Time reveals the truth
The USA seemed the jurisdiction most firmly captured by gender identity ideology. A recent case indicates a more hopeful direction of travel.
In November 2021 the U.S Court of Appeals 9th Circuit heard argument in an important appeal from a decision of the District Court of Arizona, regarding the state’s obligation to pay for ‘gender affirming’ medical care. The judgment was delivered on March 10 2022.
The appeal court upheld the district court’s decision to refuse the application of two teenage female to male transgender individuals. They wanted to compel the Arizona Health Care Cost Containment System (Arizona’s Medicaid program) to pay for their immediate male chest reconstruction surgeries (double mastectomies). The teenagers asserted that excluding such surgery was unlawful sex discrimination.
The teenagers wanted a ‘preliminary injunction’ which means they argued their case was so serious, so likely to succeed and the risk of harm to them so great that the court should act immediately, without waiting for a full hearing. The appeal court did not think that the high bar for establishing a need for an injunction had been met but did agree with the teenagers that Bostock v. Clayton County, 140 S. Ct. 1731 (2020) (which held that discrimination against transgender people amounts to sex discrimination) was not limited to employment cases but also applied to decisions under the Affordable Care Act.
It’s interesting to note how many wished to intervene in this case, clearly recognising its significance, including the Pediatric Endocrine Society, World Professional Association for Transgender Health, and United States Professional Association for Transgender Health, various Transgender Youth Support Organisations, the Child and Parental Rights Campaign, Detransvoices.org (including Keira Bell), the Society for Evidence Based Medicine.
The State put up a strong fight, providing evidence from an endocrinologist and a psychiatrist specializing in sexuality.
The endocrinologist asserted that the purported “professional consensus” embodied in the WPATH’s Standard of Care exists only within its confines and that there is no high-quality study showing male chest reconstruction surgery is safe, effective, or optimal for treating minors with gender dysphoria. …. irreversible top surgery should not be performed on Plaintiffs because there is no way to predict whether they will outgrow their gender dysphoria and minors are “still undergoing brain development and as such they are immature with respect to intellect, emotion, judgment, and self-control.”
The psychiatrist offered further criticism of WPATH, opining that it “does not welcome skepticism, and therefore, deviates from the philosophical core of medical science.” . He asserted
there is no reliable scientific data to support surgical intervention in adolescents with gender dysphoria, that the surgery will not eliminate the incongruence of female genitalia, and there is no reliable way to predict which patients’ gender dysphoria will continue into adulthood.
Reference was also made to the UK decision of Bell v Tavistock and the comments there about the ‘experimental’ nature of treatment for medical transition.
When looking at the issue of balance of harm, the appeal court noted that according to the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (‘DSM-5’), gender dysphoria does not persist into adulthood for most children and, specifically, ‘[i]n natal females persistence has ranged from 12% to 50%’. The teenagers had not shown they could give informed consent, in light of their ‘significant’ mental health issues that pre-dated their gender dysphoria. One teenager had CPTSD from ‘early life attachment trauma’ and this should be addressed before irreversible surgical procedures are employed. The psychiatrist giving evidence in support of one teenager’s need for surgery had never met nor examined the child.
What is so frustrating about this, is that all these arguments have been made before - in the UK by Transgender Trend, who intervened in the case of Bell v Tavistock. And yet this organisation, along with anyone else who agreed with them, has been consistently vilified and attacked as ‘transphobic’ and attempting to deny children ‘necessary surgery’ to become ‘their true selves’. For far too long the prevailing narrative has been hijacked by organisations such as Gender GP and Mermaids, who have not merely promoted and encouraged serious and irreversible medical interventions for children, but attempted to stifle any debate or criticism.
The green shoots of transparency and accountability are coming through; recent news from Sweden is also very welcome.
I hope that an end is in sight. Too many vulnerable children have already been harmed. All of those adults, with agency and capacity who have been part of denial and obfuscation of what is true, may never face any consequences for their actions. The children will live every day with theirs. Enough.
Let’s hope the arguments are thoroughly explored at the trial that is to come.
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Is that the sun shining.
Ah, the gentle tinkling of dominos falling…
Thanks for this, great insight and I’d not clocked this case at all till now!