Sex, Gender, Beanie Babies and Lost Luggage

People and societies are funny things. We are subject to fads. Mass hysteria of a sort, wherein something catches the public’s attention and, without good reason, takes hold of the culture and dominates the media, purchasing and personality. Most of us remember the beanie babies of the early 1990s. These were little bean-stuffed toys, animals with cute names, that came in happy meals, or could be purchased in stores. Suddenly, everyone, it seemed, with or without children, was collecting beanie babies and there was a vigorous trade in the most desirable ones. A little purple bear came out following the death of Princess Diana, which, even today, sells for thousands of dollars. Like many fads, beanie babies arose quickly, captured everyone’s attention and disappeared from popularity just as quickly. Do any of you have a shoebox (or ten) full of beanie babies in a forgotten corner of your attic? We had small children at the time and have several of those shoe boxes. Usually, fads are pretty harmless, damaging nothing more than one’s wallet. Dutch tulips, hula hoops, Furbys, Garbage Pail Kids, pick your favorite.

Sometimes fads, however, are more nefarious and dangerous.

Communism can fairly, I think, be termed a fad. The postulates of Marx and Engels, took off as a response to socioeconomic conditions in the early 20th century, without consideration of the consequences of a system that ignored basic human nature and freedom. “From each according to their abilities and to each according to their needs” is an idealistic slogan that discounts individual effort and achievement, along with an ignorance of human greed and avarice. This is particularly risky, given communism’s dismissal of religion as an “opiate of the masses.” In a godless system, where man is the ultimate master of the universe, unaccountable to any higher power (or purpose), it should not be surprising that each and every single time it has been tried, communism has resulted in totalitarian dictatorships and the death of hundreds of millions of people over the last two centuries. And yet, despite all evidence to the contrary, communism remains faddish. Perhaps Bernie Sanders and Alexandria Ocasio-Cortez know something that Stalin, Pol Pot, Kim Jong Il and Castro overlooked, but I think not. It does sell a lot of Che Guevara tee shirts, however.

Medicine is no stranger to fads. One would think that medical practice is based on evidence-proven science, determined through careful, double-blinded research studies and applied in the interest of the greatest patient benefit with minimal risk. Well, sometimes. In the United States especially, medicine is also a competitive business, highly compensated by insurance companies and other payers, disconnected from the consumer, in an artificial economy, where supply drives demand, often with little scientific basis. Research studies can be dry, boring and have little bearing on what a hospital or clinic finds sexy and appealing to consumers. One example of this is the use of medical helicopters. During the Korean War, and more so in Vietnam, helicopters were widely used for the medical transport of wounded soldiers to hospitals and aid stations, with great success. Helicopters are pretty sexy and look neat sitting next to a hospital. It was only logical that the use of helicopters would become widespread in the US and today, a helicopter can transport you from the scene of a car accident to your nearest hospital, or from a smaller hospital to a larger and more sophisticated one. The problem is, (East Saint Louis aside) most of the US is not a war zone. Additionally, with the exception of a few uniquely rural and sparsely populated areas of the country (Alaska, West Texas, etc.) a boring ambulance can get you to a hospital fairly quickly. Helicopters offer very little advantage (usually) in time, and they have significantly less working room, medical capabilities or supplies than a modern ambulance, but they are very, very expensive and sometimes dangerous, flying in suboptimal weather conditions and heavily loaded. It is my misfortune to personally know several aeromedical personnel who have perished in crashes. There are no good studies showing an advantage in patient outcome using helicopter transport in most of the US, but again, sexy. To add insult to injury, helicopter transport is breathtakingly expensive ($52,000 for a 20-minute ride from one Philadelphia hospital to another, saving zero time, compared to an ambulance) and patients are not consulted as to whether they want this level of expenditure. Because air ambulances are usually “out of network” for insurers, the patient subsequently receives a “surprise” bill of preposterous proportions. Furthermore, since air ambulances are regulated as air carriers, like the airlines, they are not subject to medical insurance safeguard legislation to prevent these unethical billing practices. All in all, a good example of problems with the American health care system and a medical fad gone awry.

When social fads intersect with medical fads, bad things happen.

For many years, the incidence of transgenderism in the US has been around 0.0046 percent. That is 1 out of 20,000. In the last decade, or so, that incidence has increased to about 3%, as the trans-fad took off. While 3% is much larger than 0.0046%, 3% is still relatively small, compared to the other 97% of the population. This hardly seems to justify the preponderance of various multi-colored gender flags, use of “preferred pronouns,” public accommodations, TV characters and, of course, elementary school curricula emphasizing gender fluidity over mathematics (unless gender multiplication counts). Drag queens seem to be everywhere, including the White House recently, to celebrate President Biden’s signing of the Respect for Marriage Act, codifying same-sex marriage (and opening a Pandora’s Box to a host of unintended consequences, harmful to our society, but that is a topic for another day). If this doesn’t look like a fad to you, you must not be looking.

