Dr. Li, thank you so much for composing and sharing this article!
I am a clinical psychologist, and I work with adolescents and adults. I live in Oregon, and I have recently decided to stop seeing adolescents in my practice, because healthcare professionals here are at risk legally if they refuse to work within the "gender affirmative care" model. It isn't possible to screen gender-confused children out of my practice, because an increasing number of young women that I am seeing for other reasons will suddenly announce to me that they are "non-binary," without having reported any previous history of gender confusion. It is completely obvious that cutting off their breasts is not the proper way to address their psychological problems, and I never dreamed that this ancient form of torture would be reinstated as a psychiatric approach within pediatric medicine or my profession.
More generally, I feel intense grief and rage about the destruction of my beloved profession by doctoral level psychologists who apparently have no clue what science or clinical practice even are, much less how to employ these methodologies. It is difficult to understand how people who must be at least of average intelligence and who attended what used to be the "best schools in the country" ended up so ignorant and brutish in their thinking and their behavior.
Looking from the outside at the woke cult and its obsession with "trans identities," I see lots of symptoms of personality disorders being acted out en masse. Not only do many of the leaders of this movement behave in a highly narcissistic or sociopathic manner, the cult as a whole also does. Many observers have described the woke cult as a social pathology, e.g. Elon Musk's characterization of the cult as "a mind virus," and I agree that it is a mass mental illness rather than a "political" movement.
I hope that pediatricians will listen to you and will take time to actually inform themselves about the appallingly destructive mistreatment of children that is being perpetrated by trans activist healthcare professionals. Vulnerable young people are being harmed by "gender affirmative care" whether or not they know it now or ever during their lives. When the adults who are charged with protecting children abuse them instead, abuse becomes normal to those kids, and in many cases they never recognize how horribly they were betrayed.
I sympathize with your dilemma. However, by withdrawing from the battle, you leave the playing field to those willing to fight the struggle "on behalf" of these confused children leading to great harm. Why not raise cain within the psychology community. It will be of interest to find out what happens to Dr Li after speaking out so eloquently against the current dogma!
You should contact Stephanie Winn who has written about how Oregon licensing boards have NOT taken action against anyone for failing to tow the "gender affirming" line in their practice of therapy. I read an article by her about her investigation of Oregon licensing boards, but cannot quickly find the link to that. https://www.sometherapist.com/
I was appalled to learn that the NHS supplies personality disordered young people with “clean blades” to use for self injury.
I have been reflecting recently on the fact that neither I nor any of my adult trans clients ever talked about a medical transition as a magical cure for all their emotional problems. It never occurred to me that the clients would think that genital and facial surgery would cure their depression, if they had it, or their substance abuse, or anything but their gender dysphoria. In reality, very few clients who transition continue in therapy, so we don’t know what goes on with them. It’s a strange phenomenon. When a person makes such a drastic lifestyle change, doesn’t it seem like he/she would want to talk about it? I tend to think that the “original” (not Gen Z) trans clients were not typical consumers of psychotherapy. Apparently they were/are so concrete in their thinking that it made sense to them that cosmetic surgery would be the optimal approach to their emotional distress.
An Oregon pediatrician, Julia Mason in Gresham, is one of the founders and most active member of the Society for Evidence Based Gender Medicine https://segm.org/ I hope you will subscribe to SEGM's newsletter.
A powerful read. I’m reading Time to Think currently. I’m not a physician nor do I work in mental health or with children. Having 2 older teens, 1 of which told us 3 years ago she was trans and wanted an elective mastectomy, I’m very concerned with professional groups legitimizing this new insanity. By the grace of God, our daughter has moved way from the trans obsession and moved more center. After reading some of Hannah Barnes’ work, I see similarities in what our daughter struggled with. She began following influencers on social and became mesmerized by the promises of a rebirth in transitioning. I empathize with any parent and child struggling with identity and am thankful for voices of reason pulling the pendulum back.
Thank you sharing. You and your daughter have been blessed that she avoided the tragic path that so many vulnerable youth have followed. I hope that at some point she will tell strong enough to share her journey with others who might benefit.
The detailed description of post-modern medicine is terrifying for all of us. One of the very chilling concepts:
"Under Gender Ideology there is no such thing as individual dignity and therefore there is no harm that can be done to individuals. There is only collective Social Justice. "
This explains why the sadistic cruelty of "gender medicine" is perpetrated on children with no thought, no remorse, and also explains the violence against anyone who would dare to tell them it is wrong. This has to be stopped, in any way possible. Since they will never give up their ideology, making them pay with massive malpractice lawsuits and legal prohibitions will have to be the main tools. When it becomes too expensive, it will at least slow down. Not before.
Though I had not thought about it in this detail before, it isn't about the children, or the transgender adults, it isn't about the people at all, it is only about the Social Justice Warrior's campaign against any and all of society. They want to break everything, just because it's there, and replace it with...what? They never say. But for an example, take a look at San Francisco or Portland, or Chicago, and how well is anarchy working out there?
This is a different tangent, but I wanted everyone to know that an African American man with 15+ years working for a NY state manufacturer got summarily fired this week for attempting to protect the women at the factory. They produce stainless steel counters for commercial kitchens and have employed many minorities, skilled labor. This man suggested to a man wearing eye shadow that he should better use the men's room, instead of the women's room he entered. This African American man was summarily fired within the hour. That's what I call Trans White Privilege.
