Gender-Critical Philosophy: A Defence

A Conversation between Alex Byrne, Holly Lawford-Smith and John McLaughlin

John: The term gender identity was first defined in two 1964 papers by UCLA psychiatrists Robert Stoller and Ralph Greenson. For Stoller and Greenson, “Gender identity is the sense of knowing to which sex one belongs. That is, the awareness ‘I am a male’ or ‘I am a female.’” This was a concept firmly grounded in biological sex. In the most recent version of their Standards of Care, the World Professional Association for Transgender Health (WPATH) define gender identity as “A person’s deeply felt, internal, intrinsic sense of their own gender.” This appears to be a circular definition, no longer grounded in any non-gender-based category. Is this a philosophical confusion?

Holly: I think it is—but I don’t think the confusion is an accident. The entire concept of trans has expanded over time. Stoller and Greenson’s initial definition tracked sex because it tracked transsexuals—a rare exception to the rule, people who felt that their sexed body was wrong. Almost all transsexuals in the 1960s and 1970s had sex reassignment surgery and tried to pass as female. That one-word change from sex to gender means everything. Now, the concept refers to a type of person and an internal sense of your affinity with that type of person. It’s much more about self-determination: the right to decide how you want your body and your self­-expression to look. And that can be entirely separate from your sex.

John: Some people have described the transgender experience as being “born in the wrong body.” I find this fascinating because it implies a sort of dualism, in which a gendered self or mind can be trapped inside an ill-fitting body. There has been pushback against this framing, as it suggests that there is something wrong with the trans individual’s body. But the question remains: how does gender identity relate to sex?

Alex: The idea definitely has a dualistic flavour—especially if you think of gender identity as the sex of the mind as opposed to the sex of the body—but dualism isn’t a necessary component of this belief. The fundamental problem with the contemporary conception of gender identity is that no one can really explain what it amounts to. What Stoller and Greenson meant was simply the conviction of belonging to one sex or the other. This is both intelligible and useful; ironically, when they defined gender identity, it was a genuine advance. Children aren’t born knowing whether they are male or female, let alone knowing what it means to be male or female. At around two or three years of age, kids realize that they’re either male or female, and later they realize that you can’t change your sex by altering your clothing or behaviour. This is an important milestone in human development. Everyone has a gender identity, in the sense that everyone—or almost everyone—knows which sex they belong to. But orthodox trans rights advocates don’t understand gender identity in this way because that isn’t the thing that is inverted in the case of transgender people—or, at least, it need not be. Buck Angel for example, knows perfectly well that he’s female and says so, describing himself as a “female who lives as a man.” So, he has a female gender identity in Stoller and Greenson’s sense—he’s not under any illusion as to his sex—but he’s still trans. In the contemporary sense, gender identity is the thing that’s inverted, the thing that doesn’t match your sex if you’re transgender. This clearly isn’t what Stoller and Greenson meant. Various people have tried to explain what gender identity means in the trans activist sense, but I don’t think they’ve succeeded.

John: What is the phrase assigned sex at birth (ASAB) meant to convey? Does it imply that the recording of infants’ sex is arbitrary or entirely socially constructed, and that we actually have no objective basis for declaring the sex (or gender) of any individual at birth?

Alex: The phrase dates back at least to the 1950s, when the psychologist/sexologist John Money was treating patients with what we now call disorders (or differences) of sex development (DSDs). In that context, the term made perfect sense. Sometimes male babies are born with a disorder that makes them look not very much like males. John Money and his colleagues often thought that it would be better for a baby of this kind to be raised as a girl (as in the notorious case of David Reimer, although Reimer did not have a DSD—he lost his penis in a botched circumcision). They needed a phrase to indicate that they were taking the decision to raise the child as a female, including using surgeries and hormones to alter the body in the female direction. In such a case, the child’s actual sex was male, but his assigned sex was female. Whether or not you agree with this way of treating people with DSDs, the phrase itself was appropriate in that context. But now many people are reluctant to speak of a child’s sex at all. And this is happening even in medical journals and scientific papers. It’s bizarre.

