When it comes to the issue of transgenderism, there appears to be one thing everyone is agreed on: it is complex and challenging! The claims of transgender ideology appear to have rushed on us in a moment; the issues involved touch everyone very deeply; there are bizarre contradictions between advocates of transgender ideology and the other elements of the LGBT+ community, and even within the transgender ‘community’ itself; and philosophical questions seem to blur into some real and personal issues of deep pain which demand a pastoral response.
These issues are what makes a book like Ryan T Anderson’s When Harry Became Sally both so important and so helpful. There are several things that are immediately helpful about Anderson’s approach (quite apart from the brilliant title!). The first is that it is rooted in primary research, and gives (in chapter endnotes) references to published papers. The second is its careful analysis of the evidence—indeed, a focus on evidence which is not pushed out of shaped by Anderson’s own theological agenda (Ryan is Roman Catholic). In fact, one of the striking things about the book is that it contains almost no theological reflection at all in its mapping out of the issues, a phenomenon to which I will return. Although there is a lot of detail about what is happening in North America in terms of legislation and ideology, the book is much less technical than Mark Yarhouse’s exploration of transgenderism and the intersex condition, and though Anderson is acutely aware of the pastoral response required, he does not offer anything comparable to Yarhouse’s threefold ethical paradigm. Instead, Anderson looks at the big picture of what is happening and why we have reached this ‘moment’—and this idea is also important. He cites clear evidence that this is not a linear trend in culture, but a particular moment on which we will likely look back in amazement.
The Introduction and short first chapter ‘Our Transgender Moment’ offers a brief sketch of the current situation in culture regarding the transgender question. Like some other sections of the book, this has a focus in North America and particularly in the United States, since this is where Anderson is writing from—but some of the issues can be evident in the UK already. But he anticipates some of the themes which will be explored in more detail later in the book. National Geographic‘s special issue on ‘The Gender Revolution’ featured
eight people on its combined covers, [including] three boys or men who identify as girls or women, a girl who identifies as a boy, individuals who identity as “bi-gender”, “intersex non binary”, and “androgynous”, and even someone who is just “male”—but not one girl who is comfortable being female. (p 12)
Anderson notes the shifts in medical terminology based on ideology rather than evidence, and observes the way that big business in the States has also jumped on the sexual identity bandwagon—but rather selectively. Whilst Paypal cancelled a major contract in protest at a North Carolina law decreeing that public toilets should be separated based on biological sex (male/female), the company
never explained why its international headquarters are in Singapore, where people who engage in private, consensual, homosexual acts can face two years in jail. (p 15)
Chapter Two focuses on ‘What the Activists Say’, and forms the first part of the vital distinction that Anderson makes between transgender activists and individuals who identify as transgender or as having gender dysphoria. For most of the chapter, Anderson simply quotes documented statements by activists without too much evaluation, but the issues become evident as the chapter progresses. For example, in one context an activist claims that transgender identity
‘is fixed, cannot be changed by others, and is not undermined or altered by the existence of other sex-related characteristics that do not align with it’
Yet in another context, it is claimed that gender identity and expression ‘can change every day or even every few hours’ and that this fluidity ‘can be displayed in how we dress, express and describe ourselves’. Anderson highlights the way in which (for activists) ‘transgender policies follow on from transgender ontology’ (p 39), that is, the claims that are made about the ‘reality’ of sexual identity—but also how the claims about reality actually have no basis in science or research. He also notes the, sometimes subtle, ways in which language has been tweaked and changed to support this agenda, the most notable being the idea that sex is ‘assigned’ at birth, rather than being recognised from the evidence. The last three pages of this chapter includes a long list of the questions and contradictions of transgender ideology—though Anderson again emphasises that these are questions for activists speaking in the public realm (mostly but not exclusively in the States), and that we need to respond to individuals in a different way.
Is there a gender binary or not? Somehow, it both does and does not exist, according to transgender activists. If the categories of ‘man’ and ‘woman’ are objective enough that people can identify as, and be, mane and women, how can gender also be a spectrum, where people can identify as, and be, both or neither or somewhere in between?
What does it even mean to have an internal sense of gender? What does gender feel like? What meaning can we give to the concept of sex or gender, and thus what internal ‘sense’ can we have of gender, apart from having a body of a particular sex?…The challenge for the transgender activist is to explain what these feelings are like, and how someone could know if he or she ‘feels like’ the opposite sex, or neither, or both. (p 46)
Chapter Three is perhaps the most important, and certainly the most uncomfortable for anyone to read. Anderson here tells the story of ‘detransitioners’—those who have undergone the process of sex reassignment, and then regretted their decision and tried to change back. The chapter begins with a story from the Daily Mail in 2012, ‘I was born a boy, became a girl, and now I want to be a boy again’: Britain’s youngest sex swap patient to reverse her sex change treatment.’
Ria Cooper made headlines last year when she became Britain’s youngest sex change patient aged 17, after years of begging her family and the NHS to turn her in to a girl. But now, having lived as a women for less than a year the 18-year has decided to change back in to a man after suffering huge mental anguish as a woman.
