Praise for When Harry Became Sally During this “transgender moment,” a government-enforced tyranny of false presumptions about nature besieges the American family. When Harry Became Sally provides the empirical information needed to refute the transgender suppositions, and—in a most original way—makes historic sense of this social misdirection by noting how the “gender- fluid” pseudoscientific claims of today’s transgender ideologues derive from dubious arguments previously passed around amongst second-wave feminists. Learn from Ryan Anderson how another craze about the workings of the mind has come to beset American households and put thousands of people at risk. — PAUL MCHUGH, UNIVERSITY DISTINGUISHED SERVICE PROFESSOR OF PSYCHIATRY, JOHNS HOPKINS UNIVERSITY SCHOOL OF MEDICINE When Harry Became Sally is an eminently readable and insightful guide for all who find themselves perplexed by today’s debates on gender identity. Ryan Anderson’s analysis of the ideas that are fueling the transgender movement, their human costs, and their political implications will be a valuable resource for parents, educators, and policymakers. — MARY ANN GLENDON, LEARNED HAND PROFESSOR OF LAW, HARVARD UNIVERSITY, AND AUTHOR OF RIGHTS TALK AND A NATION UNDER LAWYERS For an informed and sensitive presentation of gender identity issues, When Harry Became Sally is a must-read book. It is especially a must for those in psychiatry, psychology, and counselling. — PAUL VITZ, PROFESSOR EMERITUS OF PSYCHOLOGY, NEW YORK UNIVERSITY, AND SENIOR SCHOLAR, INSTITUTE FOR THE PSYCHOLOGICAL SCIENCES I always read Ryan Anderson with great admiration. When Harry Became Sally is an always focused, informative, fair- minded, lucid, and fact-based guide to just and reasonable policies in place of government- and corporation-mandated falsification of science, medicine, public records, and history; suppression of free speech and family rights; and many-sided, often irreversible injustice to the vulnerable. — JOHN FINNIS, PROFESSOR OF LAW & LEGAL PHILOSOPHY EMERITUS, UNIVERSITY OF OXFORD “Do no harm” is a fundamental tenet of medical ethics. But sadly—as shown by Ryan Anderson’s careful examination of the research—people with gender dysphoria are now commonly given treatments that involve grave health hazards and few (if any) lasting benefits. Regardless of political persuasion, all concerned citizens, especially parents, policymakers, and health-care professionals, should give serious consideration to the evidence presented in this thoughtful and balanced book. — MELISSA MOSCHELLA, ASSISTANT PROFESSOR OF MEDICAL ETHICS, DEPARTMENT OF MEDICINE, COLUMBIA UNIVERSITY Ryan Anderson forthrightly calls out the suspension of disbelief that has led us into ever more bizarre denials of reality, blindfolding our eyes and our heads in the name of political ideology and ensuring the suffering of the mentally ill. Everyone concerned with the welfare of children should read When Harry Became Sally. — MARGARET A. HAGEN, PROFESSOR OF PSYCHOLOGICAL AND BRAIN SCIENCES, BOSTON UNIVERSITY People who experience gender dysphoria deserve to be treated with compassion, kindness, and respect—just like everyone else. It is wrong to despise them, ridicule them, or disrespect them in other ways. As Ryan Anderson shows in his rigorously argued critique of transgender ideology, we can speak and stand up for the truth while loving those who identify as transgender as our neighbors. When Harry Became Sally confirms Anderson’s standing as one of our nation’s most gifted young intellectuals, and without doubt the most fearless. — ROBERT P. GEORGE, MCCORMICK PROFESSOR OF JURISPRUDENCE, PRINCETON UNIVERSITY Ryan Anderson takes up the challenging topic of the “transgender moment” in a clear and biologically well- informed manner. He writes in a thoughtful and accessible manner, and he succeeds in his goal of providing “a sober and honest survey of the human costs of getting human nature wrong.” When Harry Became Sally raises important questions for anyone who is sincerely concerned about the well-being of those struggling with their gender identity. — MAUREEN CONDIC, ASSOCIATE PROFESSOR OF NEUROBIOLOGY AND ANATOMY, UNIVERSITY OF UTAH © 2018 by Ryan T. Anderson All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without the prior written permission of Encounter Books, 900 Broadway, Suite 601, New York, New York, 10003. First American edition published in 2018 by Encounter Books, an activity of Encounter for Culture and Education, Inc., a nonprofit, tax exempt corporation. Encounter Books website address: www.encounterbooks.com The paper used in this publication meets the minimum requirements of ANSI/NISO Z39.48-1992 (R 1997) (Permanence of Paper). FIRST AMERICAN EDITION LIBRARY OF CONGRESS CATALOGING-IN-PUBLICATION DATA Names: Anderson, Ryan T., 1981– author. Title: When harry became sally: responding to the transgender moment / Ryan T. Anderson. Description: New York: Encounter Books, [2018] | Includes bibliographical references and