“Operation,” 1889, by Thorsten Wasastjerna. Public Domain.

“Gender-Affirming Care” Is the New Conversion Therapy

To be robbed by the policeman, or to have our premises burnt down by the watchman, is a small vexation compared to being kept ill by the man we pay to make us well.

Frances Power Cobbe

Sex Matters recently launched a new campaign calling for a ban on “modern conversion therapy.” In the past, the term “conversion therapy” has been used to refer to talk therapy—often influenced by Christian beliefs—that attempts to redirect same-sex attraction toward the opposite sex.

This new form of conversion therapy involves the medicalization of children—many of whom are autistic, and none of whom have fully developed brains or bodies or the ability to consent. On a massive scale, medical professionals subject these children to dangerous and unproven hormonal and surgical interventions. If Sex Matters, Tavistock whistleblower David Bell, and journalist Hannah Barnes are right, all too often these invasive treatments are motivated by the desire to escape homosexuality.

Trans advocacy groups—many of which originally focused on lesbian and gay rights—frame “healthcare for transgender people” as “settled science,” describing it as “critical life-saving care.” “Trans kids are kids,” drones the ACLU. “They deserve the same chance to grow up, thrive, and live as their authentic selves—just like any other kid.” This trope suggests that children denied “gender-affirming care” will die by suicide. Unsurprisingly, the ACLU misses yet another irony: “Puberty blockers,” as part of “gender-affirming care,” forcibly prevent children from growing up.

Pubertal suppression by gonadotropin-releasing hormone (GnRH) agonist treatment has recognizable impacts on brain development. It affects individual cognition and behavior in ways that are not fully understood, and it irreversibly stunts physical, psychological, and sexual development. Children simply cannot understand or consent to the devastating impact of the lifelong sexual dysfunction and sterilization that so many adults seem strangely willing to inflict upon them.

Indeed, children deserve to grow up, but “gender-affirming care” intervenes to prevent this growth for ideological reasons. Ironically, within this worldview, “the authentic self” cannot be produced without medical interventions to achieve the desired aesthetic outcome. “Gender-affirming care” brands natural puberty as pathological, presenting the child’s healthy reproductive maturation as a disease to be treated. Such treatment—or rather, mistreatment—leaves the child with a variety of deeper health issues that cannot possibly be outweighed by superficial, transitory benefits.

Proponents of “gender-affirming care” claim that any hesitation regarding its application to minors constitutes a human rights violation. Understanding how it functions as modern conversion therapy helps us to see the truth: It is just the latest form of medicalized dehumanization. Medical interventions have long been used to suppress homosexuality. Psychosurgery, testicle implants, aversion therapy, electroconvulsive therapy, and—yeshormone therapy: medical authorities have presented all of these as legitimate “treatments” for homosexuality.

We should not be seduced by the new “affirmative” trappings of today’s conversion therapy. A look back at the history of these hormonal and surgical treatments reveals how these practices fed upon and exacerbated the self-hatred of lesbians and gay men.

Homosexuality as Sickness, “Sex Conversion” as Cure

Consider the case of George/Christine Jorgensen (1926-1989), the man who made “sex change” into “a household term.” Referencing sexologist Ray Blanchard’s typology of male gender dysphoria, Sheila Jeffreys describes Jorgensen as belonging to the group of “homosexual men who felt unable to love men while remaining in a male body.”

Yet most contemporary accounts written about Jorgensen minimize his self-hatred and his terror at the idea of being homosexual. In his autobiography, Jorgensen lists his “problems,” as he saw them:

But just what were those problems? I restated them squarely to myself. I was underdeveloped physically and sexually. I was extremely effeminate. My emotions were either those of a woman or a homosexual. I believed my thoughts and responses were more often womanly than manly. But at that point, I was completely unaware of the many variations and combinations of masculinity and femininity, aside from homosexuality, that exist side by side in the world.

From a young age, Jorgensen noticed he was not like other boys. Because he was neither conventionally masculine nor sexually attracted to women, he became deeply conscious of his difference from other men.

In an attempt to find a sense of belonging, Jorgensen joined the U.S. Army. There, he encountered “practicing homosexuals,” men deemed “queer.” They were what he could never allow himself to be. Jorgensen wrote:

I couldn’t condemn them, but I also knew that I certainly couldn’t become like them. It was a thing deeply alien to my religious attitudes and the highly magnified and immature moralistic views that I entertained at the time. Furthermore, I had seen enough to know that homosexuality brought with it social segregation and ostracism that I couldn’t add to my own deep feeling of not belonging.

