I have been engaged in an ongoing dialogue with a physician who works in a major children’s hospital in a blue city. This physician has witnessed firsthand how transgender ideology has captured the medical profession and jeopardized the first commandment of the healing sciences: do no harm.
He has now chosen to speak out, on condition of anonymity, because he is alarmed by the sudden corruption of the medical community. His colleagues, many of whom oppose transgender interventions, have so far chosen to stay silent. This interview has been edited for length and clarity.
Christopher Rufo: Please begin by setting the scene. What’s it like in a major children’s hospital in the United States regarding transgender interventions for children?
Physician: I think the best way to answer that question is to talk about the cultural shift that happened in 2020, because transgender ideology and Covid are inextricably linked. Normally, doctors operate by the authority of the professional societies that govern our specific practice. That worked because the individuals in those institutions were reliable, intelligent, and thoughtful. But with Covid in 2020, we started getting medical decrees without peer review or evidence—you saw this with masks, social distancing, and emergency-use authorizations. These decrees were expressed as something that everyone had to do, without justification based on sound science. The other thing was censorship. If you were to ask questions or express doubt about these medical decrees, you would be ostracized within your department, and you stood a good chance of being publicly humiliated, severely reprimanded, or fired.
That’s when transgender ideology really took off. Within these academic institutions, so-called experts in the field of transgender medicine would simply declare that puberty blockers and other interventions were the gold standard of care. The evidence to support this is completely fraudulent, but no dissent was permitted. Everyone within the medical community knew that if he questioned transgender ideology, he would suffer the same type of repercussions that had happened during Covid. The best way to describe the environment would be as an authoritarian, censorious culture that discourages any meaningful debate and encourages the demonization of anyone who asks questions.
Rufo: What are the main tenets of transgender medical theory that are enforced as the conventional wisdom? And how have those tenets changed medical practice?
Physician: One, when an individual believes he or she is of a certain sex, he or she is truly of that sex. Two, the ideal response is to affirm that individual’s preferred identity. Three, the repercussion of nonintervention is a higher likelihood of that individual committing suicide. The threat of suicide removes any of the guardrails for what we must do to affirm that individual’s identity. Puberty blockers become justified at 11 years old. Hormones become justified at 13 years old. Double mastectomy becomes justified before 18.
But in reality, when you “affirm” these individuals’ gender identity, what you are doing is affirming their hatred for themselves. You have these children who are going through confusing times, difficult times; when you affirm this belief system, what you’re really doing is telling them: “You hate yourself at this moment, and I will affirm that.” We have to ask ourselves, why do these people have such high rates of suicide? Because we’re affirming that they should hate themselves and that they should try to destroy themselves.
Rufo: And yet, these are medical doctors. They presumably understand basic human biology. They presumably agree with the dictum, “first, do no harm.” And yet they’ve bought into this not just abstractly but concretely; they’re performing these procedures. How does all their background knowledge crumble in the face of these ideas?
Physician: I believe it’s because they’ve bought into the false ideology of transgenderism. And when people have a false ideology, they need a way to separate themselves from nonbelievers and to express their faith to other believers. And if these rituals are not derived from a cultural heritage with a moral tradition, they become susceptible to unbound human depravity. When you look at the Judeo-Christian tradition, you have the outlawing of child sacrifice and other ways that standards were codified. But in the transgender ideology, none of these guardrails exist. So, what becomes the greatest expression of faith to other believers? To sacrifice the most pure and innocent. Once they do that, they become heroes. They become martyrs. They have their flag hung up at the White House. And there’s no going back, because if they were to demonstrate any degree of humility, they would have to come to terms with the fact that they advocated for and participated in a practice that destroyed the lives of innocent children.
Rufo: Tell me more about what’s happening to these kids and their health outcomes.
Physician: It brings me back to a story. There was a kid in the children’s hospital in his teens who had really bad Crohn’s disease, to the point where he’d already had multiple surgeries. And that kid would always be coming back to the hospital and the operating room. But one day, at the same time that we were rolling that kid back to the OR, another kid was headed to the other operating room to get an implant put into his arm so that his hormones could be suppressed. The first kid had no choice. He had no control over his condition of Crohn’s. He was born that way. There was no way to prevent it from happening. But the second kid was put into that situation because of the psychiatrists, the psychologists, the doctors, the politicians, and those in the media who convinced him that this was the correct thing to do to cure his mental anguish.
This should weigh heavily on the consciences of the doctors who did this to a child with the opportunity to live a normal life, to have a normal childhood. At some point, that child is going to wake up, and he’s going to realize that this was unnecessary, that his sexual organs are permanently mutilated, that the balance of his hormones is completely destroyed. He’s going to realize that there’s no going back, that the people who were supposed to protect him threw him to the wolves.
Rufo: What do you predict for the future of transgender medicine? Will it continue to gain ground, or will it all fall apart?
Physician: I don’t know. I pray that there is a change. One of the things I’ve been thinking about is what puberty blockers do to children. This medication is called a “gonadotropin releasing hormone agonist” and it comes in the form of monthly injections or an implant. And because it simulates the activity of this hormone, it shuts down the activity of the hypothalamus. The hypothalamus is this almond-sized structure in your brain, it’s one of the most primal structures we have, and it controls all the other hormonal structures in your body—your sexual development, your emotions, your fight-or-flight response, everything. But it shouldn’t be described in such cold physiological terms because your hypothalamus is not just a hormone factory. It’s this system that allows you to stand in awe of the beauty of a sunset, or to hear the sounds of orchestral music and to stop whatever you’re doing and want to listen. And I always think that if someone were to ask me, Where is it that you would look for the divine spark in each individual? I would say that it would be somewhere “beneath the inner chamber,” which is the Greek derivation of the term hypothalamus. To shut down that system is to shut down what makes us human.
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