anxiety to join the men's rat race, and abandon women's.

Why would you need to be trans for this? You can just not care about your appearance and not spend time with the chick cliques. If youre enough of a nerd to be on here youve probably seen a few girls like that.

I think the idea is that you give them time to make a decision. Perhaps in 6 months, they make a decision and it's now permanent, no buyer's remorse accepted. I have no idea how long you'd assign them.

Wait, what? That's even worse! It's one thing to muse about a hypothetical transhumanist future, where you can change your sex like you change your socks, it's another to ask ~14 year olds make permanent, "no take backsies" decisions about their bodies. Doesn't the idea strike you as completely bonkers?

it's another to ask ~14 year olds make permanent, "no take backsies" decisions about their bodies. Doesn't the idea strike you as completely bonkers?

By that logic, shouldn't 14 year olds be put on mandatory puberty blockers until they're old enough in your view to make permanent decisions about their bodies? After all, the effects of natal puberty are every bit as permanent as the effects of cross-sex hormones and reassignment surgery.

Since we know that puberty is required to mature the brain to its adult capability, and since we know that cognitive abilities that deal with understanding long term consequences only develop with puberty, and since we know that puberty blockers permanently retard brain development - how can we argue for their use? How can a minor without the capability to understand long term consequences consent to a procedure that will permanently retard their ability to understand long term consequences?

You can also throw in that we know that a significant amount of gender dysphoric kids desist after puberty but not those kids who were placed on blockers. So we also have to consider that blockers may not just cause various health issues but may actively be preventing the simplest "solution" to the original concern of dysphoria: desistance.

But a simpler way to put the same argument is that the natural healthy pathway is not on an equal playing field with a totally novel, speculative approach that manifestly has all sorts of costs (financial, social and healthwise), just because a very small (even by the accounts of activists who've probably inflated the numbers) face particular psychological issues dealing with it.

The entire idea that the natural norm is equally as "problematic" seems absurd to me; some weird mix of transhumanist assumptions far too early for their time (basically underrating the damage we can do while overrating our options for controlling development) and the end result of a "queer" philosophy that things it can recenter any structure and make all traditional structures as problematic as deviant ones with a shift of focus. Well, biology isn't just a perspective.

How can a minor without the capability to understand long term consequences consent to a procedure that will permanently retard their ability to understand long term consequences?

Citation needed.

https://www.aacap.org/AACAP/Families_and_Youth/Facts_for_Families/FFF-Guide/The-Teen-Brain-Behavior-Problem-Solving-and-Decision-Making-095.aspx

A very general overview of adolescent cognition

puberty blockers cause IQ drop https://www.frontiersin.org/articles/10.3389/fpsyg.2017.00044/full#B6

and "According to the results obtained through the cognitive evaluations, the patient presented a decrease in their overall intellectual performance after the onset of pubertal block, pointing to immaturity in her cognitive development (Table (Table11)."

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694455/

Nope, try again. You claimed puberty blockers will permanently retard someone's ability to understand long term consequences. Your evidence doesn't back that up. I think you owe us either some evidence that people treated with puberty blockers are permanently unable to understand long term consequences, or else a retraction.

Lower IQ isn't associated with less cognitive ability?

I don't see a reason to treat a natural process we've observed in nearly every healthy human (to say nothing of every other mammal, bird, reptile, or even fish), the same way we would treat a radical intervention that would alter the trajectory of that natural process, particularly when there's no way to externally verify whether or not that intervention is appropriate in any specific case, and we're left to do it on the say-so of a teenager.

So I don't think the same logic should apply.

Do you believe we should ignore the risks of every "natural process", or only this particular natural process?

For example, cancer occurs as a natural result of cell mutations and has been observed in many species. Applying your logic consistently would mean that we shouldn't treat the natural process of cancer the same way we treat interventions to stop cancer, and therefore that the risks of e.g. chemotherapy can't be justified by weighing them against the risks of untreated cancer.

No, like I said I'm in favor of erring on the side of natural processes that are a part of a healthy life. We might run into the philosophical issue of "what is health" in some corner cases, but since we're talking about a process that is necessary for the development of reproductive functions of the body, reproduction literally being one of the defining qualities of life itself, I'd say things are pretty clear here.

We might run into the philosophical issue of "what is health" in some corner cases

Seems to me you're just trying to define your hypocrisy out of existence. Gender dysphoria isn't healthy.

Now, if only we had a way of verifying a teenager has dysphoria, without relying on their say-so...

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Questions over whether teenagers can consent to permanent surgeries are different than questions about whether puberty blockers might be acceptable. I agree that people under the age of 18 should not be allowed to transition, but that might be too young as well.

Then I don't understand what you mean by "they make a decision and it's now permanent".

Let's take a gender-uncertain 12-year-old. They're about to hit puberty and society says that it's best if kids have bodies undergoing the changes associated with the gender.

In this case, our hypothetically perfect puberty blockers might allow this child to come to terms with being okay with their current gender. The desistance takes hold and they don't want to stop their natural processes. So we take them off the blockers and it's all good. But after that, I'd say that stopping puberty as it's happening would probably be a bad idea, but I don't know the science of it. So when they say they want to be the gender assigned to their sex typically, it wouldn't be possible to ask for blockers again. Does that make sense? Or is your objection something else that I'm missing?

Oh, I thought you meant that if they do decide to switch genders, and go on with HRT / surgeries, they have no right to complain afterwards.