She has cancelled the full sex change operation that was scheduled for January and ceased the female hormone therapy that has seen her develop breasts saying that she has found the changes overwhelming and that they have made her deeply unhappy.
The stories are painful at every level, and are mostly recounted in the words of the individuals themselves. But the pain is compounded by the fact that the narratives told do not fit with the transgender ideology of the activists in the previous chapter, and so these people are often shunned by the activists themselves. But several consistent themes emerge from the stories as the people affected tell them. The first is that the unhappiness with sex identity was often rooted in other issues, often related to childhood experiences of violence and bullying.
When I was a child I started to have this fantasy of being a girl, because it meant I could be safe and not suffer from this violence due to being at the bottom of the male hierarchy. (p 63)
The second is that the unhappiness was fuelled by the negative perception of sex identity within society for the individual’s sex—particularly in the case of girls and women. And there was a deep perception of the need to conform to gender stereotypes in order to succeed in life.
The truth is that a lot of women don’t feel like they have options. There isn’t a whole lot of place in society for women who look like this, women who don’t fit, women who don’t comply. (p 53)
And many of those regretting their transition felt as though the medical profession, in adopting transgender ideology in their decisions, rather than looking carefully at deeper causes, were treating their bodies as subjects of experimentation. Anderson is careful to treat these stories in their own terms, regardless of whether the views of the individuals concerned would fit with his own confession ‘socially conservative stance’—and many of these stories are in the public domain online.
Chapter Four asks the question ‘What Makes us a Man or a Woman?’ and is shorter than you might expect—and where we might expect some theology, Anderson focusses exclusively on science. Anderson sets out, clearly and carefully, what scientific research says about chromosomal sex identity, how that is understood, the ways in which it affects human development, and the very well established sex differences between men and women. Sex differentiation begins from the moment of conception; it is expressed in both primary and secondary biological characteristics; and recognition of biological sex difference is vital in all sorts of ways for medicine, since men and women respond to pain differently, and are susceptible to different diseases and respond to treatments in different ways. Anderson is careful to note that cohort differences need to be interpreted carefully. If you gave someone a brain scan they could not tell whether it was male or female on its own—but the differences between male and female brains are well established in research. (The same is true of height, and every other variable: it is true that men are taller than women, but because height is distributed on overlapping bell curves for each cohort, you cannot tell someone’s sex by knowing their height.) Again, and most importantly for this chapter, all Anderson’s observations are support with reference to primary sources.
Anderson then turns to the whole question of sex ‘reassignment’, exploring three important issues. Does research show good mental health outcomes for those who undergo transition? On the whole, the evidence is poor, with the little research that has been done demonstrating ambiguous outcomes. Does the idea of ‘sex reassignment’ make sense medically? Not when a proper medical understanding of biological sex is taken into account. Does this idea make sense philosophically? Only if one accepts a mind/body duality which most medicine now rejects based on the evidence from research and experience.
Anderson then looks carefully at the most contested question in this whole debate: that of childhood dysphoria and desistance. He has, earlier in the book, introduced us to the research evidence that between 80 and 95% of children who experience dissonance between their biological sex and their felt gender resolve these issues over time if not pressed into transitioning—which should make us sit up and think about some of the stories that we see hitting the headlines. Anderson makes a plea for a responsible and informed approach to this difficult question, and is happy to draw on the research evidence of those who do not, in other regards, suit his agenda.
Children need our protection and guidance as they navigate the challenges of growing into adulthood. We need medical professionals who will help them mature in harmony with their bodies, rather than deploy experimental treatments to refashion their bodies. And we need a culture that cultivates a sound understanding of gender and how it is rooted in biology, a culture that respects our differences without imposing restrictive stereotypes. (p 144)
Chapter Seven steps back from the specific issue of transgender, and looks at questions of gender and culture. Anderson does an excellent job of looking at the wider debates about gender, and against them develops a case for seeing (socially constructed) gender as connected with (though not always determined in form by) biological sex.
Gender is socially shaped, but it is not a mere social construct. It originates in biology, but in turn it directs our bodily nature to higher human goods. A sound understanding of gender clarifies the important differences between the sexes, and guides our distinctly male or female qualities toward our well-being (p 149).
This seems to me to be a much more robust and persuasive position, with much wider appeal, than the idea that we are male and female for the theological reasons that the Bible tells us this is the way God made us. We actually know we are male and female because that is what science tells us—and Scripture gives a theological significance to this physical reality.
The final main chapter looks at policy question in the United States, and his conclusion notes that the public are not all persuaded by the claims of transgender activists, so this ‘transgender moment’ might pass—though it will need courage for all sorts of people in public life to make a stand for the truth and the evidence that we have.
If you want a comprehensive, readable, evidence-based case for questioning the assumptions of this transgender moment, then Anderson’s book is for you. I think it must be essential reading for anyone engaging in the sexuality debate, in the Church of England and elsewhere.
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