There is one argument I don't remember ever seeing made, but it seems important to me. I would be curious to hear from others why it is not discussed, because I think I must be missing something:
Why do we debate the reality of "gender" at all, in the context of providing gender-affirming health care? The science is solid, and virtually undeniable: people - and especially children - who receive the care they say they need are much more likely to thrive than those who don't. While all the discussion and research around gender is necessary in general, in regards specifically to whether or not various modes of health care should be provided, none of the discussion impacts that decision. Let's say, for the sake of argument, that gender is really just a social construct (it's not, but let's pretend for a moment it is). If that were the case, it would still be verifiable fact that the current health care modalities have the best outcomes. People who receive it benefit greatly from it, and much more so than any alternative treatments (eg, conversion therapy). That being the case, the whole debate should be moot. A health related issue is resolved successfully, and no other path offers comparable success rates. End of discussion. It should be available to anyone who believes they need it, and nobody but that person and, possibly their health care providers, has any business questioning or demanding justification for it. Why do we feel the need to convince terfs of the reality of gender in order to defend people's right to access gender-affirming health care?
Who we're talking to are the people who might otherwise be convinced by terfs and bigots to pass legislation, or support the legislators passing such legislation, that denies us our rights to health care, bodily autonomy, bathroom access, sports participation, etc etc.
As I've said elsewhere, our only power lies in our ability to persuade cis people who are not bigots and who actually believe in human rights to join us in our fight to preserve ours or regain them...(and ultimately to preserve their own) because there are too few of us to do it without them.
I must apologize. I don't think i articulated my question very well. I meant to limit it to the particular situation I've seen a lot of recently, in which a terf will insist gender-affirming care is a grift, or is abuse, and therefore should not be allowed. when their erroneous sources are pointed out, they tend to fall back to insisting that "gender," or "man" and "woman" be defined to their satisfaction as a condition of considering the merit of honoring trans people's right to gender-affirming healhealth care. I did not intend to imply that I don't think the broader conversation is necessary at all. I agree completely with all the reasons you included in your comment for why that conversation is necessary.
I completely agree that trans people's right to access medically necessary care should not be contingent on convincing anyone of the validity of their identities. The science speaks for itself - gender-affirming care saves lives and allows trans individuals to thrive. That alone should be justification enough, without needing to win abstract debates about gender theory.
If we can sidestep this part of the argument/debate and just focus on the core priority of defending trans people's right to access healthcare, and not getting bogged down in philosophical debates with those who refuse to acknowledge the legitimacy of trans identities, then I would count that as a win.
At the same time, I do think there is value in articulating a clear, evidence-based model of gender and challenging misconceptions, as a means of destigmatizing trans identities and fostering greater social acceptance. While not as urgent as ensuring access to healthcare, this kind of public education helps create a world that is safer and more affirming for trans people to exist in. Countering TERF talking points is part of building that culture of understanding and inclusion. In that sense, I see this as part of the long-game. The more arguments we have reasonable, rational answers to that stand up to scrutiny, the less these talking points/questions can be used to stand against people's right to access gender-affirming health care. And the more they are seen for the dog-whistles they are - and thus, the less weight and attention people will give them. Well, that is the idea anyhow :)
Oh, yes, I totally agree that the broader discourse is important. I don't think i articulated this very well in my comment, but I meant to limit the scope of it to only those debates (and in me experience, most often launched by terfs) in which a defense of trans people's right to appropriate medical care is challenged based on the titired old argument that we must have a universally agreed-uagreed-upon definition of gender as a prerequisite to considering said right to health care. While the larger conversation is indeed necessary, in the ccontext of this particular terfy argument, I think attempting to satisfy the demand for the definition of gender only serves to derail the core of the health care issue. That is one reason I appreciate your way of engaging in those arguments (I'm thinking specifically of the recent clashes with Kat), in which you simply ignore the repeated demand to define "man" and "woman."
Ah yes, I understand and I agree with you. Just this morning I read a delightful comment on another blog that really resonated with me, and brought to mind your earlier comment and with what you are saying here. One Lakitha Tolbert writes in her comment:
"And herein lies the problem: they set the agenda of the "debate", they were the ones who decided the parameters of the discussion, which are in bad faith, and involved much goalpost shifting so that they can keep talking.
