Doctor doesn’t know best

Non-binary blarney in Killarney

This article is taken from the June 2023 issue of The Critic. To get the full magazine why not subscribe? Right now we’re offering five issues for just £10 

“That explains the barney!” exclaimed the taxi driver taking me from Kerry airport to a conference in late April in Killarney, a popular Irish tourist destination. The previous day had been unusually busy because my conference coincided with another, and taxis had doubled and tripled up on passengers. One group he ferried had included delegates to both events, he said, and the conversation had got pretty heated.

Gourmet diners seem not to be that keen on encountering unexpected blokes in the ladies’ loos

That may not have been precisely what the organisers of the event I attended were hoping for — but sparking debate was certainly their aim. They are Genspect, a group of health professionals dedicated to challenging the excesses of gender medicine. When one of the co-founders, Irish psychotherapist Stella O’Malley, heard that epath, the European arm of the World Professional Association of Transgender Health, was planning an event in Killarney, she decided that Genspect would hold a rival one.

And so for three days the town played host to both proponents of gender ideology, and some of its fiercest critics. That meant opportunities for political theatre. After reading in The Kerryman that EPATH had designated all toilets at its venue gender-neutral, local celebrity chef Paul Treyvaud tweeted: “Call me old fashioned but you’re not allowed to use the ladies toilet in our restaurant if you have a penis.” That got him called “transphobic”, and got the clash of conferences into the national press.

Fortunately for Treyvaud, gourmet diners seem not to be that keen on encountering unexpected blokes in the ladies’ loos. Two days later he reported an uptick in custom, tweeting: “Who knew a tweet about a penis could fill your restaurant?”

The differences in approach went beyond who pees where. The Genspect conference platformed viewpoints and narratives that wpath and its affiliates silence and ignore. Among the speakers was Ken Zucker, an eminent Canadian clinician who supports paediatric gender transition — unlike most of the other Genspect delegates — but is too cautious to please the gender ideologues. In 2017 he was deplatformed from a conference held by USPATH, the American arm of wpath, after protests by transactivists who claimed he was practising conversion therapy.

WPATH events are closed to the press. Genspect, by contrast, was livestreamed and among the many journalists present were documentary-makers from America, Canada and Sweden. One was Aleksa Lundberg, a Swede who started to identify as trans as a teenager, underwent genital surgery aged 21 and now blames gender doctors for peddling a false narrative that led to depression and sterility.

Lundberg, who self-describes as a “gay, feminine male”, snuck into the epath event and tried to talk to the lead clinician at the hospital that oversaw his transition. The latter refused to engage and told him to contact the clinic’s press office before Lundberg was bundled out of the venue.

The EPATH conference opened with a remarkable statement from the organisation’s president: “We respect everyone’s freedom of speech, but we choose not to listen to it.” Among those the group chose not to listen to were two groups well-represented at Genspect: detransitioners and parents who think gender doctors are harming their children.

Detransition — re-identifying with your sex and abandoning medical attempts to disguise it — was barely mentioned at epath, which defines it flippantly and inaccurately as “retransition to the gender stereotypically associated with [the] sex assigned at birth”. That ignores the catastrophic, irreversible effects of cross-sex hormones and genital surgery, and suggests that detransitioners are people who plump for their own sex’s stereotypes after a period of confusion, when rigid sex stereotypes is what drove many to transition in the first place.

Their testimony was both moving and enraging. They had turned up at gender clinics in search of an explanation for their crippling distress, and effective, evidence-based treatment. What they got was puberty blockers, cross-sex hormones, mastectomies and sterilising genital surgeries.

Among them was Jet, an articulate, intelligent Dutch woman in her early 20s. “I believed the doctors when they said I had gender dysphoria and they knew how to treat it,” she said. But the drugs made her feel no better, and masked her true sexuality. Only when she stopped testosterone did she finally experience natural sexual desire and understand herself as a lesbian.

The gender-peddlers left Jet with some permanent reminders: a voice deepened by testosterone and a chest flat from a double mastectomy. At least she still has her reproductive organs: as her doubts grew, she cancelled her scheduled hysterectomy.

It would be much too kind to call this Frankenstein medicine: it’s not medicine at all

Another detransitioner present, Ritchie Herron, was less lucky (of course, real luck for both would have been never to go near a gender clinic). Herron is suing the nhs trust that removed his penis and testicles in 2018 in a botched operation that left him with constant pain, bladder problems and no sexual sensation. They overlooked the real causes of his gender distress, he says: depression, ocd and internalised homophobia.

It was faith in the medical profession that led her to stifle her doubts about such treatment, said one delegate from the floor. The worst moment of her life was when her son stopped identifying as a girl and told her he had made a terrible mistake. “We thought, ‘my God, what have we done?’” she said, her voice breaking. “My grief was immense.”

All these victims of medical malpractice spoke up out of a burning sense of injustice, and in the hope of halting the grotesqueries carried out in gender clinics. No wonder the clinicians at the epath event prefer to close their eyes and ears: if they were ever to reckon with the harm they have done, how could they live with themselves?

One of the few people attending sessions at both events was Eliza Mondegreen, a (pseudonymous) graduate student in Montreal who studies how young people’s beliefs about gender are shaped by online communities. The epath conference in Killarney, she says, platformed question-begging ideology and (literally) excruciating surgical detail. What was missing was any consideration of whether the ideology is well-founded or the procedures are ethical.

Take, for example, a session entitled Vagina-Sparing Metoidioplasty: Is It Possible? In a metoidioplasty, a clitoris enlarged by testosterone is made to look like a mini-penis by cutting the ligaments that attach it to the pubic bone. The vagina is usually removed at the same time.

The growing popularity of non-binary identities, however, has boosted a mix-and-match approach to surgery: the addition of a fake vagina alongside your penis, or fake penis alongside your vagina, or even “gender nullification” — the removal of all sex organs. To raise the question left unasked at epath: is any of this a good idea?

Perhaps you can indeed make the clitoris of a woman who has taken testosterone look like a mini-penis without removing her vagina. But meddling with healthy reproductive systems has major, lifelong consequences, and what’s the evidence that the benefits outweigh the costs, or indeed that there are any benefits?

It would be much too kind to call this Frankenstein medicine: it’s not medicine at all. Medicine means seeking to understand the healthy functioning of both body and mind, as well as studying what can go wrong and how to put it right. But gender doctors display no curiosity about why their patients have taken against their sexed bodies. When former patients say they don’t feel better, those doctors “choose not to listen”.

The history of medicine is littered with inglorious episodes in which gung-ho types get caught up in the excitement and drama of the technological frontier. This one has been particularly terrible, as experimental treatments have been marketed as an irresistible mix of miracle cure for teenage angst and social-justice panacea. But Genspect felt like the start of a long-overdue course correction.

Enjoying The Critic online? It's even better in print

Try five issues of Britain’s newest magazine for £10

Critic magazine cover