The first part of this series set forth a brief history of the eugenics movement in the United States, arguing that while the core principles of eugenics are thoroughly discredited today, during eugenics’ time in the sun, it was endorsed and ratified by the finest and most prestigious minds and institutions in our society. The parallels to juvenile transgenderism are patent.
Today, juvenile transgender theory and practice are considered established fact by virtually all of mainstream medicine, the psychiatric and therapeutic professions, academia, the educational establishment, and the media. It is easy to despair when considering the apparent total capitulation of all the most respected and authoritative voices in our society. Yet, as the case of eugenics makes all too clear, what is chapter and verse today, may suffer a sudden reversal tomorrow – and be shown a source of cruelty and evil, rather than the saving grace it promised to be.
A review of eugenics practice reveals striking parallels with juvenile transgender treatment. This article notes one of the saddest and most obvious similarities: that as applied, both theories result in the sterilization of people who are unable to give meaningful consent to the procedure. In fact, as we will see, the number of people ultimately sterilized by transgender treatment is likely to dwarf the numbers seen in the heyday of eugenics.
A recap of sterilization under eugenics
The eugenics movement advocated both “positive” and “negative” ways of achieving its objective of a “better, healthier race.” “Positive” and less intrusive methods included encouraging “good breeding stock” to reproduce and improve the American “germ plasm;” however, since these tactics were deemed unlikely to achieve improved population quality quickly enough, “negative” approaches, including sequestration of undesirables and coerced sterilization of unfit individuals, were also used.
Evidencing the extremely rapid adoption of eugenics ideas, by 1924, fifteen states had passed sterilization laws targeting individuals with “mental disease” which was “likely” to be passed to his or her descendants (and by 1937, 32 states had passed these laws). The American Eugenics Society hoped, in time, to sterilize approximately one-tenth of the United States population.
American eugenics had at least one avid pupil in Europe: forced sterilization was enthusiastically adopted in Germany after the Nazi regime came to power.
In “Mein Kampf,” published in 1925, [Adolf Hitler] celebrated the ideology. “There is today one state,” wrote Hitler, “in which at least weak beginnings toward a better conception [of citizenship] are noticeable. Of course, it is not our model German Republic, but the United States.” Hitler’s Reich deployed its own sterilization laws, nearly identical to those in the United States, within six months of taking power in 1933. (Source)
The Nazi sterilization program, conducted on an industrial scale, ultimately resulted in the sterilization of some 360,000 to 375,000 persons.
It may be surprising to learn exactly how many individuals were affected by forced sterilization laws in the United States. As discussed here, historians estimate that between 1909 and 1979, more than 20,000 men and women in California alone were sterilized pursuant to the state’s eugenics program. Overall, it appears that some 60,000 people were sterilized in the United States during this period, as a direct result of state-mandated eugenics programs. In the 2010’s, several states, including North Carolina and Virginia, compensated surviving victims of forced sterilization. As a historian working on a research project to restore the hidden history of eugenic sterilization in California noted,
Taken together, these experiences illuminate, often in poignant detail, an era when health officials controlled with impunity the reproductive bodies of people committed to institutions. Superintendents wielded great power and proceeded with little accountability, behaving in a fashion that today would be judged as wholly unprofessional, unethical, and potentially criminal.
Modern transgender treatment leads to sterilization
Unlike under eugenics, of course, juvenile transgender treatment does not deem sterilization as a positive good but treats it (to the extent it is discussed at all) as a pesky side effect. However, it is beyond dispute that the recommended course of medical treatment for transgender young people will, in fact, more than likely result in those young people becoming unable to bear children of their own. This is because the administration of “puberty blockers” and ensuing treatment with cross-sex hormones results, unsurprisingly, in the blocking of normal puberty and the attendant ability to procreate. Of course, removing a person’s natal sex organs (as is done in “sexual reassignment surgery”) also results in permanent sterilization.
By and large, the risk of sterilization for children who undergo the now-recommended course of juvenile transgender treatment is simply ignored or assumed away. A good example is a recent article in Vogue magazine, “How the Parents of Trans Teens Are Fighting for Their Kids’ Lives,” which contains sympathetic histories and styled photographs of transgender children and teenagers, and notes in fairly explicit detail the medical course for such children, which includes (as noted above) puberty-blocking drugs and cross-sex hormones.
Although the lengthy and seemingly comprehensive article seems comparatively forthright on the potential costs to families of having a transgender child (divorce, poverty, social ostracism), it curiously fails to mention destroyed fertility as a current or future consequence for these young people. This blind spot when it comes to sterility is common to virtually all mainstream coverage of these children. Is this because most reporters do not believe this is important? Or is it possible that the news coverage of transgender people and fertility, that highlights such far-fetched oddities as “pregnant men” and “womb transplants” has so thoroughly confused the issue? Or could it be that a full and fair discussion of these considerations might deter parents from pursuing this course on behalf of their children?
