Should gender dysphoria be treated with drugs aligned to genetic sex?

For people with gender dysphoria (transgenders), why do we brutally & dangerously force the body to match the mind, instead of gently matching mind to body?

Transgender Gender Dysphoria HermaphroditesIn Ohio, a judge decided to remove a 17-year-old girl from her parents custody and, instead, give custody to her grandparents. The parents were not beating their daughter or starving her or depriving her of access to shelter or education. Instead, when their daughter announced that she was a boy, her parents rejected the idea of stuffing the child full of male hormones and continued to treat her as their daughter, not their son. (This included causing her emotional anguish by failing to acknowledge her male identity.) The local medical establishment, the grandparents, and the court decided that the parents were wrong. The girl is now being prepped for the latest in medical treatment for children with gender dysphoria.

There are a whole host of issues folded into the above paragraph that need to be unpacked in order to address my core question: Why has the medical establishment chosen the most violent, damaging treatment for such children rather than the least violent? And by “violent” I mean committing a serious assault on the human body.

Issue No. 1: Is there even such a thing as being “transgender”?

You’ll notice that I have avoided the term “transgender” and, instead, used the traditional medical term, which is “gender dysphoria.” As Ray Kremer nicely explained,

There are all types of body dysphorias, including the so-called “transabled” people who ruin perfectly functional body parts in order to become blind, an amputee, etc. Gender dysphoria is really no different than these, it’s just a variation on the theme of which body part is the scapegoat for making the person feel ill at ease in their own skin.

I would add to the list what is probably the most common gender dysphoria around: Anorexia. We’re all familiar with the young person, usually a teenage girl, who has a perfectly beautiful and healthy body, yet believes herself to be grotesquely fat. Her remedy is to starve herself to death. Significantly, we don’t call that girl transfat or transslender. We recognize that she has a mental illness that alienates her from the reality of her own body. We respond by treating her mind, to help her reconcile herself to her body’s reality.

When it comes to sexuality, though, this kind of common sense goes out the window. Suddenly, we have the whole medical and social establishment pretending that some people, despite entirely male or female bodies can, through the force of will and fantasy, magically become a sex opposite that of their body. Indeed, that’s how we ended up with the neologism “transgender” — it implicitly accepts the notion that mental discomfort, when taken seriously, magically changes genetic, biological reality. I refuse to use a term that pretends to science, but it really a disreputable amalgam of magical thinking and medical quackery.

Issue No. 2: While people with gender dysphoria are not magically the opposite sex just because they think they are, is there a possibility that their hormones and their genetic sex are misaligned?

There may well be an external hormonal cause for these mind-body disconnects.

Thanks to the current treatment the medical establishment is doing on people with body dysphoria, we have ample and repeated evidence that hormones affect not just the body (external sexual characteristics, such as breasts and gonads; musculature; the presence or absence of body hair; etc.), but that they also affect the mind. Men given estrogen become less aggressive and less interested in sex. Women given testosterone become more aggressive and more interested in sex.

Part of why men and women think and behave as they do is because of the gender specific hormones coursing through their bodies. Indeed, anyone who has witnessed their children going through puberty can see how strikingly different these sex specific hormonal effects are.

There’s reason to suspect that oral contraceptives may affect fetuses and gender. For example, there seems to be little doubt that a woman who takes the Pill while pregnant is more likely to have a child who is a hermaphrodite, which is true transgenderism:

Hermaphroditism is another condition that can affect the fetus, if you are on birth control during pregnancy. The condition affects especially the female fetuses that develop a set of reproductive male organs, besides their own ones, that are dominant. The main cause of this condition is given by the prolonged exposure of hydroxyprogesterone and norethidrone, two synthetic progestogens contained in high doses in most of the contraceptive pills.

Some people suspect that women who went off the Pill within a short time of conceiving may still have excess hydroxyprogesterone and norethidrone in their systems that is transferred to their child and even to that child’s child. These chemical hormone baths may damage the connection between the brain and the body’s genetic gender:

In the 1980s, I had a boss who had gotten a masters degree in psychology from New York University. He was a brilliant man; could have been a doctor. He told me a story that explains much of what we see in society today.

