Facts Over Fears: Countering Kat Highsmith's Misleading Claims

The Inconvenient Truth About "Trans Is A Fraud"

In their inflammatory article "Trans Is A Fraud - And It Always Has Been," Kat Highsmith escalates their crusade of anti-transgender propaganda and misinformation. Building on arguments from their foundational piece "There Is No Such Thing," in which they flatly denied the existence of transgender people, Highsmith now goes even further to declare that being transgender is "a fraud" that has "always" been one.¹ They assert "There is simply no such thing" as transgender people, neither those who medically transition nor those who don't, painting them as either "delusional" or unreasonable.²

As I documented in my previous in-depth rebuttal of Highsmith's work “The Inconvenient Truth About Kat Highsmith's 'Will & Harper' Screed”,³ this latest piece continues to critique their well-established pattern of championing the denial of trans existence and validity. But while their original thesis was that "there is no such thing as trans,” they have now escalated to claiming it is an intentional fraud and deception.

In this article, I will critically examine Highsmith's central claims and fact-check them against the scientific consensus and evidence. Through this analysis, I will demonstrate how Highsmith's writing continues to be a textbook case of pseudoscience and propaganda that attempts to dangerously misleads readers about transgender people and the supposed "fraud" of trans identity.

Note: While I have addressed some of these claims and points in my previous article, I have intentionally not repeated the same debunking to the same depth in this article, and where unavoidable, I keep it pretty light. This allowed me to go a bit more in-depth in other areas that were a bit out of context in the “Will and Harper” response I wrote - such as a deeper look into the brain studies.
This is both to avoid repetition as it to avoid boring the reader. These two articles should really stand together as one complete whole, though I intentionally wrote them to stand on their own merits. For the same reasons, I have not pointed out all of the bad arguments/logical fallacies this time around, and I think it is unnecessary this time around, none of the claims made stand up to the weight of evidence. Caution: This is a long read.

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"There is simply no such thing"

Highsmith's foundational claim that "There is simply no such thing" as being transgender is a sweeping denial of the existence and validity of all transgender people⁴. They dismisse the diversity of trans identities and experiences, crudely categorizing trans individuals as either "delusional" or unreasonable.⁵ However, this assertion is directly refuted by both the scientific consensus on gender identity and the lived realities of transgender people.⁶

Major medical organizations including the American Psychological Association, American Medical Association, and World Health Organization recognize the existence of transgender identities as a normal variation in human diversity⁷. These expert associations base their positions on decades of research and clinical evidence demonstrating that being transgender is a valid identity, not a delusion or fraud.

Numerous studies have found biological factors associated with transgender identities, strongly suggesting a neurological and genetic basis for gender incongruence. Twin studies indicate there is likely a heritable genetic component influencing gender identity.⁸ The complex process of sexual differentiation, including gender identity development, is impacted by genes and sex hormones.⁹

Neuroanatomical differences have been observed between transgender individuals' brains and those of cisgender people of their assigned birth sex.¹⁰ For example, one study found that transgender people's finger length ratios, which are influenced by prenatal androgen exposure, more closely resembled that of their identified gender than their birth sex.¹¹ A scientific review concluded that gender identity is a multifactorial complex trait with a heritable polygenic component.¹²

However, with all that being said, I would be misleading you if I did not point out and say they are not conclusive (yet). We can certainly say there is a biological component at play here, that is without question. What we cannot say is precisely what causes it, why it happens, and where we need to look for a definitive answer. This is emerging research. Futhermore, there is a valid criticism in engaging in these studies. In the paper “After the trans brain: a critique of the neurobiological accounts of embodied trans* identities” by Maite Arraiza Zabalegui, the main point seems to be that while biological factors may play a role, they are just one aspect of a complex, dynamic process that also involves social, cultural, and individual experiences throughout life. This view allows for a wider range of gender identities and expressions, without reducing them to simple biological determinism.

This sits nicely with me and my feminist ideals, without invalidating the biological evidence we are currently presented with. This also means that though we have some solid physical evidence, that alone is not entirely deterministic for every individual. This gives room for the uniqueness and variance of the individual, just as we see in all life. This does not undermine the claims of a biological basis (i.e. “born this way”) to being trans and trans identities as being real and valid, but strengthens them by applying it to everyone’s gender identity, from both extremes and everyone between.¹³

These neurobiological and genetic findings directly disprove Highsmith's claim that all transgender people are "delusional." Studies have consistently shown that affirming transgender youth's identities is associated with better¹⁴ mental health outcomes, demonstrating¹⁵ that recognizing one's transgender identity is not inherently pathological.¹⁶

Highsmith's language, which offensively refers to "t######s"¹⁷ and sets up a false dichotomy of "delusional" versus "reasonable" trans people, underscores their lack of good-faith engagement with the full diversity of transgender people's experiences and identities. Their rhetoric denies the scientific reality that gender identity has biological underpinnings and is not simply a "choice" or "delusion."

By definitively stating there is "no such thing" as being transgender, Highsmith sweepingly invalidates the existence of all trans people. Their argument is contradicted by extensive scientific evidence, the consensus of medical experts, and the lived experiences of transgender individuals. There is indeed "such a thing" as being transgender, and it is telling that Highsmith must deny reality itself to argue otherwise.

“Doctors have known being transgender is a fraud”

Highsmith's next major claim is that doctors have known being transgender is a "fraud" but have pushed it anyway for financial and political reasons. However, this conspiracy theory is baseless and relies on misrepresenting medical consensus.