Jorgensen’s struggle was one of self-acceptance, which he “resolved” by seeing himself as a woman instead: “acceptance” by nonacceptance. In the 1960s, Jorgensen reflected, “I identified myself as female and consequently my interests in men were normal.”

Eventually, Jorgensen came to believe that he had some kind of “glandular” issue, medically treatable by hormone therapy using estrogen. Very conveniently, this case served to advance the studies of endocrinologist and sexologist Harry Benjamin, author of the influential 1966 book, The Transsexual Phenomenon.

Escaping Homosexuality

As a homosexual male who sought medical transition as an escape from his sexuality, Jorgensen was not an outlier. Rather, he represents a historical pattern among men who come to believe their gender nonconformity and/or homosexuality constitutes a pathology that should be cured through chemical and/or surgical castration. As Ben Appel observes, “Jorgensen may now be celebrated by the modern ‘LGBTQIA+’ community as a trans icon, but he seemed more concerned with escaping his homosexuality.”

The artificial construction of a monolithic “LGBTQ+ community” suppresses analysis of the conflicts otherwise apparent in the “sex conversion” of gender-nonconforming people, especially homosexual ones. Dogmatic use of the term “LGBTQ+ community” has manufactured the consent of lesbians and gay men to medical practices that have long been wielded against homosexuality.

“How many more people are there out there like me?” asked Ritchie Herron, a male detransitioner, in June 2022. Herron’s transition recovery narrative underscores the idealized “sex conversion” of “gender-affirming care” as modern conversion therapy. Although he was 26 when he began hormone therapy and 31 at the time of his “vaginoplasty,” Herron remained vulnerable, struggling in ways that undermined his capacity for informed consent. Even without trauma, Herron told me, “there is a question over consent on the nature of the surgery itself.” How can adults even truly give “informed consent” to a “conversion operation” like “vaginoplasty,” with unforeseen consequences detrimental to health and wellbeing?

Like Jorgensen many years before, Herron felt a sense of distress over the idea of being homosexual. Herron remembers:

One of the reasons I transitioned was because I did not want to be a gay man. I said to my therapist I cannot see myself as a man with another man, but I can see myself as a woman with a man, and she said, ‘Yes, that is because you are trans.’ Not because I hated myself because I am gay, not because I suffered horrific homophobia in school and growing up in the north east of England.

Over the course of his sessions with a gender therapist, Herron became convinced the distress he felt made him transgender rather than homosexual. This dissociation, his therapist told him, meant that he needed hormonal and surgical interventions. His gender therapist—who happened to be a gay man himself—even attributed Herron’s uneasiness about transitioning to “internalized transphobia.”

Having reviewed his records from the gender clinic, Herron recently said, “The words ‘ideal candidate’ are plastered all over my records.” Now, in retrospect, he questions what exactly made him “ideal” to these medical professionals. Herron suggests autism and homosexuality as two main factors that made him vulnerable to medicalization, now a recognizable pattern across increasing cases of regret. Though he appeared to be an “ideal” subject for treatment, Herron was apparently not “truly trans.” Of course, nobody is truly “born in the wrong body,” and, contrary to popular dogma, science does not sex the human body as much as scar it.

In our conversation, Herron noted the importance of greater attention to obsessive-compulsive disorder (OCD), obsessional thinking, and autism. Feelings of uncertainty, loneliness, and isolation lead young people into online spaces in search of an escape from the self. More professionals should investigate varying degrees of sexual trauma, including children’s exposure to pornography, rather than speculating about supposedly inborn and innate paraphilias.

Half a century after Jorgensen fell prey to unscrupulous medical practitioners, the same pattern continues to repeat itself. Homosexual self-hatred remains unexplored in cases of gay men who believe they will be better off as “straight women.” This view denigrates both homosexual males and heterosexual females, devaluing their identities and mistaking artifice for wholeness. Misunderstanding womanhood as a commodity that can be purchased and consumed in pursuit of male self-fulfillment, these men reject their sexual nature through medical violence done to their own bodies.

Modern conversion therapy has flourished, with legacy gay rights organizations profiting far more from promoting “gender-affirming care” than scrutinizing the ethics of “sex conversion.”

Hormone Therapy’s Untaught History

Today’s simplistic embrace of hormone therapy is enabled by willful historical blindness. To date, Bob Ostertag’s Sex Science Self: A Social History of Estrogen, Testosterone, and Identity, published in 2016, is one of the only works to document its very inconvenient history, including its use as a treatment for homosexuality.

