Please be aware that this article contains graphic descriptions of surgical procedures and first-person interviews which may be very disturbing to some readers.—Eds.

Some months ago I was contacted in my office by a woman I’ll call Lucy. She was distraught and didn’t know where else to go. For months, the public school where she worked had been installing draconian rules to ensure that the children in her care be allowed, if they wished, to pursue a change of gender. Though she opposed the new practices, she felt powerless to speak up against them publicly without losing her job.

After some research it became clear to me that a considerable number of teachers and parents are finding themselves in Lucy’s position, and more will soon. This essay, which presents firsthand accounts from Lucy and others like her, is an effort to make their voices heard.

Transition

When little boys say they want to grow up into women, and little girls say they want to grow up into men, there are options available for adults who want to help them do it. The specifics of those options vary on a case-by-case basis. But in rough outline, the procedure recommended by clinicians goes like this.

First, the child “socially transitions,” adopting the clothes and pronouns of the opposite sex so as to experience what it’s like to do so before reaching Tanner Stage Two of puberty. At that point, which typically comes between the ages of about nine and 11, the endocrine system tries to release hormones that catalyze permanent, visible changes. If no intervention is made, pubic hair begins to appear. Genitals grow larger. Breasts develop.

Before any of that happens, kids who have been socially transitioned without regret may start taking puberty blockers. The most common kind, called gonadotropin-releasing hormone antagonists (GnRHa), are usually injected or implanted in the flesh of the arm to prevent the onset of sexual maturity. If the child reacts positively to this, then cross-hormone therapy—estrogen for boys and testosterone for girls—can be administered to stimulate a sort of alternative puberty.

The child then develops along lines usually associated with the opposite sex. Those changes are perceptible and permanent, like the ones that would have happened if the child had been allowed to develop past Tanner Stage Two. Boys grow breasts; girls’ voices change; musculature, facial structure, and bone density are irrevocably altered.

Surgery may follow. One aim of childhood transition, of course, is to make such surgery less traumatic and more effective: in the words of Dr. Simona Giordano, writing in the Journal of Medical Ethics (2008), “Cross-sex surgery, for transgender people whose puberty has not been suppressed, is going to be much more invasive.” Childhood transition can eliminate the need for a mastectomy or breast implants and decrease the likelihood of sidelong glances from passersby. The body, primed for its final alterations like a slab of meat tenderized before carving, will submit more readily and convincingly to being transformed.

But it is never a simple or painless thing to remove a penis (penectomy) and testicles (orchiectomy) or a uterus (hysterectomy). The formation of an artificial penis (phalloplasty or metoidioplasty) or a vagina (vaginoplasty) is a procedure whose results will forever be treated by the body as an open wound or an alien invasion. Artificial vaginas, especially, need to be dilated regularly or they will develop scabs and close up.

Transition is a lifelong commitment to maintenance, to digging in one’s heels each day against the biological motions of one’s own flesh. It leaves constant reminders that what has happened is an intervention against forces of nature which have proven incorrigibly stubborn. As Camille Paglia wrote, “every single cell of the human body remains coded with one’s birth gender for life.”

I, who am what they call “cisgender” (happy and comfortable with my biological body) contemplate hormone therapy and sex-change surgery with a sense of primal revulsion. To envisage them happening to me does not just make my skin crawl. It makes something beneath my skin, the very core of my guts, wriggle with discomfort as if larvae had nested within it. Most cisgender people, I think, would violently resist having their body altered irrevocably in the ways I have just described.

Medical literature on transgenderism today, at least that which is typically given the imprimatur of civility and respectability, insists that transgender children feel the same way about the natural development of their own bodies that I feel about contemplating sex-change surgery. To imagine puberty happening feels, I am told, like staring down a moving freight train—like your own body will turn itself inside out against your will if you don’t stop it soon.

Transgender people who have not transitioned experience what is called gender dysphoria, a persistent and nauseating sense of discomfort with one’s body and the way it is regarded by others. Women with gender dysphoria depict their breasts as water balloons stuck to their chests, or as pink lumps shackled to their legs like a ball and chain. Men have fantasies of unzipping their skin and emerging with curvaceous new figures. It is a cloying amalgam of self-consciousness, disgust, and claustrophobia.

