The sterilization of trans kids: Pesky side effect, or modern-day eugenics?

by worriedmom

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.

hitler sterilizationIn “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.

us sterilization

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.

eugenics trans girlBy 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.

Zinnia fertility

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.

eugenics drugs

Mom? Dad? Whichever. Trans men are giving birth, so stop with the sterilization of prepubescent kids already

Request: Although the screen captures and YouTube videos discussed below are publicly available,  please respect the dignity of the family featured in this post.

There ought to be something worth pondering for pretty much everyone in this post–left, center, and right of the political spectrum;  gender critics, trans-identified people, parents, “gender specialists,” and anyone else who believes the issue of sterilizing prepubescent trans-identified kids is worth discussing with the nuance it deserves. We desperately need a society-wide conversation about this, something that is strangely lacking at the moment.

I’ll be featuring the Vlog of one young FtM named Sam (YouTube account name “MrSexyrexy8907”), who, like many of his generation, started as a gender-defiant lesbian who decided to medically transition. Note: In this post, I am choosing to refer to FtM Sam with male pronouns at times.

Sam began testosterone at age 20, had a bilateral mastectomy roughly a year later, and says in earlier videos that s/he someday hoped to undergo “bottom surgery” as well, when his budget allowed.

By the end of the Vlog journey, we learn that Sam ended up as a self-identified gay man in a committed relationship. At 24, Sam and his male partner became the proud biological parents of a baby girl.

Sam’s Vlog is comprised of only a few videos–short, by the standards of most YouTube FtM transition sagas. It spans a four-year-time frame, with sporadic uploads of brief videos, and you can watch all 21 of them in a sitting.

As a trans man who has given birth, Sam is definitely not alone. There are many other media stories and Vlogs about happy adult trans men who are biological parents. I had originally planned to include several more of these accounts in this post, but as I wrote, I realized we only need one–one happy family wherein the trans man bore a biological child. In Sam’s case, it is worth emphasizing, this is a trans man who earlier wanted bottom surgery, and who made no made no mention of future fertility.

The mainstream press, always eager to trans-fix us, has of late served up many accounts of blissful FtM biological parents (some of whom appear not to understand that identifying as male is not an effective contraceptive). Because the very physical experience of being pregnant and giving birth results in dysphoria for some of these FtMs, midwives  (and others) are being strong-armed by their professional organizations into using “preferred pronouns” and urged to eschew words like “mother” and other female-centered terminology, to ostensibly show respect for the FtMs who become pregnant and give birth but would rather be referred to as “fathers.” As in every other nook and cranny of civilized society, any remaining cobwebs of perceived transphobia are being carefully swept away (despite some pushback from brave holdouts).

What, then, are we to make of the activist-clinician zeal for curtailing the reproductive capacity necessary for conception, pregnancy, and birth in prepubescent kids who profess to be trans?

Sam’s 36-weeks-pregnant video was the first to pop up in my “trans man pregnant” YouTube keyword search.  It’s a fascinating tale. Sam tells us he’s in a gay relationship, and he is positively glowing in his happiness about the impending birth of his daughter, due in 30 days.

This was a planned pregnancy. It wasn’t an accident. It’s been rough, dysphoria wise…some times are harder than others.  I’m carrying really really low, so that gives me that beer-belly type of appearance.

 [7:00] I’m ecstatic to meet her and start this little family… After stopping hormones, my cycles came back. I’d been off hormones for over a year, in which time I met my partner and we decided we wanted a baby….decided I was ok with carrying her and having a child.

 Sam says a lot more in the video about the changes he’s been through since his last video, including a successful struggle to quit drinking. As I watched, I found myself liking Sam and wanting to know more about what preceded all this. Clearly, this was a young adult who had been through quite a lot by the age of 24, and was now happily expecting a baby girl.

So I went back four years to the beginning of Sam’s Vlog journey, which began in 2009, at age 20. As with most transition chronicles, Sam’s introductory video was “pre-everything”—no testosterone or surgeries yet. Sam had a girlfriend who he refers to as his “fiancé” whom we see and hear a lot about in these early videos; Sam is wearing an engagement band on his ring finger. sexyrexy youtube

 March 2010. Sam has been on “T” for 5 months, and we can see and hear the changes. He’s living in an apartment with his fiancé; he tells us wants to go back to school. He wants bottom surgery but can’t afford it yet. There are several more vids, including the requisite top-surgery post-op (always a staple of FtM Vlogs).

By July 2011, Sam’s been through a lot. He’s gone off T,  and he’s just over a year post-op from top surgery. Not only that: he’s been “in and out of rehab” and is just back home after living in halfway houses, with no health insurance. The engagement band has disappeared.

In October, Sam is cautioning other FtMs that they better be sure about medical transition. He’s off T, but he still has hair growing in.  “Your hairline will recede and your face will change.”

