Helen Joyce on sex, gender identity and human rights

When ideology meets gender healthcare

Killarney, April 2023

I’m going to start by telling you how and why I got interested in the belief system I call gender-identity ideology, and why I decided to take the risk of blowing up my life by writing a book about it. They are different reasons, though related.

I’ll start by defining that belief system. To quote the first paragraph of that book:

“This is a book about an idea, one that seems simple but has far-reaching consequences. The idea is that people should count as men or women according to how they feel and what they declare, instead of their biology. It’s called gender self-identification, and it is the central tenet of a fast-developing belief system which sees everyone as possessing a gender identity that may or may not match the body in which it is housed. When there is a mismatch, the person is ‘transgender’ – trans for short – and it is the identity, not the body, that should determine how everyone else sees and treats them.”

I got interested in it because I’m a journalist, and I used to be a mathematician, and I discovered some people really, really meant it when they said that men could be women. I had previously heard some people claim that “trans women are women”, but I thought they were speaking metaphorically, or with their fingers crossed behind their backs: saying something to be kind, tacitly understanding that everyone knew it was just to be kind, and that nobody would be pushed to demonstrate in any concrete way that they actually believed it. That men who identified as women wouldn’t put you in a position of having to reveal you were just being polite, because they would know, like that old sign behind shop counters advising you not to ask for credit, that “a refusal often offends”.

But in 2017, when I was asked to write about the huge increase in trans identification among young people, I discovered that some people really meant it. And therefore they really meant that straight men could be lesbians, and that therefore lesbians who don’t do dick, who don’t do people who have or have ever had dicks, were bigots as bad as racists – so awful that they would cut an entire class of people out of their “natural” dating pool because of a factor supposedly as minor and irrelevant as skin colour, namely their actual sex.

It was so crazy I couldn’t look away, and the more I looked, the more crazy there was to see. I sometimes draw an analogy with introducing just one little falsehood into an internally coherent system, like a false equation into mathematics.

You may remember from school that you can add or subtract the same thing from both sides of an equation, or you can multiply or divide both sides by the same thing. Well, if you say that “1=0”, then you can add or subtract or multiply or divide 1 on one side and 0 on the other, and just from screwing up one teeny tiny little equation, you can bring down the whole edifice of mathematics, because anything can equal anything. Any equation is true, and it is no longer possible to do mathematics at all. The tiny falsehood screws up everything, and the only things it doesn’t screw up are the things you haven’t noticed yet.

But that’s not why I decided to write my book. I decided I had to when I met detransitioners for the first time. It was at an event organised by a lesbian collective, Make More Noise, in Manchester in late 2019, and this particular group of detransitioners were all young lesbians.

They were a complicated bunch. One became evangelical and anti-gay some time after that meeting, and then, after some more time had passed, reverted to a trans identity. Last I heard she had undergone a mastectomy and started on testosterone.

Another was Keira Bell, whose anger at the poor treatment she received at GIDS, the now-closed NHS youth gender clinic at the Tavistock Clinic in London, led her to undergo the nightmare of a court case by taking a judicial review of the clinic’s practice.

A third was a 23-year-old whom I called Lara in my book, who had suffered extreme bullying at school because of being lesbian. She had nearly died of bulimia, and had landed on transness as an explanation for the extreme misery she felt about her natural curves. By 21 she had had her breasts, ovaries and uterus removed. Not much more than a year later she realised that the whole thing had been a total mistake. She told me that when she searched online for information on why she still felt so dreadful months after the hysterectomy – which had been billed as lifesaving, and certainly not as a major operation with lasting repercussions for her health – she found support groups for women who had had hysterectomies for cancer or for endometriosis. They were so lovely to her, and so supportive, and it was in those groups that it suddenly occurred to her to think: “Why is an operation that can only be done to women supposed to have turned me into a man?” And that was the sudden end of what philosopher Kathleen Stock calls the “immersive fiction”.

The young women at that event were very gender non-conforming. They had been girls who had never felt in the slightest girly or feminine. Girls who had persistently felt that they didn’t fit in, and who had wondered why they were so unusual.

It’s my experience that if you talk to people older than about 35 they readily agree that extreme gender non-conformity is common in children and teenagers who will grow up to be same-sex attracted. Younger people have been misled by the societal narrative that pretty much everything is socially constructed, including sexuality and the differences between men and women. It’s bizarre, when they also think that transness is innate, but there we are.

A lot of gender non-conformity concerns things that are hard to delineate and enumerate. They’re about affect – a style of moving and speaking. My little brothers certainly played with my dolls, but largely by pulling their legs and heads off, hitting things with them and using them as pretend guns. A researcher with a checklist would presumably have marked them down as “playing with dolls”, but they did so in very gender-conforming ways.

Meanwhile a gender non-conforming little boy who had no sisters might not have played with dolls at all. Kids can’t easily dress up as the opposite sex if the clothes aren’t around. If they don’t have siblings of the opposite sex to bring activities such as ballet or rugby to their notice, they may never know that they would have preferred the activities more usually preferred by the opposite sex. And the less conventionally masculine or feminine their parents, the less likely they are to actively reject their own sex’s stereotypes.

For what it’s worth, studies that have counted gender non-conforming behaviours have found that many kids who grow up to be gay adults are strikingly gender non-conforming. But I think these studies understate these average differences.

I have a soft spot for gay kids, because I have one. And although my son has never suffered any type of gender dysphoria, listening to the young women at that meeting in Manchester felt personal. That evening I finally said to myself the sentence I’d been circling around for months, but not allowed myself to stare at directly: they’re sterilising gay kids.