I am gay, and was a medical doctor a lawyer, and I appreciate your thoughtful analysis of Post Modern Medicine. Each of my three identities has been besmirched by the "queering" of reason in the name of "Social Justice." Gays and lesbians have been defamed by transexuals who have undone decades of work de-stigmatizing homosexuality; the transexuals have re-pathologized sexual identity. Post modern social justice warriors have committed an even worse crime by undermining the foundations of objective reality in medicine and law. Lawyers were always on a slippery slope toward subjectivity and greed, but I was proud of the medical profession's objectivity and its commitment to decency. That pride is now gone along with the reputation of medical science. Gender clinics are the ambulance chasers of our time, and all physicians are sullied by association. The American Medical Association has just declared body mass index (BMI) "racist," which confirms our profession has now become a postmodern joke.
And if you are ever in an argument with one, you find out really fast that they are not above slurs of all kinds, including racial. They actually seem to be huge bigots and they aren’t self aware enough to recognize it. They project their own biases and personality deficits onto others constantly.
Terrifically deep and thoughtful analysis. I am a retired pediatric pulmonologist and agree with Dr. Li. I am so embarrassed that "busy" pediatricians have sat silently through the deep corruption of our profession by the AAP and others while lives are destroyed in violation of "Do No Harm". This is the greatest medical and ethical malfeasance of modern times in pediatrics. Silent pediatricians are closely akin to the "good Germans" who acceded to the cruel crimes of the Nazis.
"malfeasance" -- amen to that; crime and medical scandal of the century.
Though, as I've argued (see link below), "our side" is partly to blame for indulging in euphemisms while turning a blind eye to what they really entail.
What really chaps my hide is the too frequent use of "sex change operations" which are nothing of the sort -- nothing more than the sterilization of dysphoric and autistic children; turning them into sexless eunuchs.
"Gender affirming 'doctors' are sterilizing your children!" --- pass it on ...
Horrifying. Why aren’t there more lawsuits? More “medical professionals” being held accountable? Who the hell are these doctors completely lacking in empathy, compassion, and apparently the BRAINS to be smart enough not to put their patients in danger?.
Who the hell decided that queer theory was a great idea to impose on all of us?
These doctors think they are lifesaving heroes, like jihadi who blow up school buses who think they are saving children’s souls from corruption by infidel parents. Children’s souls immediately go to heaven.
Well, heaven in gender ideology is “gender euphoria.”
Given the three recent court decisions striking down state laws prohibiting "gender affirming" medicine, I am pessimistic about the chances malpractice lawsuits will be the corrective measure desperately needed. The courts are, as expected, treating the statements by the AMA, AAP, etc. as authoritative, essentially conclusive as to standard of care. The zealots were shrewd to get them adopted, mostly under the radar.
Lawsuits by detransitioners are beginning to be filed. Three have already been filed against Kaiser in California and a few in other states around the country. It will take some time for detransitioners to become aware of which professional malpractice law firms are willing to take these lawsuits on. Washington University's Gender Clinic has announced that it will no longer give puberty blockers, cross sex hormones or surgeries to minors, on the advice of its loss control legal advisers because it is expected that many lawsuits will be forthcoming. There is no doubt that medical malpractice insurers will soon appreciate that they will face huge losses by continuing to insure doctors who perform "gender affirming"surgeries. That has already happened in Australia. And Democrat controlled legislatures in California, Oregon and Washington are aware that malpractice insurers may start "penalizing" gender clinic doctors, and have actually passed laws prohibiting malpractice insurers from doing that by increasing premiums charged to such doctors or refusing to cover such doctors. BUT nothing can force malpractice insurers to continue to offer insurance in states that do that! So before long malpractice insurers will stop offering insurance to all doctors in states like California, Oregon and Washington, which of course means that the remaining insurers will raise the premiums they charge to ALL doctors in those states. And THEN all doctors will realize that they have a stake in what gender clinics are doing, and cannot simply turn a blind eye because they themselves do not engage in "gender affirming" medicine.
Amazing piece. Thank you!! I'm a psychologist and am absolutely alarmed - and devastated - about what is happening in "gender medicine", as well as in my field.
Thank you Dr. Li, for writing such a clear, powerful, and direct manifesto. Your voice is wise and refreshing, so welcome! I hope you will keep speaking out, especially in the Seattle area (I am near there too) where we have so many great hospitals. While I read Pluckrose and Lindsey's book when it came out and have encountered many heterodox-type thinkers defending enlightenment-born science, your defense is for me the clearest whack on the head (in a good way!) I have encountered. I love the insight, "stop calling my profession Western medicine!" People get confused by the blinders and abuses of scientists: invalidation of science as culturally relative and oppressive (etc. ) results. The self-correction of the scientific method eventually leads us to pathways born of evidence rather than superstition. Science is one of the most useful and amazing inventions ever, and it's for everyone. It needs to be defended, which you have done so brilliantly. This is why I love Colin's Substack--he is taking a stand for reality and for science.