When we talk about non-human animals, we never say, for example, Some birth-assigned female rats and some birth-assigned male rats were put in a maze to see if they could get out. We’d just speak of female and male rats. And humans are animals too.

But trans activists really don’t want to have to say, There are two different kinds of women: women who are female and women who are male (i.e., trans women). That makes it sounds as if the trans women haven’t quite made it all the way to womanhood, or are, at best, women in some second-class sense. One tactic for getting around that problem is to use the locution sex assigned at birth and never speak of a person’s actual sex.

John: The ASAB phrase is intriguing because it seems to imply that there is an assigned sex in addition to some kind of real sex that may differ from that of the assignment. But then what would that actual sex consist in?

Alex: When writing about a trans person, some authors try to avoid speaking of their biological or actual sex. The problem is that if you use assigned sex all the time, and never allow yourself to say This person is male (or female), you’re giving the impression that all that exists is the labelling, and nothing else. As an analogy, imagine I’m organising a game of soccer and arbitrarily assigning people to two different teams: pink and blue. It doesn’t make sense to say, I assigned John to the pink team, but that was a mistake; he is really a member of the blue team. There is no real colour separate from the assignment. That is how a lot of people describe the situation—as if for some unexplained reason we have this habit of assigning babies to one team or the other on the basis of the superficial appearance of the genitalia at birth. From their point of view, it’s almost like making the assignment on the basis of the baby’s nose or ear shape. For them, the truly fundamental thing—the thing that you are not assigned—is your gender identity, not your sex. 

John: In your commentary on feminism, Holly, you’ve pointed out that the trans community’s understanding of gender is an inversion of how gender roles used to be understood. Traditionally, gender roles have been seen as imposed on people by society—in the form of ideas about how girls (or boys) are supposed to behave—but now gender is something one curates for oneself.

Holly: Yes, this really important concept has been essentially re-engineered by this new movement. But those two things are still running in parallel. A butch girl who thinks she’s non­binary and has chosen a gender identity that perfectly suits her, is still treated by large segments of society as unfeminine or not feminine in the right way. She’s still at higher risk of sexual harassment and assault and of all the dangers that come with being a girl. But she’s lost the tools to be able to diagnose societal injustice. She can’t appeal to feminism because she’s claiming not to be a woman. She can’t say, I have the right to be a woman no matter how I look or how I dress; I am a woman whether or not I want to be an astronaut. In second wave feminism, we used to have this useful concept that accurately diagnosed constraints on people’s freedom. Now it’s been taken away—but those girls still need it.

In a sense, this is a resurgence of gender traditionalism because all diversity and heterogeneity is being siphoned off into these other categories. So, when people talk about their gender identity, what they are really saying is, I’m non-conforming relative to ideal or perfect femininity and femaleness (or masculinity and maleness). They need words to express that, so they say things like, I’m a girl who wants to wear pants, therefore I’m nonbinary. That makes for a stark ideological disagreement between feminists and trans activists because feminists obviously want to push back on that. We don’t believe there are two perfectly distinct categories of masculinity and femininity and then a few heterogeneous people that we need to squash into a new, third category. Instead, we believe that we need to make more space for everyone.

John: A gender identity is presumably just one of the many identities that an individual can adopt. Broadly speaking, what does the phrase I identify as x convey that is not conveyed by I am x?

Alex: People don’t use these locutions consistently. But there is a difference between, for example, being disabled and identifying as disabled. Suppose I’m very hard of hearing, but I don’t think of that as defining who I really am. I wear very good hearing aids and am able to pass as a hearing person most of the time. I’d prefer it if people didn’t notice my deafness. I certainly don’t have Deaf and Proud in my Twitter bio; I’m not a member of any activist groups and I don’t argue that deaf children shouldn’t be given cochlear implants because they’re fine as they are. So, in this case, I am deaf, but I don’t identify as deaf. Of course, there are people who are deaf and identify as deaf. That’s the first thing they tell you about themselves. Some of them are deaf activists. And we all have identities in the sense that if I ask Who are you? you’ll typically answer by referring to characteristics that you think are very important or that somehow define who you are. But of course, the question Who are you? can receive an almost infinite number of answers.