Not only gay kids, and not directly because those kids are gay. But that wouldn’t be an excuse if a policy was grossly disproportionately and seriously harming, say, Jewish kids or black kids. We wouldn’t hesitate to call that policy antisemitic or racist, even if we accepted that it wasn’t intentionally so.

Many people keep quiet about their doubts concerning gender-identity ideology until they realise what’s happening to children. They may not care about the other victims, or they may think that those other victims can suck it up. They may think that female athletes should just accept men winning their medals, and content themselves with the joy of taking part. They may be so lacking in imagination and compassion that they can’t see that same-sex oriented people are no more likely than anyone else to want to sleep with someone who isn’t of the right sex for them. But they really, really don’t like the idea of people lying to and hurting kids.

So there’s a Scooby Doo problem for transactivists: they’d have got away with it, if it weren’t for those pesky kids.

Growing up isn’t easy for anyone, and both gay and straight people have quite common and typical difficulties becoming happy, fulfilled adults in lots of ways. Some of those difficulties have to do with their sexed and sexual identities.

For straight kids they include the miserable business of having to deal with the opposite sex. I think this is underestimated as a source of grief in the teenage years. If you go to a single-sex school, as is still common in my home country, Ireland, you may not actually know many people your age of the opposite sex – that was certainly true for me as a teenager.

Even in mixed-sex schools the opposite sex can seem like an alien species, with strange and stupid preoccupations. And it’s hard to simultaneously fancy someone and find them incomprehensible. You feel judged by them in a way a younger child doesn’t feel judged by anyone, and you don’t understand the criteria.

Members of your own sex can be cruel judges, too. If you’re plain or fat or spotty, or think you are, or if you’re shy or awkward, you may be entirely typical for your sex but still be ostracised.

For gay people there are extra difficulties in coming to terms with being different from the norm, wondering why that might be, and figuring out what that could mean for your adult life, including family formation. There are fewer of you, and the obvious reason why sexual desire even exists is to support reproduction, so you can find yourself a puzzle.

Negotiating platonic relationships with members of your own sex can be difficult, too, even if you don’t fancy those individuals. Same-sex groups are, for most kids, places where they can talk without feeling that they’re being regarded as a sexual object, and when you factor in the impulsivity, lack of experience and randiness of teenagers, it can be very hard for everyone to feel comfortable if one of the group’s members is known or thought to be gay.

Of course for many the difficulties of being gay and coming out will include outright homophobia and self-hatred. But it’s facile to think that if all prejudice were to end it would be as easy to be gay as it is to be straight.

I hesitate to say this because it might sound like I think it’s “bad” or “unnatural” to be gay – that I’m committing the naturalistic fallacy. But I feel I have to say it, because I think that for gay youth the path to adulthood is already more complicated, and so it’s even more important that the world is set up in such a way as not to add unnecessary obstacles.

Yet for both sexes, but especially for the proto-gay kids, it’s as if we’re trying to set things up for teenagers almost as badly as we can. Part of that is catastrophically messing up when it comes to young people’s mental health. I saw it put really well recently by Jonathan Haidt, co-author of the 2018 book The Coddling of the American Mind and author of The Anxious Generation: How the Great Rewiring of Childhood Is Causing an Epidemic of Mental Illness. He says that American schools and universities have started to promote three pernicious falsehoods: what doesn’t kill you makes you weaker; feelings are a good guide to reality and action; and people are all either good or evil, with life best understood as a battle between the two groups.

He calls these beliefs “reverse cognitive behavioural therapy”, and they’re highly dysfunctional. They encourage mental fragility and a culture of “crybullying”: using claims of victimhood to harass others.

Gender-identity ideology is another highly dysfunctional belief on top of this, and it too is being taught to children. That male and female, or man and woman, are self-declaratory opt-in categories. That the criteria by which you should judge your own gender identity are ineffable – everything you think you are must be right, but there are no external or observable tests.

It’s hard to imagine anything more confusing to tell children – all kids, but especially the gay ones. Or to think of anything so likely to destabilise their mental wellbeing and self-understanding. Because it’s about something fundamental to being human. It seems as unwise as telling them that breathing air or water is on a spectrum and that the only test is what they think and feel about how their respiratory system works. And that nobody else can tell them; there is no test, there are no criteria, for where they are on the “breathe air to breathe water” spectrum: they will just know.

To those of us not indoctrinated into this bizarre belief system it’s endlessly hard to comprehend why anyone would give it the time of day. I’ve said a lot both in my book and in various interviews about why this, and why now. But I want to add something today that I only recently understood from talking to a group of philosophers at a symposium I attended, who situated gender-identity ideology within what they called “hyper-liberalism” or “hyper-individualism”.

What they said was that you can think of what it means to be a person in either a communal or an individual way.

From a communal point of view, we’re people because we’re humans, a particular type of animal that has language and self-consciousness. We have a lot in common with each other, and those shared feelings, understandings, interests, desires and so on are why we are even able to have a concept of the common good, and why we can even think of writing a “universal declaration of human rights”.

That it’s good to be free from torture. That it’s self-evident that we should want life, liberty and the pursuit of happiness. That the point of society is to try to give life to these commonly held ideals. And there will be societal impositions and restraints on individuals whenever they butt up against structures intended to uphold these shared and communal notions of the Good.

If you think about it, without such a thing as a shared human nature there could be no such thing as human rights. You couldn’t say “rape and murder are bad” because why? We’re sure that they’re bad, that the victims are indeed victims – that they don’t want to be raped or murdered – because there is a human nature. It’s not that culture has no influence on what we think is good or bad, and it’s not that we are all the same or all want precisely the same things. It’s that we do have fundamental things in common. That’s why we can say that it’s good not to be tortured – that’s Article 3 of the European Convention on Human Rights: freedom from torture and inhuman or degrading treatment. It’s why America’s founding fathers could take it as self-evident that people desire life, liberty and the pursuit of happiness.