Dear Dr. Li, I write to you as a mother, grandmother and great-grandmother. I am not a medical professional and have no scholarly credentials at all. However, your wonderfully written Manifesto gives me hope for truth to finally shine in the darkness for my family. Three of my brilliant, talented (and abused in many ways), grandchildren have fallen into the insanity of transgenderism. I am going to send a copy to my son, the father of all three. He has not spoken to me in 4 years. and I have not seen my grandchildren or great-grandchildren in as long. Not all our issues are related to this ideology, but your relating of the history of how we got to this moment in time, wherein we were susceptible to such a fantasy is invaluable for a family such as mine. Your Manifesto is flawless, your writing impeccable. I am in hopes that many will benefit from your courage and your efforts, as I have. Thank you! Sending you love and prayers, stay safe, Indio.
NOT NORMAL indeed. Thank you for this. Why are more physicians not speaking out? I am a therapist, and I’m horrified by what most of my profession is doing under the spell of destructive queer theory which they don’t actually even understand or realize they are captured by.
Quite an impressive essay, and for many reasons, some of which I’ll get into a bit later.
However, to start the ball rolling, I think your “medical sex transition” is rather a “problematic” misuse of language though, rather sadly, quite a common one. The point is that no one, no human changes sex, and to make even the most oblique suggestion that that is possible constitutes “aiding and abetting the enemy”, if not conceding the war even before battle is joined.
But, along the same line, what really chaps my hide is the frequent reference to “sex change operations”, particularly by many who should know better. For an example of the latter, see the Statistics Department of New Zealand (zealot-land) which boldly asserts:
NZ: “Sex reassignment occurs where a person has undergone the necessary treatment to permanently change their sex." 🙄
Daily Mail: “Biden slams GOP for trying to ban sex changes ... he doesn't think states should have the right to regulate sex change surgeries or treatments ... denounced Republican states that have passed laws attempting to ban or limit sex change surgeries and transition treatments ...”
The only way “sex change” might work is if we go with the Kindergarten Cop definitions – i.e., boys have penises and girls have vaginas – which is apparently where Biden’s head is at, along with those of too many others, but I rather doubt it has much use outside of primary school. However, that misuse of terminology and the underlying scientific illiteracy – being charitable – is pervasive, pernicious, and profoundly problematic.
Apropos of which, you might be “amused”, or not, to note that the book “Exploring the Biological Contributions to Human Health: Does Sex Matter?” on the NCBI/NLM website – “an official website of the United States Government ...” 🙄 – has titled its second chapter as “Every Cell Has a Sex”:
Who knew that each and every cell has – or will have, or used to have ... 🙄 -- the ability to produce gametes all by their lonesomes? ... 🙄
But rather sadly, the Yale School of Medicine is equally clueless and follows the NCBI off into the weeds of biological illiteracy, cluelessness, and postmodernist claptrap:
As Francis Bacon, one of the founders of the scientific method, once put it, "Therefore shoddy and inept application of words lays siege to the intellect in wondrous ways."
Which seems like an apt if depressing summary of the whole "debate" over what it means to qualify as a male or a female. Or as neither. "shoddy and inept uses of words" by pretty much all and sundry.
Which brings me to your “Postmodernism is allergic to categorization” – amen to that; truer words were never spoken. However, that rather “debilitating” allergy is, sadly or not, not unique to the postmodernists and their ilk. Unfortunately, a great many people on all sides of the issue, even in this more or less enlightened neck of the woods, are equally “allergic”, and just as “obstinate” in refusing to even debate the principles of categorization on which the standard biological definitions for the sexes are solidly based.
Those definitions stipulate that to have a sex is to have functional gonads of either of two types, those with neither being, ipso facto, sexless; see the Glossary of this article in the Journal of Molecular Human Reproduction for details:
"Gamete competition, gamete limitation, and the evolution of the two sexes"
See also my Substack post on “Binarists vs. Spectrumists” where I attempt to elucidate some of the principles undergirding that process of categorization:
I agree with you that you can never actually change sex. Sex operations aren’t successful in changing sex of course, but that is the most succinct way of referring to such procedures. People understand what is meant.
I really don't think they do "understand" that -- most people haven't a flaming clue about the biological definitions for the sexes and what their implications are. Carl Sagan argued that some 90% of us are scientifically illiterate -- shouldn't be allowed to vote, much less breed.
I think "sex-change operations" are just a little lie that undergirds an even bigger one that causes no end of problems. Biden insists on throwing stones at the Republicans while being criminally negligent on the biology. Seem to recollect reading, possibly in a review of Time to Think, of a young girl at Tavistock being under the impression that she would become a functional male.
See Michele Goldberg's interview of transwoman "Helen Highwater":
Goldberg: "Though 'trans women are women' has become a trans rights rallying cry, Highwater writes, it primes trans women for failure, disappointment, and cognitive dissonance. She calls it a 'vicious lie.' ...."
"vicious lie" is just the beginning of a damning bill of particulars, arguably the direct consequence of being unable or unwilling to call a spade an effen shovel. See a 4th Wave now essay by, apparently, Sahar Sadjadi of McGill University:
"Shriveled raisins [ovaries exposed to testosterone]: The bitter harvest of 'affirmative' care
Scattered through the posts on this site, we have discussed the fact that puberty blockers followed by (or used concurrently with) cross-sex hormones to prevent the 'wrong puberty' in prepubertal kids results in irreversible sterilization."
ICYMI, you might have some interest in another of her posts, particularly given the title: "Deep in the Brain: Identity and Authenticity in Pediatric Gender Transition":
Sadjadi: "Moreover, the magico-spiritual undertone of the conversations I witnessed was striking .... I was perplexed by this merging of science, magic, and religion in explaining children’s gender transition ..."
