Provocateur Andrea Long Chu recently wrote of the basic right to sexual self-immolation. He argued that “everyone should have access to sex-changing medical care, regardless of age, gender identity, social environment, or psychiatric history.” Tellingly, this was just a week after a trove of evidence showed that gender medicine routinely violates informed consent.

It’s almost as if Chu is anxious to get the libs, whom he dubs TARLS (“trans-agnostic reactionary liberals”) back in line. Too late. They’ve peered into the activist hive that is WPATH, the World Professional Association of Transgender Health, and they are backing away in horror. Feminist Meghan Murphy considers Chu’s article a pivotal breaking point in the mass psychosis that has gripped the developed world: “trans activists are panicking.”

Chu’s argument, and ultimately WPATH medicine, is based in the prerogative of the individual’s will to “transition.” “Informed consent” is presented as just another barrier to accessing “gender affirming care.” In medicine, freedom requires risks be fully divulged so that going forward is genuinely voluntary. However, gender medicine renders consent perfunctory and practically requires dissimulation about the risks.

That full consent is impossible in gender medicine is now starkly evident. Chu nonetheless defends the kind of medical malpractice that WPATH advocates.

Kids arriving at clinics are already primed. Everywhere on social media and in schools, they are swept on the currents of influencer fashion into urgently demanding “transition.” WPATH clinicians openly acknowledge that real consent is not possible, that generally youth are developmentally disinterested in far-off consequences. For instance, a coauthor of the WPATH “standards of care” explains consent falls “outside their developmental range.” So they trade the prime of physical health for what is to them unintelligible: lifelong drug dependencies, brutal effects from invasive surgeries, ongoing negative health impacts, and the future loss of sexual function and fertility. The complete dissolution of medical standards follows when real consent is abandoned.

America’s Informed Consent Model

America has gradually weakened significant mental health safeguards around gender medicine. At Children’s Hospital in Boston, Dr. Norman Spack set up the first American clinic in 2007. He followed the Dutch model, incorporating mental health assessment. But by 2022, Komodo research suggests that American clinics no longer followed the original Dutch protocol that included months-long assessment of patient mental health. Even calling it an informed model or a consent process outpaces absurdity.

Per the WPATH Files, not even severe mental health issues are enough to pause surgery schedules or construction of hospital gender profit hubs. Discussing a case of compromised capacity for consent, the lead author for the WPATH Standards of Care version 8 waves aside any qualms: “The mere presence of psychiatric illness should not block a person’s ability to start hormones if they have persistent gender dysphoria, capacity to consent, and the benefits of starting hormones outweigh the risks.”

The WPATH Files disclose that treatments are being given to developmentally delayed and seriously mentally ill patients, including people claiming to have multiple personalities. These surgeons know informed consent is impossible to obtain from patients who are emotionally fixated or mentally troubled. What about the far more typical patient who is developmentally unable to appreciate what that loss means for a remote stage of life?

WPATH advocates for puberty-blocking drugs are well aware of long-term harms from gender “affirming” chemical castration and hormones. These include infertility and cancer. Chu shrugs this off with pure sophistry: “[I]f children are too young to consent to puberty blockers, then they are definitely too young to consent to puberty, which is a drastic biological upheaval in its own right.” The basic human right, however, is to bodily integrity and normal functioning—not to unbounded disfigurement at will through chemical subversion of normal bodily functions and surgical removal of healthy, intact tissue and organs.

End of the Line

Puberty’s pivotal role is not limited to developing secondary sex characteristics. Underscoring this reality, Chief Psychiatrist in the Department of Adolescent Psychiatry at Finland’s Tampere University Hospital, Dr. Kaltiala, recently observed: “a stable, developed identity enables an individual to have a permanent self-experience from one situation and life stage to another, as well as to maintain a sense of permanence and psychological ability to function even in the face of adversity.” Children lining up for “affirming” castration are denied the advantages of a basic stage of life involving biological processed timed within their own human development.

Freedom of self-determination has been central to gender medicine since well before Chu arrived on the scene. WPATH’s 2011 Standards of Care established a new paradigm for obtaining informed consent from patients, one that codified gender confusion not as pathology but identity. Soon after, the DSM changed its diagnostic category to dysphoria. Psychiatrist Stephen Levine, M.D. stresses that patient autonomy replaced informed consent as the operant principle. Rather than helping patients understand their suffering, the new paradigm began with the premise “patients know best what they need to be happy, generally meaning that patient autonomy is the singular ethical consideration for informed consent…. This includes children and adolescents.”

Obtaining consent under what became known as the American informed consent model is Kabuki theater. Levine notes that full consent demands coverage of multiple severe risks under the categories of biological, social, and psychological issues. “When clinicians are cheerleaders for transition, their behavior indicates to the patient that this is the best solution that only requires a bit of courage. They may lead patients and parents to believe that there is scientific certainty about the wisdom of transition.” Doesn’t this perfectly describe Cheerleader-in-Chief, WPATH President Marci Bowers?

Less ready for primetime are the out-of-control kids—and activists like Chu—that are prepared to bully anyone in their way. How do “transition” advocates corner so-called TARLS? Basically, it’s the same false choice between transition or suicide, getting people to view harm as inevitable. One WPATH Files doctor threw up his hands: “It would be great if every patient could be perfectly cleared prior to every surgical intervention, but at the end of the day it is a risk/benefit decision.”

The inviolable code of transition-as-suicide-prevention evokes blackmail or coercion, the premise on which the entire house of gender teeters. British adviser on suicide prevention Professor Sir Louis Appleby recently warned: “Trans activists must stop claiming that children will kill themselves if they are prevented from changing gender.” Clearly, framing an individual’s decision in absolute terms as suicide prevention warps informed consent into unavoidable medicalization on a par with emergency room visits.

Presenting medicalization as inevitable is actually a form of coercion. Chris Elston, known on X/ Twitter as Billboard Chris, observes: “A parent who’s new to this talking to the so-called expert at this gender clinic, they’re being coerced like this. Of course, they love their kid. They want to do the best for their kid, so they’ll go along with this, but they’re being coerced and they’re being lied to.” Adults drawn in by gender medicine are no better off. Physician Stanley Goldfarb observes voluntary choice is not possible: “We’re talking about a complete absence of informed consent—by patients or their parents—of the dangerous, life-altering, and irreversible consequences of this ‘care.’ Medical professionals are supposed to do no harm, not intentionally inflict it behind closed doors.”

The timing of Chu’s essay situates the collapse of WPATH, clinging fiercely to the liberal establishment, at the end of an era of blind trust in a discredited interest group that shelved clinical responsibility. Basic human rights do not include access to hormones and reconstructive surgeries. And gender-affirming castration is not freedom of sex, but nihilistic assent to coercion, intimidation, and manipulation.