Recently, during a radio show on which I appeared as a guest, a caller posed a question I frequently get asked: “Do the administration of cross-gender hormones and genital surgery change a boy into a girl or a girl into a boy?”
The answer is simple: biologically, not at all.
Underneath all the cosmetic procedures, vocal training, and hair growth or hair removal lies a physical reality. Biologically, the person has not changed from a man into a woman or vice versa.
Sex is an indelible fact of a person’s biology. Specifically, it describes one’s biological makeup with respect to its organization for reproduction. As Lawrence S. Mayer and Paul R. McHugh explain in The New Atlantis:
In biology, an organism is male or female if it is structured to perform one of the respective roles in reproduction. This definition does not require any arbitrary measurable or quantifiable physical characteristics or behaviors; it requires understanding the reproductive system and the reproduction process.
The authors go on to note that “[t]here is no other widely accepted biological classification for the sexes.” Sex pertains to the two different ways males and females are structured for reproduction, and these structures are permanently engrained in one’s biology. They cannot be chosen at will.
A man can mutilate his body, but he can never transform it to be organized as a female—and vice versa for the woman.
This makes sense of the head-snapping (and false) headline many of us saw about a man having a baby. The “man” featured in the story is simply a biological woman who kept her childbearing anatomy intact.
My Sex Change Fiction
My “sex change” surgery from male to female was performed by Dr. Stanley Biber in Trinidad, Colorado.
His unusual field of expertise drew clients from around the world and earned the small mountain town the nickname “Sex Change Capital of the World.” The surgeon estimated that he performed over 5,000 such surgeries during his career.
I lived legally and socially as a female for eight years, but I came to the realization that I wanted to go back to living as a man. To legally change my gender back to male, I needed to file a petition with the California Superior Court that verified I met certain criteria. (The process has since changed.)
My surgeon wrote a letter to the court stating that I met the medical criteria for the courts to legally change my birth certificate back to male. The very surgeon who earlier said that hormones and surgery had changed me to female, now admitted that it did not.
In the letter, he testified that the surgery and cross-gender hormones had the effect of neutering my external appearance and genitalia, but my internal biological structure and my genetics were still male.
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That’s the key to understand: Hormones and surgical changes can affect one’s external appearance, but no innate biological change of sex occurs.
This truth should seem obvious, but discontented trans women contact me who say they didn’t know that they could never become a “real” woman. They are unhappy and opting to go back to the gender of their birth.
False Hope Could Lead to More Suicide
A 2004 U.K. Guardian article, “Sex Changes Not Effective,” points out: “While no doubt great care is taken to ensure that appropriate patients undergo gender reassignment, there’s still a large number of people who have the surgery but remain traumatized—often to the point of committing suicide.”
Too many post-surgical patients contact me to report they deeply regret the gender change surgery and that the false hope of surgical outcomes was a factor. For children, the focus on encouraging, assisting, and affirming them toward changing genders at earlier and earlier ages, with no research showing the outcomes, may lead to more suicides.
Others Advocate Less Surgery
A growing number of people like me, 50 years after the first surgery at Johns Hopkins University Gender Clinic in 1966, are advocating the scaling back of the radical, irreversible, often unnecessary genital mutilation surgeries.
Rene Jax, in his 2016 book, “DON’T Get on The Plane!” says, “Sex change surgery will ruin your life.”
Jax and I have had similar experiences. Both of us were approved for hormones and surgery to resolve our gender dysphoria, and after following the medically prescribed full regimen of hormones and genitalia surgery, and living as women, both of us came away with the same conclusions:
- Gender change surgery was a destructive body mutilation and a waste of time and money.
- After the medically-certified gender change, life didn’t improve.
- Gender dysphoria, that feeling of unease with one’s gender, persisted, and was not relieved as promised.
Surgery as a Last Resort
Based on the emails I receive, I would urge the person who thinks that gender change is the answer in their situation to delay any surgical changes, or at the very least to restrict any physical changes to ones that are reversible.
This is especially important for younger people who may want to have children one day.
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Today in 10 states, only a verbal declaration and a doctor’s letter supporting the change are needed to legally change the gender on a birth certificate. Cross-gender hormones or surgery are not required. Only 10 states affirm that surgery and hormones do not change biology.
Studies show that two-thirds of people with gender dysphoria have co-existing disorders, such as depression and anxiety.
I’ve become an outspoken critic of gender reassignment surgeries because many people are not being treated for other co-existing problems first. Instead, they are quickly prescribed cross-gender hormones and shuttled on a path toward surgery.
But as noted earlier, this surgery cannot succeed in delivering what it promises. It will only mutilate the body, a far cry from the promised “sex change.”
Sex reassignment is as natural as being born, some in the media tell us. And many Americans are buying it.
But a growing chorus of dissenters made up of physicians, researchers, and even transgender individuals is beginning to paint a far different picture of the truth.