But THAT is what "gender-affirming care" boils down into: the sterilization of, generally, dysphoric and autistic children. Sugar-coating that fact, one might reasonably argue, is largely the reason why it has gone on so long.
Along the same line, you might have some interest in an old post -- no longer available at Standpoint Magazine -- by Helen Joyce which was not prepared to do any pussyfooting about:
"Speaking up for female eunuchs:
The woes of 'detransitioners' are a warning: treating children with gender dysphoria is riskier than zealots admit"
That is what eunuchs are -- they have NO reproductive function; they're sexLESS:
"sex: Either of the two main categories (male and female) into which humans and most other living things are divided on the basis of their reproductive functions."
Fine if some "adult" wishes to do that to themselves. But to trick or mislead dysphoric children into thinking that they can actually change sex? Crime of the century, a medical scandal to match the Tuskegee syphilis study compounded with "Dr." Mengele: those doctors and professionals responsible should lose their licenses, if not be strung up by their nuts and left to twist in the wind. Figuratively speaking of course ...
"shoddy and inept uses of words" is the problem, not a solution.
Thank you very much for writing this! I am a pediatrician in private practice in a blue state suburban area and horrified by the current situation. I can attest that everything you wrote is true, and I wish I could have described it so clearly myself.
I read through all of your comments, and don't see any other currently practicing pediatricians. I think most pediatricians really are at peace with this ideology. Since the question from your commenters about why pediatricians are so silent is appropriate, I thought I'd describe what I've done, for better or worse.
I resigned from the AAP when the statement came out 5-6 years ago, because it was so obviously not based on normal science. My approach has been to support children and their families in resisting gender ideology in a quiet, everyday way. I talk to parents privately to address their concerns when children are attracted to this, and refer them to contrarian reading materials. When talking to children privately I encourage them to see their emotional concerns holistically and remind them that gender is only part of who they are. I make sure parents and children are aware that gender dysphoria treatments are debated and controversial. I prescreen therapists to find ones who will address the whole child and try to keep the focus off gender issues (this is getting harder due to licensing concerns for therapists). Our office has no gender ideology symbolism displayed (or any other political or ideological symbolism). I strongly counsel parents to avoid taking their children to gender clinics. As a personal challenge, I've nearly mastered the art of writing a letter (for 504 plan or other purposes) that is grammatically correct and pronoun free:)
I've done my best, but still feel morally compromised by my participation in the care of these children. I only have a few that have actually had medical treatment surprisingly, and just one had a mastectomy (at age 20). I'm afraid just being with them as a doctor and knowing their history is a way of being complicit for which they might judge me harshly later. Maybe I haven't said enough. But they are whole people with many other issues, and I don't want to reject them either. And some parents are enthusiastically supportive of their child's gender "journey". I think I also have an ethical obligation to respect the parent as the person who makes decisions for their child, even if I disagree. Not for child abuse of course, but this is legal. So it's all very difficult to figure out.
I consider quitting, but I think I may be doing some good for these families so I stick with it. I pray there are a lot of pediatricians out there fighting in this way. Even though it seems like we're all silent, some of us aren't that exactly.
Thank you for your courage and eloquence, and I hope your essay will be very widely read.
Wow. Thank you. Please contact Colin and get my email and phone number from him and send me a private message. Hope to get your name and talk on the phone. Gender critical pediatricians should stay in touch.
Please connect with the Society for Evidence Based Gender Medicine which has many pediatricans in it and which has been leading the fight to get the American Academy of Pediatrics to do a comprehensive review of the studies on "gender affirming care". https://segm.org/
Dr. Li, thank you so much for composing and sharing this article!
I am a clinical psychologist, and I work with adolescents and adults. I live in Oregon, and I have recently decided to stop seeing adolescents in my practice, because healthcare professionals here are at risk legally if they refuse to work within the "gender affirmative care" model. It isn't possible to screen gender-confused children out of my practice, because an increasing number of young women that I am seeing for other reasons will suddenly announce to me that they are "non-binary," without having reported any previous history of gender confusion. It is completely obvious that cutting off their breasts is not the proper way to address their psychological problems, and I never dreamed that this ancient form of torture would be reinstated as a psychiatric approach within pediatric medicine or my profession.
More generally, I feel intense grief and rage about the destruction of my beloved profession by doctoral level psychologists who apparently have no clue what science or clinical practice even are, much less how to employ these methodologies. It is difficult to understand how people who must be at least of average intelligence and who attended what used to be the "best schools in the country" ended up so ignorant and brutish in their thinking and their behavior.
Looking from the outside at the woke cult and its obsession with "trans identities," I see lots of symptoms of personality disorders being acted out en masse. Not only do many of the leaders of this movement behave in a highly narcissistic or sociopathic manner, the cult as a whole also does. Many observers have described the woke cult as a social pathology, e.g. Elon Musk's characterization of the cult as "a mind virus," and I agree that it is a mass mental illness rather than a "political" movement.
I hope that pediatricians will listen to you and will take time to actually inform themselves about the appallingly destructive mistreatment of children that is being perpetrated by trans activist healthcare professionals. Vulnerable young people are being harmed by "gender affirmative care" whether or not they know it now or ever during their lives. When the adults who are charged with protecting children abuse them instead, abuse becomes normal to those kids, and in many cases they never recognize how horribly they were betrayed.