But we’re also individuals, and that too is very meaningful for what it is to be human, to be good, to be happy and to flourish. In particular, there’s a long and important tradition of seeing individuals as the main authority about themselves. And a lot of what we think it is to be happy is to be self-actualised: to be free to make our own decisions and to choose what for ourselves what it means to live the “good life”. From this point of view, self-knowledge, or being “in tune with yourself”, matters more than living according to shared values.

One way of understanding the difference between people with conservative and liberal leanings is to notice that they each prioritise a different one of these two concepts. Do people need to be constrained by society, to seek to live up to an external idea of what is good? Or do people need to be as free as possible to pursue their own idea of happiness, and to be as aware as possible of what they personally find appealing?

A so-called liberal democracy is an attempt to combine and balance the two. Our universal human rights must be based on some shared understanding of what it is to be human, and to flourish, but many of those human rights are rights to make our own choices and express ourselves as we wish, albeit constrained by other people’s rights. Rights sometimes collide. Freedom of conscience, in particular, explicitly places our own will and judgement ahead of communal values.

And one way of understanding what is happening right now is that the liberal side of this balance has been pushed to an extreme. The philosophers at that symposium saw what is happening on campuses as Rousseau-ian, in this sense. Rousseau emphasised the individualist line of thinking, claiming that people in a state of nature co-exist peacefully and happily because they can follow their own will at all times. In this state, they are naturally equal because inequality is something created and imposed by society. He saw human nature as inherently good, and society as what corrupts us and makes us vicious.

From this point of view, people left to their own devices will naturally find their way to a right understanding of their true selves. Those true selves are good and beautiful, unless society has twisted and deformed them. And for each individual, the “true self” embodies what it means to be morally good. Inclusion, meaning the lack of external constraints based on objective definitions, is an automatic good. And discrimination, in its original neutral meaning of noticing and when necessary acting on differences, is automatically bad. By definition, it can’t be bad to “be yourself”, or to “bring your whole self to work”.

From this point of view, communal ideas of “shared human nature” look coercive. And states, in particular, coerce by labelling and categorising. Any time a person says they are something, and “the authorities” don’t agree, it’s the authorities that are not only wrong but evil, in that they are harming individuals and forcing them to live inauthentically.

I think you can probably see where this is heading. An idea that had an awful lot to offer when “be yourself” and “follow your natural inclinations” meant “don’t feel you have to marry whomever your parents want you to marry” and “there’s nothing wrong with you if you’re same-sex attracted” and “you don’t have to be a cook or carpenter just because that’s what your mum or dad were” has been pushed to the point where it means “you are whatever you say you are, even if you say you’re the opposite sex or no sex at all, and disagreement is downright evil.”

By the by, this idea that state classification is coercive because it may not match your own self-conception explains why the expressions “assigned at birth” and even, as I sometimes see, “coercively assigned at birth” have been appropriated from an abusive, obsolete treatment protocol for babies with ambiguous or injured genitalia. And it’s why “self-ID” seems like such a no-brainer: linguistically, it taps into the highest ideal of this hyper-individualist way of thinking, namely self-definition.

This way of thinking pays no heed to what it means to other people if identifying as something means you gain access to resources you would not, on any objective measure, be entitled to. If you think that another person’s self-declaration harms you, you must be mistaken, because by definition people understanding themselves are doing something virtuous and praiseworthy. The only thing you are an authority on is yourself, and you’re being coercive and bigoted telling other people anything about them.

As someone brought up in the older, classical liberal tradition, I see this as, among other things, hopelessly romantic in the Rousseau-ian sense. We can’t all live in solitary splendour putting on our own one-man or one-woman plays. We share the stage. Metaphorically speaking, the human-rights framework and other laws are what tell us when we get to be the lead actor, when we have to accept a supporting role and when we have to be the audience.

Perhaps we could all do one-man or one-woman performances without worrying about whether or not we have an audience if we all wore earplugs and eye masks – which is sort of where we’ve arrived at regarding religious beliefs. But when it comes to gender identity, we’re required to accept supporting roles in everyone else’s play. And we’re required to be everyone else’s audience, too, and forced to clap endlessly, and not allowed to leave. In other words, we have to affirm.

And that’s before we even get around to acknowledging that people are on occasion bad actors who seek to hurt each other, including by lying and including by telling lies about themselves. And the greater the incentives, and the fewer bad consequences, the more people will lie about themselves.

There are many strange things about gender-identity ideology. One is that it’s internally inconsistent, picking up bits and bobs from here and there without any attempt at coherence. It’s a scavenger ideology. Internal contradictions, such as gender being fluid, and innate, and socially constructed – all at the same time – make no difference to the faith of believers. Because people aren’t necessarily consistent, and their feelings aren’t either. And on what grounds could you possibly disagree with someone about their gender, when there are no yardsticks or external sources of verification?

An often-cited example of this inconsistency is the way you can identify out of being male into being female, but not out of being white into being black. At one level, this is because race and gender are theorised in different fields. Skin colour is covered by critical race theory, which holds that whiteness is something like original sin: to be atoned for by “doing the work” – a type of work that is never done. You definitely can’t identify out of it. Gender identity, by contrast, is covered by queer theory, which sees the blurring and upending of categories as virtuous.