During the early twentieth century, doctors subjected homosexual males to hormone therapy, theorizing that homosexuality was caused by testosterone deficiency. An obvious issue emerged: testosterone actually magnified the male sex drive in homosexual males rather than suppressing it. When that medical intervention failed to produce sexual reorientation, the physicians tried estrogen instead. Ostertag writes:

Amping up the sex drive of homosexual men was hardly what the doctors had in mind, so the whole treatment paradigm was simply turned upside down. Beginning in the late 1940s homosexual men (usually those who had fallen into the hands of police) were treated not with testosterone but with estrogen, on the theory that since testosterone seemed to stimulate homosexual desire, estrogen might suppress it. This marked a particularly bizarre chapter in an already strange story, since male homosexuality was thought by many researchers to be the result of excess exposure to estrogens. Estrogen became male homosexuality’s cause and cure.

Alan Turing, who decrypted the Nazi codes during World War II, and whose ideas fathered modern computer science, is one among thousands of cases of “chemical castration” for the “gross indecency” of homosexuality. Sentenced in 1952, Turing’s “chemical torture,” as Ostertag calls it, involved diethylstilbestrol, a synthetic estrogen medication. For Turing, it caused impotence, breast growth, and depression, with a decline in his physical and mental health that ended in suicide.

In essence, Turing suffered a physician-assisted endocrine disorder, state-mandated as his punishment. Interestingly, Richard Green and John Money reported in Transsexualism and Sex Reassignment (1969) that the same drug used to castrate Turing had been used in “feminizing hormone therapy” for men seeking to become women.

Ostertag has written that the dark side of hormone therapy’s untaught history should make us acutely wary of using it as a treatment:

History can also teach us the wisdom of humility in medical practice. There is simply no way to contemplate the story of the extraordinary rises and spectacular falls of medical practices based on testosterone and estrogen without at least considering the possibility that the beliefs and medical practices of today will prove just as transitory. The calamities of estrogen and testosterone are unique: there is no other field of medicine so replete with embarrassing and tragic mistakes.

In short, hormone therapy has long been misused at the expense of the vulnerable. Ritchie Herron was right to ask how many others could be struggling under similar circumstances, believing themselves to be the opposite sex due to varying forms of self-denial. These patients too readily trust unscrupulous medical professionals to uphold their best interests.

Science as Superstition

Modernity came with a notable shift from the dominion of a religious point of view to a scientific one. In the twentieth century, the medicalization of homosexuality took over the role of mortifying the flesh of the sinner. Where once a distressed lesbian or gay man would go to a priest, in the modern era that same person would go to a physician. Homosexuality was effectively transitioned from sin into sickness, and some sufferers saw “sex conversion” as their cure.

Yet, even today, we are not as thoroughly rational as we like to imagine. As G.K. Chesterton once observed, “The age we live in is something more than an age of superstition—it is an age of innumerable superstitions.” Lacking religion, he argued, one will find faith in anything. Perhaps so many atheists have fallen prey to the magical thinking of transgender catchphrases like “born in the wrong body” because of some hankering for superstition. Bereft of a transcendent moral framework, they are willing to believe whatever comes along to fill that void.

Morality scares modern man. But science’s ironic dogmatism and simplistic platitudes give us no true substitute for an intelligent and responsible engagement with life. Scientific fundamentalism can be as dangerous, if not more dangerous, than religious fundamentalism, if only because we fail to recognize the new tyranny.

Into the twenty-first century, medicalization has expanded the reach of its violence, not only disregarding the principle of “first, do no harm” but also distorting medicine from “the healing art” into the art of harm. The language of affirmation for “the authentic self” to be excavated from the flesh hides a most deadly self-abnegation.

In her 2022 book, The Genesis of Gender, Abigail Favale analyzes how “gender-affirming care,” like transgender anthropology more broadly, denies the way in which “the body reveals the person.” Transgender identification, she argues, expresses “a longing for wholeness,” a good desire executed in error “through violence against the body.” Favale writes:

The affirmation model cannot offer true self-acceptance, unless the body is no longer considered part of the self. Choosing a lifetime of medicalization in order to maintain an illusion of cross-sex identity is not ‘being who you really are.’ The affirmation model is self-denial masquerading as self-acceptance. Because our bodies are ourselves, what is being “affirmed,” ultimately, is the patient’s self-hatred.

Advocates for socially and medically transitioning children and young people fail in a deadly serious way. They fetishize being on the right side of history so much that the demands of morality escape them entirely. This fetishism has impoverished their discernment. Opposed to bigotry in theory, they become bigoted in practice.

Today’s priests of progress may discover themselves, at last, betraying what they so desperately believe.