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Book Review: Ryan Anderson’s When Harry became Sally

Review of Ryan Anderson’s book ‘When Harry became Sally. Responding to the Transgender Movement’ by Ryan T Anderson. Published by Encounter Books, New York.

Ryan Anderson’s new book “When Harry became Sally” will provoke many in Australia’s feminist and LGBTIQ community: the former because it insists on complementary physiological and psychological differences between males and females;  the latter because it is intended to ‘arm’ with knowledge the ‘ordinary Americans’  who are ‘pushing back’ against the current ‘transgender’ phenomenon which they recognise as ‘a politically correct fad built on a shaky platform’.

Anderson is a Research Fellow at the Heritage Foundation in Washington and his book examines the US ‘transgender moment’ by reference to  claims by its proponents, stories of those who regret transitioning towards the opposite sex, consideration of essential differences between men and women and how they dovetail to raise a family, the current phenomenon of childhood gender dysphoria, and the development of laws that reflect a determination of the state to impose the new ideology of gender fluidity.

Not surprisingly, the LGBTIQ supporting website, ThinkProgress, condemned the book, declaring it reinforces ‘patriarchal views’, is based on ‘junk science’, ‘flawed argument and distorted research’ and has nothing to offer those seeking to ‘understand’ and ‘respond compassionately’ to transgender people.

To the contrary, I believe the book presents a timely, lucid introduction to the current transgender phenomenon and will help readers understand the challenge to traditional values posed by the ideology and practice of gender fluidity. I believe the understanding it imparts can foster compassion for the casualties of the new ideology: that Anderson is sincere when he writes ‘we must be careful not to stigmatize those who are suffering…We must avoid adding to the pain experienced by people with gender dysphoria, while we present them with alternatives to transitioning’.

Simply, the aim of the book is to ‘advocate for the truth’ and this it does.  It is not ‘junk science’ to reassure that the majority of confused children will orientate to their natal sex through puberty. This truth is confirmed by researchers in the transgender phenomenon, and published in the Diagnostic and Scientific Manual of Mental Health. It is not ‘junk science’ to declare no one knows why the current epidemic of childhood dysphoria has erupted and that a behavioural fad is as good an explanation as any, especially as many of the children also suffer from mental co-morbidities such as autism. It is not ‘junk’ to conclude that children submitted to the care of gender dysphoria clinics appear to progress inexorably up an escalator of intrusive medical care that begins with social transitioning, progresses to chemical blocking of puberty, and then administration of cross sex hormones. How many alight from this escalator before the final stages of irreversible surgery and castration is unknown.

One flaw of the book is that it does not reveal enough of the side effects of the stages of ‘treatment’. It describes the psychological predicament of a child entering puberty after years of being addressed, dressed and identified as the opposite sex, and the likelihood of continuation to the next stage of blocking that puberty with chemicals.

It mentions some effects of blocking the complex process of physical and psychological changes of puberty but neglects the work of veterinary and other scientists in Europe who have demonstrated profound and lasting alteration in the limbic systems of pre-pubertal sheep administered puberty blockers for only a matter of months. The limbic system coordinates emotion, memory, and cognitive function and leads to appropriate ‘executive function’. Sheep were permanently harmed by blockers. Yet proponents of their much longer use in human children argue the chemical postponement of puberty will enable children to consider their procreative future with greater clarity. Proponents claim the effects of blockers are safe and reversible despite mounting evidence one of the blocked hormones plays a role in maintaining the integrity of nerve cells throughout the body.

Nor does the book consider the effect of cross sex hormones on the growing brain despite evidence that oestrogens administered to an adult male for only months lead to shrinking of the grey matter at a rate ten times greater than ageing. Testosterone administered to females leads to hypertrophy of the grey matter after a similar time. It needs to be emphasised that children seeking the identity of the opposite sex will need its hormones for life.

Nor does the book consider details of the last phase of transition which is surgery to remove breasts and to fashion the urogenital system towards that of the chosen gender. If the cross-sex hormones have not castrated the patient by this stage, the knife will complete the process.