It is particularly insidious, but not particularly surprising, that gender ideology is pushed to children and adolescents. Drag queen library story hours and “family-friendly” drag shows are sprouting like odious weeds. The early teen years are very confusing and difficult for everyone. As children develop into young men and women, they are faced with the challenges of social structures outside of the family, hormonal changes, fads of their own, and a need to feel comfortable and valued in society. If communism ignored basic human nature, so does the Lord of the Flies structure of junior high school. (Anyone out there interested in reliving your junior high years? I thought not.) In a society that faddishly elevates gender fluidity to a norm, in a child who is confused by his feminine (or her masculine) impulses, being the trans kid may be preferable to being the nerd, dweeb or weirdo (or some other junior high pejorative). Star of the show, in a “Glee” sense, for those of you who ever watched the program glorifying a cappella high school choirs and homosexuality. No doubt the transgender agenda finds more traction among confused teenagers than in 50-year-old, over-the-road truckers.

Left to its own devices, the transgender fad might die away as quickly as financial speculation in beanie babies, but here is where the medical fad intersects with the societal fad, and horrific consequences may result.

The Diagnostic and Statistical Manual of Mental Disorders (DSM), is the standard handbook, prepared by the American Psychiatric Association, used to diagnose mental health disorders. It is numbered with each edition, as it is revised throughout the years, and we are now up to DSM-5, published in 2013. One would think that such an important reference is structured on carefully conducted research and grounded in evidence-based conclusions. Not so much. DSM-4, published in 1994, designated transgender ideation as Gender Identity Disorder (GID), defined as a persistent and strong cross-gender identification and a persistent unease with one’s sex. Crucially, DSM-4 considers GID to be a psychiatric condition, with mental distress arising from the mind’s misperception that it is in the wrong body, or unable to accommodate the body in which it exists. Treatment for such a disorder can be either reparative, with the goal of realigning this misperception of gender to be consistent with biological sex through psychotherapy and counseling, or watchful waiting. In watchful waiting, usually during adolescence, the patient is not directed toward any particular outcome, support for other issues is provided, and, over time, perceived gender will, on its own, realign with biological sex. In the past, this approach has proven to be very successful. The final treatment method is through “gender-affirming” medical and surgical interventions, such that the body’s appearance and hormonal balance are changed to accommodate the mind’s misperception. This actually encourages and perpetuates the mind’s confusion, and any benefits are temporary, quickly overpowered by untreated psychopathology, and exacerbated by medical and/or surgical intervention.

This all changed with DSM-5, published in 2013. In DSM-5, GID was renamed gender dysphoria (GD), because of a perceived negative connotation of a “disorder” versus “dysphoria.” More importantly, GD was no longer considered an abnormal condition. The distress attributed to those with GD was (and is) now attributed to a normal mind finding itself in the wrong body, further compounded by society’s lack of support and ostracizing those with GD. This being the case, reparative and watchful waiting were abandoned as treatments and the woke medical establishment immediately and aggressively turned to gender-affirming hormonal and surgical therapies. Furthermore, if one assumed these assumptions to be true, it would make sense to perform these interventions at as early an age as possible, to minimize the trauma to be experienced by the “normal” mind in the wrong body. Hence, the proliferation of gender clinics at children’s hospitals around the US, including some of the country’s most prestigious institutions like the Vanderbilt University Hospital and Boston Children’s Hospital (widely considered the best children’s hospital in the world). The problem with all of this is that there was no scientific evidence whatsoever on which the American Psychiatric Association changed GID in DSM-5. If one reviews the literature on which this decision was based, the APA made this dramatic change, potentially harming every patient suffering from GID, on the basis of comments and opinions from consumers of transgender health services and transgender activist/advocacy groups (1). So, a group suffering from a mental disorder petitioned the APA to declare them sane! Well, of course they would and now rational society is at fault for not supporting this. If this sort of junk science was written into a movie script, it would be rejected for implausibility. Anyone with even a rudimentary understanding of human biology and medicine knows that there is no possible way that a normal mind can exist in a body of different biological sex from its mental gender. These are bodies functioning normally, developing as dictated by their genetic code, elaborating hormones and developing secondary sex characteristics, consistent with their biological sex. It is clear that the mind follows this biological development and believing it is in the wrong body is clearly an abnormal psychiatric condition.

One cannot even conceive of a research method that would test this preposterous hypothesis.