But that difference is happenstance: a product of America’s racial history. More generally, the inconsistency is because there are no requirements to be coherent if self-knowledge is your sole measure of what is good. I’ve even heard people say that it would be wrong to allow white people to identify as black because white people don’t have the shared history of oppression that black people have – well, female people do have a very real shared history of oppression. This is obviously a post-rationalisation, but if there’s anything humans are good at, it’s finding justifications for what they already believe or want to do, and then concealing the weakness of those justifications from themselves.

Another of gender-identity ideology’s inconsistencies is that it has arisen within, and co-opts the language of, the liberal human-rights framework, even though that framework is based on a “declaration of universal human rights”. It’s a liberal framework, sure, in that it’s largely about freedoms – to not have other people constrain your speech, belief, and so on – but the way it’s all laid out, there are objective tests for what sorts of beliefs are covered, and when other considerations take precedence.

And yet this hyper-individualism makes those tests, with their need for balancing and yardsticks, essentially impossible.

Take privacy and free speech. Both are qualified rights within the human-rights framework – we may override one person’s privacy if it unreasonably constrains another person’s free speech, and vice versa.

But when a person’s privacy is to do with what they conceive of as their identity, the only acceptable position within this new way of thinking is to agree that they are right. To “affirm”. And if that means draconian limitations on other people’s free speech, too bad. As for it imposing on other people’s privacy – well, that is understood to be an impossibility, because “people are who they say they are”. The transwoman stripping off in the women’s changing-room is a woman, and no more an imposition on the other occupants’ privacy than any other woman stripping off would be. And if that’s not how it looks to some women, well, they are siding with the state that coercively assigned that poor transwoman male at birth, and are therefore evil and don’t deserve any rights.

Even when rights are supposedly based on something objective – there’s a ruling in the European Court of Human Rights that being forced to undress in front of a member of the opposite sex is a violation of Article 3, that’s the one that refers to torture and inhuman or degrading treatment, particularly important because it’s an absolute not qualified right and so states cannot balance it away – well, that objective fact of sex dissolves in the face of self-declaration.

So we supposedly have a framework of universal human rights that operates on liberal principles, and in which there are objective criteria for when one right trumps another, and for what it means for an action or situation to be, for example, inhuman or degrading – a framework in which, in the words of the American jurist Oliver Wendell Holmes:

“Your right to swing your fist ends where my nose begins.”

A framework in which the place where that collision happens can at least in principle be judged objectively.

But within that framework, and co-opting its language despite being inimical to it, is this emerging hyper-liberal position. Which holds that someone male expressing themselves to be female or non-binary and competing against women on that basis isn’t swinging his fist, and the female people who say that he’s bashing their nose are wrong, because he is indeed female or non-binary. And there was no such thing as male for him to be in the first place. He was merely assigned – coercively assigned – male at birth.

There’s nothing to object to (except authoritarian and coercive norms), no harm done (because people are who they say they are) and no grounds for objecting (because everyone is the authority on themselves, and nobody can override anyone else on matters of identity).

Thinking this through really helped me understand how this ideology is making such inroads within healthcare.

The professionals who work within this system were, at least until the last few years, trained within the objective scientific tradition. To carry out differential diagnosis using validated self-report measures and objective symptoms; to study what it means for each organ or biological system to function in a healthy or unhealthy way; to seek to understand for any sort of ill-health what caused it and how it progresses; to develop treatments by generating and testing hypotheses; to accept that all treatments are likely to have both costs and benefits, which can be measured and weighed against each other; to seek treatment pathways that minimise risks and harms; and overall to promote patient autonomy but within a framework in which it’s understood that clinicians know much more about the workings of the human mind and body than patients do.

Gender clinics are working within this system: holding consultations, taking blood tests, offering diagnoses, writing prescriptions, referring to other specialists and making claims about outcomes and efficacy. But none of it is really medicine. It fools people into thinking it is, because it sort of looks like it is. And the people it fools include not just patients but specialists in other fields of medicine, such as endocrinology and surgery, as well as funding bodies, insurers and governments.

What’s called gender medicine is better understood as a performative expression of the hyper-liberal, or hyper-individualist, notion that each person has a true self, and knows that true self, and by definition cannot be wrong. That any attempt to classify people is an imposition, is coercive, is authoritarian. That societal norms or strictures, notions of the common good or human nature, objective standards of wellbeing, are meaningful only in something like the way Judith Butler thought gender was.

Butler famously said gender was an “imitation for which there is no original” – that it’s meaningful only because we do it over and over again. In this worldview the entire superstructure of medicine becomes something like this: a repetitive practice that is meaningful only because we keep doing it. And the purpose of gender medicine is simply to affirm identities. The gender clinic is a scenario, a backdrop against which people can perform their identities. And gender clinicians tell their patients – in reality not patients, but purchasers of identity validation – that once they leave the clinic everyone else will play along.

Here’s what it would look like if it actually was medicine – I’m not saying good medicine, just something that could fit within the medical paradigm, and which would eventually stand or fall depending on outcomes and evidence. Clinicians would say: “Transition is right for some people, so right that it’s worth other people being forced to go along with something they don’t necessarily like.” This would be a sort of “balancing rights” claim, as in the case of Goodwin at the European Court of Human Rights, which was the reason for the UK’s Gender Recognition Act of 2004, the world’s first national law that granted people the legal fiction that they were members of the opposite sex, at least in some circumstances.

I would argue that those judges got it wrong, and for the usual reason: they didn’t think their thoughts all the way through to the end, and therefore set women’s rights at zero. But anyway, it was a balancing argument within the human-rights framework. It requires you think that:

anyone who doesn’t accept people as the sex/gender they say they are is a bigot
toilets and changing-rooms don’t really matter, people just want to pee and change
sport for women is about taking part, teamwork, fitness and so on, not winning.