Highsmith cites a 2008 American Psychological Association report to argue that doctors are "confused" about transgender issues and identities. But they cherry-picks quotes out of context to imply confusion and disagreement where there is actually broad expert consensus. The very report Highsmith references, while discussing evolving terminology, ultimately reaffirms the validity of transgender identities and the need for greater professional competence to support the transgender community.¹⁸ Also, this is 2024, we have come a long way in our understanding of transgender folks, and so too, has our language evolved. In 2008, the language and norms were still being established and the foundations of good practices of writing about transgender topics were still being settled. As we will see, context matters.

The introduction frames the increasing visibility of transgender people as a positive trend that underscores the necessity for psychologists to "acquire greater knowledge" in order to provide effective services to this population.¹⁹ This sympathetic tone calling for better understanding and assistance is incompatible with Highsmith's claim of a knowing "fraud."

Furthermore, the fact that this report was commissioned by the APA Council of Representatives to review policies, recommend research and training, and propose how to meet the needs of transgender psychologists and students demonstrates an earnest institutional effort to support transgender people.²⁰ Such a high-level initiative to help the transgender community is difficult to reconcile with a conspiracy to deliberately deceive the public.

As I've documented previously here, and in my “Will and Harper” article, Highsmith's pattern of selectively quoting and misusing sources to manufacture doubt or dissent where none exists is on full display here. By plucking isolated phrases out of context, they spin a narrative of medical confusion that is refuted by the very documents they cite when read in full.

Highsmith provides no actual evidence for their explosive accusation that doctors are knowingly pushing a "transgender fraud" on the public. Their vague insinuations of financial and political motives are speculative conspiracy-mongering without any factual basis.

To see how Highsmith's cherry-picking distorts the truth, consider this representative example. Highsmith writes:

"The APA report itself admits there is 'considerable disagreement' among professionals about the 'diagnosis of GID' and whether it belongs in the DSM."

But here is the full context of what the report states about this disagreement:

"The inclusion of GID as a diagnostic category in the DSM has been a major point of contention both within transgender communities and between some transgender activists and some mental health professionals, including psychologists. The depth of conviction of some activists concerning this issue is evident in the number of letters we received, asking us to work toward the removal of GID from the DSM. Psychologists who work with clients with gender identity issues are not of one mind on this issue." ²¹

When read in its entirety, this passage is not an admission of broad confusion as Highsmith suggests; rather, it is acknowledging an ongoing debate between some activists who oppose the GID diagnosis and some professionals who find it useful. The "disagreement" is between these two camps, not among medical experts as a whole. The report then goes on to explain the rationale on both sides of this particular dispute. Highsmith's selective quotation obscures this nuance to give a false impression of general bafflement.

This is just one illustration of how Highsmith misrepresents sources to prop up their conspiracy theory. Highsmith’s article is littered with other quotes ripped out of context in this same manner, all in service of a sensationalistic narrative that crumbles under scrutiny. For the sake of brevity, I focus only on the ones that are central to the claims being made.

Highsmith provides no actual evidence for their explosive accusation that doctors are knowingly pushing a "transgender fraud" on the public. Highsmithg’s vague insinuations of financial and political motives are speculative conspiracy-mongering without any factual basis.

This reckless charge also dismisses the sincere dedication of transgender healthcare providers and researchers who have devoted their careers to supporting a vulnerable and stigmatized population. It baselessly impugns the integrity of medical professionals by accusing them of orchestrating a massive, coordinated deception for unspecified personal gain.

So when facing Highsmith’s rather sensational claims, we should employ Occam’s razor²². The far more plausible explanation is that the medical consensus on the validity of transgender identities and importance of transition care is rooted in scientific evidence and clinical experience, not a nefarious plot. Highsmith's outlandish theory requires believing in a sprawling conspiracy without any proof, while ignoring the ample evidence that medical authorities are sincerely working to understand and assist transgender people based on legitimate research and demonstrated need.

When we place Highsmith's claim that doctors are pushing a "transgender fraud" they secretly know to be false under scrutiny, we see it is an extraordinary accusation that is presented without credible evidence. It relies on misrepresenting and cherry-picking expert statements to attack the motives of dedicated professionals. Like their denial of transgender identities more broadly, this assertion requires rejecting the testimony of medical authorities and a plethora of evidence in favor of an implausible transphobic conspiracy theory. The APA report they tried to cite as proof of "confusion" actually demonstrates an earnest effort to better serve the transgender community when read in proper context. Highsmith's bad-faith distortions and baseless fearmongering cannot stand up to scrutiny.

“The DSM change from "gender identity disorder" to "gender dysphoria" was political”

Highsmith portrays the DSM-5's change in terminology from "gender identity disorder" to "gender dysphoria" as a "cunning" political move to normalize a "delusion."²³ However, this accusation ignores the scientific rationale for the revision and misrepresents the meaning of gender dysphoria.

The shift in language was based on a growing understanding in the psychological community that being transgender is not inherently a mental disorder. As I discussed in a previous section, research has increasingly shown that transgender identities are a normal variation of human diversity, not a pathological delusion.²⁴ The change in the DSM reflects this progress in depathologizing transgender experiences.

Highsmith conflates the concepts of transgender identity and gender dysphoria, but they are importantly distinct. Gender dysphoria refers specifically to distress that some transgender people may feel due to the mismatch between their gender identity and assigned sex. However, not all transgender people experience dysphoria, and many do not pursue medical transition.²⁵ By equating transgender identity itself with a disorder, Highsmith perpetuates damaging misconceptions.

