My Problem with Gender Affirming Care for Children

The author wades into chum-filled waters

When applied to children, the term “gender affirming care” is an intentionally misleading euphemism. Its supporters use the term to defend and yes, promote a practice utterly lacking in moral or legal justification. To understand the full awfulness of this rhetorical artifice, we have to define terms.

“Gender” refers to social and cultural roles, behaviors and expectations. Gay, lesbian, straight, asexual, pansexual, sapiosexual, bisexual, non-binary – there’s an entire rainbow of genders. I’ve got no problem with any of it; even amongst adolescents, who are known to experiment with both gender and sexual practices.

Asinine assertions to the contrary, gender is not the same as sex. Aside from intersex biology – one to two percent of the population – a human being is born either male or female. Their gender is an open question, subject to both genetic and cultural influences. Their sex is not. Advocates of "gender affirming care” for children have it exactly backwards. They believe that sex is fluid and gender is not.

We’re not talking about “gender supportive care,” where a parent, guardian, medical professional, educator or social worker provides psychosocial support for a child’s gender “choices” (if that’s the right word). We’re talking about chemical and surgical intervention to alter a child’s sexual biology to “lock-in” (i.e., “affirm”) the child’s gender identity.

“Gender affirming care” includes hormone replacement therapy (testosterone injections for females, estrogen and anti-androgens for males) and surgery (chest, genital and facial). The procedures are not without ongoing physical pain or psychological effects – especially HRT. Nor are they easily reversible. In some surgical cases, the results are permanent.

This is rough stuff, even for an adult. If a child didn’t want it, we’d call it cruel. Inhuman. Torture. Here’s the thing: even if a child does want it, it’s still cruel inhuman torture. “Gender affirming care” for minors causes physical pain, psychological duress and shuts the door on a normal, natural part of growing-up: gender/sexual experimentation.

Don’t get me wrong: in a free society, people should be free to declare and express their gender without discrimination. Date who they want. Wear what they want. Have sex with whom they want. Love whom they want. Do what they want to their own bodies, from tattoos to abortions. Sorry, but that does not apply to children.

If parents forbid their male child from wearing a dress to school, it may be regrettable but it’s well within their rights. By the same token, if they forbid their children to date boys or girls, it’s still not a case for government intervention (which I generally abhor). But if parents inject their child with drugs or cut off a part of their body they better have a damn good reason for me to think society should butt out. “Gender affirmation” ain’t it.

"Hell is full of good intentions or desires." Twelfth century monk Saint Bernard of Clairvaux wasn’t wrong. I’m sure loving parents have arranged “gender affirming care” for their children with the best of intentions.

But there’s no getting around it: the parents or anyone else enables chemical and surgical “gender affirming care” for children are, as Florida and Texas law now stipulate, guilty of child abuse.