It seems that while doing his graduate work in the early 1960s, he had to do research on lab rats, which were given the synthetic hormones used in the then new birth control pills. The results, he told me, showed that the grandchildren of these lab rats would have high rates of homosexual behaviors. From what he told me, the findings were suppressed. Apparently, the powers that be wanted “the pill” to pass muster. What happened to the second generation of rats that followed was of no consequence to them.

Then my boss told me: The first generation of kids born to mothers using the pill have already arrived. But we should expect in another generation a noticeable increase in homosexual behavior, as they would be the second generation. As that was then still in the future, I was shocked.

This was told me in the mid ’80s. By his reckoning, we should have seen a societal explosion of homosexuality starting around 2000, and subsequently. And, of course, we have seen such an explosion. His prediction came true.

I understand that the above is a theory and one, moreover, too politically toxic ever to touch. However, as someone who fully understands just how powerful oral contraceptives are, I stand ready to accept the possibility that this forever-unexplored theory has a basis in fact.

Although the quoted material discusses the Pill and homosexuality, it seems to me that the theory could apply with equal weight to gender dysphoria. In other words, it’s entirely possible that the current rise in both homosexuality and gender dysphoria may be attributable to the ever-increasing number of women for several generations who have used hormonal birth control before getting pregnant.

Unlike people with gender dysphoria, homosexuals are happy in their own skin. They know they’re male or female. The difference between them and heterosexuals is not about identity, it’s about sexual attraction. They are drawn to their own sex and not the opposite. They therefore do not demand that they be addressed as something other than what they are, they do not demand dangerous hormonal treatments, and they do not demand deforming surgery.

However, when it comes to those kids with gender dysphoria, they are not happy in their own skin. Instead, they desperately need something to harmonize the painful disconnect between the genetic body they have and the sense of self their brain produces.

Issue No. 3: Just how violent and dangerous is the current treatment for people with gender dysphoria?

The current treatment process for those suffering from gender dysphoria is incredibly violent. First, it floods a body, usually a very young body, with hormones that the biological gender is not set-up to process. Second, it requires surgical mutilation.

Girls who suffer from gender dysphoria, believing that they are in fact boys and that their bodies should correspond with a boy’s body, get testosterone treatments. Testosterone’s effects on the female body range from permanent to temporary, and from innocuous to deadly. Here’s what happens to these girls (bolding in original; bolded-italics mine):

Females transitioning to males (FTM) may experience the following permanent effects of testosterone:

  • Atrophy of the uterus and ovaries, resulting in sterility
  • Baldness; hair loss, especially at temples and crown of head
  • Beard and mustache growth
  • Deepening of the voice
  • Enlargement of the clitoris
  • Increased growth of body hair
  • Sterility

Temporary changes, which are reversible after HT is stopped, include the following:

  • Behavioral developments associated with testosterone production during male puberty:
    • Aggression
    • Increased libido
  • Development of acne, similar to male puberty
  • Increased muscle mass and strength
  • Increase in number of red blood cells
  • Redistribution of fat from breasts, hips, and thighs to abdominal area

Increased risks associated with FTM testosterone therapy include the following:

  • Breast cancer
  • Cancer of endometrium
  • Diabetes
  • High cholesterol
  • Hypertension
  • Liver disease

In addition to the effects of testosterone on a body intended to be female, these girls often have surgery (euphemistically called “gender reassignment surgery,” as if science can “reassign” a gender) to cut off what remains of their breasts and some have surgery to turn their enlarged clitoris into something more closely approximating a penis. If they later decide that they still want to carry a baby, they undergo a whole new round of powerful hormonal treatments to try to reverse their sterility and to get their reproductive organs functioning again.