Given the majority of confused children will revert to natal sex, and the side effects of forcing them into the opposite mould, Anderson concludes with a plea for the creation of a ‘network of clinicians who are ready to help those with gender dysphoria in ways that don’t endorse transgender ideology or aim to change people’s bodies’. To the doctors he adds therapists, scholars, religious leaders, lawyers and politicians.

Anderson’s plea is for a compassionate middle path between the extreme of behavioural coercion of the child back towards its natal sex and that of chemical coercion towards its opposite. He describes a compassionate middle path of ‘regular psychotherapy for the child and parents (for mothers may often have predisposing disturbance), parent guided interventions in the naturalistic environment (which might comprise increased socialisation with members of their own sex, and limitations on cross dressing) and, when required, psychotropic medication for other problems such as depression and anxiety’. The idea is to try to find the problems at the root of the child’s confusion in order to help it become comfortable with its chromosomal destiny.

Statistics reassure this conservative approach of ‘watchful waiting’ will be rewarded by the majority of children reverting to natal sex and heterosexual orientation through puberty. Of the rest, studies reveal most will still revert to natal sex but with homosexual orientation.  The approach presumes such a homosexual life style is preferable to a transgendered one based on brain and body altering chemicals, intrusive surgery, and sterilisation, all maintained under a life time of medical supervision.

In his plea that therapists may commit or be allowed to pursue the middle path, Anderson is optimistic if not deluded. He is neglecting his preceding chapter ‘Policy in the Common Interest’ in which he reveals the relentless progress of the American state to impose the new ideology of ‘gender fluidity’ on its unwitting citizens. Graphically, he describes ‘gender identity antidiscrimination laws and policies’ as ‘swords’ in the imposition of a ‘radical ideology’, not ‘shields’ for civil rights.  Already, he acknowledges that five US states have passed laws that essentially inhibit a medical practitioner from pursuing a middle path, forcing the child onto the escalator of transgender transformation.

Are we any different in Australia? First, it must be emphasised that the newly released “Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents’ may not be accused of being based on ‘junk science’:  the Guidelines profess they are not based on medical science at all, but on ‘clinical consensus…and a limited number of non-randomised clinical guidelines and observational studies’. This consensus would put the confused child in Australia onto the transgendering escalator with all the ideological conviction Anderson deplores.

Second, an unwitting public should be aware of the implications of the Victorian Health Complaints Act which was passed last February and, in subsequent discussion, was revealed to be designed to prevent, amongst other things, ‘conversion therapy’ of sexual minorities. It does not mention age or predilection but could cause me to be de-registered in that state because I have talked with several mothers of confused children, pointing out the optimism of statistics and the side effects of therapy etc without directing them to the nearest childhood gender dysphoria clinic. In some ways, the American legislation is ‘ahead’ of us, but the provisions of this Victorian Act exceed the US in zeal and scope. The registration of any and all therapists (not just medical practitioners) who attempt a middle path and do not direct a confused child to a clinic that practices transition is vulnerable to the law and, incredibly, guilt is presumed before innocence.

There are already reminders to teachers and principals in NSW that they are obliged to report child abuse to authorities, and this might include parental opposition to a child identifying with the opposite sex.

And, The Australian Labor Party declared at its recent National Conference it would enact laws to render illegal so called ‘conversion therapy’. These laws would ‘ensure child protection authorities acknowledge attempts to ‘cure’ Gender Questioning children and young people as serious psychological abuse, and would acknowledge these harms, when suffered within the family as domestic violence against the child’.

The term ‘conversion (or reparative) therapy’ warrants further explanation. As recognised by Anderson, it is Orwellian doublespeak for any management of a confused child other than active participation in the promotion and practice of transitioning towards the opposite sex. Anything less than that, including Anderson’s middle path, will be effectively illegal. According to the ideology of gender fluidity and its defence by the state, it is anathema to attempt to ‘repair’ gender confusion by ‘converting’ the child back to its chromosomal composition.

Anderson’s book is worth reading. Given the Labor Party’s promises would affect all families in Australia, all parents should read the book.

By John Whitehall, Professor of Paediatrics and Child Health, Western Sydney University.

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