I'm reminded of Toni Morrison's statement about the purpose of racism:
"The function, the very serious function of racism is distraction. It keeps you from doing your work. It keeps you explaining, over and over again, your reason for being. Somebody says you have no language and you spend twenty years proving that you do. Somebody says your head isn’t shaped properly so you have scientists working on the fact that it is. Somebody says you have no art, so you dredge that up. Somebody says you have no kingdoms, so you dredge that up. None of this is necessary. There will always be one more thing.”
This is the same tactic used against every marginalized group where the dominant culture sets the parameters of the discussion on their worthiness to live, have rights, or be treated with respect. Transgender men and women had barely reached the stage of having their own voice before being targeted by the reactionaries and that was on purpose. The bigots who profit from targeting the marginalized picked a group of people that was Tony [sic] [tiny], not politically organized, and not unified as a community.
The irony of their behavior is that by targeting them, they end up bringing about the very thing they were most afraid of: them developing a community, and a voice. This pattern had happened again, and again, and again, for over the past hundred and fifty years."
You can tell a person they don't exist as many times as you want, but you are wasting your breath. The fact that I can perceive your message at all proves that I do, in fact exist. Do you not get the irony of interacting incessantly with someone you claim does not exist?
So what do we have here folks? Let's break it down:
Factual Inaccuracies & Logical Fallacies:
- Ad Hominem: Attacking character rather than addressing arguments
- Cherry Picking: Using selective cases (Lovdahl and Cole) to represent all outcomes
- False Attribution: Misrepresenting John Money's work and gender theory
- Straw Man: Mischaracterizing gender-affirming care as universally sterilizing or mutilating
- Black-and-White Fallacy: Presenting only two extremes with no nuance
The effectiveness of gender-affirming care isn't dependent on convincing critics - it's supported by clinical outcomes. LC Sharkey makes an excellent point: even if we set aside the entire gender debate, the empirical evidence shows better health outcomes for those who receive appropriate care versus those who don't.
The AMA reports significantly improved mental health outcomes and reduced suicide risk among those receiving appropriate gender-affirming care. This isn't about ideology - it's about evidence-based healthcare. Individual regret cases, while important to acknowledge, represent a tiny minority and often involve complex factors including inadequate support or rushed care - which is why careful, personalized medical oversight is crucial.
LC Sharkey's point about not needing to debate gender's existence to justify effective healthcare is particularly salient. We don't require philosophical debates about the nature of depression to justify antidepressants, or debates about the nature of pain to justify pain management. What matters is that the treatment works and improves lives, which the evidence consistently shows.
Furthermore, based on the research, Kat's claim that "John Money knew that [gender is only a linguistics term]" is a significant misrepresentation of Money's work and views. Let's break this down and explore this a bit further:
Money actually held the opposite view - he was instrumental in developing theories about gender identity and believed that gender was NOT just linguistic but was a complex psychosocial phenomenon. He specifically "disagreed with the previous school of thought that gender was determined solely by biology."
The irony is that Money's most controversial work (the Reimer case) was based on his belief that gender identity was malleable and could be shaped through social and environmental factors in early childhood - the exact opposite of what Kat suggests. https://www.simplypsychology.org/david-reimer.html
While Money is indeed a controversial figure whose theories and ethics have been rightfully challenged (particularly regarding the tragic Reimer case), Kat's characterization of his views on gender is completely backwards. Money didn't dismiss gender as "only linguistic" - he was actually one of the first researchers to extensively study and theorize about gender identity as a psychological and developmental phenomenon. https://kinseyinstitute.org/collections/archival/john-money.php
The key point here is that whether one agrees or disagrees with Money's theories (and there are valid reasons to criticize his work), it's historically inaccurate to claim he viewed gender as "only linguistic." This misrepresentation appears to be an attempt to give historical authority to a modern political position that doesn't align with the actual historical record. Furthermore he did not create the term "gender" - but he did coin the term "gender role." If you are using google's quick answer when you type that into google, you are being misled. https://rdcu.be/ddPj8
I find myself often having to make the point in trans spaces, because even ourselves and our allies have heard the talking point "gender is a construct" so many times in other contexts in early feminist spaces where identity was never the point of the conversation and never separated from roles (and subsequently co-opted by terfs) they've accepted that as a truth.. A case of "repeat it often enough...".