Sam’s videos are few and far between for a couple of years. We don’t know exactly how s/he got from A to B, but let’s fast forward to the video made soon after his daughter’s birth in 2013.

sexyrexy birth

Sam shares some very intimate details about his after-birth experience.

All of my weight gain was in my uterus and within a few days it was practically back to normal.

…Oddly enough—I have had a double mastectomy—and the other day one of my nipples was leaking. So that kind of caught me off guard…I don’t seem to be retaining any fluid or milk. [SMILING]. I don’t know if it’s a matter of not 100% everything was removed or hormones and milk ducts…either way, it was a very little bit and not a big deal.

We are thrilled to have her….

There’s  a longer video made a month after their baby was born, with lots of still shots and video clips of Sam and his partner, clearly enjoying family life together. We see a pre-birth sonogram, the baby shower, and even the actual moment of their daughter’s birth (Sam jokes it’s the “PG version”), and many pictures of the newborn with her doting parents.

sexyrexy proud parents

A final video uploaded in April 2014 is a collage of clips chronicling the kind of new-parent life many of us will recognize from our own days with a newborn.

Then that’s it for Sam’s Vlog. Life with a baby and toddler is all-consuming, and judging by Sam’s YouTube playlists nowadays (which seem to consist entirely of videos for young kids), the family might be too busy now to bother with YouTube uploads.

sexyrexy baby carrier

Sam’s story—that of a former lesbian who winds up in a relationship with a man—is not that unusual. Cross-sex hormones have the potential to alter a person’s sexual orientation. Some same-sex attracted women– lesbians—become bisexual or even heterosexual after undergoing testosterone treatment. (Sadly, those trans men face an increased risk of HIV infection.)

For the record, as anyone who reads here regularly knows, I don’t want lesbians to feel they need to medically transition. I do consider it a form of anti-gay conversion therapy. And while my regular readers may also wish Sam had felt she could live her life as the woman she obviously is, without surgeries, without hormones… for me, at least, it’s impossible not to be touched by the obvious love shining between these two parents, and their joy as they start  their new family.

At least this young, former lesbian went through puberty and had, at a minimum, one important sexual relationship with another woman before she transitioned. She did not have her fertility denied to her as a tween or teen too young to give informed consent.

Would Sam have said—pre or post transition—that s/he wanted kids at 14, or 16, or 18? Even at 20, trans-identified Sam made no mention of becoming a parent. How many of us parents knew we wanted children of our own while still kids ourselves?

As Sam says, this was a planned pregnancy.  Sam and partner– two adults–decided they wanted to create a baby.

Why does anyone—doctor, activist, parent–believe they have the right to proactively take the option to bear children away from future adults like Sam? Simply so that the “trans kid” will “pass” better? Watch Sam’s Vlogs and tell me s/he doesn’t “pass.” S/he passes just fine. Without going through natural puberty, Sam and his partner would not be parents. Whether you think Sam is a mother, or whether you call Sam (as he refers to himself) “Dad,” the fact remains that s/he is now the happy biological parent of a little girl.

Let me ask the parents who contribute here: If (as much as you don’t want this) any of your daughters (or sons) ultimately decide to transition as adults, would you still welcome a grandchild? Should your daughter—who may someday want to be called your “son”—be denied the opportunity to make that choice for herself?

Most 4thWaveNow parents fervently hope our kids won’t decide to use hormones or have surgeries. But we’re not stupid. We know that, once they reach the age of medical majority, they will make their own choices. We just want the activists and clinicians to cease and desist marketing medical transition to impressionable kids.

And here’s a challenge for the MtoF, late-transitioning heterosexual men, so many of whom—like Bruce “Caitlyn” Jenner—first had their own biological children:

Watch Sam’s Vlog and then tell me it’s no big deal to keep lobbying, as you do, for the medical transition of children, which will result in permanent sterilization.

Put another way: If it’s such an awful tragedy for a trans teen to go through the “wrong” puberty, how come you managed to survive yours, and have exercised your basic human right to produce biological children? Without that wrong puberty, you wouldn’t be a parent today.

How can the activists and doctors who are so eager to subject young people to medical intervention–which they know full well will sterilize these kids–know for sure that these trans kids will not grow up to want children of their own someday?

The answer is: they don’t know that.

Let’s put a really fine point on this. What sort of monumental hubris leads a doctor, psychologist, or activist to believe they have the right to proactively take away the human right of an adult to choose to have biological children?

So which is it, activist-clinicians? You really can’t have it both ways.


  • you want to celebrate the “pregnant people” and their right to reproduce with dignity; adult trans people who (like most of us) didn’t figure out they wanted kids until early to middle adulthood,


  • it’s more important for trans kids to “pass” and avoid the “wrong puberty” than be allowed to choose whether to reproduce when they are adults.