John: If a transgender individual considers themself to be of their self-identified gender, without qualification, what purpose is served by the locution identify as? Why, for example, would a trans woman of this kind say, I identify as a woman? Does this add a certain nuance not provided by simply saying I am a woman?

Alex: I’ve often been puzzled by this. At universities and in other progressive spaces, they will often announce that an event is exclusively for women by saying something like, This event is for people who identify as women. Obviously, the intent is to be inclusive and to ensure that trans women can attend if they wish—but by declaring that the event is open to people who identify as women, they are implying that trans women wouldn’t actually be invited if the event were only for women. One could say, instead, All women are welcome: cis women and trans women, which seems much more consistent with the prevailing orthodoxy.

John: In the interest of trans inclusivity, some individuals and organizations have tried to do away with the words man and woman altogether in certain contexts, instead describing people in terms of their body parts or biological activities: for example, as uterus owners or people who menstruate. This kind of phraseology has even appeared in the medical literature. Does it serve a legitimate purpose?

Holly: I haven’t been charitable about this because it undermines the idea that there is one person to whom all this stuff is happening. For me, it’s anti-feminist to talk about, say, cervical cancer people, who are completely unrelated to this other group, the breast cancer people. This will make it very hard to name systematic medical issues or systematic under-researching of female bodies. If I wanted to be generous, I could argue that this trend is consistent with some of the second wave feminists’ advocacy for humanism: they believed that if you name a difference, you build the foundation of a caste hierarchy and that therefore we should stop naming sexual orientations, and instead simply describe people being attracted to people, and so on. Humans tend to create social hierarchies and maybe the only thing we can do to prevent that—so the reasoning goes—is to stop naming the differences between people. But I don’t think the trans activists ever defend their stance in that way.

John: In your book Gender-Critical Feminism, you discuss the influence of the intersectional worldview on feminism, both as a philosophy and as a political movement. Do you think that mainstream feminism’s eager embrace of trans women is simply a consequence of the intersectional approach to politics? Or were the seeds of this development planted separately?

Holly: Maybe these are two separate phenomena that tend to occur together. One is just prioritarianism: a kind of relentless focus on whomever you think is worst off and a championing of their cause. I think it is a trait of the left to find a pet vulnerable group.

This trait easily combines with intersectionality because a lot of leftist feminists want to defer to the group they think is worst off. They don’t just say, for instance, This person has a disability and is black and is a woman; they want to rank those things and say, for example, It’s the disability that’s the worst. In a feminist meeting, I’ll defer to that woman. She’s the winner of that [victimhood] competition. So, we get that same leftist dynamic but plugged into all the baggage of the feminist identity groups.

I don’t think that’s the full explanation, though, because things didn’t necessarily have to evolve that way. If feminists had taken the idea of intersectionality seriously and thought about the intersection of every other identity category with sex, then we would have seen a relentless deference to and focus on trans men (i.e., females). And trans women would not have been part of the story.

John: The trans rights movement has focused on trans women over trans men and specifically on trans women in women’s intimate spaces and in women’s sports. Why?

Alex: One factor is the power of testosterone. If you’re a female who supplements your testosterone to male levels, it’s quite easy to turn into a very convincing man. And precisely because testosterone is so powerful, its effects are very hard to undo. If you want to transition from male to female and you’ve gone through male puberty, then you are in a bind because unless you are unusually short for a man, you’re going to be quite tall for a woman and have broader shoulders and longer bones, and so on. This is why it’s a lot easier to pass if you are a trans man than if you’re a trans woman. The second, more important, factor is that no one cares whether trans men are men because there’s no pressing reason not to allow them into men’s spaces or let them take part in men’s sporting competitions. They have no advantage in sport; they pose no threat to men in intimate spaces.