The American Psychiatric Association, which publishes the DSM, has clearly explained the evidence-based reasons for the terminology change. In a 2013 statement, the APA wrote:

"It is important to note that gender nonconformity is not in itself a mental disorder. The critical element of gender dysphoria is the presence of clinically significant distress associated with the condition…Persons experiencing gender dysphoria need a diagnostic term that protects their access to care and won’t be used against them in social, occupational, or legal areas. To get insurance coverage for the medical treatments, individuals need a diagnosis. The Sexual and Gender Identity Disorders Work Group was concerned that removing the condition as a psychiatric diagnosis—as some had suggested—would jeopardize access to care. Ultimately, the changes regarding gender dysphoria in DSM-5 respect the individuals identified by offering a diagnostic name that is more appropriate to the symptoms and behaviors they experience without jeopardizing their access to effective treatment options."²⁶

This explanation emphasizes that the shift was driven by scientific factors like the need to distinguish between identity and distress, and the concern that classifying all transgender people with a ‘disorder’ fuels stigma. Furthermore, the concern behind removing that stigma would paradoxically remove the insurance coverage, and thus, the access of necessary care²⁷. The APA's detailed rationale, grounded in clinical evidence and a thoughtful consideration of the impacts, stands in stark contrast to Highsmith's glib accusations of political motives.

Highsmith provides no proof for their claim of a "cunning" political agenda behind the DSM change. They simply assert this conspiracy theory as if it were self-evident, without any engagement with the actual justifications offered by the APA and other experts. In reality, scholarly analyses of the DSM-5 revision, like Davy's 2015 paper "The DSM-5 and the politics of diagnosing transpeople," paint a far more complex picture. Davy examines the scientific, sociological and political considerations that shaped the new diagnostic framework, acknowledging the influence of depathologization advocacy while also detailing the research basis for the changes.²⁸ This nuanced account undermines Highsmith's simplistic portrayal of the DSM shift as a unilateral political decision.

By fixating on semantics and ignoring substance, Highsmith fails to grapple with the real reasons for the evolving psychological understanding of transgender experiences. The DSM revision was based on a scientific recognition that gender diversity is not inherently disordered, and that the distress of dysphoria is distinct from identity itself. Highsmith's attempt to cast this progress as a political ploy relies on misrepresenting the meaning of gender dysphoria and disregarding the extensively documented rationale behind the change.

So we can see Highsmith's portrayal of the DSM terminology change for what it is and understanding the rationale fully. It is not a "cunning" political move, a claim that is as baseless as it is misleading. Highsmith ignores the clear scientific justifications for the revision, conflates dysphoria and identity in a way that contributes to stigma, and makes conspiratorial accusations without evidence. The APA and other leading experts have articulated a thoughtful, research-based rationale for the shift in language that stands in stark contrast to Highsmith's politically motivated attack. Scholarly analyses of the change, like Davy (2015), further demonstrates that the DSM-5 revisions were based on a substantive rethinking of transgender diagnoses, not just political pressure. As with their other claims, Highsmith's argument here relies on misdirection and unsupported assertions rather than a good-faith engagement with the facts.

“body dysmorphia and anorexia”

Highsmith compares being transgender to anorexia and suggests that trans people are delusional like those with eating disorders. However, this false equivalence relies on the unsubstantiated idea that being trans is inherently a mental illness, and it ignores the critical differences between gender dysphoria and body dysmorphic disorders.

Fundamentally, gender dysphoria is not characterized by the distorted perceptions that define conditions like anorexia and body dysmorphia. As Harrison explains, "Those with body dysmorphia have a distorted view of how they look, while those with gender dysphoria suffer no distortion."²⁹ Transgender people have an accurate perception of their bodies; their distress stems from the misalignment between their physical characteristics and gender identity, not a delusional belief about their appearance.³⁰

In contrast, body dysmorphia and anorexia involve unrealistic perceptions and obsessive preoccupations with supposed flaws. The DSM-5 criteria for body dysmorphic disorder specify that patients must have "preoccupations with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others"³¹. Similarly, anorexia is driven by an intense fear of gaining weight and disturbances in how one's body shape is experienced³². These inaccurate beliefs are not present in gender dysphoria. Transgender people who experience dysphoria are very well aware of the realities of their bodies, and all that it implies.

It's important to note that while some transgender people may also experience body dysmorphia, the two are distinct issues. As Tran writes:

"While we can conceptualize gender dysphoria and body dysmorphia as two different things, they are often not mutually exclusive. Transgender and non-binary folks may experience both simultaneously." ³³

Highsmith's attempt to equate the two ignores this crucial distinction and the well-established differences in their diagnostic criteria and clinical presentations.

Furthermore, Highsmith's comparison of affirming transgender identities to encouraging eating disorders is baseless and reckless. Recognizing someone as transgender and supporting them in transitioning is not analogous to promoting anorexia. Gender-affirming care is widely recognized as beneficial for mental health and quality of life. As I've discussed previously both in this article, and my previous “Will and Harper” article³⁴, numerous studies³⁵ have found that access to transition³⁶ care significantly reduces³⁷ rates of depression, anxiety, and suicidality in trans populations.³⁸

In contrast, eating disorders are life-threatening conditions that require comprehensive treatment. Anorexia has the highest mortality rate of any psychiatric disorder ³⁹, and encouraging disordered eating would be unethical and dangerous. Drawing a parallel between these situations represents either a profound misunderstanding or a deliberate distortion of the facts.

Highsmith's argument rests on the false premise that being transgender is inherently delusional. But this claim is not supported by scientific evidence or expert consensus. Major medical associations recognize gender-affirming care as necessary treatment for gender dysphoria, not an indulgence of a disordered belief. The American Psychological Association is clear: "Many transgender people do not experience their gender as distressing or disabling, which implies that identifying as transgender does not constitute a mental disorder"⁴⁰.

