HHS Report Author Wrote a Book Claiming Gender Identity is Fiction
Alex Byrne’s ideological commitments were clear long before he was tapped by Trump to claim gender-affirming care is bad medicine.
Opinion, by Evan Urquhart
The Amazon summary for Alex Byrne’s 2023 book, “Trouble With Gender: Sex Facts, Gender Fictions,” is not coy about the author’s intentions. “Revolutions devour their own children, and the gender revolution is no exception,” it reads. “Trouble with Gender joins the forefront of the counter-revolution, restoring sex to its rightful place, at the centre of what it means to be human.”
This clarity is notably absent from the author’s recent opinion piece for the Washington Post, in which the MIT philosopher publicly acknowledged being among the authors of an HHS report on gender-affirming care. In it, Byrne defends the report, complaining it has been unfairly maligned by the medical community. The report itself was created in response to Executive Order 14187 titled “Protecting Children From Chemical and Surgical Mutilation” that declares gender-affirming care is based on junk science.
The language of the EO suggests a report commissioned with a single predetermined result in mind, but Byrne pushes back against this, describing himself as a liberal and saying the report was conducted without political interference. However, he neglects to mention his prior history with this topic, including the fact that he authored a book taking the position that sex is real and immutable and gender identity is a harmful ideological fiction. If Byrne is representative of those tapped for the review it suggests the outcome was never in any danger of deviating from the administrations expectations.
Perhaps due to their shared authorship, both the opinion piece and the HHS review are superficially well argued, and both go to great lengths to omit or distort any information that might be inconvenient to the argument proceeding smoothly.
For example, in the WaPo piece Byrne writes, “Puberty blockers followed by cross-sex hormones compromise fertility.” This is not accurate. What researchers have said is that we don’t know what the impacts of blockers followed by cross-sex hormones are on fertility may be. There’s even reason to believe they may be fully or partially reversible.
We know that puberty blockers have no long term impact on fertility when used to treat precocious puberty. And, evidence has been mounting that both trans men and trans women on cross sex hormones regain fertility if they cease taking hormonal treatments. What we don’t know is whether the same is true of trans people who began by blocking puberty. That’s because trans youth who start on blockers are a very small group of patients, a minority of all trans youth who receive medical interventions, and because regaining fertility would mean going through all the changes associated with their natal puberty, so most trans people who blocked puberty in the first place aren’t willing to try it.
We do know that at least two prominent detransitioners have gone on to carry a successful pregnancy, Daisy Strongin and Prisha Mosley. Although both women began transitioning to male as teenagers, neither was ever on blockers. As the number of youth treated with blockers and cross sex hormones increases, eventually we’ll know whether fertility returns for those who cease hormonal treatments after blockers the way it does for those who never went on blockers.
Misleading WaPo readers about the impact of gender-affirming care on fertility is only one example of a place where Byrne misrepresents reality to supplement his argument. Another example is Byrne’s treatment of European countries’ approaches to youth gender medicine. As frequently happens in ideologically slanted pieces on this topic, Byrne presents a list of countries that have supposedly limited access to medical transition for minors. On his list are countries who have unambiguously done so such as the UK, and countries whose history is more mixed such. For example, Byrne names Finland, where care has long been all but unobtainable for youth and no cases of trans patients treated with puberty blockers have ever surfaced.
Left entirely off of Byrnes’ list are European countries who have warned against limiting access to youth care in recent years or reviewed the evidence and found it to be sufficient to continue providing treatment.
In both this opinion piece and the HHS report itself, the evident goal is a shallow rhetorical victory, using language games and disinformation to obscure the reality of young people seeking treatment for gender dysphoria. It’s easier to argue that puberty blockers followed by cross sex hormones carry risks to fertility than that cross sex hormones carry those risks alone, so just pretend most trans youth start on blockers and assume the audience won’t know it’s a minority. It’s easier to defend sweeping bans on care if many countries are imposing similar measures, so pretend that that is happening and ignore countries that have moved in the opposite direction. Byrne is a philosopher, not a scientist, but it’s an approach to arguing a case that would embarrass anyone but the most shameless rhetorician. But in America today, the conventional wisdom has shifted against gender affirming care for youth, and that’s all that really matters. Byrne knows no one in the mainstream will read a fact check, because the passions of the day are with him.
Evan Urquhart is the founder of Assigned Media.