Empathy for that kind of persistent torment motivates much transgender activism. If dysphoria feels like being eaten alive, if it drives people to attempt suicide, and if transition alleviates it, then the only humane thing to do is help people transition in every way possible. Children, moreover, are said to know that they are transgender from a very early age. Standards of Care, a widely cited manual for health professionals on dealing with transgender patients, states that “children as young as age two may show features that could indicate gender dysphoria.”

Even trans-friendly studies suggest that dysphoria will persist into adulthood only for 6­–27% of those children. Standards concedes this, but advises keeping a close eye on dysphoric kids to see if they might be good candidates for transition. “Mental health professionals should not impose a binary view of gender,” but instead should coach families through a process of trying to discern whether transition is advisable.

Popular depictitons of this philosophy have largely taken the form of heartfelt success stories in which supportive parents and their transgender kids describe the alleviation of fear and anxiety that accompanied transition. One of the first children to be featured in this way was Jazz Jennings, who entered the public eye in 2007 and whose transition from male to female is still being documented on TLC in the series I Am Jazz.

The success of that narrative has inspired others like it. “She was just a different kid. It was like a cloud lifted,” recalled Jamie Bruesehoff, whose son attempted suicide at the age of seven before socially transitioning to appear female.

No parent worthy of the name can bear the thought of a child so miserable as to take his or her own life. “The high amount of suicide that occurs scared me so much that I knew that no matter what fear or hesitation we had, or concern, that the only thing our children could and should and would feel from us would be love and acceptance.” Sara (no last name given), has two children who both consider themselves trans. She is convinced that they have been sure of their gender identity since they were very young, and that accusations of undue parental influence are unfounded.

Other parents whose children have transitioned publicly tell similar stories: there is simply no way, they contend, that this is something they are projecting onto their kids. The children themselves know who they are.

But what if they don’t?

Cracks in the Surface

What if a kid finds herself halfway through this process of transition, or all the way, and looks back in anger to discover it was all wrong? That is the substance of a U.K. lawsuit in which Keira Bell, a 23-year-old woman, accuses Britain’s National Health System of allowing her and others to pursue sex-change treatment when they were simply too young to give informed consent. “Detransitioners,” who regret their transitions and take measures to undo them, find themselves at the crux of an emotionally radioactive debate.

Take the case of Elle Palmer. She spent her adolescence battling depression, treating herself with weekly testosterone injections, and then—when her beard and chest hair didn’t make things better—quitting the hormones and letting her body reassert its own femininity. All that remains of her time as a man is her deep voice, a permanent change which gives her daily remorse. “Having to deal with the fact that I once had, like, a perfectly normal teenage girl voice and just let testosterone destroy it…it’s like, really hard to deal with that,” Elle told Blaire White, a transgender Youtuber.

White, who does not regret transitioning, is nevertheless highly critical of trans activists for shaming those who regret it: “Detransitioning is something that is incredibly taboo within the trans community. A lot of people who tell their stories of detransitioning are bullied, and shamed, and silenced.”

Carrie Callahan, who detransitioned as an adult, developed similar concerns when she realized that the negative effects of hormone therapy were being memory holed at the transgender healthcare clinic where she worked. “Most of us worked there because we rejected the idea that a strongly felt internal sense of gender could be a symptom of mental illness,” wrote Callahan in the Economist. “It was verboten for the staff to consider” that hormone therapy might intensify, rather than alleviate, the problems of the mentally ill.

Detransition stories point toward a disquieting cabal of secrecy about transgenderism. The parents, teachers, and medical professionals who put kids through sex changes present themselves as caring, compassionate allies of the weak. No doubt they see themselves that way too, and are quite earnest in their desire to help their patients and loved ones. But an uncomplicated acceptance of that portrayal apparently requires willfully disregarding the other side of the story. Those who argue that children should choose their gender do not like to hear from those children who wish they had not been permitted to do so.