We have demonstrated that Highsmith's comparison of being transgender to body dysmorphia and anorexia is inaccurate and irresponsible. It ignores the fundamental differences between gender dysphoria and conditions characterized by distorted thinking, and it advances the unsupported notion that transgender identity is inherently delusional. Recognizing someone as trans and supporting their transition is not equivalent to encouraging a life-threatening eating disorder. Once again, these false equivalencies only serve to stigmatize transgender people and dismiss the importance of gender-affirming care. Highsmith's claims are out of step with scientific evidence and medical best practices, and they should be rejected as the dangerous rhetoric they are.

“The concept of gender identity is a harmful fiction”

In this section, Highsmith suggests that the American Psychiatric Association's (APA) changes to gender identity diagnoses in the DSM-5 were driven by potential profits rather than scientific evidence, as opposed to, in addition to (it is not clear) political reasons. They claim this has enabled "disastrous effects" like trans women in women's prisons and sports, and endorses Jennifer Bilek's work investigating the financial incentives behind growing transgender acceptance, especially for the APA, pharmaceutical companies, and the medical industry. Highsmith implies that powerful interests are pushing a "trans agenda" to make money at the expense of women's rights.

However, these claims rely on misrepresenting the motives behind the DSM-5 revisions and the medical consensus on transgender care as we have previously discussed. Suggesting that the APA made these changes to enable pharmaceutical and medical industry profits is a serious accusation that Highsmith does not substantiate, and as far as I have been able to tell, just accepts Bilek’s work as gospel truth. The conspiracy theory that major medical organizations are promoting transition care for financial gain rather than because it is necessary treatment for gender dysphoria is not supported by any evidence I have seen while reading up on the sources for this article. From what I have read of Bilek’s work, this appears to be confirmation bias being raised to an art form, a trait I believe Bilek shares with Highsmith.

Numerous professional associations, including the American Medical Association and the American Academy of Pediatrics, have affirmed that gender-affirming care is safe, effective, and medically necessary for many transgender individuals⁴¹⁴². These endorsements are based on clinical research showing the benefits of transition for mental health and quality of life, not a profit motive.

Highsmith's claim that the DSM-5 revisions have led to "disastrous effects" like trans women in women's prisons and sports also misrepresents the complexity of these issues. Recognizing transgender identities does not inherently undermine women's rights or enable male violence. Trans women are women, and like all women, the vast majority are not violent offenders or threats to others. Contrary to their assertion, research indicates that allowing trans women to access facilities and services that align with their gender does not create increased risks for other women.

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Note to the reader: At the moment, I could not find a study or data from a credible source specifically on the risk change for cis women in prison when they include transgender women in the women’s prison in the US. There is some limited data internationally, that show the rate of crime/violence for trans women is the same as, or lower, then cisgender women. However, that does not speak to the very specific claim that Highsmith makes. I have found studies that show trans women are at increased risk of poor treatment, assault, rape, and having their health care needs seriously neglected, with a better outcome when housed in the prison population that matches their gender identity, or in a general LGBT specific housing/population. Even then these studies are scant, as far as I can tell. Full disclosure: this is one of the areas I have low visibility into, so if you have studies and reports that are peer-reviewed or are otherwise quite sound, I would love to hear about them! Otherwise, with what I was able to scrounge up in a couple of days, I have to default to Hitchen’s razor on this one:

“That which can be asserted without evidence, can be dismissed without evidence” - Christopher Hitchens⁴³

A 2018 UCLA study examined the relationship between trans-inclusive policies and bathroom safety in Massachusetts cities. It found "no evidence that letting transgender people use public facilities that align with their gender identity increases safety risks"⁴⁴. This peer-reviewed research directly refutes the argument that trans access inherently compromises women's privacy or security.

Major institutions have also determined that transgender inclusion and women's rights can be balanced. The International Olympic Committee's criteria for transgender athletes' participation in women's sports require testosterone suppression to ensure fairness while still promoting inclusion⁴⁵. Many schools have adopted policies supporting transgender students' safety and preventing transphobia, recognizing that equality for all depends on protecting gender minorities⁴⁶. These examples show that organizational leaders have considered the needs of everyone involved and concluded that inclusion benefits all women.

Furthermore, research suggests that transgender women do not have a consistent athletic advantage over cisgender women⁴⁷. Claiming that their participation makes competition unfair for others is not supported by scientific evidence, and may be a result of sociocultural issues of cissexism, transphobia, and (trans)misogyny⁴⁸⁴⁹. And studies have found that trans-affirming environments, including online spaces, provide important safety and support for transgender youth⁵⁰. Inclusion fosters well-being for a vulnerable population.

While concerns about women's spaces like prisons and shelters understandably evoke strong feelings, blanket exclusion of trans women is not the answer. Transgender women are women, and like all women, the vast majority are not violent predators. Their need for safety and dignity must also be considered. Policies in these sensitive areas require care, case-by-case assessment, and a commitment to balancing everyone's rights - not discriminatory assumptions that trans inclusion inherently threatens others.

The idea that there is a shadowy "trans agenda" driven by medical industry greed is a pernicious conspiracy theory that obscures the real reasons for growing transgender acceptance. Bilek's claims about "big pharma" profiting from a "transgender craze" rely on mischaracterizing the motives of transgender advocates, who are fighting for their basic human rights and access to healthcare, not lining the pockets of corporations. The medical community's consensus on the necessity of transition care is based on scientific evidence and concern for patients' well-being, not financial incentives. Suggesting otherwise without proof is an irresponsible attack on the integrity of healthcare providers.

