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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,

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

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

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

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

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 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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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 have been some clinical trials, though there's some controversy due to the author funding. Some trials for other uses of the drug do show the bone density problem, but do note the difference in dose: the height trials involve 4 micrograms per kilogram body weight, while I think the FDA's regimen for precocious puberty end up around tenth that unless I screwed up my math. I'm not sure what the common regimen for trans-related stuff is (if a defined regimen exists), but it seems more like the latter than the former.

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.

In addition to the issues on questioning the matter, the politics of misgendering get disruptive and complicated quick. I think a lot of the this reflects trying to manage norm conflicts where the only available tools are an HR or oi-can-I-see-your-license system that isn't up to the task, but the end result of an administrative system that can't tell the difference between is a whole bunch of everyday people that start seeing things through that blurry a lens, too. And then not wanting to out someone publicly or not really understanding the whole thing is treated as a dire insult.

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.

I think it's just been sliced-and-diced by the reporters. I can't find the original documents, and some of the publication ban may prevent them from being posted anywhere I can access, but at least from this reporting:

Claire Hunter, one of the child’s lawyers, argued the appeal should not proceed in part because the child has already taken treatments that are partially irreversible, thus making the father’s core arguments moot.

The boy’s voice has lowered and he has developed facial hair, the court heard.

I've... mixed feelings about starting masculinizing hormone therapy at that age (from other documents, probably 13ish?), but it's not outside of potential scope, and six months to a year would have significant changes. A lot of the most overt are below-the-belt stuff that I'm not getting into in the context of a young teenager, but promoted facial hair growth is a pretty common one, and there's some upper body muscular stuff that's not going to go away quickly if at all. I don't think he's going to turn into an extra from a circus over six months, but it's not something you turn on and off; the kid may not readily present as feminine anymore even if he wanted to.

((This is part of what makes the matter so complicated to resolve through courts: like with issues revolving around abortion or age restrictions on firearm purchases, the time frames are short and the wheels of justice grind slow and not particularly fine. There's been an American snafu regarding a Texan politician's kid that is kinda hard to talk about because he's an asshole even by the standards of politicians, but if you put a gun to my head and made me bet whether the kid's on hormone therapy in a year or two... and it's not like the alternative would be just, either.))