And now that GD was considered to be a normal mental state, we quickly progressed to a host of other acceptable normalized psychiatric disorders, such as non-binary identification and the multitude of preferred pronouns inundating us on a weekly basis, not to mention all the various pride flags coming soon to a woke hospital, university or business near you. Even language is being modified to force an air of normality on these disorders, with “cis” being used to describe a normal male or female, as opposed to a “trans.” “Cis” is purloined from the literature of chemistry, wherein it describes a type of molecular configuration of isomers, vs trans isomers, and has nothing to do with sex, gender or biology. Of course, the news media quickly adopts this invented terminology, and, to the casual observer, it becomes acceptable to add adjectives denoting what is a normal state of affairs, thereby legitimizing the abnormal “trans.”

If this is giving you a headache, consider an analogy, courtesy of the National Catholic Bioethics Center (2). Treating GD as normal and offering hormonal and surgical therapy is no different than considering anorexia to be a normal psychological condition and offering liposuction as a treatment. It should not be surprising that “treating” a psychiatric condition by affirming its delusions will not be effective in the long term. If a patient believes he is Napoleon, giving him a general’s uniform will not help alleviate his mental anguish from not being saluted on the street.

Not only are the gender-affirming treatments ineffective for the psychiatric ramifications of GD, they have deleterious medical consequences as well. Hormonal treatments have a long list of serious potential complications, including cancer and heart disease. These complications are especially troubling and largely unstudied in younger populations where their use is rare. Hormonal therapies are commonly used later in life for reasons of replacement, but, again, the complications are well-known, serious and often limit their use, despite a benefit. While studies are limited, individuals who have undergone gender reassignment surgery and hormonal therapy have a three times higher rate of death from all causes, including cancer, heart disease, substance abuse and suicide than the general population. Indeed, the risk of suicide in people with GD, following gender-affirming therapy is 19 times higher than in the general population (3). This is not because of societal pressure, as this increased risk is consistent across societies that are more accepting and tolerant, like The Netherlands versus those less tolerant, like the US (4). (As I write this, the NBC news for New York City is doing a feature on the success of the NY Public Library’s “drag queen story hour” so I am not that sure about the US as “less tolerant.”)

This collision of societal and medical fad, the anti-family progressive agenda and the desire of hospitals and clinics to capture a new, lucrative service line are combining to harm thousands of people suffering from GD and threatening a generation of children and adolescents in pursuit of an unscientific and dangerous idea. The real-world consequences of this were recently illustrated in the sad, sad case of Sam Brinton. Mr. Brinton is a nuclear engineer who was appointed by the Biden administration as deputy assistant secretary of Spent Fuel and Waste Disposition in the Office of Nuclear Energy. Mr. Brinton is also a transgender activist and describes himself as non-binary, using they/them pronouns. His public persona is so bizarrely cartoonish that it is practically unbelievable. If you see pictures of this individual out in public, at government functions, social events or just broadcasting various sexual perversions, you really wonder about the security clearance policies of the Office of Nuclear Energy. It is very clear that he is on a mission to flaunt his lifestyle in society’s face, and one hopes he spent as much energy on his job as he does his makeup and dresses. Mr. Brinton recently lost his job following his arrest on two charges of luggage theft from airports in the US. Implausible as it sounds, he would look around, take a piece of expensive luggage off the conveyor belt and abscond with the same. He was identified after a review of security footage and subsequent review of footage from another airport once his crime was publicized (trust me, it’s not a hard call on the identification of the perpetrator). Regardless of the outcome of the cases (he faces up to 15 years in prison), Mr. Brinton’s life is basically over. He has gone from a position of trust and responsibility to a felon, outcast, and media sideshow. It is not clear whether Mr. Brinton could have been helped by reparative therapy, but celebrating him as an example of a “new normal” has done him no favors. The media echo chamber will quickly move on to the next attraction, while Mr. Brinton tries to figure out how to survive.

Please note, none of this discussion applies to persons with intersex conditions, like ambiguous genitalia or various chromosomal abnormalities. These are physical conditions and are treated medically or surgically, as appropriate. They are not psychiatric conditions and are akin to something like a club foot, or a congenital heart defect.

As usual, the Catholic position on this is unambiguous and true. There are two sexes and two genders, and they are one and the same. Men and women are created in the image and likeness of God. Anything else is a psychopathology, causing suffering and distress. These people deserve competent psychiatric care and should be treated with love, compassion, dignity and respect. They should be treated, however, not accommodated and touted as a new “normal.” Children and adolescents are especially vulnerable and are targeted by the transgender agenda. The State of Florida has, quite rightly, made gender-affirming care illegal in this age group and more jurisdictions are following.

Pop culture leads to pop science, bad medicine, and to broken and suffering people.

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