While Highsmith does not directly implicate anyone, they imply through their endorsement of Bilek’s work, it's important to note that wealthy donors' support for transgender causes does not inherently compromise the legitimacy of those causes. Funding for gender-affirming care, research, and advocacy can come from a genuine commitment to improving transgender individuals' lives, not just a desire for profit. Assuming nefarious motives behind all transgender activism is reductive and targeted prejudiced activism. Finally, this creates an interesting hypocrisy, as unless Bilek and Highsmith are prepared to argue that all philanthropists have an agenda for profit, or other nefarious plots, then this because suspiciously targeted to a specific group. This raises several flags and undermines their claims and credibility.

These conspiracy theories do nothing to advance the conversation on transgender rights and obscure the evidence-based reality of why gender-affirming care is so important. They do make for interesting research into their formation and propagation. You can read a nice summary of it here under the moniker “TAnon.”

“No Intersex Connection” Mischaracterization

Highsmith argues that a footnote in a 2008 APA report "puts to rest the idiotic comparisons" between intersex conditions and transgender identities, claiming the two "cannot be compared because they are not alike." They assert that the task force's decision to remove "Intersex Conditions" from its name and focus the report on transgender issues specifically proves there are no connections between the populations. Highsmith then uses this footnote to justify their prejudiced characterization of transgender people as "delusional men who think they are women," arguing that advocates only compare the two because being transgender is "indefensible."

However, Highsmith's argument relies on misrepresenting the APA's stance and expressing anti-transgender bias, not facts. The task force narrowed the scope of that particular report due to its limited expertise on intersex issues, not because it sees no overlap whatsoever between the groups as Highsmith claims. Removing intersex conditions from the title and focus of one project does not mean the APA considers the topics completely unrelated.

In fact, the same report reveals that the task force was originally named the "Task Force on Gender Identity, Gender Variance, and Intersex Conditions," showing the APA initially saw the topics as linked enough to address together.⁵¹ The APA's choice to ultimately focus that particular project on transgender issues due to limited intersex expertise does not negate the connections it recognized in the original framing.

Furthermore, the APA has repeatedly grouped transgender and intersex populations together in other publications and statements. For example:

• The APA has released brochures answering common questions about "gender identity, gender variance and intersex conditions" as related subjects.⁵²

• A transgender-focused APA brochure directly refers readers to a separate publication specifically about intersex conditions, treating them as connected topics.⁵³

• The APA has highlighted its long history of supporting both "transgender and intersex people" through its work.⁵⁴

• APA resolutions on transgender non-discrimination⁵⁵ and gender-diverse youth⁵⁶ have included references to intersex populations, addressing the needs of both communities together.

These examples demonstrate that the APA's recognition of distinctions between transgender and intersex experiences in the footnote exists alongside an understanding of the important links and commonalities between them.

So while intersex and transgender individuals are distinct populations with some unique characteristics and needs, they also have several key points of intersection and solidarity:

1. Access to care: Intersex and transgender individuals face some similar barriers when seeking appropriate medical treatment and support. As the fact sheet from InterACT and Lambda Legal notes, the two groups have a "shared interest in autonomy" and may encounter "overlapping barriers to appropriate care."⁵⁷ Both communities often struggle to access gender-affirming healthcare and other services tailored to their specific needs.

2. Diversity of identities: There is significant diversity within the intersex and transgender populations in terms of how people relate to each label and community. A Reddit discussion highlights how "Some intersex individuals want to be completely separate from the community, in regards to being intersex, some do not."⁵⁸ This range of intersex people's relationships to the broader LGBTQIA+ community, including transgender individuals, mirrors the variety of identities within the transgender population itself. Not all intersex or transgender people identify the same way or affiliate with the wider community.

3. Biological factors: While research is still emerging, there are hints that biological factors may play a role in both intersex and transgender identities. One presentation excerpt references a study finding "structural differences in the white matter" of transgender men's brains.⁵⁹ This suggests potential neurological underpinnings of gender identity that could relate to or overlap with intersex traits. More investigation is needed, but there may be some biological commonalities between the two groups.

4. Advocacy and acceptance: Intersex and transgender communities share a common goal of pushing for greater understanding, protections and inclusion from various institutions. For example, the organization New Ways Ministry is urging the Catholic Church and Pope Francis to listen to the stories of intersex and transgender Catholics and reconsider the Church's positions on issues like gender-affirming care.⁶⁰ Both groups have an interest in advocating for their rights and dignity, often in the face of entrenched cultural and religious opposition.

In most cases, and perhaps more to Highsmith’s point not well elucidated, when advocates mention intersex experiences in discussions of transgender rights, it is not to conflate the two, but to illustrate the biological complexity of sex and gender. This complexity is relevant to both groups, even if their specific issues are not identical. Highsmith misrepresents these comparisons as an attempt to compensate for the supposed ‘indefensibility’ of being transgender, when in reality they serve to highlight the natural diversity that exists in sex and gender.

The APA's publications and policies make clear that while it acknowledges differences between transgender and intersex issues, it still sees significant overlap and relationships between the populations. The task force's decision to focus one report specifically on transgender topics does not support Highsmith's claim that the APA considers them entirely unrelated.

When analyzed alongside the APA's other work, it's evident that Highsmith is misrepresenting the footnote to advance their biased views. Their argument that it justifies dismissing transgender identities as "indefensible" and transgender people as "delusional" is an offensive assertion based on prejudice, not facts. The APA's nuanced approach, which recognizes both similarities and differences between transgender and intersex individuals, contradicts their failed attempt to use the footnote to deny any connections exist.

Highsmith's flawed reasoning and anti-transgender rhetoric are not supported by the broader evidence of the APA's positions. The footnote's emphasis on distinctions in one specific report does not negate the many other ways in which the APA has linked transgender and intersex issues. Their misleading claims rely on ignoring the full context of the APA's work in order to attack transgender people, not on an accurate representation of the organization's stance. The APA's history of grouping transgender and intersex populations together, even while noting differences between them, firmly refutes Highsmith's argument that the two have no relationship whatsoever.