No, I say, gender ROLES are a social construct.
Gender IDENTITY is an intrinsic characteristic.
We're not just fighting terfs on this. We are pushing back against a formulation that was just not inclusive (as opposed to the terf exclusive) simply because the people who created it were unaware of trans folk, and particularly women who were trans, in the first place.
In those days we were misgendered as a matter of course by the mental health and medical communities who'd not bothered to actually understand us before shoehorning us into their then limited model of what we would now understand as gender role non-conformity when we were something else entirely.
A tree's fundamental nature - its DNA, its species - is innate. An oak is inherently an oak. But how that tree grows and expresses itself is shaped by its environment:
-The innate part is like gender identity - it's fundamental to who you are, hardwired into your being
-The social construction part is like the environmental factors that influence how the tree grows:
-Society's expectations (like pruning)
-Cultural pressures (like wind and weather)
-External pressures to conform (like being tied to a stake)
You can force an oak to grow in unnatural ways, to try to look like something else. It might even survive like that for years. But:
- It's still fundamentally an oak
- The forced shape isn't its natural state
- Eventually, the pressure to maintain that unnatural form becomes unsustainable
This isn't contradictory - it's recognizing that identity can be innate while its expression is influenced by social factors. Just as we don't question a tree's existence because we don't fully understand photosynthesis, we don't need to fully understand every aspect of gender identity to recognize its reality and provide appropriate support.
The fact that you present this as some kind of "gotcha" contradiction suggests you might benefit from considering how natural phenomena often involve both inherent characteristics and environmental influences.
It is an imperfect analogy, I know - it is not meant to prove anything, it is meant to help you understand the concepts and fundamentals at play here.
Kat's response serves as a perfect foil - a means to distract from the fact that they are unable to argue against the substance and content of the article itself. Instead of engaging with the clear, non-circular definition provided, we see a retreat into sarcasm, bad arguments, and logical fallacies. Let's observe:
Logical Fallacies:
- Sarcasm as Argument: Using mockery instead of substantive critique
- False Premise: Assuming that complex phenomena must be simple to be valid
- Reductio ad Absurdum: Oversimplifying a complex topic to make it seem ridiculous
- Demand for Perfect Definition: The "define a woman" challenge is a common rhetorical trap
Kat's response fundamentally misunderstands how scientific definitions work in biology and medicine. Many real, scientifically-validated phenomena are complex and multifaceted. Consider:
Define "consciousness." Define "pain." Define "love." These are all real, measurable phenomena that resist simple definitions yet undeniably exist. Their complexity doesn't negate their reality.
The demand to "define woman" is particularly disingenuous because even biological sex is bimodal, not binary. There are multiple biological markers (chromosomal, hormonal, anatomical, etc.) that don't always align in simple ways. This is basic medical science, not ideology.
Kat's mockery of the complexity of gender identity is like mocking the complexity of neuroscience or quantum physics - complexity doesn't equal invalidity. The scientific consensus supports that gender identity has biological, psychological, and social components, all of which are supported by peer-reviewed research.
The question isn't about "feeling like" another gender - it's about being. Just as you don't "feel like" your gender, you simply are it, trans people's gender identities are fundamental aspects of who they are, supported by neurological and psychological evidence.
This kind of reductive argumentation ignores decades of research in favor of oversimplified rhetoric. In fact, Kat's response perfectly demonstrates the points from my article about TERF tactics that Kat is commenting on:
- Ignores the actual definition provided
- Resorts to sarcasm instead of engagement
- Immediately shifts to demanding new definitions ("define what a man is, define what a woman is")
![People with Inconvenient Truths about Transphobes [PITT]](https://substackcdn.com/image/fetch/w_36,h_36,c_fill,f_webp,q_auto:good,fl_progressive:steep,g_auto/https%3A%2F%2Fsubstack-post-media.s3.amazonaws.com%2Fpublic%2Fimages%2F704ba0db-3e10-4112-9364-c2f224d0cfae_500x500.png)
There is one argument I don't remember ever seeing made, but it seems important to me. I would be curious to hear from others why it is not discussed, because I think I must be missing something:
Why do we debate the reality of "gender" at all, in the context of providing gender-affirming health care? The science is solid, and virtually undeniable: people - and especially children - who receive the care they say they need are much more likely to thrive than those who don't. While all the discussion and research around gender is necessary in general, in regards specifically to whether or not various modes of health care should be provided, none of the discussion impacts that decision. Let's say, for the sake of argument, that gender is really just a social construct (it's not, but let's pretend for a moment it is). If that were the case, it would still be verifiable fact that the current health care modalities have the best outcomes. People who receive it benefit greatly from it, and much more so than any alternative treatments (eg, conversion therapy). That being the case, the whole debate should be moot. A health related issue is resolved successfully, and no other path offers comparable success rates. End of discussion. It should be available to anyone who believes they need it, and nobody but that person and, possibly their health care providers, has any business questioning or demanding justification for it. Why do we feel the need to convince terfs of the reality of gender in order to defend people's right to access gender-affirming health care?