These dissenters are now coming forward to expose just how harmful gender transition and reassignment are—both medically and sociologically speaking.
First, consider recent revelations about how problematic sex reassignment surgery is as a therapy for gender dysphoria.
In an interview with The Telegraph, world-renowned genital reconstructive surgeon Miroslav Djordjevic said his clinics are experiencing an increase in “reversal” surgeries for those who want their genitalia back. These people express crippling levels of depression and, in some instances, suicidal thoughts.
In male-to-female reassignment surgery, doctors such as Djordjevic transform the man’s genitals into the shape of a vagina, removing the testicles and inverting the penis.
In female-to-male reassignment surgery, doctors remove the woman’s breasts, uterus, and ovaries, and extend the urethra so that the woman-turned-man can urinate from the standing position.
A recent Newsweek article takes note of Djordjevic’s concerns, illustrating their legitimacy by pointing to the case of Charles Kane, a man who underwent male-to-female reassignment surgery.
In a BBC interview, Kane explains that he decided to have the initial surgery immediately after having a nervous breakdown. But after having the surgery and identifying as a female named “Sam Hashimi,” Kane soon regretted the decision and went for reversal surgery.
“When I was in the psychiatric hospital,” Kane said, “there was a man on one side of me who thought he was King George and another guy on the other side who thought he was Jesus Christ. I decided I was [a girl named] Sam.”
Similarly, Claudia MacLean, a transgender woman, is quoted as saying her psychiatrist referred her to a sex reassignment surgeon after having only a 45-minute consultation. “In my opinion,” MacLean said, “what happened to me was all about money.”
Given that clinics charge up to $50,000 for reassignment surgeries, Djordjevic says he fears that doctors are stuffing their bank accounts without concern for the physical and psychological well-being of their patients.
Physical and psychological well-being should be a concern, given that 41 percent of transgender people will attempt suicide at some point in their lives, and people who have had sex reassignment surgery are approximately 20 times more likely than the general population to die by suicide.
In addition to the problems inherent to sex reassignment surgery, we should recognize the troublesome nature of giving hormonal “treatments” to gender dysphoric children to delay puberty.
In a recent paper, “Growing Pains: Problems with Puberty Suppression in Treating Gender Dysphoria,” endocrinologist Paul Hruz, biostatistician Lawrence Mayer, and psychiatrist Paul McHugh challenge this practice.
They note that approximately 80 percent of gender dysphoric children grow comfortable in their bodies and no longer experience dysphoria, and conclude that there is “little evidence that puberty suppression is reversible, safe, or effective for treating gender dysphoria.”
Thus, scientific evidence suggests that hormone-induced puberty suppression is harmful and even abusive.
Finally, gender transitions are problematic for society at large, as revealed in recent debates about restroom usage, military realities, housing policies, and sporting events.
What is often overlooked in these debates is the troublesome and even dangerous situation created when transgendered “females” compete in female athletic competitions.
Consider the 2014 women’s mixed martial arts bout between Tamikka Brents and Fallon Fox. During a two-minute beating, Brents suffered a concussion, an orbital bone fracture, and a head wound requiring seven staples.
“I’ve fought a lot of women and have never felt the strength that I felt in a fight as I did that night,” said Brents.
As it turns out, her opponent, Fox, wasn’t born female. She is a biological male who identifies as transgender.
Brents thought Fox had an unfair advantage. “I can’t answer whether it’s because she was born a man or not because I’m not a doctor,” said Brents. “I can only say, I’ve never felt so overpowered ever in my life, and I am an abnormally strong female in my own right.”
Brents was right to consider Fox’s advantage unfair: The physical differences between men and women are significant enough that professional female fighters cannot compete effectively against other professional male fighters.
Given all this, why do we not see a more constructive and sustained public debate among surgeons, psychiatrists, and lawmakers about the ethics of sex reassignment?
The most significant reason is the power of the transgender lobby.
Consider psychotherapist James Caspian’s recent claim that Bath Spa University in the United Kingdom refused his application to conduct research on sex reversal surgeries because the topic was deemed “potentially politically incorrect.”
According to Caspian, the university initially approved his research proposal, but later rejected it because of the backlash it expected from powerful transgender lobbies.
Regardless of how politically incorrect the evidence may be, and even while we accommodate the privacy and safety concerns of those who identify as transgender, we must also draw a sober and honest conclusion about the human costs of sex reassignment.
The best medical science, social science, philosophy, and theology coalesce. As Heritage Foundation senior research fellow Ryan Anderson puts it, they reveal that sex is a biological reality, that gender is the social expression of that reality, and that sex reassignment surgeries and treatments are therefore not good remedies for the distress felt by people with gender dysphoria.
The most helpful therapies for gender dysphoria, therefore, will be ones that help people live in conformity with the biological truth about their bodies.