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In Closing…

Highsmith's arguments against the validity of transgender identities rely on a pattern of misrepresentation, pseudoscience, and false equivalencies. Their selective and misleading interpretation of the APA's work, as illustrated by their claims about the footnote, exemplifies their biased approach. Rather than engaging in good-faith discourse, Highsmith repeatedly distorts evidence to fit their anti-transgender agenda. Most often employing a linguistic attack as a basis for their accusation, and then looking for evidence to support it. Jim summarizes this concept nicely for us:

““Trans” Is A Fraud—And It Always Has Been” continues Highsmith's well-established pattern of spreading anti-trans propaganda and fearmongering. Their inflammatory language, such as calling transgender people "delusional" and "indefensible," reveals the prejudice underlying their position. Highsmith's rhetoric is not merely an academic disagreement; it has real-world consequences for the transgender community.

The harm caused by this kind of biased, misleading rhetoric is painfully clear in Highsmith's other articles, such as "A Life Ruined By Trans."⁶¹ In that piece, they exploit an individual's story to make sweeping, unsubstantiated generalizations about the supposed dangers of affirming transgender identities. Highsmith's fear-mongering claims, left unchallenged, contribute to the discrimination and marginalization that transgender people face in society.

It is crucial to emphasize that the recognition and affirmation of transgender identities is firmly grounded in scientific evidence and respect for human diversity. Major medical organizations, such as the American Psychological Association, have affirmed the validity of transgender identities and the importance of access to gender-affirming care. Their positions are based on rigorous research and clinical expertise, not the kind of pseudoscience and misrepresentations that Highsmith relies on.

Transgender people have always existed and will continue to exist, regardless of the attacks leveled against them by biased actors like Highsmith. It is the responsibility of all people of conscience to critically examine anti-transgender rhetoric and stand in solidarity with the transgender community. We must challenge prejudice and misinformation wherever we encounter it and work to create a society where all individuals can live authentically and free from discrimination.

This paper, and others like it, aim to provide the tools and parts anyone who reads to be able to stand tall, stand firm, and stand next to each other, together, in solidarity to be able to not just defend against people like Highsmith and their rhetoric, but to push back and make real, effective progress against prejudice, bigotry, intolerance, and hate.

The transgender community deserves respect, support, and affirmation, not the kind of dangerous propaganda peddled by Highsmith.⁶² Their arguments, when subjected to scrutiny, fail to hold up under the weight of scientific evidence and basic human decency. We must do better as a society and work towards a future where transgender individuals are fully embraced and celebrated for who they are. Rejecting Highsmith's harmful rhetoric is a necessary step in that direction.

1. Highsmith, K. (2024, March 05). Substack User Comment. Retrieved October 15, 2024, from https://substack.com/@kathighsmith/note/c-50954598.

2. Highsmith, K. (2023, February 23). There is no such thing. Katy Highsmith's Newsletter. https://kathighsmith.substack.com/p/there-is-no-such-thing

3. PITT. (2024, October 14). The Inconvenient Truth About Kat Highsmith's 'Will & Harper' Screed. PITT People. https://pittpeople.substack.com/p/the-inconvenient-truth-about-kat?r=3khofc

4. Roselli, C. E. (2018). Neurobiology of gender identity and sexual orientation. Journal of Neuroendocrinology, 30(7), e12562. https://doi.org/10.1111/jne.12562
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6677266/

5. Highsmith, K. (2023) See 2 Above

6. Roselli, C.E. (2018). See 4 Above

7. Trevor A. Corneil , Justus H. Eisfeld & Marsha Botzer (2010) Proposed Changes to Diagnoses Related to Gender Identity in the DSM: A World Professional Association for Transgender Health Consensus Paper Regarding the Potential Impact on Access to Health Care for Transgender Persons, International Journal of Transgenderism, 12:2, 107-114. Link to this article: https://doi.org/10.1080/15532739.2010.509205

8. Roselli, C. E. (2018). See 4 Above

9. Ristori J, Cocchetti C, Romani A, Mazzoli F, Vignozzi L, Maggi M, Fisher AD. Brain Sex Differences Related to Gender Identity Development: Genes or Hormones? Int J Mol Sci. 2020 Mar 19;21(6):2123. doi: 10.3390/ijms21062123. PMID: 32204531; PMCID: PMC7139786. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7139786/

10. Saraswat A, Weinand JD, Safer JD. Evidence supporting the biologic nature of gender identity. Endocr Pract. 2015 Feb;21(2):199-204. doi: 10.4158/EP14351.RA. PMID: 25667367.
Full paper here: https://sci-hub.se/10.4158/EP14351.RA

11. Leinung M, Wu C. THE BIOLOGIC BASIS OF TRANSGENDER IDENTITY: 2D:4D FINGER LENGTH RATIOS IMPLICATE A ROLE FOR PRENATAL ANDROGEN ACTIVITY. Endocr Pract. 2017 Jun;23(6):669-671. doi: 10.4158/EP161528.OR. Epub 2017 Mar 23. PMID: 28332875. Link: https://pubmed.ncbi.nlm.nih.gov/28332875/

12. Polderman TJC, Kreukels BPC, Irwig MS, Beach L, Chan YM, Derks EM, Esteva I, Ehrenfeld J, Heijer MD, Posthuma D, Raynor L, Tishelman A, Davis LK; International Gender Diversity Genomics Consortium. The Biological Contributions to Gender Identity and Gender Diversity: Bringing Data to the Table. Behav Genet. 2018 Mar;48(2):95-108. doi: 10.1007/s10519-018-9889-z. Epub 2018 Feb 19. PMID: 29460079. Link: https://pubmed.ncbi.nlm.nih.gov/29460079/