When Jesse Singal wrote a cover story for the Atlantic featuring a young girl (whom he called “Claire”) pulling back from the brink of transition, the sociologist Tey Meadow penned a caustic response. “To position Claire as a ‘desister’ in the way Singal did is to participate in an inherently stigmatizing discourse with a very particular and damaging social history,” argued Meadow. In other words: noting publicly that some young people decide not to transition risks undoing the whole social project of child transgenderism.

One cannot help but wonder about the integrity of an ideological edifice so fragile that the mere existence of counterargument threatens to bring it crashing down.

The Underground Resistance

Indeed, whatever its more laudable aspirations, the trans youth phenomenon seems to be attended everywhere it goes by a culture of intimidation and silence. That is exactly why Lucy reached out to me.

Lucy is a counselor at a public school in California, where the accommodation of kids who say they’re transgender is mandated by law. Assembly Bill 1266, which was passed in 2013, requires “that a pupil be permitted to participate in sex-segregated school programs and activities, including athletic teams and competitions, and use facilities consistent with his or her gender identity, irrespective of the gender listed on the pupil’s records.” To put it bluntly: boys can use girls’ locker rooms unopposed.

Lucy’s school complies with the law by requiring that counselors meet with students to develop and issue a comprehensive set of directives which, once a student asks to be treated as the opposite gender, instructs all teachers to follow along. The child’s wishes are to be respected exactly, and his or her original identity becomes strictly need-to-know: though official records must retain the child’s birth name and sex, the California Department of Education has “strongly recommended” that administrators “consider placing physical documents in a locked file cabinet in the principal’s or nurse’s office” to keep all record of birth name out of sight and easy access.

Though Lucy has worked as a counselor for years, she has recently seen a sudden uptick in transgender cases. “It’s really popped up in the last year,” she told me, to the point that she spends much more time than before processing cases of gender transition. Though she thinks few teachers or parents are aware of how far things have gone, she feels helpless to resist or even voice concern about the rapidity with which students are able—even encouraged—to catalyze and enforce their own social transition. “I had one student come in after our Spring break,” she told me,

and she had googled gender dysphoria. And she said she had that. And she wanted a gender support plan…. And this happened without the parents’ knowledge. I double-checked with our district and I said, “parents are not in favor. Do I need to document that I reached them or anything?” And they said, “nope. You just put together the plan.”

Lucy is highly skeptical about the wisdom of such practices, but cannot advocate against them or even slow them down for fear of losing her job. “If I recommended counseling for this student, if I say okay, let’s contact counseling service first, let’s take some time—that could be viewed as me being a gatekeeper.” Social transition for the students at her school is “something we have to do when they request it.”

Parents, too, are kept out of the equation unless their cooperation is assured. “It’s all about whether or not the parents are supportive,” said Lucy. The parents whom Lucy tried to notify only found out about the extremity of their daughter’s mental health problems when she was hospitalized with suicidal tendencies. Fearing for their child’s life and driven to a point of desperation, the parents hope that affirmation will make things better: “mom is now in favor,” Lucy recalled.

This is the most extreme in a litany of cases that have come in and out of Lucy’s office. “I have another student who was born a female and was identifying as a male, then changed to non-binary, then went back to being called a male.” Whatever the student asks, the school—by law—must deliver.

Another counselor, a behavior specialist whom I’ll call Zach, emphasized that power structures exist to keep dissenters from being heard. “Parents send their children to school, and they have no idea of what’s going on in public education,” he said:

They trust that there’s adults, there’s reasonable adults, but they don’t know who’s getting hired and who’s getting promoted in these organizations. You can get promoted at the low level with a conservative point of view, but if you’re not drinking the Kool-Aid, you’re not moving up. If you don’t believe in the gender support plan. If you don’t know what the game is.

Zach told a bleak series of stories in which he was called into meetings and faced with vague accusations that his views and approaches to teaching were retrograde according to the standards adopted in the 2010s. “It’s not about what you said,” one administrator told him. It’s about how he carries himself, who he is, what he is suspected of believing.