To be clear, these are not propositions I agree with. But you could say all of this and also accept that kids are still in the process of forming their identities; that their life experience is necessarily too limited for them to understand certain sorts of irreversible consequences, that they therefore cannot give informed consent to treatment that leads to those consequences, and that such treatments must therefore wait until they’re grown up.

And you could also say: adults identify as members of the opposite sex for all sorts of reasons. They might change their minds. You could weigh up the costs of medical treatment against the benefits. You could accept that there might not be any treatment that could make people who wanted to be members of the opposite sex feel any better. You could think that there are trans-identifying people for whom transition is the best policy, and people for whom it isn’t (to be clear I do not agree that anyone should gain any status as members of the opposite sex, because the consequences for other people are too serious; however you may decide that you don’t care about other people).

But that’s not what’s happening in gender medicine, because it’s not medicine. And that’s why the Scooby Doo problem: they can’t back away from the kids.

What will it take to return to reality?

Lisbon, September 2024

It’s almost a year and a half since the first Genspect conference, in Killarney, and what I spoke about there was how what’s being done in gender clinics is not medicine, although it looks like it. It’s a post-truth charade that relies on the signs and symbols of evidence-based medicine – consultations, diagnoses, drugs and surgeries – while ignoring its spirit. And I set this in a larger picture of an emerging political and ideological framework that I called hyper-liberalism, or hyper-individualism.

Today I’m going to revisit that framework and show how it upends not just law and medicine, which is what I talked about last time, but science, art, education, safeguarding and policymaking of all kinds. And then I’ll give some hope because the same thing that makes this idea so universally destructive – namely that it’s totalising because everything is connected – is a good thing when you’re on the front foot. I’ll also give some practical advice about how to do it gleaned from having heard people’s stories for years now, and from seeing the results of polling and focus groups.

To recap, you can think of what it means to be a person in either a communal or an individual way. From a communal point of view, we’re people because we’re humans. We have a lot in common with each other, and that’s why we are even able to have a concept of the common good. But we’re also individuals, and that too is meaningful for what it is to be human, to be good, to be happy and to flourish. What we’ve seen not just in the past few years, but the past few centuries, is the progress of the liberal side of this balance, and now it’s been pushed to an extreme.

The upshot, as I said in Killarney, is that we continue to have a legal framework that is supposed to be based on a shared understanding of what it is to be human, and to flourish. Many of our rights are to make our own choices and express ourselves as we wish, however, and each person’s human rights are constrained not just by other people’s rights but by things like “sound administration”, “public health” and so on.

And yet, unacknowledged, a new belief system has arisen within the liberal human-rights framework, and co-opted its language. This framework relies on objective tests for what sorts of beliefs are covered, how you balance rights when they collide and when other considerations take precedence. But hyper-individualism makes those tests, with their need for balancing and objective yardsticks, impossible.

Take privacy and free speech: if one person’s supposed “privacy right” is to conceal their sex but I can easily see that sex and wish to say it, I now can’t. Because what to me functions as the other person demanding that they can conceal their sex is to them an expression of their true self – the gendered one, not the sexed one.

It’s worth pausing for a second to notice how this shift doesn’t merely destroy human rights, it harnesses the machinery of human-rights law to work against human rights. Silencing other people on a perfectly obvious fact that everyone can see – that someone is a man or a woman – now has the force of a human right behind it, namely privacy, when in fact it’s a rights violation – a serious infringement of other people’s freedom of speech.

Similarly, self-ID means that a man stripping off in front of naked women in a supposedly women-only space is doing something right and proper if he identifies as a woman. Again, this is not just a destruction of human rights, it’s a full reversal. And it’s not just any old human-rights violation, it’s state-sanctioned sex crime – voyeurism and indecent exposure – and a violation of Article 3 of the European Convention on Human Rights, the right not to suffer torture, inhuman or degrading treatment – which is an absolute right, not a qualified one. The European Court of Human Rights has ruled that being forced to undress in front of someone of the opposite sex violates Article 3.

Hyper-individualism is also hyper-subjectivity. If you can never take the measure of a man, you can’t set objective standards or criteria, and you can’t categorise. If you want to make generalisations, to collate, group and study people’s characteristics and experiences, these can only be under headings like: “People who think of themselves as belonging to a certain category, for which I can give no objective definition, say they experienced things they understood as instances of a certain sort of experience, for which I can also give no objective definition.”

You can’t say: male people commit most violent crimes, or most rape victims are female, or nearly everyone who works as a firefighter is male, or every human being who has ever got pregnant is female. You have no test of the “reasonable person”. No yardstick by which you can even hypothetically judge whether a crime should attract the hate-crime aggravator.

All boundaries dissolve. That’s what queer theory is all about: making it impossible to say that anything is different or separate from anything else. You can’t say things are objectively good or bad – except that it’s definitely bad to disagree with someone’s self-categorisation.

This breaks institutions, and specifically, it breaks them at their point of purpose. If an organisation was set up to educate, it starts to indoctrinate – to teach lies and to punish anyone who points out that they are lies. If it was set up to do safeguarding, it turns into an organisation that works to increase the risks of harm and abuse for vulnerable people. If it was set up to promote free speech, it becomes a censor. If it was set up to support and strengthen women, it becomes an institution that sidelines women and promotes men in their place.

It also destroys entire fields of human endeavour. Take scientific research. I’ll give an example I recently heard about from a reviewer for a research funder. They were sent a proposal to research a specific harmful outcome from pregnancy. The researcher was clearly knowledgeable and passionate, and the proposal was excellent – except that among the criteria for inclusion was “recently gave birth, identifying as female”, and among those for exclusion was “not a transwoman”. But what about mothers who don’t identify as female? And do we really want our science to be done by people who have managed to get confused about whether a transwoman can possibly give birth? When the reviewer followed up it became clear that the researcher did indeed know this, but hadn’t known how to frame the criteria without being criticised for being “transphobic”.