index. Identifiers: LCCN 2017031504 (print) | LCCN 2017033229 (ebook) | ISBN 9781594039621 (Ebook) Subjects: LCSH: Transgender people. | Identity (Psychology) Classification: LCC HQ77.9 (ebook) | LCC HQ77.9 .A556 2018 (print) | DDC 306.76/8—dc23 LC record available at https://lccn.loc.gov/2017031504 Interior page design and composition: BooksByBruce.com For Anna Contents Introduction CHAPTER ONE Our Transgender Moment CHAPTER TWO What the Activists Say CHAPTER THREE Detransitioners Tell Their Stories CHAPTER FOUR What Makes Us a Man or a Woman CHAPTER FIVE Transgender Identity and Sex “Reassignment” CHAPTER SIX Childhood Dysphoria and Desistance CHAPTER SEVEN Gender and Culture CHAPTER EIGHT Policy in the Common Interest Conclusion Acknowledgments Notes Index Introduction In 1989, the classic film When Harry Met Sally dealt with one thorny issue: Can a man and a woman really be “just friends”? That question may still be up in the air, but Hollywood took on a more fundamental one with the 2015 film The Danish Girl: Can a man really become a woman? The answer from Hollywood was a resounding “yes.” The Danish Girl is based on the true story of Einar Wegener, a painter in Copenhagen who in 1930 became the first known subject of “sex reassignment” surgery. He had long thought of himself as having a female identity that he called “Lili Elbe,” but whether those drastic medical procedures made him truly a woman is another matter. The idea that a person could have been born into a body of the wrong sex and might be transformed into the other sex by surgery and hormones would remain marginal for some time. Now it is rapidly becoming a mainstream view that social and medical “transition” is the appropriate treatment for people, including children, who feel at odds with their biological sex. America is in the midst of what has been called a “transgender moment.”1 Not long ago, most Americans had never heard of transgender identity, but within the space of a year it became a cause claiming the mantle of civil rights. A discordant gender identity is said to represent who the person really is, by contrast with the sex “assigned at birth,” and therefore any failure to accept and support a transgender identity amounts to bigotry. We are told that not treating people as the gender they claim to be is discriminatory. But is it true that a boy could be “trapped” in a girl’s body? Is our sex merely “assigned” to us? Can modern medicine “reassign” sex? What is the most loving and helpful response to the condition of gender dysphoria, a profound and often debilitating sense of alienation from one’s bodily sex? Should our laws accept and enforce a subjective notion of gender? These shouldn’t be difficult questions. In the late 1970s, Dr. Paul McHugh thought he had convinced the vast majority of medical professionals not to go along with bold claims about sex and gender that were being advanced by some of his colleagues. McHugh received a world-class education at Harvard College and Harvard Medical School. As chair of psychiatry at Johns Hopkins Medical School and psychiatrist- in-chief at Johns Hopkins Hospital, he put a stop to sex reassignment surgery at that facility in 1979. Many other medical centers across the country followed the elite institution’s lead. But recent years have brought a resurgence of these procedures—not in light of new scientific evidence, mind you, but under the pressure of ideology. The people increasingly in the spotlight of the transgender moment are children. In 2007, Boston Children’s Hospital “became the first major program in the United States to focus on transgender children and adolescents,” as its website brags.2 A decade later, more than forty-five pediatric gender clinics had opened their doors to our nation’s children.3 Parents are told that puberty blockers and cross-sex hormones may be the only way to prevent their children from committing suicide. Never mind that the best studies of gender dysphoria (studies that even transgender activists cite) show that between 80 and 95 percent of children who express a discordant gender identity will come to identify with their bodily sex if natural development is allowed to proceed.4 And never mind that “transitioning” treatment has not been shown to reduce the extraordinarily high rate of suicide attempts among people who identify as transgender (41 percent, compared with 4.6 percent of the general population).5 In fact, people who have had transition surgery are nineteen times more likely than average to die by suicide.6 These statistics should be enough to halt the headlong rush into “transitioning” and prompt us to find more effective ways to prevent these tragic outcomes. Most of all, we shouldn’t be encouraging children to “transition,” or making heroes and role models of those who have done so. In this book, I argue that Dr. McHugh got it right. The best biology, psychology, and philosophy all support an understanding of sex as a bodily reality, and of gender as a social manifestation of bodily sex.