It's not terfs we're talking to :)
Who we're talking to are the people who might otherwise be convinced by terfs and bigots to pass legislation, or support the legislators passing such legislation, that denies us our rights to health care, bodily autonomy, bathroom access, sports participation, etc etc.
As I've said elsewhere, our only power lies in our ability to persuade cis people who are not bigots and who actually believe in human rights to join us in our fight to preserve ours or regain them...(and ultimately to preserve their own) because there are too few of us to do it without them.
I must apologize. I don't think i articulated my question very well. I meant to limit it to the particular situation I've seen a lot of recently, in which a terf will insist gender-affirming care is a grift, or is abuse, and therefore should not be allowed. when their erroneous sources are pointed out, they tend to fall back to insisting that "gender," or "man" and "woman" be defined to their satisfaction as a condition of considering the merit of honoring trans people's right to gender-affirming healhealth care. I did not intend to imply that I don't think the broader conversation is necessary at all. I agree completely with all the reasons you included in your comment for why that conversation is necessary.
If you're saying we shouldn't be having these conversations WITH terfs and bigots themselves, I agree.
I don't think anybody should have to, but for anyone who is up for it, I think it can sometimes be informative for bystanders.
I completely agree that trans people's right to access medically necessary care should not be contingent on convincing anyone of the validity of their identities. The science speaks for itself - gender-affirming care saves lives and allows trans individuals to thrive. That alone should be justification enough, without needing to win abstract debates about gender theory.
If we can sidestep this part of the argument/debate and just focus on the core priority of defending trans people's right to access healthcare, and not getting bogged down in philosophical debates with those who refuse to acknowledge the legitimacy of trans identities, then I would count that as a win.
At the same time, I do think there is value in articulating a clear, evidence-based model of gender and challenging misconceptions, as a means of destigmatizing trans identities and fostering greater social acceptance. While not as urgent as ensuring access to healthcare, this kind of public education helps create a world that is safer and more affirming for trans people to exist in. Countering TERF talking points is part of building that culture of understanding and inclusion. In that sense, I see this as part of the long-game. The more arguments we have reasonable, rational answers to that stand up to scrutiny, the less these talking points/questions can be used to stand against people's right to access gender-affirming health care. And the more they are seen for the dog-whistles they are - and thus, the less weight and attention people will give them. Well, that is the idea anyhow :)
Oh, yes, I totally agree that the broader discourse is important. I don't think i articulated this very well in my comment, but I meant to limit the scope of it to only those debates (and in me experience, most often launched by terfs) in which a defense of trans people's right to appropriate medical care is challenged based on the titired old argument that we must have a universally agreed-uagreed-upon definition of gender as a prerequisite to considering said right to health care. While the larger conversation is indeed necessary, in the ccontext of this particular terfy argument, I think attempting to satisfy the demand for the definition of gender only serves to derail the core of the health care issue. That is one reason I appreciate your way of engaging in those arguments (I'm thinking specifically of the recent clashes with Kat), in which you simply ignore the repeated demand to define "man" and "woman."
Ah yes, I understand and I agree with you. Just this morning I read a delightful comment on another blog that really resonated with me, and brought to mind your earlier comment and with what you are saying here. One Lakitha Tolbert writes in her comment:
"And herein lies the problem: they set the agenda of the "debate", they were the ones who decided the parameters of the discussion, which are in bad faith, and involved much goalpost shifting so that they can keep talking.