That researcher took it for granted that people want good health. That we know what it looks like for wounds to heal well or badly, and that it’s better for them to heal well. That a woman who has given birth has certain vulnerabilities and risks, and that we might do research to – just off the top of my head – make it less likely that she wets herself when she sneezes, or suffers back pain because her core muscles never recover, or stops having pleasurable sex because her episiotomy left a painful scar.

The researcher didn’t say: what is pain but a social construct? Or: it’s stigmatising to incontinent persons to suggest that it would be better not to have stress incontinence as a result of giving birth. Or: the expectation that a woman would want to continue to have penis-in-vagina sex after giving birth is heterosexist. That research was based on ideas of common humanity and of what it means for organs to function healthily, on regarding pain as worse than lack of pain, and regarding it as good to be able to continue to have sex when you want and to protect people’s fertility so they can choose whether or not to have a baby rather than having the choice taken from them.

To do good research, in other words, you have to regard some outcomes as better than others, and to judge outcomes by objective criteria.

What happens when objectivity and the concepts of “better” and “worse” outcomes are abandoned? What you get instead is papers like Medical uncertainty and reproduction of the “normal”: Decision-making around testosterone therapy in transgender pregnancy. This paper talks about how uncertainty regarding the use of testosterone in pregnancy feeds into:

“gendered precautionary practices that work toward avoiding potential risk through protecting embryos, fetuses, children, and families above all else… driven… by a focus on attempting to (re)produce normative bodies and people… involve potentially troubling assessments of the sorts of risks testosterone exposure in the prenatal and postpartum environments may pose for later child and adult development: namely, potentially heightened likelihoods of autism, obesity, intersex conditions, being lesbian and/or trans.”

It’s no better for your baby to be born “normal” and “healthy” than disabled or unhealthy, and if you think it is you’re a bigot. (And note throwing “lesbian” in with serious health conditions.)

I call this the “have a disabled baby to stick it to the cisheteropatriarchy” paper.

I read a great expression recently: tooth fairy science. It was coined by Harriet Hall, a doctor who died last year who was a proponent of rationalist medicine and opponent of quackery. She wrote:

“If you don’t consider prior probability, you can end up doing what I call Tooth Fairy Science. You can study whether leaving the tooth in a baggie generates more Tooth Fairy money than leaving it wrapped in Kleenex. You can study the average money left for the first tooth versus the last tooth. You can correlate Tooth Fairy proceeds with parental income. You can get reliable data that are reproducible, consistent, and statistically significant. You think you have learned something about the Tooth Fairy. But you haven’t. Your data has another explanation, parental behavior, that you haven’t even considered. You have deceived yourself by trying to do research on something that doesn’t exist.”

Gender medicine could be called Evil Tooth Fairy Medicine. What gender clinics do isn’t just “not medicine”, it’s anti-medicine – producing ill-health and harm. The idea that using puberty blockers to throw a spanner in the works of a teenager’s developing brain, body, personality and sexuality might be a solution to anything is for the birds. But unfortunately that hypothesis is out there now and we’re doing that research.

I’m sure you’ve noticed how ugly all the visual depictions produced by trans lobby groups and social-justice types are. It’s generally in the style called Corporate Memphis – blobby people; flat, unrealistic skin colours; no expressions, sometimes no facial features; blocky, digitless hands and feet; distorted proportions and shapes. In this style, the only difference between men and women comes from hairstyle and clothing.

That’s obviously very useful for a movement that seeks to suggest we are women if we have long hair and breasts, and men if we have short hair and no breasts. But the nastiness of this style goes further. It claims to be motivated by a desire to be diverse and inclusive, but it seeks to achieve that not by portraying individual exemplars of the human condition – pain, imperfection, overcoming, suffering, courage, joy and so on – but by being stereotyping and non-specific. Good art isn’t generalities, it’s keenly observed and expressive.

This style seems more sinister when you realise how easy it makes it to draw unhealthy or unnatural body types. Enormously obese people, missing limbs, mastectomy scars – everyone looks equally inexpressive and unreal. It’s one thing to avoid stigmatising people whose bodies fall short of some Platonic ideal, quite another to paint out all struggle and suffering. This style isn’t just inhuman, it’s anti-human.

The same happens with writing. I’m going to take as an example a review by Substacker Holly Math Nerd of a novella called Their Troublesome Crush by Xan West (the full review is behind a paywall). Here’s the blurb for the book:

“In this queer polyamorous m/f romance novella, two metamours [this means people who sleep with the same person] realize they have crushes on each other while planning their shared partner’s birthday party together. Ernest, a Jewish autistic demiromantic queer fat trans man submissive, and Nora, a Jewish disabled queer fat femme cis woman switch, have to contend with an age gap, a desire not to mess up their lovely polyamorous dynamic as metamours, the fact that Ernest has never been attracted to a cis person before, and the reality that they are romantically attracted to each other, all while planning their dominant’s birthday party and trying to do a really good job.”

I looked up reviews; this one was typical.

“This book was chock-full of representation, and it was honestly such a treat. I’m personally not kinky or polyamorous, so if you are, this book will likely work even better for you than it did for me. But I am queer and autistic, and I specifically really loved the autism rep. It made me feel very safe and very seen. Of course the queer rep was great as well, but I just don’t get to see good autism rep very often, so this means a lot to me.”