“The union didn’t care,” Zach recalled. “I had been to meeting after meeting of just being abused, and they never did a darn thing.” Frustrated, he at last reached out to lawyers who told him, “‘look, you’re the unprotected class. White, male…there’s nothing we can do for you.’”

The governing bodies of the medical and psychiatric professions have largely worked together to enforce a consensus that transgenderism is neither a mental illness itself nor likely to be a consequence of other mental illnesses. According to this theory, the high incidence of depression and suicidality in people who experience gender dysphoria should be understood as a consequence of oppression, meaning that the solution is transition and social reform.

Those who disagree, if they want to practice at all, have to consider becoming independent from major institutions. One doctor who has done so is Abilash Gopal, an M.D. who worked in adolescent psychiatric hospitals for over a decade but now solely focuses on his private practice, where he treats patients of all ages and both sexes. He has written publicly about his encounters with child transgenderism, including a harrowing court battle in which a boy was taken from his father by a mother convinced he was a girl.

“I was appalled by what was happening,” Gopal told me in an interview:

almost nobody’s saying the truth. And when people do, they’re hounded into submission. I don’t think I’ve come across a single clinician who’s willing to say what they actually think. A lot of them have serious qualms about transgenderism in children, but almost none of them are willing to say anything about it.

The state of the field, says Gopal, is dire. Scientific studies on LGBTQ issues are sent to activist groups to be vetted for ideological acceptability before publication, rendering even peer-reviewed journals impossible to trust. Practitioners themselves feel hamstrung, unable to say what “any honest clinician knows”: that child transgenderism has become a mass hysteria.

Writing for The American Mind, Gopal observed that “the prevalence of adults who identify as transgender is less than 0.5%, but up to 50% of the adolescents I see in the hospital claim to be trans, gender dysphoric, or non-binary, and many are already taking hormones, some as young as 11 or 12.” When we spoke on the phone, he added that

almost all the trans kids have behavior problems. They’re trying to get attention, other kids don’t like them, they don’t feel attractive, they’re not successful academically. But this gives them the mantle of victimhood. And suddenly, all these resources, all this attention is showered upon them. And they also don’t have to grow up. Literally, that’s what taking hormone suppressants is.

The causes of gender dysphoria are still poorly understood, despite protestations to the contrary. Further research may reveal that it is invariably tied to mental illness, or it may turn out that some few people, otherwise quite healthy, are nevertheless neurologically hardwired to feel appalled by their own bodies. Even if so, it would at least be an open question whether the body or the hardwiring needs treatment.

Whatever the answers are, it is beyond doubt that countless children—probably more than we have been allowed to know—are having their bodies irrevocably altered by adults who refuse to permit the obvious questions to be asked. As Elle Palmer told Blaire White: “one person who comes out and says ‘I transitioned as a child and now I regret it,’ I think that’s enough to say that no one should be able to.”

“There’s so much malpractice in the history of psychiatry,” said Gopal. “Lobotomy is one example, and another is the recovered memory crisis of the 1980s, which was fraudulent and destroyed families: so much of psychiatry is social norms and how things are perceived. I predict that we will look back on this period with deep regret.” That’s the best-case scenario: that western civilization recoils from itself in the realization that it has been tacitly sanctioning mass child abuse.

The Devil and the Doctors

Why is it becoming impossible, even illegal, to say these things? Why are parents, teachers, counselors, doctors, and psychiatrists being systematically firewalled out of their childrens’ lives if they even so much as question the validity of transgender identity? Less than 1% of adults in the U.S. population as of 2016 identify as transgender, according to UCLA’s Williams Institute. Why should it be that caring for these few troubled souls requires beating the rest of us into submission?

It would be easy to answer those questions by imputing malice to the transgender radicals who run our healthcare systems and our public schools. If this were a question of hostility toward children on the part of twisted sociopaths, it would be easier to handle and understand. But this is not an intentional effort to do harm, at least not among most of the parents and caretakers who perpetrate atrocities on children. It is more tragic than that.

Trans activists do not think they are doing evil: they think they are helping victims. But they are products of a philosophy which—however admirable in its aspirations and motives—teaches them to call good what is evil.