13. Arraiza Zabalegui M. After the trans brain: a critique of the neurobiological accounts of embodied trans* identities. Hist Philos Life Sci. 2024 Feb 2;46(1):10. doi: 10.1007/s40656-023-00602-6. PMID: 38305812; PMCID: PMC10837215.
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10837215/

14. Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K. Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Netw Open. 2022 Feb 1;5(2):e220978. doi: 10.1001/jamanetworkopen.2022.0978. Erratum in: JAMA Netw Open. 2022 Jul 1;5(7):e2229031. doi: 10.1001/jamanetworkopen.2022.29031. PMID: 35212746; PMCID: PMC8881768. Link: https://pubmed.ncbi.nlm.nih.gov/35212746/

15. Campbell T, Mann S, Rodgers YVDM, Tran NM. Mental Health of Transgender Youth Following Gender Identity Milestones by Level of Family Support. JAMA Pediatr. 2024;178(9):870–878. doi:10.1001/jamapediatrics.2024.2035
Link: https://jamanetwork.com/journals/jamapediatrics/article-abstract/2821064

16. Tordoff DM, Wanta JW, Collin A, Stepney C, Inwards-Breland DJ, Ahrens K. Mental Health Outcomes in Transgender and Nonbinary Youths Receiving Gender-Affirming Care. JAMA Netw Open. 2022;5(2):e220978. doi:10.1001/jamanetworkopen.2022.0978
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2789423

17. This is a slur, so I am not going to repeat it here

18. American Psychological Association, Task Force on Gender Identity and Gender Variance. (2009). Report of the APA Task Force on Gender Identity and Gender Variance. American Psychological Association. (PDF) Link:https://www.apa.org/pi/lgbt/resources/policy/gender-identity-report.pdf

19. Ibid. (Same as 18)

20. Ibid. (Same as 18)

21. You guessed it - same as 18 (Ibid.)

22. Wikipedia contributors. (2024). Occam's razor. In Wikipedia, The Free Encyclopedia. https://en.wikipedia.org/wiki/Occam%27s_razor
Link: https://en.wikipedia.org/wiki/Occam%27s_razor

23. Highsmith, K. (2023) See 2 Above

24. APA (2009) See 18 Above

25. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Link (PDF Adobe online) : https://acrobat.adobe.com/link

26. American Psychiatric Association. (2013). Gender Dysphoria. https://www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Gender-Dysphoria.pdf

27. Davy, Z. (2015). The DSM-5 and the politics of diagnosing transpeople. Archives of sexual behavior, 44(5), 1165-1176. Link: https://sci-hub.se/10.1007/s10508-015-0573-6

28. Davy, Z. (2015). See 27 above.

29. Harrison, J. (2016, November 25). The difference between gender dysphoria and body dysmorphia. Endocrine Kids. https://www.endocrinekids.com/2016/11/25/the-difference-between-gender-dysphoria-and-body-dysmorphia/
Alt Link (Archive): https://web.archive.org/web/20240529151631/https://www.endocrinekids.com/2016/11/25/the-difference-between-gender-dysphoria-and-body-dysmorphia/

30. Tran, V. (2021, May 30). Gender dysphoria and body dysmorphia in trans and non-binary folks. Center for Discovery. https://centerfordiscovery.com/blog/gender-dysphoria-body-dysmorphia-trans-non-binary-folks/

31. APA. (2013). DSM-5. See 26 Above

32. Ibid. (See 31, 26 above)

33. Tran, V. (2021) See 30 Above.

34. PITT. (2024) See 3 Above.

35. Tordoff, D. M., Wanta, J. W., Collin, A., Stepney, C., Inwards-Breland, D. J., & Ahrens, K. (2022). Mental health outcomes in transgender and nonbinary youths receiving gender-affirming care. JAMA Network Open, 5(2), e220978.
Link: https://doi.org/10.1001/jamanetworkopen.2022.0978

36. Salas-Humara, C., Sequeira, G. M., Rossi, W., & Dhar, C. P. (2021). Gender affirming medical care of transgender youth. Current Problems in Pediatric and Adolescent Health Care, 51(4), 101028.
Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8496167/

37. Cornell University Public Policy Research Portal. (2018). What does the scholarly research say about the effect of gender transition on transgender well-being? What We Know Project. https://whatweknow.inequality.cornell.edu/topics/lgbt-equality/what-does-the-scholarly-research-say-about-the-well-being-of-transgender-people/

38. Turban, J. L., & Ehrensaft, D. (2022). What the science on gender-affirming care for transgender kids really shows. Scientific American. https://www.scientificamerican.com/article/what-the-science-on-gender-affirming-care-for-transgender-kids-really-shows/

39. Smink, F. R., van Hoeken, D., & Hoek, H. W. (2012). Epidemiology of eating disorders: incidence, prevalence and mortality rates. Current psychiatry reports, 14(4), 406-414. Link: https://doi.org/10.1007/s11920-012-0282-y

40. American Psychological Association. (2024, July 8). Understanding transgender people, gender identity and gender expression.
Link: https://www.apa.org/topics/lgbtq/transgender-people-gender-identity-gender-expression

41. American Medical Association. (2019). Health insurance coverage for gender-affirming care of transgender patients. Link: https://www.ama-assn.org/system/files/2019-03/transgender-coverage-issue-brief.pdf

42. Rafferty, J., & Committee on Psychosocial Aspects of Child and Family Health. (2018). Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics, 142(4). https://doi.org/10.1542/peds.2018-2162
Link: https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for

43. I tried to give Highsmith the benefit of the doubt, and besides news articles that are misleading, sensationalized, and a scant few that seem accurate, this provides no reliable data to determine anything about their claim. They offer no evidence to support it, and appeal to emotion in the process. Thus, I felt it was fair to employ the razor.