Thank you so much. It is my hope doctors and pediatricians will read this.
I sympathize with your dilemma. However, by withdrawing from the battle, you leave the playing field to those willing to fight the struggle "on behalf" of these confused children leading to great harm. Why not raise cain within the psychology community. It will be of interest to find out what happens to Dr Li after speaking out so eloquently against the current dogma!
My prediction is I will be ignored by gender activists for a bit until my name recognition grows.
I will pray for your protection and courage. Keep up the good work.
https://oregoncapitalchronicle.com/2023/02/14/state-house-proposal-would-ban-oregon-therapists-from-trying-to-change-a-persons-sexual-orientation/
You should contact Stephanie Winn who has written about how Oregon licensing boards have NOT taken action against anyone for failing to tow the "gender affirming" line in their practice of therapy. I read an article by her about her investigation of Oregon licensing boards, but cannot quickly find the link to that. https://www.sometherapist.com/
Thank you so much, Holly! I will definitely contact her.
So well said Sandra. I’m fighting this however I can.
Thank you!
Hi Sandra I thought this link might interest you.
https://open.substack.com/pub/jamesesses?r=9oxmc&utm_medium=ios
Thank you for this link, Miguelito!
I was appalled to learn that the NHS supplies personality disordered young people with “clean blades” to use for self injury.
I have been reflecting recently on the fact that neither I nor any of my adult trans clients ever talked about a medical transition as a magical cure for all their emotional problems. It never occurred to me that the clients would think that genital and facial surgery would cure their depression, if they had it, or their substance abuse, or anything but their gender dysphoria. In reality, very few clients who transition continue in therapy, so we don’t know what goes on with them. It’s a strange phenomenon. When a person makes such a drastic lifestyle change, doesn’t it seem like he/she would want to talk about it? I tend to think that the “original” (not Gen Z) trans clients were not typical consumers of psychotherapy. Apparently they were/are so concrete in their thinking that it made sense to them that cosmetic surgery would be the optimal approach to their emotional distress.
An Oregon pediatrician, Julia Mason in Gresham, is one of the founders and most active member of the Society for Evidence Based Gender Medicine https://segm.org/ I hope you will subscribe to SEGM's newsletter.
A powerful read. I’m reading Time to Think currently. I’m not a physician nor do I work in mental health or with children. Having 2 older teens, 1 of which told us 3 years ago she was trans and wanted an elective mastectomy, I’m very concerned with professional groups legitimizing this new insanity. By the grace of God, our daughter has moved way from the trans obsession and moved more center. After reading some of Hannah Barnes’ work, I see similarities in what our daughter struggled with. She began following influencers on social and became mesmerized by the promises of a rebirth in transitioning. I empathize with any parent and child struggling with identity and am thankful for voices of reason pulling the pendulum back.
Thank you sharing. You and your daughter have been blessed that she avoided the tragic path that so many vulnerable youth have followed. I hope that at some point she will tell strong enough to share her journey with others who might benefit.
The detailed description of post-modern medicine is terrifying for all of us. One of the very chilling concepts:
"Under Gender Ideology there is no such thing as individual dignity and therefore there is no harm that can be done to individuals. There is only collective Social Justice. "
This explains why the sadistic cruelty of "gender medicine" is perpetrated on children with no thought, no remorse, and also explains the violence against anyone who would dare to tell them it is wrong. This has to be stopped, in any way possible. Since they will never give up their ideology, making them pay with massive malpractice lawsuits and legal prohibitions will have to be the main tools. When it becomes too expensive, it will at least slow down. Not before.
Though I had not thought about it in this detail before, it isn't about the children, or the transgender adults, it isn't about the people at all, it is only about the Social Justice Warrior's campaign against any and all of society. They want to break everything, just because it's there, and replace it with...what? They never say. But for an example, take a look at San Francisco or Portland, or Chicago, and how well is anarchy working out there?
How is it working out? Homeless, abandonment of the defenseless mentally ill, addiction and rampant crime.
This is a different tangent, but I wanted everyone to know that an African American man with 15+ years working for a NY state manufacturer got summarily fired this week for attempting to protect the women at the factory. They produce stainless steel counters for commercial kitchens and have employed many minorities, skilled labor. This man suggested to a man wearing eye shadow that he should better use the men's room, instead of the women's room he entered. This African American man was summarily fired within the hour. That's what I call Trans White Privilege.
https://www.youtube.com/watch?v=phJMKPBVOXY
I am gay, and was a medical doctor a lawyer, and I appreciate your thoughtful analysis of Post Modern Medicine. Each of my three identities has been besmirched by the "queering" of reason in the name of "Social Justice." Gays and lesbians have been defamed by transexuals who have undone decades of work de-stigmatizing homosexuality; the transexuals have re-pathologized sexual identity. Post modern social justice warriors have committed an even worse crime by undermining the foundations of objective reality in medicine and law. Lawyers were always on a slippery slope toward subjectivity and greed, but I was proud of the medical profession's objectivity and its commitment to decency. That pride is now gone along with the reputation of medical science. Gender clinics are the ambulance chasers of our time, and all physicians are sullied by association. The American Medical Association has just declared body mass index (BMI) "racist," which confirms our profession has now become a postmodern joke.