John: Some activists feel that the notion of a sex binary is arbitrarily constrictive. And even eminent publications like Nature and Scientific American have argued that sex actually exists on a spectrum. In your article Is Sex Binary? you point out that there are exactly two sexes. How should we think about the sex binary and sex spectrum concepts?

Alex: The two concepts—a sex binary and a sex spectrum—are different, and in principle they are compatible. Imagine there are only two colours: yellow and orange. And let’s say everything that has a colour falls somewhere on the spectrum between orange and yellow. In that case, everything is either orange or yellow: there is a colour binary. But we also clearly have a spectrum: yellow shades into orange; one thing can be yellower than another; a yellow thing can be more similar in colour to an orange thing of one shade than to an orange thing of another. So even if you held that sex is binary, you could still believe that it’s a spectrum. You’d be wrong, but not logically inconsistent.

Although it makes sense to say that one thing is yellower than another, it doesn’t make sense to say that one male person is more male than another (although he could be more masculine, or have more circulating testosterone). There is no sex spectrum, only a spectrum of characteristics that are related to sex, such as hormone levels, facial features, and so on.

John: Are you surprised at the fact that gender identity—a highly subjective and idiosyncratic phenomenon—is being used as the diagnostic criterion for hormonal and/or surgical interventions?

Holly: In one sense, it is shocking, for the reasons you mention. But there is also a sense in which we’ve been building toward this point and there is a good intention behind it. Groups that are genuinely oppressed know what their problems are, and we can avoid paternalism by talking to them directly about what they want. This lesson was brought home to me when I read Will MacAskill’s book about global poverty: Doing Good Better. [In his book, MacAskill tells the story of the PlayPump: a children’s merry-go-round that operated a water pump, designed to supply clean drinking water to African villages. Despite initial enthusiasm about the idea and millions of dollars in western investment, the PlayPump was a complete failure. The device proved too difficult for the children to operate, so the work of pumping water fell to the very women whose labour it was intended to save.] The westerners just decided that this playground would function as a well, and somehow the children’s play would pump the water. But the children weren’t interested in playing on the merry-go-round, so these poor women had to run the playground to get the water, and it was much harder than just using a hand pump.

So, the lesson there is that you should consult the people affected as to their needs and interests. But I think policymakers can go wrong by being over-deferential and this might be what is happening in medical clinics. Well intentioned medical experts want to listen to what their trans patients say they need. But the trans patient is not just explaining their medical issues, they’re influenced by an entire philosophy of how the world should be, and the medical practitioners are deferring to that ideology and not just paying attention to the empirical description of the individual’s distress or needs. In the cultural zeitgeist, these broader principles have aligned to create a perfect moral storm in favour of so­-called gender-affirming care. This probably seemed like the correct approach until someone came along and asked critically: What is the long term evidence for puberty blockers? What is the desistance rate? How should we apply the older evidence that is based on transsexuals to this newer phenomenon that is probably a social contagion?

John: The concept of gender-affirming care seems self-contradictory. On the one hand, trans communities argue that there is no necessary relationship between gender identity and biological sex and that one doesn’t reliably map onto the other. But the explicit purpose of gender-affirming care is to recreate those primary and/or secondary sexual characteristics that correspond to one specific sex. If, as trans activists attest, a self-identified woman with the primary and/or secondary sex characteristics of a male is already just as much a woman as a natal female, then what is left for gender-affirming care to affirm?

Alex: I think it’s related to the general effort to depathologize trans people—meaning that you don’t need to have had gender dysphoria to be trans. You could be a trans woman who cross-dresses but is totally fine with her male body and is not seeking hormones or sex reassignment surgery. But, puzzlingly, sometimes a person in a very similar situation, with a gender identity that doesn’t match their natal sex, does suffer immense distress at their sexed body. Given that we know that it’s possible to be a trans woman and yet to be at ease with your male body, why should we be in such a rush to medicalize someone who is very distressed at their sexed body? Why don’t we provide this person with therapy instead of sex reassignment surgery? A lot of the rhetoric about demedicalizing transness seems to be in tension with the insistence that gender-affirming care is life-saving.