As the reviewer Holly – who has several serious medical conditions – says:

“When I choose to give a character of my creation part of the complexity I know well from living in my physical body or paying attention to others who deal with their own physical challenges, I am attempting to make the character more fully realized.”

This isn’t that. It’s the opposite. The people are stereotypes, and deeply unpleasant with it.

Education, too, is being destroyed by these ideas: turned into the opposite of education, namely indoctrination. I’ll just give one example.

A friend has a four-year-old who has just started school. She’s already had her first relationships and sex education (RSE) lesson. It involved the teacher asking the children to think about which games and toys are for girls, which games and toys are for boys, and which games and toys are for neither. The teachers’ notes have obvious examples like dolls for girls, trucks for boys – and it says things like board games are for both. When my friend asked the teacher about the lesson, she was told it was about “inclusivity” because the kids were supposed to discover that there are toys everyone is allowed to play with.

The teacher seemed perfectly nice, and not obviously insane, but clearly didn’t understand that this lesson was the opposite of breaking down gender stereotypes and helping all children to flourish. Doing that would involve telling children they can play with whatever toys they like, and that their choices have no impact on whether they are boys or girls. This lesson was clearly the start of a scheme of work that is intended to have brought every child, by the end of primary school, to the point where they believe that if you play with dolls you’re a girl and if you play with trucks you’re a boy – and probably that if you like board games you’re non-binary.

When a lie is embedded in a system, over time it propagates throughout that system, and then everyone working within it has to try to protect the lie by staying well away from it. It’s worse than a loophole, which over time tends to get bigger – it’s a loophole you have to avert your eyes from and avoid mentioning.

I’ll give you a stark example. Sonia Appleby was the safeguarding lead at GIDS, she was disciplined for raising safeguarding concerns and she successfully took GIDS to the employment tribunal. Well, what led to the disciplinary action against Sonia was that she mentioned one of Britain’s most notorious and prolific child-abusers, Jimmy Savile. After he died it came out, as so often, that loads of people either had known or should have known that something was up, but didn’t do anything.

When training colleagues in safeguarding, Sonia routinely referred to Savile, her point being that it’s everyone’s responsibility to be vigilant and to speak up about any concerns, and that not just people but institutions can be groomed and be complicit. But a colleague was deeply offended at the idea that he might be considered as at risk of being complicit in child abuse, and he made a complaint. A letter was put on Sonia’s file for supposedly unprofessional and improper behaviour.

After Savile died there were official inquiries and public apologies and the usual guff about “lessons must be learned”. Well, it turns out that the lesson of Jimmy Savile is: don’t mention Jimmy Savile. Institutions that have a lie at their heart, as GIDS does, namely the lie of gender identity, end up breaking at their point of purpose.

I’ve said why I think gender-identity ideology is totalising – the same lie breaks very different institutions and fields of endeavour in what look at first like different ways, but they’re all connected. So now, let’s think about how it can be put into reverse.

Let’s start by asking where you should focus your efforts. People tend to notice one part of the problem first, and to seek to fix it in that place, partly because otherwise it feels too big to fix but also because doing something concrete means having some expertise – knowing the frameworks and the terms of art and professional standards, and whom you might be able to convince. So it makes sense, if you’re in a particular field, to work in that field.

More generally, if there’s a problem that drives you particularly mad, it may be where to start. It’s like the thing that personal trainers say: the best sort of exercise is the exercise you do. It’s pointless saying that bootcamp might be better for you than zumba, if you hate bootcamp and like zumba. You’ll do the zumba and you won’t do the bootcamp. So if what drives you insane is the threat to children, or to free speech, or to lesbians, or whatever, focus there.

But I will make three general observations:

Don’t wear yourself out or put yourself at undue risk. Don’t lose your job. Try not to lose friends and really try not to lose family.

Whenever possible focus on institutions not people, and on rules not individual examples. Go for local authorities or school chains rather than schools, and schools rather than individual teachers. Best of all, focus on policy and policy-makers.

If you’re traumatised, you will naturally want to focus on the central thing for you, and many of those attending Genspect conferences have been traumatised by the impact of gender-identity ideology on their children and have responded by throwing themselves into this fight. Of course that’s fine. But I also hear from many people privately who tell me their own awful family story and then apologise for not doing anything publicly, often because they need to protect what remains of the relationship with their child or because they are afraid they are going to go mad. It’s as if they’re seeking absolution for not stepping up – but that is such an unreasonable pressure to put themselves under. It’s for those of us who see the issue but aren’t personally affected to step up. In particular, child safeguarding isn’t children’s job, it’s adults’. Schoolchildren shouldn’t have to be brave.

But if you are genuinely asking where activism is likely to bear fruit first, or which arguments are likely to move people in one-to-one conversation, I can tell you the answer because Sex Matters has done focus groups.

In general most people are in roughly the right place, but they don’t like the idea of being mean or rude, and they definitely don’t want to be the ones who have to say “no” to anyone. When you listen to them you can hear the impact of workplace training – people spontaneously say that “misgendering” is “unprofessional”. They want to “live and let live”, and they really, really haven’t thought their thoughts all the way through to the end on women-only spaces.

They mostly know perfectly well that people can’t change sex but think that people who want to are very rare and deeply, deeply suffering. They think doctors are screening out chancers and that “transition” means something – they use expressions like “if they’ve gone through the change” or “if they’ve had the operation” or “if they’ve fully transitioned”. An increasing number know someone trans or someone who has a trans-identifying child, and they don’t want to get into any sort of in-person argument. They may feel personal sympathy.

But there are two topics where people are almost automatically in the right place, and they are child gender medicine and sports. That’s probably because in both cases there’s an easily accessible moral framework that has nothing to do with identitarianism, and which doesn’t bring to mind the false analogies – with women’s liberation, civil rights or gay marriage – that so bedevil this topic.