They call everything they cannot control racist until they control it.
And if you are ever in an argument with one, you find out really fast that they are not above slurs of all kinds, including racial. They actually seem to be huge bigots and they aren’t self aware enough to recognize it. They project their own biases and personality deficits onto others constantly.
Terrifically deep and thoughtful analysis. I am a retired pediatric pulmonologist and agree with Dr. Li. I am so embarrassed that "busy" pediatricians have sat silently through the deep corruption of our profession by the AAP and others while lives are destroyed in violation of "Do No Harm". This is the greatest medical and ethical malfeasance of modern times in pediatrics. Silent pediatricians are closely akin to the "good Germans" who acceded to the cruel crimes of the Nazis.
"malfeasance" -- amen to that; crime and medical scandal of the century.
Though, as I've argued (see link below), "our side" is partly to blame for indulging in euphemisms while turning a blind eye to what they really entail.
What really chaps my hide is the too frequent use of "sex change operations" which are nothing of the sort -- nothing more than the sterilization of dysphoric and autistic children; turning them into sexless eunuchs.
"Gender affirming 'doctors' are sterilizing your children!" --- pass it on ...
https://www.realityslaststand.com/p/a-pediatricians-manifesto-for-the/comment/17600307
As a fellow scientist, I agree with you. Sincerely, Frederick
Horrifying. Why aren’t there more lawsuits? More “medical professionals” being held accountable? Who the hell are these doctors completely lacking in empathy, compassion, and apparently the BRAINS to be smart enough not to put their patients in danger?.
Who the hell decided that queer theory was a great idea to impose on all of us?
These doctors think they are lifesaving heroes, like jihadi who blow up school buses who think they are saving children’s souls from corruption by infidel parents. Children’s souls immediately go to heaven.
Well, heaven in gender ideology is “gender euphoria.”
Given the three recent court decisions striking down state laws prohibiting "gender affirming" medicine, I am pessimistic about the chances malpractice lawsuits will be the corrective measure desperately needed. The courts are, as expected, treating the statements by the AMA, AAP, etc. as authoritative, essentially conclusive as to standard of care. The zealots were shrewd to get them adopted, mostly under the radar.
Pessimism in the short term but ultimately being pro-Reality is a winning strategy. I feel sorry for the anti-Real zealots.
Lawsuits by detransitioners are beginning to be filed. Three have already been filed against Kaiser in California and a few in other states around the country. It will take some time for detransitioners to become aware of which professional malpractice law firms are willing to take these lawsuits on. Washington University's Gender Clinic has announced that it will no longer give puberty blockers, cross sex hormones or surgeries to minors, on the advice of its loss control legal advisers because it is expected that many lawsuits will be forthcoming. There is no doubt that medical malpractice insurers will soon appreciate that they will face huge losses by continuing to insure doctors who perform "gender affirming"surgeries. That has already happened in Australia. And Democrat controlled legislatures in California, Oregon and Washington are aware that malpractice insurers may start "penalizing" gender clinic doctors, and have actually passed laws prohibiting malpractice insurers from doing that by increasing premiums charged to such doctors or refusing to cover such doctors. BUT nothing can force malpractice insurers to continue to offer insurance in states that do that! So before long malpractice insurers will stop offering insurance to all doctors in states like California, Oregon and Washington, which of course means that the remaining insurers will raise the premiums they charge to ALL doctors in those states. And THEN all doctors will realize that they have a stake in what gender clinics are doing, and cannot simply turn a blind eye because they themselves do not engage in "gender affirming" medicine.
It is hard to imagine anything more childish than “childism.”
Indeed. You might then "like" this cartoon on "progressive parenting":
https://patcrosscartoons.com/2019/10/08/progressive-parenting/
😅
Amazing piece. Thank you!! I'm a psychologist and am absolutely alarmed - and devastated - about what is happening in "gender medicine", as well as in my field.
Thank you Dr. Li, for writing such a clear, powerful, and direct manifesto. Your voice is wise and refreshing, so welcome! I hope you will keep speaking out, especially in the Seattle area (I am near there too) where we have so many great hospitals. While I read Pluckrose and Lindsey's book when it came out and have encountered many heterodox-type thinkers defending enlightenment-born science, your defense is for me the clearest whack on the head (in a good way!) I have encountered. I love the insight, "stop calling my profession Western medicine!" People get confused by the blinders and abuses of scientists: invalidation of science as culturally relative and oppressive (etc. ) results. The self-correction of the scientific method eventually leads us to pathways born of evidence rather than superstition. Science is one of the most useful and amazing inventions ever, and it's for everyone. It needs to be defended, which you have done so brilliantly. This is why I love Colin's Substack--he is taking a stand for reality and for science.
Thank you so much!
Seattle Children’s and Swedish are neck deep in gender ideology.
Do you know about Virginia Mason or UW?
What a fantastically informative, intelligent and readable article. Thankyou so much Erica for writing it and Colin for making it available.
Dear Dr. Li, I write to you as a mother, grandmother and great-grandmother. I am not a medical professional and have no scholarly credentials at all. However, your wonderfully written Manifesto gives me hope for truth to finally shine in the darkness for my family. Three of my brilliant, talented (and abused in many ways), grandchildren have fallen into the insanity of transgenderism. I am going to send a copy to my son, the father of all three. He has not spoken to me in 4 years. and I have not seen my grandchildren or great-grandchildren in as long. Not all our issues are related to this ideology, but your relating of the history of how we got to this moment in time, wherein we were susceptible to such a fantasy is invaluable for a family such as mine. Your Manifesto is flawless, your writing impeccable. I am in hopes that many will benefit from your courage and your efforts, as I have. Thank you! Sending you love and prayers, stay safe, Indio.