Boys who suffer from gender dysphoria, believing that they are in fact girls and that their bodies should correspond with a girl’s body, get estrogen treatments. Estrogen’s effects on the male body range from permanent to temporary, and from innocuous to deadly. Here’s what happens to these boys (bolding in original; bolded-italics mine):

Males transitioning to females (MTF) experience the following effects of estrogen:

  • Breast development (full development takes several years)
  • Loss of ejaculation
  • Loss of erection
  • Shrinkage of testicles
  • Sterility

Temporary changes, which are reversible after HT is stopped, include the following:

  • Decrease in acne
  • Decrease in facial and body hair
  • Decrease in muscle mass and strength
  • Skin becomes softer and smoother
  • Slowing of balding pattern
  • Redistribution of fat from abdominal area to hips and buttocks

Risks associated with HT include the following:

  • Benign pituitary tumors
  • Gallbladder disease
  • Hypertension (high blood pressure)
  • Hypothyroidism
  • Liver disease
  • Migraine headache
  • Tendency for blood to clot, causing related conditions:
    • Aneurysm
    • Deep vein thrombosis (DVT)
    • Pulmonary embolism (can be fatal)
  • Weight gain
  • Worsening of depression (if present); increased sensitivity to stress

In addition to the effects of estrogen on a body intended to be male, these boys often have surgery to add breasts and to cut off their penis and testicles. Recently, a man whose gender dysphoria caused him to feminize his body adopted a baby. His doctors gave him a series of powerful hormonal treatments to stimulate milk production in his breasts so that he could nurse this adopted child. The establishment was unconcerned about the risks for both the adoptive father and the child:

The Left is praising the use of domperidone on a male-to-female transgender individual who was given the U.S.-banned drug to induce lactation and exclusively breastfeed his child.


The “Results” of the case report read as follows: “A 30-year-old transgender woman who had been receiving feminizing hormone therapy for the past 6 years presented to our clinic with the goal of being able to breastfeed her adopted infant. After implementing a regimen of domperidone, estradiol, progesterone, and breast pumping, she was able to achieve sufficient breast milk volume to be the sole source of nourishment for her child for 6 weeks. This case illustrates that, in some circumstances, modest but functional lactation can be induced in transgender women.”


Domperidone has been banned in the U.S. by the FDA since 2004. “The serious risks associated with domperidone include cardiac arrhythmias, cardiac arrest, and sudden death. These risks are related to the blood level of domperidone, and higher levels in the blood are associated with higher risks of these events. Concurrent use of certain commonly used drugs, such as erythromycin, could raise blood levels of domperidone and further increase the risk of serious adverse cardiac outcomes,” says

Think about it: The same people who fear baby bottles with BPA lest it alter their child’s chemicals, and demand milk from cows that aren’t pumped with hormones, are kvelling about exposing a baby to a very dangerous chemical. Of course, these are the same people who also think it’s fine to stuff children with puberty blockers and sex  hormones.  (One of the things I love best about being a conservative is that I no longer have to struggle with the reductio ad absurdum of my positions or with painful cognitive dissonance as conflicting belief systems crash headlong into each other.)

Let me circle back to my original issue.

If you’re still with me, you need to accept as true the following principles:

Principle 1: Gender dysphoria is a condition in which a person’s brain and body have a disconnect. The body is incontestably a distinct biological gender (either male or female) but the person’s brain keeps telling the person that he or she is, in fact, the opposite gender. Were it not for the sexual component, which is the Left’s political hot button, this tragic condition would be viewed in the same light as other body dysphorias, most notably anorexia, in which we try to align the brain with the body rather than the body with the brain.

Principle 2: Gender dysphoria, unlike other types of body dysphoria, might have a hormonal component connected to changes in the mother’s body due to long-term oral contraceptive use. In other words, there may be more going on than mental illness. The person is not a hermaphrodite, because the body is genetically perfectly aligned with male or female, but hormones may have caused the brain not to recognize the body.

Principle 3: The modern approach to treating gender dysphoria is brutal and cruel. We use powerful chemicals and disfiguring surgery to force a change that the body was never intended to support. In addition to unpleasant side effects (acne for women, sexual disinterest in men), these chemicals make the users sterile and expose them to dangerous and deadly diseases that their bodies were not programmed to experience. And of course, any surgery is always a risk. After all, every year there’s some tragic story about a person dying while having wisdom teeth extracted.