One’s sense of oneself as a male or female person—one’s “gender identity”—is formed out of what Singal calls “a complicated weave of biological, psychological, and sociocultural factors.” It is at least true to some extent that we learn how to live out our masculinity or femininity as we grow up. Sex is not a social construct. But one’s understanding of one’s identity and social roles is shaped over time by one’s community and upbringing.

That being the case, a culture which insists that boys can easily become girls, and even celebrates those who do so, is bound to have an effect on young minds. The certainty and conviction that trans activists report among gender-non-conforming children is itself a product of that cultural conditioning: they know how to think of themselves as transgender because we teach them how.

Alison and Nick Smiley, for example, have a son who came to them at the age of five and said “I am transgender.” Why does a five-year-old even know how to refer to himself as “transgender”? An entire vocabulary, an entire worldview, is coded into that statement and has already been taught to the child before he opens his mouth. The problem is not that parents “force” transgenderism onto their children, at least not always in a conscious or intentional sense. The problem is a society which for decades or even centuries has taught itself a falsehood: that the body is a prison from which the spirit may be liberated.

“I felt like I was a girl because I liked the color pink and I liked girls’ clothes and how they wore their hair and stuff.” “I’m a girl because I have a girl brain and I have a girl heart.” “Boys’ clothes have like, cool skateboards, like I’m wearing right now, and I love skating.” “I think I’m gonna take some medicine so I can kinda like transform into a boy, get surgery.” These are the words of kids who think they are transgender. They are not, predictably, the words of people with a deep understanding of sex, of themselves, or of the world. They are the words of people done innumerable disservices by a fallen civilization. They are the words of children who have been taught to believe many lies.

One lie is that girls can’t like skateboards, and if they do they must be boys. “If I could go back,” says Palmer, “I would tell myself that I didn’t have to be a certain way to be a woman.” Perhaps if she had known this, she wouldn’t have believed the second lie—that her body and soul are not intertwined, that she could “transform” seamlessly into a boy without doing terrible violence to herself.

These being lies, nothing but more lies can follow. In service of an ideal that seems always around the corner but never quite achieved, well-meaning doctors and parents are being taught systematically to mutilate kids. The secrecy, fear-mongering, and deception which surround these practices are designed to protect this dream of an imagined future which, though it never materializes, must be defended at all costs.

From root to branch, this philosophy is wrong. It is based on a fantastical idea about the self which cannot withstand even the merest philosophical, let alone scientific, scrutiny. It teaches children disorienting and debilitating ways of seeing themselves, leading them to medicalize and so despise developmental discomforts which may be nothing more than stages on their path to adulthood. It threatens the parents of those children with unimaginable horrors—with the unavoidable suicide of their own flesh and blood—if they do not fall in line.

If indeed there is such a thing as a transgender child, we are light years away from knowing how to spot one and tell him or her apart from a confused and scared little boy or girl in need of firm parenting and wise counsel. To substitute for those things a program of sterilization, intimidation, state coercion, and surgical alteration is to commit what can only be called a grievous sin.

It doesn’t matter if the people who commit those sins think they are acting virtuously. Child abuse is child abuse. It must be exposed, and it must be stopped. Everyone to whom I spoke about this phenomenon agreed on one thing: that a silent and terrified majority, of every background and political persuasion, exists within our hospitals and public schools. They are revolted at what is being done to children, and they are desperate to end it. They will speak out if they learn of each other and can be made to feel safe in numbers.

Our academies, our hospitals, and our schools are sick with the belief—ancient and well-intentioned but fatal nonetheless—that the flesh is a prison from which the spirit can be freed. Evil ideologies—like Communism, for example, or anti-Semitism—have lives and behaviors of their own. With satanic force, they take hold of the minds in which they reside and inexorably, according to the bleak mechanism of their own contorted logic, lead normal people to do unimaginably terrible things. It is always the weak—the scared, the lost, the vulnerable, the confused—who suffer most from what results.

The rush to call children trans is a case study in that dynamic. It cannot be allowed to continue.