John: What is striking to me about the implementation of gender-affirming care—especially in the case of hormone therapy—is the degree to which the physician follows the patient’s lead in deciding on diagnosis and treatment. For example, the current WPATH guidelines state:

Some systems use a model of care for transgender and gender diverse (TGD) adults seeking gender-affirming medical and/or surgical treatments (GAMSTs) that prioritizes the TGD adult as the decision maker with the health care professional (HCP) acting as an advisor, barring serious contraindications. These models are used when considering hormone therapy rather than surgery.

In this paradigm, the patient is considered the authority on the nature of their condition—which seems to be an inversion of the standard relationship between physician and patient.

Alex: To understand their point of view, think of it in terms of sexual orientation. There are cases in which a patient’s sexual orientation is relevant to the treatment they receive. If I’m wondering whether to get the Monkeypox vaccine, the doctor might ask, Are you gay? If I respond, No, I’m not, the doctor is not going to object, Well, you look a bit gay to me. Normally, we take a person’s declaration of their sexual orientation at face value; it’s not something a medical professional will challenge. I think that is what proponents of gender-affirming care want—that everyone is an authority on their own gender.

John: The American struggle for gay marriage spanned decades before it eventually culminated in the 2015 Obergefell v. Hodges decision requiring states to license same-sex marriages. One plausible explanation of why same-sex marriage eventually gained overwhelming public approval is that the basic concepts the movement relied upon—male, female and homosexuality—have existed since time immemorial. We already had the conceptual inventory to understand the activists’ demands and our government just needed to take the next logical step by granting equal civil liberties. Trans activism, on the other hand, seems to invoke so many new or contrived concepts, and demands that we overhaul some of our basic intuitions about sex and gender. What do you consider the differences, if any, between the two political movements?

Alex: To me, the most striking difference between the gay rights movement and today’s trans movement is that the gay rights movement was never dependent on obviously false or highly controversial claims. Gay rights campaigners never argued, for instance, Gay men are fairies from Mars, and we have magical powers that will be destroyed if we can’t get married. They just stated the facts: gay men (and women) can love each other just as straight men and straight women can love each other; some of us want the right to enter into monogamous unions and there’s no reason to disallow it. The trans rights movement could have developed along similar lines, but instead people became fixated on making sex out to be as complicated or elusive as possible: on a spectrum, or socially constructed, or too muddled to be worth bothering with.

There is also an obsession with women in particular: Trans women had better be women, otherwise the whole project collapses—or so the activists imply. This is misguided. Trans women can have all the rights they want even if, literally speaking, they are not women. Even if they were women, that wouldn’t help their cause. I often see the argument: Trans women are women; therefore, they should be allowed to join other women in changing rooms and be placed in women’s prisons. But this argument doesn’t work because the crucial issues of privacy and safety remain even if trans women are women (of a special male kind). And anyway, these disputes over the question What is a woman? are not relevant to the case for treating trans people with dignity or prohibiting discrimination against them.

John: Have you seen a recent shift in momentum toward the gender-critical position?

Holly: I think so, yes, but it is a long, slow fight here in Australia. The online gender-critical community is really active, but most of their social media accounts are still anonymous. Some articles on the topic in mainstream newspapers attract a lot of comments and those commentators sometimes use their real names. So, you can see that there are people who are pushing back. But the named individuals in the public sphere who are resisting this movement are still pretty few and far between. My sense is that the UK is several years ahead of us—but that things here are just beginning to change. Over the last few months, some left-wing media outlets have published things I would not have expected. People seem to be getting braver. The case of Moira Deeming, an MP who was expelled from the (conservative) Australian Liberal party, has galvanized a lot of people. She is a conservative woman who spoke up for women’s rights and was punished for it by the media, by many members of the public and by her own party. I think she was really brave, and people are responding to that. When these serious cancellation attempts occur—like the recent attempt to get me fired—many people rally behind the women affected and that brings new people to the fight. But it definitely doesn’t feel like we’re anywhere near 50/50 yet.