I'm reminded of Toni Morrison's statement about the purpose of racism:
"The function, the very serious function of racism is distraction. It keeps you from doing your work. It keeps you explaining, over and over again, your reason for being. Somebody says you have no language and you spend twenty years proving that you do. Somebody says your head isn’t shaped properly so you have scientists working on the fact that it is. Somebody says you have no art, so you dredge that up. Somebody says you have no kingdoms, so you dredge that up. None of this is necessary. There will always be one more thing.”
This is the same tactic used against every marginalized group where the dominant culture sets the parameters of the discussion on their worthiness to live, have rights, or be treated with respect. Transgender men and women had barely reached the stage of having their own voice before being targeted by the reactionaries and that was on purpose. The bigots who profit from targeting the marginalized picked a group of people that was Tony [sic] [tiny], not politically organized, and not unified as a community.
The irony of their behavior is that by targeting them, they end up bringing about the very thing they were most afraid of: them developing a community, and a voice. This pattern had happened again, and again, and again, for over the past hundred and fifty years."
You can tell a person they don't exist as many times as you want, but you are wasting your breath. The fact that I can perceive your message at all proves that I do, in fact exist. Do you not get the irony of interacting incessantly with someone you claim does not exist?
Oh, Kat, it is so damn easy to rattle your cage. That must be an exhausting way to live.
So what do we have here folks? Let's break it down:
Factual Inaccuracies & Logical Fallacies:
- Ad Hominem: Attacking character rather than addressing arguments
- Cherry Picking: Using selective cases (Lovdahl and Cole) to represent all outcomes
- False Attribution: Misrepresenting John Money's work and gender theory
- Straw Man: Mischaracterizing gender-affirming care as universally sterilizing or mutilating
- Black-and-White Fallacy: Presenting only two extremes with no nuance
The effectiveness of gender-affirming care isn't dependent on convincing critics - it's supported by clinical outcomes. LC Sharkey makes an excellent point: even if we set aside the entire gender debate, the empirical evidence shows better health outcomes for those who receive appropriate care versus those who don't.
The AMA reports significantly improved mental health outcomes and reduced suicide risk among those receiving appropriate gender-affirming care. This isn't about ideology - it's about evidence-based healthcare. Individual regret cases, while important to acknowledge, represent a tiny minority and often involve complex factors including inadequate support or rushed care - which is why careful, personalized medical oversight is crucial.
LC Sharkey's point about not needing to debate gender's existence to justify effective healthcare is particularly salient. We don't require philosophical debates about the nature of depression to justify antidepressants, or debates about the nature of pain to justify pain management. What matters is that the treatment works and improves lives, which the evidence consistently shows.
Furthermore, based on the research, Kat's claim that "John Money knew that [gender is only a linguistics term]" is a significant misrepresentation of Money's work and views. Let's break this down and explore this a bit further:
Money actually held the opposite view - he was instrumental in developing theories about gender identity and believed that gender was NOT just linguistic but was a complex psychosocial phenomenon. He specifically "disagreed with the previous school of thought that gender was determined solely by biology."
https://en.wikipedia.org/wiki/John_Money
https://en.wikipedia.org/wiki/Gender_identity
The irony is that Money's most controversial work (the Reimer case) was based on his belief that gender identity was malleable and could be shaped through social and environmental factors in early childhood - the exact opposite of what Kat suggests. https://www.simplypsychology.org/david-reimer.html
While Money is indeed a controversial figure whose theories and ethics have been rightfully challenged (particularly regarding the tragic Reimer case), Kat's characterization of his views on gender is completely backwards. Money didn't dismiss gender as "only linguistic" - he was actually one of the first researchers to extensively study and theorize about gender identity as a psychological and developmental phenomenon. https://kinseyinstitute.org/collections/archival/john-money.php
This appears to be part of a larger pattern of misrepresenting historical figures and research to support anti-trans narratives, as evidenced by similar mischaracterizations circulating on social media. https://medium.com/@davidallsopp/no-dr-money-did-not-invent-gender-55d245fc9757
The key point here is that whether one agrees or disagrees with Money's theories (and there are valid reasons to criticize his work), it's historically inaccurate to claim he viewed gender as "only linguistic." This misrepresentation appears to be an attempt to give historical authority to a modern political position that doesn't align with the actual historical record. Furthermore he did not create the term "gender" - but he did coin the term "gender role." If you are using google's quick answer when you type that into google, you are being misled. https://rdcu.be/ddPj8
I find myself often having to make the point in trans spaces, because even ourselves and our allies have heard the talking point "gender is a construct" so many times in other contexts in early feminist spaces where identity was never the point of the conversation and never separated from roles (and subsequently co-opted by terfs) they've accepted that as a truth.. A case of "repeat it often enough...".