My gratitude and humbleness. I wish your family the best.
NOT NORMAL indeed. Thank you for this. Why are more physicians not speaking out? I am a therapist, and I’m horrified by what most of my profession is doing under the spell of destructive queer theory which they don’t actually even understand or realize they are captured by.
Quite an impressive essay, and for many reasons, some of which I’ll get into a bit later.
However, to start the ball rolling, I think your “medical sex transition” is rather a “problematic” misuse of language though, rather sadly, quite a common one. The point is that no one, no human changes sex, and to make even the most oblique suggestion that that is possible constitutes “aiding and abetting the enemy”, if not conceding the war even before battle is joined.
But, along the same line, what really chaps my hide is the frequent reference to “sex change operations”, particularly by many who should know better. For an example of the latter, see the Statistics Department of New Zealand (zealot-land) which boldly asserts:
NZ: “Sex reassignment occurs where a person has undergone the necessary treatment to permanently change their sex." 🙄
https://aria.stats.govt.nz/aria/?_ga=2.135330993.1433053733.1593671441-939313310.1593671441#StandardView:uri=http://stats.govt.nz/cms/StatisticalStandard/FrytLv0KtGf6RhVY
And various other sources, including Substacker Christopher Rufo, do likewise:
Rufo: “describing the process of sex-change interventions ...”
https://www.city-journal.org/article/sex-change-procedures-at-texas-childrens-hospital
Telegraph: “Minister orders inquiry into 4,000 per cent rise in children wanting to change sex”
https://www.telegraph.co.uk/politics/2018/09/16/minister-orders-inquiry-4000-per-cent-rise-children-wanting/
Daily Mail: “Biden slams GOP for trying to ban sex changes ... he doesn't think states should have the right to regulate sex change surgeries or treatments ... denounced Republican states that have passed laws attempting to ban or limit sex change surgeries and transition treatments ...”
https://www.dailymail.co.uk/news/article-11348505/Biden-slams-GOP-trying-ban-sex-changes-children-interview-trans-TikTok-activist.html
The only way “sex change” might work is if we go with the Kindergarten Cop definitions – i.e., boys have penises and girls have vaginas – which is apparently where Biden’s head is at, along with those of too many others, but I rather doubt it has much use outside of primary school. However, that misuse of terminology and the underlying scientific illiteracy – being charitable – is pervasive, pernicious, and profoundly problematic.
Apropos of which, you might be “amused”, or not, to note that the book “Exploring the Biological Contributions to Human Health: Does Sex Matter?” on the NCBI/NLM website – “an official website of the United States Government ...” 🙄 – has titled its second chapter as “Every Cell Has a Sex”:
https://www.ncbi.nlm.nih.gov/books/NBK222291/
Who knew that each and every cell has – or will have, or used to have ... 🙄 -- the ability to produce gametes all by their lonesomes? ... 🙄
But rather sadly, the Yale School of Medicine is equally clueless and follows the NCBI off into the weeds of biological illiteracy, cluelessness, and postmodernist claptrap:
https://medicine.yale.edu/ycci/news-article/every-cell-has-a-sex-x-and-y-and-the-future-of-health-care/
As Francis Bacon, one of the founders of the scientific method, once put it, "Therefore shoddy and inept application of words lays siege to the intellect in wondrous ways."
https://en.wikipedia.org/wiki/Novum_Organum
Which seems like an apt if depressing summary of the whole "debate" over what it means to qualify as a male or a female. Or as neither. "shoddy and inept uses of words" by pretty much all and sundry.
Which brings me to your “Postmodernism is allergic to categorization” – amen to that; truer words were never spoken. However, that rather “debilitating” allergy is, sadly or not, not unique to the postmodernists and their ilk. Unfortunately, a great many people on all sides of the issue, even in this more or less enlightened neck of the woods, are equally “allergic”, and just as “obstinate” in refusing to even debate the principles of categorization on which the standard biological definitions for the sexes are solidly based.
Those definitions stipulate that to have a sex is to have functional gonads of either of two types, those with neither being, ipso facto, sexless; see the Glossary of this article in the Journal of Molecular Human Reproduction for details:
"Gamete competition, gamete limitation, and the evolution of the two sexes"
https://academic.oup.com/molehr/article/20/12/1161/1062990
See also my Substack post on “Binarists vs. Spectrumists” where I attempt to elucidate some of the principles undergirding that process of categorization:
https://humanuseofhumanbeings.substack.com/p/binarists-vs-spectrumists
I agree with you that you can never actually change sex. Sex operations aren’t successful in changing sex of course, but that is the most succinct way of referring to such procedures. People understand what is meant.
I really don't think they do "understand" that -- most people haven't a flaming clue about the biological definitions for the sexes and what their implications are. Carl Sagan argued that some 90% of us are scientifically illiterate -- shouldn't be allowed to vote, much less breed.