44. Hasenbush, A., Flores, A.R. & Herman, J.L. Gender Identity Nondiscrimination Laws in Public Accommodations: a Review of Evidence Regarding Safety and Privacy in Public Restrooms, Locker Rooms, and Changing Rooms. Sex Res Soc Policy 16, 70–83 (2019). https://doi.org/10.1007/s13178-018-0335-z
Link: https://link.springer.com/article/10.1007/s13178-018-0335-z
Alt Link: https://sci-hub.se/10.1007/s13178-018-0335-z

45. Hilton, E.N., Lundberg, T.R. Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage. Sports Med 51, 199–214 (2021). https://doi.org/10.1007/s40279-020-01389-3
Link: https://link.springer.com/article/10.1007/s40279-020-01389-3

46. Shattuck, D. G., Rasberry, C. N., Willging C.E. , Ramos, M.M. , Positive Trends in School-Based Practices to Support LGBTQ Youth in the United States Between 2010 and 2018, Journal of Adolescent Health, 70, 5, 2022, 810-816, ISSN 1054-139X, https://doi.org/10.1016/j.jadohealth.2021.11.027.
Link: https://www.sciencedirect.com/science/article/abs/pii/S1054139X2100673X

47. Jones, B. A., Arcelus, J., Bouman, W. P., & Haycraft, E. (2017). Sport and Transgender People: A Systematic Review of the Literature Relating to Sport Participation and Competitive Sport Policies. Sports Medicine, 47(4), 701-716. https://doi.org/10.1007/s40279-016-0621-y
Link: https://pubmed.ncbi.nlm.nih.gov/27699698/

48. Hilton, E.N., Lundberg, T.R. Transgender Women in the Female Category of Sport: Perspectives on Testosterone Suppression and Performance Advantage. Sports Med 51, 199–214 (2021). https://doi.org/10.1007/s40279-020-01389-3
Link: https://link.springer.com/article/10.1007/s40279-020-01389-3

49. Canadian Centre for Ethics in Sport. (2024). Transgender women athletes and elite sport: A scientific review.
Report(PDF): https://cces.ca/sites/default/files/content/docs/2024-01/transgender-women-athletes-and-elitesport-a-scientific-review-en.pdf
Site for summary/quotes(HTML): https://cces.ca/transgender-women-athletes-and-elite-sport-scientific-review

50. Omercajic, K., & Martino, W. (2021). Supporting Transgender Inclusion and Gender Diversity in Schools: A Critical Policy Analysis. Frontiers in Sociology, 5, 611. https://doi.org/10.3389/fsoc.2020.00027. Link: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8022556/

51. APA Task Force Report (2008) See 18 Above

52. American Psychological Association. (2006, November). Brochures help explain sexual orientation, gender identity. Monitor on Psychology, 37(10). https://www.apa.org/monitor/nov06/brochures

53. American Psychological Association. (n.d.). Answers to your questions about transgender people, gender identity, and gender expression. Retrieved October 15, 2024, from https://www.apa.org/topics/lgbtq/transgender.pdf

54. American Psychological Association. (n.d.). Lesbian, gay, bisexual and transgender health. Retrieved October 15, 2024, from https://www.apa.org/pi/lgbt/resources/

55. American Psychological Association. (n.d.). APA policy statements on lesbian, gay, bisexual & transgender concerns. Retrieved October 15, 2024, from https://www.apa.org/pi/lgbt/resources/policy

56. American Psychological Association. (2023). Resolution on supporting gender diverse children and adolescents. https://www.apa.org/about/policy/resolution-supporting-gender-diverse-children.pdf?os=vblhpdr7hy&ref=app

57. interACT. (2016). Trans and intersex 101. https://interactadvocates.org/wp-content/uploads/2016/05/LavLaw-Trans-and-Intersex-Fact-Sheet.pdf

58. Reddit. (2024, April 14). What's the limit of the overlaps between the trans and intersex communities? [Online forum post]. r/intersex. https://www.reddit.com/r/intersex/comments/1ejpplf/whats_the_limit_of_the_overlaps_between_the_trans/

59. Laurentz, D. (n.d.). Transgender and intersex identities. Washington State Office of Financial Management. Retrieved October 15, 2024, from https://ofm.wa.gov/sites/default/files/public/shr/Diversity/DEIMEDIA/2020summit/Laurentz%20Transgender%20and%20intersex%20identities%201.2.pdf

60. Churchleaders. (2024, April 15). Transgender and intersex Catholics ask Pope to rethink church stance on gender-affirming care (RNS). https://churchleaders.com/news/498942-transgender-and-intersex-catholics-ask-pope-to-rethink-church-stance-on-gender-affirming-care-rns.html

61. Highsmith, K. (2024, April 15). A life ruined by "trans": The sad tale of Mackenzie McClelland. Kathi Highsmith's Newsletter. https://open.substack.com/pub/kathighsmith/p/a-life-ruined-by-trans-the-sad-tale?r=3khofc&utm_campaign=post&utm_medium=web

62. I know there is a long list of communities I want to include in this closing that share intersectionality with the trans community and the rights, freedoms, care, safety, and acceptance that are deserved by all. This is why “Trans Rights Are Human Rights” is such a powerful statement. I did not attempt to write this in, because then I would have made this far longer than strictly necessary, and if you are reading this footnote, than I am surprised, because this was way too long an article to begin with.