For children, people simply think “they’re too young” to be the boss of themselves, still less to do anything irreversible. And in women’s sports they keep coming back to “it’s not fair”.

Well, we certainly want to stop child gender medicine and protect women’s sports. But that’s not enough – and that’s when the thing that has caused us so much trouble as this idea has spread, namely that everything is connected, can start to work for us.

Take sports. Well, “sports” doesn’t just mean competition, it means changing rooms. It means the development pipeline as well as elite competitions, and that means sport in schools. And if you can’t lie about who’s a boy and who’s a girl when they are playing sports, then how can you lie about them elsewhere in school?

And “no child gender medicine” means an end to the idea of the “trans child”. It means no longer teaching children that transitioning is a thing. It means that you can’t pretend that any boys are girls, or any girls are boys. And once you stop that pretence, it’s obvious what the words “boy” and “girl” mean in school rules and safeguarding.

This is the real importance of the UK’s ban on puberty blockers. They’ve never really been a serious treatment option in the UK – I don’t think more than hundreds of kids have taken them, certainly not more than a few thousand. What they are is a rhetorical and argumentative device.

The mere fact of their existence means that it is in principle possible to start presenting a small child to everyone around them as the wrong sex and to imagine you’ll be able to get away with it permanently. If you know before you start that puberty will come along and reveal the lie, it’s less likely that you’ll ever start down this path. There isn’t a half-way position, of lying to and misleading children while knowing that down the line you cannot arrest their mental, physical and sexual development and ultimately mutilate them so that the lie is never revealed. In order to start with the lie, at least the notional possibility of arresting their development and ultimately mutilating them has to be on the table.

And if you’ve accepted that schools can’t let boys into girls’ spaces, and vice versa, because that would endanger kids, and you’ve accepted that ensuring separate-sex spaces means being clear about who is a girl and who is a boy, then you can make the same arguments for adults. First in places where there’s someone who knows who everyone is and who has a duty of care – for example, in prisons and workplaces. And then in other spaces too, because if men can’t use the women’s toilets at work, then why on earth are we letting them do so at the shopping centre?

I’m not saying the unravelling will happen automatically – every stage will have to be fought. I’m just saying that I know where we’ll make progress fastest right now, and that once each step is taken the next will be clear, because it’s all connected. We have to keep taking those steps, but we won’t come to a dead end unless we give up trying.

Once an idea is out in the world, it’s pretty much impossible to get it back into the box, so I don’t hold out much hope that we are going to all forget the idiotic idea that people have gendered essences. But the consequences of holding this bizarre and harmful belief, both for the believer and for everyone else, can be constrained. A child can think they are the opposite sex, or no sex, if they want – they can even have parents who think this. But if schools are enforcing sex-based rules when it comes to single-sex spaces and sports, and there are no clinics offering Evil Tooth Fairy Medicine, the harm will be limited.

The same with sports: if we return to cheek swabs to check that an athlete is female before she can compete in women’s events, it stops mattering whether a male athlete “identifies as female”. He can go and identify as female in the male/open competition to his heart’s content.

The third thing I want to say about how to approach activism in this field is this: don’t rush when you’re trying to persuade an individual, and be very intentional – in both directions – when you’re seeking change within institutions.

Genspect has platformed several fascinating experts in deradicalisation and getting people out of cults. And what they say is: take it slow, leave space for the other person to do some thinking themselves, and accept that it takes time for a person to change their mind.

I know it’s difficult to seem measured and rational once you’ve seen that something is nonsense all the way down.

For example, I don’t want any more enabling of gender medicine.

I don’t want a puberty-blocker trial – it would be unethical – or any more evidence reviews, because this is just Evil Tooth Fairy Medicine. But to someone good and well-meaning working within medicine – someone like, say, an endocrinologist or child psychiatrist who has severe reservations about what’s happening in gender clinics but hasn’t freed their mind from the idea of the “transgender child” or “transition” – that seems like extremism.

So it’s tempting, and probably essential, to work step by step. But the story of safeguarding failures shows that’s a big problem too. What typically happens when there’s a major safeguarding failure is that lots of people could have spoken up but they don’t because they know there will be consequences. It’s easy to think they are cowards, and maybe sometimes they are, but they’re also right. Typically, they think: if I say something I’ll be managed out and I’m the only cautious, careful person here, so it’s better that I stay and work within the system because if I’m pushed out the next person will be worse. So they stay quiet, and they stay, and then two years later they’ve become that “worse”.

It’s the whistleblower’s dilemma: your job is to speak up, but you get punished, often kicked out, and the people who replace you are worse. So I’m going to say something to anyone who knows that they are, in effect, working at a crime scene and aware that if they report the crime there will be professional consequences. It’s this: ask yourself now what the line is that you are unwilling to cross. Write it down, and pin it up somewhere visible – maybe by your hall mirror. And when you reach that line, speak up. Otherwise you will end up complicit in things you would never, ever have believed you would one day accept.

I want to finish by making a final, optimistic point. There is a meta thing all of us can do, and it’s not obviously related to gender. I said that what we’re up against isn’t just a lie about the two sexes, it’s a hyper-individualism and hyper-subjectivity that denies all standards, definitions, judgements about what is better and what is worse and understanding of what might constitute a good life and what it means that there is a human condition.

And that means that if you reject that radical and pernicious subjectivity in any sphere – if you do good scientific research, if you provide good healthcare, if you create art that reveals and recreates meaning, if you insist on quality and beauty – then you’re doing something that is inimical to gender-identity ideology and the project of hyper-individualism. You are fighting back.