I think "sex-change operations" are just a little lie that undergirds an even bigger one that causes no end of problems. Biden insists on throwing stones at the Republicans while being criminally negligent on the biology. Seem to recollect reading, possibly in a review of Time to Think, of a young girl at Tavistock being under the impression that she would become a functional male.
See Michele Goldberg's interview of transwoman "Helen Highwater":
Goldberg: "Though 'trans women are women' has become a trans rights rallying cry, Highwater writes, it primes trans women for failure, disappointment, and cognitive dissonance. She calls it a 'vicious lie.' ...."
https://slate.com/human-interest/2015/12/gender-critical-trans-women-the-apostates-of-the-trans-rights-movement.html
"vicious lie" is just the beginning of a damning bill of particulars, arguably the direct consequence of being unable or unwilling to call a spade an effen shovel. See a 4th Wave now essay by, apparently, Sahar Sadjadi of McGill University:
"Shriveled raisins [ovaries exposed to testosterone]: The bitter harvest of 'affirmative' care
Scattered through the posts on this site, we have discussed the fact that puberty blockers followed by (or used concurrently with) cross-sex hormones to prevent the 'wrong puberty' in prepubertal kids results in irreversible sterilization."
ETA:
https://4thwavenow.com/tag/sahar-sadjadi/
ICYMI, you might have some interest in another of her posts, particularly given the title: "Deep in the Brain: Identity and Authenticity in Pediatric Gender Transition":
Sadjadi: "Moreover, the magico-spiritual undertone of the conversations I witnessed was striking .... I was perplexed by this merging of science, magic, and religion in explaining children’s gender transition ..."
https://journal.culanth.org/index.php/ca/article/view/3728/430
But THAT is what "gender-affirming care" boils down into: the sterilization of, generally, dysphoric and autistic children. Sugar-coating that fact, one might reasonably argue, is largely the reason why it has gone on so long.
Along the same line, you might have some interest in an old post -- no longer available at Standpoint Magazine -- by Helen Joyce which was not prepared to do any pussyfooting about:
"Speaking up for female eunuchs:
The woes of 'detransitioners' are a warning: treating children with gender dysphoria is riskier than zealots admit"
https://web.archive.org/web/20201113021904/https://standpointmag.co.uk/speaking-up-for-female-eunuchs/
That is what eunuchs are -- they have NO reproductive function; they're sexLESS:
"sex: Either of the two main categories (male and female) into which humans and most other living things are divided on the basis of their reproductive functions."
https://web.archive.org/web/20190326191905/https://en.oxforddictionaries.com/definition/sex
Fine if some "adult" wishes to do that to themselves. But to trick or mislead dysphoric children into thinking that they can actually change sex? Crime of the century, a medical scandal to match the Tuskegee syphilis study compounded with "Dr." Mengele: those doctors and professionals responsible should lose their licenses, if not be strung up by their nuts and left to twist in the wind. Figuratively speaking of course ...
"shoddy and inept uses of words" is the problem, not a solution.
Thank you very much for writing this! I am a pediatrician in private practice in a blue state suburban area and horrified by the current situation. I can attest that everything you wrote is true, and I wish I could have described it so clearly myself.
I read through all of your comments, and don't see any other currently practicing pediatricians. I think most pediatricians really are at peace with this ideology. Since the question from your commenters about why pediatricians are so silent is appropriate, I thought I'd describe what I've done, for better or worse.
I resigned from the AAP when the statement came out 5-6 years ago, because it was so obviously not based on normal science. My approach has been to support children and their families in resisting gender ideology in a quiet, everyday way. I talk to parents privately to address their concerns when children are attracted to this, and refer them to contrarian reading materials. When talking to children privately I encourage them to see their emotional concerns holistically and remind them that gender is only part of who they are. I make sure parents and children are aware that gender dysphoria treatments are debated and controversial. I prescreen therapists to find ones who will address the whole child and try to keep the focus off gender issues (this is getting harder due to licensing concerns for therapists). Our office has no gender ideology symbolism displayed (or any other political or ideological symbolism). I strongly counsel parents to avoid taking their children to gender clinics. As a personal challenge, I've nearly mastered the art of writing a letter (for 504 plan or other purposes) that is grammatically correct and pronoun free:)
I've done my best, but still feel morally compromised by my participation in the care of these children. I only have a few that have actually had medical treatment surprisingly, and just one had a mastectomy (at age 20). I'm afraid just being with them as a doctor and knowing their history is a way of being complicit for which they might judge me harshly later. Maybe I haven't said enough. But they are whole people with many other issues, and I don't want to reject them either. And some parents are enthusiastically supportive of their child's gender "journey". I think I also have an ethical obligation to respect the parent as the person who makes decisions for their child, even if I disagree. Not for child abuse of course, but this is legal. So it's all very difficult to figure out.
I consider quitting, but I think I may be doing some good for these families so I stick with it. I pray there are a lot of pediatricians out there fighting in this way. Even though it seems like we're all silent, some of us aren't that exactly.
Thank you for your courage and eloquence, and I hope your essay will be very widely read.
Wow. Thank you. Please contact Colin and get my email and phone number from him and send me a private message. Hope to get your name and talk on the phone. Gender critical pediatricians should stay in touch.
Please connect with the Society for Evidence Based Gender Medicine which has many pediatricans in it and which has been leading the fight to get the American Academy of Pediatrics to do a comprehensive review of the studies on "gender affirming care". https://segm.org/