No, I say, gender ROLES are a social construct.
Gender IDENTITY is an intrinsic characteristic.
We're not just fighting terfs on this. We are pushing back against a formulation that was just not inclusive (as opposed to the terf exclusive) simply because the people who created it were unaware of trans folk, and particularly women who were trans, in the first place.
In those days we were misgendered as a matter of course by the mental health and medical communities who'd not bothered to actually understand us before shoehorning us into their then limited model of what we would now understand as gender role non-conformity when we were something else entirely.
I agree with you, and I tried to split that hair finely enough to differentiate that - at least I hope I did and made it clear enough :)
Think of it like this:
A tree's fundamental nature - its DNA, its species - is innate. An oak is inherently an oak. But how that tree grows and expresses itself is shaped by its environment:
-The innate part is like gender identity - it's fundamental to who you are, hardwired into your being
-The social construction part is like the environmental factors that influence how the tree grows:
-Society's expectations (like pruning)
-Cultural pressures (like wind and weather)
-External pressures to conform (like being tied to a stake)
You can force an oak to grow in unnatural ways, to try to look like something else. It might even survive like that for years. But:
- It's still fundamentally an oak
- The forced shape isn't its natural state
- Eventually, the pressure to maintain that unnatural form becomes unsustainable
This isn't contradictory - it's recognizing that identity can be innate while its expression is influenced by social factors. Just as we don't question a tree's existence because we don't fully understand photosynthesis, we don't need to fully understand every aspect of gender identity to recognize its reality and provide appropriate support.
The fact that you present this as some kind of "gotcha" contradiction suggests you might benefit from considering how natural phenomena often involve both inherent characteristics and environmental influences.
It is an imperfect analogy, I know - it is not meant to prove anything, it is meant to help you understand the concepts and fundamentals at play here.
Kat's response serves as a perfect foil - a means to distract from the fact that they are unable to argue against the substance and content of the article itself. Instead of engaging with the clear, non-circular definition provided, we see a retreat into sarcasm, bad arguments, and logical fallacies. Let's observe:
Logical Fallacies:
- Sarcasm as Argument: Using mockery instead of substantive critique
- False Premise: Assuming that complex phenomena must be simple to be valid
- Reductio ad Absurdum: Oversimplifying a complex topic to make it seem ridiculous
- Demand for Perfect Definition: The "define a woman" challenge is a common rhetorical trap
Kat's response fundamentally misunderstands how scientific definitions work in biology and medicine. Many real, scientifically-validated phenomena are complex and multifaceted. Consider:
Define "consciousness." Define "pain." Define "love." These are all real, measurable phenomena that resist simple definitions yet undeniably exist. Their complexity doesn't negate their reality.
The demand to "define woman" is particularly disingenuous because even biological sex is bimodal, not binary. There are multiple biological markers (chromosomal, hormonal, anatomical, etc.) that don't always align in simple ways. This is basic medical science, not ideology.
Kat's mockery of the complexity of gender identity is like mocking the complexity of neuroscience or quantum physics - complexity doesn't equal invalidity. The scientific consensus supports that gender identity has biological, psychological, and social components, all of which are supported by peer-reviewed research.
The question isn't about "feeling like" another gender - it's about being. Just as you don't "feel like" your gender, you simply are it, trans people's gender identities are fundamental aspects of who they are, supported by neurological and psychological evidence.
This kind of reductive argumentation ignores decades of research in favor of oversimplified rhetoric. In fact, Kat's response perfectly demonstrates the points from my article about TERF tactics that Kat is commenting on:
- Ignores the actual definition provided
- Resorts to sarcasm instead of engagement
- Immediately shifts to demanding new definitions ("define what a man is, define what a woman is")
- Uses reductive reasoning ("feel like")
I wrote it all up in an article, enjoy:
https://open.substack.com/pub/pittpeople/p/turning-terf-rhetoric-into-teachable?r=3khofc&utm_campaign=post&utm_medium=web