The goal of my column this week is simple: pointing readers to The New Atlantis, one of the nation’s best journals about science, technology and their intersection with ethics. Earlier this week (August 22), The New Atlantis released an important new overview of nearly 200 peer-reviewed studies from the 1950s to the present on issues of sexuality and gender identity, with findings from the biological, psychological and social sciences.
The overview, entitled “Sexuality and Gender,” can be found on line here. While the body of the overview may be data-dense for the average reader, the report’s executive summary, conclusion and prefatory notes to each section are clear, well-written and accessible to any interested adult. And we should be interested, because sexuality and gender identity are now sharply disputed topics with big implications for the health of individuals and our wider culture.
Fortunately, the authors of the overview are both men of distinguished professional credentials. Lawrence S. Mayer, M.B., M.S., Ph.D., is a scholar-in-residence in the Department of Psychiatry at the Johns Hopkins University and a professor of statistics and biostatistics at Arizona State University. Paul R. McHugh, M.D., is a professor of psychiatry and behavioral sciences at the Johns Hopkins University School of Medicine and was for 25 years the psychiatrist-in-chief at the Johns Hopkins Hospital.
Some of the key findings include:
The belief that sexual orientation is an innate, biologically fixed human property — that people are “born that way” — is not supported by scientific evidence. Likewise, the belief that gender identity is an innate, fixed human property independent of biological sex — so that a person might be a “man trapped in a woman’s body” or “a woman trapped in a man’s body” — is not supported by scientific evidence.
Only a minority of children who express gender-atypical thoughts or behavior will continue to do so into adolescence or adulthood. In fact, a large majority outgrow their gender confusion by the time they’re adults. Thus there is no evidence that all such children should be encouraged to become transgender, much less subjected to hormone treatments or surgery.
Non-heterosexual and transgender people have higher rates of mental health problems (anxiety, depression, suicide), as well as behavioral and social problems (substance abuse, intimate partner violence), than the general population. And discrimination alone does not account for the entire disparity.
Given the heavy media coverage of transgender issues over the past year, the overview’s third section, “Gender Identity,” is especially valuable. As the authors note, “there is little evidence that the phenomenon of transgender identity has a biological basis. There is also little evidence that gender identity issues have a high rate of persistence in children.”
Additionally, the “scientific evidence suggests we take a skeptical view toward the claim that sex-reassignment procedures provide the hoped for benefits or resolve the underlying issues that contribute to the elevated health risks among the transgender population.”
The authors are especially wary of medical interventions that are “[p]rescribed and delivered to patients identifying, or identified, as transgender. This is especially troubling when the patients receiving these interventions are children. We read popular reports about plans for medical and surgical interventions for many prepubescent children, some as young as six, and other therapeutic approaches undertaken for children as young as two. We suggest that no one can determine the gender identity of a two-year-old.
“We have reservations about how well scientists understand what it even means for a child to have a developed sense of his or her gender, but notwithstanding that issue, we are deeply alarmed that these therapies, treatments, and surgeries seem disproportionate to the severity of the distress being experienced by these young people, and are at any rate premature, since the majority of children who identify as the gender opposite their biological sex will not continue to do so as adults. Moreover, there is a lack of reliable studies on the long-term effects of these interventions. We strongly urge caution in this regard” (emphases added).
We live in a time when fundamental elements of human identity are routinely challenged and reimagined, with consequences impossible to predict. The New Atlantis does all of us a service by publishing the “Sexuality and Gender” report, and restoring some badly needed clarity, scientific substance and prudence to our discussions.