If either Principle 1 or Principle 2 is correct, it’s reasonable to accept that something very real is going on with these poor people and that we should try to treat their condition. Principle 1 suggests that psychological therapy might work. Principle 2, positing that the problem is hormonal, suggests that psychological therapy won’t help. Medical intervention is therefore reasonable. Which leads us to Principle 3.

My question, which takes place at the intersection of Principles 1 and 2, on the one hand, and Principle 3, on the other hand, is this: Why has our culture opted for such an extraordinarily brutal, cruel, dangerous medical intervention?

Genetically, absent true hermaphrodism, the body is what it is: Either male or female. It’s the brain that’s in error. Doesn’t it make much more sense to give the brain hormones that naturally align with the body than to crudely and dangerously use chemicals and knives to force a body into a shape that roughly aligns with an erroneous brain? That is, in the first instance, shouldn’t we give girls with gender dysphoria estrogen and boys with gender dysphoria testosterone?

There are only two reasons I can think of to justify the current approach:

Reason 1: My suggestion for hormones that align with the body, rather than oppose it, has been tried and failed. I have not found any data to support this proposed reason. If you know of data, please tell me about it.

Reason 2: What we’re seeing with the current medical approach is the inevitable end point of the Left’s decades’ long attack on the sexual integrity of children’s bodies. To support this contention, let me quote from an article I wrote some years ago for American Thinker before all this “transgender” madness swept the West:

Those of us who came of age before the 1980s, when the Judeo-Christian, Western tradition, though battered, was still ascendant, view our sexuality as a private matter. We believe that our bodies are our own property, which means that we should not be touched or controlled sexually without our consent. A person raised with this worldview inevitably believes as well that his ability to control his body is the essence of his individuality. This physical individuality is the antithesis of slavery, which represents a person’s ultimate lack of control over his body.

Statist regimes, of course, cannot tolerate self-ownership, which is the natural enemy of government control over the individual.


What’s interesting is that, because the Left expresses itself in terms of “freeing” people’s sexuality, many people miss the fact that it is every bit as sexually controlling in its own way as Islam is. This control comes about because the Left works assiduously to decouple sex from a person’s own sense of bodily privacy and, by extension, self-ownership. If a person has no sense of autonomy, that person is a ready-made cog for the statist machinery.

The practical problem for the Left when it tries to attack individuality as expressed through sexuality is the fact that a person’s sense of an inviolate physical self develops quite early, during childhood:

Once a child individuates, he becomes aware of being his own self. … The most basic thing one can own is one’s own self, and not letting others touch that self in ways you don’t like is an exercise in self-ownership. (Emphasis mine.)

The Left, therefore, needs to decouple self and body as early as possible in a person’s development — and it does this by bringing its own peculiar notions of sexuality into the realms of child-rearing and education.


Freud was right when he speculated that sex, perhaps because it is the least easily satisfied human need, may also be the most powerful physical need driving human beings. Freud, however, viewed sexuality through the spectrum of a given individual’s desires. What the statists understand — and have always understood — is that our bodies are the first line in the battle between statism and individualism. If a person is allowed to develop a sense that his body is his own to control, he will never willingly yield to the demands of the state. Only by convincing its citizens that they have no personal autonomy, beginning with control over their own bodies, can a state completely subsume the individual to the bureaucracy.

If you’re curious about past examples of the Left’s efforts to decouple self and body, you can read the rest of my article here.  Suffice to say that today’s obsession with torturing young bodies is entirely consistent with the premise I stated eight years ago.

Do I have a grand conclusion here? No. I have a series of issues, principles, questions, and theories. At this point, I’ve exhausted my mental resources, both factual and analytical. It’s your turn. Please chime in and flesh out my data (and definitely correct me if I’m wrong) and puncture or support my analysis. As always, I ask only that you are polite. You’re welcome to disagree with me. You’re not welcome to abuse, insult, or threaten me.