In a 2013 article, Sahar Sadjadi, a medical anthropologist and MD, drew attention to the stunning silence around the trans-child sterilization question:
It must be remembered that puberty suppression as the first step to medical transition, if followed by cross-sex hormones, which has been the case for almost all reported cases, leads to infertility due to the permanent immaturity of the gonads and the reproductive tract. The absence of the discussion of sterilization of children as a major ethical challenge … is striking. For any other group of children, such an intervention would be discussed extensively with ethics review boards. (What grounds might justify the permanent elimination of the child’s reproductive ability? Should parents be able to make such a decision for the child? Which futures are opened by the treatment and which ones are foreclosed? How might benefits be weighed in relation to the loss of reproductive capacity?) The media would likely react with investigations and questions about the long-term consequences of treatment. These “queer” children’s bodily integrity and reproductive rights should not be any less pressing than other children’s. Needless to say, children are not legally capable of consent, and 9–10 year olds are not capable of understanding all the health consequences of the treatment.
Discussion of this topic would not be complete without addressing the blithe assertions of some trans-activists to the effect that medical science or technology will somehow swoop in to save the day for future sterilized individuals.
This is a canard. First, of course, if a young person has not undergone normal puberty, he or she will not have the ability to provide tissue, eggs or sperm on which these procedures may be undertaken. Second, any analysis of fertility and sterilization that depends on the success of heroic, if not currently technically impossible, medical measures holds out a shaky promise indeed. It’s true that if a person’s heart is badly damaged by a drug, he or she might be able to obtain a heart transplant and not die, but simply because the “heart transplant option” exists does not make it the equivalent of not having taken the drug in the first place.
Modern transgender treatment leads to sterilization of gay and lesbian people
As discussed below, it isn’t easy to find reliable statistics about child or teen transgender medical treatment in the United States. One aspect of the field does, however, seem comparatively beyond dispute: that gay and lesbian young people are disproportionately affected. This is because “gender non-conforming” children – in other words, those often identified at a young age as potentially transgender – typically grow up to be gay or lesbian. (See an earlier article on this website for further explanation and detail.) A priori, the children most likely to be sterilized by transgender medical procedures are those who would otherwise grow up to be gay and lesbian adults.
A closer look at the numbers
As discussed above, that 60,000 human beings were sterilized over the 70 years that eugenics held sway in this country is now considered shocking, disgraceful and morally abhorrent. About how many children and teens are likely to be sterilized under transgender practice?
We start by noting that accurate figures for the United States of the numbers of children and teens undergoing transgender medical care are extremely difficult to come by, because the delivery of medical care is so fragmented. A family could take a child to one of the 40 gender clinics that currently serve children and youth in the United States, but that same family could also take the child to a private doctor for administration of puberty blockers and cross-sex hormones. Remember that in the United States, any doctor with a valid DEA number can write any prescription for any drug.
Recent statistics for the United Kingdom show an average of 50 children a week are being referred to gender clinics, or a rate of roughly 2,600 per year (and if anything, there still exists a much higher level of so-called “gate-keeping” in the United Kingdom than in the United States). The population of the United States, 323.2 million, is roughly 5 times that of the United Kingdom, at 65 million, and given that both countries seem equally enthusiastic about juvenile transition, in the U.S. we would therefore expect to see about 250 children per week entering the transgender medical system, or an annual rate of 13,000 children.
If only half of those 250 referred children go on to medical transition, the annual number of sterilized children in the United States could be as high as 6,500. The rate under eugenics was less than 1,000 per year; so we are looking at a rate of sterilization potentially 7 times higher than it was under eugenics (and we could attain, in less than 10 years, the numbers that it took the eugenicists 70 years to achieve). Today, we rightly perceive eugenic sterilization as having been an “ethical wrong,” “horrifying,” and “deeply, almost physically, infuriating.”
Discussion of this topic would not be complete without referring to the fact that compulsory or forced sterilization is considered under international law to be a human rights abuse. As stated in an interagency report issued in 2014 by the World Health Organization, “[s]terilization without full, free and informed consent has been variously described by international, regional and national human rights bodies as an involuntary, coercive and/or forced practice, and as a violation of fundamental human rights, including the right to health, the right to information, the right to privacy, the right to decide on the number and spacing of children, the right to found a family and the right to be free from discrimination.”
In a display of breath-taking hypocrisy, the Open Society Foundation, a major funder of world-wide transgender advocacy, argued in a 2015 position paper that “[f]orced and coerced sterilizations are grave violations of human rights and medical ethics and can be described as acts of torture and cruel, inhuman, and degrading treatment. Forcefully ending a woman’s reproductive capacity may lead to extreme social isolation, family discord or abandonment, fear of medical professionals, and lifelong grief.” We couldn’t have said it better ourselves.
The question that should occur to every reader, proponent of pediatric and juvenile transition or not, is whether in some sense – even subconsciously – we are minimizing or discounting the horror of sterilization because its likely targets are people who would grow up to be gay and lesbian adults. It would not be the first time that a group of people has somehow been determined to be “less than,” and not “deserving” of the same rights and considerations as others in society. This should make us sad, but it should also make us furious.